Every parent has wondered at some point whether a behavior is just a phase or a sign of something more. A toddler lines up toy cars by color and never pushes them across the floor. A preschooler covers their ears every time the vacuum turns on. A child doesn’t turn around when their name is called. Each moment on its own is easy to explain away, and many parents do, often out of love and sometimes out of quiet fear.
Alisha Simpson-Watt, LCSW, BCBA, LBA, has spent her career helping families make sense of moments like these. A licensed clinical social worker and board-certified behavior analyst, she is the founder and executive clinical director of Collaborative ABA Services, a behavioral health practice that specializes in applied behavior analysis therapy for children and adolescents with autism and other developmental and behavioral challenges. She is also the mother of a daughter diagnosed with autism, which gives her a perspective few clinicians can offer. Her message to parents is clear and steady: understanding your child changes everything, and understanding starts with knowing what to look for.
Know the Milestones Before You Worry About the Label
Simpson-Watt describes autism as a neurodevelopmental disorder, meaning it involves some developmental delays. Her first recommendation for families is simple: learn the developmental milestones for your child’s age. She points parents to the CDC’s website and app, which let families track milestones over time, and to regular conversations with their pediatrician.
From there, she groups early signs into a few areas. Communication differences can include delayed speech, not using gestures like pointing, waving, or showing objects, repeating words or phrases, or having language but struggling to use it to express wants and needs. Social connection signs include not responding to their name, limited eye contact compared with peers, and difficulty with back-and-forth interaction, such as not smiling back when a parent smiles.
Play offers clues, too. Simpson-Watt describes repetitive play, such as lining up cars by color without playing with them, or focusing on one part of a toy. A child handed a toy car might stare at the spinning wheels rather than drive it. Sensory differences can show up as strong reactions to sound, textures, clothing, light, smells, or foods, or as sensory seeking through spinning, jumping, or crashing into things. Finally, she notes restrictive behaviors and a need for sameness, including repetitive movements like rocking or hand flapping and significant distress when routines change.
None of these signs alone confirms anything. Together, they are a reason to have a conversation with a professional.
Why Autism Can Hide in Plain Sight
Because autism is a spectrum, Simpson-Watt explains, signs and symptoms vary widely from person to person, and some are subtle enough that anyone not trained in diagnosing autism could miss them. A child may be verbal and able to hold a conversation, yet a closer look reveals that the conversation is one-sided or centered only on the child’s specific interests.
The same is true for self-stimulating behavior. Not every child with autism flaps their hands. Some stim visually, holding a device or object very close and inspecting it, which is far less noticeable than rocking. Simpson-Watt also points to studies showing that boys are diagnosed with autism more than three times as often as girls, and she explains that symptoms in girls can be more subtle. That subtlety is one reason more adults are now receiving a diagnosis later in life.
She is also compassionate about why some parents resist the possibility. When people don’t know much about something, fear or avoidance can follow. Cultural beliefs and worries about being seen differently can make a diagnosis harder to accept. Recognizing those feelings is often the first step past them.
You Notice, the Professionals Evaluate
When a parent sees signs, Simpson-Watt’s advice is to have the child evaluated. For children under three, parents can also contact their state’s early intervention program, which in Connecticut is called Birth to Three, to share concerns and request a developmental evaluation.
Her reassurance here takes an enormous weight off parents’ shoulders.
“Parents don’t have to diagnose autism. They just have to notice the signs, be able to ask questions, and advocate for their child.”
Alisha Simpson-Watt, LCSW, BCBA, LBA, Founder and Executive Clinical Director of Collaborative ABA Services
Advocacy, in her view, grows out of education. She encourages parents to learn about autism and available resources and to know the key people in each setting. In school, that may mean the teacher, the principal, and the special education teacher. In the community, it means finding the right groups and their contacts. She calls this knowing “your pack,” the circle of people who can help a child get what they need. The earlier parents share their concerns with a medical provider, she stresses, the sooner early intervention can begin to make a difference.
Every Behavior Is Trying to Say Something
One of the most important shifts Simpson-Watt asks adults to make is in how they respond to behavior. The instinct is to stop it. Her reframe is to ask a different question: instead of trying to stop the behavior, why is this behavior occurring?
“Behavior is a form of communication,” she explains. A child may act a certain way because of sensory overload, difficulty expressing a want or need, an unexpected change or transition, fatigue, or hunger. Seeing the situation from the child’s perspective is how adults can help meet the need underneath.
