Understanding
the Problem
Paul
Paul has always been obsessed
with order. As a child, he lined
up blocks, straightened chairs, kept
his toothbrush in the exact same spot
on the sink, and threw a tantrum when
anything was moved. Paul could also
become aggressive. Sometimes, when
upset or anxious, he would suddenly
explode, throwing a nearby object
or smashing a window. When overwhelmed
by noise and confusion, he bit himself
or picked at his nails until they
bled. At school, where his schedule
and environment could be carefully
structured, his behavior was more
normal. But at home, amid the unpredictable,
noisy hubbub of a large family, he
was often out of control. His behavior
made it harder and harder for his
parents to care for him at home and
also meet their other children's needs.
At that time-more than 10 years ago-much
less was known about the disorder
and few therapeutic options were available.
So, at age 9, his parents placed him
in a residential program where he
could receive 24-hour supervision
and care.
Alan
As an infant, Alan was playful and
affectionate. At 6 months old, he
could sit up and crawl. He began to
walk and say words at 10 months and
could count by 13 months. One day,
in his 18th month, his mother found
him sitting alone in the kitchen,
repeatedly spinning the wheels of
her vacuum cleaner with such persistence
and concentration, he didn't respond
when she called. From that day on,
she recalls, "It was as if someone
had pulled a shade over him."
He stopped talking and relating to
others. He often tore around the house
like a demon. He became fixated on
electric lights, running around the
house turning them on and off. When
made to stop, he threw a tantrum,
kicking and biting anyone within reach.
Janie
From the day she was born, Janie seemed
different
from other infants. At an age
when most infants enjoy interacting
with people and exploring their environment,
Janie sat motionless in her crib and
didn't respond to rattles or other
toys. She didn't seem to develop in
the normal sequence, either. She stood
up before she crawled, and when she
began to walk, it was on her toes.
By 30 months old, she still wasn't
talking. Instead, she grabbed things
or screamed to get what she wanted.
She also seemed to have immense powers
of concentration, sitting for hours
looking at a toy in her hand. When
Janie was brought to a special clinic
for evaluation, she spent an entire
testing session pulling tufts of wool
from the psychologist's sweater.
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