need for change of goals in autism: Change the goals to see the change. Dr Kondekar santosh , autism doctor Mumbai explains

Connection to Conversation in Autism: Why Changing Goals Changes Outcomes



Introduction

In autism, progress often depends not only on therapy intensity but on what goals we choose. Many children remain stuck because interventions focus on surface behaviors instead of foundational developmental processes like connection, listening, and thinking.

Modern neuroscience and developmental psychology suggest that when we shift goals toward social engagement, auditory processing, and cognitive readiness, meaningful communication and adaptive behavior improve.

This article expands the developmental pathway by introducing a crucial concept: turning the goals in autism to see real change.

The Foundation: Connection Builds Communication

Children need to understand the fundamental need of life — humans connect to communicate.

When a child spends more time with people rather than objects, sustained engagement develops. This leads to better awareness of family members, improved eye contact, and readiness for listening.

As listening improves, story understanding and conversations can begin.

This pathway aligns with research showing that social attention and joint engagement are strong predictors of language outcomes in autism.

Why Goals Must Change in Autism

Many traditional approaches unintentionally prioritize entertainment, task completion, or motor activities over cognitive and social readiness.

Changing goals shifts therapy toward building the brain’s capacity to learn rather than only teaching isolated skills.

Turning the Goals: A Developmental Shift

1. Change the Goals to See the Change

Progress begins when therapy targets underlying developmental processes — attention, connection, listening, and thinking — rather than only observable behaviors.

Goal clarity helps align parents, therapists, and doctors toward meaningful outcomes like communication and independence.

2. From Entertainment to Learning

Children with autism often receive excessive stimulation through screens, toys, or repetitive activities meant to keep them occupied.

While enjoyable, constant entertainment can reduce opportunities for deep engagement and learning.

👉 Therapy should prioritize meaningful interaction over passive stimulation.

Research shows that active engagement promotes stronger neural connections than passive exposure.

3. From Engagement With Objects to Humans

Object-focused play limits social learning opportunities.

Increasing human interaction supports joint attention, emotional bonding, and communication development.

Evidence from early intervention models shows improved language outcomes when social engagement is prioritized.

4. From Visual Learning to Auditory Learning

Many children with autism rely heavily on visual cues. While visual supports are helpful, communication ultimately depends on auditory processing and listening comprehension.

Gradually strengthening auditory attention helps children understand language beyond visual prompts.

5. From “See and Do” to “Listen and Think”

Imitation and task-based learning are important but should evolve into cognitive processing.

Encouraging children to listen to stories, understand sequences, and think about events builds comprehension and reasoning skills.

Narrative exposure is associated with improved language and executive functioning.

6. From Hardware Exercises to Brain Software Exercises

Motor and sensory exercises support regulation, but autism primarily involves differences in brain processing.

Interventions should increasingly focus on:

  • Attention

  • Listening

  • Understanding

  • Social cognition

This “software” approach strengthens neural pathways for communication and adaptive functioning.

7. From Passive Executive Function to Composed Thinking

Executive function includes planning, impulse control, and decision-making.

Instead of only training task completion, therapy should encourage children to pause, think, and plan before acting.

Developing self-regulation improves independence and problem-solving abilities.

Research shows executive function training improves adaptive behavior in autism.

The Doctor’s Role: Preparing the Brain to Learn

Medical and developmental support helps regulate sleep, attention, and behavior — creating readiness for learning.

This can be understood as optimizing the child’s “antenna” so they can receive and process social information effectively.

The Core Principle

A simple developmental rule emerges:

👉 Less connection → less listening → less talking

👉 Sustained connection → deep listening → language and conversation

Clinical Implications for Parents and Therapists

Focus therapy on:

1️⃣ Human connection
2️⃣ Sustained attention
3️⃣ Listening readiness
4️⃣ Language understanding
5️⃣ Thinking before acting

When goals shift toward these foundations, communication improves more naturally and sustainably.

Conclusion

Autism intervention is most effective when we change the goals from keeping the child busy to helping the child connect, listen, think, and communicate.

By moving from entertainment to learning, objects to humans, visual dependence to auditory understanding, and passive action to thoughtful planning, we create the conditions for meaningful developmental progress.

True change begins when goals focus on building the brain’s capacity to connect and understand.

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 2013.

  2. Dawson G, Rogers S, Munson J, et al. Randomized controlled trial of the Early Start Denver Model. Pediatrics. 2010;125(1):e17-e23.

  3. Mundy P, Sigman M. Joint attention and social development in autism. Development and Psychopathology. 2006.

  4. Tager-Flusberg H, Paul R, Lord C. Language and communication in autism. In: Handbook of Autism and Pervasive Developmental Disorders. 2005.

  5. Zwaigenbaum L et al. Early intervention for children with autism spectrum disorder. Pediatrics. 2015.

  6. Diamond A. Executive functions. Annual Review of Psychology. 2013.

  7. National Research Council. Educating Children with Autism. National Academies Press; 2001.

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