This connects to her view of acceptance. The goal, she says, is not for a child to change, mask, or hide their autistic traits to fit in. Instead, families, schools, and communities can adjust their expectations and environments to be more supportive. She believes education and awareness are what shift society’s thinking, especially the reminder that autism looks different in every person. Everyone has strengths and limitations, with or without a diagnosis.
What a Child Needs in the Middle of a Meltdown
When a child is overwhelmed by big emotions, Simpson-Watt says the first step belongs to the parent: regulate yourself first. Children often model how the adults around them regulate, so a parent who yells or looks frustrated during a meltdown can escalate it further.
Next, reduce stimulation. She recommends fewer words, less noise, fewer people, and attention to the physical space, such as moving a child who is overwhelmed by crowds to a quieter area. She compares lecturing a dysregulated child to the muffled “womp womp” voice of the adults in Charlie Brown. The child simply cannot take in the information in that moment. Safety and regulation come first.
Coping skills still matter, but timing is everything. Simpson-Watt advises teaching strategies such as asking for help or requesting a break when a child is calm, and practicing them before the child needs them, rather than turning a crisis into a teachable moment. Sometimes, she adds, what a child needs most is space to sit with the feeling and use those strategies, with an adult supporting them through it rather than insisting they stop feeling it.
These ideas shape her children’s book, It’s Okay, Mattie: A Story About Autism, Big Feelings, and Learning to Cope, which was inspired by her daughter. In the story, Mattie struggles with changes to her routine and environment, and a caring adult helps her find her calm again while she learns to use coping strategies herself.
Caring for the Caregiver and the Whole Family
Simpson-Watt is candid that caregiver burnout is real. Parents of children with extra needs juggle therapy appointments, medical visits, insurance, school meetings, IEP or 504 meetings, transportation, behavior challenges, siblings, and sometimes the care of their own aging parents. Many parents avoid admitting burnout because they fear it means they don’t love their child or aren’t a good parent. It means neither, she says. It means they are human.
Her guidance starts with recognizing burnout early. Small moments count: journaling, drinking a favorite tea or coffee uninterrupted, reading, calling a friend, or even sitting in the car for a few minutes. She encourages parents to “build a support system before you really need one,” through family, friends, support groups, and autism organizations. She also suggests delegating tasks where possible, keeping an identity outside of caregiving through a hobby or class, and recognizing when it is time for professional support. Pride and embarrassment can keep parents from asking for help, but Simpson-Watt reminds them that burnout happens to other parents, too, and that they are not alone.
For the family as a whole, she recommends shared activities and planning ahead, especially for outings, by telling a child what to expect and packing favorite items. A thriving family, she says, is one where “everyone feels safe and everyone feels like they belong.” That includes care that respects each family’s beliefs and structure. In culturally responsive care, providers stay open to feedback rather than dictating to families. “They’re part of the process from the beginning to the end,” Simpson-Watt says.
Notice, Ask, and Give Yourself Grace
The heart of this conversation is that parents do not need to have every answer. They need to know the milestones, pay attention to what they see, and share their concerns with a pediatrician or early intervention program. Behavior is communication, and understanding what a child is trying to say matters far more than making them fit someone else’s idea of normal.
Parents also need care of their own. As Simpson-Watt puts it, “you can’t fill your child’s cup or be there for your child if your cup is running on empty.” Supporting a child should never require a parent to sacrifice themselves completely.
If there is one thing to carry into today, let it be this: if something feels off, say so, and then be gentle with yourself. Her closing advice to parents is to “give yourself grace as a parent and just be kind to yourself throughout this process.” Speaking as both a clinician and a mother, Alisha Simpson-Watt reminds families that with the right understanding and support, children and families can do far more than cope.
Alisha Simpson-Watt is a licensed clinical social worker, board-certified behavior analyst, and licensed behavior analyst. She is the founder and executive clinical director of Collaborative ABA Services, LLC, a BHCOE-accredited behavioral health practice specializing in applied behavior analysis therapy for children and adolescents with autism and other developmental and behavioral challenges. She is the author of It’s Okay, Mattie: A Story About Autism, Big Feelings, and Learning to Cope and a guest columnist for Spectrum and Soul, a series in Successful Black Parenting Magazine. She helps families understand autism, support children through big emotions, and care for themselves as caregivers.