SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet"

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October 2, 2002 CALENDAR LISTING: EVENTS@doitnow.com

TREATMENT

* Part 3: Light At The End Of The Tunnel - Story Of Hope Recovery & Autism

* The Importance of Touch

RESEARCH

* Measles, Mumps & Rubella Vaccine, Autism & Inflammatory

Bowel Disease

* Neuronal Density & Architecture In The Brains Of Autistic Patients

* US Government Not Funding Enough Research For Mental Health Problems

in Kids

EDUCATION

* Judge Tells San Diego, Calif. Schools They Must Correct Special Ed

CARE

* Drug Industry Is Told to Stop Gifts to Doctors

* ADHD in Girls Can Be Serious But Is Often Overlooked

READERS' POSTS

TREATMENT

Part 3: Light At The End Of The Tunnel - A Story Of Hope Recovery & Autism

There has been a lot written about yeast or Candida overgrowth. Less has been written about yeast die-off or "Herxheimer’s Reaction." Ironically, the "die-off" is the most visible, lasting and unpleasant manifestation of treating the gut. It is also the best signal you have nailed the problem on the head. First discovered by Dr. Herxheimer in connection with studies involving syphilis, of all things, it was observed that symptoms worsened significantly with treatment. Many microbes or single celled animals, when they die, release their toxins into the system. In many cases it is the toxin, and not the microbe itself, that causes the illness. Although yeast causes gut deterioration (like English Ivy destroying a brick wall), it is the toxin Gliotoxin, which is the cause of many immune and behavioral problems.

Yeast, as any beer drinker will tell you, is also the main mechanism for converting sugar to alcohol. Many sufferers of yeast report a drunken or foggy feeling. This is not surprising because yeast produces alcohol, which goes straight into the blood.

Gliotoxin, which has been studied largely in connection with organ transplantation, is known for its extraordinary immune suppression properties. It is also known to attack the central nervous system and to cause premature cell death. It is, in short, a very bad actor, which has not been very well studied. Yeast is one of the main causes of final system breakdown and ultimately death in AIDS patients. Animals injected with concentrated gliotoxins suffer seizures and can die.

When you start treating for yeast or clostridia, these toxins will be released into the child’s system, through a leaky gut. These can cause problems such as aggravated behavior, diarrhea, drunkenness and withdrawal symptoms. These are good signs. Herxheimer’s can vary from a few days to upwards of several weeks. Do not be discouraged! You are on the right track!.

It is possible to treat the symptoms of Herxheimer’s, often with fairly dramatic results. Studies have shown that gliotoxins attack the central n ervous system. There is also evidence that Vitamin C , combined with either Alka Seltzer Goldâ or Tri Salts ( a mixture of calcium carbonate, sodium bicarbonate and potassium carbonate) seems to be a very effective way of neutralizing the gliotoxins and preventing acidosis of the blood. We have seen William calm down within a matter of two to three minutes after getting 250 mg of Vitamin C mixed with Tri Salts (bicarb) or Alka Seltzer Goldâ Although it is also controversial, sauna, or hypothermia, also seems to help with die-off reactions. Lots of water to flush the system is also a good idea.

Chelation

Perhaps no other single therapy, with the possible exception of intravenous gamma globulin (IVIG), is as controversial, and filled with dread as chelation.

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The Importance of Touch

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Say the word "neat" and notice what happens: Your tongue rests briefly on the back of your front teeth, a column of air begins to flow from your lungs, a slightly nasal "n" sound is produced, your jaw drops slightly, your lips draw apart to release the "e" and your tongue stops the sound with a touch of a "t." In a fraction of a second, you have coordinated a vast collection of muscles to produce an intelligible sound.

You also responded to a request, accessed the meaning of the word, and likely experienced some sort of emotion. In short, you spoke, and in speaking you used physical, mental and emotional aspects of yourself.

Deborah Hayden, a speech-language pathologist and executive director of The PROMPT Institute in Santa Fe, has created a method and philosophy of speech therapy that helps speech-impaired individuals do just that. PROMPT is an acronym for Prompts for Restructuring Oral Muscular Phonetic Targets, a system Hayden has been developing for nearly 30 years.

"With PROMPT, we're really trying to work with the whole individual," Hayden said. "We build an entire program around all of these domains and make sure it is relevant to a client's life."

