978-1572305441

116 A MIND APART
parents or grandparents, who now include me in their anxious gaze. At
home, the girls like to watch old Disney videos, Fantasia especially, and
Barney. Danny loves to jump on the couch for hours on end.
At the conclusion of the interview the parents and grandparents
want to know only two things: Do the triplets have ASD, and what possibly
could have caused this tragedy? How is it possible that three children
born into the same family and at the same time all have ASD? I tell
them it is perhaps too early to tell, but we should do some assessments
of communication and cognition, get them into day care, and follow
them closely. I will see them again in three and then six months. I tell
myself that it’s likely they have autism, but I know that a diagnosis at
twenty-four months of age can be difficult, especially in twins, who are
often speech delayed, so I decide to wait a bit. In any case, they will receive
useful interventions in day care, so there will be no real delay in
receiving services.
* * *
Another couple, Ron and Carol, ask me to see their son, Robert,
who is now ten years old. I saw him for the first time some six years ago
for a diagnostic assessment, but the purpose of this current appointment
is to discuss possible causes of his autism. They have two younger
children, ages four and five, both of whom are doing very well, and
there is no history of autism on either side of the family. Carol and Ron,
who are both lawyers, have seen many physicians about their son’s autism.
I vividly remember the history from the first time I saw the family.
Apparently Robert developed very nicely until age eighteen months. He
had about fifty words, was always smiling, responsive, and engaging. All
this could be seen from the videotape of his first birthday that his
parents kindly supplied me. It showed him happy, blowing out the
candles, clapping his hands, and laughing at all the goings-on. But a few
weeks after his vaccination needle at eighteen months, he became quite
ill. One night he developed a high fever and had a prolonged convulsion
that terrified his mother. He turned blue and started shaking as she
held him tenderly in her arms. Carol described this night as if it were
yesterday—the layout of the bedrooms in the house, the cries that
awoke her in the middle of the night, the frantic scramble to find the
phone and call an ambulance. She was convinced he was going to die.
Robert was rushed to the hospital, but thankfully he did not have any
more seizures. A few weeks after he came home from the hospital, how-