Author: Lindsey Malc

Lindsey is a Board Certified Behaviour Analyst from Vaughan, Ontario, Canada. She specializes in working with families of children with Autism or other special needs.

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Autism and Memory: Can you guess the superpowers of a child with autism?

Read time: 4 minutes

This post was written by Dr. Tracy Alloway. She is an award-winning psychologist, professor, author, and TEDx speaker. She has published 13 books and over 100 scientific articles on the brain and memory. Her research has also been featured on BBC, Good Morning America, the Today Show, Forbes, Bloomberg, The Washington Post, and Newsweek, and many others.

Autism is characterized by a difficulty to recognize and respond appropriately to social and emotional cues, which causes problems with social interactions. Yes, they have unique strengths that can give them an advantage in certain areas. Watch a clip.

IFrame

Working Memory and the Brain: from Understanding Working Memory

The brain of a child with autism develops differently from children without it. Recent research has found that the prefrontal cortex (PFC), the home of working memory, is one of the brain regions most affected by autism. Initial results show that the PFC of a child with autism has a much greater volume of neurons, up to 67% more. One possible explanation for this excess growth is that the genes controlling neuron development are overactive, resulting in greater brain volume. Exactly how this is related to autistic behavior is unclear at the moment, but the link an abnormal PFC and autism suggests that there may be a working memory connection to the behavior. (Courchesne & Pierce, 2005).

Children with autism also display less activation in the PFC when they are asked to remember and process information. This pattern seems to be evident regardless of the nature of the task. In one experiment they were asked to process letters, in another, shapes, and in another, faces. In all instances, the result was the same: there was less activation in the PFC for children with autism than in those without it. The study with faces, also found that children with autism tend to analyze facial features like objects, rather than in light of social relationships, which may explain their trouble interpreting social nuances (Koshino et al., 2005; 2008).

Furthermore, when a child with ASD is presented with two tasks and has to focus on one while ignoring the other distracting task, their brain activity reveals that they do not actually shift their attention to the more important information (Luna et al., 2002). They have a difficult time determining what information is important. In the classroom, some students with ASD might appear to struggle with certain memory-heavy activities. However, this may be connected to their difficulty in knowing what they should focus on, rather than a working memory deficit per se.

Working Memory is linked to AUTISM

The working memory profile of the student with ASD depends on whether they are low or high functioning. In some cases, high functioning students can have an above-average verbal working memory, while low functioning students perform at the same level of a student with a specific language impairment. In general, low functioning ASD students also have a poorer working memory than their typically developing peers do.

However, even high functioning ASD students can display verbal working memory problems. In my own research, I found that the type of material they have to remember provides us with a clue to their working memory profile. They struggle in particular with abstract information like nonsense words or new vocabulary. Why? One explanation is that when they are presented with abstract ideas that they have to both process and remember, they spend too long trying to comprehend the material and so forget what they need to do. For example, during a verbal working memory test, Daniel, a 14-year-old with ASD, was presented with the sentence: Dogs can play the guitar. Daniel spent a long time thinking about the sentence before finally answering “True”, because “you can train a dog”. As a result of the lengthy time spent deliberating the answer, he forgot the final word in the list of sentences (Alloway, Rajendran, & Archibald, 2009).

The strategies they use to remember information can also over-burden them. Studies confirm that when remembering information, high-functioning ASD individuals do not use their long-term memory, visual strategies, or even contextual clues. Instead, they rehearse things over and over again. While this can be useful in remembering short sequences of information, it is ultimately a time-consuming and inefficient strategy to simply keep repeating things. These students are aware of their own memory problems. Alistair, a high-functioning 13-year-old, commented that he had “number overload” when he failed a test that required him to repeat numbers in backwards order.

Now, let’s look at their visual-spatial working memory profile. The majority of individuals with ASD do not have deficits in this area.  In one task, students are shown a matrix with dots that appear in random locations and they have to recall their location in a backwards sequence. Both my own research, as well as other studies, confirms that students with ASD do as well as their peers without autism. In the classroom, this means they should be able to remember information that is presented visually. 

Tracy Alloway




To find out more about the memory superpowers of a child with autism, check out Dr. Alloway’s new children’s book here.

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References

Alloway, T.P., Rajendran, G., & Archibald, L.M. (2009). Working memory profiles of children with developmental disorders. Journal of Learning Difficulties, 42, 372–82.

Courchesne, E.,  & Pierce, K. (2005).  Brain overgrowth in autism during a critical time in development: implications for frontal pyramidal neuron and interneuron development and connectivity. International Journal of Developmental Neuroscience, 23, 153-170.

