A San Jacinto mother desperately seeks help for an autistic son spiraling out of control

[Guest guest]

A San Jacinto mother desperately seeks help for an autistic son spiraling

out of control

<http://pe.robocaster.com/download.mp3?http://www.pe.com/localnews/healthcar

e/stories/PE_News_Local_S_nicholas15.42d657a.html>

09:42 PM PDT on Saturday, June 14, 2008

By JANET ZIMMERMAN

The Press-Enterprise

The fallout from 11-year-old Dooley's rage is everywhere at his San

Jacinto home, from the broken windows and battered walls to the bruises on

his mother's arms.

The sweet-faced boy with big brown eyes turns violent in an instant and

without provocation, his family says. ' behavior is dismissed by

some as a complication of his autism, but his mother thinks there is mental

illness, too.

Robin Dooley is desperate. Her son's furor has given her panic attacks,

robbed her life of pleasure and threatened the emotional health of her

4-year-old son, she said. Dooley, who separated from ' father, Mike,

last year, fears the worst by the time is a teen and can outmuscle

her.

She has pleaded with mental health officials and the agency that coordinates

services for ' autism to have him temporarily hospitalized,

evaluated and regulated on medication. Though he receives five hours of

one-on-one therapy a week, attends a special school and is on powerful drugs

used for depression, hyperactivity and bi-polar disorder, nothing seems to

work, Dooley said.

Story continues below

<http://www.pe.com/imagesdaily/2008/06-15/nicholas15ccjr_400.jpg>

Rosema/The Press-Enterprise

Robin Dooley, of San Jacinto, works with her son, , 11, who has

autism, putting pressure on his head to help him with sensory issues. She

says he has outbursts of violent behavior for which she has tried to get

help.

Autism experts say that no one treatment works for every child. Finding the

answer can be frustrating and difficult because there are too few programs

and they have long waiting lists, they say.

" I can't get help. They tell me, 'It's autism. Deal with it.' I can deal

with an autistic kid. This is something else, " she said.

Children with autism have a high rate of psychiatric disorders, and many

cases go undiagnosed because of lack of training among mental health

professionals, said Fletcher, founder of the National Association for

the Dually Diagnosed. The organization is dedicated to educating the public

about people who have a developmental disability and mental illness.

Last year, Fletcher's group helped publish the first diagnostic manual of

guidelines for professionals who are assessing people with developmental

disabilities for a psychiatric disorder.

" What often happens is ... they don't get assessed to see if they have a

psychiatric disorder or not, and they get bounced back and forth between

agencies, " Fletcher said.

But autism expert Stan Swartz said such behaviors -- biting, hitting and

breaking things -- often accompany autism, a developmental disability that

affects 1 in 150 children in the United States. Violence often results when

children can't communicate their needs.

" There is no medication for that, " said Swartz, a special-education

professor at Cal State San Bernardino. The most effective treatment is

behavioral therapy that involves parents and teaches them how to redirect

and reinforce positive behaviors, he said.

The case illustrates how devastating an autism diagnosis can be for entire

families, who just want some semblance of normalcy, Swartz said.

" I don't know how some of them even get out of bed in the morning, " he said.

Out Of Control

' problems surfaced two years ago and have gotten steadily worse,

Dooley said.

In the past few months, has hurled himself into a mirrored closet

door, flung the blades of a ceiling fan into the wall and urinated on his

clothes. He has gone after his younger brother and other children, and

jumped on his mother while she was driving, causing her to hit a fence, she

said.

Twice since April, police officers responding to Robin Dooley's calls for

help deemed a danger to himself and others and transported him for

a mental health evaluation.

Both times he was held for several hours but didn't meet the criteria for

transfer to a mental health hospital. Staff sent him home to his mother, who

isn't sure how much longer she can care for him.

looks like a typical pre-teen, tall and skinny, with a mop of brown

hair. But he never sits still, prowling around the house like a nervous dog.

His mother follows him around, shooing him off the counter and out of an

upper cupboard where snacks are kept.

In the backyard, he stands in a baby pool, still except for the

tap-tap-tapping of a metal watering can on his hand. He moves to the

sliding-glass door, staring inside and chewing on a leaf he picked up off

the ground.

Nicky, as his family calls him, constantly splays both hands over his eyes

and the front of his head. He grabs the back of Dooley's hand and presses it

to his forehead. His mother repeatedly asks him if his head hurts, but he

never answers. It may just be the pressure that calms him.

developed normally until he was 18 months old, when he stopped

using language, making eye contact or sleeping for more than two hours at a

time, Dooley said.

