Last Updated on August 4, 2025 by John Hookway
Autism changes how children talk, learn, and connect with others. Studies show that children with autism may have delays in language and social skills.
They also process sounds, touch, and movement differently. These differences can make daily life and making friends harder.
Development is not always the same for everyone. Some children are strong in one skill but struggle in another. Early help and support let each child do their best.
Key Takeaways
- Autism changes how kids talk, learn, and connect with others. It often causes delays in talking and social skills. Kids with autism learn best when help fits their strengths and needs.
- Early signs like late talking or odd actions help families get help sooner. This can make things better for the child. Therapies like speech, occupational, and ABA work best when started early.
- They work even better when families join in. Routines and visual aids help kids feel safe and focus better. These tools also help them learn daily skills more easily.
- Many kids with autism have sensory issues and trouble with movement. They need special ways to help them. Emotional skills can be hard for kids with autism.
- Teaching feelings and social rules helps them grow. Community resources and family support are very important. They help kids with autism do well and keep families strong.
Autism and Communication
Communication is very important for a child’s growth. Children with autism can have special problems with talking and social skills. Knowing about these differences helps families and teachers help each child grow.
Speech and Language
Delays
Many children with autism talk later than other kids. Some use fewer words or have trouble understanding others. Speech-language pathologists, or SLPs, help these children learn skills like:
- Talking with others
- Understanding and using language
- Playing and using language in real life
If a child talks before age five, they often do better later. Parents and teachers try to find problems early and help right away so children can do their best.
Children with autism might not have trouble making sounds. But they often use language in different ways. Some repeat things people say or talk in a flat voice. This can make it hard for others to know what they feel or need.
Nonverbal Cues
Nonverbal communication means things like eye contact, faces, gestures, and body movements. Children with autism may find these hard to use or understand.
They might:
- Look at people’s eyes less
- Show fewer feelings on their faces
- Use fewer hand or body movements
Neurotypical children often copy faces and gestures, but autistic children may not. They like clear and direct words instead of hints. This can cause confusion, especially in groups.
Both autistic and neurotypical kids can have trouble reading each other’s nonverbal signs. Learning about each other helps everyone talk better.
Social Interaction
Social Cues
Children with autism may not notice social clues like voice tone, faces, or body moves. This makes it hard to know if someone is joking, upset, or wants to talk. These problems can make social times confusing or stressful.
Teaching social skills step by step, using things like stories or emotion cards, helps children learn to see and use social clues.
Relationships
Making and keeping friends can be hard for children with autism. They may find it tough to start talking, take turns, or join group games.
Some children have trouble knowing how others feel or sharing their own feelings. These problems can make them feel alone or get bullied.
Children may have trouble with:
-
- Starting and keeping talks going
- Getting jokes or sarcasm
- Playing with groups
Adults, routines, and clear rules help children make friends and feel included.
Variability
Communication skills in autism are very different for each child. Some children talk well but have trouble with social words.
Others use few words or need other ways to talk. How much help a child needs depends on how strong their autism is.
- Children with mild autism may have fewer problems talking.
- Children with more severe autism often need more help.
- Every child has their own mix of strengths and problems.
Experts use different ways to help each child. Knowing that every child is different helps them get the right support.
Learning and Cognition
Learning Styles
Kids learn in many ways. Many kids with autism use one main way to learn. Neurotypical kids often use more than one way. Parents and teachers can help by finding the best way for each child.
Visual vs. Auditory
Kids with autism often like to learn by seeing things. They understand better with pictures, charts, or videos. Some kids learn best by listening to songs or spoken directions. Others need to move and touch things to learn.
Learning Style | Signs in Autistic Children | Support Strategies |
---|---|---|
Visual | Likes pictures, videos, and charts. Has trouble with spoken words. Enjoys puzzles and drawing. | Use picture schedules, flashcards, storyboards, step-by-step demos, and videos. |
Auditory | Remembers songs and rhymes well. Listens to spoken prompts. Likes audiobooks and music. | Give clear spoken directions, use songs, rhymes, stories, and audio reminders. |
Kinesthetic | Learns best by moving and doing things. Likes hands-on projects. Has trouble sitting still. | Add movement to lessons, use sensory activities, real-life tasks, and action rewards. |
Parents and teachers can watch how a child acts during activities. This helps them pick the best way to teach.
