Preface One

Attention to Autism Spectrum Disorder（ASD）is growing around the world.Attention includes not just awareness of ASD，its prevalence and diagnostic processes，but growing focus on interventions that effectively improve outcome and quality of life for those affected by ASD.

My own ASD journey began in graduate school in psychology back in the late 1970s where the description of autism was narrow and intervention options were limited.Little did I know that a few years later，my first child would be born and subsequently diagnosed with ASD.It is a mixed blessing to be a clinician and researcher involved with ASD while also being an autism“consumer”.At times along the ASD journey，one may feel lonely.At other times，one may feel a part of a large，welcoming and strong group of advocates，families and providers.One can go from feeling overwhelmed，to having laser focus on securing services.There are times of worry for the future，to times of being excited about new developments，levels of acceptance and inclusion.There are benefits to having one foot in the“typically developing”world and the other foot in the“special needs”world.My experience as the parent of a child with special needs has helped me as a professional by bringing a richness of experience which informs and improves my practice.I can better recognize which interventions are feasible for a family and which may be unrealistically burdensome.It has helped my communication with other professionals by stressing the importance of focusing on quality of life，practical help and how to partner with people with ASD and their families to choose and prioritize goals.Having a child with ASD also helps me appreciate every small victory that families of typically developing children may take for granted.My experience in the typically developing world gives me a realistic perspective on the limitations of interventions and research.

Occasionally，there are also possible negative aspects to being an autism professional and parent.For example，while I may know how to handle a behavioral issue as a professional，as a parent，my anxiety may interfere with my actual implementation of the intervention.As a parent，I may feel grateful that a service exists，but as a professional，I may be more aware of the rough road ahead and the uncertain future.

In my professional role，I currently coordinate ASD services for a large pediatric hospital system in the United States.We serve several thousands of children and adolescents with ASD with services ranging from early developmental screening，home-based intervention for children from birth-age 3 years，diagnostic assessment，primary and specialty medical care，and varied therapies geared toward improving functional communication，social skills，play，activities of daily living，recreation/leisure skills，mental health and motor functioning.We also provide community outreach such as working with recreation providers and police，fire and rescue workers regarding how to recognize ASD，better communicate and partner with people with ASD and their families，and provide a welcoming and safe community.I also coordinate research programs where one of our areas of focus is improving access to care，recognizing that the earlier young children at developmental risk are identified，the quicker they can receive effective intervention and the better their functional outcome will be.

I recently had the honor of traveling to China to provide ASD training to various professionals and families.The beauty of the country and the warmth and enthusiasm of the people were inspiring.I felt a surge of energy geared toward removing stigma and a commitment to improving services for people affected by ASD.Not only must this commitment include education and implementation of systematic，accessible and sensitive diagnostic services，but also identification and implementation of effective interventions for people with ASD across the lifespan.This book plays an important and exciting role in the commitment to improving the lives of children with ASD and their families.

ASD is a spectrum disorder.It is often noted that“if you know one person with autism，you know one person with autism”.This means that each person with ASD is different and may respond to different interventions.The editors of this book recognize that and have included a wide variety of interventions，strategies and approaches which provides the reader with a depth and breadth of understanding.

When reviewing ASD interventions，there are several important points to keep in mind.What goals are being targeted by the intervention? ASD affects multiple areas of functioning and some interventions may be broad-based while others may target a more narrow focus.How do we know that the intervention actually works，and does it represent evidence-based practice? There are various definitions of evidence-based practice，typically referring to the quality of research involving the specific intervention.An evidence-based intervention or practice should be described in sufficient detail that it can be reproduced.Ideally，there should be well-designed published studies in peer-reviewed journals demonstrating significant positive outcomes of the intervention or practice.What are the expected outcomes and how are those outcomes measured? Has the intervention been demonstrated to be effective in the“real world”or only in carefully controlled research settings? Additional important criteria when considering an intervention is whether the approach is culturally sensitive and has been successfully implemented within the culture of the children/families of interest.It is possible that some interventions in wide use in Western cultures may be less acceptable or less feasible in China.Or that interventions widely used in China may not be well-understood or well-studied in other parts of the world.

Health care and educational providers，researchers and other readers of this book are encouraged to partner with people with ASD and their families to jointly determine goals and possible interventions.The hope is that future research will inform a“precision medicine”approach to ASD in which each person with ASD will be able to be matched to the intervention most likely to be effective for him or her.We owe it to children with ASD to recognize their strengths and partner with families to provide interventions that will enhance functioning and quality of life to all affected by ASD across the spectrum and across the lifespan.This book represents an important step in that direction.