The Silent Battle: Caregiver Mental Health in the Realm of Autism

In the quiet corners of countless homes, a silent battle is being waged every single day. It’s not fought with weapons or on a battlefield. It’s fought within the hearts and minds of caregivers for those with profound autism and intellectual and developmental disabilities (ID/DD).

The mental health challenges these caregivers face are often overlooked. However, some studies say they’re as intense and real as those that war veterans or caregivers for terminally ill children face.

The Unexpected Battlefield

Post-traumatic stress disorder (PTSD) symptoms are increasingly common for mothers of children with autism. Some researchers have compared the stress profiles to those of combat veterans.

That might seem shocking until you consider the constant stress these mothers face daily.

Unpredictable behaviors, communication barriers, and overwhelming needs are associated with profound autism. They can trigger a constant state of high alert.

Some compare those maternal cortisol levels to hypervigilance of a soldier on the battlefield. It’s a feeling of always on guard, always ready for the unexpected. Over time, this sustained state of stress can lead to PTSD. It manifests as intrusive thoughts or emotional numbness. Some people feel the need to avoid situations that remind them of traumatic experiences.

Stress Can Be Debilitating

Parents and caregivers of children with profound autism and ID/DD also share another similarity. Their mental health profiles can reflect higher levels of strain than those with parents of children with other disabilities. These caregivers experience chronic sorrow, anxiety, depression, and stress. It can be debilitating.

Some studies link these overwhelming feelings to caring for a child with a terminal illness. This comparison isn’t meant to equate autism with terminal illness. Instead, it highlights the significant emotional burden some caregivers carry. They grieve for the typical life their child might have had. They worry incessantly about their child’s future. They grapple with feelings of helplessness and exhaustion.

Understanding the Differences

It’s important to note that there are differences between DD (developmental disabilities), IDD (intellectual and developmental disabilities), and autism. While autism can be classified as a DD or an IDD, not all DD/IDD diagnoses are autism. Autism is characterized by social interaction difficulties, communication challenges, and a tendency to engage in repetitive behaviors. However, the severity of these symptoms can vary greatly from one person to another. Autism exists on a spectrum, and it’s different for every child.

Recognizing Caregiver Burnout

The first step to providing better support is recognizing the burnout caregivers can face. Mental health professionals, friends, and family are starting to acknowledge the emotional war some caregivers fight.

Some caregivers find support through resources like respite care, peer support groups, and counseling. Some providers offer stress management strategies, and researchers are trying to better understand caregiver PTSD to come up with more effective interventions.

Recognizing burnout and offering resources and relief are part of supporting the autism community. The silent battle these caregivers face doesn’t have to be one they face alone. The road ahead may be long, but with increased awareness and support, together, we can make it a little less daunting for those who tread it every day.

Navigating Mental Health in Today’s Workforce: A LEARN Behavioral Perspective

In our rapidly evolving world, the nature of work has transformed dramatically. In the past few years, prioritizing mental health and destigmatizing conversations around support have brought about progress. This shift has brought to light the critical issue of mental health in the workplace, particularly for those in high-stress professions like ours at LEARN Behavioral.

As Chief Human Resources Officer at LEARN, I’ve seen firsthand the emotional and physical toll this noble profession can take on our staff, including behavioral analysts, clinicians, behavior technicians, and our invaluable staff in roles across the company.

The Rise of Workplace Burnout

Research indicates that workplace burnout is becoming increasingly prevalent across various sectors, marked by symptoms such as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment.

For those in the behavioral health field, these challenges are compounded by the emotionally charged nature of our work, making it imperative for organizations like ours to prioritize the mental well-being of our team.

Understanding the Impact

Burnout not only affects the individual experiencing it but also has a ripple effect, impacting their colleagues, the quality of care provided, and ultimately, the families we serve.

Symptoms can include chronic fatigue, anxiety, depression, and a decrease in job performance, which can lead to higher turnover rates and a reduction in overall workplace morale.