Routines
Kids with autism feel safer with routines. Schedules help them know what comes next. This lowers stress and helps them learn.
- Routines help kids feel calm and less worried.
- Knowing what will happen helps kids finish tasks and feel sure.
- Tools like picture schedules, timers, and alarms help kids follow routines.
- Routines teach life skills and help families work together.
- Sudden changes can upset kids. Social stories or pictures help them get ready.
- Occupational therapy helps kids build routines and learn to handle changes.
Keeping routines steady helps kids learn and feel safe. Slow changes and clear signs make new things easier.
Focus and Attention
Hyperfocus
Some kids with autism can focus deeply on things they like. This is called hyperfocus. They may spend lots of time on one thing and learn a lot about it. Hyperfocus helps kids get really good at their favorite things.
But hyperfocus can make it hard to switch to new tasks. Kids may miss other important things, like schoolwork or time with friends. Parents and teachers can help by setting limits and using timers to help kids change tasks.
Distractibility
Kids with autism can get distracted easily. Noises, lights, or changes in class can break their focus. This makes it hard to finish work or listen to lessons.
Quiet spaces, clear steps, and simple routines help kids focus. Breaks and movement can help them pay attention again.
Academic Skills
Kids with autism have different school skills. Some are strong in reading, math, or memory. Others need extra help with basic skills or small hand tasks.
Aspect | Summary |
---|---|
Academic Skills Compared | Kids with autism may be slower at moving skills like using hands, aiming, catching, and balance. They often score lower than neurotypical kids on these tasks. |
Prevalence of Deficits | About 80% of kids with autism have trouble with motor skills or are at risk for it. |
Strengths and Weaknesses | Balance can be a strength, but small hand skills like writing or catching are often harder. |
Contributing Factors | Sensory problems, trouble with time, and hard tasks can affect learning. Gender does not matter much. |
Implications | Early checks and special help, like occupational therapy, can build skills and confidence. |
Practice and support help kids grow school and motor skills. Teachers and therapists can use games and hands-on work to make learning fun and helpful.
Uneven Development
Children often show uneven development in their thinking and learning skills. This means they may have strong abilities in some areas and big challenges in others.
Teachers and parents may notice that a child can do something very well, but struggles with a similar task. This pattern is common and can make learning both exciting and confusing.
- Splinter skills are special talents that stand out. These skills do not always help with other tasks. For example:
- A child might read long words but not understand their meaning.
- Another child could name all the US states but not find them on a map.
- Some children remember many facts about dinosaurs but cannot explain what a dinosaur is.
These skills often come from deep interests and lots of practice. Children may spend hours learning about a favorite topic. This focus helps them get very good at one thing, but it does not always help with other learning.
Teachers and parents should look for both strengths and struggles. They should not assume a child understands everything just because they show a special skill.
Many children have a “spiky” learning profile. They may do well in music, math, or memory games, but have trouble with language or working memory.
Some children can repeat facts or lists but cannot use that information in real life. Others may know the names of body parts but cannot point to them on themselves.
Strengths | Challenges |
---|---|
Memorizing facts | Understanding meaning |
Solving puzzles | Using language in context |
Playing music by ear | Following multi-step tasks |
Children often have trouble using their skills in new places or with new people. This is called trouble with generalization.
For example, a child may tie their shoes at home but not at school.
How to support uneven development:
-
- Find and celebrate each child’s strengths.
- Use strong skills to help with weaker areas. For example, use a child’s love of trains to teach counting or reading.
- Give clear steps and lots of practice in different places.
- Build trust and listen when a child says something is hard.
- Avoid making quick judgments about what a child can or cannot do.
Recognizing uneven development helps adults give the right support. Every child learns in their own way and at their own pace.
Sensory and Physical
Sensory Sensitivities
Children see and feel the world in special ways. Many react strongly to sounds, lights, textures, or smells. Some notice these things too much or not enough. Knowing these patterns helps families and teachers give support.
Over-Responsive
Some children react a lot to sensory things. They might cover their ears when it is loud. Bright lights or certain foods can bother them.
These children might:
- Stay away from loud or busy places
- Not like hugs or some clothes
- Get upset when things change
More than 90% of children with sensory issues act this way. Early signs are not liking tags, strong smells, or loud places. These feelings can cause worry and make daily life hard.
