ASD

Background

5.5-year-old boy, K2 international kindergarten. Parents sought help after teachers reported he "never joins group activities", "plays very differently from peers", "cries during activity transitions". At home, haircuts were a nightmare, he refused new foods, and refused new clothes. Parents were waiting for DH assessment with a ~14-month waitlist.

Evaluation Findings

Tactile defensiveness: resistant to new textures and crowded close contact. Auditory hypersensitivity: noisy environments (malls, birthday parties) overloaded his nervous system. Transition difficulty: nervous system needed longer to down-regulate. Social interaction profile matched ASD spectrum features; referral to psychologist for diagnostic confirmation was recommended. Cognitive ability at or above age level.

Intervention Approach

Weekly 50-minute individual home-visit sessions: dinosaurs (the child's strongest interest) as entry point, embedded with sensory-integration activities. Therapeutic Listening Programme: 20 minutes daily at home. Parent training: identifying early dysregulation signals, co-regulation techniques, designing a home sensory-safe corner. Established "transition preparation" routines with parents and school: visual schedule, 5-minute warnings.

Outcome

After 6 months: child began voluntarily joining group activities (initially observing for 5 minutes, gradually building to full participation); haircuts went from 30-minute meltdowns to 10-minute calm completion; learned to use visual schedules for self-prepared transitions. Parents learned to identify "yellow-light" signals; meltdown frequency dropped ~70%. Psychologist confirmed ASD Level 1; because the family already had a complete intervention plan in place, they received the diagnosis with relative calm — "We're not starting from zero, we're already walking this path."

Background

10-year-old P4 boy. Diagnosed ASD Level 1 (formerly Asperger's) at age 3; added ADHD-Combined Type diagnosis at age 6. FSIQ 130+; exceptionally strong academics but social, emotional, and executive functioning difficulties intensified with age. Already switched schools twice (the previous two had asked him to leave after emotional outbursts). Mother told me at intake: "I've tried other therapists, each one plateaued at 3 months. They said my son is 'too smart, too challenging'."

Evaluation Findings

- Cognitive strengths: language, abstract reasoning, visual-spatial. - Difficulty domains: Executive functioning — markedly weak task initiation, time sense, transitions, self-monitoring. - Emotional regulation — "0 to 100" explosive episodes triggered by sensory overload combined with cognitive rigid thinking. - Social — difficulty taking others' perspectives, yet deeply yearning to be understood. - Sensory — auditory and tactile hypersensitivity, vestibular seeking. - Key finding: previous therapists mostly used "behaviour correction" approaches, which the child resisted; he needed an intervention model that treated him as a collaborative partner. - Pre-existing self-image damage: "I keep wondering whether something's wrong with me."

Intervention Approach

First step — talk directly with the child. At 10, he needed to be treated as a collaborative partner, not a treatment object. We defined goals together; he chose: "I want to learn how to pause before I melt down" and "I want to learn how to chat with friends without annoying them." Polyvagal Theory psycho-education: taught him to identify his own nervous-system states (using a traffic-light metaphor), reframing "I lost control again" into "My nervous system is on red — how do I down-regulate?". Executive functioning coaching: using his favourite Minecraft as analogy, framing daily tasks as "building blocks". Sensory strategies: appropriate use of noise-cancelling headphones, classroom seating recommendations. Close collaboration with school SENCo and EP. Parent coaching with mother: shifting from "daily disaster management" to "daily collaboration".

Outcome

After 8 months: emotional outburst frequency dropped from 3–4 times weekly to 1–2 times monthly. School reported he began proactively requesting "I need a sensory break" instead of melting down. Family relationship visibly improved — mother described "I finally feel like my son and I are on the same team." Academics continued excellent, but more importantly he started taking ownership of his brain: "My brain is unique; I'm learning how to work with it."