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

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A San Jacinto mother desperately seeks help for an autistic son

spiraling out of control

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.

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.

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. "