Under-Responsive
Other children do not notice sensory things as much. They might not hear their name or feel dirty hands. These children often want more feeling by:
- Spinning, jumping, or rocking a lot
- Touching things again and again
- Not caring about pain or hot and cold
Caregivers can help by adding sensory play to each day. Using bumpy toys, music, or movement breaks can help kids focus and feel calm.
Sensory differences change family life and routines. Special plans, like sensory diets or quiet rooms, help kids feel safe and happy.
Motor Skills
Motor skills help children move, play, and do daily things. Many children have trouble with small and big movements. These problems can make self-care, school, and play harder.
Fine Motor
Fine motor skills use small hand and finger moves.
Children may have trouble with:
- Holding pencils or crayons right
- Buttoning shirts or tying shoes
- Using forks or spoons at meals
Easy games, like stringing beads or playing with clay, help hands get stronger. Occupational therapists give step-by-step help and special tools.
Gross Motor
Gross motor skills use big muscles for moving. Children may find it hard to:
- Run or climb well
- Catch or throw balls
- Stand on one foot
Playing outside and sports help these skills grow. Group games and obstacle courses get kids moving and playing with others. Early help builds confidence and helps kids join in.
Studies show about 79% of children have motor problems. These problems can get bigger over time, so early help is important.
Health Issues
Children can have health problems besides sensory and motor ones. Studies show more anxiety, sadness, and other mental health issues. Physical problems, like trouble sleeping or stomach pain, are also common.
Families may see more meltdowns, bathroom trouble, or changes in how kids act when stressed. Missing therapy can make these problems worse. Seeing doctors often and keeping routines steady helps health.
Many children do better with a team of helpers, like doctors, therapists, and teachers. Finding problems early and giving help makes life better and daily things easier.
Emotional Development
It can be hard for many children to understand feelings. They may have trouble knowing, showing, or handling emotions.
These problems show up in how they act and talk. Families and teachers can use special ways to help children learn these skills.
Emotional Processing
Expression
Some children cannot show their feelings well. They may not know what they feel or how to say it. This is called alexithymia.
About half of children on the spectrum have it. They might not know if they are sad, mad, or happy. This can make them upset or cause sudden outbursts.
Aspect | Description | Impact on Children with Autism Spectrum Disorder |
---|---|---|
Emotional Recognition | Hard to read faces and know big feelings | Causes confusion and social problems |
Emotional Regulation | Slow to notice feelings, which can cause meltdowns | Makes it hard to handle feelings and friends |
Sensory Sensitivities | Strong or weak reactions to sounds, lights, or touch | Can cause worry or make kids cranky |
Behavioral Manifestations | Meltdowns, hitting, or pulling away | People may think it is bad behavior |
Neurological Factors | Brain and body work differently | Feelings are strong and hard to share |
SEL Interventions | Use pictures, show how to act, and give help | Kids learn feelings and get less upset |
IEPs | Set goals for feelings and social skills | Gives better help and support |
Therapeutic Interventions | Use therapy, calming, and family help | Kids grow stronger and handle feelings better |
Double Empathy Problem | Both autistic and neurotypical people miss each other’s feelings | Everyone needs to try to understand each other |
Kids need help learning words for their feelings. Pictures and charts can help them show what they feel.
Communication
It is hard for some children to show feelings with words or faces. They may not notice hints like voice or body moves. Some react a lot to small things or stay calm during big things. Loud sounds or bright lights can make these feelings stronger.
Studies show that sensory problems can cause worry and acting without thinking. Kids may have meltdowns or pull away when they cannot handle feelings. Families and teachers can help by teaching calm-down steps, using easy words, and practicing feelings every day.
Social-Emotional Growth
Kids learn social-emotional skills as they grow. These skills are knowing yourself, handling feelings, understanding others, making friends, and making choices. Many children on the spectrum find these skills hard:
- Hard to name and talk about feelings
- Trouble knowing how their body feels inside
- Problems with empathy and helping others
- Hard to make and keep friends
Families and teachers can use these steps to help kids grow:
- Use pictures and stories to teach feelings and rules.
- Practice social skills with games, acting, and tech tools.
- Make routines with time to check feelings.
- Work with therapists and use special programs for help.
- Get home, school, and community to work together.
Doing these things often helps kids feel sure and get better at social-emotional skills.
