Helping Parents Understand Autism from the Inside Out
There is a lot of information about Autism on this page. We suggest you scroll through all of the content before clicking links to leave the page, or come back and continue reading where you left off. There is so much we want to share with you. We know you landed here because you have questions and we want to provide answers.
Autism Spectrum Disorder (ASD), as defined by the Diagnostic and Statistical Manual Fifth Edition of the American Psychiatric Association (DSM 5)*, is a neurodevelopmental disorder associated with symptoms that include "persistent deficits in social communication and social interaction across multiple contexts" and "restricted, repetitive patterns of behavior, interests, or activities." The DSM 5 gives examples of these two broad categorizes:
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive):
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
These symptoms result from underlying challenges in a child’s ability to take in the world through their senses, and to use their body and thoughts to respond to it. When these challenges are significant, they interfere with a child’s ability to grow and learn, and may lead to a diagnosis of autism.
Autism is Not a behavioral disorder
Many parents are told autism is a behavioral disorder based on challenges in behavior. While children with autism do display behaviors that can be confusing, concerning, and even disruptive, the basis of these behaviors is a neurodevelopmental difference. Understanding autism based on behaviors is superficial at best. The behavioral perspective has dominated the "airwaves" for the past 15 years and Applied Behavioral Analysis (ABA) has become the most known intervention for autism as a result. However, clinical practice and research are creating a paradigm shift to more fully understanding autism from a neurodevelopmental perspective rather than simply behaviorally. You can read about the differences in these perspectives on our ABA or DIR page.
When the challenges of autism are understood and appropriately addressed, and the autistic individual is accepted for who they are, their potential is no less than a neurotypical person. Too many professionals look at autism as something that needs to be controlled and contained. We look at autism as a neurodiversity that needs to be understood and the person needs to be supported in the right way. Once understood, then the person's potential can be realized. There are aspects of autism that are disabling and very challenging. Nevertheless, seeking to understand the neurodevelopmental differences in an effort to promote growth and development can help the autistic individual reach their potential while addressing the disabling aspects.
To learn more about autism and Floortime, the "DIR 101: An Introduction to DIR and Floortime" course is open to parents and professionals. It is a great way to get started understanding autism developmentally and not just behaviorally. Click here to learn more.
Autism Myths & Facts
Some think that children with autism cannot love with the same degree of warmth and intimacy as others. This is a false myth. Learn more about this myth and others in Autism Myths and Facts.
Virtual Parent ConsultatioN with A Floortime Expert
ICDL offers individualized virtual (live online) Floortime consultations for parents. This is for parents who are new to Floortime or parents who know about Floortime but are interested in learning about the DIR® Home Program or the Floortime Intensives at the International DIR® Institute. This is a unique opportunity to individually meet with a Floortime expert to gain insights and explore implementing Floortime strategies with your child. We will happily review videos of you interacting with your child to help you gain insights into his or her functional emotional development and to explore the Floortime parent coaching process so you can see how parent coaching and a Floortime program can help. Click here to see available times and to schedule an appointment (This is limited to one consultation per family and space is limited and available on a first-come first serve basis),
A DIR (pronounced with each letter as D-I-R) home program is a parent coaching program focused on helping parents strategically promote their child's development through joyful interactions and activities that help address the unique needs of their child(ren). A DIR home program is a comprehensive approach that is implemented by the caregivers and natural supports in the child's life. Parents and caregivers know their children better than anyone else and these secured attached relationships are instrumental in helping children develop and overcome challenges.
Autism and Related Conditions
Children with difficulties or differences in relating and communicating may fall within a broad spectrum of diagnoses or challenges that includes language processing disorders, attention disorders, sensory or regulatory disorders, and Autism Spectrum Disorder. These challenges often involve a number of different underlying difficulties, including:
Taking in sensations or information: the child may be under or over reactive to the information received through their senses of vision, hearing, touch, smell, taste and body awareness.
Processing information: the child may have difficulty understanding or organizing the sensory information they receives.
Planning or executing responses: the child may have trouble using their body or thoughts to respond to the information they have taken in.
A child may develop unusual or concerning behaviors in response to these difficulties or differences. For example, a child may be so under reactive to sensation that they spins in circles in an attempt to increase their sensory input; another child, overwhelmed by the confusing information their receiving about his world may withdraw, finding security in lining up their cars over and over again. Examples of behaviors parents may observe, by area of difficulty, are:
Relating and emotion
a tendency to avoid interaction
difficulty paying attention
limited eye contact with others
repetitive statements, play, or behaviors
failure to develop pretend play
intense fears about ordinary objects, activities or events
problems following simple directions
echolalia, or repeating what has just been said
difficulty making needs and desires known by gestures, words or play
Regulatory and sensory-motor
difficulty dealing with changes in environment
avoidance of hugs or light touch
does not point to show you things
“self-stimulatory” behaviors: spinning, hand flapping, head banging
A child receives a diagnosis based on observation of the behaviors outlined above. However, though a child may share a common diagnosis with other children, each has a unique pattern of development and functioning. Each child is unique in their processing of sensory and other information, and their motor planning (the ability to plan and carry out actions). Some children are over reactive to sensations, such as touch and sound, while others are under reactive. Some children have relatively strong auditory memories, and can memorize entire scripts; others have relatively strong visual memories. Some children are able to plan and carry out a number of actions in a row, such as going upstairs, getting a toy, and bringing it back down, while others are only able to carry out one action at a time, becoming very fragmented in their behavior.
In addition to differences in sensory processing and motor planning, children differ in their basic mastery of the foundations for relating, communicating, and thinking. Some children with ASD can form relationships and engage in two-way communication, while others appear to be very self-absorbed and aimless. Some children can focus and attend and engage with others, but can only participate in a back-and-forth flow of communication in a limited way, finding it difficult to use language meaningfully or connect ideas together for logical and reflective thinking. Other children show some mastery of the basics, and the ability to engage in more complex communication as well as the ability to create ideas and use them logically, but are very limited in their capacity to apply these abilities to a broad range of situations. Therefore, while some children may exhibit common symptoms that lead to a diagnosis of an autistic spectrum disorder, their individual patterns – and therefore their developmental journeys - are quite varied.
*American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.