Some presentations of autism are not obvious to those outside the close family or friend circle. Sometimes it is not apparent to teachers or even behavioral health providers and evaluators (of which there have been many sometimes!).

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Children and adolescents with this type of “high-functioning autism spectrum disorder” are often misunderstood and subsequently misdiagnosed. They are treated for ADHD, social anxiety, oppositional defiant disorder, bipolar learning disorders and while many have a co-occurring diagnosis of ADHD, anxiety, etc., the ASD is never appropriately diagnosed.  Why is this so important? Because once we have identified the ASD, the entire paradigm of treatment changes.  ASD is predominantly a skills deficit -these individual lacks essential functional social and life skills. In addition to these core deficits, many individuals experience significant struggles with emotional and sleep regulation, sensory modulation and executive functioning. To further complicate this complex learning and behavioral profile, individuals with ASD often do not metabolize medications in the same manner as their neurotypical counterparts - therefore many times they are prescribed medication which significantly worsens their irritability, aggression, hyperactivity, impulsivity, sleep and overall functioning.

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As the years pass, the consequences of these skills deficits and dysregulation becomes more apparent to the individual and their close circle. They desperately want positive relationships with their parents or siblings.  They want friends.  They want to do well in school but all the “trying”, “tutors” and negative consequences don’t help or motivate. They become anxious and depressed and their self-esteem plummets. 

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If the child or adolescent is never appropriately identified, this struggle persists into adulthood. It is important to note that this struggle is often well-masked especially by females who are even less likely to be appropriately diagnosed.  Many times, these individuals have given up on treatment after years of failed medication and therapy attempts. They become depressed, anxious and frustrated as life continues to be an uphill battle for them. They may have a college degree and some superficial relationships, but making and maintaining those close relationships they desire (personally or professionally) just doesn’t happen. They may make one least attempt at treatment ………and if appropriately diagnosed and treated, the journey toward emotional, physical and spiritual wellness can begin. The world starts to make sense, they start to feel hopeful, comfortable and motivated. While it may be a long road, they can start to walk their path with newfound hope and optimism.

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Debra Trasati uses a collaborative, integrated treatment approach, supporting the individual and their loved ones on their healing journey. She developed a model which starts with a comprehensive evaluation from which a treatment plan is developed. The treatment focuses on developing and refining functional life and social skills (including self-monitoring/regulation, relationships). In some cases, medication can help the individual become available to learn and use emerging skills and strategies. When appropriate, medication is used judiciously.  Another crucial component to this integrated approach is Collaborative Caregiver Coaching. This work is completed with the family in the context of the individual. Often individuals with ASD struggle with significant emotional and behavioral dysregulation. Frequently the trigger is frustration related to their rigidity or sadness related to social isolation. Almost always the dysregulation is saved for those with whom the individual feels safest and most secure —- their family and closest supports. This creates a challenging and chaotic family dynamic as parents struggle with the best way to manage these behaviors and minimize the detrimental effect to the other family members (often siblings). Collaborative Caregiver Coaching focuses on education and the development of strategies to manage and reshape those behaviors in the hopes of bringing peace and healing to the home.

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If you would like to explore if this approach may benefit you and/or your family, you can inquire at hello@integratedwellnessstrategies.com