Casey O'Neill plays with schoolmate Jonathan Bundy.

The preschoolers in Jennifer Knowles class a Milton Elementary School start every class with circle time.  As Knowles greets each child in turn, she comes to one student who particularly relishes every moment of his school day.

Four year old Casey O'Neill, was diagnosed with Spinal Muscular Atrophy Type I (SMA), the number one genetic killer of children under the age of two, when he was four months old.  SMA destroys the nerves controlling voluntary movement such as crawling, walking, head and neck control, and swallowing.  Casey has movement in his fingers and toes and he can communicate by blinking his eyes and making noises.

Casey, who is mentally at or above his age level, has been riding the bus and attending school since September.

"Riding the bus and attending school are two things we never thought he would do," says Sue O'Neill, Casey's mom.

"The kids and teachers have been so great.  They all love him and he has a wonderful time each week," she added.

There is a lot of preparation involved to make Casey's school day run smoothly.

"It's definitely worth it," says O'Neill, who along with one of Casey's nurses attends each class.  Casey has a wheelchair and a tracheostomy, a surgically created opening from his neck into his windpipe where a tube has been placed to provide an airway and allow removal of lung secretions, and he uses a ventilator for respiratory support.  He has a special chair, designed low to the floor that enables him to participate in circle time.

"We get in ahead of time and set him up in the chair," says O'Neill.

Knowles also uses a voice recorder called "Big Mac" to record her voice.  During class activities such as singing and reading, each child is given a part; by pressing the pre-recorded words when it is his turn, Casey enjoys a higher level of participation.

"She always tries to involve him", says O'Neill of Casey's teacher.  Knowles has been working with Casey in his home since he was a baby.

"I'm excited to have him here," says Knowles, who finds the diversity he brings to her classroom a very positive learning experience for her students.

"We were nervous about people's reactions and whether there would be any major mishaps," says O'Neill.  "We had a lot of meetings.  The first day all went well, everyone was a little shy.

"Jennifer sat down and talked with the children about Casey's wheelchair and the noise from the machines, the kids were interested."

And added O'Neill, "the other moms that go almost every time talk to Casey like all the other kids.  I don't think he was very nervous, he's so social."

"I think we're really lucky that we live in Milton, they've been really accepting and pushing for him to get what he needs," says O'Neill.  "Casey is so much happier, school has expanded his world.