Working therapeutically with Autism in children and adolescents

Some of the core skills of a therapist include active listening and being fully present. These capacities come together to create a quality of positive transmission, from being to being, in each moment.

Listening and being fully present as it relates to Autism in children and young people

For parents with children who are on the autistic spectrum, being fully present when listening can be especially challenging. As each child is unique there are so many facets in thinking processes, body posture and how they move, behaviours, feelings and so on. There may also be a lack of eye contact. Characteristics might include repetitive patterns of monologue involving an intensely driven interest in which the child or young person speaks about in the minutest of detail. In addition, their voice might sound monotone and flat, though this is not always the case.

Giving time, energy and patience to listen

When I am seeing someone who is either diagnosed as autistic, or I make a diagnostic hypothesis based on my observations, I am treating them as an individual not a label. I am looking at their true nature as it emerges in the therapy space. It’s all there and one just needs to help this child or young person because what they are dealing with often involves social difficulties, marginalisation and bullying such as being ridiculed, anxiety arising out of such behaviours from others and a whole lot of confusion. 

Other issues exacerbated by challenges may include low moods to more serious depressive states, and/or a sense of hopelessness and despair that arises out of isolation. We are looking here at the vulnerability of that child, as well as bringing awareness to attitudes about differences. The absence of compassion and empathy is becoming endemic amongst peers and played out in person at schools and on social platforms. We cannot change others, but I speak from experience when I say that the internal and external landscapes of these children have the potential to flourish with the appropriate, heartfelt support.

Protective factors

A supportive, loving, caring family is central to the wellbeing of a child but it would be unrealistic to expect perfection. Let’s say that about 75% of goodness is good enough and will go a long way. If the situation is difficult and challenging, it’s normal for a parent to veer off-track and this is why it’s so important for parents of autistic children to ensure that self-care is factored into their daily lives. In addition, discover ways to self-regulate and get help. Doing so can make an enormous difference such as, rather than allowing irritability to escalate, pause, take a deep slow breath. One of the things that can come up could be a feeling of guilt about something such as losing control in the moment when acting harshly towards a child. Speaking with someone trustworthy where you can be totally honest about your thoughts and feelings, realising that there are others who think and feel the same or similar, can provide enormous relief.

How therapy can make a big difference

A number of years ago a boy aged 14 was referred to me in the school where I was counselling. I’ll use a pseudonym and call him Eton. There was no mention of autism, only that no-one could pinpoint what they perceived as ‘oddness’. The primary issue was that he was vulnerable and continually being bullied. I noticed immediately the awkwardness of his posture, his monotone voice and that I was being talked at. There were no gaps between words whatsoever for me to engage in a two-way conversation. To do so would be to interrupt, and a skilled therapist would not normally interrupt unless it’s to say that the session is nearly over, to give the client time to wrap up.

In those sessions I spent months listening and listening. One could say that obviously this boy lacked interpersonal skills, but that judgement would be redundant. Through the use of the arts which mostly consisted of drawings and sandplay with symbolic miniatures to show me he was communicating through sharing. Within those repetitive stories and the intense obsessional subjects which had deep meaning to him what I discovered was profound. Not just in the content which I cannot share here, but the need for Eton to be given a quiet space to speak, be truly listened to, heard and responded to. Complete attentiveness was something he desperately needed and wanted.

One day - It must have been quite a number of months later - I noticed that there was a gap. An actual pause and eye contact. I took that as an invitation. The awkwardness, including the sort of robotic body posture and stiffness started to ease. The monotone voice over time suddenly became more animated and it was as if something inside of Eton had lit up. His being was able to shine through. And he was funny! His sense of self, his personality and humour – it was just there

It took me about a year for Eton to be open to me facilitating a mediation with his parents for him to have the courage to say how he felt, and to say that he needed them to spend quality time with him. As I do in mediations, I go through what the young person wants to say and I’m there to support them. I share this because it was such a moving experience in how his parents responded as he spoke from deep within his heart and cried. They totally got it and responded emotionally and caringly and from there we discussed a strategy to move forward which Eton was very pleased about. I noticed as left the room, his dad put his arm around him.

Several weeks later, a teacher who knew I was seeing Eton, mentioned that he hadn’t seen Eton in the canteen after lunch sitting alone, which was his previous routine. As I walked through the playground on the way to my therapy room, I saw Eton in the near distance during the break. He was looking mischievous, laughing and joking with his new friends.

If you would like to receive professional support and further guidance, you can contact me starting with a free 10 mins, initial phone consultation