Moments after walking through the front door of a tidy Colonial home in Montclair, New Jersey, Debbie McCarthy is ambushed by her adoring fans: 2-1/2-year-old twins, Kevin and Andrew Wallace. As mom Juliet takes Andrew to inspect the box of toys their visitor has brought, McCarthy pulls Kevin up onto her lap, tickles him a little, and nuzzles him a bit. He then joins her in a scrappy round of "Head, Shoulders, Knees, and Toes." If you knew nothing about this scene, you'd figure you were simply watching the world's most energetic aunt playing around with her adorable nephews.
But that's not the case. McCarthy works for the Jeffrey Dworkin Early Intervention Program at Montclair State University, which provides home visits to young children who show evidence of developmental delays. In this case, McCarthy (along with other specialized therapists) spends several hours a week at the Wallace home because both twins have Pervasive Developmental Disorder-Not Otherwise Specified, a diagnosis for those who have some autistic traits but do not meet the criteria for a diagnosis of classic autism.
"I have to say that these boys aren't what you might typically think of when you think of autism. They're beginning to talk. They go to a regular preschool each morning. I have every expectation that they are going to end up doing just fine in life," says McCarthy.
The Wallace twins, in fact, are not so exceptional in today's autism world. That's because autism -- a word that still evokes images of completely withdrawn children rocking in a corner or of Dustin Hoffman's childlike savant in the movie Rain Man -- doesn't mean the same thing today that it once did, says Geraldine Dawson, PhD, director of the University of Washington Autism Center, in Seattle.
"Autism, as we define it now, has a very wide range of symptoms. It can refer to a child with 'classic' or 'full-blown' autism, who is quite severely affected, to a child whose difficulties are so subtle that most people would not be aware he had autism at all," says Dawson.
Also included in the realm of what is now termed Autism Spectrum Disorder, or ASD, are those with Asperger's syndrome, a high-functioning form of ASD that is characterized by obsessive interests and social awkwardness. What children on the autism spectrum have in common is difficulty relating to their world and the potential to improve, sometimes dramatically, if they are diagnosed and treated early in life, says Dawson.