Autism, Disability Justice, Down syndrome, Parenting, Therapy

Regarding Applied Behavioral Analysis (ABA) Therapy

I have been reluctant to write anything about ABA. Often times when I talk about my position, I am accused of being “judgy” or “mean” to other parents. More importantly, people who have experienced ABA, practiced it themselves, and then chosen to stop have already written and created such excellent pieces about it that it felt like I’d be echoing them for my own benefit.
Every couple months, a friend or acquaintance privately reaches out to ask me about ABA and why I say such negative things about it on social media. Often times their child is in ABA therapy and seems to be playing and having fun, so how harmful could it be anyway? Rather than recreating that conversation over and over and re-living the fear of being friend-dumped each time, I want to lay out what it is I find so abhorrent about Applied Behavioral Analysis “therapy” so that I can point to it the next time someone asks. Friend-dump me quietly, if you must.
I try really hard to remain diplomatic about issues of disability justice– not because I have to or even because I should but in the hopes that because I usually have the capacity to, it may be better received. This piece is not particularly diplomatic. For a much more diplomatic post on this subject, please visit Unstrange Mind. For a calm and reasoned takedown, please see Michelle Dawson’s piece entitled, The Misbehavior of Behaviorists: Ethical Challenges to the Autism-ABA Industry.
There was recently an article on HuffPost entitled, “I Don’t Know How to Explain To You That You Should Care About Other People,” and when it comes to ABA sometimes I feel like saying, “I don’t know how to explain to you that training children like dogs is wrong.” I realize how off-putting that probably sounds, but it’s my initial reaction every time I am asked about why I have a negative view of ABA.
The principle behind Applied Behavioral Analysis (ABA) therapy is that you can train a person by using positive and negative reinforcement. There are a lot of ways to put an academic shine on that, but O. Ivar Lovaas, the founder of ABA, once wrote:

With responsibility, the developmentally disabled individual takes on dignity and acquires certain basic rights as a person. No one has the right to be taken care of, no matter how ret*rded he is. So, put your child to work; his work is to learn.”
Wow. Let’s unpack that for a moment. Developmentally disabled individuals do not have dignity or basic human rights until they perform to a certain standard. Further, they do not intrinsically have the right to be taken care of. (Side note: please check out Interdependence theory!) This is a part of the underlying philosophy associated with this practice. Disabled people need to earn their right to exist by performing less disabled, and ABA will train them to perform as a less disabled person. At its core, ABA is rooted in the hatred and denial of the humanity of disabled people. Even with the most generous interpretation, it is about pathologizing and rejecting disabled ways of being and holding up non-disabled ways of being as the only right way and the only way to be correctly human.
It doesn’t matter that it may seem like fun, it doesn’t matter that your “Behavior Technician” seems like a really nice person. It doesn’t matter that you read a study that ABA “works,” because what it “works” at is wrong. It is compliance training at its core.
Of all the demographics, one of the groups most at risk of experiencing physical, sexual, emotional, verbal, institutional, financial, and educational abuse is the demographic of people with developmental disabilities. You can double, triple, and quadruple those risks according to how many other marginalized groups they fall in.
In their piece “I Abused Children for a Living,” a former ABA therapist writes, The ‘evidence’ that they love to cite is based on torture. Would you comply with demands if tortured enough? Probably. Does that make it effective? Well, I guess that depends on what your goals are. If your goal is to gain compliance (which is the goal of ABA) then yeah I guess it’s effective at that goal, but that’s a pretty shitty goal to have, and at what cost?”
Even if we stop here, this alone makes ABA enabling of abuse against people with developmental disabilities because training compliance facilitates abuse. Yes, even compliance about putting toys away and yes, even compliance with not banging your head on the wall and yes, compliance about looking into your mother’s face when she talks. Teaching people to listen without question is grooming them for abuse, and grooming is itself abuse.
Our culture has a way of seeing words like “racist” or “abuse” as insults rather than objective realities and therefore separating them from the regular, everyday people who harm others and making it seem as if only villains in masks (hoods?) and obvious monsters can be perpetrators. That cultural practice isn’t a reflection of reality. Some things are objectively harmful and need to be recognized as such. ABA, no matter how normalized, is one of those things, and calling out injustices for what they are is a crucial part of the road to justice.
ABA uses “rewards” and “aversives” to manipulate behavior, which can remove intrinsic motivation including for learning and socializing. The lack of a reward is itself a punishment, as is the requirement to perform a task that may be painful, scary, or otherwise unbearable in order to receive it. Author and educator Alfie Kohn has written extensively about how rewards and punishments are harmful to children and promoted the concept of “Unconditional Parenting,” saying, “How we feel about our kids isn’t as important as how they experience those feelings and how they regard the way we treat them.”
Parents and therapists often use an ends-justify-the-means approach to therapy for their disabled children, believing that acquiring skills is the most important thing and that it is worth the child having negative experiences if it means that they will have a “better life.” In this context, what is considered better is what is most “normal,” or non-disabled. Survivors of ABA have come forward to say that they have Post Traumatic Stress Disorder (PTSD) and Complex-PTSD (C-PTSD) as a result of their experiences in ABA. This is not an acceptable trade-off. Suicide is dramatically shortening the life-expectancy of autistic people and autistic people are saying it is because they are not being accepted.
Autistic writer Max Sparrow, “All those years of ABA therapy will have taught them that they are fundamentally wrong and broken; that they are required to do everything authority demands of them (whether it’s right or wrong for them); that they are always the one at fault when anything social goes wrong; that they get love, praise, and their basic survival needs met so long as they can hide any trace of autism from others; that what they want doesn’t matter.”
People often say that their child has fun at ABA therapy, or that “their” ABA isn’t “like that.” Insurance and Medicaid cover ABA and not play therapy and no doubt there are therapists using other types of therapy and billing for ABA. The problem is that this perpetuates the myth that ABA is acceptable and helpful, so it really doesn’t help anyone. Similarly to how ABA sacrifices long-term mental health for short-term compliance goals, insurance fraud gives a small group of kids a better experience at the expense of the long-term realities for all children with developmental disabilities.
With the coverage of up to 40 hours a week of therapy for a growing number of children, ABA has become a cash cow for what I not-so-affectionately call the Disability Industrial Complex. (Anyone whose child has ever needed medical equipment or therapy knows exactly what I mean. $3500 for a stroller???) ABA vendors are raking it in, and even with more and more kids being diagnosed with autism, they are looking for other demographics to target. Enter children with Down syndrome. The latest and most certainly NOT great trend in Down syndrome parenting is ABA therapy. This is not about supporting people with Down syndrome, it’s about using them to make more money by preying on parents’ fears.

