Autism
Autism is a lifelong neurodevelopmental difference. It involves differences in social communication, together with focused interests, repetitive behaviors, and differences in sensory processing. It shows up very differently from person to person, and many autistic people also have co-occurring conditions such as ADHD, anxiety, or sleep difficulties. [1][2]
CDC monitoring found that about 1 in 31 eight-year-olds at 16 US sites were identified as autistic in 2022. Identification has risen over time, partly because of better awareness and screening. [3]
The American Academy of Pediatrics recommends autism-specific screening at the 18- and 24-month checkups, and early referral when there are concerns, without waiting for a formal diagnosis to begin support. [4]
ADHD
ADHD is a neurodevelopmental condition with lasting patterns of inattention and/or hyperactivity-impulsivity that affect daily life. It is highly heritable, often continues into adulthood, and frequently co-occurs with other conditions. An international consensus statement brought together 208 evidence-based conclusions about it. [5][6]
For preschool-aged children, the AAP guideline recommends parent training in behavior management and/or behavioral classroom interventions as the first-line treatment. For school-aged children and teens, it recommends combining medication with behavioral and school supports. [7]
Supporting young autistic children
Naturalistic developmental behavioral interventions (NDBIs) teach skills inside play and daily routines, follow the child’s lead, and use natural rewards. They have empirical support for young autistic children. [8]
A large meta-analysis of early interventions found positive effects for some approaches, especially developmental and naturalistic developmental behavioral ones. It also found that much of the research had important limitations, and it called for better-designed studies. [9]
A systematic review by the National Clearinghouse on Autism Evidence and Practice identified 28 evidence-based practices, including visual supports, modeling, prompting, reinforcement, and naturalistic intervention. [10]
Neurodiversity research
The double empathy problem describes communication difficulties between autistic and non-autistic people as a two-way mismatch, not a one-sided deficit. [11] In one experiment, information passed along chains of autistic people as accurately as along chains of non-autistic people, while mixed chains lost more detail. [12]
Researchers increasingly call for a neurodiversity approach that values autistic people’s experiences, and for research done with autistic people rather than only about them. [13][14]
Language preferences vary. In a large UK survey, many autistic adults preferred identity-first terms such as “autistic person”, while many professionals used person-first terms. The best choice is to ask the person. [15]
Strengths & families
In interviews, autistic adults described strengths they connect to being autistic, such as attention to detail and deep focus. [16] Successful adults with ADHD described positive aspects too, including curiosity and creative thinking, energy, courage, and resilience. [17]
Caregivers need support as well. A meta-analysis found higher parenting stress in parents of autistic children than in parents of children who are typically developing or have other conditions. [18]
How HFB uses this
The Play Together games draw on widely used ideas: big visual choices, read-aloud, gentle prompts that make the right answer easy to find (errorless learning), stars as positive reinforcement, and missed items coming back a few rounds later. They are designed to be played together, inside a calm routine.
HFB games are prototypes. They have not been clinically evaluated and are not a treatment. If you are a researcher or clinician interested in collaborating, please get in touch.
