Monday, April 27, 2009

Western Pennsylvania county records largest number of students with autism

From the Tribune-Review in Pittsburgh. In the picture, West Mifflin Middle School student Jenna Granatire, 12, puts her name on a puzzle piece supporting autistic children as Leah Mangino, an autistic-support teacher, keeps an eye on the class.

The number of children with autism educated in Allegheny County is at an all-time high — surpassing even Philadelphia, the most populated county in the state.

During the 2007-08 school year, 1,570 autistic children were educated in the county's public schools, compared with 1,121 students in Philadelphia, even though that city has more students. Autism experts say difficulty in spotting and identifying the baffling disorder, environmental factors and parental awareness are factors contributing to the difference.

"We're somewhat surprised that Allegheny County has that high of a number," said Sarah McCluan, spokeswoman for the Allegheny Intermediate Unit. "It's no secret that the numbers of students diagnosed with autism has been consistently and dramatically increasing in the last decade."

Nearly 311,000 children between the age of 5 and 19 reside in Philadelphia, compared with approximately 229,000 residing in Allegheny County, according to 2007 U.S. Census Bureau statistics. In Philadelphia, 8.7 percent of children have a disability, compared with 6.9 percent in Allegheny County.

It is important to make an accurate diagnosis of autism as early as possible, experts said. Students misdiagnosed or diagnosed late in childhood do not get the help they need, said Dr. Scott Faber, developmental pediatrician at The Children's Institute in Squirrel Hill. But diagnosis is often difficult and can be subjective.

"When you see such a discrepancy in the numbers of individual diagnoses we see in schools, it has a lot to do with the people making the diagnoses," said Travis Haycook, assistant director of the school program at the Cleveland Clinic Children's Hospital Center for Autism. "You can't do a medical blood test to see if you have autism — you have to go through the different areas of deficit."

Autism covers a wide spectrum of disorders — ranging from mild to serious impairment — that affect communication, and social and cognitive skills. A student with autism might need therapy and education much different than other special education students, said Cathy Guzzo, director of Special Education at Penn Hills School District, which educates 83 autistic children, the second-most in the county.

"There are varying degrees of disabilities," Guzzo said. "We try to base it on what needs a kid has."

Faber said it is logical that more school-age children would be diagnosed with autism in the Pittsburgh area than in Philadelphia because of the pollution here, which he believes is a factor in the disability, and the medical and support services available here for disabled children.

"Maybe in Pittsburgh you're paying more attention to autism, maybe the parents are more aware. It could be any number of factors," said Nancy Erskine, director of special education high school region, school health and related
services with Philadelphia schools.

Nationwide and in Pennsylvania, one in every 150 children is autistic, statistics show.
Dr. Nancy Minshew, professor of psychiatry and neurology at the University of Pittsburgh's school of medicine and director of one of the National Institutes of Health's Autism Centers of Excellence, said autism experts in Allegheny County have a high level of experience with diagnosing the disorder, dating to the initial programs at Western Psychiatric Institute and Clinic.

"The kids are out there and are being picked up, and I don't think that is happening in other cities," Faber said.

In Philadelphia there are 3,265 children diagnosed with mental retardation educated in public schools, 2.4 times more than in any other county.

Jean Ruttenberg, executive director for the Center for Autism in Philadelphia, the oldest autism center in the nation, said psychiatrists at her facility re-evaluate many children diagnosed with mental retardation or attention deficit disorder and determine the child has autism.

"This is a complex disorder that is very difficult to diagnose," Ruttenburg said. "I'm sure misdiagnosing is still happening. There are people who are still untrained in autism making other diagnoses."

The state Department of Education estimated it would spend more than $941.3 million on special education funding this school year. The average cost to educate an autistic student is $18,790, though there is no standard amount because each child has unique needs.

As the number of autistic students in public schools has grown, districts have added aides and therapists to work with them one-on-one, McCluan said.

"Often times we see kids that have so much of the neurological stuff that people underestimate what they can do," Ruttenburg said. "Once we deal with those, it's like a different child."

Marie Mambuca's son Tony was diagnosed with autism 15 years ago. He is now a senior at North Hills Senior High School. For the first eight years, she spent 30 hours each week working on behavior training in her home with Tony. She recognizes the difficulties districts have in educating autistic students.

"If you've met a child with autism, you've met just one child with autism," said Mambuca, 46, of Ross. "You can't generalize the teaching, and the way you teach a child with autism is very different than the way you teach a child with Down syndrome. Each student is an individual, so think about how exhausting that is for a school."