ABA has a predatory approach to parents. The message is that ‘if you don’t work with an ABA provider, your child has no hope,” says Ari Ne’eman president of the Autism Self-Advocacy Network. This message is now being sold to parents of children with Down syndrome, particularly under the guise that it will help them behave in such a way as to be more successfully included in school. The onus for inclusion is on the district, the school, the faculty, and the other families– it should never be on the disabled child. Children with Down syndrome have a right to be included unconditionally and all of the time.
Parents believe ABA will give their child an advantage in a world that is unaccepting because of a reasonable fear for their children. Another former ABA therapist writes, “I thought that because I cared about the kids’ well-being, because I had a strong desire to help them, everything I did must therefore be in their best interest. In my mind, it gave me a special immunity to making mistakes. Caring meant there was no way I could be hurting them. I now realize how dangerous this idea really is. I’ve hurt many people I care deeply about. Just because you care about someone or have good intentions does not guarantee you’re doing the best thing for them.”
For all the material created by adult autistics about their experiences, we have a tiny fraction of that amount from people with Down syndrome reflecting on their own experiences and none that I know of is related to the therapies they’ve done. We need to be asking ourselves the tough questions as parents of disabled children: What is my child’s experience of this intervention? What is the long-term lesson of this intervention? What else is being learned with this intervention? Just because parents have good intentions for their child does not mean they are not harming them.
I want to be able to ask people, “Would you do this with your typically developing child?” but our culture is so manipulative of children, and so demanding that their behavior mold itself to our convenience. We use sticker charts and timeouts and take away devices to cajole and force our kids to bend to our convenience and schedule. Behaviorism is an entrenched part of our culture, but not a necessary part. ABA and ABA-inspired practices might seem normal to people in part because our mainstream child-rearing practices carry similar underlying principles– that children are lesser and should be subservient to earn their place.

Amy Sequenzia writes, “I had some ABA when I was young, and I ‘flunked.’ I want to say, I am proud of this ‘F’ in my life. Of course, the ‘experts’ explanation for having failed to make me into a ‘tidy,’ appropriate,’ ‘good girl,’ obedient and compliant Autistic was my severe impairment, my extreme low IQ, my inability to learn or, as Lovaas would probably have said (and something a doctor actually said), my lack of human dignity. I prefer my own assessment: if you want something from me, if you want me to do something, respect who I am, respect my way of doing things, listen to me and allow me to disagree and to find my own way. ABA rejects all of this and that’s why I failed it.”
As a parent, I have been asked for almost 16 years now how I get my child(ren) to comply without forcing, rewarding, or disciplining them*. I don’t really know how to explain to people that children are deserving of the same level of respect and autonomy as everyone else from birth, but I do know that it’s true. I don’t know how to explain that children with disabilities have the same rights and feelings as every other person, but I know that’s true too.
“We can best help children learn, not by deciding what we think they should learn and thinking of ingenious ways to teach it to them, but by making the world, as far as we can, accessible to them, paying serious attention to what they do, answering their questions — if they have any — and helping them explore the things they are most interested in.”–John Holt

*I’m still learning and trying and growing and messing up, that’s how!

