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ERIE, Pa. (AP) — Small treats like going out to dinner once seemed out of the question for David and Kara Steiner.
Their 6-year-old twin boys, Braden and Mason, have autism. The idea of sitting through an hourlong meal in public seemed like torture.
"A restaurant environment was way too much for the boys, with the break in routine and all the sounds," said their father. "They wouldn't have sat still for that long. No way."
As David Steiner talked at his Erie home, Mason bounded out of his dining room chair and leapt into his father's arms for a hug. Braden paid no attention to his brother and continued to play a game with his therapeutic support staff aide from the Barber National Institute.
It's been five years since the fraternal twins, who will turn 7 later this month, were diagnosed with autism, officially called autism spectrum disorder. It can cause speech delays, a lack of interest in others, repetitive behaviors and unusual reactions to the ways things feel, taste or smell.
The Steiners aren't alone in having multiple children with autism. A recent study showed the sibling of a child with autism has a 7 percent chance of developing autism.
"I have quite a few families with more than one child diagnosed," said Jennifer Musolff, a Barber National Institute behavioral specialist who oversees the twins' therapy. "One family has three children diagnosed with autism."
So many children have been diagnosed with autism in recent years some advocates have called it an epidemic. The U.S. Centers for Disease Control and Prevention now estimates that 1 in 68 children has autism, an increase from 1 in 150 children in 2002.
The number of people being treated for autism in Erie County rose from 502 in 2005 to 1,263 in 2011, while Crawford County's number increased from 173 to 444 in the same period, according to the Pennsylvania Department of Welfare.
"In 1980, we had one classroom devoted to children with autism," said Cindy Priester, an occupational therapist and education coordinator at the Barber National Institute. "Now between one-third and one-half of our 22 classrooms are for children who have been diagnosed with autism, though some also have other diagnoses."
Braden and Mason were born 14 weeks early and showed developmental delays early in their lives. They received support through the Achievement Center's early intervention program.
As the babies grew into toddlers, their parents worried because they weren't talking and making eye contact like other children their age.
An appointment was made with a psychiatrist, who diagnosed both of them with autism.
"It shocked us. We were in denial a little bit," Kara Steiner said. "We thought it was due to them being born prematurely."
"We had talked about it and watched video on the Internet," David Steiner said. "We saw children with autism, and the similarities to the boys was tough to see."
Though both boys have autism, their symptoms and development haven't been the same.
Braden learned to speak earlier and is able to make friends more easily. He is a first-grader at Grover Cleveland Elementary School, attending regular classes with the help of a therapeutic support staff aide -- though the aide will soon be phased out.
Mason attends school at the Barber National Institute, where he thrives in its more rigid structure and more individualized teaching approach, Kara Steiner said.
"Speech is more difficult for Mason, but he's getting better," she said. "We're working on full sentences, and people are saying how much better he is speaking."
Raising a child with autism can be difficult, even with support. Raising two can be overwhelming at times, the Steiners agreed.
The key has been to establish routines and to let both boys know what is expected of them each day.
"There is a lot of planning," Kara Steiner said. "One thing, though, is that they both have always been good about going to bed. There have been no sleep issues like we hear from other families with autism. When they were younger, they would stand at the bottom of the stairs with their blankets when they wanted to go to bed."
In addition to the support each boy receives during school, Barber National Institute aides visit the home twice a week and spend at least an hour with each boy.
They provide activities that promote speech, concentration and how to sit still for extended periods of time. Both have benefited from the therapy, Musolff said.
"Both boys have advanced far beyond whatever I could have hoped for," said Musolff, who first met the boys when they were 2. "Braden is doing extremely well in a fully inclusive first-grade classroom, and Mason has made so much progress from when he engaged in tantrums and didn't speak."
The Steiners also have a 2-year-old daughter, Morgan, who does not show any symptoms of autism.
Boys are five times more likely to develop autism than girls are, according to the CDC.
"We thought a lot about Morgan and autism," David Steiner said. "I still think about it."
The twins have improved their communication and social skills enough that the family decided a few weeks ago to eat a meal at a restaurant.
"We prepared for the trip," Kara Steiner said. "Their TSS aides put together a picture book that explained, step by step, what to expect when they visited a restaurant. We practiced at home."
When the time came, the boys did well. They were able to order food themselves and remained seated throughout the meal.
"Mason kept thanking the waitress," Kara Steiner said. "He'd say, 'Thank you, girl.'"
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Information from: Erie Times-News, http://www.goerie.com
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