This article was published in the Pittsburgh City Paper. September 15, 2004
as part of "When Joshua Lost His Words"   www.pghcitypaper.com

Across the Spectrum
Autism is a series of diagnoses, and sometimes what you get depends on which you have.
At the Waeltermann house in McCandless, I don't get invited in so much as welcomed aboard. Upon my entry Christopher, age 7, announces: "I'm going to get a $380 train for my birthday." Then he and Alexander, 5, hurry me up to Christopher's bedroom, where the Lionel train track is. Then it's down the hall to Alexander's room, which the sign on the door identifies as The Flying Scotsman. According to Alexander, the bedroom is a train, though it's currently not moving. That's lucky for one of the family cats, who runs out the door. Christopher says he has eight cats. Alexander says he has 100.
Normal kid stuff? Not exactly. After a while, patterns emerge. Christopher doesn't want to talk about anything but trains. Ask him a question about something else, and he becomes antsy, tries to get away, rubs his chest nervously, says "Ahhhhh!" Alexander, meanwhile, is relentless in his demands. He wants me to color with him, go to the basement, and play a board game, seemingly all at the same time.
Their mother, Cindy Waeltermann, looks over at Alexander. "He never shuts up," she says. Then she turns to Christopher. "And he never talks."
They seem as different as brothers can be, but each has been diagnosed with a variant of autism. Christopher's inability to truly converse and his sometimes angry resistance to trying new things are symptoms of autism disorder, says Cindy. Alexander has no problem conversing, but it has to be on his terms, and about one of the limited number of subjects he's interested in. That inability to master the rules of social interaction is called Asperger's syndrome, and is considered a less severe form of autism. 
There are five diagnoses under what's known as the autism spectrum. The best known are autism disorder and Asperger's syndrome. Also fairly common is Pervasive Developmental Disorder Not Otherwise Specified -- a long way of saying that some, but not all, features of autism are present. Kids sometimes "graduate" from classical autism to Asperger's or PDD-NOS. Far rarer is Child Disintegrative Disorder, in which a kid develops normally for two to four years and then retreats into an autistic state. Rett's disorder is a slowing of head growth accompanied by autistic behavior.
"I want to be rude to you!" rails Christopher, shortly after his state-paid aide -- called a therapeutic support specialist, or TSS -- arrives at the house. She's there to coach him in the nuances of conversing and coping, and asks him what will happen if he only gets $200 for his birthday, and not the $380 he wants to buy a particular train. He'll get a smaller train, he says. Good. "Then I'll break the little train!" he roars. Not good. It doesn't come off as bad manners so much as the squeal of a mind that's easily derailed.
Alexander's issues aren't as obvious, but for that very reason they may be even more challenging, Cindy says. He had a TSS for a while, but then was "discharged" from the service. This year his preschool "didn't want him back without a therapist there, because he's so disruptive," says Cindy. Now it looks like the state will supply a TSS to help at school. Cindy is worried about how he'll fare in grade school, where kids with Asperger's often get little of the help available to other autistics. "He probably will not qualify for services [like an in-class aide]," she worries, "and then he's going to disrupt the class and have discipline problems."

Cindy runs AutismLink, a large and growing compendium of autism information: www.autismlink.com.
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