I provide individualized therapy for children and adults diagnosed with autism spectrum disorder (ASD).
Therapy is particularly helpful when concerns involve anxiety, emotional or behavioral difficulties, executive functioning, relationships, flexibility, or co-occurring ADHD. I offer individual therapy, parent consultation and training, parent–child interaction therapy (PCIT), in-home services in the San Diego area, and telehealth when clinically appropriate.
What is ASD?
ASD is a neurodevelopmental condition that shapes how individuals perceive the world, process information, and interact with others. As autism exists on a broad spectrum, its impact on daily life varies significantly from one person to another.
Communication, social interaction, cognitive flexibility, emotional regulation, executive functioning, and sensory processing can all affect daily routines. Restricted interests and repetitive movements or behaviors may also be present. Unexpected changes and transitions may cause significant distress. Planning multistep tasks, managing time, or initiating activities may require tailored visual or structural supports. Sensory reactivity to lights, sounds, textures, or crowded spaces can affect comfort and the ability to engage in daily routines.
What Brings Families to Therapy
Parents contact me because they wonder whether their child may have ADHD, ASD, or both. They are unsure what to do next and have valid concerns about children being overdiagnosed and labeled based on a few symptoms that may “go away” as their child gets older. Many are also struggling to balance being warm and understanding while setting limits and maintaining appropriate expectations for their child’s individual needs.
The majority of parents I meet with have done their own research and have tried popular parenting or discipline approaches they found through books, podcasts, or social media. A strategy might work occasionally or help to some degree, but the child continues to struggle, and the parents need more. Their child may become extremely upset when a game does not go a particular way, eat only a few foods and then reject those foods, or have a reaction that is significantly out of proportion to the request.
Some families are already working with an occupational therapist on emotional regulation and sensory needs. I value occupational therapy (OT) and the understanding it can provide about a child’s sensory needs. A child may learn or practice something while calm but have difficulty accessing that skill during a stressful moment at home. I help parents understand what is happening during those moments and determine how to incorporate the knowledge and lessons from OT and Cognitive Behavioral Therapy (CBT) into other settings.
Common Co-Occurring Conditions
Attention-deficit hyperactivity disorder (ADHD) and autism commonly co-occur. The combination of ASD and ADHD is now informally referred to as AuDHD. Co-occurring ADHD is not a new diagnostic phenomenon, but recognizing this overlap helps tailor strategies that account for both clinical and developmental needs.
Anxiety may present as generalized worry, social anxiety, or intense distress surrounding unexpected changes and transitions. Specific learning disorders and communication differences may also be present. Children diagnosed with ASD may experience frequent arguing, refusal, aggression, or other disruptive behavior, and some meet the criteria for oppositional defiant disorder. Treatment considers how these overlapping concerns interact.
Some children show an extreme resistance to everyday demands and an intense need to remain in control. Families may use the terms pathological demand avoidance or pervasive drive for autonomy (PDA) to describe this presentation. Neither term is a formal diagnosis. Parents often tell me they are “walking on eggshells” to avoid triggering their child. Parent training involves learning a new way of interacting with your child and responding to those difficult moments.
Therapy Details
How I Work
I help families move beyond trying one isolated strategy after another. I look closely at what happens before, during, and after difficult interactions; how the family handles limits and decisions; what may unintentionally reinforce a pattern; and what has or has not worked in the past.
I also ask what matters most to the family. For one family, the priority may be helping their child become more flexible. For another, it may be getting through bedtime without an intense episode every night. We examine what is interfering with that goal, what is developmentally reasonable to expect, and what can be addressed through treatment.
Supporting Children and Families
I explain the available treatment options and make specific recommendations. For some families, PCIT is the best fit. Research supports the use of PCIT with children diagnosed with ASD, particularly when behavioral concerns and challenging parent–child interactions are present. Parents who are unable to commit to PCIT may choose to meet with me weekly and practice the interventions we discuss at home.
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Therapy for Adults Diagnosed with ASD
Adults diagnosed with ASD may seek therapy for anxiety, emotional regulation, executive functioning, relationships, communication difficulties, work-related stress, or major life transitions. Some adults begin therapy after receiving a diagnosis later in life and want to better understand longstanding patterns in their experiences and relationships.
Therapy is individualized and may focus on developing practical strategies, improving communication, navigating relationships, managing anxiety, and identifying approaches that make daily responsibilities more manageable.
In-Home Services
For some children and families, meeting in the home provides a clearer understanding of the routines, transitions, interactions, and environmental factors affecting daily functioning. In-home services in the San Diego area may include observation, parent consultation, individualized strategies, and direct work with the child. I can also provide classroom observations, school staff consultation, and collaboration on IEP or 504 accommodations when appropriate.
What to Expect
The initial consultation gives us a chance to discuss your concerns, what you have already tried, and what you would like to change. We can discuss whether individual therapy, PCIT, parent consultation, in-home services, or help navigating school and other treatment options would be most helpful, and determine whether my services are a good fit for your needs.
For children, I adapt treatment to their developmental level, communication abilities, cognitive profile, sensory needs, and presenting concerns. For adults, I consider communication differences and preferences while respecting autonomy and addressing primary concerns.
As a Certified Autism Specialist (CAS), I bring specialized expertise and advanced training to my work with children, adults, and families.
I offer in-home services in the San Diego area and virtual consultations and therapy for clients across California when clinically appropriate.
Contact Del Mar Psychology to arrange an initial consultation with Dr. Gran.