Autism, Disability Justice

We Need to Start Recognizing Ableism as the Serious Issue It Is|Guest Post

Guest post by Persephone Smith-Donohoe, 14 year old disability advocate, musician, martial artist, dancer, and big sister. This essay was originally written as an 8th grade assignment and was voted Best Presentation by Persephone’s classmates and went on to become an inspiring speech presented to students and teachers.

     On November 3rd, 2014, Jillian McCabe took her 6 year old son, London, to get ice cream. After, she took him to the middle of the Yaquina Bay Bridge. She picked him up, then put him back down again. Then, she picked him back up, said “sorry,” and threw him over the bridge. She walked back to her car, called 911 and admitted to killing London. Journal entries conclude that she had been planning the murder for weeks. The reason she did it: because she felt burdened by having to take care of an autistic child. Many people defended  her saying “well she was put under so much stress taking care of a child with ‘special needs.’” September 20th, 2016, North Carolina, Keith Lamont Scott was a black disabled man who was sitting in his car, reading while waiting for his son to come home when he was shot and killed by the police. The officer who shot him faced no charges. Joseph Nathaniel Weber was a non-speaking autistic man who was confused and scared as he tried to find protection in a home for disabled people when he was shot and killed by Kansas police on sight. Mitchell Wilson, age 11, was bullied for having muscular dystrophy to the point where he suffocated himself to death. Disabled people’s lives are not valued in our society. Many parents have beaten and murdered their children for the sole reason that they are disabled. And nearly half of the people killed by the police in the U.S. are disabled. Disabled people are constantly persecuted and discriminated against every day. Our history is filled with the bloodshed of our disabled ancestors. Their stories of oppression and mistreatment have been overlooked and ignored. Our everyday language is packed with slurs against people with disabilities, and the media continues to perpetuate it. We need to start recognizing ableism as the serious issue that it is.

Ableism is not a new or uncommon thing. It has been happening throughout all of history, but still we overlook the suffering of disabled people. Just by living in 2017, you probably know at least a little bit about racism, sexism, homophobia, and other oppressed minorities, but the majority of people have never even heard of ableism. Ableism is the discrimination against disabled people and though it’s overwhelmingly common, it goes unrecognized constantly. More than 7 out of 10 people with disabilities report being abused and yet still people pretend like it doesn’t exist. Disabled people aren’t getting support or help because we aren’t giving them the safe space to do so. Because when they do speak out, we shut them down and belittle them. But they’re probably just making it up or exaggerating because they’re ¨retarded,¨ right? During the Holocaust, Hitler made the T4 program which made it so that people with disabilities would be murdered because he wanted the “master race.” The T4 program ended up killing approximately 275,000 people with disabilities. This program was inspired by the American Eugenics Movement, which had the same idea of killing disabled people to “eliminate” any traits they perceived as “negative” from the human race. Even now scientists are trying to make technology to “fix” disabilities before the child is even born. Businesses are legally allowed to pay their disabled employees just pennies an hour and Goodwill takes advantage of this law all of the time. We can’t keep our backs turned to this injustice anymore. The longer we continue to ignore and silence the disabled community, the worse ableism will become, and the more innocent people will be harmed and killed.

Throughout this history, our language has become loaded with derogatory words and phrases that target disabled people. The English language has hundreds of ableist slurs that are used every day by ignorant people who know nothing of the harm they are inflicting on the disabled community. When people find out that their words are discriminatory, they are defensive and continue to say the words after they know its true meaning. Because of this, many disabled people are hurt for trying to stand up to oppression.  A lot of the word’s meanings have changed as well, which leads people to believe it’s okay to use them as slurs. It’s not. “Mental retardation” used to be considered the preferred term when referring to intellectual disabilities. The term translates from Latin to  “slow,” so it was used in the medical field to mean that the disabled person would meet their milestones at a slower pace. However, this word stopped being the medical term when people started using it as a slur. Similarly to the R-word, words like dumb and lame were used differently as well. Dumb means unable to speak and lame means unable to walk. Individuals with Down syndrome, a genetic difference caused by the appearance of a third 21st chromosome, would be diagnosed as a “Mongoloid Idiots.” “Duh” was used to mock the way people with low muscle tone talk. Words like “imbecile,” “moron,” “spaz,” “derp,” “cretin,” and “feeble-minded” have similar histories.  By using these words casually, it diminishes its history and causes pain to those around you who might have been or known someone who would have been considered “mentally retarded” or any of the other words listed.

