Whatever 6-year-old Rogan Isbell does, he wants it to be the best.

"Do you think I'm extra funny, or really funny?" he asks his mom. He jumps onto the couch to sit beside her, and continues to bounce on the cushion like it was a trampoline.

"Really funny," Trisha Johnson tells him.

"Am I plain funny or crazy funny?" he asks, giggling, and trying to grab his feet while lying on his back.

"Crazy funny," she says to him, which makes him laugh.

He asks questions often, Johnson says. His T-shirt prompted his questions to his mother about just how funny he is on a recent Friday evening in his family's living room. The back of the white T-shirt, which was muddied from playing, said, "I have beautiful eyes, a goofy sense of humor, lots of hugs to give, autism."

The T-shirt tells people what his symptoms might not. He has a highly functioning form of autism called pervasive development disorder not otherwise specified, also known as PDD-NOS. He sometimes speaks unclearly, moves his arms erratically without reason and needs continual reminders of what to do.

Doctors are identifying more children with autism spectrum disorders because of changes in classification and identification, according to the Centers for Disease Control. The prevalence rate was assumed to be about 4 in 10,000 children, but a prevalence rate study in 2000 and a follow-up study in 2002 showed the rate to be 6 in 1,000, according to the CDC. This new prevalence rate meant 1 in 166 children could have autism, where before it was thought 1 in 2,500 children could have autism.

Locally, an autism task force has begun to raise awareness of the disorder. It is organizing a fundraiser walk for next summer.

Rogan falls into the group of children who are at the high-functioning end of autism who weren't caught before the definition for autism spectrum disorder changed. Now parents, educators and physicians are finding more ways to help a growing group of people with a wide range of needs.

There are three basic developmental areas affected by classical autism: social skills, language skills and motor skills. The amount of deficit in these skills determines if a person has high- or low-functioning autism.

"Autism is a brain-based developmental disorder," St. Alexius Medical Center child neurologist Dr. Siriwan Kriengkrairut says. She has practiced at St. Alexius for 16 years as a childhood neurologist, sleep specialist and pediatrician. She is not treating Rogan.

On the horizon

Rogan was diagnosed with the disorder in 2003, when he was about 2 years old. At first, Johnson thought his problems with speech and interacting with others were his reaction to her divorce. His symptoms have changed over time.

"When he was 18 months or so, I called him my little Rain Man," Johnson says. Rogan would do things, like line up his toys, that reminded her of the Dustin Hoffman character in the 1988 movie.

His symptoms worsened between 18 months and 2 years of age.

"When it didn't get better, I was in denial a while. I knew in my heart, but I did not want to accept it," she says. "When I got his diagnosis, I was devastated. I was fearful of his future and sad for him."

There are two primary reasons it takes so long for children to get diagnosed with autism: they are not tested or the doctor does not listen to the parents' concerns.

"For doctors, I would tell them to listen to parents," Kriengkrairut says. "I have parents who told me their doctor kept telling them their child would catch up."

The doctors could have other reasons for wanting to look to other reasons to explain the symptoms.

"It's hard to give a label," she says.

It took Johnson's new husband to help her see what she didn't want to see. She had him see a physician for a diagnosis. His habit of arranging his toys in a line, flapping his arms at his side, walking on his toes and sensory problems were some of the clues.

People with autism can have awkward mannerisms, poor eye contact and difficulty using imagination.

"They can't pretend play," Kriengkrairut says.

Language delays can be with verbal and nonverbal communication. An autistic child might not be able to read a person's nonverbal body language to tell how a person is feeling.

"His siblings get really frustrated with how to cope with his mannerisms and speech," Johnson says.

Johnson has four children: Logan, her husband's son, is 10; Bradee, her daughter, is 8; Rogan is 6; and Landon, their son, is 2.

Rogan calls Landon his best friend, she said. At school, Rogan plays by himself at recess. He doesn't talk with his classmates often, either. Once, his teacher called Johnson at work because she spotted Rogan on the playground talking to some of his classmates.

Rogan will talk with people, such as answering their questions, but he doesn't carry on a conversation with people, Johnson says.

He tells a reporter some of his favorite jokes.

"What do dogs eat at the movies?" he asks, a mirthful smile on his lips. "Pupcorn."

Then another.

"What kind of train can sneeze?" he asks. "A choo-choo train."

The jokes continue until his attention turns to a Game Boy game. He likes playing PowerPuff Girls. His fingers fly over the game controls as he explains what he's doing.

Although the game works his fine motor skills, it also helps him focus. After a few minutes, he stops jumping on the sofa and running around the living room. Then his questions become less frequent until he is absorbed in the game.

