In Arizona case, school district and medical experts in conflict over boy's autism diagnosis

From The Arizona Republic:

A frustrated teacher and a child struggling with autism have combined for a tumultuous year for the Brunos.

The Gilbert family spent months caught in an escalating dispute with Gilbert Public Schools officials about their son's disorder - autism - and his need for special services to help him succeed in school.

Their battle represents a long-standing divide between the educational and medical worlds, in which experts dispute the diagnoses of child disorders and the therapies kids need to do well in school.

Valley doctors say the Brunos are among dozens of families who get caught in the middle.

The Brunos' story began when Luke (pictured), now 6, was in preschool two years ago.

Luke struggled then with potty training, sometimes ran away, hated loud noises and refused to accept what seemed like minor changes in routine, recalls his mother, Courtney Bruno.

He would, for example, throw a tantrum when his breakfast of oatmeal with hot water and milk wasn't made the same way every day. He shied from affection.

The Brunos took Luke for testing at the Melmed Center in early 2009 after they were asked by Gilbert school staff to withdraw him from preschool because of his behavior.

Experts thought Luke likely had "high-functioning autism."

But the preschool staff at Patterson Elementary determined Luke had skills delays and created an Individualized Education Plan.

The federal document detailed services and goals children like Luke need to do well, including a routine for using the bathroom to reduce accidents.

In May 2009, the team decided he had met the goals of his plan. His family asked for a new review, but Bruno said school-district officials declined, saying Luke was fine.

In October, two months after Dr. Daniel Kessler of St. Joseph's Hospital and Medical Center confirmed autism, it was clear Luke wasn't fine.

The kindergarten teacher complained repeatedly in e-mails to Bruno of Luke's misbehaviors - spitting, hitting, throwing sand at other children and defecating in the classroom.

The teacher also said Luke seemed "defiant" but she didn't believe it was because Luke had autism.

Her e-mails showed growing frustration while Bruno's responses showed she tried to educate the teacher about autism and the behavior that sometimes came with it.

In November, a team of educators created a new Individualized Education Plan that acknowledged Luke had some sort of health impairment.

Bruno said then she was seeking a review by a child psychologist, Dr. Joseph Gentry, but asked the school to do its own behavioral analysis first. She said the school staff refused, asking for Gentry's assessment.

In March, Gentry confirmed autism. The education team created an IEP to address autism.

A week later, Luke's teacher wrote to Bruno, "I don't even want him in my classroom to be honest with you."

Bruno filed a formal complaint with the U.S. Department of Education's Office for Civil Rights to investigate discrimination. The teacher was placed on temporary leave as punishment.

School officials cannot discuss individual cases publicly because of the federal Family Educational Rights and Privacy Act.

But Gilbert Public Schools officials acknowledged that, in general, educational assessments often differ from medical opinions.

"It is confusing for families to have a diagnosis in their hands and come to the school and have the school do a little bit of a different process," said Dr. Julene Robbins, the district's lead child psychologist. "We want to try to verify that diagnosis is true, but also, we have to measure by state law and federal law how that (disability) impacts their education."

That requires a series of tests and observations, she said.

Arizona special-education law says that to be diagnosed with autism, the child's disorder must "adversely affect educational performance."

Children with mild disorders may have great test scores but struggle socially.

"Academics are just part of education," Gentry said. "Social skills, self esteem - all of those things are part of what education is all about."

Kessler said children with autism need special therapy to learn social behaviors.

"Many schools seem to think that if we integrate a child with autism into a mainstream . . . classroom and present them with models of mainstream behavior, that the child with autism will learn those through osmosis," Kessler said.

"That doesn't happen. You have to have role play, you have repetition, you have practice."

Bruno believes her family's struggle this year was preventable.

"If (the staff) had accepted the diagnosis and put him in a school with appropriate supports, such as an inclusion program . . . this would have been avoided," Bruno said.

"By the end of the school year with the new plan and supports, he was doing phenomenally and had virtually no issues or accidents the last few weeks - a month before school ended."