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Others require constant supervision and exhibit severe learning difficulties throughout their lives. The care of an autistic person over his or her life span runs more than $3 million. Whether they are high- or low-functioning, children with autism tend to be visual learners who gravitate toward technology and screens. They are less adept at recognizing human faces and expressions.
"It's not uncommon that autistic children will panic because they can't find mom," says neuropsychologist Robert Schultz, who is also the director of the Center for Autism Research at the Children's Hospital of Philadelphia.
Additionally, he says, these children tend to process language more slowly than other children, which can cause confusion and anxiety.
That may be a reason that those with autism tend to prefer interacting with inanimate but engaging objects like the iPad. What happens on an iPad's screen is predictable. Humans — particularly those making cryptic sounds and faces — are not.
The Rosas first became aware that Leo might be different when he was 18 months old and a family friend who was a pediatrician suggested having the boy evaluated. Because Leo had always been "a sweet, bubbly, affectionate mama's boy," Shannon and Craig were mystified. But they took their son to a psychologist, who agreed that Leo did have some of the symptoms, including a lack of interest in people and a limited vocabulary for his age.
The Rosas began to worry. At that time, they didn't know anyone with autistic children. "Nobody tells you it isn't the worst thing that could ever happen," Shannon says. They began reading up on autism, and what they found was scary.
Perhaps their son had been poisoned by vaccines. Or mercury. Or some other environmental toxin. They read books that said Leo could be cured — if they were willing to take immediate action with expensive therapies.
Applied behavioral analysis (ABA) therapy, which involves predicting and controlling behavior, was one option. A gluten-free and casein-free diet, which restricts most carbohydrates and dairy products, was another. There was also chelation, which could supposedly extract mercury from the body. Back then, there was little literature debunking autism myths, and Leo's parents wanted to try everything. Rosa was so set on curing her son that she named her new blog The Adventures of Leelo, the Soon-to-Be-Not-Autistic Boy.
Although the doctor initially said Leo was not "a responder" to the gluten- and casein-free diet, he recommended trying it anyway. For more than a year, the Rosas denied their bread-loving son gluten and dairy. They also enrolled him in ABA therapy.
Leo's progress out of toddlerhood was slow at best, Rosa remembers. He was still in diapers, his attention span was brief, and he didn't sleep through the night. At the same time, he was becoming violent. On family outings, Leo would leave his car seat and pummel his younger sister, India, whom he seemed to resent for taking his place as the baby. On one trip, he threw a tantrum so extreme that strangers in an airport stopped to help him. The family stopped traveling.
Although the Rosas were initially hesitant to put their son on medication, Leo's intensifying brutality left them little choice. On Abilify — an antipsychotic commonly used to treat schizophrenia — he gained 15 pounds. His behavior worsened, and he seemed tormented and uncomfortable in his own skin. Rosa couldn't stand to see her son so miserable.
She began to realize she might not be able to cure her son, and entered what she refers to as "my dark period," which she likens to having post-traumatic stress disorder. She cried often, stopped engaging with people, and even stopped writing. She would sometimes be driving and realize she had forgotten the rules of the road. "I lost hope," she says.
When the doctor recommended Leo try an antiseizure drug called Risperdal, Rosa had low expectations. But almost instantly, Leo seemed calmer and more comfortable. He began sleeping through the night.
The Rosas moved to a larger home in Redwood City, and Leo switched to a special school. Victor Cabrera, a therapist of whom Leo is fond, started coming to the house four times a week for respite hours. All of this made the family's life easier, and, in Shannon's mind, prepared Leo for what she considers his biggest breakthrough, his near-miracle: the iPad.
After finishing his own bread at the Ferry Building and everybody else's at the table, Leo requested his prize possession.
His mother handed it over, and he brought his head very close to it, as if to snuggle. Then he began scrolling through the apps, gazing intently at the screen while deciding what he wanted to pull up.
"Want to watch a video?" Rosa asked. Although Leo didn't answer, he had clearly understood her, because he scrolled easily to a new cluster of icons, one of which represented his favorite Teletubbies video. He selected it, then watched in awe for several minutes as the vibrant, bizarre creatures rolled around.
After Leo exited the video and continued browsing, his mother suggested he make a rainbow. Leo can't use a pen or pencil very well, because, like many autistic children, he has problems grasping small items. Before the iPad, his most advanced drawing was a smiley face with legs.