Koshino, H., et al. (2005). Functional connectivity in an fMRI working memory task in high-functioning autism. Neuroimage, 24, 810–821.

Koshino, H., et al. (2008). fMRI investigation of working memory for faces in autism: visual coding and underconnectivity with frontal areas. Cerebral Cortex, 18, 289-300.

Luna, B., Minshew, N.J., Garver, K.E., Lazar, N.A., Thulborn, K.R., Eddy, W.F., & Sweeney, J. (2002). Neocortical system abnormalities in autism: an fMRI study of spatial working memory. Neurology, 59, 834-840.

World Autism Awareness and Acceptance Day: April 2, 2020

Add Your Voice to the Giant Autism Billboard for World Autism Awareness Day
Add Your Voice to the Giant Autism Billboard for World Autism Awareness Day

World Autism Awareness Day is today, which means it’s a great time to contribute to the Giant Autism Billboard (see it here). It’s a thought-provoking project centred around the importance of autism awareness, and it stems from the belief that the sharing of lived experiences is a great way to help others gain a better understanding of neurodiversity.

The Giant Autism Billboard, an online collaboration that invites autistic people of all ages as well as their family members, caretakers, and doctors to condense their life experience and advice about autism into one pearl of wisdom to share with the world, the idea, thought, or message they most feel represents their experience. Finding a way to distill life with neurodiversity into one statement is no mean feat, but it has inspired many voices throughout the autism community to offer their unique input.

World Autism Awareness Day is today, which means it's a great time to contribute to the Giant Autism Billboard (see it here). It's a thought-provoking project centred around the importance of autism awareness, and it stems from the belief that the sharing of lived experiences is a great way to help others gain a better understanding of neurodiversity.

The large collaborative project serves to illustrate an idea that’s central to autism awareness, which is that no two neurodiverse people are alike and no one’s experience with autism is exactly the same. This helps to create an understanding of autism as a spectrum of behavioural differences which are experienced uniquely, defying negative stereotypes and embracing the idea that neurodiversity can bring skills in addition to challenges. The project celebrates the voices of those affected, acknowledging that they are most able to provide true autism awareness and amplifying their voices to contribute to the cause.

World Autism Awareness Day is today, which means it's a great time to contribute to the Giant Autism Billboard (see it here). It's a thought-provoking project centred around the importance of autism awareness, and it stems from the belief that the sharing of lived experiences is a great way to help others gain a better understanding of neurodiversity.

The Giant Autism Billboard will be featured on the We The Parents website during the month of April, which has been designated as World Autism Awareness month. The site was founded in 2017 by parents Neve and Keane as a welcoming, judgement-free resource which parents can look to for advice, and takes special interest in supporting families affected by autism.            

I have contributed and I hope that you will as well.

Lindsey

Side by Side Therapy is Growing!

Read time: 3 minutes

Lindsey-Malc-Autism-ABA-Therapy-Side-by-Side-Therapy-Toronto


In these uncertain times, it’s important to have a goal and work towards achieving something. At Side by Side, that’s exactly what I’ve been working on! When I began Side by Side, I envisioned a group of talented therapists who would use behaviour analysis to improve the lives of special needs kids and their families by empowering parents to implement the strategies we use every day. 

What I very quickly realized is that parents want the support of a team of professionals, not only behaviour analysts.  Each of the disciplines brings a valuable skill set to the table and families deserve to have access to all of these skill sets under one roof. While I believe in ABA with my whole heart, I recognize that it doesn’t hold all the answers and that my ability to be helpful is amplified when I work with a team. 

I would like to announce that Side by Side Therapy is expanding our services and will be offering ABA, speech therapy, occupational therapy, therapeutic recreation and respite. I have been working hard to put together an excellent team of therapists who are dedicated to our mission of empowering parents to empower their children. Check the blog in the next few weeks for some short profiles of our team members. 

Please read below for a short description of each of the disciplines and some examples of goals that might be targeted:

Read time: 3 minutes

Applied Behaviour Analysis (ABA): A therapy based on the science of learning and behaviour.  The main goal of ABA is to change socially significant behaviours. A socially significant behaviour is one that is stopping you from fully participating in your life.  Some examples are: communication skills, social skills, play skills, life skills and decreasing challenging behaviours (aggression, self-injury etc). ABA can also be used to teach academics. 

Possible goals: 

  • Responding to name
  • Sorting items 
  • Reading
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Speech Therapy (SLP): A therapy that revolves around increasing speech, language, social communication, cognitive communication and swallowing disorders. Speech-Language Pathologists work with children with autism or other special needs to increase their ability to communicate their needs and this often has an added bonus of decreasing challenging behaviours.  

