natural development/progress on the spectrum

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My son has had very little formal therapy or intervention. I mean besides what we his parents have been doing since we noticed his issues early on, around 18 months- and we are always aware and working on things. I know a couple of other kids we know who are similar, on the spectrum and who have been in all kinds of therapy- I mean probably hundreds or thousands of hours at this point. We also know one little boy whose parents are in complete denial about (what we suspect is) his ASD and do very little to help him along.

My husband and I have noted both with our son these other kids we've known over the past few years (no not a solid basis for a scientific study, just for our casual observation!) that they all seem to chug along in their development no matter what, some with more ease than others of course. There have been things we've really had to push our son along with, toilet training for example, and other skills that seem to happen earlier and more naturally for NT kids. But other things just seem to click into place for him- not on "schedule" but eventually. For example, my son hasn't had really any OT but his coordination, motor skills, etc have really gotten so much better and he is pretty much squared with his peers in many areas at this point after coming a long way. He hasn't done any special therapy to address these things, just normal kid stuff - gymnastics, playgrounds/climbing/swinging all the time, tons of swimming, lots of sensory play (sand, play dough etc). His speech seems to be coming along the same way... slowly but surely with unexpected leaps and definitely at his own individual pace and along a strange path.

I wonder if all this therapy isn't just taking the place of the natural play the kids would be doing if they weren't in therapy all the time? And their development is just happening and unfolding at the pace that is right for their specific neurology instead of the NT development track...
Sometimes it helps me to see things this way when we just can't seem to find a solution to a problem he is having. Otherwise I drive myself crazy looking for solutions and ways to address it that just don't end up working. I try to think that maybe only time will help...he will grow and grow up.

This is a thing I wonder also. Maybe it only helps on the margins, I don't know. Sometimes the regimen helps for kids who won't do normal kid things because they are bad at it or don't like it or would only do it, if part of a schedule, but yeah, there is some of it that seems that way. I guess you would have to look at all the studies that say EI helps, and see if there are methodology issues with them or if it is one of those things where there are early gains that become irrelevant over time.

I agree with this premise.

Sometimes, it's just good to let the kid develop at his/her own pace. Some things might come late--but there are many occasions when kids catch up to so-called normal kids.

I know a kid who didn't talk until he was TEN years old. Then he started talking and he quickly caught up to his peers. He is now an auto mechanic. There was no intervention. He lives in a Caribbean country.

Yes, we need early intervention. Yes, we need therapy. But we should not over-therapize kids. Sometimes, a passive, observational approach is good.

I beg to disagree. I'm pretty sure if I hadn't had received speech and language therapy I would be in a far worse position today. It brought me out of my own little world. As far as language development is concerned, you absolutely *must* intervene early or it can be too late.

I didn't say Early Intervention/therapy is not required in many instances.

All I said was that, at times, a naturalistic/passive/observational approach, at times, is better than an active approach.

I had very active therapy as a small child, less active therapy as an older child. I made my social milestones, albeit late--but I made them. I used my own cognition at times to "make" the milestones.

This is natural development of a healthy autistic kid, it seems.
My history was similar, very poor motor skills early on, no OT but natural play, big improvements by late childhood and esp teenage years.
Very late speech, did have special help for speech, but not many hours per week from age 3.
Very asocial in childhood, no social skills or cognition, but big jump in teenage years and continued steady progress in adulthood with full intellectual capacity of adult and life experience to help with this too.
I think the OP was so correct in her decisions to minimize therapies, let her child grow up healthy and natural, her child may be more capable of flexibly adapting to the world as he gets older and more independent capable adult.

I disagree in most cases. The world has a way of making demands on us. And like it or not that affects most parents.

You may be immune to that at least right now, OP, but eventually most of us are confronted by those pressures and it helps enormously to have people you can lean on to smooth out the obstacles.

Or am I misunderstanding; is your point that therapists don't have magical powers that are beyond all parents and environments to provide support around in ways that work? If you are saying that, with the right environment, and accepting, encouraging parents and teachers and schools and communities, many children might learn to play and enjoy and appreciate others without all kinds of professional supports......I agree with that!

We as parents aren't enough, though, and as children enter the world, they need acceptance and inclusion and if they cannot get that on their own, they need professionals to help them learn to. At least this is my take on the issue.

