Craig was about 2 years old when he first was carried into the waiting room of the 0-3 program by his dad Larry. The way he wiggled indicated that he wasn't happy about it.

"Help me!" was all Larry could say. I sat down beside him and observed Craig's bizarre behaviors. He inched on his back from one side of the room to the other like a worm. He fixated on the ceiling lights and struggled to get to some unknown destination. When he reached it, he started again.

This was not a time to drill Larry about his son or to judge anything other than the immediate behavior.

"He likes being on his back," I said.

"Yeah," replied Larry, smiling at me.

"Let's go on back to the therapy room. We have a chair for him back there," I said.

"He won't sit in one," said Larry with certainty.

I smiled at him. Craig did not sit easily in the therapy chair, but never underestimate the strength of two adults.

The little boy had multiple delays with a possible diagnosis of cerebral palsy, seizure disorder, a variety of syndromes, and mixed developmental delays. He had not been diagnosed formally as autistic, but our team of professionals felt sure that autism was one branch of his total disability as time progressed.

Craig would only lie and move on his back. He stared at lights and liked vertical blinds. He paid no attention to a speaker and had no eye contact. He didn't like being touched a lot, but he didn't withdraw completely from it.

I admired Larry. Over the next 12 months he listened, talked, and did everything recommended by the child development specialist and the speech, physical and occupational therapists. He asked questions about the when, why and how of each therapy.

My therapy focused on attention and turn-taking. I wish I had videotaped the progress because the father and son brought tears to my eyes. Craig transitioned into public school at age 3. During our last session, he wobbled down the hall on his own while his dad held onto his miniature walker. Craig came into the therapy room and went directly to his chair. His dad pushed him up to the table, and he was ready to go.

"We have new little teddy bears today," I said. "I'd like to play with them. Do you want to join me?"

We gave Craig a few seconds to respond. He didn't.

"I'd like one," said Larry, holding out his hand toward me.

"One for you, Larry," I said.

A small hand reached in my direction, and I placed a blue teddy bear in it. The three of us took turns dropping bears of different colors into a plastic box, rattling them around in the box, and laughing.

"Now, we're going beyond turn-taking," I said to Larry. "We're going for choice. Let's see if he's ready."

Holding up a yellow bear beside my face, I said enthusiastically, "Do you want to give this yellow bear to Daddy or to Kathie?" We both held out a hand in Craig's direction. After a long pause, he took the little bear from my hand and turned toward his father. As he placed the bear in Larry's hand, he said "Da" for the first time in his life. Craig then turned to me and gave me a high five.

That would have been enough for any heart to handle, but there was more. Craig had been developing speech from grunts to vowels to babbling. Now, he looked toward the mirror on the wall and babbled in a pattern of connected speech sounds. This "scratched" sentence had all the components of speech: intonation, pausing, cadence and inflection. Larry and I cried together.

Attention, turns, choice. Early intervention for children with autism should focus on these domains. They are the foundation of language learning skills that are inherent in normal children. Persistence is vital because change does not come rapidly. Working with a team of professionals is imperative, and including the parent as an active intervention participant is vital. Success can begin today!

Kathie Harrington is the owner of Good Speech Inc. in Las Vegas, NV. She can be contacted at kathieh2@cox.net.