When someone you love is diagnosed with Autism Spectrum Disorder (ASD), or you’re exploring what autism means for yourself, it can be hard to know where to begin. You might find yourself searching online for treatment options, therapy for ASD, or the best treatments for autism. Most of what you’ll see is based on outdated, one-size-fits-all models of autism, especially ABA therapy and other behavioral interventions.

This guide offers something different: an introduction to autism-affirming approaches to care. We’ll explain the most common therapies, what their goals are, and how to choose a path that truly supports the well-being of autistic people, especially young children, adolescents, and young adults navigating life on the spectrum.

What Is Autism Spectrum Disorder (ASD)?

The medical model views ASD as a developmental disorder or disability that affects how someone experiences the world. It can involve differences in sensory integration, emotional processing, communication skills, social interaction, and motor skills. It’s called a spectrum because no two autistic people are the same.

Some people may be very verbal, while others may use alternative communication. Some may enjoy social situations in small doses or specific ways, while others may avoid them entirely. Some may need help with activities of daily living, while others may live independently with occasional support.

Autism is a genetic difference in the structure of the brain and nervous system. The social model of disability views autism as a developmental difference — not a disorder or illness — that is addressed through deeper self-understanding, lifestyle adjustments, and accommodations at home, school, and the workplace. Autism is not a disease. It is not caused by bad parenting, trauma, or vaccines. It is not something to “cure.”

Autism Assessment, Diagnosis, and Self-Discovery

If you think you or your child might be on the autism spectrum, getting an assessment is one place to start, but it’s important to understand the different types available. Public schools are required to evaluate students for learning differences, and their assessments can determine whether a child qualifies for services like an IEP. However, schools do not diagnose autism. Their focus is educational, not diagnostic, and they may miss autistic traits in adolescents, girls, gender expansive people, or anyone who masks their symptoms.

For a formal diagnosis, a neuropsychologist, licensed psychologist, or developmental pediatrics can conduct a comprehensive evaluation. This typically includes interviews, observation, cognitive testing, and standardized tools like the ADOS-2. A formal diagnosis can help with insurance access, accommodations, and understanding, but waitlists are often long and costs can run into thousands of dollars. Formal assessment can help with access to services but also comes with the stigma of an ASD diagnosis. To begin, you can ask your primary care doctor or mental health counselor for a referral, or search for local autism diagnostic clinics.

If there isn’t a need for access to disability services, a full diagnostic evaluation isn’t required. A licensed marriage and family therapist (LMFT), professional clinical counselor (LPCC), or social worker (LCSW) can offer an informal assessment. This may involve screening tools, a clinical interview, and a collaborative conversation about whether autism feels like a good fit. While not a medical diagnosis, this kind of assessment can still guide treatment planning and validate lived experience.

In the autism-affirming community, self-assessment is as valid or more valid than a formal assessment. Many autistic adults recognize their traits through personal reflection, reading, online screeners, or connecting with peers. A formal diagnosis isn’t required to begin counseling, build community, or advocate for affirming support. For a list of online screeners, see the Resources section on our Neurodivergence page.

Whether formal or informal, the most important part of any autism assessment is that it’s done with respect for sensory needs and cognitive differences. A validating provider will approach the process collaboratively and without judgment, focusing on understanding rather than pathology.

What Does “Treatment” Mean for Autism?

There’s no cure for autism, and many autistic people don’t want one. But support is helpful. The goal of therapy should be to improve quality of life, help with co-occurring challenges (like anxiety or hyperactivity), and make the world feel more understandable and easier to navigate, but not to change someone’s core identity. Autistic people benefit from developing executive functioning skills, identifying sensory and emotional needs, how to advocate for accommodations, practicing social skills, developing routines for self-care, and finding supportive community.

This is why mental health and therapy services need to be autism-affirming, viewing autism as a difference to be accommodated, not a deficit. Therapies centered around the autistic experience adapt to sensory needs, support differences, and validate strengths. Developing emotional intelligence, treating depression and anxiety, building self-esteem, and processing trauma and PTSD are all therapies useful to autistic people, but only if they are used in an autistic-affirming way.