LEARN’s Proactive Approach to Mental Health

At LEARN Behavioral, we recognize the importance of addressing these challenges head-on. We have several key resources aimed at supporting our staff’s mental health and well-being:

  • Employee Assistance Programs (EAPs): Our EAP provides confidential assessments, short-term counseling, referrals, and follow-up services to help employees manage both personal and work-related problems.
  • Caregiving Network: Understanding the demands of caregiving in the midst of a growing shortage of childcare, we offer access to resources for finding caregivers through Care.com for children, adults, or pets, easing one aspect of our employees’ lives.
  • 24/7 Therapy Services: Through partnerships with platforms like Talkspace, our team has access to dedicated therapists any time, anywhere, making sure they have the support they need when they need it.
  • Library of Well-Being Videos: Our collection of videos from UnitedHealthcare covers more than 70 health-related topics, providing valuable information on everything from mental health to physical wellness.
  • Self-Care App: The AbleTo app connects our staff with coaches and offers self-care resources and strategies, helping them manage the demands of life more effectively.

A Human Resources Perspective

From a human resources standpoint, investing in these resources is not just about enhancing productivity. It’s about valuing our employees as individuals with unique needs and challenge—just as we do our clients. It’s a testament to our commitment to creating a supportive, compassionate work environment where everyone feels empowered to seek help and take care of their mental health.

As we navigate the complexities of today’s workforce, it’s clear that mental health must be a priority. At LEARN Behavioral, we’re proud to be at the forefront of this effort, offering our team the support and resources they need to thrive, both professionally and personally.

By acknowledging the challenges and taking proactive steps to address them, we’re fostering a culture of well-being that benefits not only our employees but the families we serve.

For those in the behavioral health sector experiencing burnout or mental health challenges, remember, you’re not alone. Resources are available, and it’s OK to seek help.

Why Early Diagnosis of Autism Matters: A Deeper Dive

Many misunderstandings exist about autism. However, science confirms that early diagnosis is essential.

Studies show that kids diagnosed with autism from age 2 to 4 often have slow speech development, lack age-appropriate play and social skills, and avoid eye contact. With early and intensive behavioral intervention, they can improve in all skill areas. Research suggests that children diagnosed in early childhood and participate in early intervention have optimal outcomes.

What we know already is that early diagnosis of autism is not a verdict. It’s an opportunity to start treatment earlier to put the child on a path to success. An autism diagnosis doesn’t mean a child is less than another child. They’re just different. They see the world in a unique way. Early diagnosis helps us understand their differences better.

Understanding this brings us to an important realization: Kids learn quickly in their first years.

Kids’ Brains Are Like Sponges

Harnessing the power of a child’s brain in their early years can be instrumental for kids with autism.

Children’s brains are like sponges, especially in the first few years. As a child’s brain develops, it can adapt and change based on the child’s experiences. The ability to “rewire” or change the brain is known as neuroplasticity. Kids learn to talk, walk, and interact with the world around them. This early period of brain development is the ideal time to begin intervention for children with autism.

When a child’s brain grows, it makes many new connections. This time is perfect for learning and developing. The brain’s flexibility can help kids with challenges like autism. That’s why starting help early is so important.

What Science Says

The science is clear: The earlier we can diagnose and begin treating the behavioral manifestations of autism, the better the outcomes for children.

Research consistently supports early diagnosis and intervention of autism. Studies show that early identification and therapy can help put kids on a path to success. A 2023 study published in the journal Children found that children who started therapy before turning 3 showed significant improvements in their IQ, language, and adaptive behavior.

An early diagnosis allows for a head start in addressing core deficits. It also gives parents a head start in finding support and resources.

The Role of Parents and Caregivers

Parents and caregivers play a crucial role in the early diagnosis of autism. Often, they are the first to notice developmental delays or behavioral differences. Their observations and concerns form a significant part of the diagnostic process. If you recognize the early signs of autism, you can seek help and get an evaluation.

From there, if your child receives an autism diagnosis, professionals can help you figure out the next steps and a treatment strategy.

A Case for Starting Treatment Early

While every child’s journey with autism is unique, it’s never too soon to ask questions if you notice signs that your child is missing milestones or showing signs of autism.

Early diagnosis of autism is crucial. It opens opportunities for intervention during a period when the child’s brain is most malleable. Science and research strongly support this, highlighting the profound impact of early intervention on the trajectory of a child’s development.

Recognizing Autism Symptoms: How to Spot Early Signs

By Sabrina Daneshvar, Ph.D., BCBA-D, senior vice president of clinical services at LEARN Behavioral

Recognizing Autism Symptoms: How to Spot Early Signs

Autism isn’t always easy to spot. It’s a complex neurological and developmental disorder. It often shows up in early childhood and affects how a person interacts with others, communicates, and learns.

