There are sounds that remain with you long after they fade. Not because they were loud, but because they were unanswered. It was the morning before a Parent-Teacher Meeting at Addwik’s special school in Jaipur. The building was already awake. Chairs were being arranged. Files were stacked neatly. Progress charts hung from soft boards. Staff moved quietly through corridors carrying the familiar confidence of routine. We had arrived a little early. Addwik had been gently handed over to the care staff while my wife and I met the educational team. Around the table sat special educators, therapists, and sports instructors who had worked with him over the previous months. Folders were opened, notes were referenced, and progress charts were displayed. Everything appeared orderly, measured, and professional.
I should have felt reassured. Instead, I was listening.
From somewhere down the corridor came a sudden vocalization—sharp, followed by silence. A few moments later it came again. To anyone else it might have blended into the ordinary sounds of a special school. To us, it was instantly recognizable. A parent learns to identify his child’s distress long before the mind consciously processes it. The discussion continued—adaptive behaviours, task engagement, speech goals, fine-motor development, and areas requiring reinforcement. Then the sound returned, longer this time, more strained. I noticed my wife’s posture change. It was subtle: a stillness in her shoulders, a silence that signalled attention rather than withdrawal.
When the current discussion ended, she asked a simple question: “When he shouts like that, what exactly do you do?”
The professionals answered sincerely. “We try to calm him. We redirect him to an activity.”
Someone mentioned sensory input. Yet the answers remained broad and general.
My wife asked again: “What is the very first thing you do?”
That question stayed with me because first responses matter. If a child is overwhelmed, immediate correction may add another demand. If the child is frightened or dysregulated, instructions may not be reaching him in the same way they do when he is calm.
As the discussion continued, I felt two identities colliding within me: the physician and the father. The physician understood the language of physiology, stress responses, and regulation. The father was listening to his son. I had spent years studying the human body. Yet hearing my own child’s distress echoing down a corridor stripped theory down to its essentials.
Eventually one educator said, “We usually try to understand what may be triggering him.”
It was the closest thing to a structured answer, and perhaps the most important.
The meeting ended politely. We thanked the staff for their dedication and commitment. No confrontation occurred. But something fundamental had shifted. As we walked down the corridor to collect Addwik, he stood quietly beside a caregiver. His eyes were slightly flushed. His body still carried traces of tension. I knelt beside him.
“Long day?” I asked. He answered in the form he knew best: a broad smile.
On the drive home, neither of us spoke much. Then my wife said quietly, “They don’t really have a system.” It was not criticism. It was observation. Until that day, we had evaluated schools largely through infrastructure, credentials, curriculum, and therapy schedules. From then onward, we began evaluating something deeper.
Did the institution understand regulation?
Did it look beneath behaviour for possible triggers?
Could it distinguish outward compliance from genuine calm?
Did it know how to intervene early, before distress became escalation?
These questions are not simple. Autism is heterogeneous, and no single physiological explanation accounts for every episode of distress. Research does, however, show that emotion-regulation difficulties are common in autistic children and adolescents, while studies of autonomic responses suggest complex and variable physiological patterns rather than one universal “autistic nervous system” response. That distinction matters.
Regulation should not become another fashionable word that replaces observation. It should sharpen observation.
In the weeks that followed, we began building our own framework at home. We documented triggers. We tracked sleep. We observed sensory patterns. We experimented cautiously with environmental modifications, movement, deep-pressure activities, predictable routines, and recovery periods.
We were no longer trying simply to stop behaviours.
We were trying to understand them. The change sounds small, but it altered our approach. Instead of beginning with: “How do we stop this behavior?” we increasingly began with: “What might he be trying to tell us?”
Sometimes the answer was obvious—fatigue, hunger, pain, noise, or an unexpected change. Sometimes it was not. There were days when we interpreted him correctly and days when we did not. Parenting a child with limited expressive communication means accepting a degree of uncertainty. But uncertainty does not excuse us from curiosity. A shout can be a behaviour. It can also be information. The two are not mutually exclusive. A child may still need boundaries, teaching, and support to develop safer or more functional ways to communicate. Understanding the reason beneath a behaviour does not mean abandoning expectations. It means choosing the starting point more intelligently.
That corridor therefore did not teach us how to silence a shout.
It taught us to ask a different question.
The real journey had only begun.
Lt Col (Dr) Amit Kumar, MBBS, is a serving officer in the Army Medical Corps, India, and can be reached at [email protected] or +91 8826220568.
References
Lugo-Marín J, et al. Emotion regulation and emotion dysregulation in children and adolescents with autism spectrum disorder: A meta-analysis of evaluation and intervention studies. Journal of Affective Disorders. 2024.
Mazefsky CA, Herrington J, Siegel M, et al. The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(7):679–688.
Zadok E, Golan O, Lavidor M, Gordon I. Autonomic nervous system responses to social stimuli among autistic individuals: A systematic review and meta-analysis. Autism Research. 2024;17(3):497–511.