Damn...and how old are those kids? I think some parents really go overboard and lose sight that even if their kid has autism its still a kid, hundreds of thousands of hours of therapy to the point they are in therapy more than they get to be a kid and play and learn. I mean can you imagine spending most of your childhood in a therapy setting having therapists tell you how to act and how to be and point out whenever you do something 'wrong' or autistic and not really being able to let loose without always feeling like eyeballs are on you waiting for you to express 'autistic' traits and symptoms so constant pressure to 'be normal'.

Of course this is not to say I agree with the approach of flat out denying the possibility and doing nothing to help your child along if they have autism....but constant behavior therapy designed to give them a normal demeanor on the outside can't possibly allow for development of unique personalities and could be detrimental to some development....like forcing them to focus on normal behavior and social skills rather than any of their skills they do have.

I say a balanced approach is best, some therapy to help learn some basic social skills...and give them guidance on things they prove to have difficulty with. But not thousands and thousands of hours of it to the point it takes up so much time they can't just run around and be a kid at all. I mean when it gets to the point the therapist is telling the kid how to play, and correcting them for say playing in a more autistic way and its bleeding into every other aspect of their life I'd say its gone too far for instance.

Problem is, it's very hard to generalize because specifically part of the autism spectrum is that each child has his or her unique place on it.

My son didn't qualify for any services at all, and we didn't have an inkling that he was on the spectrum until the end of 1st grade. If I compare him to friends' "quirky" kids who recieved early intervention, he is significantly impaired: not only is he behind in the areas where he's naturally behind, but he developed crippling anxiety and depression.

When we finally did the full battery of tests privately in 4th grade, he was seen by an OT...they explained he had a proprioperceptive deficit, but that he was compensating and didn't qualify for services. They did, indeed, suggest that we put him in activites that supported that deficit (yoga, tai chi, circus arts, tumbling, gymnastics, etc.) and those did seem to make a difference. From that experience, and also our experience of services being thinly stretched, I doubt it is general practice to give kids services they don't need.

I can see where it's difficult to tell early on...but if it were me, and I had it to do over again, I'd get my son much more help much sooner. There is very good science that early intervention services work, and offer better outcomes for kids.

That said, I think parents know their children the best, and they are probably the best at helping professionals determine what works for their individual child.

Well, I guess I'll give my two cents. This is long, sorry, but it's important, as I feel kids NT or NT-diverse and their childhoods are the most important thing a parent can focus on - it primarily sets up who a person will become in life (for good or bad).

My son is 3 and a half and non-verbal, with little but slowly improving self-initiated communication on his part to us. From all my reading (books, studies, articles and this website too ), seeing therapists, doctors and other mental help professional I've tried to piece together a therapy that centers around communication.

But before I could start doing therapy, I had to understand what's "wrong" or different before I could understand how to help him communicate. After a lot of the above, I now know that there are many different medical diagnosis's (known or suspected but yet proven) or pathways to an observational ASD diagnosis. In my son's case, no tests determined a medical cause for his basically a-typical brain development that led to his observed ASD diagnosis. If one was found, I might of had a better direction or guidance for his therapy based on his medical cause and other successful studies of similar kids with positive "outcomes" (I really dislike the terminology that goes with ASD).

With that being said, how does a parent go about helping a child without a unknown cause (as is most of the time)? I studied what typically happens in development from birth to language/conversation - true language and back and forth conversational skills develop while/after theory of the mind develops (TOM). The degree at which TOM develops coincides with kids pointing things out while looking at their parents, first words and then eventually language development and conversations with parents/people.

Babies/kids basically go from thinking everything in their mind is the same as in everyone else's mind to slowly understanding people’s minds are different, and they have to communicate with them. Once this happens, feelings are tied to true communication/language and this is the beginning of our long-term memories. This is why adults generally can't remember anything that happens as a 1 year old, toddler year memories are "fuzzy" and 5-6 year old and older memories are remembered more clearly.

Ever have a bad or happy memory of something/an event/someone? I bet yet can remember the circumstances when that memory formed in your mind in much better detail then say the random stuff that happened just before it that you had no emotional feeling about. For example, I remember way back to when I was a kid and I found a bug in the tube of toothpaste. Why do I remember this 30 something years later? I had a "ewe gross" feeling about it. Think I remember the brand of toothpaste I was using? Nope, because I was little and had no concept of how to feel about a brand of toothpaste, but I sure do remember that little black bug trapped in the toothpaste sitting on my toothbrush!

