While recently giving a presentation on counseling clients with autism spectrum disorder (ASD), I had a more than professional concern: I am on the spectrum as well. Not that far along, true, but still on it, and if you were not to suspect this meeting me, it is only because a lifetime of learning to function successfully in the neurotypical world has borne fruit. As an autistic clinician, I offer these insights to help colleagues better understand and effectively support neuroalternate clients. (Note: “Neuroalternate” is a term I have personally coined and will be used in place of the clinical term “neurodivergent” for the purposes of this article.)

What is the Neuroalternative Experience?

The neuroalternate experience is like listening to someone who is not a native speaker of your language; while you may understand them, it takes extra effort. In contrast to a richly diverse and kinetic environment, what we prefer, long for, and even need is one that is straightforward, structured, predictable, and low in stimulation. Any deviation from this is unwelcome, stressful, and overloads our circuits. Social rituals and expectations appear strange and nonsensical, and the cues that accompany them are perplexing and inscrutable. There seems no good reason to pay attention to them (despite often getting us, obviously, into hot water).

Direct Communication: Clarity Over Social Rituals

From a neuroalternate perspective, communication the way we want it is direct and straightforward, even blunt. There’s no need for niceties. Just say what you mean, mean what you say, and get on with it. Keeping up with a group conversation is like keeping your eyes on each ant in a swarm of ants. Sarcasm, double meanings, plays on words, idioms, and colloquialisms can go over our heads. Thus, we can sometimes come across as painfully earnest in conversation. True, we don’t enjoy the misunderstandings resulting from all this, but it’s hard for us to see what to do about them. That’s where counseling comes in.

Key Considerations for Clinicians Working with Neuroalternate Clients

Drawing from my clinical experience and personal perspective as an autistic counselor, here are key insights for working with neuroalternate clients.

1. Don’t try to make them into someone they’re not and can’t be. By the time they get to us, most clients are already beaten up by years of expectations they cannot meet and have failed at, leaving them feeling excluded and often ashamed.
2. Remember that neuroalternates do have a need for human relationships. However, after repeated collisions with the neurotypical world, isolation becomes preferable to pain.
3. Accept that to the neuroalternate, relationships built purely on social interactions – hanging out, chatting, bantering – will likely be unrewarding. Likewise, acknowledge that acquiring an instinctive feel for social cues will not happen. It would be like trying to get someone who is color-blind to see color.
4. Use concepts from physical objects to engage. Neuroalternates are drawn to concrete things, so progress can be made on this basis. Think of signals or gauges; if we know what they mean, we can react even if we do not understand the processes behind them. Thus, identifying social cues and learning how to respond to them must be framed in terms of reading instruments that tell the operator to take specific actions. To a neurotypical, this may come across as mechanistic and off-putting; however, it is something the neuroalternate mind can embrace and work with.
5. Be quiet, calm, and patient, and let the client approach you. Buy-in – the alliance – is even more critical than with other clients, since change can feel especially threatening to the neuroalternate client’s sense of self. Reassure them that you will help them learn to cope with the world only as much as they need to yet still remain themselves.

In conclusion, think of a brick wall, with the neurotypical as the bricks and the neuroalternate the mortar. Stacking the bricks on top of one another would result in a wall that is easy to push over. Likewise, mortar by itself does not a wall make. But with mortar to hold the bricks in place, you get a strong and lasting wall. We need each other.

About the Author

James P. Bruner is the high school ASACS counselor in Vicenza, Italy. He has been with ASACS since 2001 and served at three sites in Germany prior to moving to Italy. He grew up in the Upper Ohio Valley and will eventually move with his wife to be with their family in Oklahoma. His interests are in anything that’s alive, any kind of machinery, and any kind of science – frankly, just about anything.

Autism Acceptance Month celebrates the unique strengths of individuals with autism spectrum disorder (ASD) while promoting understanding and support for their needs. ASD affects 1 in 36 children and an estimated five million adults in the U.S. Many face co-occurring mental and physical conditions, requiring holistic care to support their overall wellbeing.

