Autism Spectrum Disorder | ABA Therapy Brussels

Children / teenagers within Autism Spectrum Disorder (ASD)

Autism - what is?

Autism has various descriptions and many parents may or may not see their children in some of them. But diagnosing autism is made according to complex criteria and only if the child meets many of the things spanning these definitions:

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history:

Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:

Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
Hyper- or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)

C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

(Source: https://www.autismspeaks.org/autism-diagnostic-criteria-dsm-5)

Parents often sense that something may be off with their child—this awareness can arise from comparing their child to others, an intuitive feeling, or understanding the typical developmental milestones a child should reach.

What is missing - what can be developed

Humans naturally focus on the eyes and faces of others because they provide rich information. From an early age, a child’s brain directs their attention to their parents’ faces. Through repeated exposure, children gradually learn to interpret what they see and begin to assign meaning to facial expressions - they start to attribute meaning. This complex ability starts developing as early as one year old.

Looking at faces to gather information remains a pivotal behavior throughout life. As children grow and explore their environment, they often check an adult’s face to understand whether they are being approved or corrected. The ability to decode facial expressions is a foundational skill that helps children learn about their surroundings and prepares them to understand more subtle social signals, like body language, later on.

Another important skill that develops from paying close attention to the faces of parents and caregivers is imitation. We start with language imitation—children notice that people around them are making sounds, and they naturally want to try doing the same. One key part of becoming aware of ourselves is that we first develop as attentive listeners before we begin to reproduce what we see and hear.

As listeners, children start by hearing others, then gradually begin to hear their own voices. This is how language learning begins—listening to others, listening to ourselves, and then listening to ourselves as we repeat sounds. When children imitate speech, they move their tongues and produce sounds, discovering they enjoy the sensations in their mouths. At the same time, they notice how happy their parents are when they make these sounds, which encourages them to keep trying.

Even as we become fluent speakers over the years, we often don’t realize that we still ‘listen’ to the voice inside our heads—an almost instantaneous, internal process. When children first start speaking, their speech is loud and external. With practice, language becomes more internal and subtle, and we learn when to speak out loud and when to keep our thoughts to ourselves.

I often meet people (myself included) who thought they had communicated something clearly, but in reality, they were just talking to themselves and never truly shared the information with others. This shows how complex and fascinating the process of communication really is.

But children don’t just focus on faces—they also begin to notice the body, especially movements of the hands and limbs. They see their parents using their hands in meaningful ways and naturally wonder, “If they can move their hands like that, why can’t I try too?” Over time, children become more aware of different body parts and develop the desire to imitate what they observe.

This process is supported by the encouraging responses from their parents. Having already learned to read facial expressions, children start to understand these positive reactions as reinforcements, which motivates them to keep practicing and exploring new movements.

Our behaviors gradually become more complex, interconnected, and often occur simultaneously.

But what happens when a child does not go through these natural, repetitive steps of looking at their parents’ faces? Many important milestones—such as decoding facial expressions and learning how to interact with the environment—may be missed. Language imitation might be limited or absent altogether. It is possible that the brain has not fully developed the connections with the nervous system and sensory receptors, so the child does not feel the sensations in their mouth that usually encourage them to repeat sounds because they enjoy them.

Additionally, the child might struggle to hear their own voice internally—they may not “listen” to themselves in the way most children do. They might observe the movements of others’ bodies and hands but not understand that they are meant to imitate those gestures. This lack of connection can make early communication and social learning much more challenging.