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Is Your Child on the Spectrum? Recognizing 10 Early Symptoms and Signs of Autism

December 3, 2021

If you notice that your child is experiencing delays or is behaving differently from kids, as a parent you may be thinking to yourself, does my child have autism? It can be so hard to know what is “normal” and what could indicate an Autism Spectrum Disorder. Luckily, there are symptoms and signs of autism that parents should look out for. With enough awareness, parents can help their autistic children receive early intervention treatment. These early warning signs include sensory issues, repetitive movements, delayed communication skills, difficulties making eye contact or maintaining conversations with others, and social isolation. If you recognize any of these signs in your child and would like to learn more information about what therapies and assessments we offer for autism, please contact Side by Side Therapy to set up a no-charge consultation today.  

When Do the First Signs of Autism Appear?

Signs of autism become noticeable around 18 months of age.  Typically, parents begin to notice if their child starts missing speech milestones or if they’re not picking up on social cues as well as their peers or siblings. Children as early as 6 months can start to show symptoms of autism. Let’s talk about 10 early signs of autism to look out for:

1. Avoids Eye Contact

Avoiding eye contact is very common in autism.  If you notice your baby is not making eye contact by 6 months of age, this may be a sign of autism. Avoiding eye contact gets carried into adulthood sometimes, so you may notice autistic people of all ages engage in this behaviour. The reason for not making eye contact is different for each person.  Understanding social cues from a person’s eyes can be challenging for an autistic person.  This can be overwhelming and make them feel uncomfortable.  Sometimes they have a hard time focusing on making eye contact and listening to what someone is saying to them at the same time.  Therefore, even if they are not making eye contact with you when you are speaking to them, this doesn’t necessarily mean that they are not listening to you.

2. Lacks Response to Other’s Voices

If you notice your child doesn’t respond to or look at someone when they’re being spoken to, this may be a sign of autism.  Many parents assume this behaviour is associated with their child having hearing issues.  Over time, it becomes clearer that the child can hear fine and instead their behavior has more to do with being withdrawn.  When you’re trying to talk to an autistic child, they probably don’t seem engaged in the conversation and won’t respond in a timely manner.  For example, your child doesn’t respond to their name when it’s being called. Autistic people are also more sensitive to sounds and have a hard time filtering out these noises.  This means that they may be distracted by the sounds around them and are struggling to pay attention to the person talking to them.

3. Hand Flapping

One of the many signs of autism is stimming. Stimming is when a person repeats the same action over and over again. An example of this is hand flapping.  Autistic children do this as a form of stimming, which is calming for them.  Sometimes, autistic children also flap their hands when they get very excited or feel other strong emotions, like stress. It is common for some children to flap their hands, but make sure to pay attention to how long they’re doing this.  If the child stops hand flapping around the age of 3, there’s no reason to worry.  With children that hand flap all the time, take note that this may be an indicator of autism.

4. Frequently Walking on Tip Toes

Another type of stimming is frequently walking on tip toes. Instead of walking on their entire foot, they prefer to walk on their tippy toes and if you notice your child is doing this all the time, it may be a sign of autism. There are a few reasons why an autistic child prefers to walk on the tips of their toes. If the child has sensory issues, they may feel uncomfortable putting all their weight on the surface of the floor Although this behavior is often harmless, it can still put the child at risk of injury because they could lose their balance and fall. Both Occupational Therapists and Physical Therapists are qualified to develop strategies to help reduce toe walking.

5. Trouble Controlling Emotions

If you’re a parent and have been out in public with your child, there have probably been incidents where your child gets fussy or throws a tantrum.  For an autistic person, these tantrum behaviors can be more intense and last for long periods of time.  Usually, the fussiness isn’t a result of not getting access to a toy or treat, rather it can be happening because of the bright and loud conditions of the public space, which can lead to them experiencing a sensory overload.  A typical tantrum lasts only a few minutes, while a sensory tantrum can last hours. 

6. Aggressive Behaviour

Aggressive behavior is another indicator of autism.  Autistic children can be more aggressive than others and sometimes there’s no clear reason as to why they behave like this. If the autistic child is used to getting a strong response from others when they’re aggressive, sometimes it increases the chances of them acting this way again. Another example is if the child has previously been able to receive access to something they want, such as a toy, by acting aggressive towards others. If the child realizes that they can get what they want through aggression, they will most likely continue to behave this way. Therefore, it’s important that interventions, like Applied Behaviour Analysis (ABA), targets aggressive behaviour as early as possible, to prevent injury to themselves and others.

7. Rigid Play

You may notice that your child plays a little differently than their peers. Perhaps, they’re a little rigid in their play routines.  This means that they prefer to play with their toys in a certain way and may repeat the same play actions over and over again.  For example, you may notice your child lines up all their toys in a row, or repeatedly spins them. Most likely, they will play with the same toys all the time and rarely switch them up. When autistic children play with their preferred toys, most of the time they are playing by themselves, almost as if they are in their own little world.

8. Issues with Food and Textures

Problems with food, textures or clothes is also common for autistic people.  Being a picky eater is something an autistic child may experience due to their sensory related issues.  These sensory issues relate to the taste, smell, texture, and look of the food item.  Certain textures of food, like pudding, may not be appetizing for them.  They may even be particular about their foods not touching each other. Remember that these sensory issues are different in every autistic child.   If your child doesn’t like the food, it can be very challenging for a parent to get the child to eat it.  Being sensitive to textures is not always related to food though. 

food issues as a sign of autism

Clothes can also be an issue for autistic kids.   Sometimes they don’t like the feeling of the material rubbing against their skin.  Clothing tags can also be irritating.  To avoid these sensory issues, parents can try different clothing materials.  For example, switching to seamless materials for socks and underwear.  Tagless shirts are a great idea as well however, if you can’t find any you can always flip the shirt inside out.

9. Delayed Speech

Lack of speech and communication are big signs of autism.  It is not uncommon for autistic children to miss speech milestones.  Autistic children sometimes develop speech later than their peers.  By the age of 3, if your child has not started speaking yet, start paying attention to potential speech delays for them.  If the child is older than 3 years of age and still has limited speech, we recommend reaching out to your doctor or a Speech-Language Pathologist to help.

10. Repeating Words and Phrases

Another common sign of autism in speech, is when the child repeats words and phrases over and over again.  This is called echolalia, meaning the echoing of words.  This sometimes happens because it’s a form of stimming and helps them feel calm.  In addition, it is a way to communicate if they are learning to speak. Both ABA therapy and Speech-Language Pathology help with improving an autistic child’s communication skills.

How Do I Know if My Child has Autism?

In conclusion, there are many early symptoms and signs of autism for parents to recognize. Although we only touched on a few indicators of autism, we hope this helps parents have a better understanding of what to pay attention to if you think your child has autism. The sooner these signs of autism are recognized, the better. With intervention, autistic children can learn skills to develop independence and self-care. Parents should consult their pediatrician for more information on diagnosis and treatment options if they recognize these early signs of autism in their child.  If you would like to learn more about ABA therapy, Speech Therapy, and Occupational Therapy, please contact Side by Side Therapy to set up a no-charge consultation.

The Importance of Finding the Best Therapy For Autism-Is it ABA Therapy, Speech Therapy, a Combination, or Another Therapy All Together?

November 17, 2021

The goal of autism therapy is to help the child develop academic skills, communication and social skills, increase independence, and learn daily living skills. There are many different interventions that have been developed to aid in this process. Choosing an evidence-based treatment is important. This means that it is based on the best available scientific evidence and clinical expertise. There are several types of evidence-based therapies used to treat Autism Spectrum Disorder (ASD): Occupational Therapy (OT), ABA (Applied Behavior Analysis), Speech-Language Pathology (SLP) and Physical Therapy (PT). This is a guide for helping you find the best therapy for autism.  Learn more about what ABA, OT, SLP, and PT have to offer!

Child sitting with therapist

What is Applied Behaviour Analysis (ABA)?

ABA Therapy is the science of learning and motivation and is one of the most effective therapies for autism. It helps us understand how behavior works and how it is affected by the environment. The goal is to increase desired behaviors and to decrease interfering behaviors.  

ABA focuses on enhancing a variety of skills, including language, social skills, attention and learner readiness skills. There are lots of strategies we use in ABA, such as positive reinforcement (offering rewards) to increase desired behavior.  For example, a child gets a star for doing a good job of following the rules at school. And when they get enough stars, they earn a prize, like ice cream with their friends.

A Board-Certified Behavior Analyst (BCBA) is a Masters or PhD level therapist.  They are the clinical supervisors that assess and coordinate the autistic child’s treatment plan.  Their role is to make decisions to assist the rest of the child’s therapy team.  Depending on the size of your team and how many hours of therapy the child requires, a supervising therapist assists the clinical supervisor on assessing the child’s progress.  In addition, an instructor therapist works with the autistic child and collects data for the team to review.

How Much ABA Therapy Does My Child Need?

How many hours of therapy an autistic child receives depends on their skill level and areas of need.  The BCBA considers the parents goals along with the child’s assessment results to figure out how many hours of therapy they need. If they decide your child needs more of a Focused ABA approach, then the therapy ranges from 5-15 hours a week.  Focused ABA is when children are taught one or two areas of skill development.  On the other hand, if the child needs to focus on a variety of skills, they might suggest a comprehensive ABA approach, which is over 20 hours of therapy a week.  Comprehensive ABA focuses on both skill development and behavior reduction. 

There are many strategies and techniques used to address most areas of need in ABA, such as behavior, communication, social skills, motor skills, and many more.  Behavior analysts know that sometimes other specialists, like speech-language pathologists and occupational therapists, need to be added to the team to improve a specific area of need.  Let’s talk about the other therapies an autistic child can benefit from!

What is Speech-Language Pathology (SLP)?

Communication is challenging for autistic children.  They may find its difficult to socialize with others, to pick up on social cues, and to vocalize their needs.  Aside from ABA, Speech-Language Pathology (SLP) helps reduce communication issues.  Speech therapy helps your child improve their language and speech skills. A speech language pathologist is qualified to provide effective speech therapy. An autistic child sometimes struggles with speaking, language, and fluency.  Luckily, speech therapy helps with this and teaches them to express themselves better through verbal and non-verbal language. They first conduct an assessment to identify the best treatment method.  Next, they create a treatment plan that addresses the child’s individualized needs.

Speech therapists address 5 main areas:

  1. Receptive language
  2. Expressive language
  3. Speech (articulation),
  4. Pragmatics (social skills)
  5. Feeding and swallowing

Along with language issues, autistic children may not be able to articulate their speech well.  For example, struggling to pronounce sounds like “ch” or “th”. Not to worry, a speech therapist helps with the pronunciation of sounds and words too.

If your child needs help improving their language and speech, we recommend looking into speech therapy.  It is an important tool for autistic children to improve their communication skills. Children can use these skills throughout their lives to make friends and develop relationships with family members.

What is Occupational Therapy (OT)?

In our every day lives, we are expected to take care of ourselves.  Starting with self care, we brush our teeth, shower, get dressed, and cook ourselves yummy meals.  We go to work and school.  We also enjoy leisure activities, such as gardening and biking.  For an autistic person, these every day routines can be challenging.  Occupational therapy for autism can help make these every day routines a little easier. It teaches people skills that improve their leisure, productive, and self-care skills.  Occupational therapists have advanced degrees and receive a lot of training in the field. By using a variety of techniques, they work towards regaining and maintaining an autistic persons independence.   

Child exercising during Occupational Therapy for Autism

How Can OT Help with Autism?

An occupational therapist works with your child on improving many different skills, such as:

  • Printing and handwriting
  • Fine and gross motor skills (e.g. grasping objects)
  • Improving sleep and sleep hygiene
  • Leisure activities (e.g. gardening)
  • Improving self-care (e.g. teeth brushing)
  • Increasing attention and focus
  • Feeding skills
  • Improving self-regulation skills

For early learners, an OT focuses on sensory integration and sensorimotor issues.  This means, they are improving how a person processes and reacts to information coming from their senses. Learning a new skill requires the OT to break it down into small steps.  For example, if an autistic child is struggling to learn how to write, an OT breaks that skill down by first teaching the child fine motor skills that can improve their hand strength.  This small goal leads to acquiring other skills, such as being able to pick up a pencil and write. 

An OT also provides prescriptions of assistive technology and recommends equipment that helps the child. For example, if the child is at risk of falling out of their bed or falling down the stairs, an OT might recommend grab railings to prevent injury. 

Occupational therapists for autistic children can be a great help to teachers and parents working with this population. They are knowledgeable about the spectrum of conditions that affects these children. We recommend to start occupational therapy in important early childhood years because it helps children develop more functional skills that they will need later on in life.   

What is Physical Therapy (PT)?

Physical Therapy (PT) for autism is similar to OT because they both work towards teaching people skills to help them with their everyday routines.  An Occupational Therapist focuses on improving fine motor skills, such as writing, using utensils, grasping objects, and getting dressed. On the other hand, a Physical Therapist focuses on improving gross motor skills for larger muscle movements, such as walking or even learning to ride a bike. They also help with pain management and strength training. For autistic children, a physical therapist assesses their:

  • Postural strength
  • Body and safety Awareness
  • Mobility (e.g. walking and running)
  • Coordination and balance
  • Play skills (e.g. bouncing a ball)

Once the assessment is complete, the physical therapist develops goals to work on with the child.  Remember that each child has different needs and therefore, there is not only a single physical therapy treatment to use. The physical therapist personalizes the program to the children’s needs. To sum up, we believe that physical therapy is another great treatment that enhances an autistic child’s quality of life.