Since symptoms of autism vary so widely from person to person, it can be challenging to diagnose.

Recognizing early signs can be vital to getting help. If you suspect your child may be on the autism spectrum, talk to your pediatrician. A medical professional can guide you on the next steps. This may include a complete diagnostic evaluation.

Understanding Autism

You may be familiar with people talking about autism existing on a “spectrum.” This means a person’s symptoms can vary in severity across many areas. For example, some people might have trouble with social interactions and communication. They might have difficulty understanding body language or maintaining a conversation. Others might have repetitive behaviors or be intensely focused on certain interests.

Simply put, autism doesn’t look the same for everyone. Everyone experiences it differently.

Early Signs of Autism

While every child is unique, there are common signs of autism to watch for. Here are some:

  • Social Challenges: Your child may avoid eye contact. They might have yet to respond to their name. They may show little interest in people or toys.
  • Communication Difficulties: Look for delayed speech. Or your child might repeat words without understanding them. They may not use gestures like pointing.
  • Repetitive Behaviors: A child with autism may flap their hands. They might line up toys instead of playing with them. They could insist on routines and get upset with changes.
  • Sensory Sensitivities: Your child may react unusually to sounds, lights, or textures. They could either be overly sensitive or not sensitive enough.

Watch for signs such as:

  • Not smiling at others by six months
  • Not using gestures to communicate by 12 months
  • Not babbling by 12 months
  • Not speaking single words by 16 months
  • Not speaking two-word phrases by 24 months
  • Not reacting to voices, sounds, or their name

Remember, these signs don’t confirm autism. But they suggest you should check with your health care provider.

What to Do If You Notice These Signs

If you think your child may be showing signs of autism, early intervention is critical. Children’s brains are most adaptable and responsive to learning during the first few years of life. Research shows that high-quality early intervention can significantly improve essential skill development. These include communication, social interactions, cognition, and self-care.

So, if you notice signs of autism, document your observations. Talk to your child’s doctor, and stay patient and positive.

Getting a diagnosis of autism is not an end. It’s a beginning. It opens the door to getting the services and support that can help your child thrive.

Accessing therapies early can lead to better long-term outcomes. It reduces the need for intensive support in the future. It can also help foster supportive environments for your child’s growth.

Early intervention can also teach you strategies for navigating the world of autism.

Interested in learning more about the early signs of autism? Visit our website for additional information and how we can help you get started on your child’s journey to success.

What Causes Autism? Understanding the Latest Research

Hanna Rue, Ph.D., BCBA-D, chief clinical officer

What does science say about what causes autism? The latest research indicates that a combination of genetic and environmental factors likely causes it.

There’s no simple answer, and scientists are still trying to develop better ones. “What caused my child’s autism? Was I to blame?” As David G. Amaral, Ph.D., a psychiatry and behavioral sciences professor at the University of California Davis wrote in 2017 in the journal Cerebrum, “Autism research has made tremendous progress over the last 20 years, but yet we still can’t provide definitive answers to most of these questions.”

What We Know for Sure

What we know for sure is that autism is a complex condition. It’s not caused by one single factor. The exact cause is still not fully understood, making it a subject of ongoing research.

Much of that research involves two main categories:

  1. Genetic factors: Scientists have found that certain gene changes, unusual gene combinations, and other genetic conditions can make a person more likely to have autism.
  2. Environmental factors: Since genetic factors don’t always lead to autism, that suggests that environmental factors could play a role. That could include factors, such as prenatal exposure to certain drugs or chemicals, complications during birth, or advanced parental age at the time of conception.

What Myths about Autism Science Has Debunked

Science has debunked several myths about autism, most notably the claim that vaccines cause autism. Large-scale studies have proven this theory to be false. Other debunked myths include the idea that autism is caused by parenting style or that it’s a mental health disorder. Autism is actually a neurological disorder resulting from differences in brain development.

It’s also worth noting that the prevalence of autism is rising, but this doesn’t necessarily mean more people are becoming autistic. An article in Scientific American explains that the bulk of the increase in autism rates stems from growing awareness of autism and better diagnostic methods.

