On the Spectrum: One Family's Autism Journey

Allison
Eatough

The Maloni BoysDominic Maloni could not have been a better baby. He was quiet and easy going. In his first year of life, he met all of the usual milestones sitting up, speaking his first words, walking.

At 13 months, he could organize his toy cars in a line from smallest to largest. He could even figure out a puzzle designed for a four-year-old in just two minutes. Still, he wouldn't look his mother in the eye or turn around when his parents called his name. "On one hand, we wondered, Is he a genius?'" remembers Jennifer Maloni, Dominic's mother. "On the other hand, he was too little to be purposely ignoring us."

When Dominic was 21 months old, doctors diagnosed him with autism. Autism is a complex developmental disability that affects the functioning of the brain. It typically appears during the first three years of life, and can impact a child's social interaction and communication skills. It is a spectrum disorder, meaning it can affect individuals in varying degrees.

Questions immediately raced through Jennifer's mind: What does this mean for my son? Is he ever going to get married? Will he be potty trained? Talk? Go to college?

That's when Jennifer, who had given birth to her second son, Dylan, just five months earlier, began to panic. "Is this going to happen to the baby too?" she remembers thinking. "I was told it could but that it was rare. And Dylan seemed fine."

In some ways, Dylan was the opposite of Dominic. He laughed a lot and was affectionate. But just like Dominic, he would not look his mother in the eye. Around that time, Jennifer read a story in the Washington Post about Dr. Rebecca Landa, director of the Center for Autism and Related Disorders (CARD) at Kennedy Krieger Institute. Dr. Landa was conducting a research project aimed at early diagnosis and early intervention of autism. Part of the project involved studying the development of younger siblings of children diagnosed with autism.

Jennifer called the Center to enroll one-year-old Dylan in the study. During the initial evaluation, therapists found that Dylan was showing "yellow flags" for autism. When he returned six months later for a follow-up appointment, Dr. Landa confirmed Dylan's behaviors also fell on the autism spectrum.

Autism, which affects one in 150 children in the United States four times as many boys as girls is the fastest growing developmental disorder in the country. Its cause is unknown, and there is no cure. But thanks to structured educational programs and research by Kennedy Krieger Institute faculty, children with autism are beginning to live happier, more productive lives.

Dr. Landa administers a set of comprehensive assessments to children at 14 months of age to predict autism. Prediction is not necessarily a diagnosis, but it gives children who show signs of autism a chance for early treatment.

For the Malonis, confirmation of Dylan's autism caused a mix of emotions. But mostly, Jennifer says that she and her husband P.J. finally felt a sense of direction.

"They seemed so confident at Kennedy Krieger," she says. "I trusted them, and I trusted Dr. Landa."

Over the next few years, the Center for Autism and Related Disorders will continue to develop its services for families like the Malonis. The Center's Achievements Therapeutics Day Program for two-year-olds expanded to two classes in September. The Achievements program provides individualized treatment in a small-group setting to young children who have difficulties with communication and social interaction. The program focuses on language, social interaction, and self-regulatory development skills.

The Achievements program also has classes for three-to-six-year-olds, and plans to establish a national outreach and training program.

In an extension of the Center's programs, two new preschool classroom programs were recently created. One of the programs is housed at the Kennedy Krieger Fairmount campus; the other is located at Lois T. Elementary in Baltimore City.

Each of the new classroom locations will become additional sites for the Center's unique professional immersion training program. The Center for Autism and Related Disorders research staff will provide authentic training opportunities for educators immersed in the classroom setting. For those professionals new to providing programming for young children with an autism spectrum disorder, this training will create a capacity-building opportunity for participating school districts and county programs.

The Center's research opportunities are growing as well. "We were recently funded to follow infants who participated in our early detection study," Dr. Landa notes. "We'll follow them through age eight." A new treatment study for one-year-olds showing signs of autism is also starting.

In addition, the Center is examining the learning process in three- to five-year-olds with autism, in three- to five-year-olds with Down Syndrome, and in typically developing toddlers.

Because of their participation in programs like these, the Malonis have made considerable progress. Both can speak. In fact, Dominic even makes requests, such as asking for a cup of juice. And he always says "please."

They're also making strides socially and emotionally. Recently, Jennifer saw Dominic touch his brother's back. He then began to gently rub. It was one of the first times Jennifer witnessed true affection between the two.

"It's always going to be a struggle," she says. "But they're making progress, and they're happy little boys."