Choosing the Right Therapy

In conclusion, there are many methods that can be used to help autistic children.  There is no one way to treat autism and it is important to find the right treatment for each child with different needs. If you or someone you know has a child with autism, speak with your doctor to determine what type of treatment will work best for them.

At Side by Side Therapy, we offer interdisciplinary services.  This means that your child has the opportunity to not only access ABA therapy but also Occupational Therapy and Speech therapy with us.  An OT, BCBA, and/or SLP work together to create a therapy plan that works for your child’s individualized needs. If you would like to learn more about the different types of therapy treatments we offer, please contact Side by Side Therapy to set up a no-charge consultation today. 

Speech Therapy – Alternative and Augmentative Communication (AAC): a powerful tool

August 30, 2021

Autism Spectrum Disorder (ASD) affects a great number of children and often these children have difficulty communicating.  In addition to having an applied behaviour analysis team, these children benefit from speech therapy.

Updated: August 30, 2021

This by no means, should suggest, that these children understand less. Rather, they just have difficulty expressing what they understand. Speaking is one of the most effective ways of communicating and it allows us to successfully interact and navigate our way through life.  However, many ASD children, do not have this option and sadly have a challenging time having their needs met. 

How can Speech Therapy help?

Being the parent of an ASD child can be very stressful and overwhelming.  It is important to know that there is help. Communication and language development have been helped by numerous tools and programs. These are known as Alternative and Augmentative Communication (AAC) systems.

AAC is an alternative method of communicating, outside of traditional speech, that has been developed to assist those with communication and language issues. These systems can be added to your child’s existing speech therapy programs. In some cases, they also introduce new and alternative ways of dealing with communication issues.

AAC is a way to provide your ASD child with the ability to relay their thoughts and needs through alternative ways that include the use of pictures, gestures, sign language, visual aids or speech-output devices such as an iPad or Tablet. 

AAC systems help your child access their basic human right of communication. AAC also helps ensure that their needs are heard. Every person deserves the right to share in the decisions surrounding their care and well-being.

Sounds liberating, (not only for your child but for you, the parents and caregivers), doesn’t it? Taking the guesswork out of what your child is trying to communicate helps to reduce stress, for everyone, and opens up the opportunity to build stronger relationships between your child and the rest of their world. 

Unaided and Aided & Low and High Tech Systems in Speech Therapy

Unaided systems – These systems don’t require the use of any equipment. Gestures, facial expressions, body language and sign language are some examples of unaided systems used to communicate.

Aided systems – These systems use tools or materials and can be either low-tech or high-tech. Some examples of low-tech are symbol boards, choice cards, communication books, alphabet boards or cards. High-tech examples include speech-generating devices (SGD) or communication devices and AAC apps on mobile devices.  Often the Speech Therapy team will advise which system is best for the child.

Below I will further elaborate on four of the aided systems that I feel may be helpful with your ASD child’s path to achieving successful communication.

LOW-TECH



Picture Exchange Communication Systems (PECS) – This program is a tool to aid in communication with non-verbal ASD children. Pictures of desired objects are exchanged (such as clothes or food) as a way of communicating.  These pictures can be photographs, digitally created images or hand-drawn pictures.

When a child wants something, they would hand a picture of the desired item to their communication partner (the parent, peer or caregiver) in exchange for the desired object. PECS begins with a basic request which will be extended to include sentences and eventually comments as well. 

As with most things that are of value and worthwhile, this program can take a long time (months) to become independent.  It also requires special training and materials and is able to be supervised by anyone who has taken the PECS training (usually speech therapists or BCBAs). Often Speech Therapy is used to introduce PECS.

While some children will be able to pair a vocalization with the exchange, PECS itself does not teach the use of vocal language. Creating a ‘verbal’ child is not the goal but rather creating a ‘communicative’ child is the end goal.

HIGH-TECH

Speech Generating Devices (SGDs) or Voice Output Devices

These are hand-held electronic devices that when a child presses a button or flips a switch, the device will play pre-recorded words or phrases. These SGDs allow non-verbal people to communicate electronically. Therefore, in its most basic form, if a child would like a banana, they would press a picture of a banana and the device would then say “banana”, “banana please”, “I want banana” or I would like a banana, please” (or some other variation) in a pre-recorded human voice. 

Here are three examples of apps that become SGDs when paired with a dedicated device:



TouchChat HD with WordPower – Although this is one of the most costly communication apps on the market, this program offers a range of options that far outweigh the competition. Utilizing Its voice recording capabilities allows you to touch individualized set-up cells and the program will then conveniently speak.   

Linggo Logo, an app used in speech therapy to help non-verbal people communicate.


LINGGO – Created by a team led by a behaviour analyst in Toronto. The app lists words that are most used and relevant to the child’s daily needs, preferences and social activities. Linggo learns the language patterns of its users through machine learning.  It also aims to enhance literacy by transitioning the learner from using picture-based communication to written words and phrases.

Linggo also encourages vocal speech in the learner with the optional time delay feature to allow time for the learner to vocalize before the app. One of the most exciting parts of Linggo is that it gathers data on the learner’s independent vs prompted communications which will help the speech therapy team fine-tune the teaching program to achieve maximum learning and communication.


LAMP Words for Life – This is an AAC app that is available for the iPad.  It is based on the motor planning theory of language acquisition. It utilizes pre-designed vocabulary pages that do not require much individualization or adjustment. This allows the user to transition between pages without having to re-learn the positions of previously acquired words.  There is evidence to suggest that children can become more proficient AAC users using motor planning because there is less searching for icons and specific phrases or sentences become almost rote. 

Now that you know about some of the AAC systems, the implementation may be another challenge. Finding professional help can be useful and will play a very important role in your child’s communication development.  It is important to work closely with a Speech Therapy team to ensure that you are using the correct AAC systems.

Some AAC programs can be quite costly, you want to be sure they are worthwhile and effective for your child’s specific needs. A Speech Therapy team will often include a Speech-Language Pathologist, a communication disorder assistant or a speech therapy assistant. The Speech Therapy team will take into consideration which AAC is appropriate and valuable for your child and will be able to address the many questions you will have.  Furthermore, they will create and implement a program that will work with your child at their current stage of communication development and capabilities.

Some advantages of AAC as described by users include:

  • Improved ability to communicate
  • Stronger friendships and relationships 
  • Increased ability for social interactions
  • Improved independence
  • Increased involvement in decision-making and autonomy regarding their lives
  • A feeling respected
  • Access to employment and volunteer opportunities
  • An improvement in physical and mental health.

AAC systems have proven to be tools that can open up doors for your ASD child by empowering them to communicate their needs and wishes.  Through the set-up of a well-designed communication program with the help of a Speech Therapy team, including the use of AAC tools and consistent practice, your child will find that a whole new world of opportunities can become available.  

If you would like help to develop your child’s communication skills using AAC or otherwise, please contact us to set up a no-charge consultation today. 

What kind of therapy does a child with autism need?

June 21, 2021

Many parents of children recently diagnosed with autism ask themselves “What kind of therapy does a child with autism need?” This blog will cover therapy options and some guidelines for what to avoid when picking a therapy model and provider.

What kind of therapy does a child with autism need?

There are many evidence based therapies for autistic children. Applied Behaviour Analysis, Speech-Language Pathology and Occupational Therapy are 3 options. Each child is different and will need an individualized therapy program. In any case, therapy should begin with an assessment that is updated regularly. Each kind of therapy will have it’s own way of setting goals but the goals should be specific to the child. The type of therapy that a child needs will likely change as they grow and learn.

What are the different therapies?

Applied Behaviour Analysis (ABA)

ABA is a scientific discipline that focuses on analysis and evaluation of social and environmental shifts to produce meaningful changes in a person’s life. One of the main ideas behind ABA is the identification of functional relationships. In other words, functional relationships are the correlation between the person’s environment and their behaviour.

ABA can be used to both teach new skills and to reduce challenging behaviours. In fact, it is very important to do both of these things when implementing ABA. When a behaviour is reduced, it needs to be replaced with an alternative that meets the same need or serves the same function. You can read more about the functions of behaviour in this post.

ABA programs can be Comprehensive (more than 20 hours per week) or Focused (between 5 and 15 hours per week). The intensity of your child’s ABA program will depend on a number of factors (age, needs, challenging behaviours, other programs or therapies etc.).

ABA can be a bit like your family doctor. ABA has lots of strategies and techniques to help with most areas of need (behaviour, communication, social skills, motor skills etc), but there are times when a specialist is required – like a speech-language pathologist or an occupational therapist.

Child playing with wooden toys. What kinds of therapy does a child with autism need?

Speech-Language Pathology (SLP)

Speech therapy or SLP focuses on a number of areas: communication, language, pragmatics (or social skills) and feeding/swallowing. Speech therapy is a very popular therapy for autism. Your child’s SLP will do an assessment to determine where your child is in terms of skills and what needs to be targeted and taught. Sometimes the SLP will do a standardized assessment (where the child’s performance is measured against other same aged peers). Other times the assessment is informal. Sessions will usually take place for an hour or two each week.

Occupational Therapy (OT)

OT can be an incredibly effective therapy for autism. The OT will look at a number of domains (or areas) when they’re assessing the child. Some examples are: motor skills, sensory integration skills, self-help/adaptive skills, even academics. OT sessions can happen anywhere: at home, at a clinic, in school even at the park or grocery store. It’s most important that the OT is able to see the child in their natural environments in order to give the best suggestions and be the most effective. Similar to Speech, OT sessions are usually an hour or two per week.

What is an interdisciplinary team in autism therapy?

Interdisciplinary teams happen when clinicians from different disciplines work together to achieve the child’s goals. For example, the OT would give strategies and set goals around a child’s sensory needs while the SLP guides the child’s language program. Both the sensory goals and the communication goals will be carried out by the ABA team, as well! Interdisciplinary teams are the best kind of therapy for a child with autism.

There are lots of decisions to be made when you’re picking a therapy for your autistic child. Let Side by Side Therapy help you understand your options and what services are available.

What is Stimming in Autism?

February 28, 2021

One of the clinical indicators of autism is repeating the same actions over and over again (AKA: stims or stimming). Stimming in autism is movements or other behaviours that are either calming or alerting. Most of the time stimming is not a problem and does not need to be stopped or changed unless it is causing harm.

Who stims?

EVERYONE.

Each person has specific behaviours or habits (stims) that they find comforting or alerting. Most of the time, we aren’t aware when we are stimming. When you’re nervous, maybe you are twirling your hair or rubbing your hands together. Maybe you are bouncing your leg to wake up when you’re tired. When you’re concentrating, maybe you stick your tongue out of your mouth. Autistic people also do these same things, sometimes in a more obvious way. There are many common stims that you may see a person with autism repeat frequently. Let’s talk about the different types of stims.

What are Some Examples of Stimming?

There are several different types of stimming that you may notice someone do. These different types of stims can include all of the senses, such as taste, smell, touch, sight, balance, and movement. You can refer to them as auditory stimming, tactile stimming, vestibular stimming, visual stimming, and olfactory or taste stimming.

Auditory stimming means the person is using their hearing and sounds to stim, such as humming or making high-pitched sounds.


If a person is using their sense of touch to stim, such as tapping their fingers repeatedly or rubbing their skin, it is tactile stimming.


Hand flapping, lining up objects, turning the lights on and off a lot are all examples of visual stimming. This is when the person uses their sight to repeatedly do something.

Vestibular stimming, such as toe walking, spinning in circles, hand flapping, and rocking back and forth, is when a person is using their balance and movement to stim.

The last type of stimming behaviour is olfactory and taste stimming. This type of stimming is when the person is using their taste and smell to repeat actions, such as licking or sniffing objects and/or people.

When and why do autistic people stim?

Autistic people stim at the same times that other people do. The intensity of these stims and types of stims vary. You may find that one autistic child is doing it all the time, while another only stims occasionally. Some autistic self-advocates explain that it helps them block out distractions to help them concentrate, while others say “it just feels really good”. People who don’t have autism may avoid stimming in specific situations. For example, despite being nervous, the person is not bouncing around or fidgeting while at the dentist. It is difficult for autistics to stop
stimming, especially when upset or nervous.

Some autistics say that stimming helps them control their emotions, such as fear, excitement, and stress. Stimming also helps make them more aware of their bodies. Another really interesting function of stims is to communicate emotions or arousal to others in a non-verbal way.

In the show Love on the Spectrum, one of the show’s cast, Olivia, says stimming is “…a massive build-up, with a pleasant release” (Episode 4).

What should be done about autistic stimming?

Usually… nothing.

Child spinning in circles outside engaging in stimming.

Many autistic self-advocates share that being told to stop stimming is very damaging. Stimming is intrinsic to the autistic and to expect them to change part of themselves because it makes us more comfortable is just wrong.

No one is telling a neurotypical kid to stop playing with their hair or to stop drumming their fingers on their leg. The same rules should apply for autistics.

Stimming is usually harmless. There are times however when stimming is dangerous or disruptive to the autistic person’s quality of life. For example, some people injure themselves or others while stimming. This can sometimes be seen in the form of headbanging or excessively rubbing or scratching skin. Also, if a stim is interrupting them from engaging in activities that they need to do (like sitting in a chair to learn) then alternative stims should be found. A BCBA works with the family to identify the function of the stimming behaviour and finds replacements. An Occupational Therapist might suggest a sensory diet if the stimming serves a sensory function.