Early Signs
Noticing early signs helps families and teachers help kids grow. Finding these signs early means kids can get help sooner. This can make things better for them. Here are some signs to look for:
Milestone Delays
Kids grow at their own speed, but some delays mean they need to be checked. Some early signs are late talking, not using phrases, or being slow to sit, stand, or walk.
A big study with over 17,000 kids showed these delays can be short or last almost 20 months. Kids with both intellectual disability and genetic conditions often have bigger and more mixed delays.
Developmental Milestone | Delay in Children with Autism | Percentage or Note |
---|---|---|
Sitting without support | Often delayed | |
Standing alone | Often delayed | |
Walking alone | Often delayed | |
Motor skill delays (18–35 months) | Present in 25% of toddlers | Higher than other developmental disorders |
Unable to walk (16–32 months) | 9.1% of children | |
Speech and walking delays (16–32 months) | 2.2% of children |
Kids with motor delays usually get checked about eight months sooner than kids without delays. Finding these delays early helps kids get checked and helped sooner.
Regression
Some kids lose skills they already had. This is called regression. It often happens between 18 and 36 months old.
About one out of three young kids go through regression. Most lose language skills. Some also lose social skills, like looking at people or playing with others. Losing motor skills does not happen as much, but it can.
Aspect | Summary |
---|---|
Frequency | About 33% of children experience regression |
Timing | Most often around 20 months old |
Skills affected | Language loss is most common; social and motor skills less often lost |
Broader definition | Many children show slowing or plateauing of skill development |
Clinical importance | Regression can be an early marker and is distressing for families |
Experts say regression may happen more than people thought. Some kids slowly stop talking or playing before parents see a big change. Watching kids over time helps find these signs early.
When to Seek Help
Families and caregivers should act fast if they see these things:
- No answer to name by 12 months
- Avoids eye contact or makes odd faces
- Has trouble talking back and forth or playing with others
- Repeats actions, like lining up toys or flapping hands
- Needs routines and gets upset with changes
- Sensory differences, like covering ears or not liking some foods
- Trouble with pretend play or making friends
- Late talking or uses language in a strange way
Parents should talk to a doctor if they see these signs. Getting checked by a specialist, like a child psychologist or developmental pediatrician, is important. Families can bring notes from teachers and therapists to help. While waiting for answers, they should reach out to early help programs or special education. If they still worry after a check, getting another opinion is a good idea.
Getting help early can really help a child grow and learn.
Support and Intervention
Therapies
Children with autism get help from many therapies. These therapies teach skills for talking, learning, and daily life. A team works best. Therapists, families, and teachers all help together.
Speech
Speech therapy helps children talk and understand others better. A speech-language pathologist, or SLP, teaches kids to use words, gestures, or pictures.
Some children use picture boards or speech apps if they do not speak. Therapy includes things like practicing sounds, learning to take turns, and using pictures or devices to talk.
SLPs work with families and teachers. They show parents how to practice at home and in the community. This teamwork helps children use new skills every day.
Occupational
Occupational therapy, or OT, helps children with daily tasks. An occupational therapist teaches kids how to dress, eat, and play. OT also helps with sensory problems, like loud sounds or scratchy clothes.
OT activities include making hand muscles stronger, practicing buttons or tying shoes, and playing games for balance. OT sessions use fun, hands-on activities. Therapists set goals for each child. They teach families how to help at home.
ABA
Applied Behavior Analysis, or ABA, is a common therapy for autism. ABA breaks skills into small steps and uses rewards to help kids learn.
Therapists use ABA to teach talking, social, and self-care skills. ABA has clear goals, uses prompts and rewards, and practices skills in many places.
ABA programs may use Discrete Trial Teaching or Pivotal Response Training. The Early Start Denver Model is another ABA program for young kids. Studies show that kids who get ABA or ESDM for 20 hours a week for two years make big gains in talking, thinking, and daily skills.
Families should ask therapists to explain each step and show how to practice at home. Practicing often helps kids learn faster.
Therapies work best when used together. Speech, OT, and ABA therapists share ideas and change plans as kids grow.
Some kids also need physical therapy for movement or medicine for sleep or behavior. Melatonin can help kids sleep better when used with other supports.
Early Intervention
Early intervention means starting help early. Kids who start therapy before school often make the most progress. Early programs build language, play, and social skills.