So, how is this important in terms of ASD and my child (or your’s) and his "therapy" or in a better way to describe it - what I do with my son? Well, I'm always evaluating what I see from him and try to set up/frame teachable moments for things/areas he's lacking in. He has decent-good receptive language and can understand a lot of what we're saying, but doesn't say words (he did say a few words before he regressed so there's nothing physically preventing talking), and he doesn't point stuff out to us (me and his mom). He generally does like to be around us (he prefers mom of course) and is very aware of everything and everyone around him. He currently makes a little eye contact, but no real sustained eye contact. If we're in the room with him he usually doesn't look at us even when asked. But if we leave the room or he's in an outside setting and we introduce ourselves to him by say his name or just by intentionally talking to another adult loud enough so he can hear our voice he always looks right at us (near 100% perfect eye contact) and usually comes over to us.

So after learning as much as I could and trying to observe/understand my son he showed me that his TOM is very slow to develop (this is usually a huge problem with kids who have an ASD diagnosis). I had to understand what was causing this lack of communication and what he needed help with before I just blindly started this or that intervention. This is what his therapy focuses on – learning about his needs. Over the past year, we've worked in small ways to make ourselves more and more enjoyable to him, so that he can choose to come to us own his own.

As a dad, I have to work harder at this than does my wife, as he has naturally had more opportunities for pleasurable/bonding moments with her. I started by trying to play/do little things that make him laugh and giggle - this makes him feel good and builds a bonding moment with me, and in turn slowly builds his TOM. How do I know this? In a little over a year, my son went from the kid who would almost never approach me, to me gently playfully tickling him and him laughing but not making eye contact and trying to get away, to him coming up to me and taking my hand to where he wants tickles and when I tickle him he’s usually looking right at me, into my eyes and naturally learning why people look at each other (in this case to convey a feeling of happiness with its associated facial expressions).

I've expanded this out to jumping, swinging, airplane rides, play, etc. - all I have to do is say "do you want to jump?" and he comes smiling and running to me. This communicating of good feelings/moments has expanded to other areas - before he used to be a runner, I could never let his hand go, but now he loves holding my hand or just walking next to me without holding hands - I even test this by playfully running ahead of him and he smiles and runs to catch up, or I abruptly stop and he quickly realizes I stopped and he comes back to me. As well as him hugging me and getting a little upset when I leave him at daycare – before I’d put him down and he’d walk into the room and never look back as if I didn’t exist.

But he’s 3 and a half and no words yet right? What has all this done so far? It’s laying the ground work of developing all those preverbal communication milestones that just didn’t happen, but in a natural pleasurable way, rather than forcing him into doing things that he doesn’t like (like demanding eye contact), which most certainly would lead to him developing an aversion to us/people in general and thus further delaying his TOM/communication/eventual speech (hopefully). If I didn’t take this therapy approach with my son, I’m sure he’d still be completely in his own world and not coming slowly back into ours. Once we develop strong bond with each other, good natural or unforced back and forth communication, I’m sure all the other learned skill type therapies will be much easier to do with a willing, happy participant rather than a forced one. I feel this is critical to development of some kids who have ASD, but other may have more complex medical issues that may impede this kind of approach.

Again, just my LONG two cents…

BTW - to parents whose kids aren't speaking by age 3 - my husband was 3 and his first words were a complete, perfectly articulated request in a full sentence ending in "please." He had not been identified as delayed (although we are finding now that it's likely, but nobody was diagnosed back in the day,) the deficit was blamed on his brothers doing everything he "asked" without him speaking.

This is not to say that my husband is in any way the norm, or that you should not get theraputic support (we know now that he could have benefitted greatly if it had been caught early, not for language issues but for other communication issues that still impact him as an adult.)

I just wanted to point out that some children do develop language, full language, later. Another friend of mine whose son is pretty heavily impacted and had tons of therapy is finally able to communicate by speaking (I think he started speaking a very little bit in preschool, and slowly added more and more speech and now that he's in grade school is in an inclusion classroom and doesn't need a lot of support; I haven't talked to him directly for a while but he's now developed to the point that one wouldn't immediatly assume a delay.)