Is There a Cure for Autism? Part 1

February 1, 2021

“Is there a cure for Autism?” 

“How long will my child have to be in therapy?” 

“How long until they’re like other kids their age?” 

Each week I speak with 10 or so parents, most of who have newly diagnosed autistic children. 

These are questions that many parents ask. It’s so difficult to ask these questions and it’s equally difficult to answer them. I am always honest when I answer.  I tell them that I believe that each child can make change and learn new skills but that there is no cure for autism. It’s not for me to say how ‘normal’ they will become. I try to stress to these parents that their child has so much potential and with the right mix of learning opportunities they will grow into incredible little humans. 

Mom holding son while searching the internet for a cure for autism.

Taking the expectation of being ‘normal’ off the table is a relief for some parents. Others aren’t ready to hear my message. They’re still grieving the loss of the child they thought they’d have. One of the most difficult things for people to handle is uncertainty. Humans are hardwired to have a plan or at least a destination. We dream of the future. When your child is diagnosed with a special need your journey takes a turn. There is a wonderful poem that conveys this message so beautifully. It’s called ‘Welcome to Holland’ and it was written by Emily Perl Kingsley in 1987. 

(I need to say that no one poem or piece of writing will perfectly sum up the experience of the entire special needs parenting population.  This poem should be taken for what it is, one woman’s perspective, at one point in her life. Some people will identify with it and others will not.) 

What Should Parents Do?

There are a number of evidence based treatments for autism. Research the options that are available in your area and decide which aligns with your beliefs and goals. Applied Behaviour Analysis (ABA) has the most research backing it’s effectiveness for autistic children. There is also Speech Therapy that can be essential for autistic kids as well as Occupational Therapy. There is a lot of overlap between the disciplines. Sometimes your child’s needs can be addressed by the ABA team alone, but sometimes the expertise of a specialist is required. Any therapy team you work with should be open to collaboration with other disciplines that provide evidence based therapy. 

Alternative Cures For Autism

As with any issue that affects a group of people, there will always be bad actors who try to dupe vulnerable people. I always caution my clients against spending resources on non evidence based interventions.  Resources can be money, time and energy.  Very few people have unlimited resources. When you devote resources to one treatment, automatically you’re taking resources away from the others. You want to ensure that you’re putting your resources where you’ll get the most benefit. Some examples of non evidence based interventions are: biomedical interventions (chelation therapy, autism diets, supplements) or other treatments like swimming with dolphins or hyperbaric oxygen chambers.  While these treatments may have many glowing reviews look for peer-reviewed, double blind controlled studies to use as your base of information when determining if something is evidence based. 

Here is a list of evidence based interventions for you to consider with your child. 

Come back next week as I discuss if we should even be trying to cure autism. 

Strategies used in ABA: Top 5!

January 18, 2021

ABA uses a number of different strategies. Way more than 5, but here are 5 of my favourite (in no particular order). 

Strategies used in ABA

Prompting: 

Cues or hints that help the learner know what they should do are called prompts. They can be either visual, verbal or environmental. There are prompt hierarchies that organize the different levels of prompts based on how much support they give the learner.  The goal is to reduce the level of the prompt so that the learner is eventually independent. Most learners need some kind of prompting when learning a new skill. It is possible for the learner to become dependent on the prompt.  This happens when the prompts are not methodically faded out.  The learner never moves past the stage of requiring the prompt in order to engage in the behaviour. 

Behaviour Contracts:

Behaviour contracts are like other contracts.  They spell out the expectations and what will happen if they occur or don’t occur. The Behaviour Analyst and the learner both agree to the contract. A behaviour contract is a collaborative effort. It’s not one sided. The learner has to have a stake in the contract or else they won’t participate. Here is an example of a behaviour contract. Both the learner and the BCBA write and sign the behaviour contract. Behaviour contracts are a great ABA strategy for older learners.

Teacher working with student using ABA strategies.

Reinforcement: 

Reinforcement makes a behaviour more likely to happen again in the future. There is positive and negative reinforcement.  Many people get negative reinforcement and punishment confused. But, they’re not the same! In ABA terms, positive and negative don’t have the same meaning as in regular english. Usually, we assume something positive is good and something negative is bad. In ABA, positive means adding something and negative means removing something.  So… positive reinforcement is adding something to the environment that makes a behaviour more likely to happen. Meanwhile, negative reinforcement is removing something from the environment that makes a behaviour more likely to happen. Some examples of positive reinforcement are: praise, a high five and extra time to play. Some examples of negative reinforcement are: being excused from the dinner table after eating a specific amount of food or turning off your loud alarm clock. 

Video Modeling: 

Some learners are visual, they learn by watching. Video modeling is showing the learner a video of people engaging in the behaviour. Video modeling can teach all kinds of behaviours. Social exchanges are a very popular video modeling topic.  Video modeling is popular strategy outside of ABA also.  Have you ever gone to YouTube to learn how to do something? That’s video modeling.  One of the benefits of video modeling is that the learner can watch the video many times. They can stop it and rewind to review and ask questions.  Video modeling is especially useful now, during the pandemic while in person instruction might not be possible. 

Task Analysis:

One of the keys to ABA is breaking big behaviour chains down into smaller more manageable steps; this is task analysis. To do a task analysis you first need to identify the target behaviour. Once you know the target behaviour you identify each step in the behaviour chain. When you’re ready to teach, there are three processes you can use: forward chaining, backward chaining and whole chain. These processes determine how you will be prompting the learner when you’re teaching. For example, in a forward chain, you would teach the first step but prompt the rest. Alternatively, in a backward chain, you prompt each step except the last. As your learner masters the steps you move either forward or backward on the chain.  In a whole chain approach, you’re looking at whether prompting each step is needed. 

Conclusion

These are just 5 of the strategies that are common in ABA. There are many more. You can use any combination of these strategies. Each ABA program should be individualized and designed specifically for your learner. BCBAs are the people who are best trained to design ABA programs. 

Top 5 Myths about ABA

January 11, 2021

Every day we hear fake news. Sometimes it’s hard to tell fake news from real news. When you’re choosing a therapy to help your child having real news is vital. Here are the top 5 myths about ABA briefly explained.

Top 5 Myths about ABA Explained:

Myth 1: ABA is only for autism.

While ABA is most well known for it’s use with autistic children there are many other applications. ABA can be used to address a wide variety of conditions: ADHD, substance abuse, anxiety and anger, traumatic brain injury are only a few. There is also a lot of really neat use of ABA in business and sports. The Florida Institute of Technology has a certificate program in Organizational Behavior Management (OBM). OBM addresses performance management, safety systems and behavioural systems analysis.

ABA is in classrooms around the world every day. But it’s not called ABA… it’s just called teaching!

Myth 2: ABA is all about drills at the table

Old-school ABA was drills at the table. However lots of research in education shows that young children learn best through play. As the decades pass and research continues, new naturalistic interventions are becoming common, like the Early Start Denver Model and Pivotal Response Treatment. Generalization is also becoming an integral part of all good ABA programs. The child needs to show the skills across settings, people and materials in order for it to be useful. Generalization doesn’t happen exclusively at the table.

Myth 3: ABA is only effective when it’s more than 40 hours per week.

This is one of the most widespread myths about ABA. Early research showed that ‘intensive’ programs of 40+ hours each week were the most effective. However a recent study showed that there was no difference in outcomes between 15 and 25 hours/week of therapy. It is very common to see children in 6-15 hours of therapy each week with great results. Comprehensive ABA is 20+ hours of therapy per week. It’s comprehensive because it delivers a full curriculum. 5-19 hours of therapy per week is called Focused ABA because it focuses on specific skills and teaches those to mastery.

Myth about ABA: It's all about drills at the table.

Myth 4: ABA uses food as a bribe.

A big part of ABA is using positive reinforcement. We want to encourage the behaviours we want to see again. A surefire way to do this is by using positive reinforcement. By adding desirable things to the environment after a behaviour occurs you make it more likely that the behaviour will happen again. Anything can act as a reinforcer, as long as it makes a behaviour more likely to happen again. Sometimes that’s food, but more often it’s toys, praise and privileges. The ABA team should always be developing new reinforcers to keep the person motivated.

Myth 5: ABA will fix the autistic child.

ABA teaches skills and reduces challenging behaviour. This leads to improved quality of life. Autism is a neurological disorder. It has no cure. However, there is still plenty to be hopeful about. All children have the potential to learn and grow. It’s not about reaching a specific milestone, but rather about becoming the best that they can be.

Myth about ABA: It will cure your autistic child.

Conclusion

Finding the right therapy for your autistic child is vital to improving their (and your) quality of life. Don’t be led astray by the fake news. ABA is one of the most studied and effective treatments for your child.

How to choose an ABA Provider

December 28, 2020

This post will describe the elements you need to consider when you choose an ABA provider for your child.

As soon as you get an Autism diagnosis the first place you turn is likely Google. When you’re reading you find again and again that Applied Behaviour Analysis (ABA) is the most recommended therapy. If you live in a bigger city, you’ve got many options to choose from – but how do you choose an ABA provider?

Here are 5 things to consider when you choose an ABA provider:

Home or centre based?

There are many benefits to both home and centre based programs. What you need to decide is: which will benefit your child and be most manageable in your life?

In home based programs, the clinicians come to your house for each therapy appointment. Generally, a responsible adult has to be home with the child and clinician during sessions. You can see what the clinician is doing and how they’re teaching your child. You can participate in therapy sessions. Depending on the age and goals of the child, the clinicians might need a desk or table that’s free from distractions. Home based programs typically focus on using the toys and materials you have in your home to do the programming. This is a great strategy because it will allow you to continue the interventions when the therapist leaves.

Clinic based programs allow you to drop your child off and get things done while they’re in therapy. Your child will have access to a lot of novel toys and games. There will likely be peers around for social skills programming and they will hopefully learn to be a bit independent as they’re away from you and the ‘safety’ of home. Clinic based therapy sessions can often mimic school more closely than home based sessions can.

Black father and son laying on a bed reading about how to choose an ABA provider.
Black father laying on bed with son searching on a laptop.

Credentials and Supervision

In Ontario, behaviour analysis is not a regulated profession. The title ‘Behaviour Analyst’ is not protected like psychologist or social worker. Anyone can say they’re a behaviour analyst. That’s a terrifying thought.

There is a certification board that credentials Behaviour Analysts. It’s called the Behavior Analyst Certification Board. To become a Board Certified Behaviour Analyst (BCBA) the candidate must have completed an approved graduate degree, completed 2000 hours of supervised work and passed a board exam. To utilize provincial funding for evidence based behavioural services (aka: ABA!) the program must be overseen by a BCBA.

It is vital when you choose an ABA provider that there is a BCBA on the team who will ACTUALLY SPEND TIME WITH YOUR CHILD. It is not enough to have a BCBA who simply signs off on the reports. They should spend a minimum of 2 hours each month supervising and monitoring your child’s progress. The BCBA also trains the front line staff on the interventions.

Some agencies employ Senior Therapists to take over some of the supervision of the BCBA. Often, senior therapists are in training to become BCBAs. This is totally okay, as long as the BCBA remains involved. At Side by Side Therapy, we do 10% supervision (for every 10 hours of ABA a client has they will have 1 hour of supervision). That’s a reasonable standard to look for when you choose an ABA provider.

Reviews and Recommendations

Rely on word of mouth. Other families have walked your path and can often be reliable sources of information when you choose an ABA provider. Most businesses have Google reviews that you can read. Also, there are many support groups on Facebook or other social media platforms that can provide recommendations for ABA providers in your area. You can also ask for references when you’ve narrowed down your search to a few providers.

Parent or caregiver involvement

Instructing parents not to participate in therapy is a huge red flag. There is no reason that you should not be in the room or able to watch what’s happening (whether in a home or centre based program).

Parent training is vital to a child’s success. You must learn the strategies and techniques that will be most effective for your child. One of the best ways to learn is called Behavioural Skills Training (BST). There are 4 steps in BST: instruction, modelling, rehearsal and feedback. You need to practice the skills with the clinician there to provide feedback in order to learn them.

You should also have an equal voice in the direction of the programming and how the programs are chosen. Each ABA program is ABA is individualized to each client so it is important that your family’s goals and values are taken into account when creating the programming. The goal development should be guided by two things: the curriculum assessment and your input.

Interdisciplinary Team

While ABA is the most evidence based intervention for Autism, there is definitely an important role for the other disciplines to play in your child’s autism therapy. Speech-Language Pathology, Occupational Therapy, Recreation Therapy and respite all bring valuable insights and skills to the team.

Bringing an excellent team together with clinicians from multiple agencies is possible, but it is WAY easier to have everything under one roof. Choosing an ABA provider that is open to collaboration with other disciplines is super important.

Questions to ask when choosing an ABA provider

  • What does a typical session look like?
  • How do you measure success?
  • How frequently are revisions made to the programming?
  • Who does parent training? How often is it done?
  • What is your philosophy on punishment?
  • What training do the instructor therapists have?
  • How many years have you been a BCBA?

Call or email Side by Side Therapy today to schedule a no charge/no obligation consultation to learn about our ABA program or for advice on how to choose an ABA provider.

How to get your child to cooperate!

