DATE: Saturday, July 19, 1997               TAG: 9707180062

SECTION: DAILY BREAK             PAGE: E2   EDITION: FINAL 

SOURCE: THE WASHINGTON POST 

                                            LENGTH:   63 lines

HIGH-FUNCTIONING AUTISM IS USUALLY DIFFICULT FOR DOCTORS TO DIAGNOSE

LIKE MANY parents of autistic children, Dan Mont and Nanette Goodman suspected something was different and perhaps wrong with their firstborn long before the autism was diagnosed. When he was 11 months old, Alex Mont, who now attends elementary school in Rockville, Md., wanted to sit in their laps for hours while they read to him, usually books with singsong verse or rhyme. He could shut out everything, focusing on a single object with almost frightening intensity. He played no peekaboo. He never babbled.

It was his phobic reaction to other children that really alarmed them. At the playground, he'd scream and hide if another toddler wandered too close. He behaved much the same in the play group his mother joined and quickly abandoned. By 18 months, Alex still lacked definitive speech, and the combination of concerns pushed his parents to visit a psychologist in Ithaca, N.Y., where the family was living while Dan taught at Cornell.

The psychologist, after quizzing them at length, offered reassurance. Don't worry, she said, Alex is just a little shy like his father: ``He's one of those kids you're going to have to put in karate when he's 6 years old to make assertive.''

They lost more than a year of therapy because of that advice, Nanette says almost bitterly. They flew blind, trying to suppress their fears, trying to ignore family and friends who said they were catering to a temperamental 2-year-old.

But what else could they do? Their son made rigid, inexplicable demands. If his routine for getting in his car seat was interrupted - to this day they can't figure what the routine was - he'd throw a fit. At a store, Alex had to be the one to open the door, and Dan remembers timing their approach into malls so no customers would arrive at an entrance at the same time.

In desperation, the couple followed their son's lead. With his then-infant brother Simon in their laps, they rolled the dice endlessly on board games; it was as if the rules governing players' moves allowed Alex to relax. Bowling also provided respite, less because of the pins and balls than the scoring system.

Together the family read recipes and how-to manuals. Alex enjoyed those. He could not understand fiction.

``If we had responded to what people were saying, to just let him play by himself, it would have been a disaster,'' says Nanette, 36. ``He hadn't a clue how to play by himself. I remember asking other mothers, `Okay, exactly what do you do with blocks?' ''

Alex was 3 when the autism finally was diagnosed. One psychological evaluation identified a panoply of problems: his refusal, at times, to respond even to his name; his obsession with routine and acute distress over the unexpected; his inability to play with other children or within an imaginary world; and his occasionally echoing speech.

All those are characteristic of autism, which affects nearly 400,000 people in the United States. Two-thirds also are mentally retarded. Seventy-five percent are male. And although some are able to live on their own and hold jobs, many remain overwhelmingly dependent their whole lives.

Alex's evaluation also pointed out some positives: ``His keen observation skills and ability to focus attention are an advantage. He seems to be trying very hard to understand things he finds difficult and to learn ways to do things.''

For his parents, the diagnosis was a welcome relief. KEYWORDS: AUTISM AUTISTIC

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