If an autism therapy takes six months to show outcomes, is it really working?  This is a tricky question for two major reasons.

First, autism therapies are typically applied to very young children, who are rapidly growing, changing and maturing.  Six months in the life of a three year old is an enormous amount of time - time enough for even a typically developing child to build a vocabulary, develop social skills, learn to manage emotional overloads, and so forth.  If you have to wait six months for results, it becomes extremely difficult to know whether it's ABC therapy or simple maturation that's making the difference.

Second, most children with autism are involved in multiple therapies during any six month period (in addition to school, which may be therapeutic in its own right).  It can be very tough to know whether it's the speech, occupational therapy, physical therapy, social skills therapy, dietary supplements, behavioral interventions or special diet that's most effective in changing behaviors or improving skills.

Is there really any therapy, though, that can show outcomes "instantly?"

The answer is yes - and I can vouch for this because I've seen it, both in person and in videos.  Two such instant outcomes stand out in my mind.

The first relates to my son.  When he was three, he had virtually no idea of pretend play.  He'd play chase games or scribble with a marker, but make believe had no place in his world - and this was a major issue in his social/emotional development.  I had read a book by Stanley Greenspan about Floortime therapy, and, based on his examples, I started to teach my son to make believe.  In just twenty minutes, my three-year-old had gone from no symbolic play to "getting" the idea of pretending to feed grapes to his stuffed cat - and was well on his way to role-playing with his Thomas the Tank Engines.

The second comes from a video I viewed about the proper use of PECS picture exchange cards with children on the autism spectrum.  PECS are simply cards with images of often-desired objects; non-verbal children trade the cards for the actually objects as an initial step in the process of building communication skills.  In the video, I literally watched a wild thing turn into a small human being within moment by the simple measure of being offered the means of communication.  Frustratingly, Pyramid Educational Consultants (inventors of PECS) does not offer this or similar videos for free - though it looks like their site will soon offer downloads.

Both of these events brought tears to my eyes, as they probably would to yours.  And both proved to me that improvement for kids with autism is not only possible but probable - and that we need not wait for days, weeks, months or years to see positive outcomes.  While my son - and almost certainly those children I watched in the PECS videos - are still autistic, they've come a very, very long way.

Have you had an opportunity to witness "instant outcomes?"  Share your story!

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Just wanted to wish you all a joyous holiday. All the best, Lisa Jo Rudy Autism Guide

I'm a great reader of children's literature.  And now that I'm homeschooling my 13 year old son with high functioning autism, I'm "previewing" (and reviewing) novels that I think he might enjoy.  What's struck me in reading these books is how many of the characters - sometimes the heroes, sometimes the secondary characters - seem to be described in such a way that they could easily be considered autistic.  For example...

Calder's grandmother had once told him that he breathed patterns the way other people breathed air. Calder sighed. If only thoughts didn't have to be broken down into words.  Too much talk was hard to listen to, and writing, for him, was a brutal process. So much got left behind. ( From Chasing Vermeer by Blue Balliett)

It was true that Charles Wallace seldom spoke when anybody was around, so that many people thought he'd never learned to talk.  And it was true that he hadn't talked at all until he was almost four. ...  "Don't worry about Charles Wallace, Meg," her father had once told her..."There's nothing the matter with his mind.  He just does things in his own way and in his own time." (From A Wrinkle in Time by Madeleine L'Engle)

Of course, characters like Calder and Charles Wallace wind up being heroes, and saving the day by the end of the book.  Their status as weirdos and outcasts don't seem to have any serious impact on their ability to solve mysteries, defeat baddies, or otherwise take action on the world around them.  Are they autistic?  Their differences are distinct enough that, to me, they certainly appear so.

As I thought about it, I realized that many, many characters from literature share the status of smart-but-odd loner, capable of great things but trapped in a world that misunderstands them (and that they misunderstand). Could they all be autistic?

And it's not just literature.  Last night, I watched the relatively new animated film Polar Express with my kids, and realized that one of the main children in the film showed every characteristic of Asperger syndrome.  Socially awkward with a flat affect, "professorial" in his self-presentation, and incredibly knowledgable about selected subjects, he's actually referred to as a "know it all."

All this reflection is simply a way of saying that I now see autism - everywhere.  And I begin to realize that the qualities that make up high functioning autism and asperger syndrome - social disconnectedness, perseveration on patterns and parts of things, verbal delays and differences, difficulty with establishing interpersonal relationships - have been around for a long time.

Do you know a character with autism?

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Santa is a very big part of the holidays in our part of the world.  From malls to grocery stores (!), you find him ho-hoing and generally pushing merchandise.  He's all over the TV, he's on every package in the store... and of course he'll be arriving tomorrow evening with his sack of toys.

Last week, we walked into a toy store where Santa stood outside welcoming kids.  He shook hands with my typically developing daughter, and then turned to shake my son's hand.  Tom is 13, but still looks like a little kid, and is not obviously disabled.  When Tommy turned his head away and tried to slip past, the Santa actually reached out, grabbed his shoulder, and said "Oh no, you've got to say hi to Santa!"  Fortunately for everyone involved, Tom just kept his face averted, shook hands, and continued into the store.  I followed.

Not every Santa would have been so lucky with a child on the autism spectrum.

Despite all the hype, we still get a kick out of Santa.  But I have sometimes wondered whether introducing pretend/real characters like Santa, the Easter Bunny or the Tooth Fairy into an autistic child's life is a terrific idea.

On the one hand, they're simply part of the surrounding culture - and no matter what your religious or personal views, it's important to know what they are and how they are supposed to act.

On the other hand, asking a tween with autism to grasp the idea that Santa is "real but not real but keep it a secret from the little ones" seems a bit over the top.  In many cases, it's tough enough to get across the idea of mutual gift giving and appropriate thank yous, along with managing radical changes in decor in and outside of homes.

How do you manage Santa with your child with autism?  Share your stories!

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