December 21, 2020

Robert Schramm has developed these 7 steps to get your child to cooperate. In applied behaviour analysis, cooperation or compliance is one of the first things we work to establish. The instructor must have instructional control, meaning that the child attempts to do the things that the instructor is asking. Instructional control is an effective working relationship. These 7 steps give you control and will motivate your child to engage with you to earn the things they want. These steps were developed with autistic children in mind but they work for all children! 

Schramm’s 7 steps:

  1. You need to be in control of the things your child wants and you decide when they will get those things.

You should be the ‘giver of good things’. Your child should not be able to freely access these items. Start by going around the house and put any toys or items your child enjoys playing with out of reach. It’s best if your child can see the items, but sometimes these things need to be put into cupboards or treasure chests etc. 

  1. Show your child how fun it can be to be with you. You want your child to enjoy the time they spend with you. 

The focus of most of your interactions should be on pairing yourself with reinforcement. You need to be careful not to put too many demands on your child at the beginning. To do this, you want to comment and narrate your interactions WITHOUT asking questions.  This can be tricky so you  might have to practice! When looking at a book together, instead of saying “What do you see?” “Where’s the dog?” try “I see a dog”, “Here’s a red balloon”. 

Book cover for Robert Schramm's book: The 7 steps to successful parenting. A guide to gaining cooperation while building better relationships.
  1. Be true to your word. The expression to ‘say what you mean and mean what you say’  is vital.  Your child needs to know that they can trust you and you will be consistent. 

Your child uses your words as a guideline for what will happen and what to expect.  If you don’t follow your own rules, why should your child? Consistency is key in getting your child to cooperate.

  1. Make it clear to your child that following your directions is the only way to get the goods. Provide frequent, easy to follow instructions and always provide reinforcement for cooperation. 

We want to teach the child the contingency that they get what they want for cooperating. You can use high P’s or high probability requests to do this.  You give your child directions they’re likely to follow and then reward them for cooperating.  

  1. At the beginning, you have to reward your child after each instance of cooperation. You want to really cement the idea that good choices lead to good things happening for your child. 

By reinforcing each time your child cooperates, your child will start to make the connection between following your directions and receiving the outcomes they want.  This positive working relationship will encourage them to try more and more challenging things in the future. 

  1. Know your child’s priorities and your own as well. 

Write down your child’s preferred reinforcers. Use them. Try to expand that list as often as possible.  While it’s important to know your child’s priorities (what they’re working for) it’s also vital to know what your goals are.  You will often have many goals and they will sometimes compete.  Knowing which is top priority will make it more likely that you will reinforce the most important goals and achieve success faster. 

  1. Teach your child that not cooperating will never result in being reinforced. 

The same way that we need to be hyper vigilant to reinforce all cooperation, we need to be equally as vigilant in not rewarding non-cooperation. When we stop reinforcing a behaviour, sometimes we see a phenomenon called an extinction burst.  This happens when the intensity and/or frequency of a behaviour increases dramatically before it disappears.  The expression that it gets worse before it gets better is 100% true in behaviour.  If we’re prepared and stick to our guns, extinction bursts are quickly overcome. If you’re unsure, it’s best to get help from a behaviour analyst. 

Conclusion

When you employ these 7 strategies, your child will be the most cooperative! Try making one change at a time until you’ve mastered all 7.  Using these ABA strategies with your child will help your child to cooperate as much as it will help you to be an effective teacher.

Red Flags for Autism: 8 Behaviours to look for

December 7, 2020

Each child develops at their own pace. However, there are general guidelines, called milestones, that are used in monitoring if your child is progressing. When a child doesn’t meet their milestones, it can be a red flag for autism. Red flags don’t necessarily mean your child will be diagnosed, but they are considered when determining if further assessment is needed.

Red flags for autism are divided into 3 categories. These categories align with the 3 diagnostic domains for autism: language, social skills and repetitive and stereotypic behaviours.

8 Red Flags for Autism

Language

No words by 18 months or no two-word combinations by 24 months

Most children will have 10 words by the time they’re 18 months old. These words might not be complete but will be easy to understand and consistent. By 24 months many children are using two-word combinations. These combinations are often a name + item to make a request (e.g.: “Julia Milk”, “Daddy bed” etc.)

No pointing or use of gestures

Pointing is a very important skill. It allows a child to share their thoughts and interests in a non-verbal way. Most children point with their whole hand at first (reaching) but will eventually begin to extend their index finger to point. Likewise, gestures allow us to understand a child’s meaning without spoken language.

Inconsistent responding to name

By about a year old, your child should be consistently looking when you call their name. Responding to their name demonstrates that the child is able to divide their attention from what they’re doing when they hear a specific auditory cue.

Toddler boy covering his eyes. Lack of eye contact is a red flag for autism.

Loss of previously mastered language skills

One of the biggest red flags for autism is a regression in language skills. Regression is when a child has mastered a skill but is then unable to demonstrate the same skill. Many parents of children with autism describe their child’s language development as typical until around 2 years of age, when the child lost the words, comprehension, pointing and gestures they were using.

Social Skills

Inconsistent eye contact

Many children with autism do not make eye contact naturally. In fact, adults with autism have said that eye contact can be painful or anxiety provoking. This goes beyond shyness.

Lack of joint attention

One of the red flags for autism is the inability to show joint attention. Joint attention happens when a child and their communication partner use gaze and gestures to divide their attention between a person and an interesting object or event.

Stereotypic or Repetitive Behaviours

Unusual or repetitive behaviours with their hands or other body parts

One of the red flags for autism is moving hands and the body in general in unusual ways. Some children will wave their fingers near their eyes, flap their hands, rock their body or walk on their toes.

Preoccupation or unusual interests

Another red flag for autism is intense preoccupation with non-toy items. Some children become very attached to random objects (a spoon, a block, a piece of clothing) and will become upset if it is removed.

What to do if you notice red flags for autism in your child

Bring them up with your paediatrician! Getting early intervention is wise because even if your child does not end up with a diagnosis, the early intervention will teach a skill that was lacking. Speech Therapy, Occupational Therapy and Applied Behaviour Analysis can all be helpful.

Conclusion

While none of these red flags for autism are enough to get a diagnosis on their own, it is important to notice them. When a child’s displaying a combination or stops making gains make an appointment with your paediatrician for advice and potential referrals.

IBI and ABA: What’s the difference?

August 16, 2020

Read time: 3 minutes

When your child receives an autism diagnosis you are introduced to an alphabet soup of acronyms. IBI, ABA, OAP, FA, IEP, IPRC; the list is endless.  In this post you’ll learn the differences between two of the most used and often confused: IBI and ABA. 

Boy working with therapist in an IBI session for autism treatment.

What is ABA?

ABA stands for applied behaviour analysis and it is the science of learning and behaviour. There are a few laws of behaviour, very much like the laws of gravity. These rules are reliable, observable and measurable. The focus of ABA is to change socially significant or meaningful behaviour.  That  means that the goal is to improve people’ lives by helping them achieve more independence and access to the things that matter to them.

What is IBI?

IBI stands for intensive behaviour intervention. IBI is the intensive application of the science of ABA. For a program to be considered IBI, it has to occur more than 20 hours per week.  Because of the intensity, IBI programs are usually comprehensive. This means that they cover many domains of learning.  IBI programs are often recommended for children with level 2 or 3 autism (previously known as lower functioning children).

What are socially significant behaviours?

Socially significant or meaningful behaviours are the behaviours that matter to you and your family. Some examples are: communication, self-care (toileting, hygiene, self-feeding) and reducing challenging behaviour. Independence in these areas will allow your child to participate more fully in life.

Neither IBI nor ABA is better than the other. Some children learn best in a very structured environment (like IBI) while others learn best in a naturalistic setting (like school). Your child will make progress in both. There is a lot of research that shows that early intensive behaviour intervention has the best outcomes for young children. 

In an IBI program, your child will learn communication and language, social skills, play skills, pre-academic or academic skills, self-help skills, motor skills and much more.

In an ABA program, the therapy will focus on one or two specific goals that you want to address. Some parents choose to focus on challenging behaviour when doing a focused program. Also, some families find it helpful to focus on ‘high impact’ behaviours like toileting or feeding.

How do I decide which program my child needs?

Choosing which program is best for your child is a difficult decision. There are many factors that will play a role: your child’s needs, their other programs/therapies, location, finances, waitlists and your beliefs about education. You know your child best and it’s important that the therapy you choose fits your lifestyle and beliefs.  Therapy plays a big part of your life and it needs to make sense for your family. 

Working with a Board Certified Behaviour Analyst (BCBA) that you can trust is really important. The BCBA will do an assessment to figure out what skills and needs your child has. Some common assessments are: the Assessment of Basic Learning and Language Skills – revised (ABLLS-r), the Verbal Behaviour Milestones and Placement Program (VB MAPP) and PEAK Relational Training System. These are curriculum assessments that determine current skills and areas of need. They do not provide a new diagnosis. The BCBA might also do a Functional Analysis (FA) to determine the function of a challenging behaviour. Based on the results of the assessments your BCBA will make a recommendation that is specific to your child.

You should be fully aware of and give permission for each part of your child’s program. The clinical team must explain how the skills will be taught. Behaviour does not happen in isolation, so you will need to implement the same strategies outside of therapy.

Who is on an IBI/ABA team?

There are 3 levels of clinicians on an IBI team: instructor therapists, Senior Therapists and the BCBA or Clinical Supervisor. The instructors are delivering the therapy on a daily basis.  The Senior Therapist does the assessment and follows the programming to ensure that it is being properly executed and that the child is making progress. The BCBA works with the Senior Therapist to do the assessment and determine what the goals should be.  They will work together with the Senior Therapist to write the programs and train the instructors.

How much does IBI/ABA cost?

Each centre is different and ABA is not regulated in Ontario (yet!) but you can expect to pay roughly $55/hour for the Instructor Therapist, $75/hour for a Senior Therapist and $150/hour for the BCBA.  At Side by Side Therapy, we use a 10% supervision model. That means that for every 10 hours of therapy your child  will have 1 hour with either the Senior Therapist or the BCBA.

The Side by Side Therapy Process

At Side by Side Therapy we determine which of our 4 streams of ABA service (IBI/Comprehensive ABA, Focused ABA, Parent Coaching or Behaviour Consultation) will meet your child and family’s needs. We write programs specifically for each client. Each program is different.

You are able to use your Ontario Autism Program (OAP) funding with Side by Side Therapy. We will help you navigate the process and will ensure that our services fall within the OAP guidelines.

Connect with Side by Side today to schedule your free no obligation consultation.

Ontario Autism Program (OAP): a short history.

July 26, 2020

Early 2016

The government announced a huge investment into a new program called the Ontario Autism Program. This announcement was very exciting at first. Once it was studied the reality sank in: children would be removed from intensive services at age 5.

In June 2016

Michael Coteau, the Minister for Children and Youth announced changes to the Ontario Autism Program. The plan was to offer evidence based Applied Behaviour Analysis services at amounts that were based on need. Families that had been removed from IBI would receive $10,000 instalments until the new program was introduced in 2017. The children entering the Coteau plan would be the luckiest in the province, receiving the most therapy for the longest duration.

Boy reading a book as part of his Ontario Autism Program funding.

From the start, the government presented it as a program that they would improve and expand. The foremost goal was to facilitate access to therapy and reduce the financial burden on families. Key points of the OAP included: family-centred decision making, individualized intervention and the possibility to choose a specific private provider.

Changes to the OAP in 2018/2019

Doug Ford became the Premier of Ontario in June 2018. He brought a new government, changing from a Liberal government to a Progressive Conservative majority. In September 2018, the Ford government quietly instituted a pause on new service offers to children on the waitlist.  This freeze dramatically increased the waitlist. A few months later, Lisa MacLeod, the Minister of Children and Youth used the ballooning waitlist as the reason for making dramatic changes to the OAP Funding.  

In February 2019

Lisa MacLeod, announced a “new and improved” version of the OAP. This plan provided Childhood Budgets to autistic children. The budgets were based on the child’s age when they began therapy. Younger children being eligible for much more funding than older children. One element of the childhood budgets was income testing, meaning that families with higher incomes would get less funding. There was no consideration for any extenuating circumstances (level of need or availability of services in the child’s location).  

In March 2019

Lisa MacLeod announced that SLP and OT services would become eligible expenses for the childhood budgets. She also announced that the income testing would be removed. The announcement also allowed children currently under the Coteau OAP to have their funding extended for an additional 6 months. 

In June 2019

Todd Smith took over the Autism file when Lisa MacLeod became Tourism Minister.

In December 2019

Todd Smith announced that the province would follow the recommendations of an Advisory Panel it had established. Despite having previously stated that the new program would be ready by April 2020, Minister Smith stated that the new program would be implemented by April 2021. The reason for the extra year was to let the province to ‘get the program right’. The main recommendation was to move back towards a needs-based funding model and to remove the childhood budget. 

The province also announced that they would begin offering one-time funding payments to families. These payments were based on the child’s age to bridge the program until the needs-based funding could be rolled out. Children aged 1-5 years would receive $20,000 and children between the ages of 6-17 years would receive $5,000. The newest OAP would include 4 pillars:

  • Core Services
  • Foundational Family Services
  • Early Intervention and School Readiness Services
  • Mental Health Services. 

Where do families stand now?

Some children are still on the Coteau OAP program. These children are called ‘Legacy Kids’. Some children aged out of the program and received nothing. Some families accepted childhood budgets and have spent those funds. They should apply to receive one-time funding. Many other families on the waitlist still have not received invitations to apply for the one-time funding. 