Possible goals:

  • Increasing vocabulary
  • Improving articulation
  • Improving social skills
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Occupational Therapy (OT): A therapy that focuses on teaching the skills that a person needs to fully participate in their daily activities (or occupations).  Occupational therapists can help address mobility difficulties and how a child accesses their environment. OTs can suggest ways that the environment can be modified to allow the child to participate. 

Possible goals:

  • Learn toothbrushing
  • Improve handwriting skills
  • Expanding variety of foods eaten
Read time: 3 minutes

Therapeutic Recreation: A therapy that addresses goals from all domains of a person’s life using recreation and play as a vehicle for change. It’s about more than just playing. A recreation therapist will use recreation (play and leisure) to achieve goals and push your child to learn and grow. 

Possible goals:

  • Increasing engagement in social interactions with a peer
  • Improve fine motor skills
  • Increase time spent engaged in independent play
Read time: 3 minutes

Respite: A service available to families of special needs children.  This service offers you the peace of mind to know that while you’re having a much needed and deserved break your child is being cared for and entertained. Our respite workers are informed of your child’s specific needs and interests and will design respite sessions to highlight these needs and interests. 

Possible respite activities:

  • Play at the park
  • Swimming at the community centre
  • Cooking with your child 

If you would like to know more about how your child and family might benefit from any or all of these services please contact me directly by phone at 1.877.797.0437 or by email at [email protected]

Stay healthy everyone!

Lindsey

Autism and Transitions – 11 Tips: Part 2

Read time: 3 minutes

This post continues from the last post about autism and transitions. To recap: transitions happen any time you end one activity and begin another. Transitions can be big (graduating high school and starting to work) or small (ending an episode of your favourite tv show and watching something else). Transitions are often difficult for autistic kids because of the way that they are impacted by the core symptoms of autism (communication, social skills and restrictive and repetitive behaviours). These core symptoms can negatively impact how easy it is for a child to transition.

The first 5 tips that were listed in the previous post are:

  1. Talk about and prepare for transitions before they happen.
  2. Give warnings about upcoming transitions.
  3. Use countdowns.
  4. Create visual schedules.
  5. Give options to increase feelings of control.

Here are the last 6 tips:

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  1. Use Natural Breaks – Using natural breaks is one method that can ease transitions naturally.  For instance, if your child is playing with a puzzle, upon completion it would then be an appropriate and ideal time to move into a transition. Since the prior activity had a concluding point, this allows the child to feel closure and a more willingness to move onto the next event. 
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  1. Likes and Interests – As transitions can be daunting, especially transitions that are not preferred by your child, it is helpful to try and make the transition fun or exciting.  This playful and creative method can alleviate some of the associated stressors through distracting your child with games/activities that they enjoy. Let’s say you need to go on a long drive, and you know being in the car for long periods is a trigger for your child, try playing “I spy”. Or, how about if getting to school in the morning is a challenge try hopping on one foot all the way there. Use your imagination!  
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  1. Objects or Songs – Using a physical object can help your child in understanding a transition. Have your child grab their towel before bath-time, this will then alert and prepare them for the upcoming transition. Transition objects offer a visible reminder for your child to help recognize an approaching transition.   Songs can also offer concrete cues for the upcoming change such as singing or creating a bedtime song. Once the child hears or sings the song, they will then associate it with their bedtime. You can also have your child keep a favourite coping tool on hand, perhaps their special stuffed animal or blanket.       
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  1. Use Appropriate Forms of Rewards – Using a reward system is a very effective tool when dealing with transitions. By arranging a plan with your child prior to an event/transition with the understanding of what can be earned is a great motivator. It is important to be able to differentiate between a reward and a bribe.  Where a reward can have positive effects, a bribe can have the opposite outcome. For instance, if you plan to go out grocery shopping and agree to a reward of a chocolate bar should your child behave as expected then a reward is in play. However, if you go out to the store without an agreement  and your child has a meltdown because they want a chocolate bar, when you give in to this behaviour and buy them the chocolate, it is actually a bribe. Therefore, ensure you are making the distinction between rewards and bribes to ensure you’re using this transition tool effectively.

Additionally, rewards can be earned through using a First/Then Chart (or first/then language) which is a tool that visually explains what activity needs to “first” be done in order to “then” receive or do something the child may want.  For instance, if you have trouble getting your child to brush their teeth, you can say, ‘first’ we brush our teeth and ‘then’ we can read a book. With this sense of involvement and essentially partial control usually will lead the child to participate unknowingly.  