Research shows that kids who get two years of early help before school often join regular classes. Intensive programs, with 20 to 30 hours a week, help kids talk and think better. Teaching joint attention and play skills early helps kids talk and make friends later.
A typical early intervention plan includes checking a child’s strengths and needs, setting simple goals, practicing skills every day at home and in therapy, and changing the plan as the child grows.
Early help works best when families, therapists, and teachers work together. Daily practice and support help kids use new skills in real life.
Family Role
Families are very important in helping children with autism. Parents and caregivers act as teachers, helpers, and supporters. Their help makes therapy work better and helps kids feel safe and ready to learn.
Families can help by practicing therapy skills at home and in the community, keeping routines, using visual schedules, working with therapists and teachers, and learning about autism to share with others. Parent training programs teach families how to use therapy strategies.
These programs lower stress and help parents feel sure of themselves. When parents join therapy, kids learn faster and keep skills longer.
Family Role | How It Helps Children |
---|---|
Practice Partner | Helps kids use skills outside therapy |
Emotional Supporter | Builds confidence and motivation |
Advocate | Makes sure needs are met everywhere |
Logistical Helper | Keeps routines and schedules |
Families who stay involved see more progress in their children. Talking openly with therapists and teachers leads to better results.
Community Support
Families and caregivers can get help from many places. These supports give real help, comfort, and advice for daily life. Knowing how to use these resources can really help.
Types of Community Support
- Medicaid Waivers and Home and Community-Based Services (HCBS): Many states pay for therapies and family help at home. These programs let children get care outside hospitals. Families see better health, especially when money is tight. Where you live and meeting rules decide if you can get help.
- Early Screening and School-Based Services: Early checks find delays so kids get help sooner. Schools give therapy and support with special plans. Sometimes Medicaid pays for these services at school. This makes it easier for kids to get help during the day.
- Parental Involvement: When parents join therapy and use tips at home, kids learn faster. In-home services teach parents how to help their child grow. This lowers stress and helps the whole family feel more sure.
- Social Groups and Peer Mentoring: Community centers run groups to practice talking and sharing. Kids play games and act out real-life talks. Peer mentors with similar stories help kids feel understood and included.
- Caregiver Supports and Respite Care: Caring for a child with special needs can be hard. Respite care gives parents a break. Even a few hours off can help families feel better and less stressed.
- In-home Caregivers and Nursing Care: Some families have helpers or nurses at home. These helpers support daily routines and give parents time to rest. This care is not common but can be very helpful.
- Self- and Family-Directed Services: Some programs let families pick their own helpers. This control makes families feel more in charge and happy.
- Family/Systems Navigation: Navigators help families find doctors and services. They help with forms and answer questions. This makes it easier to get the right help.
Community support works best when families use more than one kind. Early, family-centered help leads to better progress and less stress.
How to Access Community Support
- Start with Early Screening: Ask a doctor or school to check for delays. Early checks help kids get more services.
- Contact Local Agencies: State and local offices run waivers, respite, and therapy programs. Call or check their websites to learn how to apply.
- Work with Schools: Meet teachers and counselors to set up special plans. Ask about therapy during the school day.
- Join Parent Groups: Many places have groups for parents. These groups share tips, resources, and support.
- Ask for a Navigator: Some hospitals and agencies have family guides. They help families find and use services.
- Explore Social Groups: Look for social skills groups or peer mentors at centers or online.
- Plan for Respite: Use respite care for regular breaks. Even short breaks help families recharge.
Benefits and Challenges
Support Type | Main Benefit | Challenge |
---|---|---|
Medicaid Waivers/HCBS | Better health and development | Access changes by state |
School-Based Services | Therapy during school hours | Not all schools offer the same |
Parental Involvement | Faster skill growth, less stress | Needs time and training |
Social Groups/Mentoring | Better social skills, friendships | Not always easy to find |
Respite Care | Less caregiver stress | May have waitlists |
In-home Caregivers | Daily help, parent relief | Less common, may cost more |
Family Navigation | Easier access to services | Not always available |
Getting community support depends on where you live, insurance, and family needs. Families may need to try different options to find what works best.
Community support helps children learn skills, make friends, and feel included. It also gives families the help and breaks they need to stay strong. Using these supports early and often helps everyone do better.
