Eli is a four-year-old autistic boy with bright eyes that seem to notice everything. Eli’s favorite place in the house is the corner of the living room, where a thick rug cushions the floor and a basket overflows with wooden train tracks. Each morning, right after breakfast, he makes his way there. Piece by piece, he constructs elaborate railways that loop around furniture legs and stretch under the coffee table. Eli uses a few spoken words when someone prompts him to say them—“up,” “go,” “cookie”, “blue”. When he wants a snack, he brings his mother the same green bowl every time. If he wants a particular snack, he might guide her hand toward the cupboard. When he’s ready to go outside, he stands near the door. If he wants to play “tickle monster,” he brings over the fluffy red blanket and hides under it with a little wiggle of excitement. He and his father enjoy playing “chase” around the kitchen island, with Eli squealing softly. When he wants a break, Eli pauses and presses his cheek to the cool floor. Eli also uses movement to communicate excitement or anticipation. He might bounce on the balls of his feet when something fun is about to happen or flap his hands lightly in a rhythmic, joyful way. 

Discovering Avela Health’s online therapy services

When Eli and his parents, Sam and Linda, found Avela, their goals were similar to many others: they hoped to support Eli’s play, interaction, and communication. But they also held concerns. They had heard again and again that the “right” choice for autism care was a center-based program—25 to 40 hours of therapy each week. The idea felt overwhelming. What about their favorite gymnastics class? Storytime at the library? Would intensive therapy take away the moments that made family life feel whole?

That’s when they met their Avela Health provider, who recommended a plan that surprised them: just 90 minutes of therapy per week. Could such a small amount of time really make a meaningful difference?

Sam and Linda visited the Avela website and discovered a very different approach to care. Avela’s model uses Naturalistic Developmental Behavioral Interventions (NDBIs), supporting a child’s learning through everyday routines and play. The focus is on building joyful connection, communication, and engagement—centered around the child’s interests, not imposed upon them.

Therapy that helps families feel seen, heard, and supported

In their first meeting, Sam and Linda were surprised—and deeply moved—to realize that their knowledge and priorities for Eli were not only welcomed but centered. Their Avela Health provider gently explained that while it’s natural to hope Eli will speak and play in expected ways, the first step was honoring how Eli already communicates. By respecting his current ways of connecting, they would create a foundation for spontaneous, authentic communication.

Their Avela Health provider recommended a plan that felt sustainable and empowering: a one-hour weekly parent session and a 30-minute play session with Eli. During parent sessions, Sam and Linda would reflect on Eli’s unique ways of being, learning strategies tailored to his interests and needs. The play sessions were a chance for Sam to try those techniques in real time, with gentle coaching. Since Linda was at work during those times, the provider sent a detailed follow-up email after each session, filled with insights and resources.

The provider also encouraged them to join Avela Health’s Parenting With Joy group—a clinician-guided online support group providing helpful information and space for connection with other parents on a similar journey.

A day in one family’s life with Avela Health therapy

This week’s focus was spontaneous communication. During their parent session, Sam and Linda learned that Eli is much more likely to use new words when they’re embedded in experiences he enjoys and cares about.

At the play session, Eli was busy lining up his trains, focused and content. Sam sat across from him, making sure Eli could see his face. He began to label the trains with enthusiasm: “Yellow train!” “Red train!” “Choo-choo!” A small smile flickered on Eli’s face—his way of saying, I like this.

Then Eli placed a green train on the track. This time, Sam paused. He smiled, waiting. Eli noticed the change. He looked up, his gaze meeting Sam’s. Their Avela Health provider said excitedly, “Look at that beautiful spontaneous communication—he looked right at you! Let’s name the train!”

Sam grinned and said, “Green train!” A moment later, Eli picked up the purple train and looked to Sam again before placing it down. Sam met his gaze with enthusiasm: “Purple train! Choo-choo!”

Eli laughed and softly echoed, “oo,” before grabbing another train. The game continued, filled with shared glances, laughter, and connection.

At the end of the session, their provider reflected warmly, “Sam, when you followed Eli’s lead and made space to play his way, you created the perfect opportunity for learning. Look how he used his eyes to include you, to invite you into his world. I even think he said ‘choo choo’!”

For Sam and Linda, it was a reminder that progress doesn’t always look like loud milestones or long hours. Sometimes, it sounds like a soft “oo,” or looks like a shared glance over wooden tracks. And sometimes, it feels like a train ride—with Eli in the lead and his family right beside him, following the joyful curves of his track.

After six months of Avela Health therapy

Six months into their journey with Avela Health’s intensive therapy program, Sam and Linda have seen beautiful growth in Eli—and in themselves. Eli is now using more spontaneous words during play and daily routines, often pairing his vocalizations with gestures and joyful expressions. He has begun to initiate more interactions, like gently placing a toy in Sam’s hand or leading Linda toward a favorite book with a bright “go!” 

Sam feels more confident recognizing and responding to Eli’s cues, and Linda has started weaving communication opportunities into their bedtime rituals and mealtimes. Most meaningfully, their home feels more connected, more playful, and more attuned to Eli’s unique way of navigating the world. The family’s days are still filled with trains and tickle blankets—but now they are also filled with shared moments of communication, trust, and joy.

This story is an example of one family’s potential experience with Avela Health, with names and identifying characteristics changed.