The Covid-19 pandemic has totally upended the therapy of autistic kids because most providers were forced to stop services. The province has extended the deadline to spend the one-time funding by 6 months in an effort to give families time to use their funds. Service providers are gradually beginning to reopen. Families are scrambling to put together teams for their children.

Much of the information in this post was taken from the Ontario Autism Coalition’s website.

3 Applied Behaviour Analysis Tips to Get your Child Wearing a Mask

June 14, 2020

In these changing times, due to COVID-19, we have had to change our behaviour in a lot of uncomfortable ways. We’ve done this to follow the rules and recommendations set out by the government and public health officials.  The field of Applied Behaviour Analysis has a lot to offer to help!

One of the recommendations is the wearing of masks while out in public where physical distancing isn’t possible. Wearing masks may be uncomfortable and foreign to most adults. Parents of autistic children have been particularly concerned with how to get their children to safely and effectively wear masks.

Parents of children that have sensory issues already know how the struggle of the basics such as underwear and socks! Now with the expectations of wearing masks, there is the introduction of yet another stressor (for both child and parent!).

Create a plan based in Applied Behaviour Analysis:

Developing a plan to help desensitize your child to masks is essential. It is best to work with your therapy team to ensure you are taking the right steps for your child.

As changes in routine can be more difficult for children on the spectrum, I am providing you with these guidelines as a starting point.

If you don’t have a therapy team, feel free to reach out to Side by Side Therapy for a no-charge consultation. 

Here are 3 helpful tips to encourage mask wearing:

Make your Expectations Clear

Explaining to your child what you expect regarding mask-wearing will help to clearly outline what needs to happen and why.  It may be helpful to use the “If-Then” or “First-Then” language approach.  For instance, “If you want to go outside, then you have to wear your mask”. “First we put your mask on, then we can go to the store”. 

Boy sitting at desk wearing a mask after using applied behaviour analysis to learn to tolerate the mask.

Reinforcement and Praise

One of the foundations of ABA is reinforcement. Since wearing a mask is a huge accomplishment for your autistic child, it’s important to provide tons of reinforcement and praise. This will help make wearing a mask as motivating as possible. A few suggestions are:

Mom fixing a mask on her daughter using the principles of applied behaviour analysis.
  • Purchase a mask that has a preferred character or personalized touch on it.
  • Provide a favourite reward for wearing the mask for the agreed-upon time.  Remember, start slow so you can work to build up your child’s tolerance. 
  • Initially, you could have your child wear the mask while doing their favourite activity, such as playing on their iPad or Lego. 
  • When you have your first practice run in public you should do something fun! Going to your child’s favourite place or visiting loved ones are great ideas.  

Work on your child’s mask tolerance

Mask tolerance is going to be a challenge for a lot of autistic children and it is necessary to make the experience as fun and pleasant as possible.  This can all start with having your child, pick out their own material or mask while paying special attention to their sensory needs.  Once you have chosen a mask that you feel will be appropriate for your child, your next step is to create a plan of action for introducing and then successfully wearing the mask. 

The field of applied behaviour analysis suggests adopting three strategies to help in the desensitization of mask-wearing: Pairing, Shaping and Chaining. Read more about ABA terms and meanings.

Pairing

Pairing is a way that introduces unfamiliar objects, in this case a face mask, to a person. Present the unfamiliar object at the same time as a preferred object and the pleasant qualities of the preferred object are transferred to the unfamiliar one. To make the mask seems fun and welcoming present it to your child at the same time as you give reinforcers. It can take many presentations before the unfamiliar object becomes ‘paired’ with the preferred one. Once your child becomes comfortable holding it, it is then time to introduce shaping. 

Shaping

Shaping takes place once your child has become familiar and comfortable with the mask, and at this time, you can then, using the same positive reinforcers, have your child begin to gradually engage more and more with the mask. For example the process in a shaping procedure for mask wearing might be to:

Mom and son using the applied behaviour analysis concept of pairing.
  • Hold the mask;
  • Bring the mask close to their face;
  • Then touch the mask to their face;
  • Allow you to pull back the elastic bands or bring the ties around to the back of their head;
  • Fitting the mask to their head. This piece may need to be started in very short increments. You may want to use a visual timer to help cue your child to how much time is left. 

After your child engages in each step without challenging behaviour you need to reinforce their efforts. This may seem easy and straightforward but it may take some practice and many trial runs before success is achieved. As you know, practicing and learning a new skill takes patience, so too will becoming comfortable with mask-wearing. Be sure to initially practice pairing and then shaping at home or in a safe environment and once the comfort level is achieved you can try it out in public. And remember, your ABA therapist is always available to guide you and provide you with the resources you need to help manage this challenging situation.   

Chaining

Chaining is the idea of putting a number of behaviours together to create a sequence (or chain). In this example, a chain for mask wearing would include washing hands before putting the mask on, securing the mask to the head, wearing the mask, removing it safely, putting it in the trash or washing machine and washing hands again.

Chaining is a helpful way of teaching complex behaviours that happen in a specific order each time.

As wearing a mask can be difficult and uncomfortable in general, the challenge, unfortunately, may become magnified for those that have sensory challenges such as autistic children.  Therefore, it is important to work with your therapy team to come up with a plan and strategies to help your child manage successfully wearing a mask.

Top 7 Effective Speech Therapy in Toronto Strategies to Try With Your Children

June 7, 2020

Read time: 5 minutes

Parents are often the first ones to notice that their child isn’t developing, especially in terms of communication. The lack of infant babble, the absence of eye contact and reduced interest in interaction are just a few of the features that cause one to question a potential diagnosis of autism. It is possible and often practical to begin speech therapy in Toronto before a formal diagnosis is given.

Mother and child sharing a tender moment before speech therapy in Toronto.

Autistic children might also present a limited range of facial expressions, being unable to comprehend language or show a regression (loss of words). The sooner Speech Therapy in Toronto is started, the better the outcomes are going to be. In this article, you will find a number of therapeutic strategies which might be of help. 

Speech Therapy in Toronto Strategies:

#1 Using non-verbal communication 

Interestingly, non-verbal communication accounts for 90% of all communication. Our body language, the gestures we make, along with eye contact, help us interact with other people and communicate our needs. 

A good strategy is teaching the child, through imitation, gestures that can be used daily. You can begin with gestures that are easy to imitate such as: clapping the hands, waving, stomping feet or raising arms in the air. 

#2 Oral Motor Exercises

For children who exhibit few or no facial expressions, this strategy might be quite useful. Performed regularly, it can strengthen the oral muscles, especially the ones around the mouth and jaw. 

The exercises can be practiced with a  mirror, so your child is able to see what their face looks like when they make the specific movements.  You can get some ideas of exercises from this Youtube Channel: Speech Therapy Practice. They have a series of different videos depicting different exercises you can try with your child. 

#3 Animal noises 

A fun beginning step to teach vocal speech might be to try and have the child make animal noises, especially if the child is motivated by animals. Capitalizing on this motivation might be helpful in engaging your child in doing the difficult work of learning to make the sounds. 

Various toys or books can be used to introduce the child to animal sounds. As his/her interest becomes visible, you can move to more complex games – perhaps you can create a toy barn or an animal train, having fun in the process. Be patient and have fun. 

#4 Singing songs

Very few children dislike music. Singing can help the child to learn new vocabulary, rhythm and even new topics or ideas.  

In choosing songs, it is important to take into account not only the current communication abilities of your child, but also their cognitive level. Nursery rhymes are a great place to start for younger children but older children can be introduced to all kinds of music. 

#5 Technology as basis for communication

We are lucky to live in an age where technology is advanced, creating opportunities for us to help autistic children communicate. Augmentative and alternative communication represents an option for children with limited or no functional speech, allowing them to communicate desires, needs, preferences, dislikes and comment. 

There are devices that contain recorded messages, which the child can use with the push of a button. As progress is made, these messages can become more complex. A low tech alternative is a picture exchange communication system.  You can read more about Alternative and Augmentative Communication in this blog I wrote at the end of April. 

#6 Learning how to sequence and tell a story

This is a strategy which is generally used in children with more advanced receptive language, allowing them to continue to develop their language. You would present them with images of the parts of a story, and ask them to put them in order.

For example, you might provide a picture of an empty glass with a carton of milk beside it, another picture with a full glass of milk and a third picture with half the glass of milk drank by a child in the picture. 

In opting for this activity, you would choose to begin by presenting the stories or situations that your child has experienced. This makes it more concrete and is easier for the child. In time, he/she can do this activity alone, or even draw his/her own pictures to tell a story. Many children enjoy ‘authoring’ their own stories. 

#7 Pretend play

Pretend play is a difficult skill for an autistic child to achieve but, with perseverance, it will help improve many aspects of the child’s development. On the plus side, it helps with social interaction, reinforcing communication again and again. 

The strategy would be to choose some of the child’s favorite activities, expanding on their existing sounds, words or sentences. Once you’ve identified what your child is doing naturally, you want to encourage the next step.

For example, if your child is building towers with blocks, you might begin labeling the colours of the blocks or dividing the blocks into colour groups to make red buildings and blue buildings.  You could also create a road (by laying the blocks side by side instead of on top of each other) to expand their play. 

With expanded play comes the opportunity for you to model expanded language use. The more you speak to the child, the more likely it will be for new words to appear in his/her vocabulary. 

These are some of the strategies that might be used in promoting speech and language development in autistic children. We offer speech therapy in Toronto, as well as a number of other useful therapies: Applied Behaviour Analysis, Occupational Therapy and Recreation Therapy – do not hesitate to contact us for a no charge consultation.

ABA in Toronto: 9 Life-Changing Benefits for Autistic Children

May 30, 2020

Read time: 3 minutes

ABA stands for applied behaviour analysis. It is a form of therapy based on the sciences of behaviour and learning. In some, it will lead to remarkable progress, helping them acquire an important number of skills. ABA is the most widely studied and most effective therapy for autism and related developmental disorders. 

Why should you consider ABA in Toronto for your child?

We have gathered nine of the most important reasons why one could benefit from this type of therapy. ABA in Toronto focuses on teaching socially significant behaviours, meaning behaviours that have a high probability of being important and pivotal to the child and family. 

Boy with autism playing with toys during ABA in Toronto


#1 Play

Autistic children often play in a stereotypical manner, engaging in repetitive behaviours. Through ABA in Toronto, they can be taught how to engage in spontaneous play, using a wide range of toys and learning to take turns. 

The therapist might facilitate the learning experience, prompting the child with the appropriate behavior. The therapist can also teach leisure skills, helping one develop a hobby, or an interest for personal enjoyment. 

Girls playing together learning social skills in ABA in Toronto


#2 Social Skills 

If a child already has good language skills, ABA in Toronto would be useful in teaching the necessary social skills for making friends. The more one practices social situations, the easier it will be to interact with peers in real life. 

ABA in Toronto can help the child develop additional skills (i.e: sharing, turn-taking, rule following etc) which might be useful for daily interaction with other children. These skills are addressed using structured play dates, social games and role play, among other strategies. 

Boy learning to brush his teeth in ABA in Toronto


#3 Activities of Daily Living (ADLs) 

For an autistic child, going through the normal routine can be challenging. In ABA in Toronto, he or she can learn and practice the tasks associated with the routine, including dressing and feeding. 

In teaching how ADLs should be performed, the therapist will take into account the child’s gross and fine motor skills, as well as their cognitive and speech skill levels. At-home practicing can help to jumpstart generalization and maintenance. 

Boy demonstrating independence learned in ABA in Toronto


#4 Independence

A big part of ABA in Toronto involves helping the child communicate more effectively. As the language skills develop, it will be less challenging to interact with peers. 

The child will learn how to handle situations by him/herself, developing the necessary confidence for more complex tasks and to be more independent. Positive reinforcement is used to foster skills, so that the child is less reliant on his parent or caregiver. 

Alphabet toy laid out in ABA in Toronto session


#5 Academics

Autistic children can struggle from an academic point of view, requiring help in that learning as well. ABA in Toronto can help develop reading and writing skills, as well as mathematical abilities.

The strategies used in therapy can and should be implemented not only at home but also in the classroom. Many classrooms are built on a foundation of ABA, without even intending to be. Most good teachers utilize the principles of ABA (even if they don’t call it ABA). 

Cartoon of boy saying "I need", self-advocacy skill learned in ABA in Toronto


#6 Self-Advocacy 

All children grow and become adults. As the child advances in age, ABA in Toronto will be useful in teaching self-advocacy – it will teach the child to speak up for him/herself, asking for what s/he needs. All children need to learn to become self-advocates.

Even in non-verbal children, ABA therapy can teach the child how to communicate immediate needs, preferences and how to protest and stop undesired situations. 

Girl with autism sitting on ground after ABA in Toronto session


#7 Quality of Life

As mentioned at the beginning, ABA in Toronto aims to improve socially significant behaviour. All of the things that the child will learn in therapy will contribute to a better overall quality of life. Even though the days might seem long and the therapy sessions will require a lot of dedication, in the end, you will have a child who likes his/her life. 

By fostering independence, language and social interaction, just to name a few, ABA empowers the child and his/her family. 

Parent learning with son during ABA in Toronto therapy session


#8 Parent Involvement and Learning

As a parent, it is normal to want your child to reach his/her full potential. In autistic children this path to reaching full potential can seem impossible. ABA can help parents benefit from a positive change in themselves, teaching them the skills needed to fight for their children. 