Where Research Is Headed

The latest research in autism focuses on understanding the genetic and neurological aspects of the condition. Studies are further examining the perceptions of counselors in treating children with autism, which could help improve therapeutic approaches.

Other research is debunking more myths about vaccination risks related to autism. Still other researchers are looking into the intersection of autism in adulthood and the LGBTQ+ community. And some new research is looking into how certain proteins associated with autism interact with other molecules, shaping synaptic plasticity.

Our Understanding of Autism Is Evolving

Yet the most basic question — “What caused my child’s autism?” — may have no simple answer. Little by little, our understanding of what causes autism is evolving.

It’s becoming clearer that the causes of autism are multifaceted. While we might not have all the answers now, we are continuing to unravel the complexities of autism.

The Autism Diagnosis Process: What to Expect

When it comes to parenting, the unknown can be one of the hardest parts. Worries creep in if you suspect something’s wrong with your child’s development. If you think your child may be showing signs of autism, there’s no guidebook to tell you what to do next.

It’s natural to feel overwhelmed. The process gets easier when you know what to expect.

If you’ve found your way to this post, you’ve likely taken the first step: questioning whether your child shows signs of autism.

Recognizing this possibility is a significant and sometimes challenging move. Rest assured, you’re not alone. This guide is here to provide you with valuable insights and support as you navigate through this process.

Understanding Autism

Autism spectrum disorder (ASD) affects how a person interacts, learns, and behaves. Everyone on the spectrum is different. Signs of autism usually start showing up when a child is very young.

Recognizing the Symptoms

Autism symptoms can be different for everyone. If your child is not growing or learning like other kids their age, or if they have any of the following signs, you might want to talk to your pediatrician:

  • Not smiling at others by six months
  • Not gesturing or pointing to communicate by 12 months
  • Not babbling by 12 months
  • Not using single words like “no,” “mama,” “dada” by 16 months
  • Not using two-word phrases like “want cup,” “go play” by 24 months
  • Not responding to sounds, voices, or their own name by three years
  • Poor eye contact by three years
  • Little interest in other children or caretakers by three years
  • Losing skills they once had at any point by three years

The Diagnosis Process

Getting a diagnosis of autism starts with an evaluation. Experts will examine how a child behaves and will look at their past development. If your child’s pediatrician thinks it might be autism, they’ll send your child to an expert for a closer look. This process includes:

  • A parent interview
  • Review of medical, psychological, and school records
  • Assessment of cognitive, developmental, and adaptive functioning skills
  • Observation of your child during play

What Happens Next?

After an autism evaluation, our team of specialists will review and interpret the results. If your child is diagnosed with autism, our team will work with you to create a personalized treatment plan. This plan includes therapies to help improve communication, social skills, and behavior.

At LEARN, we work with families on a plan tailored to your family’s needs. We will adjust the treatment plan as needed. We’ll also provide you with resources and support.

Whether you’re just noticing signs or you’re already deep into the diagnosis process, our team is here to help. We know that recognizing and diagnosing autism can be challenging. But with the right support and guidance, you can navigate it confidently.

Shaping the Future: Influential Women in Autism and ABA Therapy

March is Women’s History Month. It’s a time to celebrate the accomplishments of women in all walks of life.

In the area of autism and contemporary applied behavior analysis (ABA) therapy, many women have made a lasting mark. They’ve broken barriers. They’ve conducted significant research, and they’ve paved the way for better understanding and treatment of autism.

Today, we spotlight seven women who have shown us what it means to lead with passion, dedication, and commitment. They are making a difference, and their work continues to inspire future generations of women in the field.

1. Temple Grandin: The Trailblazing Voice in Autism Advocacy

Temple Grandin, Ph.D., is a name synonymous with autism advocacy. Born in 1947, she was diagnosed with autism in early childhood. Despite the challenges, she went on to become an esteemed academic and animal behaviorist. She has gained recognition for writing books and delivering speeches on autism and animal behavior. Today, she is a professor of animal science at Colorado State University.

2. Greta Thunberg: Championing Climate Action and Autism Acceptance

Greta Thunberg is a Swedish environmental activist. She has gained global recognition for her efforts to fight climate change. She’s also known for being openly autistic. She has referred to her autism as her “superpower,” and has discussed how it has helped her in her activism by allowing her to focus intensely on topics that interest her. Greta has used her platform to advocate for acceptance and understanding of autism. On her Facebook page, she identifies herself as an “Autistic climate justice activist.”

