How do individuals maintain a sense of efficacy and purpose in the face of high levels of ambiguity and uncertainty? In research on medical uncertainty, sociologists often discuss the strategies health practitioners employ to control uncertainties relating to diagnosis and treatment. Over six months of ethnographic field work at an autism-only therapy school, we observed seventy-five students and forty-seven instructors and formally interviewed ten instructors and four parents. While other studies on medical uncertainty have focused on controls over external circumstances, we demonstrate that another management strategy is for individuals to perform ethical work on themselves in order to adjust how they conduct themselves in uncertain situations. Despite the ambiguity of both the autism diagnosis and the therapeutic method employed at the school, instructors are able to maintain a sense of efficacy and to recognize themselves as "doing floortime" by transforming themselves to become "child directed."