PROMPT can be used to correct speech problems that might be caused by developmental delays, autism, mild cerebral palsy, Down syndrome, hearing impairment and stroke. It is also effective in correcting mild stuttering and general articulation disorders, Hayden said.

Touch is Key

A large part of what distinguishes PROMPT from conventional speech- language therapy is touch. Hayden and other certified PROMPT clinicians touch the face, head and neck of a client as he or she works to produce words. These gentle, well-timed touches stimulate specific muscles to contract for the time needed to produce certain sounds.

For example, if a PROMPT client were having a hard time uttering the word "neat," Hayden would first gently touch the nose to cue for the nasal "n." Then, using her thumb and forefinger, she would put pressure on the corners of the mouth to draw the lips back for the "e." She would make sure the jaw didn't drop too far down, and she'd touch beneath the chin to signal the tongue to contract for the "t."

"PROMPT takes them through the motor control aspects," Hayden said. She explained that often a speech-impaired child or adult will overuse certain muscles, which causes other muscles to develop less fully. PROMPT seeks to correct that.

"Speech is all about contraction of muscle groups in certain ways to produce acoustic results," Hayden said. "The muscles have to work independently yet also together, like different instruments in a symphony.

"Touch is critical as a way to guide and shape," Hayden explained. "Using tactile information helps to organize and 'glue' sensory information into concepts."

The Difference

In conventional speech-language therapy, Hayden said, pathologists rarely touch the client. Instead, they model how sounds are produced and encourage the client to mimic those facial movements.

Hayden also said that conventional therapy focuses a great deal on verbally labeling items, perhaps having a client utter phrases such as, "this is a cat" and "this is a ball." By contrast, she explained, PROMPT sessions feature interaction, with responses engendered by questions such as, "Would you like some tea?" and "How are you?" In addition, the words that get worked on are those the client needs for his or her daily interactions.

Kathleen Castle, a Santa Fe speech-language pathologist, said she admires the PROMPT method. "It's good technique," she said. "I wish I had it in my bag of tricks.

"It's a wonderful resource to have in the community," Castle continued. "There are children and adults who specifically need this, and I think they can progress much more quickly with it."

However, Castle said, she believes that PROMPT is not necessary for all speech-impaired individuals. "The treatment is very specialized," she said. "Not every kid who has an articulation problem needs PROMPT."

No Longer Alone

When Wyatt Gordon celebrated his third birthday, he was not yet speaking. His mother, Katja Gordon, said that this caused a great deal of difficulty for her son and their family.

"He was unable to speak at all," Gordon said. "He was really frustrated because he couldn't communicate. He would throw tantrums, shake his head no, and wouldn't cooperate. He didn't want to do anything or be with other kids, because the other kids were already talking."

Gordon took Wyatt to The PROMPT Institute for treatment. After nine months of weekly sessions with Hayden, she said, he was speaking "perfectly."

"He talks up a storm now," Gordon said. "All the behavior problems are totally gone. Now," she added with a laugh, "sometimes I wish that he would just shut up."

On a videotape of past clients, an older woman who had suffered a stroke struggled with making single sounds. After 11 months of treatment, she was speaking in full sentences.

Although thousands of people have improved their speech with PROMPT, Hayden acknowledges that the treatment has its limitations. "You can't go in and fix everything," she said. "There will be some people I can't help - sometimes the muscle problems are just too severe. When you know what you can and can't do, then a parent (or a client) can be proud of the gains.

"Communication is such a big part of our lives," Hayden said. "Without it, you're locked away, you're alone. It's one of the worst things that can happen to a person."

PROMPT Institute

Hayden, 57, began developing the PROMPT method in the 1970s, as director of the Speech Foundation of Ontario, at the Toronto Children's Centre. By the mid-1980s she published a technique manual and began conducting workshops to train other speech-language pathologists.

Today, she said, there are 22 PROMPT instructors worldwide and approximately 2,000 clinicians using the method in the United States. The manuals are available in four languages.

"It's been a process of refinement and expansion over 25 years," she said, adding that the institute is a 501(c)3 nonprofit.

Hayden moved to Santa Fe in 1995, and at first operated The PROMPT Institute from her home. She recently moved the clinic to Office Court Drive, behind Villa Linda Mall, where she treats clients and conducts research. She and two employees coordinate approximately 45 training workshops a year, in an effort to firmly establish the method in the field of speech-language pathology.

