Published: February 25, 2008 12:02 am      

Autism’s complexity makes for rural treatment challenge

Seemingly oblivious to his parents and a visitor, 4-year-old Maxwell DeWitt bounces back and forth across his Brownstown living room.

“He’s excited because you are here,” Racquel DeWitt says to the visitor, cueing up a Rugrats DVD for her son.

Max was diagnosed with autism when he was 2 years old. Although he is learning to read and knows all his shapes and colors, he has trouble communicating and struggles with daily-living skills such as dressing.

“Autism, if you look at a definition, is a neurobiological disorder,” speech therapy manager Kristie Elliott said from Crichton Rehabilitation Center in Johnstown.

“It affects someone’s ability to communicate and relate to others.”

A spectrum disorder, autism covers a wide range of symptoms and characteristics. At one end, some people with autism can cook and do their own laundry but might not understand they should leave a burning building. At the other, many autistic people need help even bathing and eating.

Many have related health issues, especially digestive problems, leading many experts to look at a physiological connection.

“There are a lot of theories about what causes autism, but nobody knows,” Elliott said.

The sooner autism is identified and treatment begins, she said, the better the long-term prospects for patients. Last year, the American Academy of Pediatrics began recommending screenings for all children at 18 and 24 months.

“That is really a hallmark statement,” Elliott said. “There are signs they can pick out early, and early intervention is really the key.”

Intervention involves education, behavior training and speech, occupational and physical therapy. The broad range of autism symptoms requires an even more expansive selection of treatments.

“One thing about autism, there’s no cookie-cutter regimen,” Racquel DeWitt said. “All the children are different; all the diagnoses are different; all the treatments are different.”

Max gets therapy at Crichton and educational support at an Intermediate Unit 8 preschool.

“He prefers school days to nonschool days,” said Max’s father, Jason DeWitt.

Increased screening of toddlers should provide more services for autistic children, said Carolyn Labic, early intervention service coordinator for Bedford-Somerset County Mental Health-Mental Retardation.

“I think it will definitely help get them into our program sooner,” Labic said. “We provide in-home services for children who qualify.”

Through the state-funded Early Intervention Program, teachers, therapists and other professionals travel the rural areas of Somerset County to provide free services to children who have a 25 percent or greater delay in any area of development, Labic said.

“It is natural-environment based, and it is a family training program,” Labic said. “We come in and teach the family or caregiver to help that child develop.”

One of the biggest challenges is getting parents to accept that their child could use the help, Labic said.

Integrating various therapies and treatments at an early age is the key to progress, said Cheryl Weckoski, senior home-based service coordinator for United Cerebral Palsy of Southern Alleghenies. UCP’s personal-care attendants help those with disabilities in daily living.

“The ideal scenario is to coordinate the personal-care attendant with therapeutic staff, support aides, and work with the family and school,” Weckoski said.

Because those with autism often respond in specific areas of interest, parents seek out new programs and socialization opportunities. It creates challenges for those living outside major metropolitan areas.

“I think it’s terribly lacking in this area,” said Kristin Santos of Upper Yoder Township during an autism support group meeting in Denny’s Restaurant, 3156 Elton Road.

Members of the group have traveled to Ebensburg and Greensburg for play groups, while others have gone to Pittsburgh for music and drama therapy.

The challenge can be even greater in isolated rural areas where transportation becomes an issue for many families, Labic said.

Those working with autistic children in this area are skilled, caring individuals who provide quality care, Santos said. She’d just like to see more support here.

“(The) divorce rate for parents of special needs children is like double,” she said. “I’d love to see marriage counseling offered – someone who understands autism. And they should have baby-sitter respite care for single parents.”

Some of those issues could be addressed by the regional autism service, education, research and training center that is envisioned for United Cerebral Palsy of Southern Alleghenies headquarters along JARI Drive in Richland.

Unlimited Care Providers, a sister organization, has applied for $1.6 million to launch one of three state-authorized centers.

“Anything to help people with autism and provide services to these children would be wonderful,” Labic said.

Information about the proposed center is available by calling 262-9600.