May 19, 2008 — -- On the front lines of autism treatment, things can get emotional, controversial and -- sometimes -- hopeful.
One doctor in California is arguing that trying to diagnose autism without looking at the brain is like trying to diagnose a heart condition without looking at the heart, though the established autism community isn't so sure.
But for parents like Sarah Kavanagh, Dr. Fernando Miranda has changed their lives.
To be sure, Kavanagh would have had her hands full anyway. For the single mother of twin 6-year-old boys, Beckett and Webb, the days start early.
"Come on guys, let's have some breakfast," she shouts.
Beckett and his brother, Webb, come bounding out of bed smiling. It takes quite a while to get these two youngsters to arise from their slumber. But once they are up, the twins are ready for the day.
Beckett immediately runs to his dog, Wilson, an old English sheep dog, while mom prepares their morning meal.
"Breakfast," yells Beckett, loud and clear.
For the last five years, Kavanagh has been struggling to get him to this point and it's still hard for her to think back on the heartbreaking diagnosis she got when Beckett was 18 months old.
"They just watched him play in a room with a little kitchenette set and some stuffed animals and from that they deemed that he would be autistic," she said, shaking her head. "I was shocked, devastated."
Beckett always struggled with his speech, unlike his twin brother, Webb. More and more specialists gave her grim news about his condition.
"I heard everything from a resident telling me he would never advance beyond the intellect of an 18-month-old to the school district telling me he'd have to have a companion for the rest of his life," Kavanagh said.
But there was something -- his eye contact, his eagerness to relate or maybe it was just a mother's instinct -- that told her otherwise.
And her lawyer's instinct. Kavanagh's legally trained mind allowed her to think outside the box.
The lawyer's thorough searching led her to a doctor who was taking parents' demands for answers to a new frontier.
Miranda, who runs the Bright Minds Institute in San Francisco, insists that you have to look inside the brain to determine what's wrong.
"You have a child that comes to me and mom says, 'Why is my child not talking?'" he said. "We know that speech is in the brain. What's going on in his brain? I think we should answer that and I think we should answer that as objectively as possible."
But that is not the typical method of diagnosing autism. Behavioral tests are the standard. Indeed, neurologists are often only brought in when cases seem unusual. Even then, high-powered MRIs and cutting-edge EEGs are only used selectively.
Miranda said that's because neurologists have not been as fully involved in the field of autism as they should have been. He thinks that should change.
After looking at Beckett's MRI, Miranda explained that the corpus callosum, the brain freeway that connects the two hemispheres, was a bit thin. That is crucial in any sort of diagnosis because it can affect language.
Miranda's Web site has more specific information on what to look for and treatment options.
Miranda was asked about the fact that so many doctors might say, "Yes, this technology is great, but we don't know enough about what we're seeing to recommend that this be the norm."
Miranda said it's time that more neurologists learn to look for problems in kids' brains.
"We neurologists are experts in the brain," he replied. "The brain is the integral part of our body for behavior. So we need to look at that in detail in our children. If not, we're not doing anyone a favor."
In the end, parental instinct is key. Paula and Todd Senigar are thankful they never gave up their search, but are plagued by video they have of Justin at age 2. What they thought was daydreaming was almost certainly seizures. And they are angry and confused that the top neurologist Justin saw when he was 4 never did any tests. These physicians never even suggested to them that this could be in fact, seizures.
"I feel like we lost out on a lot of time and development for him," Todd said.
"That's the one thing we can't get back no matter what," Paula said. " We can't get those years back to try to."
At that point Paula started crying, and asked to take a break.
But half an hour later, as Justin prepared for his karate class, his favorite activity, she brightened.
Later, watching him in the studio with Todd, they realized that moments like these, with Justin calmly doing his moves and talking to the class, would have been unthinkable just a few years ago. Justin now participates in the same afterschool activity as his older sister, Jordan.
In fact, he was even called on to recite the school creed.
"Amongst my brothers and sisters," he started, "I profess to live my life in a positive manner, to respect my self." He got through every word like that of any 8-year-old.
Paula is convinced that Justin will grow up to be an artist -- a talented one at that. He enjoys drawing his favorite pizza restaurant. And most importantly, he paints a portrait of his family -- one that has gone through so much, but sees a brighter and more colorful picture for the future.