MYTH: “Children with autistic spectrum disorders can not form loving relationships, or can not love with the same degree of warmth and intimacy as others.”
FACT:With a comprehensive, affect, relationship-based approach to intervention, children can learn to enjoy closeness, warmth and intimacy, and can love others very deeply. When autism was first identified as a disorder in the 1940’s, it was thought that the fundamental problem in autism was an inability to form intimate, warm relationships. This concept has persisted in all the subsequent definitions of autism. But clinical work with children diagnosed with ASD has shown that when we apply the DIR/Floortime approach, following the child’s lead to focus on the child’s natural pleasures and build interactions off the child’s pleasures, we see that the first element that responds is the sense of relatedness. This sense of relatedness, in the shared smiles, shared joy, shared pleasure and the deep sense of mutual belonging to one another, comes in relatively quickly with appropriate treatment.
Children with ASD can love as deeply as any other child, and many can love even more deeply than most because if they are in a proper program, we’re providing them a lot of warmth and love and a lot of interactive opportunities, even more than the average child gets. We believe that the primary challenge for children diagnosed with ASD is in the communication of their emotions, not in the experience or feeling of warmth and intimacy.
MYTH: “Children with autistic spectrum disorders can’t learn the fundamentals of relating, communicating and thinking, so the best you can do is try to teach them to change their behaviors.”
FACT: Many children with autistic spectrum disorders can learn the fundamentals of relating, communicating and thinking. This requires hard work with a comprehensive treatment approach that focuses on each child’s individual processing differences and on helping the child master the basic building blocks of relating, communicating and thinking. Helping children master these foundations is more effective at helping them move beyond symptoms or behaviors than focusing on symptoms alone. Our study of 200 children diagnosed with ASD and treated intensively with an approach that worked with their individual processing differences and focused on the fundamentals of relating, communicating and thinking (the DIR/Floortime approach) showed that a high percentage could master these foundations for healthy emotional and intellectual growth. (See Research on the DIR®/Floortime Approach)
Autistic spectrum disorders should be viewed as a dynamic, not a static, process. When we think of a static process, we think of something that is fixed, no matter what the environment, the context, or the circumstances. A child who has blue eyes is unlikely to change his blue eyes from one circumstance to another, between today and six months from now. We may perceive his blue eyes differently, depending on the lighting, but his blue eyes are likely to remain relatively stable. On the other hand, dynamic traits have to do with many of our feelings or emotions. They are changeable from one day to another and certainly changeable over months or years of time. The processes at the core of autistic spectrum disorders - the ability to relate with intimacy, the ability to exchange emotional gestures and signals, and the ability to use ideas meaningfully and with emotion - these are dynamic, not fixed, processes. These can and do change, more for some children than others, and more with treatment programs that are individualized to meet the child’s needs and focus on developing the core capacities of relating, communicating and thinking. In our systematic observations of 200 children having access to such an approach, almost all the children showed significant gains in their ability to relate with warmth and intimacy. A subgroup of children not only became warm and intimate, but also very verbal, empathetic and reflective.
MYTH: “Children who exhibit certain autistic-type behaviors, such as perseverating (e.g., lining up cars over and over again), self-stimulating (e.g., staring at a fan or spinning), or repeating words in a scripted way (e.g., echoing what someone else says) necessarily have an autistic spectrum disorder.”
FACT: These symptoms are secondary symptoms in autism and should not be used as the primary criteria for making a diagnosis. These symptoms are seen in a number of other kinds of developmental challenges, not simply autistic spectrum disorders. They are not specific to autism, and therefore do not characterize the disorder. A child who has difficulties with sensory processing, such as under-reactivity and over-reactivity to sensation, or with motor planning can become perseverative or self-stimulatory when overwhelmed or stressed.
The core, or primary components of autism involve difficulties in the areas of relating, communicating, and thinking. Parents and professionals should consider the following:
If these three components are not
present – the capacity for intimacy, the capacity for exchanging and
reciprocating different types of emotional gestures in a continuous way,
and the capacity for using emerging words or symbols meaningfully with
good emotional intent, then we should consider that the child may be
showing a form of an autistic spectrum disorder.
MYTH: “Children with autistic spectrum disorders cannot empathize with others; they do not have “theory of mind” capacities.”
When working with a relationship-based affect approach tailored to the
child’s individual differences, as a child’s language and cognitive
abilities improve, so do his theory of mind and his ability to empathize.
The children who have done very well following a DIR/Floortime
treatment program are very capable of high levels of theory of mind (the
ability to understand that other people have independent minds of their
own, which allows a child to think about other people’s perspectives,
as well as his own),and high levels of empathy. In fact, we have a
subgroup of children originally diagnosed with autistic spectrum
disorders, many of whom are described by parents and teachers as having
probably a little better empathy than their age peers who never had
developmental challenges in the first place. They are highly warm,
empathetic, caring individuals with friends and they are also doing well
academically. This is only for a subgroup, but it is a significant
subgroup. It shows what is possible with the proper program.
MYTH: “Autism is a fixed biological disorder based on a single genetic pattern.”
FACT: Current research suggests that there is no single cause of autism, but rather multiple causes working together in a cumulative way, and multiple paths leading to the disorder.
There are clearly genetic components and genetic susceptibility, but this genetic susceptibility may also make certain children more vulnerable to other risk factors. These risk factors may be cumulative, so that the presence of one may make a child more vulnerable to the effects of others later. Depending on the child’s particular susceptibility, these risk factors may be more or less destabilizing and lead to developmental problems.
The other piece of the
model has to do with multiple paths. For example, some children are
sensory over-reactive; some are sensory under-reactive; and others have
severe motor planning problems. And some children have combinations of
these challenges. These are all very different biological pathways that
may result in difficulties of relating and communicating.
In summary, current
research suggests a complex model for understanding the causes of
autism. It is likely that there are a number of different paths, each
with different cumulative risk factors associated with them, that lead
MYTH: “Children with autistic spectrum disorders can’t read the emotions of others.”
FACT: The research that has supported this assertion is open to major questions by more recent research.
A recent study suggested that children with ASD process facial
expressions in a different part of the brain than those without the
disorder. But Professor Morton Gernsbacher and colleagues at the
University of Wisconsin found that in the original study, the children
may not have been looking at the face, so that the reason they appeared
to not be processing the emotions of the face in the areas of the brain
that normally process emotion was because they weren’t actually looking
at the face. So in a replication of the original study, Gernsbacher et
al encouraged the individuals to actually look at the face, and their
finding was that then the individuals with autistic spectrum disorders
processed the emotions in the exact same areas of the brain that those
without ASD did.
The human face provides an enormous amount of information and can be overloading, especially for someone with sensory processing difficulties. Just like a shy person at a cocktail party may look down at your ankles or look away until they warm up, similarly children, or adults, who are sensory over-reactive may need a little warm-up period before they can look at your face. This doesn’t mean they can’t look at the face or that they process emotions from the face differently; it just means that they find it stressful to look at the face too quickly. When Gernsbacher and colleagues measured the emotional reactivity of these individuals, they found that when they did encourage them to look at the face, the physiological measurements suggested some degree of stress response. In conclusion, they found that the individuals were processing emotion in the same way as everyone else, but that they had a preference for not looking at the face because it was overloading and somewhat stressful.