Taking part in therapy sessions, you will learn how to help your child develop useful skills and assess the progress he/she has made. The therapist can also guide the at-home teaching process. 

Parents looking happily at their child after ABA in Toronto therapy session


#9 Renewed Optimism

Sometimes, parents have a hard time seeing the strengths of their autistic child, as they rather concentrate only on the challenges their children face. ABA can help to highlight these strengths and transform them into learning opportunities. You will see your child being successful in ABA in Toronto and it will give you a new lens with which to view your child. 

During the ABA therapy sessions, you might also learn what motivates your child, allowing you to use these preferences later on to teach or maintain skills outside of a therapy session. 

If you are looking for ABA in Toronto, we recommend you connect with us. We can talk more about the services we offer and schedule a no charge consultation to assess your child’s needs. Looking forward to hearing from you!

2 Necessary Social Skills you should teach your child!

May 11, 2020

It is often said that a parent is a child’s first teacher, playing an important role where development and learning are concerned. A diagnosis of autism only reinforces this belief, in the sense that the parent will work harder to help his/her child develop strengths and overcome challenges. Social skills, specifically self-awareness and self-determination are vital to your child’s future.

You can teach social skills

Self-awareness is a difficult concept for almost all autistic children, but nonetheless, it is a social skill that they must learn and use every day. As parents, you bear the responsibility of “equipping” your children with such skills, preparing them for becoming their own advocates in adolescence and adulthood.

Parent talking to her son about his social skills. They're both smiling.



We can empower autistic children from an early age, helping them become more aware of their own self and also to discover self-determination. Our efforts will allow them to express themselves in an capable manner, to better understand those around them and engage in suitable behavior in response. 

What are the factors affecting self-awareness in autistic children?

Autistic children might battle language and communication impairment, as well as social difficulties and sensory differences. They might exhibit stereotypical behaviors or intense interests. It goes without saying that all of these impairments will affect self-awareness. 

Imagine your child as being equipped with the wrong skills. He/she does not know how to express how he/she is feeling, and they have serious difficulty understanding others. An autistic child might not know the expected behaviors and emotions, and he/she will rarely consider how others are feeling or what they are thinking. 

Main factors affecting self-awareness are:

  • Difficulty with transitions/changes 
  • Deficits in understanding emotional exchange
  • Lack of attention to others
  • Language and social communication impairments 
  • Impaired ability to take another’s perspective

Empowering your child to develop self-awareness 

Your child has both strengths and weaknesses. As mentioned in the beginning, you can empower your child by working together on developing his/her strengths. 

Parents have an amazing power, in the sense that they can help their children understand not only how the world functions but also how they should function in that world. Self-regulation will appear as a natural result, allowing the child to advocate for himself/herself, especially in difficult situations.

Activities/solutions for improved self-awareness from study.com

  • Drawing a bug on paper and adding pictures of things that “bug” him/her – encourage the child to be as specific as possible, adding foods, animals, etc. 
  • Glue a photograph of your child to a piece of paper and ask them to draw things he/she is good at; images might be used for non-verbal children. Encourage the child to reflect on his/her strengths. 
  • Yes/no – read your child simple sentences, waiting for his/her answer. If non-verbal, use gestures to signify approval or negation. Examples: “I like to eat…”, “I prefer (toys)”, “My favorite activity is…” The goal of this activity is to help your child be able to identify their preferences and communicate them to others. 
  • Mirror self-awareness – working in the mirror, together with your child, to develop self-recognition; the more you work, the more aware the child will become of his/her body and its position in space. Work on gestures and making eye contact as well. 

Self-determination 

This is also a critical skill to achieve, as it will guarantee independence in adolescence and adulthood. Research has confirmed that it plays an important part in academic success, as well as in personal life. Social skills can predict the capacity for self-determination – as a parent, you need to work on these every day. 

How to help your child achieve self-determination 

  • Provide your child with opportunities to make decisions and then follow through with them even if you know the outcome might not be ideal.
  • Teach your child the specific behaviours for specific situations, and do not make the assumption that an autistic child will know the correct behaviour without being taught.
  • Be patient and offer concrete examples of the behaviour you expect to see. Tell your child what to do, not only what not to do. Give your child plenty of opportunities to observe adequate behaviour.
  • Practice, practice and practice. Do not expect for your child to learn social skills automatically, but rather keep in mind that learning requires both observation and practice. Offer your child the support he/she needs, and plenty of encouragement. 
Parent and child working on sharing as a social skills. They are sharing some building blocks.



While it is true that applied behaviour analysis can help autistic children develop a lot of valuable skills, you have to remember that in many autistic children, skills don’t automatically generalize. The skills learned in therapy must be practiced at home in order to be solidified and maintained. The earlier you teach self-awareness and self-determination, the easier it will be for your child to advocate for himself/herself later in life.

Autism: what’s more important equality or equity?

April 13, 2020

Read time: 6 minutes

Equality and equity are words that are often understood as being synonymous as they both have the implication of fairness, however, the two meanings are actually very different. Equality means to have the same opportunities as everyone else. Equity speaks to ensuring that everyone has the opportunities they need to be successful.

There have been many political movements that have espoused equal rights: women’s groups, minority groups, autism advocacy groups and other disability rights groups.

With equality, it is assumed that everyone has the same starting point and should be treated in exactly the same way. While with equity, the belief is that not all people start at the same point and for that reason, each person should receive (based on their distinct abilities) what they need to be successful. In understanding the difference between the two, we can conclude  that fairness does not mean equality. 

Modifications and Accommodations for Autism

While the idea behind equality is to treat everyone “fairly” and “equally”, it has sadly missed the mark when looking at fairness around Autism Spectrum Disorder (ASD). Assuming that everyone is equal and is starting from the same place (which we know is not true, especially in autism) can actually create unintentional barriers. For instance, modifications are necessary for those with autism to be successful in their daily routines.

Making practical changes allows the starting point to truly become one of fairness. Simply put, modifications and adjustments are how we can promote fairness and ensure that all people are provided with the tools they need to achieve success. 

An example of these modifications put into action is an autism framework is that of a child who has sensory concerns or challenging behaviour and has trouble sitting in a circle on the floor with the rest of the class.  Pressuring the child to join on the floor may create resistance or even a meltdown which affects not only the autistic child but the class as a whole. A small concession that a teacher may make is to allow the child to sit on a chair in the circle to help with engagement and integration.

Yes, this may seem to some degree “unfair” to the other children or “special treatment”, however with this minor adjustment being made to accommodate a child that has additional needs, the teacher has effectively created a more positive and successful learning environment not only for the autistic child but for the entire class as well.

We cannot and must not expect every child to fit into one box and hope that success will be the same across the board. We have to realize that accommodations and flexibility provided by parents, professionals and autism caregivers are not only kind but are actually essential to achieving true equity. 

Autism ABA Therapy Lindsey Malc Side by Side Therapy Equality vs Equity Cartoon of boys trying to see over a fence.
Equality vs equity cartoon showing the practical difference between the two terms.

As these adjustments are necessary, we need to position them as being so. Instead of the modification being looked at as unfair, it rather should be seen as levelling the playing field to ensure fairness. If we don’t make a big deal about these accommodations than others (classmates, siblings etc.) won’t either. We need to keep in mind that it’s not only those with autism that are different, but we are also all different in our own way and therefore have different capabilities and needs.

In focussing too much on equality and  fairness, we end up overlooking the wonderfulness of difference. Instead, we need to look at each person individually to ensure equity and flexibility are at the forefront. Then and only then we can indeed provide fairness in its truest form.  

To further exemplify, here in Ontario, Canada all of the changes that are being proposed and made regarding the Ontario Autism Program’s funding is a prime example of the misunderstanding surrounding equality and equity.  The province seems to be under the impression that allocating the same amount of funds for children who fall within provincially designated categories (age, etc). will provide equality across the board.  However, where the mistake lies is that autism does not affect each person in the same ways.

Therefore, funding and resources should not be allocated based on provincially set rigid categories such as age, and should instead be provided and distributed based on individual need. As autism falls on a spectrum from mild to severe, one child who is nonverbal may require, for example, far more Applied Behaviour Analysis (ABA) Therapy or Speech Therapy, than a verbal autistic child. This example is just one of many reasons why “equality” in this case will just not work.    

Below is a helpful example of a lesson that can be played with your children to help explain this confusing topic:  

The One Size Fits All Band-Aid Lesson – Ask the children to share their most serious injury: some may say a broken arm, a dislocated shoulder or a cut on the forehead. Once the injuries have been acknowledged, explain to them that your solution to heal them is to provide them each with a band-aid. 

This solution will most likely raise some confusion to the children, as how is a band-aid supposed to fix a broken arm or a dislocated shoulder? This unhelpful solution shows that there is not one solution to all situations and that each situation needs to be addressed in it’s own way. Even though using the same solution (the band-aid) may in theory seem fair, how can this “equal” method of treating three different injuries be acceptable? All that is accomplished is that only a small number of people actually get the help they need while the rest of the group suffers. 

Once again, it is important to remember that there is a difference between equality and equity. Fairness can only truly be gained with compromises and modifications which ensure that all people are indeed given the tools they need to be successful.  Would you not agree to a person with bad eyesight getting glasses or a non-english speaker having a translator at the hospital? It is a similar situation when making adjustments for autistic children and others with exceptionalities.

We know that not all people are born the same, and in keeping this in mind, we need to continue to work towards levelling the playing field to ensure actual fairness is received. 

Autism Spectrum Disorder Diagnosis? 8 Steps to help kickstart your child’s success

February 10, 2020

Read Time: 5 minutes

The word autism in a magnifying glass, demonstrating that this article is about autism spectrum disorder.

Receiving a diagnosis that your child has Autism Spectrum Disorder (ASD) is not only scary but overwhelming too. There are so many questions and while there is a vast amount of research to turn to these answers often only result in further questions and possibly further confusion.

It is important to rely on your treatment team including a Board-Certified Behaviour Analyst in Toronto (BCBA) for support and guidance as they understand just how exhausting and challenging such a diagnosis can be. Working together will help with your child and family’s success both at home and at school.

Here are some helpful tips to try when your child gets an autism spectrum disorder diagnosis:

1.  Become an Expert in your Child’s Needs, Likes and Dislikes

Each child with autism spectrum disorder is different and we need to embrace, understand and support their differences. This can be achieved through research and asking questions about autism spectrum disorder and more specifically your child’s individual needs. As each child is unique, you must remain open minded about their experience of having autism. Once you gain some knowledge you will then be able to ask insightful questions to help build the best treatment plan for your child. 

The best place to start is with your child’s family physician, they will be able to refer you to an autism consultant who can work with you to develop a team. Your physician should also be able to provide you with useful resources such as finding the best Applied Behaviour Analysis (ABA) therapist or group including Board Certified Behaviour Analysts (BCBA) for your child. Remember finding the right therapist may take time and patience. There is no such thing as “one size fits all” in a treatment plan. 

2. Find Help through Technology

As technology has become an integral resource within our society, it has become a very useful tool for parents of children with autism spectrum disorder. Firstly, a vast array of knowledge and research regarding your child’s diagnosis and treatment can be gained through the internet. Secondly, technology is also used as a resource for community building through social media including parenting groups and intervention discussion forums.  Here there is an opportunity to seek the support and experiences from parents in similar situations and professionals in the field. These communities are amazing and can help one to realize they are not alone. 

Lastly, and perhaps most importantly, technology holds a critical use for autism spectrum disorder children that have communication difficulties and is used as a tool to remove this barrier. AAC (Alternative and Augmentative Communication) gives a voice to children who cannot speak using tablets or computers with specialized apps that utilize text or image to speech technology. These are sometimes called SGD (Speech Generating Devices). 

3. Get Intervention as Soon as Possible

Parents that feel that their child might have autism spectrum disorder should speak with their child’s physician as early as possible to investigate a diagnosis. Don’t allow your child’s doctor to dissuade you or convince you to ‘wait and see’. With an early diagnosis and then prompt invention parents are able to start working towards helping their child to address interfering behaviours and increase communication skills.

Intervention is most effective in younger children. If your child’s interfering or challenging behaviour (e.g.: outburst in public) is addressed and dealt with early on, then the hope is that through reinforcing positive or desirable behaviour, the child will eventually be independent in the future in the same situations. Positive outcomes are possible for older children as well, so don’t give up if your child is older when they begin to receive treatment. 

4. Ensure your Child’s Treatment is a Family Affair

An autism spectrum disorder diagnosis not only affects the diagnosed child but it affects the entire family. It’s therefore necessary that the therapy plan includes siblings’ and parents’ opinions and experiences. Since schedules and rules set out in the plan will put expectations on the entire family, their input and buy-in is imperative for the success of the program.

It is also vital that family members are involved in the treatment plan to ensure that generalization occurs. This means that your child is able to demonstrate all the skills they are learning in new settings and with new people instead of only with the treatment team. It may become a balancing act for you, however with support, consistency and careful consideration and execution of the therapist’s recommendations your day-to day routines will become less overwhelming. 

5. Trust your BCBA, Treatment Team and the Process

As mentioned, finding the right BCBA and program can be a difficult journey, however, once this is accomplished you will soon see that you are on the right path. As your child is unique in their needs you must remain optimistic and open-minded. There will be necessary tweaks and adjustments along the way and through trial and error, you will certainly see positive changes.