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  1. Slow down – As discussed, there can be numerous transitions in a day, and you may find that too many transitions are just too difficult for an autistic child. It may be for the benefit of the parent, childcare worker, teacher and especially the child to slow down and even eliminate some transitions. Not every transition is necessary.  Find the transitions that can be cut out and structure your child’s day for maximum success. 
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  1. Deep Breathing / Calming Strategies – Deep breathing and calming strategies are not only important for children, but they are also useful for parents, caregivers and teachers alike. In learning how to use breathing and other calming strategies one is better able to self-regulation thus helping ease the anxiety surrounding the transition. In trying to teach your child deep breathing, it is helpful to have your child start with blowing bubbles and after practice, they should have a good grasp of the breathing action. Keeping bubbles on hand can help during times of need and once the action is mastered it is a calming mechanism that can then be used anytime and anywhere. 

Your child must realize that transitions are not punishments and should therefore not be associated as such. Instead, your child should understand these are necessary throughout the day in order to follow the daily schedule. Having the parent, caregiver or teacher show excitement in moving through transitions may help in easing your child’s anxiety and difficulties. With your enthusiasm alongside your well thought out plan and tons of praise and encouragement, you will see changes in your child’s ability to transition smoothly. Be aware though, there may need to be frequent tweaks to your plan and schedules as this ensures the best modifications are being made.

In keeping in mind the many factors that contribute to your child’s difficulties with transitions and maintaining flexibility and open-mindedness you will help in easing their transition and in turn, set them up for success.

Autism and Transitions – 11 Tips: Part 1

Read time: 4 minutes


This post is quite long, so it will be divided into two parts for your reading pleasure!

Read time: 4 minutes

Transitions happen many times throughout our day and for the most part, as adults, we don’t necessarily even realize how often. While these transitions may not seem noticeable or bothersome to us, they are in fact quite difficult for most children and especially for autistic children. Being able to effectively transition between activities in our daily routines is imperative to leading a successful life: at home, school or at a job. Transitions include any change, big or small, such as a change of activity (especially from a fun one to a less enjoyable one), environment or teacher.

Autism Spectrum Disorder (ASD) is known to influence the way children process and interact within their environment and presents communication challenges, sensory issues and deficits in social skills.  All these challenges have an impact on the child’s ability to smoothly make transitions. It can be difficult for ASD children to shift attention or change from the comfort of their routine. These difficulties and stressors can lead a child to experience agitation, sadness or anger.  

All of these concerns need to be considered and addressed in order to help your child thrive. The first step in dealing with transitions is dealing with the associated worry around transitions. Understanding your child’s transitional issues, sensory sensitivities and concerns combined with creating a plan will better help your child to manage their worry connected to transitions. Being prepared and well equipped to assist your child before, during and following transitions is the absolute greatest support you can provide them. 

When strategies are used to help ASD children with transitions you can expect: a reduction in transition times; behaviours will improve during transitions; there will be less need for adult reminders and participation in school and community excursions will become easier.

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Sometimes, creating a plan for your autistic child can feel like you’re trying to solve a calculus equation.

In the preparation of your plan, it is important to understand what transitional issues you are dealing with, including your child’s sensory needs.  By observing your child for 3 – 5 days and jotting down each time your child gets frustrated or angered you will have a better understanding of what is going on. This review should include identifying the patterns and triggers that led up to the problems transitioning. For instance, does your child not like being interrupted to move onto the next activity if they are still working on the present one?  Do line-ups and busy hallways at school make it difficult for your child? Is there sensory stimulation such as bright lights or cold temperatures that may impact them and therefore affect the transition? Once you have identified the transitional issues then you can move towards creating a plan to account for these barriers. 

Transitional strategies are methods that, when used, can help autistic individuals manage during times of change or disruption in activities, routines or situations. As challenges can exist at any point during the transition, it is helpful to go over the techniques before, during and after a transition. This preparation strategy can (and probably should) be explained verbally and/or visually with the hopes of increasing predictability and maintaining consistency in their routine. 

Your child must realize that transitions are not punishments and should therefore not be thought of as such. Instead, your child should understand that they are required throughout the day in order to follow the daily schedule. Having the parent, caregiver or teacher show excitement in moving through transitions may help in easing your child’s worry and the challenging behaviour they exhibit. With your enthusiasm alongside your well thought out plan and tons of praise and encouragement, in time, you will see changes that are heading in the right direction. 