The media is also to blame for the widespread acceptance of ableism. Many media outlets perpetuate ableism by using ableist language, turning disabled people into comedy and using disabled people as inspiration or plot devices. Most TV shows and movies have that one character that’s a little different from the others and generally the butt of many jokes. Some examples are Patrick from Spongebob, Stimpy from Ren and Stimpy, Karen from mean girls, and many other characters portrayed as “stupid” for comedic effect. Some characters have specific disabilities are made fun of throughout the film for entertainment. Take Gerald the seal from Finding Dory as an example. Then there are the characters that have physical disabilities who are “overcoming” or are turned into villains with a grudge against the person who caused their disability. Many TV shows and movies do a good job portraying disabled characters, but then use them as a plot device to help the main character grow and have no relevance after that. Nearly all movies and TV shows use ableist language as well. Legally Blond, Clueless, That 70s Show, The Wolf of Wall Street, and many more all use the R-word in negative ways. Even in the news, disabled people are almost always used as inspiration or as the object of pity. When people are constantly exposed to this type of discrimination, it’s hard not to adapt to it and start using the same language and laughing when someone does something “stupid.” Society has etched into our brains that being smart is good and being “stupid” is bad. That our IQ determines our self-worth. But being able to recreate patterns with blocks and do a certain amount of math problems in 30 minutes doesn’t say anything about your creativity, your ability to empathize, or your determination in things you love. We need to get rid of this ridiculous idea that not being society’s version of “smart” makes you a less deserving of a happy life. The next time you laugh because someone does something you perceive as “stupid,” ask yourself, “why do I find this funny? Is this idea rooted from society’s ableists beliefs?” And the next time you call someone “stupid” think to yourself “why is it a bad thing to not meet society’s expectation of intellect?” I challenge you to change your mindset and ideology around what it means to be “smart” or “stupid.” We can’t continue to let the media control the way we perceive disability.

Ableism is a very real, very serious issue that needs more recognition. Disabled people are mocked, beaten, and murdered every day. The list of disabled people killed by their parents and caregivers in the past 10 years is so long, it would take nearly 45 minutes to say all of their names. Not only have parents betrayed and hurt their children, but police brutality has taken many disabled lives as well. Our society has trained us to believe this is okay. Our language has given us the weapons to inflict pain upon the disabled community. Our history is haunted by the cries of disabled children who have been left in the streets to die. We can’t just sit and watch this discrimination anymore. We need to stand with the disabled people in our communities. The current events in America are scary for all oppressed groups, including disabled people. Our new president does not care about the rights of disabled people. He will not try to protect their rights and he will not try to protect their lives. We can’t let our government steal the rights of our friends and family with disabilities. We must take a stand against the oppression and bigotry disabled people are subjected to day after day. We must work to grow as a society that’s accepting of all people! All races, all genders, all religions, all sexualities and all abilities! And we must never fail to recognize the pain of another oppressed group again!

 

Works Cited

“Ableism/Language.” Autistic Hoya. N.p., n.d. Web. 08 Mar. 2017.

Agorist, Matt. “Cops Kill Speech Impaired Autistic Man Trying to Find Safety in Home for People with Disabilities.” The Free Thought Project. The Free Thought Project, 24 Aug. 2016. Web. 9 Mar. 2017.

“Crime Against Persons with Disabilities, 2009-2012.” Bureau of Justice Statistics (BJS). N.p., n.d.      Web. 08 Mar. 2017.

Everton Bailey Jr. | The Oregonian/OregonLive. “‘Sorry,’ Mom Said as She Threw Son off Oregon Bridge after Weeks of Planning His Death.” OregonLive.com. N.p., 23 Feb. 2016. Web. 08 Mar. 2017.

O’Hara, Mary. “Up to Half of People Killed by US Police Are Disabled.” Mary O’Hara: Lesson from America. Guardian News and Media, 29 Mar. 2016. Web. 08 Mar. 2017.

“People with Disabilities.” United States Holocaust Memorial Museum. United States Holocaust Memorial Museum, n.d. Web. 08 Mar. 2017.

“Retard.” Dictionary.com. Dictionary.com, n.d. Web. 08 Mar. 2017.

“Survey Finds Disability Abuse Widespread.” Disability Scoop. N.p., 10 Sept. 2013. Web. 01 Mar. 2017.

 

Autism, Parenting

Is My Baby or Toddler Autistic?

[Note: I will use identity first language throughout this post. For more information on identity first language versus person first language, particularly as it relates to autistic people, please check out  these two posts on Autistic Hoya.]

Some parents of babies and toddlers may notice that their little one seems like they’re operating at a different frequency than the other kids at the playgroup, or they may have flagged a couple of questions in a developmental questionnaire at the pediatrician’s office, but they don’t know where to begin looking for information. A simple google search leads to articles like “Early Warning Signs Your Child Has Autism” and it feels dangerous, perhaps alarming. When you look at your perfect little baby who you love, you only want good things for them; you only want to think good thoughts about them. Yet all that seems to exist for exploring ideas about their neurology is article after article warning you that your perfect little kiddo may have something wrong with them that requires immediate intervention to give them a chance in life. Phew! Deep breath.

Autism, at its core, involves differences at the neurological level that affect sensory experience, communication style, and information processing. These things can affect executive functioning. Much of the framing around signs a baby or toddler may be autistic is about how the parent experiences what their child does. None of it encourages a parent to look deeper into their child’s experience. What’s worse, none of it comes from a loving or accepting place.

