Putting the Pieces Together

Autism Defined
Autism is a highly complex and variable developmental disorder characterized by impaired social interaction, communication and restricted and repetitive behavior. Autism is one of five disorders that are categorized as “pervasive developmental disorders” which means that the symptoms penetrate or pervade every aspect of the child’s development: educational, social, emotional and physical. Rett Syndrome, Childhood Disintegrative Disorder (CDD), Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and Asperger Syndrome are also categorized as pervasive developmental disorders. These five developmental disorders have been referred to as “spectrum disorders” (ASD – Autism Spectrum Disorder) because the multiple impairments can vary in severity and combinations. In addition to the core areas of impairment, physical and medical conditions may accompany autism to include:

  • genetic disorders
  • gastrointestinal disorders
  • seizure disorders
  • sensory integration disorder
  • sleep disorders
  • auditory processing disorders

The following “red flags” could be signs that a child should be evaluated for autism or a related communication disorder:

  • Does not respond to his/her name
  • Cannot explain what he/she wants
  • Language skills/speech are delayed or language skills are lost at some time in development (used to say a few words or babble, but now he/she doesn’t)
  • Doesn’t follow directions, acts deaf or seems to hear sometimes, but not others
  • Does not point or wave bye-bye
  • Repeats words he or she hears but does not use spontaneous language
  • Throws intense or violent tantrums, is hyperactive, uncooperative or oppositional
  • Has odd movement patterns and is very uncoordinated in movements (most noticeable when running or during gross motor activities)
  • Cannot sequence steps to accomplish a task (wants a cup off of the table but cannot sequence steps to get to cup)
  • Uses the same toys repeatedly and obsessively and never varies game, play pattern or activity with toys
  • Does not smile when smiled at and lacks emotional affect
  • Poor eye contact
  • Does not transition between activities
  • Seems to prefer to play alone and is not interested or aware of activities going on around him or her.
  • Gets things for him/herself only
  • Does not share personal interest in item with parent or caregiver (Look at this, Mom!)
  • Child is very independent for age and hits milestones “early” compared to other children
  • Walks on his/her toes
  • Restrictively eats only a few favorite foods
  • Avoids or seeks messy activities involving hands or body
  • Avoids activities where feet leave the ground (swinging and/or climbing)
  • Child shows unusual attachments to toys, objects, or schedules (always holds something in hand or must put socks on before pants)
  • Child spends a lot of time lining things up or putting things in a certain order

Early Signs & Symptoms of Autism
12-14 months

  • Single words not emerging (by 16 months)
  • Lack of reciprocity
  • Lack of problem solving
  • Not responding to Name

18 months

  • Lack of motor gestures
  • Not beginning to pretend
  • Language not emerging for social interaction
  • No subtle looking

24 months

  • Lack of imaginative play
  • No meaningful two word phrases

36 months

  • Inability to verbalize Emotions
  • Difficulty interacting with peers
  • Difficulty with taking turns and sharing
  • Little to no pretend play
  • Little to no communication

Autism statistics in 2012 from the U.S. Centers for Disease Control and Prevention (CDC) identified 1 in 88 American children as on the autism spectrum–a ten-fold increase in prevalence in 40 years. These figures represent a 23% increase since the 2009 report and a 78% since the 2007 report. Studies show that autism is four to five times more common among boys than girls. An estimated 1 out of 54 boys and 1 in 252 girls are diagnosed with autism in the United States. However the numbers are climbing and today an alarming 1 in 50 school age children are diagnosed with autism.

Why is the incidence increasing? Researchers cannot agree on whether the trend is a result of heightened awareness, an expanding definition of the spectrum, an actual increase in incidence or some combination of all factors. Certainly some of the increase is due to the way children are identified, diagnosed and served in their local communities, although exactly how much is due to these factors in unknown. The largest increases over time were among Hispanic children (110%) and black children (91%). It is suspected that some of this increase is due to greater awareness and better identification among these ethnic groups. However, this finding explains only part of the increase over time, as more children are being identified in all groups.

A child can be diagnosed with autism as young as 12-15 months.  Often children are diagnosed between 18-24 months.

There are no medical tests for diagnosing autism, so an accurate diagnosis must be based on observation of the individual’s communication, behavior and developmental levels. Diagnosing the condition is not an exact science. Medical tests may, however, be used to rule out or identify other possible causes of symptoms since many of the behaviors associated with autism are shared with other disorders. While currently each order has a specific set of accompanying symptoms, with the new publication of the DSM-5 diagnostic manual in May 2013, all sub-types of autism will be merged under one umbrella diagnosis of ASD.

No single cause for autism has been identified and there is much debate among top researchers whether the triggers are genetic or environmental. However there is general acceptance that abnormalities in brain structure or function are at the root. Brain scans show differences in the shape and structure of the brain in children with autism versus those who do not have autism, and researchers continue to investigate a variety of theories and links.

Curable? Treatable?
While autism is not yet curable, it is treatable with early diagnosis and implementation of intensive therapy interventions such as:

  • Speech therapy
  • Occupational therapy
  • Physical therapy
  • Behavioral therapy
  • Play-based floor therapy
  • Social therapy
  • Auditory integration therapy
  • Sensory integration therapy
  • Biomedical and Detoxification Therapy
  • Diet modification
  • Bio/Neuro Feedback
  • Oxygen therapy

Origin of Puzzle Piece
The puzzle piece has been a symbol for autism since 1963 when the National Autistic Society in the United Kingdom adopted it as their logo. They explain “the symbol of the Society should be the puzzle as it did not look like any other commercial or charitable one as far as we could discover. The puzzle piece is so effective because it tells us something about autism: our children are handicapped by a puzzling condition; this isolates them from normal human contact and therefore they do not ‘fit in’.”

Since then, the interlocking, multi-colored puzzle piece has become the international symbol of autism. Its significance has become multi-faceted. For some it represents the mystery and complexity of the disorder, for others it represents the mechanical nature of a person with autism’s thought process. Also, since every puzzle piece is different in some way, a puzzle piece accurately represents the diversity of the individuals affected. The bright colors are used to represent hope.