The Importance of Small Victories: Reflections on Treatment for Autism, ADHD, and Related Disorders

I was conducting a seminar recently when a member of the audience asked me if I believe that treatment for autism can lead to “recovery”, or if I believe autism and related disorders can be “cured”.  These types of questions are asked often by parents and professionals and are worth addressing.  While it may be a controversial topic, here are my thoughts:

• I believe that every individual has the ability to be better tomorrow than they are today.  Each of us is infinitely more capable than may be immediately evident, and we all have the capacity to function in different and more effective ways than we do at the present time.
• Every individual deserves the opportunity to achieve his or her highest potential.  This is going to look different for each of us, as no two people are exactly the same.  Even the most severely impaired individuals have within them the capability to grow and change.  Whether or not they become all they are capable of being depends on the expectations to which they are held, the relationships they have with those who care for them, and the opportunities provided to them.
• To me, disorders such as autism and ADHD are not diseases to be “cured” or conditions to be “fixed”.  They are the names we give to symptoms that stem from neurological systems that work differently than the “typical” population, and create challenges for functioning.  I prefer to think of treatment for autism and related disorders as providing opportunities for these individuals to build brain connections that allow them to engage with the world in more satisfying and productive ways.  The goal is to help them achieve the things that are important for them to experience a satisfying quality of life.  We should aim to help individuals with neurodevelopmental disorders overcome the challenges they face such that they can lead meaningful and productive lives, however that may look for them.
• Putting the emphasis on “cure” or “recovery” implies that the entire process lies within the person with the diagnosis.  This is not the case as parents, family members, teachers, therapists, and others involved in the lives of these individuals have a responsibility to provide opportunities and interactions that support development.  Even for children who have a physiological issue (such as illness or injury) that caused the neurological symptoms they experience, there is still a strong role parents and others must play beyond just addressing the physiological issues.  For anyone to develop to their fullest capacity they must have strong guidance and engaging relationships that foster learning and development in all areas.  To provide help for ADHD, autism, or any other neurodevelopmental disorder involves strong relationships, a commitment to high expectations, and the supports to meet them.
• Even for individuals with neurodevelopmental disorders who never achieve full independence, there are many small victories along the way that make a major difference in their quality of life.  Complete removal of all symptoms and challenges is often not attainable, and should not be the primary goal.  Rather, the goal should be to consistently help the individual achieve things that make a difference now and for the future.  Examples of these small victories include being able to attend family functions; sitting with the family in church; sleeping through the night; eating a variety of healthy foods; completing chores without arguments; enjoying a walk with family members; playing a game with siblings; and so on.  These are the kinds of things that make a difference in the lives of diagnosed individuals and their families.  They are extremely valuable and meaningful; even if the individual does not go on to attain completely independent functioning in adulthood.

The bottom line is that none of us knows what the future holds, for our children or ourselves.  Despite not knowing what each of us may achieve over the course of our life we can strive to accomplish more tomorrow than we did today; to improve in small and large ways; to deepen our relationships; to overcome our challenges; to build on our strengths; and to reach a little more of our innate potential with every day that goes by.  Every small victory leads to even greater ones; and some of the seemingly smallest accomplishments may end up being what really matters.