Many parents considering whether or not their toddler is autistic may be interested in approaching the question with love and acceptance for who their child is and what their experience of the world is, but there’s not much out there for them to connect with or learn from. I’ve attempted to take the clinical screening questions along with other information and turn the language and ideas on their head a bit, so that they reflect an empathetic view of the child’s experience, and offer an accepting re-framing around pathologizing, clinical language and concepts. In the writing of this piece, I have sought feedback and input from autistic parents of autistic children*– one of the best resources around for connecting the outward behavior of young autistic children with their unique experience of the world and autistic identity.

This is by no means an exhaustive or definitive list. Autistic children are children, and they’re all unique individuals. They may have some of these characteristics but not others; they may be completely opposite in some cases! That’s to be expected.
Here are some differences parents may notice about their baby or toddler who is autistic based on clinical screening guidelines for babies and toddlers**:

-You may notice that your child doesn’t communicate as you expected or the way you see other children their age communicating. Where other children point to things to express interest or desire, your child may not show you as explicitly. When you call their name or give a simple direction, they might not respond at all, or they might give you half a glance and return their interest to where it was before. Many autistic babies and toddlers do respond to their name and simple directions at least some of the time if not all. 

If your child is doing these things, it may be because they are taking in so much information from the world around them that it’s difficult to prioritize what you’re asking them to prioritize– paying attention to you! They may be learning about what the texture of their clothes feels like, where the light from the window goes, what sound the neighbor’s dog makes, what the diaper pail smells like, what your voice sounds like, and what that leftover chunk of banana in their cheek tastes like all at the same time. Your child may be remembering and working through all they learned in play earlier that day and be extremely focused on categorizing or analyzing that information. All those things may feel as big and important as any other, and sifting through all of them to get to your request is a lot to ask. Your child may also be experiencing thought tendrils (see Tendril Theory by Erin Human) and not be prepared to interrupt their current thought process and transition to another just yet.

-You may notice that your young child is very interested in visual things like light, ceiling fans, dust floating near a sunny window, or they may use their hands to make movements that they watch. This is known in the autistic community as visual stimming, and is a way that autistic children (and at times all children, because everyone stims) seek out positive sensory information to focus on as a form of self-regulation. “Stimming” is a way of bringing about sensory input. For an autistic child who is experiencing an onslaught of sensory information that may be overwhelming, finding a pleasant sensation to focus on can be soothing. A bonus to visual stimming is that it is great for fine motor skill development in the eyes, which is particularly important in learning to read.

-You may notice that your child has unique physical movements, such as rocking when they sit, twisting around when they stand, or they may flap their hands when they are experiencing delight (and sometimes when they are sad, too). Your child may enjoy the vestibular input of being pushed on a swing or spinning around even more than the other children you see. This is another aspect of seeking positive sensory input. There’s nothing wrong with these movements, although because they look different than the movements of other kids sometimes parents want to intervene to make them stop. Allowing children the freedom to move their bodies is a basic aspect of respect for their bodily autonomy, and an important part of teaching them body boundaries to keep themselves safe. If your child has unique or stereotyped movements, they have found great coping skills for being in their environment– this is a good thing! Accepting your child as they are means accepting the way they move through the world. Plus, pushing your child on the swing is a really fun past time, and makes for great Instagram photos.

-You may notice that your toddler doesn’t seem quite as interested in other toddlers and young children. They may take a lot of time watching others play before they join in, or they may not join in at all. Your toddler may show interest by spending a lot of time looking, but not much time, if any, engaging directly with other children. Autistic people interact socially in a different way than their non-autistic peers. Your child may be observing in order to try to learn the social language of their peers who do not have the same way of communicating and interacting as they do. A cautious approach feels safer. This doesn’t mean they are “stuck inside” themselves or have a social “deficit,” it means they are trying to learn about how others interact before sticking their neck out. Studies and the expressed experiences of autistic people confirm that autistic folks read each other’s cues better than they read the cues of allistic, or non-autistic, people. Having autistic friends of all ages will be a really beneficial aspect of your child’s social development if they are indeed autistic.

Your child may not use your facial expressions as social cues because they haven’t interpreted what all of them mean yet.

There is an erroneous but widespread belief that autistic children are withdrawn, “zoned out,” and disconnected from other people, that they are not communicating and that these things are deficits. The reality is that autistic children are especially engaged in the world and in things around them. They are passionate and focused as they collect information. The deficit is in the way allistic people interpret their focus and communication. A part of raising an autistic child is learning about what their experience is and how they communicate it. If you watch and listen closely, perhaps mimicking your autistic child’s intense focus on collecting information and analyzing it, you will see that autistic children are very expressive in their own way, and can be remarkable at setting and expressing boundaries, and those boundaries will assist you in parenting and in protecting them from outside harm.