Why acceptance matters

Acceptance creates opportunities and builds a sense of belonging. When individuals with autism are accepted and supported:

• Early intervention becomes possible. Diagnosing autism early enables access to therapies, such as Applied Behavior Analysis (ABA), that improve communication and social skills, promoting independence and meaningful connections.
• Barriers are broken down. Approximately 85% of adults with autism are unemployed or underemployed. Increased awareness and support can help overcome challenges in education, employment and healthcare, creating opportunities for inclusion and success.

Why co-occurring conditions matter

Co-occurring conditions often significantly impact the lives of individuals with ASD.

• Physical health conditions, such as gastrointestinal issues, epilepsy and sleep disorders, affect approximately 50 – 70% of children with ASD.
• Mental health conditions, like anxiety, depression and attention-deficit hyperactivity disorder (ADHD), impact up to 80% of adults with ASD.

Addressing these co-occurring conditions in tandem with ASD improves quality of life, strengthens relationships and promotes greater independence.

How you can make a difference

• Learn: Educate yourself about autism and co-occurring conditions.
• Advocate: Promote participation in schools, workplaces and communities.
• Amplify: Celebrate the strengths and perspectives of individuals with ASD.

Together, we can create a world that embraces neurodiversity, fosters acceptance and empowers individuals with ASD to thrive.

Visit MagellanHealthcare.com/Autism-Resources for more information and helpful resources.

Fostering inclusivity helps people to thrive in a diverse world. One vital aspect of inclusivity that often goes unnoticed is neurodiversity—the recognition and acceptance of neurological differences. By embracing neurodiversity, we can foster inclusive and thriving environments that celebrate unique minds and promote the success of all individuals. Here are some tips to support neurodiverse individuals.

1. Avoid sensory overload – Sensory overload can be a significant issue for neurodiverse individuals. This can include bright lights, loud noises and strong smells. Be mindful when engaging with neurodiverse individuals by suggesting quieter environments and reducing visual clutter.

2. Adapt your communication – To better accommodate neurodiverse individuals, vary your communication style. This may include:

• Avoiding using ambiguous or figurative language.
• Offering advance notice for any changes in plans or routines.
• Using visual aids, charts or diagrams to supplement verbal instructions and enhance understanding.

3. Foster empathy and understanding – Take time to learn about neurodiversity and the unique challenges faced by individuals with conditions such as autism, ADHD, dyslexia and others. Listen, learn and seek to understand the experiences and perspectives of neurodiverse individuals.

4. Be an advocate – Stand up for neurodiverse individuals by challenging stereotypes and misconceptions, advocating for their needs and celebrating their unique strengths. If you see or hear something potentially harmful or offensive, address it. Your support will not go unnoticed.

How can I learn more about neurodiversity?

Find more information and helpful resources at MagellanHealthcare.com/Autism-Resources, including online and tech-enabled resources to help neurodivergent individuals navigate daily life and empower parents, families and caregivers to support children on their journeys.

Sources:
• Forbes
• The Pink News

About 1 in 36 children in the U.S. has been diagnosed with autism spectrum disorder (ASD), according to the Center for Disease Control and Prevention.[1] Getting an ASD diagnosis is a life-changing event for families that can trigger feelings of panic, fear and distress. You may be uncertain or confused about what to do next and how to navigate your new reality. Here are nine tips to help you and ensure your child lives their best life.

