Reflections on "A Miracle of the Heart"

November 4, 2026

I want to share a deeply personal story—not my own, but the journey of a father and son whose lives have been shaped by autism.

Their recently published book, Miracle of the Heart, invites us into the lives of David and Jacob Raphael. Through their words and experiences, we may recognize parts of our own journeys and discover new ways to understand the experiences of others.

Over the decades, I have read many books written by parents of children diagnosed with autism and have worked alongside families as a clinical psychologist and co-creator of the DIR Model. Every family has taught me something: about determination, creativity, the search for support, and, above all, the profound love parents have for their children.

David and Jacob offer an especially personal perspective. Their story invites us to look beyond a diagnosis and meet the people, relationships, and emotional experiences at the heart of a family’s life.

Written by both father and son, Memoir of the Heart reflects on 34 years of life together, beginning when Jacob was diagnosed at age two with what was then called pervasive developmental disorder.

Like many parents at that time, David was told that his son might one day need institutional care. I have heard versions of this prediction too often. Yet I have also seen how children can move beyond the limits others imagine when their individual developmental needs are understood and they receive the support, relationships, and opportunities they need.

David was determined to help Jacob develop and thrive. Early in their journey, he discovered the work of Dr. Stanley Greenspan, who introduced the family to a way of engaging Jacob through play. This approach, which became known as Floortime, offered David a new understanding of how relationships and emotional engagement could support development.

What might appear, in retrospect, to be a miracle grew through countless everyday moments: a family’s sustained commitment, love, persistence, and belief in Jacob’s potential. Their story reminds us that a child’s development unfolds over time; what we see today does not define all that may become possible tomorrow.

Dr. Greenspan introduced Jacob’s parents to Floortime and referred the family to me. Although they consulted with him periodically, I worked with Jacob and his parents several times a week, with a parent always present, guiding a comprehensive developmental intervention. Together, these supports helped the family understand Jacob’s individual needs and find ways to support his development in everyday relationships.

David kept a journal documenting Jacob’s development, therapies, educational experiences, and the family’s evolving understanding of how best to support him. I was fortunate to work with the family for many years before they moved, and I continued to follow their journey from afar.

David recorded Floortime sessions, speech and language work, occupational therapy, educational supports, and the many professionals who contributed to Jacob’s developmental team. At the time, he could not have known that these notes would one day become a memoir.

Years later, when Jacob was grown, David returned to his journals and began a second journey: looking back with the understanding he had gained over time. Each original entry is followed by his present-day reflections, showing how his perspective—and his understanding of Jacob—had changed and deepened.

Eventually, David invited Jacob to help create the book. When Jacob added his own voice and perspective, the memoir became something extraordinary. We witness two journeys side by side: David’s growth as a father and Jacob’s development as an individual. Each illuminates the other, showing how understanding can deepen across a lifetime.

As I read this memoir, I recognized a story of integration: the weaving together of individual lives, family relationships, developmental processes, and supports that honor each child’s unique profile.

The DIR Model brings together three inseparable dimensions: **Development, Individual Differences, and Relationships.** Development does not arise from a single factor. It unfolds through the interaction of a person’s developmental capacities, individual ways of processing and responding to the world—including sensory processing and motor planning—and the relationships in which experiences are shared. Understanding these individual differences helps us understand how a child engages, communicates, learns, and develops.

Affect is central to this process. In the DIR Model, affect is not simply an emotion added to development; it is an active mechanism through which the brain, body, and relationships become integrated.

Affect is expressed in many ways. The same words can carry different meanings depending on the tone of voice—gentle or harsh, melodic or flat, whispered or shouted. Affect also appears in movement and gesture: moving toward or away from another person, looking up or down, waving, trembling, clapping, or withdrawing. Sounds such as “aha,” “uh-oh,” “whew,” and “ahhh” can communicate meaning even when words are limited.

These expressions differ in intensity and duration. They may convey joy, distress, interest, hesitation, a wish to engage, or a need to withdraw. Their meaning is experienced between people and may be understood consciously or unconsciously.

When affect is shared within meaningful relationships, experiences begin to connect and communication deepens. Affect helps organize attention, engagement, purposeful communication, problem-solving, and symbolic thinking, supporting the emergence of new developmental capacities. Relationships do not merely surround development; they help make development possible.The memoir also reveals the emotional dimensions of integration: fear and uncertainty alongside persistence, determination, and hope. Relationships shape us across the lifespan, influencing who we are, who we become, and what we imagine may be possible.

David writes about the early loss of his own father and his fear of losing his son, showing how experiences and anxieties can echo across generations. He also describes the strength he drew from his Jewish faith and from biblical figures such as Abraham and Moses, whose stories offered courage and guidance in uncertain times.

Families may experience doubt, exhaustion, and worry about a child’s development, acceptance, and future. They may feel overwhelmed by difficult decisions, educational systems, or the need to advocate for appropriate support. Yet there can also be moments of joy: a gleam in a child’s eyes, an effort newly recognized, a burst of humor, or a step forward made possible through persistence, care, and shared experience.

Every family’s path is unique. We share the wish to understand our children, nurture their development, and help them build lives that are meaningful to them.

David and Jacob’s story reflects a central principle of the DIR Model, which I co-developed with the late Stanley Greenspan, MD: development cannot be understood in isolation. Individual differences, emotional experiences, relationships, family history, culture, and environment interact throughout life to shape who we are and who we may become.

Integration is ongoing, not simple or complete. There is no single path every child will follow, and no guarantee of a particular outcome. Our task is to understand each person, stand beside them, and support their own emerging interests, relationships, and aspirations.

Not every journey will mirror David and Jacob’s. Research and practice continue to expand our understanding of autism and neurodiversity, and autistic people are increasingly sharing their own perspectives, hopes, and needs. In this memoir, Jacob speaks in his own voice about his hopes for the future. We should encourage all individuals to pursue their goals, follow their passions, and shape lives that hold meaning for them.

David and Jacob remind us to speak from the heart and listen with the heart. Their story offers an honest account of love, perseverance, and commitment—and a reason for hope.

For decades, developmental, relationship-based approaches have emphasized the active role parents and caregivers play in supporting development. Parent-mediated intervention is a cornerstone of this work.

The intensive engagement described in this memoir reflects the extraordinary commitment of David, his wife Jo, Jacob’s mother, and their family. But families do not need to replicate the intensity of their efforts to make a meaningful difference. Families have different resources, circumstances, and capacities. What matters is understanding a child’s individual differences, responding to emotional cues, and creating opportunities for shared engagement and growth.

Development is supported by countless interactions over time, not by hours alone. Every effort counts. Every moment of meaningful engagement matters.

Ultimately, this is a story of family, persistence, and love. It shows how relationships support development and how growth unfolds through shared experiences over time. What looks like a miracle from the outside may be the result of many small moments of learning, understanding, and sustained commitment.

Thank you, David and Jacob, for allowing me to share these reflections on your remarkable journey. I will treasure your story, and I look forward to all that lies ahead for both of you.

With gratitude and admiration,

Serena Wieder, PhD
Co-creator of the DIR Model 


You can find this book on Amazon and The Narrow Bridge Press. I encourage you to purchase it and read this book. Parents will further their reflections and discover their pathways to possibilities.

The DIR Model guided Jacob’s and his family’s  progress into adulthood and continues to guide development. Deepen your understanding of the DIR® Model and learn how to put it into practice through Profectum’s DIR Certificate Training Programs.

This blog post was developed with AI-assisted editing.