BREACHING THE BARRIERS OF AUTISM\New therapies raise kids' quality of life.

Byline: Warren King Seattle Times

For the first time all morning, Brian Rosenberg is really focused.

The fish crackers that have his attention are crunchy and tasty, and Brian wants more. He shoves a small, laminated picture of a fish at a student teacher, who says she doesn't have any crackers.

Only slightly irked, he quickly passes the picture across the table to a classmate, the keeper of the cracker bowl. He immediately gets another handful.

It is snack time at the University of Washington's Experimental Education Unit's (EEU) preschool class, and Brian, a handsome 4-year-old with autism, is using an innovative picture-exchange system to learn how to communicate better.

His soft blue eyes, which frequently stare off into space, look directly at his classmate.

"I think he has a lot of potential," says Jennifer Annable, the EEU's insightful, energetic principal. "He's young. He has some language already. . . . This is kind of a bridge, a support, to verbal communication."

The picture-exchange system Brian is using is one of an array of cutting-edge teaching techniques to help autistic children at the school. The University of Washington has built a national reputation for its innovations in teaching and research on autism, including pioneering work in early diagnosis of the disorder and analysis of which areas of the brain are affected. The sooner autistic children receive therapy, the better their long-term prognosis, experts say.

Scientists believe autism is caused largely by the failure of certain areas of the brain to develop fully. It is a permanent condition. But in recent years, research like UW's has made significant inroads in the diagnosis, understanding and treatment of the disorder.

More than 400,000 Americans have some form of autism, one of the most difficult and pervasive of developmental disorders.

Besides impairing language development, autism generally inhibits the ability to relate to others, to reason and to imagine.

Many autistic individuals may prefer objects to people. They generally resist changes in routine and, when frustrated, may exhibit repetitive body movements such as rocking. About two-thirds are mentally retarded, while a small percentage have exceptional computational abilities and memories for certain subjects.

One of the most important trends in the treatment of autistic patients has been the emphasis on diagnosis and therapy as early as possible in a child's life.

"We think there are early, sensitive periods of brain development. Getting stimulation early in their lives really helps make a difference in the long-term prognosis," says Geraldine Dawson, a UW professor of psychology nationally known for research on autism.

In the best of circumstances, "high functioning" autistic individuals may live and work independently. Perhaps the most famous in the United States is Temple Grandin, a Colorado State University professor of animal science known worldwide for her design of livestock control systems.

Far more typical are those who cannot live alone and struggle throughout their lives to get along in a world that is confusing and difficult for them to understand.

Jeffrey Rohrback, a graduate of the Experimental Education Unit's preschool and kindergarten, has come a long way in his 12 years. But he is still very much in the midst of the struggle.

"It's the clock," Jeffrey says in a monotone as chimes ring at his home. His parents, Lisa and Brian Rohrback, immediately praise him.

Like many autistic people, Jeffrey often experiences sensory overload. He is unable to tune out different sounds; all are important to him. To a lesser extent, he has the same problem with touch. When he is frustrated with the distractions, he sometimes bites his arm.

Jeffrey has undergone "sensory integration therapy," which included therapists flooding him with sensations: swinging him high in a swing, rolling him around in a foam-rubber container. The idea was to train him to recognize where each stimulus was coming from and how to organize each mentally.

"We don't know if it's helped. We like to think it's helped," says Lisa Rohrback, 42, who with her husband has explored a wide variety of therapies to help Jeffrey cope with a world that to him seems only to intrude.

Only in the past five years have experts been able to diagnose the disorder as early as age 2. Now the UW's Geraldine Dawson has found a pattern of telltale symptoms as early as age 1.

The earlier that tests lead to a firm diagnosis of autism, the earlier a child can get help at a facility such as the Experimental Education Unit. Children who enter such programs between age 2 and 4 increase their IQs an average of 20 points, research shows. They also have better chances of succeeding in regular classrooms when they are older.

Founded in 1960, the EEU is known for successfully integrating disabled and typically developing children, and for testing or developing effective instructional techniques.

The Picture Exchange Communication System (PECS) used with autistic and other children, for example, was developed elsewhere but is being used successfully at the EEU. Three-fourths of the children trained in the system eventually communicate by speech or speech with pictures.

Other activities emphasize communication and social and functional skills.

In the school's play court, children crawl through tunnels, climb ladders and fly through the air on swings. Here and in the gymnasium, occupational and physical therapy are combined with a good time.

Brian Rosenberg steps off the obstacle course's balance beam to wander over and feel the ridges of the gymnasium wall. It is difficult to focus, to listen, to care about what others are saying. Occupational therapist Molly Haling-Jensen gently encourages him back to the course and onto a jungle gym, which he then climbs with considerable skill.

"I want to go!" he exclaims as he begins his climb. Teachers and visitors smile at his expression and his success. He is focused again and learning.

It is difficult to know how autistic children at such an early age will fare as they grow older. Teachers and parents concentrate on the present and near-future, teaching communication, socialization and skills needed in the next level of school.

"We don't like to focus on initial prognoses," says EEU principal Annable as yet another 15-minute activity begins in a busy classroom.

"We go back one year later and look at a prognosis and we can't believe how far they've gone. We keep our sights high."

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Photo Autistic 4-year-old Brian Rosenberg works with Bonnie McBride at the University of Washington's Experimental Education Unit. Knight-Ridder Tribune Photo Service