1. Do your homework—Learn everything you can about ASD and how it may affect your child throughout their life, including the laws and rights that you and your child have under the Individuals with Disabilities Education Act. The knowledge you gain will help you be an effective advocate for your child.
2. Become a voice for your child—As a parent, you are your child’s first, strongest and lifelong advocate. No one knows your child better than you do. You are the best qualified person to shape your child’s situation in the most caring way and speak out when it comes to their well-being and ensuring that they have the supports they need to flourish.
3. Seek help—The autism community is full of parents and professionals willing to help others in their ASD journeys. Allowing others to help can lighten your load, help you become a better advocate and protector for your child, and make the sometimes difficult journey more enjoyable. Seek out support groups, teachers, therapists, social workers and others for help.
4. Give help when you can—If you can, helping other parents on their ASD journeys can help you to put things in perspective, feel more positive about your own circumstances and create a sense of belonging. Helping others has shown to lower levels of stress and anxiety, which improves overall well–being.
5. Express yourself—As human beings, we need connection. Sharing your feelings with someone you trust, such as your partner or spouse, parents and/or siblings, can be liberating and go a long way in deepening your relationships, and improving your physical and mental well-being, making you a better person, parent and family member.
6. Make self-care a priority—Spending most of your time caregiving can quickly lead to burnout. Proper hydration, a healthy diet and sufficient sleep can help you cope best with daily challenges. Finding time for activities that are fun and fulfilling, such as going to the gym, going for walks and meeting friends, can help you recharge and be the best parent you can be.
7. Find the right providers—While it is important that your child’s providers use evidence-based practices and keep abreast of treatment options, it is also important that they are culturally aware and respect your ideas and traditions. Each cultural group has its own customs, thoughts and taboos regarding physical and mental health care. Find a doctor who not only speaks your language, but is also sensitive to your cultural, religious and personal beliefs.
8. Foster healthy eating habits—Children with ASD often experience issues such as insomnia, eczema, constipation, diarrhea, behavioral outbursts and more. If your child has any of these issues, you might want to see if it is a reaction to foods that are not good for their system or if their intestines are out of balance. Healthy eating habits can make a big difference in the lives of children with ASD.
9. Nurture your child’s strengths—Children improve faster when they work on strengths. Focusing on your child’s strengths, not weaknesses, puts them on the path to their personal best, allows them to develop and excel in things they’re good at, and can greatly improve their self-esteem and well-being. It can also foster a better parent-child relationship.

Magellan Healthcare is committed to improving all lives affected by autism. Visit our Autism Acceptance website for:

• Free resources that increase awareness, celebrate differences and support inclusion.
• Online and tech-enabled resources to help children with autism navigate daily life and empower parents, families and caregivers to support them on their journeys.

Sources:

[1] https://www.cdc.gov/ncbddd/autism/data.html

What is neurodiversity?

 Everyone’s brain is different and develops in its own way. Neurodiversity refers to diversity in the ways in which people experience the world, be it at school, at work or in social settings. Neurotypical individuals’ brain functions are considered “usual” or “expected by society.”

Understanding neurodivergence

Individuals naturally approach thinking in various ways. Neurodivergent individuals’ brains are unique and their behaviors or responses differ from what is expected socially, physically or verbally. Approximately 15-20% of the population is neurodivergent. Some of the most prevalent conditions among individuals who identify as neurodivergent are:

Myths and facts about neurodiversity

 Understanding neurodiversity and the specific challenges neurodivergent individuals face is crucial for creating inclusive and supportive environments. By educating ourselves, we can dismantle stereotypes and stigmas that inadvertently affect others.

Myth: Neurodiversity is the same as ASD.

Fact: Neurodiversity includes ASD, as well as other neurological conditions, such as ADHD, dyslexia, dyspraxia, intellectual disabilities, Tourette’s syndrome, obsessive- compulsive disorder (OCD) and other mental health conditions.

Myth: All neurodiverse individuals are the same/similar.

 Fact: All individuals, whether neurotypical or neurodiverse, are unique in their learning and experiences. Recognizing the diversity within neurodiverse individuals is key to developing inclusive environments.

Myth: Neurodivergent individuals lack communication skills. 

Fact: Like neurotypical individuals, neurodivergent individuals have diverse communication styles. Many communicate effectively in their own unique ways. Tailoring communication strategies to diverse styles fosters inclusivity and supports personal growth.

Myth: Neurodivergent individuals choose not to engage in forming relationships.

Fact: Many neurodivergent individuals genuinely desire connections with others but often feel sadness or a sense of isolation when faced with difficulties in forming those connections. Nonetheless, they can have authentic, enduring relationships, particularly when others are accepting and mindful of their differences.

Myth: Neurodivergent individuals have little chance of succeeding in school, at work or in their communities.

Fact: With equitable opportunities and tools, neurodivergent individuals can be just as successful as others.

Famous neurodivergent personalities

 Many well-known individuals are neurodivergent and have made extraordinary contributions to our world.

