Child With AutismQuestion:I'm writing because I need some advice. I haven't mentioned this to many people because it is so new and my husband and I are still struggling to come to terms with it, but our 18 month old son has been evaluated by pediatricians, neurologists, and psychologists, and they are of the opinion that he is on the autistic spectrum. We have of course been doing our homework and talked with our providers about treatment, and they have ordered the standard treatments for autism which are all behavioral interventions based on rewards and punishment. We don't want to parent that way, of course, yet we are not aware of other treatments for autism and we want our son to have the best start. I guess my question is, are you aware of more Positive Discipline compatible treatments for autism and, if not, any advice for how we can get our son treatment while also keeping with the principles of Positive Discipline? Thank you in advance for any insight you might have into this matter. AW Answer:Dear AW, I am one of the people on the panel who answers questions to the Positive Discipline website; I am the parent of two adult children, and have worked with children with special needs for over 30 years (as a Clinical Social Worker and Psychologist). I can empathize with you and your husband as you struggle to understand what a diagnosis of autism might mean for your child (and for yourselves). One caution I have for you is to consider you child's young age and the vague diagnosis he has been given (i.e., "on the autism spectrum"). While it seems that your child has some unusual behaviors and/or special challenges (or, I'm guessing, you wouldn't have sought out assessment for him), I believe that there is an over diagnosis of special needs conditions for our children today (including for autism and related diagnoses). That said, he may benefit from interventions that would be different from the way you would parent a more typical child. Positive Discipline wouldn't offer "treatment" for autism, but could be a great compliment to an effective treatment program. Children with autistic behaviors typically respond well to set structures and routines; behavior modification programs (e.g. reward and punishment) are not necessary for them to be able to grow and develop cognitively and socially. However, I think you will find that most programs for children with autism rely upon behavior modification techniques; this makes sense when you remember that most elementary schools, and other programs serving school-age children, rely upon these methods, too (although they have repeatedly been shown to be ineffective). I don't know if any studies have been done, but I have worked with children with autism (and other special needs) for about 30 years, and I have found that PD works well, in conjunction with the structures and routines I mentioned earlier. (Although that's a fairly simplistic description of an effective approach to working with children diagnosed with autism – a full discussion is beyond the scope of this response.) You might also find it useful to read some of the popular literature about growing up with autism. One of my favorite books on the subject is Nobody Nowhere, by Donna Williams. The book is autobiographical, and very easy to read. Bernard Rimland, Ph.D. (and Director of the Autism Institute at the time the book was published in 1992) states in the Forward, "One of the techniques currently used by skilled teachers ...., behavior modification, the reward-and-punishment process ... [is used] to teach autistic children many of the simple things that normal children learn by osmosis ... [and] often brings about surprisingly great improvement in the child's overall behavior." However, it's interesting to note that Ms. Williams does not mention rewards or punishment as being useful to her learning process. She does give the reader insights into the way she processed the world as a child, and helpful hints for interacting with a child diagnosed with autism. For those of us familiar with Positive Discipline and the concept of the "purpose of the behavior," she includes a glossary at the back of the book explaining the "meaning behind" some of her behaviors. For example, she explained that she would tear paper as a "symbolic act of separation from others in order to reduce fear"; and noted that she would often tear paper when she had to say goodbye to someone, because she found to useful to symbolically "destroy the closeness in order not to feel any sense of desertion or loss." Ms. Williams' book, and others written by people diagnosed with autism, helps us to put ourselves in the child's shoes – a useful exercise for working with any child. I wish you the best as you work with your child's needs; remember to celebrate his strengths and uniqueness, and to take care of yourself as you travel this parenting journey. Mary Jamin Maguire | 
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