So how do you choose from the many treatment options? Let’s walk through the most common types of therapy offered to autistic people, what they involve, and where they help or hurt.

Common Autism Therapies: What They Are and What to Know

There are many different therapies offered for autism, each with its own goals, methods, and assumptions. Some focus on teaching new skills or improving communication, while others aim to reduce behaviors seen as “challenging” to non-autistic people. It’s important to understand what each therapy is trying to do, and whether it supports the autistic person’s quality of life or simply pushes us to mask as more neurotypical. Below are some of the most common treatment options, along with what to consider before choosing one.

ABA Therapy (Applied Behavior Analysis)

ABA therapy, or Applied Behavior Analysis, is the most widely promoted autism treatment in the United States. It’s often recommended by health care providers, school districts, and pediatricians. The idea is to use rewards and repetition to “teach” new skills or reduce “challenging behaviors.”

ABA programs target young children, are often led by a BCBA (Board Certified Behavior Analyst), and involve early intensive behavioral interventions including 40 or more hours a week of training, especially for young children.

What to watch out for: Many autistic adults say ABA caused long-term harm. It often teaches children to hide their symptoms of autism—like avoiding eye contact, not stimming, or acting neurotypical—even if it causes distress. ABA can make children more “compliant,” but that doesn’t mean it’s helping their mental health or quality of life. Studies labeled “evidence-based” often measure surface behaviors, not emotional well-being. Autistic-affirming therapists strongly discourage against ABA therapy.

Avoid ABA as a treatment approach for autistic children. Operant conditioning was developed for training animals, not healthy people, and has roots in other brutal practices such as gay conversion therapy.

Occupational Therapy (OT)

Occupational therapy focuses on building functional life skills, such as using utensils, dressing, or handwriting. OT can support both motor skills and sensory integration, helping with things like sensitivity to sound, light, or texture. Used well, OT can support activities of daily living, support transitions, and reduce distress.

What to watch out for: Some OTs use ABA-like practices or set goals based on neurotypical expectations. Look for OTs who individualize treatment plans and respect your or your child’s unique needs.

Cognitive Behavioral Therapy (CBT)

CBT helps people identify unhelpful thoughts and behaviors and replace them with more supportive patterns. It’s often used for anxiety, depression, or emotional regulation challenges, especially in adolescents and young adults. CBT is widely touted as evidenced based, yet many people find that it fails to address root causes such as developmental trauma. CBT can be used alone, or CBT interventions can be integrated within a broader psychotherapeutic process.

What to watch out for: Traditional CBT may assume neurotypical communication styles. Clinicians should adapt it to match the autistic person’s processing style and avoid blaming the individual for social misunderstandings. Some autistic people have called CBT “ABA for adults”.

Speech and Language Therapy

Sometimes called language therapy, this intervention supports communication skills. It may involve spoken language, alternative communication (like tablets or picture cards), or social communication strategies.

What to watch out for: Avoid speech therapy that aims to make a child “sound normal” or push spoken language at the expense of comfort. Autistic-affirming clinicians will honor echolalia, scripting, and other natural forms of autistic communication.

Social Skills Training

This aims to help people with ASD navigate social situations like making friends, understanding facial expressions, or managing conversations. Helps develop skills to interact better with allistic people. Valuable for developing self-confidence to discover and enter communities with shared interests.

What to watch out for: Social skills programs often focus on making autistic people act more neurotypical. That can teach masking and lead to autistic burnout, which can take years to recover from. The best programs offer tools without shame, encouraging authenticity, finding the right community, and helping build confidence.

Physical Therapy

Physical therapy supports gross motor development, balance, posture, and coordination. This can be especially useful when ASD co-occurs with developmental disabilities or motor skill delays.

What to watch out for: Like other services, physical therapy should be strengths-based and individualized. It’s not about making someone move “normally,” but supporting movement that feels good and functional for their body.

