What is Autism?
If you are reading this, it is probably because you have something to do with a child who has been diagnosed as being on the autistic spectrum. Perhaps you are a parent, a teacher, a therapist. You are probably trying to make sense of this child. There are, in fact, many ways to do this, as there are several theories out there that try to explain what autism is and how we should respond to it. I want to introduce you to a theory that I believe can make sense of the big picture of autism. It is one that can explain the myriad of sometimes enigmatic “symptoms” but still imbeds autism in an encompassing “all too human” dynamic. It is one that draws on our insights about human nature and child development in general and allows us to trust our intuitions in our interactions with children on the spectrum. It is referred to as the relational, developmental approach.
This way of making sense of autism starts with a focus on the sensory-motor-emotional system of the brain. For reasons we do not yet know for sure, some children are born with a brain that lets more information into the brain than the brain can handle. These children are overloaded with all kinds of sensory information from the outside world, as well as sensory-motor-emotional information from inside their bodies, which results in critical impairments in terms of their attentional system. Simply put, these children are unable to filter out a sufficient amount of stimuli for their brains to focus and function optimally in our “neurotypical” world. Not only is this state of overload overwhelming and threatening in the moment, but it has serious developmental consequences over time (the extent of which depending, in part, on the degree of the filter issue – which is why autism is understood as being on a spectrum). One of the most serious of these consequences is the effect this state of overload has on the ability to form attachments.
The forming of attachment ...
...is a complex dance involving an intricate back-and-forth interaction between attachment partners. This dance involves being able to focus attention, receive and respond to gestures from the other in many different sensory-motor modalities, register and regulate emotional reactions, and much more. It is a complex “duet”. These interactions take place unconsciously and involve back-and-forths in the time span of micro-seconds. It is a highly coordinated yet intuitive “composition” for both parties involved. However, for a child with filter issues involving precisely the sensory-motor-emotional systems that this “duet” relies on, such back-and-forth interactions can quickly become belaboured, undefined, confusing – in fact, it may simply feel like noise instead of “music”. It may even feel aversive. At the least, these interactions do not have the “flow” that the child needs to feel contained by and connected to the other. The attachments are simply not able to “hold” them.
We are social animals dependent on attachments for our survival. This is also true for the child on the autistic spectrum. So when an autistic child is not able to form the attachments it needs (or atleast not as deeply or to the extent it needs), then the child will feel very highly alarmed indeed, especially considering that it is already experiencing a threat from sensory bombardment. It will also go into a kind of desperate seeking mode and experience profound frustration. These intense emotions themselves then feed additional overload into the child’s sensory-motor-emotional system and the child is caught in a tragically escalating dynamic.
The brain has few options in this kind of situation. One of the most serious of these options is to retreat, shut down. This is what people are often seeing when they comment on autistic children seeming to be “in their own world”. This defensive retreat has further negative developmental and attachment consequences, and so once again we have an escalating, tragic cycle, swinging back and forth between over and under stimulation, both on a sensory and an emotional level.
Even with this very brief overview of a relational-developmental approach to autism, we already have a clear road map for how to respond to our children on the spectrum. On the one hand, we need to reduce the sensory-emotional overload in the lives of these children in whatever ways we can. Ultimately this means we need to change “our” world so that it “works” better for them. This can be done very practically in terms of structuring daily life or reducing sensory stimulation, but also involves reducing the kinds of responses of ours that “fan the flame” of their overload on an emotional level. At the same time, we need to find ways to orient towards their brains in order to facilitate the forming of attachments that will give them the security and support they need to develop. If we understand what the brain is doing and how attachments form, we can enter the world of our autistic child and better support the “duet” of attachment.
One of the best ways to offer this support is in play. Play is a full-body experience, involving the entire sensory-motor-emotional system. Yet, due to the characteristics of play, when a child is in play mode, it does not experience overload. Play is deeply instinctual, for all mammals, including adult humans (although we may have lost our access to it). Children atleast are intuitively drawn to it, even autistic children. Play is, by definition, engaging, pleasurable. Within play, the child on the spectrum experiences safety and motivation to engage and explore. Granted, the child will need support to enter into this world of play (see Editorials). But once it is in this world – and there are always windows and doors to help the child slip in – the child has a stage upon which attachments can form and development can naturally unfold. This is precisely what needs to be happening in our process of “becoming” – whether we are “neurotypical” or on the autistic spectrum.