Autism and Therapy

For those of you who are not so familiar with autism, or need an update or reminder about this condition, here is a little review of what we mean by autism. First of all, autism is a spectrum disorder, which means that even though individuals with autism share certain characteristics that define all of them with autism, those at the high end of the spectrum tend to have better cognitive capability, better language skills, better academic skills and a better ability to function independently.  These are the individuals who are often called high functioning or identified as having Asperger’s.

Those individuals at the low end of the spectrum typically have poor language skills, and some are even non-verbal. These individuals are often characterized as being low functioning, and appear to have poor cognitive abilities. They usually have poor academic skills, and can’t function independently, even as adults.

Although behavior is often problematic with those on the autism spectrum, there is a very direct correlation between poor language/communication capabilities and out of control behavior.  I learned early on that behavior IS communication, and if it’s your only means to communicate(i.e meltdowns and tantrums to express yourself), then sometimes it will be hard to control. And this is not to say that only low-functioning individuals on the spectrum have meltdowns, because most people with autism have them, usually more frequently when they are young and lack the language to express themselves.  As individuals on the spectrum get older and are able to understand what triggers their meltdowns and then learn to control them, their meltdowns are less intense and less frequent. Learning to anticipate and self-calm is key.

I’ve worked for years with students who were considered low functioning with autism, and the first thing they all need is an effective means to communicate. That often means an individualized communication system(AAC-augmentative and alternative communication) such as a picture exchange system, picture boards and voice out-put devices. I’ll get into all of that later.

Getting back to the spectrum and autistic characteristics, individuals with autism can exhibit a number of conditions: struggles with language and communication, social interaction difficulties, poor problem-solving and ability to predict, poor flexibility for changes, severe anxiety and depression, severe sensory sensitivities, seizure disorders, digestive issues and allergies, behavior disorders, sleep disorders, ADD/ADHD, OCD, learning disability, fine and gross motor difficulties; just to name a few. You can also have autism with other neurological conditions and syndromes. I’ve worked with kids who have autism and Down Syndrome, as well as Fragile X Syndrome. Autism is not a stand alone condition, and when you consider that autism is a neurological disorder, that’s not surprising.

So, given all that, and especially considering the fact that autism is a spectrum disorder, there is no way one approach to therapy will work for everyone with autism.  In fact, I find I need to individualize therapy approaches all the time and even change therapy approaches with an individual as they grow and change. When I talk later about therapy approaches and materials, I will explain the autism characteristics and capabilities each approach is best suited for. A good therapy approach is all about using their strengths to help them learn. And believe me, they all have individual strengths we can work with.

I typically dislike talking about autism definitions and characteristics, but I feel it’s important to have a brief perspective of autism before approaching therapy for this incredibly variable condition.

My next blog will talk about kids with autism and going back to school: what teachers need to know!

All my best to all you parents, therapists, teachers and individuals with autism! And let me know if you have any questions. Hang in there!



Thoughts on autism therapy

When it comes to autism, probably the questions I hate the most are: What is autism and what causes it? Both are questions with complicated and in some cases differing answers.  When I’m asked either of those questions my response is usually, ‘How much time do you have?’, because in my opinion neither question can be answered simply and certainly not in a few sentences. At least not if you want a comprehensive answer opposed to something you could read from a dictionary.

The one thing I can address and the purpose of this blog is autism therapy. There is much written about autism therapy and you can find any number of different therapy approaches to autism to target behavior, sensory integration, feeding, academics, fine and gross motor, self-care, and of course language and communication, which is the approach I will take in my blog.  As a speech-language pathologist with 30  years experience working with students with autism from pre-school to adults, I know, have used, and have been certified in many different therapy approaches.  I will address some of those needs (behavior, sensory integration, self-help, academics, etc.) while using a language/communication approach to therapy.

Problem solving specific situations for individuals is what I do best. There are many approaches to autism therapy and no one approach is appropriate for all students with autism.  In fact, I typically use a combination of approaches to address an individual student’s needs and capabilities.  I use all my accumulated knowledge and many years of experience to find the best solution for a student or adult with autism.  So what are my favorite tools?

I’m a huge fan of visual supports, of course, and have used abstract pictures and well as photos and words in a variety of communication boards, Picture Exchange Communication systems(PECS), books and stories, iPad use and computers. I feel visuals are a must, especially when using a communication system or introducing a  new skill or concept.

I’m a firm believer in using Social Stories.  Social Stories(invented and named by Carol Gray) have been around for a long time and the reason they are still used is because they work.  I’ve written hundreds of Social Stories over the years for any age or capability from very young children up to and including adolescents and adults with autism. And it doesn’t matter what the cognitive or language level of the individual is; it’s simply a matter of constructing the Social Story to the level of the individual and keeping the story specific and focused.  In fact, I’m often asked to write a Social Story for individuals with autism, usually by teachers, therapists and parents.  That’s part of the problem- solving service I give to others, and I’m happy to do it if it can help a situation.

I love music therapy and a music approach with young students, and have used that approach for years.  I find most kids with autism love music, and coupled with visuals, it’s a great ways to allow them to enjoy and participate in stories and songs. I’ve had many non-verbal students who can’t easily or ever generate verbal language, yet they can sing words to favorite songs.

A game approach to learning and reinforcing new skills is a must.  It’s a great way to engage students of any age. Group games encourage turn-taking, listening and participating in enjoyable activities with  peers, from simple games like “Duck, Duck, Goose” to board games. I’ve invented many games over the years to address any number of skills and learning activities, and as soon as my students think they are playing a game their attitude changes and they are all about it! I probably have a game for every concept, topic, and skill I have ever taught a student with autism. Games are a great way to reinforce newly learned skills and check to see what the students have retained.

Speaking of games, I’ve used a Floortime(DIR) approach to teaching or encouraging play and interactive skills, as well as more structured approaches to teaching play. As with all things, my approach always depends on the student/client I’m working with. Play is so important to social interaction and communication skills and I always recommend it no matter the age or capability of an individual.

When it comes to academics I’m all about modification. I can modify almost anything to fit the needs of an individual student. I can take an entire section of curriculum and re-word it with appropriate visuals to help the student comprehend the information. I can re-write worksheets, assignments and tests on most school subject matter.

Finally, I’m probably best known to the world for my ability to teach self-help skills, puberty, personal safety skills, and relationship skills from my two books: Taking Care of Myself( for students 3-15) and Taking Care of Myself 2 (for teens and young adults with autism).  Both are published by Future Horizons, Inc.

So, what do I want to talk about in my blog?  Well, that’s basically up to those of you who read this blog and have questions or have need of my expertise.  I typically depend on what people need me to talk about.  If I don’t get any response from anyone reading my blog, I might choose my own topic; one I think might be useful to parents or instructors serving the autism population.  I also speak directly to young adults or teens with autism, if any have a need for help with a situation.

I hope to give examples of worksheets, games, modifications of information, Social Stories, and perhaps suggestions for visual supports and layouts of visuals supports for individual or group needs.  I only covered a fraction of what I can do and how I do it.  And so far I’ve only presented my ideas and therapy practices.  If you want something more concrete, let me know.  I hope to provide some great websites and other information as I continue, as well.

Let me know what you think and how I can make this blog helpful to you. You can leave a reply or contact me at  I look forward to hearing from my readers!