3. Breanna Clark: Shattering World Records and Autism Stereotypes

Breanna Clark is an American Paralympic athlete who was diagnosed with autism at age 4. She competes in T20 category races, a classification for athletes with intellectual impairments. She has represented athletes with autism on an international stage. Off the track, she’s been an advocate and role model for people with autism.

4. Ronit Molko: A Powerful Force in Autism Therapy and Entrepreneurship

Ronit Molko, Ph.D., BCBA-D, is another luminary in the field. She is a thought leader and subject matter expert in autism spectrum disorder, developmental disabilities, and behavioral healthcare. She co-founded Autism Spectrum Therapies (acquired by Learn It Systems) and is a LEARN Behavioral board member. In this All Autism Talk podcast, she talks about how ongoing research is helping us better understand the unique challenges girls with autism face.

5. Devon Sundberg: Shaping the Future of ABA Therapy and Autism Awareness

Devon Sundberg, MS, BCBA, co-founded the Behavior Analysis Center for Autism (BACA). She has made significant contributions to the field of behavior analysis, both through her work at BACA and as the founder of the Women in Behavior Analysis conference. In this All Autism Talk podcast, she shares how raising three daughters helped open her eyes to how gendered life can be — and about the need for more women in the autism field.

6. Hanna Rue: Pioneering Innovations in Autism Treatment and Research

Hanna Rue, Ph.D., BCBA-D, is chief clinical officer for LEARN Behavioral. Her research interests are broad and include the identification of evidence-based practices for the treatment of autism. Her influence in the field of autism is evident in her wide-ranging work that spans clinical care, research, and advocacy. She has made significant contributions to STEM fields, sharing her insights through various platforms, including top-performing podcast episodes about autism, and extending her influence and reach in the autism community.

7. Sabrina Daneshvar: Revolutionizing the Field with Innovation and Compassion

Sabrina Daneshvar, Ph.D., BCBA-D, serves as the senior vice president of clinical services at LEARN Behavioral. Her research interests include video modeling and teaching social skills. This work has contributed to developing innovative strategies for improving social skills in children with autism. Sabrina has also taught, mentored, and trained many graduate students pursuing their degrees.

These are just a few women who have helped to shape the field of autism and ABA therapy. Their work underscores the importance of early intervention, peer support, and recognizing the diverse signs and symptoms of autism in girls and women.

We celebrate these women and everyone who has made contributions to advance our understanding of autism. They provide hope and inspiration to countless families across the world affected by it.

The Benefits of Summer Social Skills Programs for Kids with Autism

Even though the school year is still in full swing, it’s not too early to think about how you’re going to fill your summer schedule.

For parents of children on the autism spectrum, planning for summer involves more than just vacations and relaxation. You want your child to continue to make progress even during a school break.

When regular routines and structured learning environments pause for the summer, children with autism can be at risk of not maintaining skills. They might lose social skills, behavior improvements, and communication. This loss can mean that skills learned over the school year may diminish, leading to a challenging start when school resumes.

Summer Can Provide Continuous Learning Opportunities

Experts at LEARN say consistency is key for reinforcing learned skills. A disruption in routine can be unsettling for children with autism. They often thrive on predictability. Summer programs can provide a framework where they can thrive.

Consider enrolling your child in a social skills program this summer. Here’s why:

  • LEARN’s summer social skills programs are structured activities. They are designed specifically for children with autism.
  • Our summer social skills programs take place during the school break. They focus on improving social interaction, communication, and behavioral skills.
  • Our programs can include group activities, one-on-one sessions, and a range of therapies. We tailor them to each child’s unique needs.

What Will Kids Learn in a Summer Social Skills Program?

