Psychology is the study of the human mind. This social science has made huge contributions to the understanding and treatment of autism. There are a number of ways in which psychologists can and do play a role in helping children and adults with autism. It’s important to note that psychiatry, a closely related field, also involves medical interventions (pharmaceutical treatments).
:max_bytes(150000):strip_icc()/childtalkingtotherapist-5a368b1f980207003717858c.jpg)
izusek / E+ / Getty Images
Psychotherapy is built around the use of the spoken word. For verbal people on the spectrum, psychotherapy can be a very useful tool for managing symptoms such as anxiety or compulsions. It can also help people with autism to better understand how their actions and reactions are perceived by others.
Applied behavior analysis is a form of behavioral therapy, which is based on traditional psychology. ABA is often used successfully to treat individuals with autism. ABA, however, is not talk therapy; rather it is a carefully structured process wherein an individual is taught skills using rewards to reinforce correct answers or preferred actions. Typically, ABA is provided by therapists with specific ABA training.
Both psychotherapy and other forms of therapeutic interventions are used to improve psychological functioning through behavioral means. These therapies can be completed individually and in groups at both schools and outpatient clinics. Children and parents can participate.
Developmental psychology is a branch of psychology that deals with child development and explores typical and atypical development, questions of nature versus nurture, and related topics. Developmental psychology is the basis for several well-known treatments for autism, including SCERTS, Floortime, and Relationship Development Intervention (RDI).
Some other areas of psychology that are often helpful for people on the spectrum and their families include:
- Drama therapy
- Play therapy
- School/educational psychology
- Family psychology
What Does a Psychologist Do For People With Autism?
Psychologists are often involved in the process of diagnosing both children and adults with autism. They may also recommend appropriate treatment programs, and/or support the process of evaluation, benchmarking and ongoing assessment.
Developmental and child psychologists work with children to help them engage with others through play, and learn skills such as joint attention (doing something WITH rather than NEAR someone else).
School psychologists may work with autistic students to help them engage with their peers, manage stress, or handle difficult interactions with bullies or general teasing. They may also work with parents and teachers to develop strategies for school success.
Psychologists work with both children and adults with autism to treat issues such as social anxiety, depression, and perseverative behavior (doing or saying the same things over and over again). Psychologists also work with individuals on the autism spectrum to help them manage self stimulation (stims), “autopsy” social interactions, understand social cues, and manage school and work relationships.
Behavioral psychologists are in high demand within the autism community. They may evaluate autistic behaviors to better understand their meaning and purpose, develop behavioral (ABA) programs to teach a wide range of skills, or help families to manage aggression and other problematic behaviors in the home.
Where Can I Find a Qualified Psychologist?
Because there is no such thing as an “autism psychologist,” there is no directory of psychologists skilled in working with children or adults with autism. To find an appropriate psychologist, parents may want to start at a local children’s hospital with an autism center or program; at a regional autism center; or in the school district. Adults with autism can do a local online search, but may be better served by connecting with autism self-advocacy organizations such as GRASP.org.
A child who is struggling and falling behind in school is not a happy child. Kids who have learning disorders, or attention problems that make learning unusually difficult, often suffer for several years before parents and teachers figure out that something is standing in their way.
Once a child’s learning challenges are identified, they may benefit from having an educational therapist to work with them on developing the skills they are missing, and on devising learning strategies that build on their strengths and compensate for weaknesses.
An educational therapist is a professional who is trained to understand an individual child’s learning challenges, and the patterns and behaviors they have developed to work around, or mask, their deficits. Some of those behaviors—avoidance, acting out, even tantrums—may have been misinterpreted by parents and teachers who read them as opposition or impulsivity.
Helping the whole child
ETs have a range of professional backgrounds, from special education to speech and language therapy to psychology. But they are all focused on the whole child—that is, the emotional as well as cognitive factors involved in successful learning.
When educational therapist Ruth Lee, M Ed, works with children who have dyslexia, for instance, they have usually fallen behind their peers in reading skills, and are often discouraged and anxious, to some degree, about learning in general.
