THE video being shown visitors to the Boston Higashi School shows a three-year-old Japanese girl labeled autistic who cries inconsolably and kicks and screams when the teacher tries to get her to put on her shoes. Nine years later, however, the same girl, Urara, is playing the xylophone in the Boston Higashi band, greeting visitors with poise, and happily confiding that she wants to write children's books when she grows up. What's behind Urara's transformation is an educational philosophy that refuses to accept limitations for autistic children. It was developed by a Japanese woman 22 years ago.
The woman, Kiyo Kitihara, found soon after starting a kindergarten in Tokyo in 1964 that one of the children was considered autistic. Knowing little about the problem, she taught him as she did the others and took him home with her for further care. ``He was my textbook,'' she says through an interpreter. ``I learned everything about autism from him.''
When other mothers asked if she would take their autistic children, she agreed, since there were no other schools. Her kindergarten, the Musashino Higashi Gakuen (school), expanded to include all grades through high school. Since its founding, the school has taught 4,800 autistic students. It has been hailed as having a progressive approach to coping with this problem.
In medical terms, autism is a developmental disorder. Children diagnosed as autistic (3 out of 4 are boys) are seen as anxious, hyperactive, unable to speak, and out of touch with reality. Eighty percent are considered mentally retarded. Drugs are sometimes used to control hyperactivity; occasionally helmets and gloves are worn to protect the children from their own flailing fists. Behavior modification that uses positive reinforcement - and sometimes the more controversial aversive therapy - is a main form of treatment. Autism is believed to be a permanent handicap.
Dr. Kitahara operates from an entirely different premise. ``In every child ... there exists the most precious sprout of self-identity. To discover this sprout and develop it with full affection, that is the spirit of education for autistic children,'' she says. Employing neither psychotherapy nor drugs, her Daily Life Therapy includes lots of physical activity (dancing, marching to Japanese martial music, running). The exercise helps the children sleep better at night, she says, so they can concentrate the next day on learning their tasks. They also learn to play wind instruments to help with physical dexterity and vocalization. Music and physical exercises are normal fare in Japanese elementary education.
Some United States students attended the school's international branch. Kitihara decided to move it to the US at the request of a group of American parents. The Boston Higashi School, which opened last month, has 93 pupils, 60 of them American.
Arthur Golden, whose son attended Musashino Higashi Gakuen, is one of the founders of the Boston Trust for Autism, a group devoted to helping parents of autistic children. He says he thought Kitihara's approach was one of the few that held out hope. ``She has much higher expectations. I felt that making the program available to as many children as possible ... was a matter of saving lives.''
A group of interested US doctors and educators helped pave the way in Massachusetts for the Boston Higashi School. They found the recently closed Maria Hastings School to house it and built a dormitory in a nearby town. Tuition, set by the state, is $16,583 for day students. The rate for residential students has not been set, nor does the school have state approval for the residential program.
As the tiny, smiling principal shepherds visitors around this former elementary school, it is clear her confidence in the children's abilities and refusal to accept limitations has yielded remarkable results.
Several children run up and throw their arms around her. They used to cringe when touched, she says. A class of kindergartners sits quietly watching their teacher draw on the blackboard and sing. When school started a few weeks ago, she says, they couldn't make eye contact.
Children with weak legs and lack of coordination are now roller skating in the gym. That is the only place, Kitihara says, that you'll ever see helmets at the school.
At a school assembly, students gather onstage in powder blue outfits to play their recorders and sing ``My Way,'' in harmony. Public performances are a major part of Kitihara's program. The videotape of the school in Japan shows a massive performance by all members of the school, dressed in dazzling silver outfits. This helps them with self-confidence, says Takako Oe, Kitahara's translator.
In Kitihara's school, children are taught in groups of 10 with one or two teachers, rather than the conventional one-to-one method of teaching autistic children, which she says encourages dependence. The teachers are on the run constantly, correcting myriad forms of behavior and keeping the children involved. They're also dedicated; in Japan they often work 60 hours a week.
The Kitihara approach is also unconventional in that it mixes autistic and nonautistic students, so that the autistic children will learn to imitate normal actions.
``It stabilizes their emotions to give them stimulation from other children,'' says the founder. To provide role models, she has brought over 33 of her most functional Japanese autistic students. These older students, in addition to taking classes, act as house parents in the dormitory and do maintenance around the school.
The approach is not universally hailed. Some researchers privately wonder if Kitihara is getting such good results because she is screening out physically handicapped children.
``I value it for what it has to offer but don't think it would work for everybody,'' says Amy Lettick, founder of Belhaven, a school for autistic children in New Haven, Conn.
Dr. Fred Volkmar, assistant professor at the Child Study Center at Yale University, says, ``The fundamental problem is, to really know if a treatment works you have to evaluate it scientifically. I also question its being so cast within the Japanese culture. That's not to say that some things wouldn't be helpful.''
Dr. Bernard Rimland, founder of the Autism Society of America and director of the Institute for Child Behavior Research, went to Musashino Higashi Gakuen with three other researchers. ``We went with a great deal of skepticism and came away feeling like she had a good program. We had suspected the kids weren't really autistic, but found some very severe cases and did see kids who had been severely affected, functioning at much higher levels than we had anticipated.''
One seven-year-old Ohio girl, Miriam Kuzecki, would not eat when she went to the school in Japan. ``At one point it didn't look like she'd make it,'' said her mother, Paula Kuzecki, in a phone interview. ``I think the school saved her life. She now has no eating problem, she eats everything. She couldn't stand to be touched, now she loves affection. And she plays with her brother and sisters, which she never did before.''
Toshiko Lyons, a mother of one of the older students, came over from Japan to help out at the school answering phones. Her son was 19 when she heard of Musashino Higashi Gakuen. At first Kitihara did not want to take him because of his age, she says. But after several requests, the boy was accepted.
``There was a drastic change in his behavior,'' says Mrs. Lyons. ``Before no one could control him. He turned right around as soon as he got to the school [in Japan] and now they're training him to be a leader.''
The staff is alert to signs of musical and artistic talent, which researchers often find in autistic children. Miss Oe points out 14-year-old Koshi Kawakami, sitting at a piano in the middle of the gym/auditorium floor. He was not able to speak when he came to the school, she says. But the staff noticed he was always tapping his fingers. So they taught him piano. Now he plays a difficult selection by Mendelssohn for visitors. Later he introduces himself and talks briefly about his music.
While Kitihara says younger children make the most progress, she does not put limits on what any child is capable of doing. Referring to the first autistic child she had in her school, she says, ``When I looked at the child's eyes, they were very clean, pure-looking eyes. I thought the boy had many abilities and talents in him that wanted expression. Because I believed that, that led to success for the program.'' That student is now learning pottery in the vocational wing of the school.