What is Autism

 Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by challenges with social interaction, communication, and behavior. It is called a “spectrum” disorder because it affects individuals differently and to varying degrees.  Autism’s most noticeable signs often appear in early childhood, typically within the first two years of life. However, the severity and combination of symptoms vary widely among individuals, as well as the same individual across their life span. Common characteristics include difficulties with communication in the social context (Pragmatics) including, but not limited to impaired understanding of other's verbal and nonverbal communication, emotional dysregulation, difficulty maintaining relationships and limited and/or repetitive patterns of behavior or interests. Other communication challenges range from delayed speech development to the inability to use or understand language. The causes of autism are not fully understood, but research indicates that both genetic and environmental factors play significant roles. Each individual has their own clinical picture, thus requiring  tailored assessment  and intervention.

Speech is how we say sounds and words. People with speech problems may

not say sounds clearly,

have a hoarse or raspy voice,

repeat sounds or pause when speaking, and manifest stuttering

A speech disorder is identified when a child does not articulate developmental sounds that are expected for their age. A delay could be as simple as misarticulating sounds, or, with the more affected child, using unintelligible sounds as words. 

Language involves the words we use to share ideas and get what we want. A person with a language disorder may have problems understanding, talking, reading and/or

writing.

A receptive Language Delay is manifested when a person does not understand oral and/or written language. Auditory Processing weaknesses are often the culprit for impairment in receptive language usage. Deficits include, but are not limited to, when the individual does not process information at the normal speed, the same way, with difficulty understanding with conflictual background sounds. 

A receptive language delay can also  occur when a person does not understand the words spoken to him/her because of poor understanding of the language used.  

  Communication modalities include verbal speech, gestures and nonverbal communication, and augmentative/alternative communication, including sign language, AAC devices, and/or Picture Exchange Communication System (PECS)

 At NNR verbal speech will always be addressed in each session, and often paired with the most functional system at that time for that child. 

An AAC device allows a child to communicate with others when speech is difficult for them. Various AAC devices  offer many other benefits, like improving receptive language skills and encouraging verbal speech production.

 The Picture Exchange Communication System (PECS) is a good resource, which can benefit some  persons on Autism Spectrum.

Sign Language provides environmental versatility and quick learning for most children. At NNR, we often pair signs with other forms of communication. 

At three months, your baby has already begun to understand your connection with them, and begins to show early signs of their own expressive communication, like: Coos and Gurgles-These sounds aren’t just cute; they’re actually the precursors to speech, indicating that your baby is starting to explore their vocal abilities. Responsive Smiles-Smiling back at you or in response to familiar voices shows social engagement.

 Startling at Loud Noises-Reacting to sounds demonstrates that your baby’s hearing is developing appropriately, which is an important aspect of speech and language skills.

By six months, your baby’s communication skills become more noticeable. You might notice the following: 

Babbling-Babbling refers to repetitive consonant sounds like “ba-ba” or “da-da.” These sounds will eventually develop into words.

Responding to Sounds- When your baby turns their head toward sounds, it indicates they are beginning to understand their environment.

Name Recognition-Your baby will start recognizing and responding to their own name.

By the first year your child will start to use simple words like “mama” or “dada.” 

Simple Gestures-Your child’s non-verbal communication skills will develop alongside their verbal skills. Gestures might include waving goodbye or shaking their head. Following Simple Commands-Responding to simple instructions like “come here” shows your child’s growing comprehension skills.

A typical eighteen-month-old will know around 20 words and can start combining them into simple phrases like “more juice.”

Pointing to Objects-When your child can point to objects or pictures when named, it shows an understanding of labels.

Imitating Words- Children learn through imitation, so when your child mimics words and sounds they hear around them, know they are just growing their vocabulary.

By 2 years  your child will start combining two words to form simple sentences, such as “Want cookie. 

”Following Two-Step Instructions- As your child’s comprehension skills develop, they’ll be able to understand more complex directions, such as “Pick up your toy and give it to me.”

Naming Familiar Objects-Another sign of an expanding vocabulary is when children can name common items and people.

Please Note

It is extremely important to understand that  there is significant individual variability among children of different ages,  which may not necessarily indicate the presence of ASD or other neurodevelopmental conditions. This is why treatment interventions need to be individually tailored to the specific pattern of deficits each child presents.  

  Sensory Processing Disorder (SPD) is a complex neurological condition that affects how the brain processes sensory information. Children with SPD may have difficulty managing and responding to the sensory stimuli they encounter in their daily environment, such as touch, sound, taste, sight, and movement. This can lead to challenges in everyday tasks, including engaging in typical childhood activities. When SPD occurs in children with autism, it can particularly compound their difficulties, as sensory issues are often already a part of the autistic experience.

Children with Autism and SPD may exhibit hypersensitivity or hyposensitivity to sensory inputs. Those who are hypersensitive might find certain sensory experiences overwhelming, leading to sensory overload. They may react strongly to sounds that are barely noticeable to others, find certain clothing textures unbearable, or be unable to tolerate bright lights or specific smells. This sensory overload can result in "meltdowns", extreme anxiety, or avoidance behaviors.

Conversely, hypo-sensitive children seek out sensory stimulation. They might have a high tolerance for pain, enjoy spinning or other repetitive movements, or have a fascination with certain textures or sounds. These sensory-seeking behaviors can pose challenges in terms of safety and social appropriateness.

In both scenarios, the sensory processing issues can significantly impact the child’s ability to navigate social situations, leading to difficulties in making friends or participating in group activities. It can also affect their ability to learn in traditional educational environments.

By recognizing and accommodating their unique sensory needs, our team can help children with autism and SPD engage more fully with the world around them.

  Play therapy is based on the premise that children learn best in their natural environment of a play setting. Within this environment the child is free to be curious and explore. Engagement begins at the common ground of interactive play, as they are more willing to respond to established communication goals. Play skills coincide with developmental and cognitive skills. It sets the stage for communication, social skills, problem solving, decision making, resolving conflicts and self advocacy. 

There are six stages of social play beginning at birth.

1. UNOCCUPIED PLAY (Birth – 3 months) At this stage, babies make a lot of random movements with their arms, legs, hands, and feet. This is actually the beginning of play.

2. SOLITARY PLAY (Birth – 2 years) At this stage, children start to play on their own. They are not quite ready to play with other children just yet.

3. SPECTATOR/ONLOOKER PLAY (2 years) As the term suggests, a child at this stage just looks/watches other children play but does not join or play with them. They may also have many questions of what the other children are doing, etc.

4. PARALLEL PLAY (2+ years) Parallel play is when children begin to play side-by-side but are not playing with each other. It may seem that they have no interaction but they are paying attention to each other, sometimes even copying one another. This is the beginning of the desire to be with other children.

5. ASSOCIATIVE PLAY (3-4 years) Children at this stage start to interact with other with whom they are playing. They start asking questions and talk about the toys and what they are making. This is the beginning of understanding how to get along with others.

6. SOCIAL/COOPERATIVE PLAY (4+ years) Here you will see the beginning of teamwork. Children at this stage play with others for a common purpose. Thus,  they are beginning to socialize with other children. 

 Neurodivergence identifies the way information is gleaned, and interpreted  (thinking, learning, feeling and processing) that is outside societal expectations including, but not limited to Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Dyslexia, Dyspraxia, and Obsessive Compulsive disorder. When these unique challenges are understood, children can develop a sense of belonging and acceptance, leading  to improved social skills and emotional regulation. 

NNR-ASD Center considers neurodiversity as an important parameter, and focus is placed on having the child develop  skills congruent with necessary life skills.