In addition to video games and computers, he likes to read. His skills are above his age level. He has a knack for recalling what he's read.

"He has a very strong preoccupation with books," Johnson says. Rogan learned to read at an early age. At first, she thought he was only memorizing the books; then she gave him an unfamiliar book at the doctor's office, which he read.

Once, though, he was given a book by his favorite author, and he didn't like it. It wasn't the story he didn't like, but the chirping noise it made when the pages turned. He became upset.

"He was terrified of the noise," Johnson says.

"Did I freak out?" Rogan asks his mother about the crickets. "I never freak out."

He tends to ask questions when he already knows the answers, she said.

It's not the first time he's become upset over something innocuous. There was a birthday party when he started screaming when his family sang "Happy Birthday."

Calming the storm

The outbursts are not as common as the questions and needs of assurance.

"It's still the same question: 'Mom, will you drop me off and pick me up?'" Johnson says about their morning routine.

Transitions are the most difficult part of his days. She has a calendar for him, so that he knows what his routine is, but it doesn't stop the questions.

He also has difficulty when she is away from him.

"If I go out for a walk, he has a hard time with the separation from me," she says.

He even gets anxious when she goes to the bathroom. It takes a lot of reassurance to keep him calm.

Preparation helps the family get through events outside the normal routine so that Rogan can adjust to the change without excessive worry. Rogan is driven to school each day and picked up by his mother.

Even Johnson's schedule is routine to help Rogan. She is a nurse at Medcenter One. She works Monday through Friday, and makes sure he knows what her schedule will be and that she has weekends off. She had to work six 12-hour days in a row, then be off for eight days, before she moved to Bismarck.

"He had a hard time and knew when it was close to my eighth day off," Johnson says. "Now he knows I'm home weekends and at night."

Johnson attends a support group to connect with other families with children with autism spectrum disorders. The children in the group are across the spectrum of disorders.

"I just started going a few months ago," she says. "Now I look forward to it. It's a chance to vent and release some of the pressures."

She can talk with the other parents about the day-to-day issues of raising a child with autism.

"Most adults don't know," he has autism, Johnson says. "For them, they just know he's different."

In public, people usually think she's trying to calm a temper tantrum. People look at her funny, like she can't keep her kid under control, but she's so focused on what Rogan needs, she doesn't give it much thought. She would like people to be less judgmental.

"Just spend an hour or two in my shoes," she says. "Try to be empathetic before you make a judgment."

Sunny outlook

Treatment doesn't come in a pill or a single approach. Medication can treat some of the symptoms, such as a seizure disorder that occurs in some people with autism. Kriengkrairut refers patients to physiologists and nutritionists, depending on the child's needs, and the special education department of the school system.

Johnson and her family moved to Lincoln in 2006 from Fargo and got him involved in school. Rogan has an individualized education plan, a requirement for school districts through the Individuals with Disabilities Education Act. It helped get him speech and occupational therapy. Before he started school and therapy, he couldn't ride a bicycle or grasp a pencil, Johnson said.

He gets treatment at Red Door Pediatric Therapy, a speech and language thereapy provider, and this month he sees a specialist with Defeat Autism Now! in Kansas. This specialist will look at a special diet with probiotics, enzymes and that is sugar-, gluten- and casein-free.

At school, he is in a regular classroom with a paraprofessional. This person helps keep him focused on his tasks. As he moves into first grade, he will need more time with the paraprofessional because of the longer school day.

Nationally, school districts are categorizing more students with autism in their special education programs. The number of students classified for autism increased from 22,664 to 193,637 between 1994 and 2004, according to statistics from the CDC.

Rogan, a soon-to-be first-grader, gives careful thought to what he wants to be when he grows up.

"Jail guard," he says. But, he was just playing a game where the goal was to break someone out of jail. His mother helps remind him of some other career ideas he likes.

"A firefighter, a policeman, a doctor, because you like to help people who are sick and hurt," Johnson said to him.

Rogan doesn't understand what it means to have autism.

"It's OK with me," she says. "He's a happy kid."

Rogan brings happiness to her life with his funny sayings, which she call "Roganisms." She has a lot of hope for him in life.

"I just want him to be happy," she says. "I want him to be Rogan. I want him to blend in because it is so important to go somewhere and be successful."

When he's finished with his game, he goes outside to play tag with his brothers and sister and their friends. He's already running around the house while his siblings stand in the driveway.

"He makes me laugh every day," Johnson says. "He's a blessing. He always has a smile and a giggle."