• Benjamin Banneker—Self-taught African American mathematician, astronomer and inventor who was appointed by President George Washington to assist in the surveying and planning of Washington, DC
• Simone Biles—African-American gymnast who has won numerous Olympic and World Championship medals and is considered one of the greatest gymnasts of all time
• Tim Burton—American filmmaker, artist, writer and animator known for his unique and imaginative film style, including “Edward Scissorhands” and “The Nightmare Before Christmas”
• Lewis Carroll— English writer, mathematician and photographer who is best known for his literary works, particularly “Alice’s Adventures in Wonderland” and “Through the Looking-Glass”
• Bill Gates—Co-founder of Microsoft and a leading figure in the development of personal computing
• Thomas Jefferson—One of the Founding Fathers of the United States, principal author of the Declaration of Independence, and third president of the United States
• Michaelangelo—Italian Renaissance sculptor, painter, architect and poet who is renowned for masterpieces like the Sistine Chapel ceiling and the statue of David
• Nikola Tesla—A Serbian-American inventor who made significant contributions to the development of alternating current (AC) electrical systems and other inventions
• Emma Watson—English actor and model known for her role as Hermione Granger in the “Harry Potter” film series and being an advocate for women’s rights

Neurodiversity involves acknowledging and valuing the diverse ways our brains work. Neurodivergent individuals experience, interact with and interpret the world in distinctive ways. When we appreciate and celebrate neurodiversity, we cultivate inclusive communities that allow neurodivergent individuals to thrive.

 How can I learn more about neurodiversity and neurodivergence?

Find more information and helpful resources at MagellanHealthcare.com/Autism-Resources, including online and tech-enabled resources to help neurodivergent individuals navigate daily life and empower parents, families and caregivers to support children on their journeys.

Sources:

• Debunking Myths About Neurodiversity in the Workplace | by Stephanie Barnes | Medium
• Debunking The Neurodiversity Myths – eLearning Industry
• Famous Neurodiverse Individuals – CASS (casscounselling.co.uk)
• Successful People with Neurodivergent Disabilities – Student News (manchester.ac.uk)

As October comes to a close, so does the monthly observance known as National Disability Employment Awareness Month. This year’s theme selected by the Office of Disability Employment Policy was “Advancing Access and Equity.” According to the Autism Society, adults with Autism are represented in every field of employment.

In this Q&A article featuring Dr. Amy Latta, a psychologist advisor for Magellan Healthcare, we explore the question – is Autism a disability?  Dr. Latta shares her thoughts on this question below.

Q: Is autism considered a disability (from social, legal, and medical viewpoints)?

Dr. Latta: The medical and legal perspectives both view Autism as a disability. The disability is created when the individual’s impairments (social communication and social interaction, as well as restricted interests, behaviors, or activities) interfere with daily functioning.

In contrast, a social perspective views the individual with Autism as “neurodivergent”  or having a brain style that is simply different from the average or “neurotypical” person in society.  From this perspective, Autism is not a disability. The disability is created by society’s lack of acceptance of an individual with a different or “neurodivergent” brain style. Within this framework, as society becomes more inclusive of persons with Autism and adapts better to their needs, the disability fades.

Q: How do you discuss neurodivergence with a child with autism?

Dr. Latta: If you ask a group of children to draw a person enjoying something fun, do you think all the pictures will look the same? Would anyone’s drawing be the “right” drawing or the “wrong” drawing? That is neurodivergence. It means everyone’s brain functions differently. There is no right or wrong way.

Q: Please briefly outline state government disability benefits people with autism can take advantage of.

Dr. Latta: Social Security Administration’s (SSA) administers the Social Security Income (SSI) program, which provides financial assistance to children and adults with Autism. In order to meet eligibility for SSI, there are income limits and medical requirements (e.g., symptoms of Autism need to be severe enough).

Q: How does getting disability benefits differ for children and adults (especially for parents with teens about to turn 18 – do they need to go through the process of conservatorship before the 18th birthday or will their child need to show financial responsibility, such as a job or paying rent, to get the full amount of disability)?

Dr. Latta: A child (under age 18) with Autism may qualify for Social Security Income (SSI) if the symptoms of Autism are severe enough and the parents’ income does not exceed the income limit. The income limit increases with each additional child under age 18 in the family.