"It's pretty powerful," Hayden said of PROMPT. "I want it to live on."

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RESEARCH

Measles, Mumps & Rubella Vaccine, Autism & Inflammatory Bowel Disease Advising concerned parents.

ds=12269839&dopt=Abstract

Elliman DA, Bedford HE.

Department of Child Health, St George's Hospital, Tooting, London, England.

Measles, mumps and rubella (MMR) vaccine has been used for almost 30 years in the US, 20 years in Sweden and Finland, and over 10 years in most of the rest of Europe.

During this time, it has brought about a dramatic reduction in the morbidity and mortality due to measles and mumps, as well as a considerable reduction in the number of babies with the congenital rubella syndrome.

In spite of extensive evidence confirming the efficacy and safety of the vaccine, concerns have recently been raised about a possible link with autism and bowel problems.

These arose principally from a research group in the UK, but have now spread to other countries.

In the UK this has caused a fall in the uptake of the vaccine with fears of possible outbreaks of measles and mumps in some groups of children.

Over the last 3 years a number of studies have addressed this possible link between MMR and autism and inflammatory bowel disease.

Studies from the US, UK, Sweden, and Finland have all failed to demonstrate a link.

Amongst others, the American Academy of Pediatrics, the Royal College of Paediatrics and Child Health, the Institute of Medicine, and the World Health Organization have all considered the evidence and endorsed the continuing use of the vaccine.

No regulatory body in the world has changed its policy as a result of this hypothesized link.

Professionals and parents can be assured that MMR is well tried and tested and one of the most successful interventions in healthcare.

PMID: 12269839 [PubMed - in process]

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Neuronal Density & Architecture In The Brains Of Autistic Patients (Gray Level Index)

ds=12269731&dopt=Abstract

Casanova MF, Buxhoeveden DP, Switala AE, Roy E.

Department of Psychiatry, Medical College of Georgia, Augusta, USA. casanova@np2.mcg.edu

Although neuropathologic studies have centered on small samples, it is accepted that brains of autistic individuals tend to be large, on average.

Knowledge regarding the cause of this macrocephaly is limited.

Postmortem studies reveal little in terms of cortical dysplasia.

Some of these studies suggest increased cell-packing density in subcortical structures.

These neuronomorphometric studies have been subjective or based their conclusions on measures of neuronal density.

Our study sought the possible presence of increased cell-packing density by using the Gray Level Index.

The Gray Level Index is defined as the ratio of the area covered by Nissl-stained elements to unstained area in postmortem samples.

Analyzed images included Brodmann's cortical areas 9, 21, and 22 of 9 autistic patients (7 males, 2 females; mean age of 12 years, with a range of 5 to 28 years) and 11 normal controls (7 males, 4 females; mean age of 14 years, with a range of 3 to 25 years).

The overall multivariate test revealed significant differences both between autistic patients and controls (P = .001) and between hemispheres (P = .025).

Follow-up univariate tests showed significant diagnosis-dependent effects in feature distance (P = .005), the standard deviation in distance (P = .016), and feature amplitude (P = .001).

The overall mean Gray Level Index was 19.4% in controls and 18.7% in autism (P = .724).

In autism, an increased number of minicolumns, combined with fewer cells per column (or their greater dispersion), results in no global difference in neuronal density.

PMID: 12269731 [PubMed - in process]

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US Government Not Funding Enough Research For Mental Health Problems in Kids Yale Study Finds

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Although it is well established that primary care doctors are on the front lines in identifying and treating behavioral and emotional problems in children, there is little federally funded research in this area, according to a study by a Yale researcher published this week in the Journal of the American Medical Association.

"We were looking at whether the funding for research in children¹s psycho-social issues that had been so heavily recommended in federal planning and policy documents was in evidence in the funded projects. In other words, did the money essentially match the written word," said Sarah Horwitz, associate professor in the Department of Epidemiology and Public Health at Yale School of Medicine. "We found that it did not, that indeed there was very little emphasis on research for children with emotional and behavioral disorders in primary care settings."

Horwitz and researchers from several other institutions came to their conclusion after conducting an analysis of the Computer Retrieval of Information on Scientific Projects (CRISP) database, which lists all of the projects funded by the federal Department of Health and Human Services.