-You may notice your baby or toddler does not make eye contact, or does not like prolonged eye contact. This comes up first on most lists. Allistic people and developmental pediatricians have their own special interest in eye contact! For most people, eye contact is a form of communication and intimacy that is a standard aspect of interaction. For autistic people, it can be incredibly intense, even painful, to engage in or prolong eye contact. This is not a sign that a child is not engaged, or that they cannot be emotionally intimate– it’s a sign that they are experiencing many things at once, including lots of emotion, probably lots of emotional connection as well, and that adding your intense gaze is overwhelming. Some of what they might be processing all at once: the entire sensory profile of the room (sounds, visual stimulus, smells, textures), your voice, your words, your body language, interpreting what all those things mean, trying to remember if there is a specific way they are supposed to respond to those things, and more. Eye contact is one more thing to process, and can also feel like scrutiny. It can be so distracting that it’s difficult to know what the next “correct” social move is supposed to be.

Plenty of autistic children do make eye contact or learn that there is a social reward for approximating eye contact, like looking at people’s eyebrows. Autistic children may make eye contact with their parents and siblings only, but not with others. Many children have had their diagnosis delayed or rejected based on the idea that autistic people never make eye contact or look into people’s faces. This is another way the stigma and stereotypes of autism can be harmful to autistic children– by denying them access to their autistic identity and supports based on stereotypes.

Communication looks different for autistic people, and that can mean that other ways of communicating besides speech are better for your child. It can also mean that from an early age an autistic child speaks with fervor and gusto about their favorite subjects.

Some of the things you may notice about your baby or toddler if they are autistic that are not always a part of early clinical screenings, are:

-You may notice -You may notice that your child is not particularly interested in bringing you things to show you, or getting your attention to watch them as they try new things, while other kids their age may be doing that. Autistic children are taking in lots of information and processing it. They may be a little too busy or preoccupied to bring it to your attention. They may also assume you already know or are doing the same thing because to them it is so obvious. What’s obvious to you may not be obvious to an autistic person and vice versa. This does not mean your child does not want you to engage with their interests and activities! If your child isn’t using your way of communicating to show you what they’re working on, you can try using their language to show them you are interested nonetheless. One way of doing that (that is appropriate for all toddlers regardless of neurology,) is to put yourself near them and engage in a similar style of play. If they are coloring, quietly color your own picture nearby. If they are lining up cars, sit across from them and line up blocks in a similar pattern. You may find that they will use this space to communicate a lot about what they are learning and interested in, just not in the way you might have expected.

-You may notice that your child is very sensitive to noises that may seem commonplace to you. Autistic people can experience sensory stimulus in a much more intense way than non-autistic people do. This can mean that what feels like 40 decibels to you feels like 140 decibels to them. Imagine trying to carry on a conversation and learn in a room with a jet engine going. You’d probably get pretty cranky and overwhelmed in short order. Whatever your child’s reaction to noise– it is reasonable– the experience they have of sound is very real, and not something they can just “get over.” Many young children are sensitive to noise, and it makes sense. The constant noise around us is a pretty modern phenomenon. Garbage trucks, dishwashers, blow dryers, beeping phones, background TVs, the neighbor’s constantly barking dog– none of us were evolved to have to filter out these noises all day, and autistic people filter and process sensory information differently, so this constant sound burden can take up a lot of coping skills.

-You may notice that your child’s gross motor development takes a little longer or that they walk a bit later than their peers or siblings did. This is not the case for plenty of autistic babies, but it may be for some. Babies and children organize their development in a compartmentalized way. Often times they focus on one area almost exclusively, ignoring other areas of development for awhile. For autistic children processing lots of information from the world around them and trying to observe and learn the behaviors of all the non-autistic people around them, some other skills may get put on the backburner for a little bit. Lots of opportunities for play and movement will give them the tools they need, and there is no reason to believe that the age at which a child walks has any predictive quality about any other aspect of their life.

-You may notice that your child’s speech development is unfolding differently than their peers. They may speak less or not at all. One rubric used is that a child is not using two-word phrases by 18 months. Often times delayed speech or having no speech has been so intensely focused on by doctors that precocious speech in autistic children is used to deny a diagnosis or make a long term assessment about an autistic child’s future. Precocious speech can also be a part of an autistic child’s repertoire, for example, using complete sentences in early toddlerhood. your child needs more time and warning than other children you observe to transition between activities. Some examples are diaper changes, leaving the park, ending play with a specific toy, leaving the house, and getting into the car seat. These things can be difficult for any little one. Your toddler may spend the first part of their day at preschool observing from a safe distance. If your child has a hard time transitioning between activities, plan extra time to support them, and give them lots of early notification that the activity will be changing– even if you don’t know if they understand you yet. This can mean an extra 5 or 10 minutes of playing around the car seat or playing with the buckles before it’s time to get into the seat and buckle it to leave, or setting one of more “warning” timers on leaving the park (10 minutes, 5 minutes, 1 minute, and so on). This goes back to Tendril Theory. Your child may be deeply engaged and quick changes are startling and dysregulating. Allow your child a chance to observe before joining into an activity. Observation is learning, it’s not a bad thing.