Once a child with Autism turns 18, the parents’ income is no longer counted (even if the child is living at home) in the calculation for SSI benefits.

If a child is going to turn 18 and needs help making life decisions as an adult, the family may want to consider providing support to the child after age 18 through guardianship, conservatorship, or power of attorney. Guardianship and conservatorship are more involved legal processes so the family will want to start this process six months before the child turns 18.

Guardianship: A trusted adult is court-ordered by a judge to make decisions on behalf of the individual. There are full and partial guardians. A full guardian can make decisions about all areas of an individual’s life. A partial guardian can make decisions about select areas of an individual’s life.

Conservatorship: A trusted adult is court-ordered by a judge to make decisions about financial affairs only.

Power of Attorney: Is a legal document that authorizes a trusted adult to make decisions about the individual’s property, finances, or medical care. Under a POA, the individual still retains the right to make decisions on his or her behalf.

Applied behavior analysis

Applied behavior analysis (ABA) is a science-based therapy that can help individuals with behavioral, developmental and social challenges. It is rooted in the principles of behaviorism and focuses on reinforcing positive behaviors while reducing negative ones. In this article, we will explore who can benefit from ABA, who can provide ABA therapy, how to access ABA therapy and more.

Who can benefit from ABA?

ABA therapy can be beneficial for a variety of individuals, including those with autism spectrum disorder (ASD), developmental disabilities and learning disorders. ABA therapy can help with communication skills, social skills and behavior management. It can also improve adaptive living skills.

Who is qualified to deliver ABA?

ABA therapy is delivered by what is generally known as a Board-Certified Behavior Analyst (BCBA). These professionals have a master’s or doctoral degree and have passed a certification exam. BCBA’s also have extensive training and experience in the principles of ABA therapy. There are also professionals who can provide ABA therapy under the supervision of a BCBA and are commonly referred to as:

• Board Certified Assistant Behavior Analysts (BCaBAs)—Have completed a bachelor’s degree and have passed a certification exam.
• Registered Behavior Technicians (RBTs)—Have completed a minimum of 40 hours of training and have passed a competency assessment.

In addition to these professionals, ABA therapy teams may also include speech-language pathologists, occupational therapists and physical therapists. These professionals work together to provide a comprehensive approach to ABA therapy, addressing your child’s unique needs and goals.

How are ABA services accessed?

Accessing ABA services is a multi-step process:

1. A diagnosis and recommendation for ABA therapy is made by a medical doctor (MD) or a healthcare-related PhD.
2. Parents contact their health plan or an ABA provider to begin the process of securing insurance authorization to conduct an assessment.
3. An ABA provider works with parents to ensure insurance approval is granted before the assessment begins.
4. A BCBA conducts the assessment. If the child is deemed a suitable candidate for ABA therapy, the BCBA submits treatment recommendations to the health plan.
5. Once the health plan approves the recommendations, ABA therapy can begin.

Insurance coverage for ABA therapy may vary depending on the specific diagnosis. It is always prudent to check with your health plan to determine which diagnoses are covered. This process ensures your child receives the proper care and the health plan covers the cost of ABA therapy consistent with the terms of your coverage.

What are other pathways to ABA?

In addition to accessing ABA therapy through health insurance authorization, you can explore:

• State-funded programs which provide services and support to individuals with developmental disabilities. They can also help you identify ABA providers and may cover the cost of therapy for eligible children.
• Local school districts that offer Individualized Education Plans (IEP). Schools may have in-house ABA providers or work with outside agencies to provide services to children in need.
• Out of pocket, or private pay, allows you to choose your own ABA provider and have more control over the type and frequency of therapy sessions.

It is important for you to explore all options and choose the pathway that best meets your needs and the needs of your child.

How are goals developed and how is progress measured?

Goals for ABA therapy are developed based on your child’s unique needs and abilities. A BCBA will conduct an assessment to identify areas of strength and areas for improvement. Once goals are established, progress is measured through data collection and analysis. This information is used to adjust treatment plans as needed. Progress reports are shared with you and other professionals involved in your child’s care.

