Contributor: Thomas Frazier, II, PhD
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Imagine I’m having a light-hearted conversation with a friend who says something silly. I gently joke, “Your head is full of rocks.”
I don’t mean that literally. If you are a neurotypical person, you understand I’m joking. You hear it in my tone of voice and see it in my body language.
But if you have autism and witness this conversation, you might be confused. If you have autism with severe social impairment, you might take my words literally and wonder why I would say such a thing. If you have autism with mild to moderate social impairment, you might understand I’m not being serious. However, you might still struggle with the context of the joke and why I am making it.
This situation illustrates a difference people with autism face in how they perceive the world. This perception includes many elements — social cues, body language, verbal language, interaction and more. But it boils down to how a person pieces together a coherent story of the world around them, then acts on that story appropriately.
Below are a few examples of how this perception plays out as a child ages, as well as how you, as a parent, can help your children practice to better understand the world around them.
“It boils down to how a person pieces together a coherent story of the world around them, then acts on that story appropriately.”
Director, Center for Pediatric Behavioral Health, Center for Autism
Perception changes appear early
Parents often ask me when these perception differences appear. The answer: very young. We can see them in infants in many cases.
As neurotypical infants develop, they start to clue in to facial expressions. They look at your mouth and your eyes. They listen to your voice for emotional cues. They respond to your behavior with a giggle or a smile.
Those reactive giggles and smiles are often missing in children with autism. In addition, common actions such as pointing to draw attention to an object — usually common by age 1 — might be missing, too. And if a child does not respond to his or her own name by 14 months, that often is an early sign of autism.
It’s important to note there are different levels of perception depending on your child’s diagnosis. All of these behaviors might be absent in lower-functioning children with autism. But things often look different for high-functioning children.
For instance, they may exhibit some of the typical social cues in early development. But then, when they start learning language, they often become frustrated by those “nonliteral” verbal scenarios like the joke example above. Think of how many similar scenarios play out on playgrounds and in classrooms as a kid grows up.
That sort of perception difference is a little harder to spot. But if your developing child commonly struggles with interaction and is easily frustrated by not “getting it,” it’s worth discussing with an autism expert.
How you can help
For people with autism, navigating the social world with a different sense of perception takes time, practice and support.
That’s why it’s critical for parents to heed signs and reach out for guidance when needed. It’s much better for children to get assistance through behavioral approaches than for them to withdraw in frustration or act out because the world around them provokes anxiety.
Behavioral approaches start early — and simply. Take responding to a name, for example.
We help a child practice their response to names by:
- Saying the child’s name, then orienting the child’s body or face to the person saying it.
- We then immediately reinforce this appropriate behavior with a reward — a cracker, a toy or a sippy cup.
Best of all, parents can reinforce this behavior easily at home. And it works far better than simply saying the child’s name over and over again. That’s a recipe for frustration.
There are behavioral strategies for more difficult situations, too. For conversations, we often practice what we call “whole-body listening” in a clinical setting. We use pictures and models to show them what a typical conversation looks like in terms of body language, facial expressions, and both verbal and nonverbal cues.
Then, we practice with them. This practice may start with a clinician modeling appropriate listening, extend to classmates, and then grow into real-world situations. A parent can help by continuing this practice at home.
A parent also can help simply by recognizing how frustrating it can be for a child with autism to navigate a social world that doesn’t come naturally to them. In this regard, patience and understanding can be just as important as practice.