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PaulPaul has always been obsessed with order. As a child, he lined up blocks, straightened chairs, kept his toothbrush in the exact same spot on the sink, and threw a tantrum when anything was moved. Paul could also become aggressive. Sometimes, when upset or anxious, he would suddenly explode, throwing a nearby object or smashing a window. When overwhelmed by noise and confusion, he bit himself or picked at his nails until they bled. At school, where his schedule and environment could be carefully structured, his behavior was more normal. But at home, amid the unpredictable, noisy hubbub of a large family, he was often out of control. His behavior made it harder and harder for his parents to care for him at home and also meet their other children's needs. At that time-more than 10 years ago-much less was known about the disorder and few therapeutic options were available. So, at age 9, his parents placed him in a residential program where he could receive 24-hour supervision and care.
AlanAs an infant, Alan was playful and affectionate. At 6 months old, he could sit up and crawl. He began to walk and say words at 10 months and could count by 13 months. One day, in his 18th month, his mother found him sitting alone in the kitchen, repeatedly spinning the wheels of her vacuum cleaner with such persistence and concentration, he didn't respond when she called. From that day on, she recalls, "It was as if someone had pulled a shade over him." He stopped talking and relating to others. He often tore around the house like a demon. He became fixated on electric lights, running around the house turning them on and off. When made to stop, he threw a tantrum, kicking and biting anyone within reach.
JanieFrom the day she was born, Janie seemed different from other infants. At an age when most infants enjoy interacting with people and exploring their environment, Janie sat motionless in her crib and didn't respond to rattles or other toys. She didn't seem to develop in the normal sequence, either. She stood up before she crawled, and when she began to walk, it was on her toes. By 30 months old, she still wasn't talking. Instead, she grabbed things or screamed to get what she wanted. She also seemed to have immense powers of concentration, sitting for hours looking at a toy in her hand. When Janie was brought to a special clinic for evaluation, she spent an entire testing session pulling tufts of wool from the psychologist's sweater.
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