**9. An illustrative case study: The story of Jason**

**5. Manage your own arousal**

286 Autism Spectrum Disorder - Recent Advances

**6. Multiple sensory integration processing**

processing by requesting conceptual thinking.

**7. Conceptual thinking**

developmental stage of the participant.

**8. Low arousal as a condition for reprocessing**

If we work with families, we start by teaching the parents how to manage their own arousal. We provide parents with a technique to lower their own arousal and the tools to help their children with stress and emotion regulation. To provide a good therapy session, the ReAttach

People with autism experience difficulties processing information through more than one channel; they process sensory information atypically. Because of monotropism, people with autism store information in a fragmented manner. According to Bogdashina and Siebelink [10], children with autism have disrupted concept formation because of these sensory integration problems. I believe that we can teach them how to improve in this area. To build coherent concepts we must use multiple sensory integration processing. During optimal arousal under multisensory stimulation (tactile, auditory, visual), we can stimulate multisensory integration

At approximately the first year of age, children become capable of placing coherent informa‐ tion into concepts. People with autism lack this ability. They continue to process incoming information in pieces; consequently, they do not create a coherent image of 'the self', 'the other', or 'the world'. Baron-Cohen believes that the social interaction problems of people with autism arise because of a basic inability to think about mental phenomena in terms of 'self' and 'other' [11]. It has been my experience that with ReAttach we can train people with autism to form concepts. During our cognitive training, we follow the same order of development that occurs in a young child [12]. We start with the concept of 'the self' – the name. Then, we train concepts of significant others, theory of mind and social concepts. Autistic individuals with average or high intelligence can start this training at the age of six and follow it through to completion. With low-functioning people with autism and with younger children, our purpose is to teach them to differentiate between 'the self' and 'the (significant) other'. At a later stage, we can try to train theory of mind and inter-relational concepts. We must adjust the intervention to the

Based on the theory proposed by Bogdashina, I assume that people with autism have an entire database of loose fragmented pieces stored in their long-term memories [10]. It is important

therapist must manage his/her own arousal before addressing the participant.

Jason, a 22-year old male, demonstrated development after undergoing ReAttach therapy four years ago. Jason was diagnosed with Asperger syndrome when he was eight years old. Despite his high intelligence level, it was obvious that something was wrong. Asperger's manifested itself in a typical manner. Jason himself describes some of the more prominent features of his condition before and after the ReAttach therapy.

'Before receiving the ReAttach therapy, I, for instance, had always had trouble signalling my own pain sensations. According to my mother, this was already apparent when I was young. As a baby, when I accidentally held my arm in a hot bath, I did not flinch. When I was a teenager, I broke my arm twice but did not hesitate to shake the general practitioner's hand with my injured arm, simply because I was unable to sense the pain this must have caused. The same goes for sensing hunger: it has always been difficult for me not to forget to eat.

Another example was trouble in both perceiving and showing emotions. I remember how my grandfather died when I was ten, and of course it was obvious to me that everyone was sad, as that is what most people are at funerals. However, it was very difficult for me to become aware of the way I felt myself. I remember thinking I had to feel sad too, but was not able to show empathy. Looking back, I notice how seeing someone crying was connected to the cognition of feeling sad, but the actual feeling never came.

When reflecting with my mother, it became clear that I was often absent-minded, and could completely focus on one activity, for instance playing a video game. In these situations, I completely lost track of time and the people around me. Simple tasks like walking the dog or doing the dishes were not executed, not because I was unwilling but because of the lack of overview.

The first time I was going to receive the ReAttach therapy, I was slightly sceptical of the improvements it could offer me. Afterwards, I realize that because I was not able to reflect on my own situation, I could also not see the skills that I lacked. Of course I was aware of my diagnosis, but that did not mean that I felt limited in my daily functioning. So far, I had lived a happy life. My results at school had been excellent; why bother improving?

It is impossible for me to fully describe my gain from ReAttach, not only because it comprises so many aspects but also because I lack a proper self-image from the first 18 years of my life. According to my relatives my social interaction skills have improved dramatically. Not only are my facial expressions more appropriate but people in conversation with me also feel better understood, and...I actually take part in a conversation.

Another big improvement is the ability to multitask in everyday life. Since ReAttach, I have been able to live on my own, get my driver's license, play in a band, maintain my social life with my roommates and friends, and undertake university study with an internship abroad, but above all I have been able to do these things with ease. I do not think I would have been able to, for instance, live on my own if I had not received the ReAttach therapy. I do think that it would have come with a lot more trial-and-error. This is the exact reason I would recommend the therapy to everyone: after a couple of almost effortless sessions my life has become so much easier, it would be almost foolish to not see what ReAttach could offer you'.