Only 0.1 percent of the entire research portfolio examined children, adolescents or youth and primary care and only 2.3 percent of the federally funded research on children, adolescents or youth overall is dedicated to this area, the researchers found. Looking at one area specifically, only six of 103 federally funded research studies into depression were related to depression in children. "On a topic that is important across the lifespan, adults received more than 15 times the research attention compared with children," Horwitz said.

Twenty percent of children in this country are diagnosed with behavioral and emotional problems and yet only a small portion of those children ever receive services, she said. "Kids get into the system through primary care when they are young and through the schools when they are older," Horwitz said. "You would expect the system that comes in contact with the kids would be very good at identifying, referring and treating kids with problems, yet there is a dearth of research in this area."

Without an understanding of the opportunities and barriers that face physicians confronted with these and a host of other important issues, primary care will remain an underused venue for providing mental health services to children, the researchers said. "Developing knowledge of the capacity for change in primary care necessitates creating a well-planned research agenda that builds knowledge in an orderly fashion and implementing it," they said.

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EDUCATION

Judge Tells San Diego, Calif. Schools They Must Correct Special Ed Ruling is a result of state suit seeking district's compliance

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A San Diego Superior Court judge yesterday ordered the city school district to make changes to its special-education program, a ruling the state says reaffirms its authority to investigate how disabled students are educated.

The California Department of Education sued the San Diego Unified School District more than a year ago, accusing the district of failing to make changes ordered in its special-education program.

The state called for the corrections in January 2001 after investigating a complaint from parents of 16 disabled children who said their children had been denied therapy, trained educators and classroom materials, among other things.

San Diego Unified has complied with many of the mandates and it addressed the problems that were specific to each of the 16 children named in the suit.

Some of the state-ordered changes were thrown out by the court. Others will be enforced as a result of yesterday's ruling.

Superior Court Judge Janis Sammartino dismissed a countersuit filed by the district arguing that the state conducted a shoddy investigation and that an overzealous investigator made reckless interpretations of state special-education policies when reviewing complaints in San Diego.

"This appears to the court to be a probing and detailed investigation,"

Sammartino said in her ruling. "The district cites no authority demonstrating that a more thorough investigation was necessary."

State education attorney Michael Hersher said the ruling will send a message to school districts throughout California that the government has the power to scrutinize special-education programs and order changes when necessary.

"There are maybe 10 other districts in California that are thinking about legal challenges to (state-ordered) corrective actions," Hersher said. "What happened in San Diego is going to instruct them as to whether it's worth the price of admission to go forward."

State investigators found that problems in San Diego went beyond the 16 students named in the suit. They ordered systemic changes in the district because they felt many more students were at risk.

The San Diego school district agrees with some of the state's findings. Many of the changes were already under way, officials said. But most of the government-ordered mandates were unnecessarily strict and could rob the district of its ability to make local decisions based on its needs, said Robert Hocker, an attorney hired to represent the district.

Furthermore, Hocker said the court threw out the bulk of the state's mandates, a sign that the district's complaints were accurate. Meanwhile, he said the district is hopeful that its challenge will spark reforms in Sacramento that give districts more control evaluating and fixing problems in their special-education programs.

Roxy Jackson, the district's new special-education director, said a recent reorganization of the department has made many of the state complaints moot.

"Everything we are doing is about improving the education for kids," Jackson said. "We made our changes based on what will be best for kids, not based on how the state would react."

Among the state orders upheld by the court, San Diego Unified must provide specialized training to any employee who works with any one of about 150 students in a program for children with disorders such as autism and Down syndrome.

The district has also been ordered to improve the way it prepares disabled students for life once they leave school. Educators must also ensure that each child's federally required individual education plan is carried out by educators.

Since 1994, a series of state and federal investigations have found the district has operated with insufficient staffing, training and special classes for its nearly 16,000 emotionally and physically disabled students.

Since then, the district has worked to comply with state and federal laws and it has increased its special-education staff. What's more, the district recently completed a restructuring of the special-education program that addresses many of the concerns outlined in the state investigation.

Even so, parents continue to complain about the quality of special-education programs in San Diego.

Given the district's history, Allison Brenneise is skeptical that her two autistic sons will see any improvements in the education they receive.

"I am happy that the courts are supporting the California Department of Education by enforcing the mandates that support children who have not gotten support from San Diego Unified," said Brenneise, whose 16-year-old son is represented in the lawsuit. "It's been hard. No one felt obligated to educate my son."

