Piecing the puzzle: April marks National Autism Awareness Month

As Monday marked World Autism Awareness Day and April serves as Autism Awareness Month, staggering new statistics from the Centers for Disease Control and Prevention, which were released on March 29, said that 1 in 88 U.S. children, have been "identified with an Autism Spectrum Disorder (ASD)."

Suzanne Bonifert, who is the head of Speech Language Pathology and Clinical Lecturer at the UT Dallas Callier Center for Communication Disorders, said that medical professionals currently do not know the cause for the increase in autism; however she said the testing for the disorder has changed.

"There is better diagnosis available and pediatricians are much more aware because there's just been so much news and information," she said. "The American Academy of Pediatrics has put out a statement to mandate screens in pediatrician's offices for children for signs of autism, so children are getting referred to professionals at earlier ages, which is good. So we're recognizing children and seeing them, and just the evaluation process has been proved to be able to better recognize those signs and symptoms because of the improvement in the diagnostic process -- that is likely a part of the reason why -- it's not fully, it doesn't fully account for it."

Bonifert said that the medical field is aware that autism is a "neurobiological disorder" but they do not yet understand the cause. She also added that there is research being conducted as to a connection with autism and environmental factors.

"That is something researchers are looking at in terms of environmental pollutants, also processed foods, just all kinds of things, we don't really know -- there's no science behind that right now," Bonifert said. "We know ... the cause of autism is multifactoral, it's a neurobiological disorder: children are born with it, but there are a number of factors. There is a genetic component, but we don't fully understand that, and not all children that have it have that genetic component, so the environment could be a part of it, we just don't know."

Bonifert also added that families that have a child with autism have a higher chance of having a second child with the disorder.

"There is research going on, on sibling phenotypes where you have ... a family and they have two children ... they evaluate the child that has autism but also evaluate the 'typical sibling' and sometimes they find certain characteristics or there's certain phenotypes that are noted in siblings of autism they may have some subclinical symptoms or they may have some other related symptoms," Bonifert said. "Some of the phenotypes, they can be at risk for higher anxiety, eating disorders, some other mental health issues ... but they're just beginning to show some of the research on that and studying the siblings dealing with autism."

According to the CDC website, www. cdc.gov, "The largest increases over time were among Hispanic children (110 percent) and black children (91 percent). We suspect that some of this increase is due to greater awareness and better identification among these groups."

Associate Professor-Behavior Analysis at the University of North Texas, Dr. Shahla Ala'i- Rosales said one possible reason for the change in autism statistics for minorities is due to minorities being "under diagnosed" or being diagnosed at a later age in their childhood.

"Part of my research looks at ways that clinicians or behavior analysis's working with children and families can be more culturally responsive to families of many different backgrounds," Rosales said. "I don't know if the incidents have increased or if the disparities and diagnosis have been addressed. There's fairly strong literature that suggests that children from minority groups are diagnosed at a later age and they're not detected as easily, not because of the children, but because of the way our societies are structured, and that's actually true in many different areas in healthcare and behavioral health. There are disparities in access to services and it seems to be no different for children with autism."

Boys are more likely to be diagnosed with autism, the CDC said. Statistics show one in 54 boys will be diagnosed compared to one in 252 girls.

"We don't see many girls that have autism -- the majority of children that we see with autism here at UT Dallas Callier Center are boys," Bonifert said. "We do have some girls, but the percentage is much lower. Also of disorders, communication and developmental disorders, we see a higher prevalence in boys than girls."

The puzzle piece, Bonifert said has become a symbol for the disorder.

"Our kids that we see that have autism can be very much like a puzzle," she said. "Sometimes they can do some things very well that would seem very challenging, and then there are some simple things socially that you would think they would be able to do based on their intelligence or other abilities. Trying to figure them out is like putting together a puzzle; trying to discern what their strengths are and their challenging areas, and how we can work with them to help them progress in those areas of need."

There are many resources for parents who think their child maybe showing signs or symptoms of autism.

"That's the one good thing about living in this Metroplex is we have a lot of good resources and people that are available to help," Bonifert said. "I would recommend for any parent, if you find some symptoms of autism, to ask their doctor about that, their primary care doctor, their pediatrician, but don't stop there."

Bonifert also recommended visiting a speech pathologist if parents are concerned that their child may have autism or difficulty with their communication skills. She said a speech pathologist will look for any "red flags for autism" in the child's communication however, only a psychiatrist or psychologist can formally diagnose the child.

For parents who are concerned that their child may have autism, Bonifert said, early detection is recommended.

"The research shows us that the earlier we're able to intervene with children with autism the better their prognosis," Bonifert said. "So when parents first start noticing any symptoms or areas of concern, whether it be with communication or development, even if they're not sure if it's autism, if it's something else going on, they need to be asking questions and being proactive about that, because again the sooner we're able to see them for treatment, the better."

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