For the first couple of years of school, many kids with dyslexia successfully mask the fact that they’re not learning to decode, or sound out words, the way other kids are. They are able to keep up, more or less, by memorizing words and listening extra hard to the teacher. But by the third or fourth grade they often hit a wall, because the amount of reading, and the number of new words they are expect to be able to decipher, rises exponentially. “In the first three grades,” Lee notes, “we say kids are learning to read. By the fourth grade they need to be reading to learn.”
Her job is to bolster a child’s reading skills and their fragile self-confidence. For the reading work, Lee, who is a trained Wilson Reading System instructor, goes back to the point where the student ran into difficulty and moves forward. “You have to start where the child can be successful,” she notes. To develop decoding skills she uses what she calls multi-sensory instruction. “That means hearing the sound of the letter, saying it, repeating it, visualizing it in your head, sky-writing it with big hand motions, kinesthetically, and then writing it small, using fine-motor muscles. Sometimes we have kids write in shaving cream or whipped cream, or draw the letters in sand or mud, to experience that resistance.” She’s not working with kids on their homework, but working on skills they can apply to their homework.
Understanding the rationale
In addition to dyslexia and other learning disorders, many kids need help organizing the work they need to do, using what are called executive functions to visualize, plan, and push a project through to completion. Educational therapists help with strategies for getting started, memorizing information, and building new skills.
“One of the biggest struggles that characterizes almost all of kids I see is they don’t know how to think about how to do work in an organized way,” says Matthew Cruger, PhD, a neuropsychologist at the Child Mind Institute. They don’t have a strategy or plan to do it, a sense of the skill set they have to bring to bear on it.”
Without that mindset, Dr. Cruger notes, kids experience a lot of frustration when they approach homework. “They don’t see that homework has a purpose, that the reason they’re doing these problems, for instance, is to be able to master a new skill, or reinforce what they’ve learned in class. Sometimes assignments don’t get translated explicitly that way for kids.”
One of the roles of the homework therapist is to help kids understand why they’re doing what they’re doing, what the rationale is. “Kids with attention problems, in particular, are very pragmatic in a way about how much effort to put into things. We think of it as ‘neuroeconomics’—they save their energy for things they are confident will pay off.”
That’s why it’s so important for an ET to help kids score some successes. “When kids put hard work into something, they expect a return, and if don’t see the return, it’s doubly frustrating,” says Dr. Cruger. “They’ll think, ‘You see, it wasn’t a good idea to try.”
End procrastination
Often the work of an ET involves helping kids develop a routine to get started doing homework, to get into gear, so to speak, without squandering a lot of emotional energy. “Sometimes a parent will say to me, ‘He just doesn’t want to try,’ says Dr. Cruger. “I’ll talk to the child and he’ll tell me, ‘I’m lying there thinking, but I just can’t get started.’ We have to figure out what’s getting in the way of that.”
“You want them to learn to be independent self-starters,” notes Lee.
Building a positive relationship
Finding an educational therapist to work with your child depends upon their particular needs, but also personality. The first thing the ET needs to do is build a positive relationship with the child. “You have to overcome the negative feelings that have built up around learning,” says Dr. Cruger. “Kids have to feel safe and comfortable in order to learn, especially when you’re asking them to expose what they can’t do.”
A good therapist will use a lot of positive reinforcement. “When they do something great, you make the most of it,” Lee says. “When they mess up, you minimize it. You need to show them that making errors is part of learning.”
Dr. Cruger adds that while different kids will respond to different kinds of specialists, personality matters a lot—”a person who’s clear, nonjudgmental, encouraging, and able to use humor will be most effective for many kids, especially one’s who have become demoralized about learning.”
Of course the therapist also needs to be fairly firm, he adds. “We can’t let a kid use the time inefficiently,” he notes. “If they’re spending a lot of time fooling around, it would be a death knell not only for the therapy, but also for learning how to how to approach schoolwork effectively.”
