Urgent need for holistic understanding of autism

DUE in part to Autism Awareness Month, which is observed globally in April every year, autism spectrum disorder (ASD) is no longer a condition discussed within isolated communities; it has become a growing concern across nations worldwide.

As awareness increases, so, too, does the urgency to respond. Parents, educators, therapists and policymakers are actively seeking solutions.

Amid this pursuit, a critical question must be asked: "Are our efforts truly helping the child, or are they fragmented attempts driven by individual understanding?"

Across the globe, well-intentioned individuals often advocate for a specific therapy, a particular intervention, a preferred expert or a specialised school. While these efforts stem from genuine concern, they frequently operate in isolation.

Drawing from the ecological systems perspective of Urie Bronfenbrenner, an American psychologist best known for using a contextual framework to better understand human development, a child does not exist within a single system but within interconnected environments, including the home, school and therapeutic settings.

Yet, in reality, each caregiver often functions within their own framework, applying strategies based on personal expectations of what is “best” for the child. This lack of alignment raises a fundamental concern: How does this disjointed approach impact the child?

Understanding autism beyond labels

Autism is commonly classified into three levels – Level 1, Level 2 and Level 3 – based on the support needs required. While these categories offer a structural framework, they do not fully capture the complexity of autism as a neurodevelopmental condition involving cognition, communication, sensory processing and behaviour.

Level 1 – Misinterpretation of “high functioning”: Consider a child diagnosed at Level 1, often described as “high functioning”. The child may be enrolled in social skills training to improve interaction. The parent, hopeful and reassured, expects visible improvement.

The child learns appropriate responses, such as how to express disagreement politely or engage in conversation. On the surface, progress appears promising.

But in a real-life classroom scenario, the same child, under pressure to complete schoolwork, impulsively takes a classmate’s eraser without asking. What appears to be a minor incident quickly escalates into conflict. The teacher is uncertain how to respond, the parent is confused, and the social skills trainer is unable to provide a clear solution.

This happens because the intervention addressed surface behaviour but not the underlying cognitive processing, impulse regulation and contextual understanding. Without a deeper understanding of how the child’s brain processes situations, learned skills fail to generalise across environments.

Level 2 – When communication lacks context: At Level 2, a child may have limited verbal communication. Speech therapy is often introduced, sometimes over several years. Yet, challenges persist – not necessarily due to lack of effort but due to misalignment in reinforcement.

For instance, a child may repeatedly use the word “no” regardless of intent. In some situations, caregivers interpret “no” as agreement, reinforcing the incorrect usage. Over time, this inconsistency creates confusion, making it difficult for the child to develop meaningful communication. The issue here is not merely speech but also contextual understanding and consistent environmental feedback.

Level 3 – Behaviour without a shared understanding: At Level 3, where verbal communication may be minimal or absent, behavior often becomes the primary mode of expression. Parents, out of familiarity, may interpret these behaviours accurately within the home environment.

However, when the same child enters a school setting, the interpretation changes. A behaviour understood by the parent may be viewed as inappropriate or disruptive by the teacher. The child, receiving conflicting responses, becomes overwhelmed. This often results in meltdowns – not as acts of defiance but as expressions of confusion within an inconsistent system.

Illusion of inclusivity

Inclusion is widely promoted in education and society. In practice, however, it is often reduced to physical placement rather than functional understanding.

When caregivers, educators and therapists operate independently, strategies are inconsistent, expectations differ and reinforcement becomes contradictory. For the child, this creates a fragmented experience of the world— one where the same behaviour produces different outcomes depending on the environment.

This is not true inclusivity; it is parallel systems functioning without integration.

Towards a holistic approach

A meaningful shift requires moving beyond isolated interventions towards a holistic understanding of autism.

This involves understanding the brain and cognitive processes behind behaviour; recognising the role of sensory experiences and environmental triggers; applying consistent strategies across home, school, and therapy; and developing critical thinking among caregivers rather than reliance on rigid techniques

When caregivers share a common framework, they become aligned in their responses. The child, in turn, experiences consistency, clarity, and security.

From fragmentation to empowerment

Over the past two decades, growing evidence and lived experiences have highlighted the need for structured, integrated approaches that empower caregivers rather than isolate expertise within professional silos.

A model grounded in holistic understanding enables parents, teachers and therapists to interpret behaviour accurately; respond consistently; adapt strategies across contexts; and support the child’s development not just in the present, but for the future as well.

Such approaches demonstrate that empowerment is not about transferring techniques, but about building understanding.

Autism cannot be addressed through isolated solutions. A therapy, a book or a specialist alone is not sufficient. Without alignment, even the most well-intentioned interventions may fail to produce meaningful outcomes.

True progress lies in recognising that autism is complex and interconnected; the child exists within multiple systems; and consistency across these systems is essential.

Inclusivity is achieved when everyone understands and works together within a shared framework. Only then can we move from fragmented efforts to sustainable, life-changing impact for the child.

DR RUTH ARUNASALAM

Klang

(The writer holds a PhD in Autism from Universiti Malaya and is the founder of a structured parent-training framework known as the RUTH Module.)