Autism Spectrum Disorder

Available by Telehealth

What is ASD?

Autism Spectrum disorder (ASD) is classified as a neurodevelopmental disorder. The brain of a person with ASD is uniquely wired, causing them difficulty with social interactions, communication, and behavioral issues.  This impacts the person’s ability to function in home, work, school, and community environments. No two people with ASD present in the same way, and each person with Autism has their own unique strengths and challenges.

Many individuals with autism do not consider it a disorder, but an atypical neurodevelopment that comes with hardships, but also some unique benefits. John Elder Robison, a neurodiversity scholar at the College of William & Mary, who is himself on the spectrum states:

Our duty in autism is not to cure but to relieve suffering and to maximize each person’s potential.

We don’t really know why diagnoses of Autism are increasing, or what the causes may ultimately be. There currently is no “cure,” but treatment at Spencer Psychology offers options to improve quality of life through developing skills needed to function successfully in the world, and self-acceptance of the innate wiring differences people with autism experience.


Symptoms generally present by the age of two, however symptoms for those with higher functioning autism may not be clearly evident until late elementary or middle school. Symptoms typically fall in categories including social deficits, communication issues and behavioral problems.

Speech and Language Issues

  • Repetitive movements or speech
  • Odd speech or word choices
  • Delays in speech or monotone speech
  • Difficulties starting a conversation or keep one going, or only starts one to make requests or label items
  • Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
  • Repeats words or phrases verbatim, but doesn’t understand how to use them
  • Doesn’t appear to understand simple questions or directions
  • Learning disabilities (though people with ASD can be of normal or high intelligence as well)

Social Deficits

  • Intense focus on one item or area of interest
  • Unresponsiveness to others
  • Not interacting or playing with others, or playing inappropriately
  • Social withdrawal
  • Failure to respond to his or her name, or appears not to hear being called
  • Resistance to cuddling, holding and touch
  • Preference to play alone
  • Avoidance of eye contact
  • Lack of emotional expression and lack of empathy  (unaware of others’ feelings)
  • In small children, doesn’t point at or bring objects to share interest
  • Inappropriate approach to social interaction by being passive, aggressive or disruptive
  • Difficulty recognizing nonverbal cues, such as interpreting other people’s facial expressions, body postures or tone of voice

Behavioral Symptoms

  • Aggressive behavior
  • Self-injurious behavior like head-banging or biting
  • Screaming/crying to express needs
  • Performing repetitive movements, such as rocking, spinning or hand flapping
  • Developing specific routines or rituals and becoming upset at changes  
  • Problems with coordination or odd movement patterns, such as clumsiness or walking on toes, or odd, stiff or exaggerated body language
  • Fascination with details of an object, such as the spinning wheels of a toy car, but not understanding the overall purpose or function of the object
  • Fixation on certain objects or topics
  • Unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
  • Doesn’t engage in imitative or make-believe play
  • Fixates on an object or activity with abnormal intensity or focus
  • Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture


Therapy can help address social deficits, communication styles, and challenging behaviors.

*We regularly treat moderate to high functioning individuals on the spectrum. (We do not have specialty programs for severe diagnoses of Autism or for non-verbal or aggressive adolescents or adults.)

Our Autism Spectrum Specialists

Ms. Hinkle has worked with children with autism almost exclusively for nearly ten years. She approaches  treatment by first establishing good self-care habits, like a sleeping routine and an adequate diet.  She then works on identifying feelings in themselves and in others, developing better empathy and social skills. She uses role-playing, play therapy, toys and games to help clients express their feelings in appropriate ways. It is often difficult for children and adolescents with autism to generalize their experiences outside of therapy to their families, school and community. Ms. Hinkle teaches clients about “context blindness” which happens when clients on the spectrum have difficulty understanding where, when and how to  behave in different settings and with different people. 

Ms. Hinkle’s interventions also focus on teaching clients to manage intense emotions and accompanying aggressive behavior, or behavior that may alienate others, so that they can manage relationships and work/school more effectively.

Our specialists combine play therapy, cognitive behavioral approaches, skill development and trauma treatments (for those who have been bullied or have experienced other stressful or traumatic events as part of their diagnosis or separate from autism spectrum symptoms). 

Anxiety and depression are common co-occurring issues as well, frequently treated in tandem for people on the spectrum.

A note from Melissa

My name is Melissa Hinkle and I’ve been working with children with autism for 10 years, almost exclusively. I approach the  treatment of children and adolescents with autism, by first attempting to establishing good sleep hygiene and developing an adequate diet. These may require accessing additional  resources. Most of this will primary be completed at home with this therapist guiding the family.

Initial sessions start by developing a working relationship with the client by meeting them where they are. I assess their ability to identify feelings within themselves and others. I use role-playing, toys and games to help them express their feelings versus showing them in a more physical manner. In addition, after assessing their social skills they we will work on using them using role play sand tray therapy , watching video clips, creating comic strips and reading social stories, in session.

It is often difficult for children and adolescents with autism to generalize their experiences outside the therapy to the greater community. Many people with autism spectrum disorder have context blindness. This creates  difficulty understanding where, when and how to behave in various ways. for example what they might be able to say to appear would not be the same thing as they could say to their teacher.  Using the image of a social filter, we  often discuss what is appropriate to think and what is appropriate to say and how to know the difference.

Behavioral Interventions focus on teaching the clients to manage “what is often intense emotions” at home and in the community. Clients often need the assistance of a visual schedule to help understand and feel their day is predictable. These are often made in session with the client choosing the images. Please feel free to contact me here at Spencer Psychology to discuss any questions or concerns you might have about initiating treatment.


A searchable database for a variety of resources in the area

National Autism Resource and Information Center