-You may notice that your toddler becomes intensely focused on a specific topic. The most stereotyped of all these interests is trains, of course! Who doesn’t love trains? But there are plenty of ways autistic toddlers become focused on specific subjects. They might be interested in or passionate about certain media characters, collecting specific objects like rocks or sticks (or anything, really), a specific way of playing, like stacking objects into towers, insects or animals, drawing the same subject, mixing colors, or anything else under the sun. A lot of times these interests are called “special interests,” and there can be a lot of pathologizing around them or comparisons to obsessive compulsive disorder.

What parents should know about special interests is that they are incredibly rewarding and therapeutic to autistic people. They bring joy and delight. When a non-autistic person learns a lot about a certain topic, they are considered an expert. While an autistic person may be an expert on their special interest, often they are called a “savant” or have their expertise treated as a symptom rather than a positive trait others can learn from. If your child expresses a passionate fervor for something, pay attention and learn about it with them. There is no better way to show them how much you love them and are excited to be their parent than to express a desire to learn from them about what they love to do. This may mean that if your autistic child uses speech to communicate that you listen to an hour of chatter about all the different types of trains or how a rhinoceros beetle uses its horn to flip a rival every day. Let your child share their delight with you! Try to be delighted with them!

-You may notice that your child develops a nervous habit around social interaction. A lot of adults have a really difficult time with the social behavior of respecting children’s boundaries. They get into little ones’ faces and ask questions and try to force a giggle. They may expect social reciprocity for hellos and goodbyes your child isn’t ready for yet. This can be overwhelming to any young child, and especially to autistic children. Some examples of nervous habits in response to social pressure are covering their face with their hands, turning away and burying their face in your shoulder, nose picking, playing with their hands, and attempting to run away. They may also set a stronger boundary, like putting out a hand to push someone away, yelling, or crying. While other adults may not perceive these as socially appropriate behaviors, setting a boundary on one’s space is a crucial skill and young children should always be supported in doing so, no matter their neurology and no matter how much Grandma clutches at her pearls.

-You may notice that your child melts down or has tantrums from an early age and particularly in certain situations, like going to the grocery store or family parties. The amount of sensory stimulus in places we take our young children can be overwhelming for any toddler, but it can be downright painful for autistic toddlers. Crowds of adult voices talking, fluorescent lights, ambient noises, repeated demands for social engagement, and lack of familiarity are some of the things that can just push a little one beyond their limits to cope and they may break down.

When a neurotypical adult is in a situation the average person finds to be extremely stressful or torturous, most people find that their emotional response is reasonable, even if it is crying, yelling, throwing things, hitting a wall, or pulling out their hair. When a child experiences things that have the same effect on them, we call their response “behavior” and try to forcibly stop it. Sensory overwhelm in a sensitive child is just as real as the torment adults can face in oppressive*** situations, and we should take it seriously. If your child melts down when they are overloaded, provide them with a safe place to release their feelings and reorganize their thoughts. This may mean sitting with them as they scream, cry, say they hate someone (maybe you), and move their body wildly. Give them as much safety as possible while restricting their movement as little as possible. Being a loving, calm, and accepting presence as your child processes intense feelings will only bring them closer to you in trust and love. It is not reinforcing a behavior or “giving in,” it is providing emotional stability and safety.

-You may notice that when your child takes on a new activity, like preschool, that their tolerance for other things, like food or clothing textures, is reduced. We all have a certain amount of bandwidth for each day to do all the things we need to do. For autistic children, a lot of that bandwidth is spent on sensory processing. When you add something new to your child’s workload, like lots of social interaction or physical play, they will have less energy to for sensory processing. Adding new things to their life may mean they need a break in other areas. Often times this means some foods they used to eat are rejected, or clothes they used to wear become too tight, scratchy, or stiff. These rejections make perfect sense, and you can help your child adjust to changes by being flexible about other areas of their life, like buying multiple set of their favorite comfy clothes, or taking selective eating in stride.

-You may notice that your baby or toddler has a unique “lovey,” or comfort object. All children may connect with a certain object as a source of comfort, such as a teddy bear or blanket. Sometimes autistic children pick less typical objects to tote around and find comfort in. They may not be soft and cuddly or represent animals or people, but they are just as important to your child’s security. Of all the unusual loveys I have ever heard of, my favorite was a rubber spatula: a useful tool for play, an object to chew on, and with an easy to grasp handle so it doesn’t slip away during naps! Perfect!

-You may notice that your toddler uses the lines from TV shows or movies rather than their own words. Or they may repeat the things you say back to you to convey the answers. For example, your child may ask, “Are you thirsty?” to tell you they would like some water. After all, it is what you say before you offer them water. This is not parroting, it is important and valuable communication. When an autistic person uses scripting, sometimes they are explaining a feeling or experience by using a different story they’ve heard to do so, because translating their experience into words is difficult. Listen closely for the feelings conveyed and the bones of the experience laid out. Don’t get caught up in the details of the script, which may or may not be a perfectly accurate description of what your child is trying to tell you. Scripting is a very useful tool that all people use to some extent or another. Often times autistic people use scripting in a more noticeable way, particularly in early childhood.