Pivotal Response Treatment (PRT)

PRT is a form of play-based behavioral intervention that focuses on motivation and “pivotal” areas like response to cues or social engagement.

What to watch out for: PRT is sometimes described as more naturalistic than ABA. However, it still comes from a behavioral model and may have similar risks, especially if led by a behavior analyst who prioritizes neurotypical masking over well-being.

Relationship Development Intervention (RDI)

Relationship Development Intervention is a parent-guided intervention that focuses on improving social communication, flexible thinking, and engagement in social situations. It is often presented as a more relationship-centered alternative to traditional behavioral therapies.

What to watch out for: While less rigid than ABA, RDI still frames autism as a set of deficits to correct. It may encourage masking and does not have strong evidence-based support. Look for providers who respect autistic ways of relating rather than trying to reshape them.

So What Is Autism-Affirming Therapy?

Allistic or neurotypical assumptions of what autistic people need in therapy will likely miss the mark. Due to issues like alexethymia, the double-empathy problem, and high sensitivity, therapies that don’t specifically support autistic needs are likely to make things worse.

Autism-affirming therapy sees autism as a valid way of being. The goal is not to change who we are or train us how to mask our differences but to support our well-being, identity, and relationships. Instead of focusing on compliance or masking, therapy intended for autistic people helps clients live more authentically and sustainably. It doesn’t try to erase stimming, enforce eye contact, or make people pass for neurotypical.

This approach includes interpersonal work tailored to the autistic experience, focusing on managing stress, understanding masking, and exploring safe self-expression. Therapy may include deep dives into special interests, building meaningful relationships, and developing communication strategies that feel natural. Autistic people know that info-dumping is a love language!

Trauma-informed care is a core element, recognizing the high rates of trauma autistic people face, including abuse, sexual assault, autistic burnout, and chronic empathetic misattunement. Rather than blaming defense mechanisms like masking, this therapy creates space to heal and identify environments where it’s safe to unmask.

Advocacy is also key. Many autistic people come to therapy after years of ignoring our needs. Counseling helps us set boundaries, navigate difficult relationships, and work towards speaking up for ourselves to request accommodations in a world that often misunderstands us.

Counseling for autistic people supports basic well-being. Because of interoception difficulties and differences in sleep-wake rhythms, autistic people often don’t notice when they’re hungry, tired, or need to use the bathroom. In counseling, that means attending to nutrition, sleep, sensory comfort, and developing routines that support daily functioning.

Autism-affirming therapy doesn’t aim to make you seem more “normal.” It’s practical, compassionate care for a nervous system that often runs hot. It helps you become more yourself. That’s the real goal.

How to Choose the Right Providers and Clinicians

• Avoid anyone who promises to “reduce” autism traits. If they say ABA can be helpful, they likely don’t understand autism-affirming care.
• Ask if they have experience with neurodiversity-affirming care. Look for people who listen to autistic adults and lived experience. Check if they know some key terms like “alexithymia”, “interoception”, and “double-empathy problem”.
• Check whether their goals support the individual’s needs, not just what’s expected by schools, parents, or institutions.
• Ask if they have a sensory-accommodating office, including low or adjustable lighting, scent-free space, and comforts like stim toys, plushies, or weighted blankets. Therapy should reduce stress, not add to it, so inquire if telehealth is an option for some or all sessions.

What Parents and Caregivers Should Know

As a caregiver, it’s natural to want your child to succeed. But success doesn’t mean hiding who they are. It means helping them feel safe, seen, and supported.

Autism-affirming care respects your child’s needs, fosters confidence, and gives them tools to navigate the world on their own terms. This is true for young children, adolescents, and even young adults coming to understand themselves later in life.

Get the Support You Deserve

If you’re looking for autism therapy that respects who you are or supports your loved one without trying to change their nature, I can help.

As a licensed mental health counselor, I offer autism-affirming psychotherapy for individuals, teens, and families. I work in person in Santa Rosa and online across California.

Let’s build a plan that supports your thriving — not your masking.