 What does ABA look like?

ABA sessions are typically conducted one-on-one with a BCBA, RBT or BCaBA. ABA sessions are highly structured and tailored to meet your child’s specific needs. A typical ABA session is comprised of three main components.

1. Goal implementation—During sessions, the therapist works with your child to help them achieve their goals which are developed based on their unique needs and abilities.
2. Behavior plan implementation—Behavior plans are developed to address specific behaviors your child is struggling with. Therapists use positive reinforcement strategies to increase positive behaviors and decrease negative ones.
3. Family/caregiver training and support—Family and caregivers play a key role in the success of ABA therapy. During ABA sessions, therapists work with family and caregivers to provide training and support. Family and caregivers learn the core principles of ABA, along with strategies to help reinforce positive behaviors at home and manage challenging behaviors. By working together, the therapist, your child and you can achieve positive outcomes and promote meaningful change.

Where can ABA take place?

ABA therapy can be delivered in your child’s natural settings, including home, school and the community. Therapy can also take place in clinics. The therapist will collaborate with you and other professionals to determine the most appropriate setting for your child.

Interested in learning more about ABA?                              

• Find and watch the recording of our webinar, “What is Applied Behavior Analysis (ABA) and how can it help my family?” here.
• Visit the following websites:
  • Centers for Disease Control and Prevention (CDC)—Learn about early signs of ASD, severity levels and how they are defined, types of testing available and more.
  • Autism Speaks—Learn the signs of autism and become familiar with the typical developmental milestones that your child should be reaching at all ages.

A certain amount of ambiguity surrounds the term autism and often suggests a stereotypical image, but autism affects individuals uniquely. Over the years, professional theories about autism and other childhood disorders shifted to try to better capture what is now known as Autism Spectrum Disorders (ASD). Causes and treatments continue to be put forth to capture pieces of the mysterious puzzle. Though commonalities persist, each person with ASD experiences a unique level of impact on skills, intelligence, and capability and even the characteristics of siblings with ASD can vary widely. A few unique thinkers and accomplished artists that fall into this population are Albert Einstein, Thomas Edison, Emily Dickinson, Sir Isaac Newton, Beethoven, Mozart, de Vinci, Anthony Hopkins, and Jerry Seinfeld.

Early Warning Signs

Currently, one in forty-four children are diagnosed with ASD, with over 1 million reported to be in active-duty military families, according to 2021 CDC data (7) and Operation Autism (11). The American Autism Association offers some early signs and symptoms to be aware of for parents raising young children. (1):

Communication

• Delays in language development.
• Quirky repetitive language or sounds.
• Inability to initiate or maintain speech.
• Responds by repeating a question, rather than answering it.
• Difficulty communicating needs or desires.

Social Interactions

• Lack of appropriate verbal and nonverbal behavior.
• Lack of ability to develop peer friendships.
• Social and emotional exchange challenges, including maintaining eye contract.
• Minimal tolerance to being touched, held, or cuddled.
• Trouble perceiving or talking about feelings.
• Trouble sharing interests or successes with others (art, playthings).

Patterns of Behavior

• Restricted, repetitive and stereotyped behaviors.
• Difficulty in motor control
• Peculiar connection to objects.
• Distress with change in routine.
• Lining up toys.
• Head banging or rocking back and forth.

Looking Closer

Concerned parents are encouraged to speak to their child’s medical provider. Most communities offer free screenings to assess developmental progress and check for school readiness. The earlier an ASD screening occurs, the better, as this is the first step toward diagnoses which leads to important early interventions. Siblings of children with ASD screened, since ASD can present families. Military treatment facilities can assist through Educational and Developmental Intervention Services (EDIS). Once a screening determines risk factors and signs of ASD, a formal diagnostic evaluation is conducted to identify areas that may be addressed in treatment, such as challenges in social communication, behaviors, sensory issues, and the level of impact on daily functioning is assessed. (1)

Children on the autism disorder spectrum experience a unique combination of impacts on brain functions (i.e., thinking, memory) that may reflect some strong skills in one functioning area and low abilities in other areas. For example, a strong math aptitude may be coupled with a slow processing speed that appears as laziness to observers. Social issues may surface as peer conflict and loss of friends due to errors in interpreting social cues and sensory discomfort felt when looking others in the eye. A perceived lack of empathy may result from a child experiencing intense feelings of empathy, but not knowing how to identify or act on them, and then responding inappropriately. Inadequate verbal skills and meltdowns may occur when emotional or sensory stimulation floods the child, maxing their coping skills (as with loud noises or unexpected changes).