-You may notice that sometimes your child communicates with speech, and other times they do not. It is easy to assume that since they can talk sometimes, they should be able to do it all the time. That is not necessarily true for autistic people, who can lose speech for periods of time under stress, or have an up and down trend around speech development– for example using a word and then no longer using it. Look to all your child’s actions as a part of their communication. All communication is meaningful and valid, whether it is physical, behavioral, spoken, signed, gestured, sung, recited, or some other type. All children learn multitudes of ways to convey their needs, feelings, and ideas to their parents as they develop, but our culture tends to value speech above all else. Listen and observe your child as they show you all kinds of ways to communicate you may have forgotten since you were a child. Find the magic in it– it’s there.

-You may notice that your child has unique ways of playing with toys, such as lining them up in a row, sorting them by color, stacking them into towers, or otherwise organizing them instead of playing make-believe. This type of play is just as valid, meaningful, and important to learning as any other. A part of being autistic is sorting and processing information differently, and this is one aspect of that. Rather than assuming your child is doing something wrong, spend some time copying what they do to show them you are interested. They may show you a whole new set of criteria for sorting, categorizing, and making patterns that you had never considered before.

-You may notice that your baby or toddler does not like to be held as much as you would expect, or at all. Being held may be an overwhelming amount of sensory and social stimulus for them to process as they focus on their surroundings. Alternately, your baby or toddler may relax and calm down most when being held tightly or worn in a sling, because the gentle squeeze of pressure around their body gives a calming sensory input in an environment where they are overstimulated. Listen to your child’s cues about physical contact and honor them. Remember, it isn’t really about you and what you wish they wanted from you, it’s about meeting their needs for emotional and physical connection how they need to be met. When you do meet those needs, even if it isn’t how you expected, it will be rewarding for both of you.

-You may notice that your baby or toddler has a great eye for detail. They may notice things you didn’t, or respond to changes in their environment you wouldn’t think they’d notice. They might notice and play with the tiny string coming out of the seam of your pants while you hold them on your lap. Most kids notice things adults overlook, because so much is new to them and they have a different perspective at their size. Autistic children can often have an even more refined attention to detail than their peers. This is a really fun aspect of parenting an autistic child– seeing all the things you are missing through their eyes.

-You may notice that your toddler has a different perception of danger and safety, and needs more guidance around freedom to explore and strangers than you might have expected. This can mean your toddler makes friends with everyone at the park and would like to examine their picnic basket. It can also mean they explore without worrying how far they’ve gone, or what dangers may be in the area they are exploring. They may run further than is safe just to feel the breeze on their skin and the pounding of their feet in the grass. Your child is counting on you to gently help them learn what is safe and what is polite. Be patient with them and explain why you are setting a boundary every time.

-You may notice that your child makes unusual noises, perhaps in response to things, or perhaps absent-mindedly as they go about their business. This may be humming, blowing air, making popping or clicking noises with their mouth, repeating a word, phrase, or sound over and over again, squawking, copying an animal noise, or any number of interesting sounds. This is generally referred to as vocal stimming, or creating sensory input by making noise. This can be calming and regulating for autistic babies and toddlers, and it is a part of learning how to use their voice, as well. When autistic children create their own sensory input, it helps them process, filter, and ignore other sensory input they can’t control. Whenever possible, be supportive of this outlet. Your own sensory experience is important too, so try to find compromises that allow your child to stim and give your ears a rest often enough that you can remain patient. A huge part of parenting work is trying to figure how everyone’s needs can be met harmoniously– vocal stimming is a need.

Again, this is not an exhaustive or definitive list. If this sounds a lot like your child, you may be interested in finding out if they are autistic. Seeking a diagnosis is complicated, and there are pros and cons to when, where and how to seek a diagnosis that I hope to write about another day. I will say that autistic children know they are different, but without the naming and acceptance aspect of autistic identity, they may perceive themselves as consistently failing, or being somehow wrong in the world. This is a terrible feeling. Loving and accepting your child as they are is a foundation for their sense of self, whether they are autistic or not.

*of which I am also one
**adapted from the modified M-CHAT screen currently used as an initial clinical assessment tool to screen babies and toddlers for autism
***I used the word ‘oppressive’ here intentionally because an inaccessible environment that is causing pain to an autistic person is oppressive according to all the definitions of the word, however, I would point out that we do not require neurotypical adults to experience actual oppression to feel understanding or compassionate about their outbursts. 

Special thanks to Sonya Austin Emerick for consulting with me about overwhelm, communication, and for reminding me to mention how connected and passionate autistic toddlers truly are– and most of all for sharing her beautiful children’s lives with me.

Special thanks to Salem Leonard-Goosby for consulting with me on eye contact, communication, peer interaction, and for sharing tons of wonderful anecdotes about his children, who sound like very cool people.