She links the changes to a series of childhood vaccines he received around

the same time.

He was diagnosed with autism shortly before his fourth birthday.

, who has words for only the most basic needs but not his feelings,

attends a school for children with autism. He has far fewer rages there than

at home. The county transports him in a car, strapping him into the back

seat so he doesn't attack the driver or jump out.

He has a history of running away. He has climbed out of his bedroom window

and bolted down a busy street. He once emerged naked from the tub and hopped

the fence into a neighbor's yard. Several times, he has entered neighbors'

homes and rearranged their furniture or helped himself to something from the

refrigerator.

Dooley noticed a change in after he was diagnosed with encopresis

in 2006, a painful complication of chronic constipation that required

hospitalization to relieve impaction.

" He came home and he was a different kid -- raging, not toilet trained, no

social skills, " Dooley said. " We couldn't get it under control. "

She has stripped his room bare because threw his dresser against

the wall and broke his headboard and box springs. He crashed through the

windows, so she boarded them up because she can't afford the $650 for

bulletproof glass. On the advice of police, she said, she put a lock on his

door to keep him in at night.

Few Options

In December, the first time police took to the Riverside County

Children's Evaluation Service Unit on a psychiatric hold, he was referred to

Loma University's behavioral health unit, where he stayed almost a

week.

Doctors adjusted his medications, but his aggression returned a month later,

Dooley said.

In March and April, police again took him to the evaluation unit, where

staff deemed it inappropriate to hold him, according to Donna Dahl,

assistant director for programs in the Department of Mental Health.

Story continues below

<http://www.pe.com/imagesdaily/2008/06-15/nicholas15acjr_400.jpg>

Rosema/The Press-Enterprise

Robin Dooley sits with her sons, , 11, and Caden, 4. Dooley has

pleaded with mental health officials to have temporarily

hospitalized, evaluated and regulated on medication.

Dooley said she was angered because she was told to pick up within

hours of his arrival.

Staff at the evaluation unit called at 10 p.m., when she was home alone with

her younger son, Caden, who was sleeping; Dooley told them she was afraid to

drive with because of his history of attacking her in the car.

Staff at the unit threatened to call Child Protective Services if she wasn't

there in an hour, she said.

In a written response to Robin's complaints about the situation, Dahl

apologized for any insensitivity by staff and said the evaluation unit is

for crisis situations only.

She urged Dooley to continue working with an in-home therapy team provided

by Inland Regional Center, which coordinates services for people with

developmental disabilities.

" It's like everybody is pointing, 'Take your kid here,' but nobody has an

answer. They say, 'We don't have room,' or 'Your kid is too violent for this

program,' or 'He's too small.' We hear every excuse there is, " Mike Dooley

said.

The mental health department generally doesn't treat autism because it

doesn't have the expertise, said Swartz, who runs a behavioral therapy

program in Imperial County.

" There aren't many residential options and hospitalization is meant to be

very temporary. The reason (mental health doesn't) keep him is they don't

have anything to offer, " he said.

Dahl's assistant manager, Steve Steinberg, agreed. He said Inland Regional

Center is responsible for therapies, support and referrals for people with

autism.

Swartz, who has never treated , questioned whether the boy's therapy

program is effective, if he's still having rages.

' regional center caseworker, Elaine Estrada, did not respond to

questions about the case. Thomson, clinical director at '

therapy provider, EMQ Children and Family Services in San Bernardino,

declined to comment.

'Right On The Edge'

There is no disputing the Dooley family is suffering.

Mike, a computer systems manager for San Bernardino County, said the

disorder contributed to the breakup of his marriage.

Mike said he is unable to handle ' aggression when he and Caden

visit their father's apartment. He also worries about Robin and Caden's

safety.

Robin is a stay-at-home mom who receives child support and a monthly income

from the county to be ' caregiver. Except when is at

school, she rarely gets a break, and has had trouble getting a respite

worker who can handle .

Robin said she broke out in hives and began suffering panic attacks a couple

months ago and had to see a psychiatrist for medication.

" My daughter has gone through hell, literally. How she's maintained, I don't

know, and I think she's right on the edge, " said Robin's mother, Phyllis

, of Murrieta.

Robin and her mother worry that Caden will suffer emotional damage from

witnessing the violence at home. He has begun imitating the screams and

repetitive language of his big brother.

and her husband often take Caden for days at a time when Robin needs

a break. They go to the movies, play and snuggle.

" We do everything we can for him, but it's not enough, " said. " You

can't grow up in that atmosphere. It's too much stress for a little guy. "

Reach Janet Zimmerman at or

jzimmerman@....