Brenneise is part of a group of parents that filed the complaint with the state on behalf of about 150 students with severe cognitive disabilities. The students are enrolled in the district's integrated life skills program and are educated in traditional classes with help from special teaching assistants.

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CARE

ADHD in Girls Can Be Serious But Is Often Overlooked UC Berkeley Study Shows

Berkeley - Although boys with Attention Deficit Hyperactivity Disorder

(ADHD) greatly outnumber girls, girls have been underdiagnosed and their condition is greatly underappreciated, according to a pair of studies in the October issue of the Journal of Consulting and Clinical Psychology. The lead author is Stephen Hinshaw, professor of psychology at University of California, Berkeley.

These new studies contradict earlier findings about girls with ADHD. But Hinshaw's explanation is simple: Unlike the six-to-12-year-old girls in his studies, girls in several previous studies were taking ADHD medication. Hinshaw's work also included a much larger sample than nearly all earlier studies and was conducted over a longer period of time.

"These girls, compared to a matched comparison group, are very impaired, academically and socially," said Hinshaw, an expert in child clinical psychology and developmental psychopathology, who continues to study them.

Hinshaw said the girls are rejected by their peers and have a harder time making and keeping friends. "Social problems with peers are quite predictive of long-term adjustment problems," he explained, "so it will be essential to observe outcomes as the sample matures."

The girls also were more likely to have had early experiences such as being adopted and histories of language problems and learning difficulties.

Hinshaw's study involved one of the largest samples in the world of preadolescent girls with ADHD. A total of 228 girls - 140 diagnosed with ADHD and 88 not diagnosed with ADHD - were studied intensively at six-week summer camps held three years in a row. There were approximately 80 girls at each year's camp, which ran in 1997, 1998 and 1999.

The girls were recruited to participate in the camps in a number of ways. For the ADHD sample, Hinshaw sent mailings to health maintenance organizations, clinics, hospitals, mental health centers, pediatric practices and local school districts. In addition, presentations were made to self-help groups, and advertisements were placed in newspapers.

For the comparison girls, similar mailings were sent to school districts and community centers in the San Francisco Bay Area, and advertisements were placed in papers. The ads were almost identical to the ads for girls with ADHD, except the wording emphasized "summer enrichment programs" rather than "summer enrichment programs for girls with attentional problems."

The girls who appeared to be good candidates for the program participated in several levels of family screenings and evaluations to make sure they met appropriate criteria for the study. In addition, the families of the girls with ADHD had to agree to take the children off of ADHD medication during the six weeks so that their natural behavior patterns could be observed.

The sample was ethnically diverse - 53 percent Caucasian, 27 percent African American, 11 percent Latina and 9 percent Asian American. Incomes of these families ranged from upper class to those receiving public assistance. Girls with IQs lower than 70, overt neurological damage, psychosis and medical conditions that precluded participation in camp activities were excluded from the study.

The girls spent six weeks enjoying the same activities that children who go to other summer camps enjoy, but they were very closely monitored by people who had training in micro-observation.

Their "counselors" took copious notes relating to each girl's activities; the staff was not aware of which girls had ADHD diagnoses.

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Drug Industry Is Told to Stop Gifts to Doctors

[Monday morning's New York Times carries a news report by Robert Pear. As the article notes, the government is inviting comment on these standards. Here are a few brief excerpts thanks to Ken Pope and Robert Koegel.]

The government warned pharmaceutical companies today that they must not offer any financial incentives to doctors, pharmacists or other health care professionals to prescribe or recommend particular drugs, or to switch patients from one medicine to another.

The government informed the industry that many practices commonly used in the marketing and sale of prescription drugs could run afoul of federal fraud and abuse laws. Specifically, the government said that drug makers could not offer incentive payments or other "tangible benefits" to encourage or reward the prescribing or purchase of particular drugs by doctors, health plans or companies that manage drug benefits for employers and insurers.

The new standards, the first of their kind, were issued by Janet Rehnquist, inspector general of the Department of Health and Human Services, as guidance to the pharmaceutical industry. Aggressive marketing is the norm in the industry.