Sorry - I'm blathering. Just want to give a little encouragement to parents who are worried - I do agree 100% that all kids develop, and think it's helpfu to know that the outcomes with kids on the spectrum is not determined by what skills they have or don't have in preschool.

My son has been getting services since before preschool. However, he was only officially diagnosed as having ASD at 7. He did not have hours of therapy, but had OT about 1 1/2 hours a week, counseling (small group of kids) 1 1/2 hours a week, then speech 1 1/2 hours a week. However, this was all done during school hours in school. I've noticed the least amount of progress in OT. The school has dumped so much time into his handwriting (which I could care less about), when OT really should have been focused on sensory issues. But, they made handwriting this huge deal. Finally, now that he is in an ASD program, they are focusing less on the handwriting (which really has barely improved since preschool), and giving him a device to type on. Other than that, the speech and counseling did help. My son was visibly frustrated when he tried to communicate with other kids. Speech gave him a safe space to practice at his own pace. Both speech and counseling helped him to learn to take turns playing games, which was important for him as he was getting really frustrated during games, but really wanted to play. It also really helped him learn about turn taking in conversation. My son was speech delayed, but not enough to qualify for speech at 3 because he had a lot of receptive language. Once he did really speak, he displayed advanced vocabulary and sentence structure, but it became apparent that he had a pragmatic delay that was delayed enough to get him services for it at 5 (when it really became noticeable).

I have not seen major progress in his pragmatic speech or social skills, but I do think the therapy sessions have been valuable to him. They also offered him relief from the overstimulating classroom so that he could work on stuff that was really frustrating him in a fun, engaging way.

I did take him to a social skills group outside of school for a brief spell, but it ended up frustrating him more. It just added one more major transition to his week days, and way longer days (long subway ride). I did it upon the suggestion of the social worker at his school when he was not in the ASD class. I dropped it after a couple of sessions and decided to get him in a different school instead (which is also when I went ahead and got him formally assessed for ASD). Now that he is in the ASD program, he gets this during the school day as part of their curriculum. He also connects better with the kids in this program than he did with the counseling sessions previously.

I would try to teach reading and writing to kids who are not speaking or highly asocial.
Wouldn't wait for suddenly speaking one day or spend much time in speech therapy that revolves around social interaction instead of teaching language.
I wouldn't have learned from social speech therapy, and didnt pick up on language by myself either, probably met zero language milestones before age 8.

This thread is so validating. I don't talk about it but outside of school, and a social skill group here or there, we do zero therapy. No PT, no OT, no speech, nothing. When my oldest was 4.5 it was strongly recommended that we do ABA because despite excellent language skills, she was behind in every other way and her behavior was very hard to handle ranging from smearing poo on the walls to just wandering away, to slipping out over a crack in the sidewalk... forget interacting with other kids. Zero therapy and about 3 years later and while she is still "behind" in a few departments, she is about where they said she would be WITH ABA. And she has a couple of good acquaintances. I'm so glad we did not do it. We tried a few sessions and it really just didn't seem like a good fit for her. Instead we encourage activities to build her skills and if needed we actively participate either so that she has support if she needs it. We will do the same with my youngest.

It's good that you chose this route that differs from the professional recommendations.
Building skills is important, and they can be done in lots of kids activities.
Parent support during activities is a good idea for the kids to be comfortable.
Since autistic kids are not on NT developmental trajectory, they will not catch up in some areas like social cognition even as adults, but they can be capable and independent and more likely to be so if they have good childhood and there is no one telling them there is something wrong with them.

We have taken a similar approach with our son who is now 10. He did qualify for services when he was around 15 mos old mainly because he had low muscle tone and was a delayed walker. He did not walk until 22 mos, and I thank God for the early intervention for him because the therapists started noticing his language delays as well and other things. So, he received in home therapy until he was 3 yrs old and then we had to put him into the school system to continue with therapy. We have done very little therapy with him other than what the school has offered for free. His speech and language skills are great now. The biggest obstacles he has now is social. I feel that the social will probably come in his own time when he is ready. We have seen a slow but steady progression in his development. He has never really enjoyed playing all that much, but we get him outdoors and do the best we can. I mainly just try to take him places where other kids will be to give him an opportunity to play and be around other kids.

I think what the original poster is trying to say is that some parents spend exorbitant amounts of money on trying to get there child to function normally, when maybe all they have to do is just wait and do the best they can. I am not saying do not do any therapy, but keep it within reason.