PUERTO RICO — First-time mom Patricia González worried when she noticed that her two-year-old daughter Victoria was struggling in school. “She barely vocalized words; she didn’t socialize. She was not at the same level as her peers,” explained Patricia. “The school told me ‘She will need to repeat the year’ without any explanation.”

After numerous evaluations, Victoria was finally diagnosed with autism. “It was not easy understanding the diagnosis and thinking that your daughter is not going to be an independent person…,” said Patricia. “Because in the end, as a parent, all you want is for your kid to lead an independent life.”

The number of students with autism in Puerto Rico has doubled over the last decade, reaching 7,575 in 2022, according to the Autism Alliance of Puerto Rico. However, there is an island-wide shortage of special education teachers and therapists.

“Like any other parent, I didn’t know where to go or what options were available to us,” explained Patricia, until she discovered the Centro de Aprendizaje del Niño (CAN), or “Children’s Learning Center” at the Hospital del Niño. CAN is an intensive learning and therapeutic center specializing in developing academic, social, behavioral, and communication skills for children aged 2-5 with autism diagnoses and various learning challenges.

CAN provides individualized therapy services through an interdisciplinary team incorporating Montessori methodology, enabling each child to learn at their own pace, strengthening and stimulating academic growth.
Jacqueline Giannoni, Director of Speech and Language Therapy at CAN, celebrated the progress made by children like Victoria, who no longer carry an autism diagnosis thanks to the program. “Victoria was one of the girls that came in with a diagnosis of autism spectrum disorder. Thankfully, as a result of her last evaluation in 2022, she no longer meets the criteria for the diagnosis, which for us is the biggest achievement.”

Once children reach five years of age, they transition to other schools. Children like Victoria enter the regular school system, while those requiring ongoing services continue to receive support from schools tailored to their needs, supplemented with therapies from the Hospital del Niño.

Centers like CAN are rare finds, and Patricia considered the support she received as a blessing. She emphasized the importance of actively involving parents and maintaining open communication throughout the process, advocating for more centers like CAN to address the existing service gap. “I feel like there should be more centers like this one, because it works and is exactly what’s missing,” she added.

Currently serving 50 children, CAN is expanding its facilities to increase capacity. However, there remains a pressing need for more such institutions in Puerto Rico, where services are severely limited, stressed Gianonni.

Direct Relief awarded a $107,000 grant to Hospital del Niño to subsidize the salaries of six trained professionals who will provide educational therapies for children with disabilities.

School Disruption in the Aftermath of Disasters

To bridge gaps in service access, Hospital del Niño also provides outpatient therapies to nearly 2,000 students under the Special Education Program of the Puerto Rico Department of Education. The Covid-19 pandemic brought additional challenges and exacerbated the shortage of therapists and professionals in schools. The organization has taken measures to train special education teachers and recreational therapists to work with special education students and help them thrive.

Although there has been a rise in the number of children diagnosed with autism, Jacqueline Gianonni raised awareness about another group of cases where children may appear to fall within the autism spectrum, but are actually experiencing delays in social skills due to the isolation imposed by the Covid-19 pandemic.

To address this, the Hospital del Niño is collaborating with the Department of Education to expand its “Avanzando Juntos” or “Learning Together” program. This early intervention initiative identifies early signs of autism and developmental disorders in children aged 0-3, providing parents with an individualized plan to help children progress and gain independence. Additionally, they are conducting training sessions for service providers in five different school regions, equipping them to recognize specific needs among children.

For Patricia González, her experience with Victoria’s diagnosis made her more attuned to early signs when her second daughter, Aurora, was born. At 18 months old, Aurora was diagnosed with autism and is now a student at the Centro de Aprendizaje del Niño (CAN).

Patricia emphasizes the importance of early intervention, celebrating Aurora’s remarkable progress and her promising future, much like her sister Victoria. “Every day, she surprises us even more. She is on the same path as her sister, Victoria. We see her progress each day. This is why early intervention is important,” said Patricia.