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CHARLOTTE, N.C. - Christiane Gram's infant son, a 4 1/2-pound preemie, was 2 weeks old before she rocked him in the hospital nursery.
As she held him in her arms, she remembered the warmth of her firstborn, Haley, who curled up in a ball at her chest. Bobby was different. He arched his back and stiffened his arms and legs, outstretched like a startled crab.
When Bobby came home two weeks later, Christiane noticed that, when she put him down for a nap, he rocked his head from side to side. Even at night, when she looked in, his head would shake in his sleep.
When Christiane asked about this, the pediatrician reassured her: Every child is different.
Bobby's differences piled up. He screamed and pitched toys across the room. He pulled out handfuls of his sister's hair. By the time he was 2, doctors had diagnosed several developmental disabilities, typical of what is now called Autism Spectrum Disorders.
Health experts don't know much about this mysterious syndrome. It affects an estimated one in every 500 children. The cause is unknown, and there is no cure. In recent years, diagnoses have soared, but officials aren't sure if autism is becoming more common or if there is just greater awareness. They're convinced that identifying the problem early will help.
With no clear guidance, parents such as Christiane and Frank Gram of Matthews, N.C., are left to educate themselves about how to help their children.
Symptoms differ from child to child, and there is no single treatment for all children. The standard approach is structured education, to modify behavior and teach life skills. And many doctors prescribe drugs to treat hyperactivity and anxiety.
Christiane didn't want to put Bobby on drugs that hadn't been tested in children. But she was desperate. She searched the Internet and found alternative approaches - dietary changes, nutritional supplements and chelation therapy.
"We were at the end of our rope," she said. "This little guy was totally, totally out of control."
At 9 months, Bobby didn't roll over, crawl or stand. He refused to touch his bare feet to the floor. When Christiane dressed him in socks and shoes, he pulled them right off.
By age 2, after intensive physical therapy, he could walk. But he started throwing tantrums. He'd dump cars and action figures from his toy bin, climb on a chair and jump on them, never seeming to feel pain. At meals, strapped into a chair with a belt, he'd hurl his plate and scream until his face turned blue.
He licked everything - people, chairs, tables. At a Georgia amusement park, Bobby's mother took him with her to the public restroom and watched incredulously as he licked the floor.
Doctors in Georgia, where the Grams lived until last summer, diagnosed Bobby with attention deficit hyperactivity disorder and sensory integration dysfunction - the brain's inability to correctly process information from the senses.
When they moved to Matthews, they took Bobby to a Charlotte neurologist, who also diagnosed pervasive developmental disorder and oppositional defiance disorder. The doctor offered to prescribe clonidine, a high blood pressure medicine to calm Bobby, but the Grams declined.
At the doctor's office, Christiane read an article about neurofeedback therapy. Days later, a flyer arrived in the mail from Myra Preston, a Charlotte neurofeedback therapist. Christiane scheduled an appointment
They arrived in Preston's southeast Charlotte office in August, a month before Bobby turned 3. He was strapped into his stroller, screaming. Christiane was crying.
"What," she asked, "is wrong with my child?"
Preston recognized Bobby's behavior. She applied electrodes to his scalp, connecting him to a computer that beeped each time his brain responded correctly. Preston calls it physical therapy for the brain.
Five weeks later, Bobby seemed calmer and happier. He sat still longer at dinner. He left his shoes and socks on. Preschool teachers sent him home with smiley face stickers instead of frowns.
Christiane continued her search. On the Internet, she found a site that recommended removing food additives and dyes from the diet. She took away Bobby's goldfish crackers and fruit snacks.
She also learned about a conference near Cincinnati last October. Sponsored by the Great Plains Laboratory in Kansas, it was about treating autism with alternative therapies. Christiane signed up.
At the conference, she listened to biochemist William Shaw describe his ideas about why deficiencies in vitamins and minerals, excesses of heavy metals, and food allergies to wheat and dairy products, could cause her child's symptoms.
For the first time, Christiane met other mothers with children like Bobby. One, who had followed Shaw's program, said her son had fully recovered.
"That's what I want for my child," Christiane said.
Two weeks later, the Great Plains lab ran tests of Bobby's hair, blood and urine for $1,299. The results showed Bobby had toxic levels of mercury, arsenic and aluminum. He was allergic to eggs, chicken and turkey, and he was deficient in zinc, calcium and vitamin C.
Christiane followed Shaw's suggestions, changing Bobby's diet, adding the supplements.
In mid-November, four days after he started taking the pills, Bobby changed.
For the first time, he crawled into his mother's lap, wrapped his arms around her, looked straight into her eyes and kissed her on the lips.
Christiane wept.
Not long after, Bobby said the words she'd been waiting to hear for three years:
"I love you, Mommy."
Great Plains' Shaw claims to have seen many such transformations.
"The best results are obtained with the youngest children," he said. "If you get a child at 2 years old, you're much more likely to have a reversal compared to starting at 8."
Shaw knows it's controversial to suggest that the mercury from childhood vaccines could contribute to autism. Several studies have found no connection. But when metals are removed, through chelation therapy, he said he's seen symptoms improve. "It's not a grand slam, but pretty close."
Michael Cuccaro, an autism researcher at Duke University, said some children may be helped by alternative therapies.
"We need to study in a more systematic fashion the potential benefits of these therapies," he said. "We don't know enough at this point."
Christiane recently added chelation therapy to Bobby's regimen. Every other day, she rubs his back, tummy and legs with drops of transdermal DMPS. The product, developed by Dr. Rashid Buttar of Cornelius, N.C., leaches metals like mercury from the body.
The Grams have spent about $10,000 on Bobby's treatments in the past year. Christiane says she knows other parents who spend more on special schools and other approaches.
Bobby continues to improve.
"I'm not saying that he's perfect yet," Christiane said. "(But) he's not angry like he was. He's much happier. I just want to give him the very best start I can."
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RESOURCES
U.S. Centers for Disease Control and Prevention: www.cdc.gov/ncbddd/autism/index.htm.
Cure Autism Now: www.cureautismnow.org.
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WHAT TO LOOK FOR
No single factor indicates a child may have autism. Several symptoms could be cause for concern.
Does not babble, point or make meaningful gestures by age 1.
Does not speak a word by 16 months.
Does not combine two words by age 2.
Does not respond to name.
Loses language or social skills.
Poor eye contact.
Doesn't smile.
Repetitive body motions such as rocking.
Oversensitivity to textures, smells, sounds.
Sources: U.S. Centers for Disease Control and Prevention; National Institute of Mental Health.
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(c) 2005, The Charlotte Observer (Charlotte, N.C.). Distributed by Knight Ridder/Tribune News Service.
