listenPart 1 of 2

By Emily Zeugner

Autism is relatively new and mysterious but is now the most commonly diagnosed childhood disorder in the US. Autism typically appears during the first three years of life. The disorder affects the brain, impacting social and communication skills and often causing sensory problems. On the Cape, a state-funded early Intervention program is helping more children be diagnosed earlier in life. In part one of a two-part series on the condition, we look at the diagnosis and possible causes.

It's the beginning of February and kitchen of the Lipinski's four-room house is hot. Daniel Lipinski chops up discarded pallets and packing crates to burn in the woodstove - - "free heat," he says. The Lipinskis' three children - as well as Daniel's three older sons - all share the small space, sitting on folding camping chairs to maximize floorspace so the kids can have room to play.

When Jenny and Daniel Lipinski's younger son Iasis was only a few months old, something seemed wrong. He never cried. He didn't babble or coo the way other babies did. He didn't seem bothered by loud noises or interested in any of his toys. And he never looked at his mother.

Jenny Lipinski: "He never gave eye contact. That's the biggest warning sign, no eye contact. And you could go behind him and clap and he wouldn't even budge, you could crumple a bag behind him - you could drop a chair behind him he wouldn't budge. They're so much in their own little world you just can't - and we thought it was maybe his hearing and we got him tested. Well, no. It wasn't hearing".

Jenny and Daniel weren't surprised when their pediatrician in Harwich suggested autism. Their older son four-year-old Elijah was diagnosed with a processing disorder as a toddler and had delayed speech, but after months of early intervention therapy he caught up with his peers.

Jenny Lipinski: "Elijah kind of popped out of it, you know the processing disorder? He goes to regular preschool now. He's now on track to be completely typical, typical school not integrated."

Iasis' condition seemed different to his parents, more severe. Iasis displays many classically autistic behaviors: during the day he walks an endless series of figure-eights through the house, eyes on the floor, babbling quietly to himself. When his mother kneels down next to him to give him a toy, he usually stares into the middle distance, completely uninterested. Routine things -- getting him to eat, to use the potty, to stop turning in circles -- are a constant battle. The contrast between Iasis and the Lipinskis' third child, who developed normally, is stark.

Jenny Lipinski: "With Asana, the little baby girl, it's just so easy. she discovers these things on her own and she's curious and just progresses normally. With him it's constant - you're constantly on it, you're constantly worrying, you're constantly watching it, so that's what's very very difficult."

Autism is now seen as a spectrum - very low-functioning people may never learn to speak while high-functioning autistics often have jobs, marry, and lead regular lives. Not much is known about the possible causes of autism or why has been such a dramatic increase in the number of reported cases over the past ten years. Pat Antenellis runs the Children Making Strides center for autistic children in Pocasset. She says many theories point to environmental triggers.

Pat Antenellis:" There's been some controversy about mercury in vaccinations, and if that's the reason why. There's other places in the country with an even high rate of autism - California has an extremely high rate of autism. There's an area in New Jersey that has like clusters, which leads you to believe there's an environmental assault on the brain. The problem is to do research on the brain, you need to look at the brain, so you need a dead brain. There haven't been too many of those to study yet."

There also appears to be at least some genetic component; it is common to find more than one autistic child in one family. Antenellis says her center has seen at least two dozen autistic siblings, and several sets of twins. Autism is also more common in boys - the Autism Society of America says nearly four times more boys than girls are diagnosed with the disorder. Despite the increased knowledge about autism, Antenellis says the Cape especially is lagging behind the rest of the state in early diagnoses.

Pat Antenellis: "On the Cape, in many cases we tend to get the children later. I don't know if the parents aren't looking at it or seeing it as an issue, I don't know whether the pediatricians just aren't catching it or the child looks pretty typical when they come in, Part of the problem is the average pediatrician isn't in the position to really diagnose the child, they have to be sent up to Boston to see a specialist and there's a six to eight month waiting list for the specialist to see the child and make the diagnosis."

The early Intervention program now funds a diagnosis clinic once a month for Cape Cod children under three. Jenny and Daniel say Iasis' early diagnosis has been a blessing for them. The label of autism has helped them feel less alone, and also given them a way to understand and enjoy Iasis on his own terms. Daniel constantly hugs and kisses his son, hoping that lots and lots of love will help Iasis come out of his own private world.

Link to Part 2 in a story on autism.

Children Making Strides
4 Barlow's Landing Road
Suite 13-16
Pocasset, MA. 02559

Broadcast February 9, 2006
Re-broadcast March 15, 2007

Emily Zeugner reports for the Cape and Islands NPR stations