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The Right Place for Patrick : Living With an Autistic Child Is Painful, but Getting Him Into a Regular School Can Be Traumatic

February 24, 1991|KATHLEEN DOHENY | Kathleen Doheny writes frequently about health and medicine.

PORCELAIN-SKINNED and cherub-faced, Patrick Rudd, like nearly every other baby, babbled constantly. But by his first birthday, the babbling had not progressed to a single understandable word.

Mary and Channing Rudd tried to tell themselves nothing was wrong with their red-haired son. They brushed off comments from friends who suggested that Patrick might have a hearing problem. He was just a late talker, the Rudds reasoned. His sister, Clare, a year older, was a late-talker-turned-chatterbox. "And boys always take longer than girls," Mary remembers telling herself.

The Rudds focused on enjoying their life in Middletown, a tiny community in Northern California's wine country. These former San Franciscans had migrated there in 1983 to become winemakers and to raise a family. Despite a recent building boom, Middletown still has a sky clear enough to make the staunchest urbanite rethink the lure of city lights. The town is a mix of old-timers and big-city refugees who say they wish they'd packed up sooner. Within easy driving distance are Calistoga's bubbling natural spas and pine-topped Cobb Mountain.

At Patrick's second birthday party, in October, 1987, the knot in Mary's stomach became too tight to ignore. Her nephew Willie, seven months younger than Patrick, was the life of the party. Patrick was the wet blanket. "He didn't want to open presents," Mary says. "He wouldn't dance. He just wasn't involved."

Patrick's frequent awakenings in the night were another unsettling sign. One night, "he started laughing hysterically over nothing," Mary recalls. "It freaked me out. I remember holding him and saying over and over, 'Patrick, stop it.' But he continued, on and on, for about 15 minutes. It sent a chill up my spine. I thought, 'What is going on with this kid?' "

Six months later, the Rudds sat nervously across from a team of experts at UC San Francisco who had given Patrick a thorough physical exam, a hearing test, a brain scan and developmental tests. "Mary and Channing," the head of the team said, "I didn't sleep a wink last night having to tell you this." Then the Rudds heard the word they knew but had tried to ignore.

"Patrick is autistic."

AN UNCOMMON DEVELOPMENTAL DISORDER, autism afflicts about 350,000 Americans, according to the Autism Society of America. It affects the way the brain processes information and results in social, behavioral and communication problems. In 1943, psychologist Leo Kanner first used the term autism (combining auto or "self" with "ism") to describe an inability of certain children to relate to other people. Since then, he and others have put together more pieces of the bizarre puzzle, though they form a far from complete picture. Autism, which occurs more often in boys than girls, can be connected with mental retardation, although some autistic people are extremely intelligent. Autistic children frequently have under-developed language skills, which may or may not improve as they get older. They may have certain repetitive or unusual behavior, such as constant rocking or inexplicable laughing. Some bang their heads against walls or routinely injure themselves in other ways. Some recoil from hugs and other physical contact, but others accept affection. Their life expectancy is normal, but most will require some sort of supervision throughout their lives, ranging from living at home to institutionalization.

Patrick's symptoms are fairly undramatic. He hums much of the time, but it is a happy hum. He can play with other children or amuse himself; his attention span is brief but not noticeably briefer than that of many 5-year-olds. Occasionally, his mother says, he will get frustrated and hit himself on the head with his hand, but never hard enough to hurt himself. He is an affectionate child who likes to hug his family and friends. He appears to be, for the most part, ordinary, except for his gaze. Patrick can look right at someone with his bright blue-green eyes as if there was no one there. It is the most chilling characteristic of his condition--an almost visible wall between the little boy and the world around him. It is the first clue that something isn't right.

Although all of Patrick's tests pointed to autism, the Rudds denied it. " My son was not going to be autistic," says Mary, a brunette with expressive eyes the same color as Patrick's. "It's like all of a sudden your child, who was going to go to Harvard and play for the San Francisco Giants, is gone. It's almost like a death."

"Worse in some ways," intercedes Channing, who is slender and silver-haired. "Because a disability is staring you in the face every day. It's here forever."

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