In the early 1980s, the state of New Hampshire itself was in need of new possibilities when it came to services for people with disabilities. Unhappy with the treatment and conditions at the state's institution in Laconia for people with disabilities, parents sued and won a 1981 court order closing the facility. As the state embarked on a new plan to de-institutionalize services, three top state officials, including Donald Shumway, now commissioner of the Department of Health and Human Services, agreed to throw out a challenge to the state's only public research university. Could UNH establish a center that would be a source of innovation in the field of disability, a model for the best practices and an advocate for change? "We wanted an institute that would work in creative tension with the state," says Shumway.

The state got what it wanted, and then some. UNH took the challenge, founded the Institute on Disability and in 1987 hired Dr. Jan Nisbet -- then a professor of rehabilitation and disability policy at Syracuse University -- to build the institute from scratch. With seed money from the state and some office space from UNH, Nisbet set out to help New Hampshire change course.

Autism is a baffling condition. First described in 1943 by Leo Kanner, a psychiatrist at Johns Hopkins University, it's now the third most common developmental disorder. Symptoms, which usually appear before age 3, can vary widely, and range from lack of eye contact to a rigid need for routine. The cause is unknown, but a hallmark is impaired communication skills. About half the people with autism -- most of whom are male -- may never speak.

Like Dustin Hoffman's character in the 1988 film "Rain Man," most children and adults with autism were once institutionalized. Starting in the 1980s, however, disability experts began to find that specialized forms of instruction could be very effective. And the earlier intervention began, the more effective it seemed to be.

As a child with autism, Rosie was eligible for a number of services from the state. But like many families with a newly diagnosed child, the Macks felt as if they had suddenly dropped into a hidden parallel universe, where the people spoke an alien language and survival depended on filling out reams of forms. Rosie was erupting in tears over loud noises, frustrations, changes in routine and new experiences. In addition, Kathy Mack, a new graduate of Exeter Area High School, was living at home, attending Northern Essex Community College full time and working part time at a Shaw's grocery store. Rosie's father, Kathy's high school boyfriend, would visit when he could. "It was a very hectic time," says Kathy. "We were out of our minds, with people and papers and school and work. You would want time to yourself, and there wasn't any." Kathy had hoped that Rosie would attend a Montessori school. Now it seemed as if the goal was to get through each day.