JACKSONVILLE, Fla. — Tiffany Boyarovsky is learning the language of autism spectrum disorder, the language of her 22-month-old daughter.

“I didn’t know how to relate to my own daughter,” she said of Rosemary.

Their interaction is not verbal, not yet, but it is communication just the same. They play together, in Rosemary’s repetitive fashion.

“We copy each other. She’ll see me doing what she’s doing and she’ll try something else,” Boyarovsky said. “The biggest thing is get her to speak.”

The goal is to build from repetitive play to repetitive sounds and to speech. Mother and child are learning the way at Wolfson Children’s Hospital Rehabilitation Autism and Neurodevelopment Center on Jacksonville’s Southbank, which opened in December. The center focuses on early autism intervention, aimed at children 18 months to 4 years old, with speech and occupational therapy, among other things.

Autism, which affects an estimated 1 in 68 children, is a neurodevelopmental disorder marked by repetitive behaviors and impairment in verbal communication and social interaction.

Designed to complement other autism programs, Wolfson’s new center includes soundproof treatment rooms to increase attention and language development. There are swings in every room for movement, balance and alertness. An indoor playground helps children use the skills they are learning in a more natural setting. Also, the center educates parents, siblings and other caregivers on how to relate to a child who has autism spectrum disorder.

“We had an overwhelming number of patients being treated at our other rehabilitation locations. We wanted to design something specific (for children who have autism),” said Lauren Papke, the center’s team lead.

Currently the center has 36 patients with 70 visits a week collectively, she said, but those numbers are expected to grow.

Rosemary walked, ran and climbed on the couch earlier than her two older siblings had as toddlers. But Boyarovsky knew something was off. Rosemary failed to start talking, not even babbling. She played repetitively with her toys, banging blocks against each other rather than building them, spinning a car’s wheels rather than pushing the car across the room.

At her 9-month and 1-year checkups, Rosemary’s pediatrician said to hold off on testing, to give her time. Meanwhile, Boyarovsky followed her “mother’s intuition” and exhaustively researched her daughter’s symptoms. So when Rosemary was finally evaluated at 1½ years old, Boyarovsky was not surprised at the diagnosis of autism spectrum disorder.

“I knew it was coming. It was a relief,” she said, “but it was devastating.”

Early intervention is key, said Nathan A. Call, clinical director of the Marcus Autism Center at Children’s Healthcare of Atlanta, and Celine A. Saulnier, director of research operations at the Marcus Center. Well-known researchers in the field, the two were in Jacksonville this month for the 10th annual Autism Symposium at the University of North Florida and toured the Wolfson center.

“What we know about autism is how important it is to start treatment when they’re young, 4 years and under,” Call said. “Early detection pushes the onus to early recognition. … There needs to be a lot of education.”

The center’s “state of the art” facility, multidisciplinary approach and training for parents is “a match for success,” Saulnier said. The parental training in particular “changes the game to allow parents to be agents of change,” she said.

Boyarovsky has been the agent of change for her husband, Oleg, and their two older children, teaching them what she has learned at the center about relating to Rosemary.

Rosemary’s siblings were upset that she did not like to be hugged and kissed, loving interaction they had looked forward to, so they have found other ways to spend time with her, she said. Rosemary and her brother both like blocks so they play together with Duplo blocks, a preschool version of Lego toys. Her sister reads to her.

For several weeks Rosemary and her mother have come to the center twice a week for 30 minutes of speech therapy and 45 minutes of occupational therapy. For Rosemary, it’s all play. For the therapists, it’s about helping her learn, express herself and develop other skills and watching for improvement.

“She is increasing her comfort level and confidence in the play apparatus,” Papke said. “She was showing progress … in her interactions since she was more engaged and vocal than in the past.”

Boyarovsky marveled at her daughter.

“This is amazing. I am excited for Rosemary — she is getting the help she needs at the age she needs it,” she said. “This has been the biggest blessing for us.”


Information from: The (Jacksonville) Florida Times-Union, http://www.jacksonville.com