Practical Tips
Home Strategies
Routines
Children do best when they know what to expect. Families can help by making a daily plan that shows each step.
Using picture charts or lists helps children see what comes next. These tools make routines simple and easy to follow. They also help children feel calm and more able to do things on their own.
- Try a picture chart for morning and bedtime.
- Have set times for eating, playing, and learning.
- Show children what will change before it happens.
Giving praise or small rewards helps children stick to routines. Breaking big tasks into small parts makes learning easier. This is called task analysis. Children can practice these steps at home or school. This helps them learn and become more independent.
Caregivers can use simple charts or notes to track progress. This helps them see what works and change routines if needed.
Visual Supports
Visual supports help children know what to do and remember steps. These can be:
- Schedules with pictures or symbols
- Timers to show how long something takes
- Charts to mark progress and celebrate wins
A special, neat space for learning or therapy helps children pay attention. Taking away distractions and keeping things in the same spot makes starting and finishing tasks easier. Families who use these supports see better talking, focus, and daily skills.
Families learn best with hands-on training and regular check-ins with experts. This keeps strategies working well for each child.
School Support
Schools are very important for helping children learn and grow. Studies show that school support helps children do well, even after early help. Classrooms with less noise and soft lights help children join in and feel comfortable.
Support Type | Description | Impact |
---|---|---|
Explicit Instruction | Gives clear steps, shows how, and uses pictures | Helps with reading, math, and social skills |
Social Skills Training | Practice with adults or friends, using stories and prompts | Builds friendships and social skills |
Structured Teaching (TEACCH) | Uses picture schedules and neat spaces | Supports talking and independence |
Occupational Therapy | Helps with senses and changes in class | Improves focus and lowers stress |
Collaboration | Teachers, parents, and therapists work together | Gives steady, personal support |
When families and schools work together, children get the help they need everywhere.
Caregiver Self-Care
Taking care of a child with special needs can be both hard and rewarding. Caregivers who take care of themselves help their child do better too.
Aspect of Well-Being | Self-Care Strategies | Benefits |
---|---|---|
Mental Health | Mindfulness, therapy, relaxing | Lowers worry and sadness |
Physical Health | Exercise, healthy food, good sleep | Gives more energy and patience |
Emotional Health | Writing, support groups, accepting help | Lowers stress and builds strength |
Social Well-being | Making friends, using respite care | Less loneliness and shared help |
Making time for hobbies, exercise, or quiet time helps caregivers feel better. Support groups and respite care give breaks and support. Caregivers who care for themselves show good habits to their children and make home a happier place.
Self-care is very important. Even small things, like a walk or talking to a friend, help a lot.
Autism changes how each child grows in their own way. Some early signs are talking late, being sensitive to sounds or lights, or doing the same thing over and over. Families and teachers can help by looking for these signs and getting help early.
- Studies show that finding autism early and giving special therapy helps kids learn and make friends.
- Tools like eye-tracking and virtual reality help find autism sooner and make treatment better.
- When families help and care is made for each child, kids do better and feel happier.
Every child is different. If they get help early and have good support, children with autism can do their best.
FAQ
What are the first steps if parents suspect autism?
Parents should watch for early signs. They can write down concerns and talk to a doctor. Early screening helps find delays. A specialist can check the child. Early action gives the best chance for progress.
How can teachers support a student with autism in class?
Teachers can use clear routines and visual supports. They can break tasks into small steps. Quiet spaces help students focus. Teachers should work with families and therapists for the best results.
What therapies help children with autism most?
Speech therapy, occupational therapy, and ABA help many children. Each child needs a plan that fits their strengths and needs. Early and regular therapy brings the best results.
How do families create helpful routines at home?
Families can use picture schedules and set times for daily tasks. They can break big tasks into small steps. Praise and rewards help children follow routines. Consistency builds confidence.
What should parents do if their child loses skills?
Parents should note what skills changed and when. They should contact a doctor or specialist right away. Early help can prevent further loss. Support from therapists and teachers is important.
Can children with autism attend regular schools?
Many children with autism go to regular schools. They may need extra support, like aides or special plans. Teachers and families work together to help children join in and learn.
How can caregivers manage stress while supporting a child with autism?
Caregivers can join support groups, use respite care, and take breaks. They should ask for help when needed. Self-care, like exercise or hobbies, keeps caregivers healthy and strong.