Easily knocked out of balance, these children struggle to identify and communicate their needs. Sensory sensitivity, such as the feel or fit of clothing fabric, food texture or taste, odors, certain sounds, temperature variations, and light levels can flood the brain at unbearable levels. Food refusals can make it difficult for them to receive adequate nutrition, complicating healthy development. Nearly half will run or wander off without warning and many struggle with physical tasks like writing or riding a bike. With 40% of ASD children lacking verbal skills, it can be stressful for both caregivers and child to understand each other despite access to communication assistance devices. (4)

Diving Deep

The five major types of disorders falling under the ASD umbrella are Asperger’s, Rett’s, Kanner’s syndrome, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder. It is very common to see other disorders accompanying ASD like Attention Deficit Hyperactivity Disorder (ADHD), Dyslexia, and Dysgraphia which can complicate the individual’s learning processes. Other concerns affecting this population in higher numbers are bullying, self-injurious behavior, anxiety, depression, schizophrenia, various health issues and physical disabilities.

Boys are four times more likely to be diagnosed with ASD than girls. (7) Professional theories have asserted that girls may be more likely to compensate by masking their symptoms resulting in a missed diagnosis or being misdiagnosed. (11). Girls may have subtle symptoms or higher functioning and do not always exhibit characteristics according to traditional ASD testing markers.

High functioning autism, (Asperger’s, ‘Aspie’), is seen in individuals with high levels of intelligence in some areas and deficits in others. The terms ‘camouflaging’ or ‘masking’ refer to sophisticated compensation skills where one notices, studies, and mimics the social skills of others, to compensate for natural tendencies. This can trigger remarks about them being too outgoing to have autism and undermine their self-awareness and identity. (5) ‘The invisible edge’ coined by Autism specialist Tony Attwood, describes these persons as flying under the radar resulting in either a late diagnosis or a missed diagnosis. (2) Delays in confirming the diagnosis hinder crucial access to early services and lead to the child facing expectations outside their abilities.

Compassionate Responding

Caring for a child with ASD can be quite physically and emotionally exhausting. Finding support can make a big difference. When a parent is stressed, it can be hard to be their best self for their special needs child and the rest of the family. Self-care for the caregiver is a necessary survival skill. Military installations offer respite care to help the caregivers and some states will offer pay for respite caregivers.

Emotional outbursts are common for children with ASD and challenging for parents to handle. It is helpful if the caregiver remains calm and models good coping skills from which the child can then draw to self-soothe. Using a distraction or special interest of the child (reading or playing with cars) can help calm the child. Raising voices and increasing tension can inadvertently prolong periods of challenging behaviors. Attuning regularly to the nuances of the child offers a parent greater ability to notice and appropriately respond to symptom escalation.

The American Autism Association identifies common interventions to include speech and language therapy; occupational therapy to address motor skills, sensory issues, and functional living; play therapy and floor time to aid in emotional and cognitive development; and social skills/ communication therapy to assist with socialization and emotional management. (1) Building a team of professionals around the child supports growth. It is vital to keep in mind that individuals with ASD can be quite gifted in areas of aptitude, enjoy life, and lead productive careers.

Military Families

Military lifestyle challenges are already difficult for the average family but for the family dealing with autism, essential care can be complicated. The process of confirming an ASD diagnosis can take up to 18 months to complete due to long wait times for testing. For the military family, duties, and permanent changes of station (PCS) moves can not only complicate this timeline but also delay the feedback process from providers and teachers who may have less opportunity to consistently observe and work with a child. Additionally, remote installations may not be able to offer access to all the necessary services, making participation in the Exceptional Family Member Program (EFMP), a significant benefit to the military child, less feasible. Operation Autism offers an in-depth resource Guide for Military Families and an interactive geographical map of resources. (11)

Many ASD symptoms can be intensified by stress and frequent changes that come with the military lifestyle as these children benefit most from a predictable routine and steady environment. Frequent relocations, changing homes, schools/ teachers, and making new friends, are especially difficult for children on the spectrum. With social skills already elusive, the ASD child may find these changes unbearable. Frequent social rejections and bullying can further frustrate attempts at making even a single real friend. Higher stress can lead to more health issues with these children who do not read their body cues well and even a loss of previously gained skills.

