Matt Freed, Post-Gazette Joshua Koscinski, 4, plays on a swing with his mother, Cara, at the Autism Center of Pittsburgh in McCandless earlier this month. Click photo for larger image.

Painted soothing colors and sprinkled with playthings that intrigue young curious minds, the Autism Center of Pittsburgh in McCandless held its grand opening this month as a single location for a broad range of services for children with autism and their families.

"Now we have a physical place where people can come in. Families can get guidance and support here," said Cindy Waeltermann, center director.

A suite of rooms at 135 Cumberland Road is designed as a welcoming spot for families often overburdened with concerns when their children are first diagnosed with the complex disorder. It appears in a broad spectrum of symptoms that can include repetitive behaviors such as head-banging, avoiding physical or eye contact with others and communicating with gestures rather than words.

A part of AutismLink, a nonprofit organization that started here almost seven years ago, the center and its busy Web site (247,000 hits last month) are run by Ms. Waeltermann.

She's the mother of two sons, ages 7 and 9, both diagnosed with autism. She knows families' needs for psychological evaluations, speech and occupational therapy, help with applying for funds and services, and fellowship. For that, the group continues its practice of taking children on outings together. Fishing trips, trolley museum visits and holiday gatherings are free for families. Funding for the center comes from donations and sales at the online store.

There is also a branch of the Autism Center located in the AVID Learning Center in New Kensington, offering speech and occupational therapy services and education advocacy.

Therapist and a mom

Another mom, Cara Koscinski, who has a 4-year-old with autism, Joshua, is also an integral part of the operation. She and Amy Morgan own Aspire Pediatric Therapy, which offers speech and occupational therapy for children, including services at the Autism Center.

Ms. Koscinski decorated a therapy room with blue walls and wispy clouds, green trees and colorful birds. Hanging from the ceiling is a platform swing that can move according to whatever movement calms a child. It can be specific: back and forth, left and right. Children with autism can repeat endlessly whatever movement they like.

Big pillows line the walls, which comes in handy, Ms. Koscinski said, when children tire of sitting at a table doing a task during therapy. One child, she said, spent three minutes at the table, got up to crash into the pillows for a minute, then came back to the table ready to work.

At a recent visit, her son Joshua was urged to try the swing, but instead he became absorbed in spelling a wide variety of words with multicolored letters: his full name, "lollipop" and "elevator." The last one's of particular interest, because one of Joshua's favorite repetitive behaviors, called "stims" by the moms (for stimulation), is playing a game of using his hands as elevator doors.

Getting a diagnosis

It's around Joshua's age that children with autism are often diagnosed. Reducing considerably the possible wait of four months for an appointment at Children's Hospital, Ms. Waeltermann said, one of three staff psychologists can evaluate children at the Autism Center.

After that diagnosis, the center can then steer families to financial assistance, medical experts, therapists and social services.

After Ms. Koscinski's child was diagnosed, she went to all of his therapy appointments.

"I decided I could help," she said. With more than eight years of experience as a therapist, she's got the skills. Her staff encourages parents to get involved and join their child's therapy at least once a week.

"It gives them a clear idea to take home," she said. For example, a child with trouble keeping saliva in his or her mouth -- trouble with "oral motor" skills -- will get a suggested home activity of blowing bubbles with a straw in a cup of water. That is known as an organizing and calming activity, much needed by autistic children.

"You see a lot of disorganized thinking," Ms. Koscinski said.

Ms. Waeltermann explained how she understands it: "They have an immature nervous system; the nerve endings constantly need to be stimulated ... [for the child] to know where they are in space. They're very hyper.

"If their thoughts are organized, they can attend to a task," she said, such as eating a meal or doing homework.

Many challenges

The challenge of having autism understood is daunting, the center director said. Since children with autism don't appear any different, she said, other people may think they're misbehaving instead of having difficulties due to autism.

		Learn more For more information about the Autism Center of Pittsburgh, see www.autismcenterofpittsburgh.com. Its main office is at 135 Cumberland Road, Suite 105, Pittsburgh 15237; phone, 412-364-1886 or 1-866-PUZZLE-2 (toll-free); fax, 412-364-7120. The Allegheny Valley branch is at AVID Learning Center, 4 Kensington Square, Suite A, New Kensington 15068; phone, 724-594-1090. For AutismLink on the Web: www.autismlink.com. To reach the Alliance for Infants and Toddlers: The Hough Building, 2801 Custer Ave., Pittsburgh 15227; phone, 412-885-6000. To reach DART at the Allegheny Intermediate Unit, call 412-394-5736. Pittsburgh Public Schools also provides Early Intervention services for eligible children ages 3-5. The Early Intervention Office can be reached at 412-323-3960.

"There are lots of misperceptions about autism, such a spectrum. One kid is so bright; some think Einstein was autistic. On the other hand, a kid with a low IQ is introverted so much he doesn't interact with other people ... I think that's why it's so misunderstood."

Ms. Koscinski said when the autistic child is not paying attention, that's because it's a "nonpreferred" task. Most are very interested in something, she said, and that can be used as a reward for doing the less pleasing task.

Joshua's elevator interest means he is allowed to play the game for a half-hour after coming home from school to relax.

Ms. Koscinski's family has pulled together to allow her to care for her children as well as work as a therapist. Her parents, Richard and Patti Baker, retired and moved into her home with her husband, Brant. The Bakers provide much-needed child care.

"We're there 24/7. We help with baby sitting, grocery shopping, cooking. Whenever she says, 'I need you,' we go," Richard Baker said. "It takes four adults to take care of kids like this."

Another adult, Joshua's therapeutic staff support person, Lynn Berneburg, offers additional guidance for Joshua. She said his spelling helps him express himself, since his speech skills are limited.

"I work with him on communication and compliance with difficult tasks. We do sign language; he knows 35 words and the alphabet," she said, adding that pictures help him understand what his daily schedule will be.

"Today we had trouble with compliance at home," she said. They were working on "mirror time" practice with sounds and words, where he has to imitate Ms. Berneburg's mouth. To encourage Joshua to use his words, they also use an assistive communication device -- they call it his "talkbox" -- that he can use to express the words he is trying to say.

Watching over young Joshua, Mr. Baker said, requires a lot of driving around. "He always has therapy; he has school twice a week," adding that Joshua has food allergies to watch out for as well.

"What do you do if you don't have parents around here?" Ms. Waeltermann asked. That afternoon a single mom with an autistic child called her for help.

"We get it. We understand," she said. "Your child gets a diagnosis, we'll help you fill out the paperwork and figure out what to do next."

Education choices

The sequence of learning options begins for children diagnosed up to age 3, who can receive early intervention services through the Alliance for Infants and Toddlers. For ages 3-5, the DART program through the Allegheny Intermediate Unit offers services and early childhood education classes. From that point on, schools must offer individual education plans for children with special education needs.

Right now, the center's looking for high school students interested in earning community service credits to help parents who need a break. They would watch the children at the center, overseen by therapists.

What does Ms. Waeltermann hope will happen in the future for families with autism?

"I would hope for more acceptance. These kids are so bright ... they're often overlooked because of their disability."

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Correction/Clarification: (Published Dec. 2, 2006) In this story about the new Autism Center of Pittsburgh in Nov. 29, 2006 editions, it was not noted that Pittsburgh Public Schools also provides Early Intervention services for eligible children ages 3-5. The Early Intervention Office can be reached at 412-323-3960.