Finding a team that suits your family’s needs and expectations is extremely important. You will also need to ensure there is a constant flow of communication between your family and your child’s BCBA so that modifications can be implemented and changes made whenever required. 

6. Celebrate the Successes

As you continue to fill your toolbox with more tips and knowledge it will open the door for greater success. At times there may be a lot of growth and positive changes and at others, there may be little or none. It is important to stay focused on the positive and reflect on the successes and celebrate them frequently. Continuing to stay on course and provide consistent routines and expectations for your child. The more you celebrate the successes the more likely it will be that you feel good about your child and family’s future. 

7. Make Safety a Top Priority

The challenges and long-term responsibilities that come with an autism spectrum disorder diagnosis can be additional stress placed upon an autism parent. To help ease the sense of being overwhelmed it is important to get organized and put proper measures into place for a “just in case” situation (for example, looking into life insurance for family members). As children with autism can engage in more dangerous behaviour (wandering, mouthing and self- injury) a safety plan is essential.

It is necessary to develop a plan to address these safety risks with your treatment team. For example, you should ensure that your child always carries or wears identification, especially if they are a wanderer. A simple google search will yield many options for safety tools for your child with autism spectrum disorder.

8. Work on Establishing a Good Sleep Routine

One of the challenges many children with autism spectrum disorder face is difficulty sleeping. Poor sleeping can exacerbate some of the challenging behaviours associated with autism such as impulsivity, compulsions, hyperactivity and physical aggression.  Good sleep hygiene is vital to providing your child with quality restful sleep.

Keep in mind a few things while creating a routine, for instance: maintaining consistent times for going to bed and waking up; how much light is in their bedroom while they’re trying to sleep; ensuring your child has enough play time during the day and not too much screen time prior to bed; perhaps instituting a wind-down quiet period before bed; taking sensory issues into account, i.e. itchy pajama’s, white noise etc.  

If your child has recently received an ASD diagnosis and you are looking for ways that the Ontario Government can support you, please know that changes to the Ontario Autism Program are in the process of being established. They are working towards creating a new “needs -based and sustainable autism program”. Eligibility for this program has the following criteria:

To register for the Ontario Autism Program, your child must:

  • be under age 18
  • currently live in Ontario
  • have a written diagnosis of autism for a qualified professional

Your child’s written diagnosis must include:

  • your child’s full name and date of birth
  • the date of your child’s assessment
  • a statement indicating that the child meets the diagnostic criteria for autism spectrum disorder
  • the qualified professional’s name and credentials

For registration information please contact the central intake and registration team at:

Ontario Autism Program
Ministry of Children, Community and Social Services
P.O. Box 193, Toronto, Ontario M7A 1N3
1-888-444-4530 [email protected]

The site notes that if you have registered in the Ontario Autism Program before April 1, 2019 you do not need to register again.  As well, they mention that once your registration is complete, your child will be added to their waitlist and you will receive a letter from the ministry when it is time to complete further steps to receive funding.

Additional services and support are provided by the Ontario government for children with special needs, these are listed below:

For more information please visit:  https://www.ontario.ca/page/ontario-autism-program

If your child was recently diagnosed with autism spectrum disorder, please connect with us. We can help you navigate these distressing times.

10 Helpful tips on raising a child with autism in 2022

January 24, 2020

Read time: 5 Minutes
Last Updated: November 2022


As a parent raising a child with autism spectrum disorder, you are faced with many difficulties and daily challenges which require adjustment in your parenting skills to include flexibility, patience, understanding and strength. You need to become very aware of your child’s specific needs while all along ensuring your own wellbeing and mental health.

It is important to realize that no two children with autism (as with all children) are the same. This therefore requires you to have the flexibility and open-mindedness to try numerous strategies and techniques to find the best fit for your child and family. This discovery may take some time and will include ups and downs, however, with persistence and the help of your child’s team you will find the path that will provide the direction necessary to seek positive change.

Here are 10 helpful tips to try with your child with autism:

1. Don’t make comparisons 

Every child is unique and faces their own challenges. It is important to not compare your child with siblings or classmates. All children develop at their own pace and react to situations differently. Situations that don’t cause one child to bat an eye might be devastating for another.  Comparing your child’s behaviour to that of others can cause your child to feel guilty for something that might be out of their control. 

2. Help your child realize when they need a break 

When your child with autism starts to feel frustrated, it is important for them to be able to identify their emotions and to be able to access the tools that will help them to calm and regulate their emotions. You can teach your child the tools they need in order to seek a break in a calm, comfortable and safe environment. This break will provide a safe place to allow them to calm down whichever way works best for them. This skill is crucial for all children but specifically for children with autism.

Parent talking with a boy with autism.

3. Listen to your child calmly and do your best to understand

Dealing with any young child can be quite difficult and trying to rationalize with them often is not successful, this is especially true of children with autism where there are language skill deficits. This ongoing challenge often leads parents to become frustrated and overwhelmed.

As a parent, it is crucial to maintain calmness (regardless of how difficult the situation becomes) to prevent escalation in the child’s behaviour. If you can calmly understand your child’s perspective you may then be able to adjust your methods so that you’re working with our child instead of against them. 

4. Help your child apply new skills to different situations (generalization)

Many children with autism don’t generalize their learning, meaning that they cannot apply a skill in novel situations. They might be able to use the bathroom at home but seem unable to use a public washroom, for example. It is important to practice the same skills in different situations and through repetition. Your child will eventually learn to apply them more easily regardless of the circumstances.

5. Keep an open mind

Our life experiences dictate our perspective and how we view the world. This simple fact can get in the way of understanding our child’s experiences. Neither yours nor your child’s beliefs are wrong. It is therefore important that you as a parent of a child that looks at the world differently is open-minded. Through tolerance and acceptance, you will be better able to understand your child’s point of view as well as acknowledging that there are alternatives and various approaches to helping them.

6.Maintain a sense of humour

Some of your child’s behaviours may not initially (or ever) fit within societal norms and may be perceived as unconventional. As mentioned earlier, these are only perceptions that we have been taught, if you were to look at the difference with an alternative lens using humour, you’ll likely find that you are bothered less and feel less judged. 

7. Never underestimate how much your child understands

 There is a difference between receptive language (what we understand) and expressive language (what we can communicate with words, sign language, picture exchange or augmentative communication). Many children with autism have difficulty with expressive language while their receptive language falls within normal development.  This means that they cannot express all the things they understand. There may appear a lack of understanding but this is likely not the case. 

Autism ABA Therapy Side by Side Therapy Toronto

8. Look into Applied Behaviour Analysis (ABA) therapy

As mentioned, it is important to be open-minded and this involves looking into therapeutic methods and techniques to help your child. ABA therapy has been established as one of the most effective methods in working with children with autism. It is important that your ABA team is lead by a BCBA (Board Certified Behaviour Analyst). You should investigate the ABA providers in your area because not all people practice in the same way.  ABA should be individualized to the child so if you’re concerned about a specific aspect of your child’s ABA therapy, you should feel confident to bring it up with your provider. 

9. Work with the school and be an advocate for your child’s needs

School plays a large and critical role in your child’s development. Your relationship with the school is important as your child will require additional services, support and programs.  These additional resources can and should be provided through the educational system. If you feel that the school is not recognizing your child’s additional needs or working with you for your child’s betterment then you need to advocate for them. You know what is best for your child and it is up to you to convey your needs and concerns. Ongoing communication and feedback will help keep you and the school on the same page and will align every player on your child’s team. 

10. Take a break yourself and seek support

Raising an autistic child may come with many challenges however on the flip-side it comes with many rewards. You need to remember to be kind to yourself, know you are an amazing parent doing your best in a demanding situation.  You need to ensure that you are in a place that you can handle and manage all that is needed of you. Don’t take everything onto yourself, reach out to your support network frequently. Seeking help will take care of yourself and in turn you will be the best parent you can be. 

Check out the Autism resources page to find links to valuable information about autism spectrum disorder.

Applied Behaviour Analysis: 59 Terms and phrases translated for easy understanding

January 20, 2020

Read time: 7 minutes

Therapist and child doing applied behaviour analysis.

There are so many terms and acronyms that you’ll be encountering when you enter the world of applied behaviour analysis. It can be very confusing, especially because some of the words that are commonly used in ABA are used with another meaning in common language. I’m going to give the definitions in terms of children but they can be applied to anyone (adult or child).

Applied Behaviour Analysis Definitions of Common Words/Phrases:

ABA Therapy: Applied Behaviour Analysis is the application of the sciences of learning and behaviour to teach, increase or decrease behaviours that are meaningful to the client and their family. 

ABLLS-r (The Assessment of Basic Language and Learning Skills – revised): This is a tool that is used as an assessment, curriculum guide and skill tracker when doing applied behaviour analysis. It was created by Dr. James Partington. Similar to the VB MAPP, it tests whether the child has specific language skills. The skills that are measured are sequenced from easiest to most difficult.  There are 25 domains, some of which include: expressive language, receptive language, writing, imitation, fine and gross motor skills. 

Accuracy: How close to the target something is or how correct it is. 

Acquisition Target: A target that is currently being taught.  This is a behaviour or skill that has not been learned yet. 

Adjusted Age: This refers to the age of your child based on their due date. For example, if your child was born 6 months ago but was 2 months early, they would have an adjusted age of 4 months. Doctors or therapists will sometimes use adjusted age when speaking about the development of your child.  People usually stop referring to adjusted age when the child is around 2 years old. 

Antecedent: In applied behaviour analysis an antecedent is what happens before a behaviour. Think of it like the trigger for the behaviour.  

Aversive: A stimulus that your child finds unpleasant or bothersome.  Aversives can be used as a punisher to decrease behaviour or the removal of an aversive can be used as a reinforcer to increase behaviour.  Your therapists should not be using aversives in your child’s programming without having a discussion with you and gaining your consent.

Behaviour: This is what the child does. Behaviours have to be measurable and observable. 

Behaviour Intervention Plan (BIP): This is a plan that will target the reduction of challenging behaviour for your child. They should always include: a specific definition of the behaviour, antecedent strategies, reactive strategies, a replacement behaviour and a mastery criteria.

Board Certified Behaviour Analyst (BCBA): This is a masters or PhD level therapist who has completed the requirements (specific courses, over 1500 hours of work experience and passed a credentialing exam) of the Behavior Analyst Certification Board.  

Chaining:  In applied behaviour analysis chaining is when a skill is broken down into steps and then the steps are taught in isolation then brought together to form a longer sequence (or a chain). You can forwards chain (teach the first step then the second and so on), backwards chain (prompt all steps except the last, then prompt all steps except the last two and so on) or you can teach the whole chain (fade prompting across each step of the chain at one time). 

Chronological Age:  This refers to the amount of time your child has been alive. Even if they were born prematurely, this is the number of days/months/years that they’ve been on the planet. 

Clinical Supervisor (CS): In Ontario, a CS is the BCBA who is responsible for overseeing your child’s ABA program.  They make clinical decisions (decisions about what and how to teach) and collaborate with you and the rest of your child’s team in supporting your child as much as required. 

Consequence: In applied behaviour analysis, this is what happens immediately after a behaviour.  Consequences are neither good nor bad, they simply follow a behaviour. 

Deprivation: When your motivation for something is really high because you haven’t been exposed to it in a long time.  When you stop using or consuming something your desire, your need for that item grows. 

Developmental Age: This is the age at which your child demonstrating most of their skills. Doctors and researchers have set all of the developmental milestones to specific age windows.  For example, most children learn to speak in two-word sentences at around 18-24 months. Your child’s developmental age is the age at which they’re functioning emotionally, physically, cognitively or socially. Developmental age is not always correlated to chronological age.

Discrete Trial Training: This is a method of presenting the child with small segments of learning that are repeated, known as trials. Often the skill is presented in 5 or 10 trial blocks.  The blocks are repeated a few times a day until the child can demonstrate the skill without prompting. 

Discriminative Stimulus (SD): In applied behaviour analysis this is the demand, request or question that elicits a specific response.  The presence of an SD signals the availability of reinforcement.  

Duration: The length of a behaviour.  

Echoic: A verbal operant meaning repeating.  When the speaker repeats what they heard from someone else.  For example, when a father says “bedtime” and the child repeats “bedtime”. In applied behaviour analysis programs, echoics are usually one of the first language goals targeted.

Expressive Language: This describes our ability to use language, gestures and writing to express ourselves. 

Extinction Burst: A rapid escalation in the frequency, intensity and/or duration of a behaviour once the reinforcement for this behaviour has been removed.  Usually, the pattern during extinction is that there is a small reduction in the behaviour, a big spike and then the behaviour disappears completely. There is something known as spontaneous recovery, which can happen after extinction is used.  The child will test the waters and re-engage in the challenging behaviour that has previously been extinguished. By sticking to the plan and not reinforcing the behaviour, spontaneous recovery is usually short lived. 

Extinction: When you intentionally stop reinforcing a behaviour with the goal of reducing that behaviour. For example, if you don’t answer the phone when someone calls, they will eventually stop calling you.  Often leads to an extinction burst.

Fine Motor Skills: These are the skills that require movement and coordination of the small muscles of the body, specifically the muscles of the hands.  Cutting, writing and pointing are all fine motor skills. 

Functional Analysis or FA: This is a highly specialized process that BCBAs use to determine the function of the behaviour targeted for intervention.  By manipulating reinforcement the BCBA will see if they can influence the behaviour. By controlling the reinforcement for a behaviour, you’re able to determine the function of the behaviour and can create function based replacement behaviours. One specific type of FA is called IISCA (Interview Informed Synthesized Contingency Analysis), it was created by Dr. Greg Hanley. 