Magellan Federal Solutions

Magellan Federal provides counselors for many programs like the Military Family Life Counseling Program (MFLC) located on many installations within the US and overseas. The MFLC program is available to service members and their families for non-medical support. Although the medical nature of the ASD diagnosis causes the child to be out of scope for direct MFLC services, family members can be supported with counseling, resources, and referrals. The MFLC program offers a variety of including Healthy Steps Specialists working with parents of children 0-3 in pediatric clinics; Child and Youth Behavior Counselors working in the Child and Youth Program in CDCs/ school age services, and schools; and Adult MFLCs located in the family readiness centers. Other resources an MFLC might make referral to are Exceptional Family Member Program (EFMP), New Parent Support Program (NPSP), Tricare, and Military OneSource. Each of these assist parents with specific concerns related to their children.

EFMP is an installation-based program (offered by the Magellan Federal family in some locations) serving the military family with special needs members and is the best first stop for the family with a child newly diagnosed; offering support, resources, and information on assistance like respite care for parents. NPSP, also provided by Magellan Federal family at some locations, offers military families in home support to assist families with children under age five with visits by a nurse or social worker.

Regardless of when in the journey an ASD diagnosis is received, the military family does not have to travel the road alone. Magellan Federal is committed to providing support and guidance along the way.

This article was originally published on MFed Inform.

Resources and Bibliography

1. American Autism Association: myautism.org, https://www.myautism.org/information-kits https://www.myautism.org/informational-kits/general-therapies-for-individuals-with-autism
2. Attwood, Tony. Asperger’s Syndrome: A Guide for Parents and Professionals. Jessica Kinglsey Publishers 1998.
3. Autism Society: https://autismsociety.org/
4. Autism Speaks: autismspeaks.org
5. Abilities Workshop: https://special.abilitiesworkshop.com/autism-resources?gclid=EAIaIQobChMIiPj53OG9_QIVGXxvBB3CQg1tEAAYASAAEgJgTPD_BwE
6. Bargiela, S., Steward, R. and Mandy, W. (2016) ‘The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. Journal of Autism and Developmental Disorders 46, 3281-3294
7. Center for Disease Control https://www.cdc.gov/ncbddd/autism/index.html
8. Exceptional Family Member Program (EFMP), an installation-based program offered by the Magellan Federal family in some locations, serving the military family with special needs children, including autism and is the best first stop for the family with a child newly diagnosed with ASD; offering support, resources, and information on assistance opportunities like respite care for parents.
9. Military OneSource offers a special needs consultant at 888-342-9647, articles and information. militaryonesource.mil
10. National Professional Development Center on Autism Spectrum Disorder. (NPDC). https://autismpdc.fpg.unc.edu/national-professional-development-center-autism-spectrumdisorder. Develops free professional resources for teachers, therapists, and technical assistance Focused Intervention Resources and Modules (AFIRM), a series of free online modules.
11. Operation Autism website offers a resource Guide for Military Families including an interactive geographic guide to local resources at https://operationautism.org/autism-101/causes-and-prevalence-rates/. https://operationautism.org/resources/bases-map/.
12. Organization for Autism Research (OAR). https://researchautism.org/ Non-profit organization responsible for creating Operation Autism and guide and offers free resources either as a digital download or hard copy.
13. Tricare offers special needs liaisons and autism specific resources and information including providers and programs like Echo and Autism Care Demonstration.
14. Extended Health Care Option (ECHO) supplemental benefit for Active Military families with special needs. More information provided through Tricare.org
15. Autism Care Demonstration. https://www.tricare.mil/Plans/SpecialPrograms/ACD