How a 'miracle' changed Joe

Autistic children don't like surprises, so four-year-old Joe has been prepared for my visit. A laminated drawing of a smiling face marked "visitor" is sitting next to a card marked "Friday" on a Velcro strip on the living-room wall. This time, it doesn't work: my arrival sends him into a tailspin.

Screaming and tearful, he lunges at me and pinches me, hard. Then he runs back to his mother, Sally Hare. She cuddles him, reassures him, repeats his name.

Still bewildered by my presence, he lunges again and stings me with another defensive pinch. Sally repeats the reassurances, then brings out a bottle of bubbles, which she blows again and again. Only after several minutes and many bubbles, is Joe calm.

While Joe says "again, again" and "higher, higher", Sally explains how, for the first two years of her third son's life, she and her husband, Toby, thought his "challenging" behaviour was caused by little more than the acute hearing difficulties he had because of severe glue ear.

When neither his behaviour nor his grasp of language improved after he passed his two-year hearing test, they began to worry. Last October, when he was three and a half, Joe became one of the one per cent of children in Britain who are diagnosed as autistic.

Although "devastating" for Sally, 36, a former belly-dancing teacher, and her husband, Toby, 37, an education officer, the diagnosis at least meant they could get help. Two weeks later, a very frazzled Sally was put in touch with the South West Autism Project (Swap), launched in September 2000 and directed by Professor Alec Webster of Bristol University and funded by Bristol City Council. That, says Sally, is when fear gave way to hope.

Swap works, says educational psychologist Valerie Webster, because of "the innovative way it works with parents at home and forges links with schools and health authorities. It is also grounded in an understanding and acceptance of autism - we are not trying to cure it." Ninety-four per cent of the children who have completed the programme of intensive tutoring, including the very disabled, are now able to attend mainstream school.

Joe was struggling in an ordinary nursery in a class of 26 children when he was assessed by Swap. Poor communication and what's called "non-compliance" were the main concerns. His family tutor, Claire Lovell, got to know Joe at home, spending two hours with him after nursery, four days a week during school terms, establishing "a really good relationship based on a confident, calm, caring approach".

The results, says Sally, are staggering. "He has come on in so many different ways. His language has improved terrifically. He's easier around other people and has formed his first close relationship outside the family. The frustration has diminished an awful lot.

"He's got more tools to express himself and understands more what is expected of him. He's confident and much more affectionate and sociable towards other children."

Nursery had been "very, very tough. We'd been unsuccessful in getting emergency support so it was me going along or nothing. The other parents see you as a mother who can't control your child and they don't talk to you any more. You feel like you're being judged. Meanwhile, Joe was going nuts and couldn't cope with the sharing or the socialising."

By the time Claire arrived, Joe had developed an aversion to health visitors, which is what he had mistaken me for. "He's a bright lad and he knows when he's being evaluated and gets very upset. During the diagnosis he was dragged round to see so many professionals that he got stuck in a very physical, angry reaction. Autistic children become bewildered very easily and that comes out as anger and frustration - and pinching.

"Now that he knows you're not going to prod him and bring out your educational toys, he'll turn into a little show-off in about 10 minutes."

In January, his tutor Claire started attending nursery with him, where she set up a workstation for him within the classroom. "It was a very busy environment and what autistic children need is calm," says Sally. This week Joe started at a resource unit within a mainstream primary school. He is in a class of six and all the children are autistic.

"I think he'll thrive in an environment more suited to his needs," says Sally. "He has high self-esteem and, in that environment, that will grow," she adds, smiling at Joe, who has just produced a bigger bottle of bubbles. Then she says: "See! There goes Mr Hyde and now Mr Jekyll comes back."

Sure enough, Joe starts chatting and singing and, at the mention of school, picks up one of his "communication books", containing photographs and picture symbols. "Taxi!" he says, then "School!", looking at the photograph of the school building.

Clearly pleased with himself, he asks for one of his favourite toys, a whoopee cushion. "Bum, bum!" he shouts and Sally, giggling, brings it down from a shelf.

Outside, whoopee cushion in one hand, dustpan brush in the other, Joe dashes around the garden. "He's chasing snitches on his Harry Potter broomstick," explains Sally. He's got the Harry Potter bug from his older brothers, David, eight, and Charlie, six. All three had the MMR jab (alleged by some to cause autism), but Joe had started falling behind other children before then. "I'd noticed that he hit milestones later than his brothers, but I didn't think much of it."

Joe's brothers are "mature and very caring. We are a rumbustious, shouty, noisy kind of family with a lot of laughs and he has learned a lot from them". Through his brothers, Sally has also gained insights into Joe's innate abilities. The children share a bedroom and one night she was reading Harry Potter to the older boys. "The next day we were in the park and Joe suddenly said, 'Harry Potter saw a snake in the zoo.' It is difficult to pick out what is attitude with Joe - and what is disability."

Meanwhile, upstairs, Joe is chasing snitches again. Perched on the edge of an armchair, I ask him how it's going. He climbs up next to me - the stranger he had attacked just a little while ago - and topples backwards. I do the same, legs in the air. "Again! Ready, steady go!" he shouts. And so the game begins, instigated by a confident, giggling, fun-loving little boy. "If I woke up tomorrow morning and Joe was a typical child," says Sally, "I wouldn't know him. I love him exactly as he is."