Autistic Boy ‘Happy as Can Be’ After Treatment : Unit Specializes in Mentally Ill Children

For most of his 7 years, Joey Kelly hardly spoke. He slept poorly, didn’t eat properly, wouldn’t dress himself. He sometimes lapsed into screaming tantrums that lasted several hours.

Joey is autistic. Late last year, his parents checked him into Yale-New Haven Hospital’s new children’s psychiatric ward. When the family went home to Aberdeen, S.D., six weeks later, Joey was talking fluently, sleeping well, grooming himself and was able to eat a sit-down meal with his family.

“Before, he was kind of a cross little boy,” said Joey’s father, Joseph Kelly. “He was unhappy and got into fits. Now, he wakes every morning with a smile and he’s as happy as he can be.”

One of First Patients

Joey was one of the first patients of the 12-bed Yale Children’s Psychiatric Inpatient Service which opened in December. The unit treats children from 4 to 14 who have serious mental health problems.

Many major teaching hospitals have psychiatric wards for children, said Dr. Joseph Woolston, director of the Yale service. But Yale’s program is unusual, he said, partly because it also teaches parents how to deal effectively with their children’s difficult behaviors.

Besides autism, the unit treats such problems as psychosis, affective disorders, emotional illness aggravated by physical conditions and physical conditions brought on by emotional turmoil. Recent patients include a 4-year-old boy who burned down a house and two emotionally impaired brothers who were abandoned by their mother and abused by their alcoholic, drug-addicted father, Woolston said.

‘Children Simply Suffer’

Studies indicate that 5% to 15% of the nation’s school-age children nationally suffer significant mental health problems and a majority of them probably do not receive adequate treatment, said Dr. Donald J. Cohen, the director of the Yale University School of Medicine Child Study Center.

“Adults who have disorders often find ways to announce it publicly. Children simply suffer,” he said.

At Woolston’s unit, children see a variety of specialists who work for the Yale School of Medicine and its Child Study Center as well as Yale-New Haven Hospital. Cohen hopes the program will come to be regarded as a national model because of this multidisciplinary approach.

Woolston said a youngster’s stay at the hospital begins with a diagnosis, made through evaluations of physical, mental, neurological and educational capabilities. Then treatment is formulated.

During his stay, usually about six weeks, a child follows a routine that includes regular schoolwork.

Diagnosis of Autism

Treatment for Joey Kelly started with a diagnosis of autism, a serious developmental disorder whose victims are often out of touch with reality. Woolston said doctors found that Joey’s IQ was normal, and that he could function at a higher social level than many autistic children.

Doctors then determined what Joey was and was not capable of achieving and guided him toward reachable behavior goals, such as sleeping through the night. Just being in the highly structured unit encouraged Joey to talk and socialize more, Woolston said.

Family instruction and therapy are important too, the doctor said. In Joey’s case, the doctors wanted his parents to visit three times a day in order to wake him, eat with him and put him to bed.

A Connecticut mother whose 12-year-old son was treated for an attention disorder said: “They taught me not to yell at him, to use a low voice.”

“We learned in family therapy how to deal with everything that we were feeling in a positive way,” added the mother, who did not want to be identified.

‘Quiet Room’ Is Used

The unit also has a “quiet room,” used to calm a child whose behavior is out of control. Such children are taught the concept of “time out,” in which they are required to sit quietly.

If that doesn’t work, they are temporarily locked in the quiet room, which is adjacent to the nursing station. About five feet square, the room has a padded bench, two windows and a heavy door.

The mother of the boy with the attention disorder initially objected to the quiet room.

“Then I saw the necessity of it as a place to calm down without any distractions and to think about alternate behavior,” she said. “The longest he was in the quiet room was 20 minutes.”

If a child is so out of control that he could hurt himself, Woolston said, he is tied to a hospital bed.

A Positive Environment

When a child is ready to go home, the unit tries to see that he returns to a positive environment at home and school, Woolston said.