A summer social skills program can continue the momentum of what your child learns over the school year. These are some of the skills we work on:

  • Communication skills: Children with autism often find it hard to advocate for their needs to be met or express their preferences. They also might have trouble using language effectively and maintaining conversations. Our program gives kids a chance to practice these skills through guided activities, role-playing, and peer interactions.
  • Building confidence and self-esteem: Our summer programs can also have a tremendous impact on a child’s confidence and self-esteem. By mastering new skills and successfully interacting and forming friendships with peers, children with autism can gain a greater sense of self-worth. This boost in confidence can positively influence other areas of their life, from academic performance to relationships with family and friends.
  • Learning to interact with peers and make friends: Children with autism sometimes have difficulties making friends and maintaining relationships. Summer social skills programs specifically address these issues by providing opportunities for children to interact with others in a supervised, safe, and nurturing environment. This can help them understand the nuances of social interaction, learn to cooperate with others, and even form lasting friendships.
  • Fostering independence: Another key benefit of these programs is that they foster independence. By participating in new activities and routines, children can gradually become more comfortable with change and learn to adapt to different situations.

Keeping Skills Sharp During the Summer

Sometimes, educators talk about the “summer slide.” That refers to an educational phenomenon where students experience a loss of learning gains that they made during the previous school year over the course of the summer vacation.

If you want to prevent that kind of regression for your child, a summer social skills program can reinforce what they’ve learned over the school year and help them continue their growth and development.

Summer social skills programs for children with autism are more than just a way to keep kids occupied during the break. It’s another tool for keeping them engaged in learning. So, as we approach the summer season, consider enrolling your child in a social skills program. It could be just the thing to make the transition to next school year easier.

Learn more about building social skills during the summer in this LEARN blog post.

Advancing Autism Services: Our Commitment to Public Policy

Written by Dr. Ashley Williams, Ph.D., LABA, BCBA-D, Vice President

National Social Justice Day is a time to reflect on the progress made in creating a more equitable and inclusive society. At LEARN Behavioral, this commitment goes beyond the confines of our therapy rooms; it extends into the heart of public policy advocacy. Our dedication to social justice is evident through our active involvement in various organizations and our continuous efforts to champion policies that support the autism community.

1. Advocating for Autism Services Nationwide

LEARN Behavioral is proud to be an active member of the Council for Autism Service Providers (CASP). Our leadership team actively participates as CASP Special Advocacy Group Leaders in 11 states where LEARN Behavioral operates. This engagement allows us to contribute firsthand to the shaping of policies that impact individuals with autism and their families. Additionally, our membership in the National Coalition for Access to Autism Services (NCAAS) underscores our commitment to addressing state and federal barriers to autism services. By collaborating with like-minded organizations, we strive to create a unified voice advocating for positive change on a broader scale.

2. Advancing Autism Equity Through State Organizations

At LEARN Behavioral, we understand the importance of grassroots efforts in promoting social justice. Our active involvement in local trade and professional organizations, including CalABA, BABAT, WAPA, ORABA, MAC, MIBAP, reflects our dedication to the larger behavior analytic community. Through volunteering and membership in these organizations, we aim to contribute to the development of equitable services for the diverse communities we serve. We believe that fostering connections within the behavioral community is crucial to creating a more inclusive and supportive environment for all.

3. Leading National Advocacy Efforts for Autism Policy Reform

LEARN Behavioral is fortunate to have resident experts in public policy who actively contribute to the
advancement of the autism community. LEARN leaders have published peer-reviewed journal articles on
public policy, presented at local and national conferences, and provided numerous testimonies
advocating for access to care. Our chief clinical officer, Dr. Hanna Rue, is a beacon of leadership in this
regard. Her participation in NCAAS’s “day on the hill” in Washington, D.C., exemplifies our commitment
to effecting change at the highest levels. By engaging with House and Senate offices, we strive to
influence initiatives that positively impact the autism community on a national scale.

4. LEARN Advocacy Network

The LEARN Advocacy Network, led by Dr. Rebecca Thompson, is a vital part of LEARN Behavioral’s public policy efforts, providing a monthly meeting ground for leaders from each state. Driving our advocacy initiatives, this collaborative team engages in meaningful discussions, sharing insights, and staying abreast of the latest developments in public policy. The network serves as a platform where LEARN Behavioral leaders exchange information, ensuring a well-coordinated and informed approach to navigating the complex landscape of policy initiatives.

As we observe National Social Justice Day, it is imperative to recognize the multifaceted approach LEARN Behavioral takes to contribute to a more just and equitable society. Through active participation in national and state organizations, as well as championing public policy initiatives, we are dedicated to making a lasting impact. Our commitment to social justice extends beyond our therapeutic interventions, reflecting our belief in the power of advocacy and policy to create positive change for individuals with autism and their families.