By Alison Jerabek

A little boy is throwing various objects-paper, pens, anything he can get his hands on-across the long brown table. His Sunday school teacher is frantically trying to calm him while he yowls several unintelligible words. To an outsider who doesn't know Alex,* this episode just looks like an oversized temper tantrum. But Alex has a form of PPD, Pervasive Development Disorder, a broad spectrum disease 'umbrella' that includes severe cases of non-verbal autism (where the person affected cannot vocalize) as well as more mild cases like Asperger's Syndrome.

PDD is a confusing disease. No one seems to agree on what causes it, why it seems to disproportionately strike boys, or why some children 'recover' and show no autistic behaviors. Most agree that first-born boys are more likely to suffer from it, and that it is not psychologically-based, but rather a difference in actual brain structure. Some insist that it is caused by vaccine reactions, mercury poisoning, and other outside influences. Others say it is genetic in origin, basing this theory on past histories of autism in certain families, particularly those with high percentages of mathematically and scientifically minded males. For some children, however, like Alex, none of these theories fit- he isn't the first-born boy, doesn't have a bunch of techno-geek relatives, or had any noticeable reactions to a vaccine.

Experts are just now only beginning to find that, unlike Down's Syndrome, autism is not a disability that affects intelligence. In fact, people known as savants, or basically, "super geniuses," have historically been autistic. Non-verbal autistics, especially, were commonly thought to be brain damaged with low IQs, until recently, when special speech assisting devices allowed persons with the non-verbal form of autism to type out sentences that the device then repeats for them in an automated voice. Sue Ruben, in her autobiographical documentary, Autism Is a World, relates her journey as a non-verbal autistic from a 'brain damaged' youth with an infinitesimal IQ to a successful college student. When her therapist found out about speech assist technology, she decided to teach Ruben to type, who describes the experience like "waking from a deep sleep," as strangely enough, she had little memories of her past (almost as if she had been in a coma up until that point). Her life was radically changed by the speech assist device, as she immediately began typing complete sentences, pouring out her frustration about being unable to control her strange behaviors and especially about her inability to communicate normally. Gone was the silent girl who seemed to just stare blankly at walls, rocking back and forth.

Amid all this confusion, it is the families who suffer the most. The public is largely uninformed about PDD. This disability is often coined as a "silent" disability because children who are on the milder end of the spectrum tend to appear as just noisy, rude, 'mean' temper-tantrum throwers who can't get along with other kids. Just like Alex. These children, unlike those who are non-verbal, have the best chance of learning to manage their autism and leading fairly normal adult lives if they are diagnosed early and receive intervention therapy. Although PDD is still very misunderstood and many scientists and physicians can't seem to agree on exactly what a successful intervention program consists of, the general consensus is that the window of opportunity for these children is between birth and age three. The sooner the diagnosis is made and a program is begun, the greater the odds that therapists and their programs will be effective. Alex's family has endured the daily grind of several therapists essentially living with them to intervene on his every waking moment for several years already. He has made substantial progress, but when he was diagnosed, there was little information available to his family, who live a fair distance away from any major metropolitan area and the help of autism specialists. They were lucky enough to have supportive family members who pitched in and helped, but still, as Alex's mom says, "Sometimes I wish we could just be a normal family." Alex's siblings have had to deal with the fact that their brother requires a lot of their parents' attention, and often have had to deal with the criticism of outsiders as well. One Sunday, Alex and his siblings were attending a children's choir practice when he began shoving away his younger brother, who he obviously thought was sitting way to close to him. As his brother refused to budge (there was really no place he could move to, anyway), Alex decided to start pinching him, provoking loud squeals but not achieving his objective. One of the Sunday school teachers' assistants noticed this exchange and very loudly exclaimed her disapproval at Alex's behavior. Even when I informed her that Alex wasn't intentionally being cruel, he just needed a little extra space because he is autistic, she still maintained her opinion. Finally, Alex's older brother intervened and removed the younger brother.

These types of incidents are received everywhere with the same type of condescension. Why? Because Alex appears to be a normal child. He doesn't walk with braces, utilize a wheelchair, or need a guide dog. Yet autism is a very real disability that needs to be noticed. Greater acceptance of this disorder in our society and education about its signs and symptoms is essential for Alex and many other children like him to ensure they get the treatment they need, so that, hopefully, someday, they will be able to sort out the tangles of their mind to match an outward normalness.

*name changed to protect identity