For years, drug makers have treated doctors to free Broadway plays, weekend trips, expensive meals and other lavish perks. Many companies have rewarded middlemen, or pharmacy benefit managers, for putting their products on lists of recommended drugs, known as formularies. Some companies have also rewarded doctors and drugstores for switching patients from one medication to another. Similarly, doctors in a position to influence the prescribing of drugs for large numbers of patients have been retained as advisers and consultants to drug manufacturers.

<snip> The public will have 60 days to comment on the standards. The government may revise them in the light of those comments.

<snip> The inspector general said that payments to consultants, advisers and researchers "pose a substantial risk of fraud and abuse" if the payments exceed "fair market value for the services rendered." The new guidelines say that drug makers can violate the kickback statute when they offer entertainment, recreation, travel, meals or similar benefits; when they sponsor "educational conferences"; and when they offer research grants, gifts, gratuities and "other business courtesies" to doctors, hospitals and other health care providers who influence the prescribing of drugs.

<snip> Ms. Rehnquist said that every drug company should appoint a compliance officer, establish a hotline to receive complaints of fraud and abuse and consider paying rewards to employees who report misconduct. Under the new standards, companies are responsible not only for their own employees, but also for sales agents and contractors who "engage in improper marketing and promotional activities" on their behalf.

<snip> John M. Rector, senior vice president of the National Community Pharmacists Association, said, "Pharmacy benefit managers increasingly take payments from drug makers, with the result that patients are switched from a product that might be the best prescription drug for them to a more expensive brand-name product."

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Readers' Posts

Autistic disorders - Attention parents of individuals diagnosed with high-functioning autism. The Greater New Haven PDD/Asperger's Support Network offers education, support and more. This network is trying to reach more families whose loved ones are diagnosed with autistic spectrum disorders. Lois Rosenwald at 272-7529.

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I am looking for a talk board that a family might have but is no longer using and would like to sell. I have 3 and 5 year old boys on the spectrum. If you have one of these, please email me at BowedOak1@aol.com.

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Does anyone have experience with any school, private or public, in S. Orange. County, CA. area that has knowledge of and experience in education of high functioning autistic children in upper elementary grades? cagne@cox.net

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Whoa: My god, where do I begin? Thank all you for responding to my post regarding my 13 year old son Nigel being handcuffed and "restrained" (I use the word loosely) at his new school. I was feeling really scared and alone for a minute, but you guys gave me strength, conviction and most important information on how to fight this battle, and represent someone who has the mind of a 5 year old and can't speak for himself. Yes, I've gotten an attorney (thank you Jeanne) and I'd like to thank L. Hallam, Shari, Nathaniel, SFMoore, Jenny, Heidi and J. Gero for all your insights, prayers and advice. –Karen

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I am the mother of 4 with 2, on the autistic spectrum. I am interested in how I apply for social security for them. They are 14 and 8. Please let me know if this is a possibility. We are getting killed by all the expenses not covered by our insurance. Jill @jwend@aol.com

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Does anyone have information about the school paying for a special diet (GFCF, yeast-free, etc.) We are low income, and qualify for free breakfast and lunch. Also, the class goes out to eat once a week. I've asked the school for accommodations, but they won't accommodate his special diet, and I have to send all food in with him. I live in MN, Kim. kimsmisek@attbi.com

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Looking for an 'au pair' for teenage son with autism, on the GF/CF diet and very sociable, but needs supervision. We live in a lovely old farmhouse near Sarpsborg, about 90 mins train ride from Oslo. For about 35-45 hours per week, and include room and board and a stipend. The caregiver would have his/her own room in a guesthouse on the property, and every other weekend off. Son uses simple language and is very charming, but his self-help skills are not very good. He spends weekdays at school from 8am to 5pm. For someone who is interested in autism, and would like to live with a Norwegian-American family for six to twelve months. Karyn KSeroussi@aol.com

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I am the parent (and sole spokesperson) of an high functioning autistic/aspergers/developmental delayed child, AND a student. I am writing a research paper about the trials and tribulations of parents within the special education system. When completed, this information will make it easier for parents who are struggling to obtain services for their child. If I only knew then, what I know now! For more information about this project, please email me at tamre2@msn.com

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I am looking for persons or companies offering instrumental instruction

(lessons) to autistic children. My son is 7, plays several instruments and loves music. Unfortunately, I have had no luck finding an instructor with the patience to teach him. Southern CA (Orange County). Allan acwbart@sbcglobal.net

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