**1. Introduction**

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Autism is a developmental disorder that affects a child's perception of the world and how the child learns from his or her experiences. Even among the most complex disabili‐ ties, autism remains an enigma. Autism is the frequently occurring form of a group of disorders known as Autism Spectrum Disorders (ASD). The term Autism Spectrum Dis‐ orders (ASD) covers diagnostic labels which include Autistic Disorder, High Functioning Autism, Asperger's Syndrome, and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS).

Autism Society of America [1] defines autism as a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disor‐ der that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Autism has also been defined as a neurological disorder characterized by qualitative impairment in social interaction and communication as well as the presence of restricted, repetitive, and stereotyped patterns of behaviors, interests and activities [2]. Children with ASD share the social and communicative symptoms which are the core of autism, but they vary in severity of symptoms and in level of functioning.

The first three years of life are critical to a child's development. Parents take their child to the pediatrician, during this period for general health check up, screening and vacci‐ nations. Although child with autism can be screened by 18 months by a pediatrician, pa‐ rents often are the first ones to suspect behavioral deviations in their child. The mean age for such screening is approximately 15 months and in some cases it can be as early as 11 months [3]. According to the parents, children manifest patterns of extreme reactiv‐ ity, either by getting upset when new stimulus is shown or by completely ignoring it. The infants often fail to copy verbal behavior of others and do not babble by 12 months.

© 2013 Lal and Chhabria; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Research reports a significant difference between age-matched infants with autism and typically developing infants with respect to visual attention to social stimuli, smile fre‐ quency, vocalization, object exploration engagement, facial expression, use of convention‐ al gesture, and pointing to indicate interest [4].

age of 3 to 4, mental state understanding in individuals within the autism spectrum often continues to be conspicuously absent throughout the lifespan and leads to significant so‐

Early Intervention of Autism: A Case for Floor Time Approach

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**•** Play Behavior: Play is considered a key social behavior. Children play, regardless of age, so this is a behavior that is typically found in the behavioral repertoires of all children. To teach play to children with autism is to teach them skills that other typically developing children have and give them a common ground, a common language to engage with oth‐ ers. Play phases occur in developmental stages that typically developing children go through, so play is not only for fun, but for a purpose. Children learn about social interac‐ tion and language through play. As children with autism have trouble in symbol use and joint attention, understanding another's perspective, participating in pretend play and us‐ ing imitative skills are difficult for many of them. They are more self-centered than self‐ ish. When involved in joint play, there can be a tendency to impose or dictate the activity. Social contact is tolerated as long as other children play their game according to their rules. Children with ASD play in a 'bubble' and can resent other children intruding into their activity. They prefer to be left alone and continue their activity uninterrupted. There is a strong preference to interact with adults who are far more interesting, knowledgeable and more tolerant and accommodating to their lack of social awareness. It is often hard for them to enter into play with other children, maintain that play, and be appropriate. The children do not see themselves as members of a particular group and follow own in‐ terest rather than that of other children in the group. In fact, while other children have mastered the rules of simple childhood games, these children may not understand what is expected of them in team sports. They are often not interested in competitive sports or team games. Even understanding basic turn-taking may elude them. Most of them are un‐ able to comprehend how or why one would have a sense of satisfaction in knowing that

**•** Comprehending Emotions: Inability to empathize with people may be misinterpreted as a complete lack of the ability to care for others. It is more often a lack of *understanding of emotions*. The child is either confused by the emotions of others or has difficulty express‐ ing own feelings. The child does not display the anticipated range and depth of facial ex‐ pression. As interaction continues, one is aware that the child is not recognizing or responding to changes in the other person's facial expression or body language. Hands may be moved to describe graphically what to do with objects or express anger or frustra‐ tion, but gestures or body language based on an appreciation of another person's thoughts and feelings- e.g. embarrassment, consolation or pride- are conspicuously di‐ minished or absent [7]. Subtle clues may not be recognized by a child with Asperger's Syndrome. The child can then be confused and offended when criticized for not comply‐ ing with the signals of hidden intention. Not only are there problems with the under‐ standing of the emotional expressions of others, but the child's own expression of emotions are unusual, and tend to lack subtlety and precision. A complete stranger may be given a kiss on the lips, or distress is expressed quite out of proportion to the situation. Sometimes they cannot express their anger appropriately. When they are anxious or

cial and communicative challenges.

one's opponents felt inferior.

Identifying autism in toddlers is a recent practice. A large number of children have been di‐ agnosed reliably at 2 years. Professionals can now predict autism from the behaviors ob‐ served in a child younger than 2 years. Providing therapeutic intervention at this age would improve developmental and adaptive outcomes. The global trend in early intervention of autism is to provide training to parents so they can help the children develop in key areas of social responsiveness, attention skills, early communication skills, and interactive behavior.