Functional Behaviour Assessment or FBA: This is a process for hypothesizing the function of a behaviour that is being targeted for intervention. In an FBA the BCBA does some or all of the following: observes the behaviour, completes interview style questionnaires and takes data. 

Generalization: When your child is able to demonstrate a skill using novel materials, with novel people and in novel environments. All ABA skill acquisition programs should have generalization steps built into the program because generalization does not always happen automatically. 

Gross Motor Skills: These are the skills that require movement or coordination of the large muscles of the body, specifically the muscles of the arms, legs and trunk. Walking, running and sitting are all gross motor movements. 

Intervention: This the strategy that will be used by the team to change a behaviour or teach a skill. Intervention is another word for program. 

Intraverbal: A verbal operant meaning conversation.  When the speaker responds to another person’s language in a conversational way. For example, if someone asks you “What’s your favourite colour?” your response “Red” would be an intraverbal. 

Latency: In applied behaviour analysis, this is the time between when an instruction is given and the beginning of the behaviour.  

Maintenance: When a skill or behaviour is able to be demonstrated long after it was originally taught and with less reinforcement than was used during teaching.  Sometimes a skill will be ‘moved to maintenance’ this means that the child will be asked to demonstrate the skill on a regular basis to avoid losing it.  Often there is a maintenance schedule that the applied behaviour analysis team will use to practice the learned skills so that they are not forgotten. 

Mand: A verbal operant meaning request.  When the speaker uses a word to make their needs known.  For example, saying “apple” when you want to eat an apple. Mands can be requests for objects, people or attention.  Mands can also be requests for the removal of something you don’t like. 

Mastery: The requirement for something to be considered learned.  Mastery criteria are always set before the behaviour is taught.  Often in applied behaviour analysis programs mastery criteria is 80% correct (or above) over 3 consecutive days with different instructors and novel stimuli. 

Natural Environment Teaching (NET): A form of applied behaviour analysis where learning occurs naturally or incidentally in the child’s typical environment.  Examples of programs that are best run in the NET are tooth brushing or feeding programs run at a family table during meal times. 

Negative Reinforcement: When something is removed from the environment that makes a behaviour more likely to happen again in the future. In applied behaviour analysis, negative reinforcement is not the same as punishment.

Neutral Stimulus:  Something in our environment that does not affect our behaviour.  We have not associated that object or event with anything else. 

Positive Reinforcement:  When something is added to the environment that makes a behaviour more likely to happen again in the future. 

Program: The specific strategies that will be used to change a behaviour or teach a skills. Each skill should have it’s own program description. Program is another word for intervention. 

Prompt Hierarchy: These are the graduated steps that a therapist will use to methodically remove support for a child to be able to perform a skill independently. Having a prompt hierarchy in place is important in order to ensure that all team members are using the least intrusive prompt required. An example of a most to least prompt hierarchy is: full physical, partial physical, verbal, gestual, modeling, pointing, gaze and no prompt (independent). 

Prompting: These are the strategies that are used to help a child learn a new skill. Generally, BCBAs will put a prompt hierarchy in place to guide the therapists in how to support the child. 

Punisher: Anything that makes a behaviour less likely to happen again in the future. 

Punishment:  A procedure that is used to decrease the likelihood that a behaviour will happen again in the future.  Punishment weakens behaviour. Your child’s therapy team must gain your consent before implementing punishment procedures in their applied behaviour analysis programming.

Rate: This is how many times a behaviour is displayed within a specific time frame.  Rate is always described in relation to time. For example, 7 incidents per day or 2 incidents per minute. 

Ratio: This is the number of responses required before a reinforcer will be delivered. It is possible to have either a fixed ratio (for every 5 responses reinforcement will be delivered) or a variable ratio (on average reinforcement will be delivered every 5 responses – sometimes it is delivered after one response and other times it is delivered after 9 responses). 

Receptive Language: This describes our ability to understand the words that are spoken to us. 

Registered Behaviour Technician (RBT): This is a credential offered by the Behavior Analyst Certification Board.  An RBT is a person who practices applied behaviour analysis under the close and ongoing supervision of a BCBA. RBTs are not allowed to practice independently (without supervision) because they have not met the standards set by the BACB for that level of work. 

Reinforcement: A procedure that is used to increase the likelihood that a behaviour will happen again in the future.  Reinforcement strengthens behaviour. 

Reinforcer: Anything that makes a behaviour more likely to happen again.  

Response: An observable and measurable behaviour.  Often applied behaviour analysis folks talk about response classes, or groups of behaviour that fit into a category. 

S-Delta: A stimulus whose presence indicates that a behaviour will not be reinforced.  For example, an “out of order” sign on an elevator will decrease the likelihood that you’ll push the elevator call button. 

Satiation: When your motivation for something is really low because you’ve been exposed to it too much.  This happens when you use a reinforcer too frequently or in amounts that are too big. 

Schedules of Reinforcement: The frequency that reinforcement is delivered. There are fixed and variable schedules as well as ratio and interval schedules. Fixed Interval (FI) schedules provide reinforcement for the first example of the target behaviour after a predetermined amount of time has expired. Fixed Ratio (FR) schedules provide reinforcement after a specific number of correct responses (think of a token board). Variable Interval (VI) schedules provide reinforcement after an unpredictable amount of time has passed. Variable Ratio (VR) schedules provide reinforcement after an unpredictable number of responses have been given.

Scrolling: Rotating through a set of answers when you don’t know the specific answer. For example, if you showed your child an apple and asked “what’s this?” If your child was scrolling they would say “Orange, ball, tomato, apple”.  This happens if the prompting procedure is not applied correctly. Scrolling can happen with any of the verbal operants, not only tacting/labeling.

Self-Injurious Behaviour (SIB): Actions that the child does that cause injury to themself. Hitting oneself, biting oneself and headbanging are examples of self-injurious behaviour. 

Stims/Stimming: Self-stimulatory behaviour. These are some of the repetitive or stereotypic behaviours that a person with autism might engage in. For example, hand flapping, rocking and repeating movie scripts are all stims. Some people with autism report that they engage in stimming because they’re either under or over responsive to sensory stimuli and it helps to balance them. 

Tact: In applied behaviour analysis this means a label.  When the speaker names what they see or perceive in the environment. For example, smelling pie and saying “pie” or hearing a dog barking and saying “dog”. 

VB MAPP (Verbal Behavior Milestones Assessment and Placement Program): This is a curriculum assessment that is based on Skinner’s Verbal Behaviour. It was created by Dr. Mark Sundberg.  Similar to the ABLLS-r it tests whether the child has specific language skills. The sections or domains of the assessment are based on Skinner’s verbal Operants. The assessment is divided into 5 parts: Milestones Assessment, Barriers Assessment, Transition Assessment, Task Analysis & Supporting Skills and Placement & IEP Goals. 

Verbal Behaviour: A branch of applied behaviour analysis based on the work of B.F. Skinner.  Skinner identified verbal operants or different parts of our language, each serving a different purpose or function.  There are many verbal operants but the basic ones are: mands, tacts, echoics and intraverbals. 

If you’re embarking on your applied behaviour analysis adventure and would like to discuss anything with us, please contact us for a no-charge 30 minute consultation.

Behaviour Intervention Plans: The 8 essential elements

January 6, 2020

Read time: 2 minutes

Example of a behaviour intervention plan that addresses challenging behaviour.






There are many ways to intervene to address challenging behaviour.  In Applied Behaviour Analysis the Behaviour Intervention Plan (BIP) is used. Here are the essential parts of a behaviour intervention plan to look out for when designing one or if one is being implemented with your child.

Elements of a behaviour intervention plan

Operational Definition of Target Behaviour: 

This is the definition of the target behaviour.  It is used throughout the behaviour intervention plan. It is important that this definition is accurate and explicit so that anyone who reads the definition would be able to identify the behaviour. The operational definition should include descriptions that are measurable and observable. It is good practice to include a non-example of the behaviour. For example, if the target behaviour was crying, you would not track crying if the child was hurt. Everyone needs to be working from the same framework and that begins with a solid operational definition. 

Function of Behaviour:

It is important to identify or hypothesize the function of a behaviour before you attempt to change it.  Knowing the function will lead you to a function based replacement behaviour. Functional replacements are more effective because they meet the need that the original behaviour as serving. Read more about the functions of behaviour here.

Replacement Behaviour Definition:

Each target behaviour should have a replacement behaviour that will be taught and reinforced.  This behaviour also needs a proper operational definition to ensure that there is consistency across implementers and to ensure that each instance of the behaviour is reinforced. 

Antecedent Strategies:

These are the things in the environment that will be modified to avoid the target behaviour in the first place.  Some examples of antecedent strategies are to reduce distraction, provide scheduled or free access to reinforcers or proactively reducing demands. 

Skill Building Strategies:

In a behaviour intervention plan, these are the strategies that will be implemented to teach new skills.  These strategies can be tools like visual schedules, token boards or the specific steps that will be taught to the child to accomplish a new skill. 

Consequence Strategies:

These are the strategies that will be employed once the behaviour has happened.  These are important so that everyone on the team is aware of how to respond when the target behaviour happens. Consequence strategies are not exclusively negative, they are simply what happens after the target behaviour. Examples of positive consequences are receiving praise for completing an assignment on time, getting a high five for trying a new food or earning extra time on a device.  

Data Collection Procedures:

Data is an important part of any applied behaviour analysis intervention.  Data is taken to measure change, how quickly that change is happening and to identify when that change is not occurring. Treatment decisions like when to change targets, when to revise interventions or when a skill is mastered should all be made based on the data that has been collected. Data collection should be specific to the situation and able to be gathered with consistency and integrity.  Bad data doesn’t help anyone.  

Generalization and Maintenance Procedures:

Generalization and maintenance needs to be programmed from the outset of treatment in order for them to occur. It is very unlikely that a skill will be generalized without specific planning. Generalization is when a skill can be demonstrated in a number of settings or environments, with different materials and with different people. Maintenance occurs when a skill is reliably demonstrated with a level of reinforcement that is less than what was used to teach the skill. 

If you would like to discuss your child’s behaviour intervention plan please contact us for a no-charge consultation.

Lindsey Malc: Inspired Founder & Clinical Director

December 22, 2019

Read time: 2 minutes

Hello, my name is Lindsey Malc. I’m the founder and Clinical Director of Side by Side Therapy. In 2013, I became a Board Certified Behaviour Analyst. I have spent my entire career working with children with special needs and their families.  I have extensive experience in clinical as well as community settings. I have worked primarily with autistic children but have considerable experience working with typically developing children with challenging behaviour as well. 

I graduated with a Master of Applied Disability Studies degree from Brock University. I also hold an Honours Bachelor of Social Work degree from Lakehead University. I worked for many years at Zareinu Educational Centre (now known as Kayla’s Children Centre).  At Zareinu, I held many positions, from classroom assistant to Behaviour Analyst.  In my 14 years at Zareinu, I was fortunate to learn from a trans-disciplinary team of therapists who were passionate about helping our students achieve their maximums. Working with Psychologists, Speech-Language Pathologists, Occupational Therapists, Physiotherapists, Social Workers, Special Education Teachers, Early Childhood Educators and Recreational Therapists provided me with a very well rounded understanding of and respect for these vital disciplines. 

How I, Lindsey Malc, can help your child and family

I offer 4 services based on your family’s needs.  

I will help you better understand how you and the environment are impacting and maintaining your child’s behaviour.  Using Applied Behaviour Analysis, I will provide you with alternatives and help guide you to effective ways that you can change your child’s behaviour. Looking at the antecedents, behaviours and consequences will be the starting point for this service.  We will meet weekly or biweekly and will discuss what has happened since our last meeting. I will ask you to take some data because it can be difficult to remember everything and then analyze the information and identify patterns.  

I work with private schools or daycares to identify the function of challenging behaviour and to develop intervention plans that will be effective and easy to implement. Individual programs or class-wide behaviour interventions can be developed.  Realistic data tracking and follow up are provided.  These meetings can happen weekly, bi-weekly or monthly depending on your needs.

If your child with autism or other developmental disability is struggling with a specific skill or skill set, I can develop a targeted intervention to address this need.  I would develop the intervention and teach you or a caregiver how to implement it. We will meet weekly or bi-weekly. Manageable data collection would be an integral part of this intervention with the goal of empowering you to implement the same strategies to address future goals as they arise. 

If you’re looking for a comprehensive ABA Therapy program, to address all areas of your child’s development I can be the Clinical Supervisor for your child’s ABA program.  I qualify as a Clinical Supervisor for the Ontario Autism Program and am listed on the  OAP provider list.  I will complete a curriculum assessment and develop all of the teaching programs and targets for your child’s ABA program. I am happy to work with you to develop your child’s treatment team and to train the staff in all of the behavioural interventions that they will be implementing.  Supervisions would occur either weekly or monthly, depending on the supervision structure of your ABA team.

Professional Services

If you are pursuing BCBA or BCaBA certification, I am also available to supervise all of part of your experience hours.

Photograph of Lindsey Malc, Behaviour Analyst

I would be happy to discuss your ABA Therapy programming needs. Please don’t hesitate to contact me.

Call me: 1-877-797-0437

Email me

Thanks for your time and I look forward to working with you to address your child’s special needs.

Lindsey Malc, BCBA

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