Here are 11 useful tips and strategies to use in the development of your plan; they are the stepping stones to helping ease your child’s transitions:

Read time: 4 minutes
  1. Prepare & Talk About Transitions – To help in ensuring a smooth transition, it is useful to plan out and discuss the plan with your child and support them before, during and after the transition. It is easier to deal with and manage your behaviour when you know what to expect. For instance, if you know you only have an hour at the zoo, then you should discuss this with your child prior to arriving. Knowledge is power and if your child knows what to expect the element of surprise will be removed and this will likely help with the transition. 
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  1. Time Warnings – Providing time warnings prior to a transition is quite helpful.  This allows the child to be aware that a transition is coming up shortly and can then better prepare themselves. Therefore, half an hour before the change of an event you can start to give 30, 15, and 5-minute warnings. As these verbal warnings may be too abstract for some ASD children, especially when time-telling is not yet learned, it is suggested to use a concrete tool such as a clock or a timer that can visually help to alert your child of the upcoming transition.  This visual tool can be reassuring during an unenjoyable activity as it shows the child that there is an end in sight. 
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  1. Countdowns – To go alongside the time warning strategy, it is also helpful to give final countdown notice.  So, instead of expecting your child to move right into the next transition once the final 5 minutes have finished, giving them a 10-second further countdown will continue to help with the transition.  Even though you may have provided the time warning, which may seem enough, the transition may still seem sudden to a child with difficulty transitioning. Adding in the additional and final 10-second countdown will certainly make your expectations clear. If visual tools are more effective then you can show your child a visual that has a countdown from 10-1. As you’re counting down you remove the numbers until your visual is empty and your child knows that the transition is imminent. This final countdown method can also be useful when doing unfavourable tasks such as cutting nails, bathing or brushing teeth as the child will know the end is near which helps with their coping.
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Picture from
Pocket of Preschool
  1. Create Visual Schedules – A visual schedule is a very useful tool when managing transitions. The schedule helps to reinforce the predictability that your child requires alongside outlining the events in a way that your child can review throughout the day. As autistic children often thrive with routine and consistency this visual method helps them see things in a format that they can clearly understand and remember especially if out of the ordinary things are going to happen. Being able to understand what the schedule holds can create opportunities for the empowerment of your child as they may be able to move through the transition on their own without coaching or reminding. 
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  1. Offer Options – Just like adults, children like choices. Having options gives them a feeling of empowerment and control. Therefore, offering two realistic choices allows your child to feel part of the decision.  For instance, when getting ready to leave the park you can ask would your child prefer to play on the slide or the swings in their last 5 minutes at the park. Achoice can be as simple as asking would they rather skip or walk to the washroom.  It is surprising how willing children are to participate when choices are offered.

Come back next week to read the second part!

Sleep Problems in Autism

Read time: 4 minutes

If reading’s not your thing, watch this YouTube video instead!

Research shows that children with autism spectrum disorders (ASD) tend to experience other problems that go hand-in-hand with ASD, which are known as comorbid conditions. This research estimates that the number of children with ASD who would qualify for also having a comorbid condition is approximately 70-80%. The range of comorbid conditions that exist can affect an individual’s mental and physical health, as well as impact them neurologically and medically. Some examples of how these comorbid conditions can manifest include an atypical reaction to one’s surroundings, sleeping disorders such as insomnia, and poor muscle development.

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It is very common for children to go through a stage where they don’t sleep through the night. This is actually a normal stage within a child’s physical and mental maturation. However, it is a stage that, should it be persistent, is detrimental to not only their health and development, but also their daily functioning. This can affect how they interact with others on a daily basis, especially in children with ASD. Researchers have also demonstrated that insomnia, on its own, tends to worsen the symptoms of ASD and lessens an individual’s ability to thrive in their life.

Existing research shows that there is a strong tendency for autistic children to have  problems with establishing proper sleep patterns and that they are impacted to a much greater degree than neurotypical children. Additionally, the studies also reveal that autistic children are at a much higher risk of developing these sleeping disorders than neurotypical peers. The number of autistic children who have trouble sleeping ranges anywhere between 44-86%. This is contrasted by the overall child population, where only 10-16% experience sleeping problems. 

Many autistic children who experience difficulties regulating emotions and behaviour are shown to also exhibit difficulties with their sleep. A past study of Asperger syndrome and other forms of autism discovered that the children who had persistent insomnia displayed greater emotional and behavioural symptoms than children without sleep disturbances. Parallel conditions are also known to disrupt sleep, some of which include gastrointestinal irregularities, stimulants, attention deficit hyperactivity disorder (ADHD), and anxiety. 

Child Sleeping

A study found in the academic journal Autism looked at the frequency that sleep issues in children with symptoms that are commonly associated with ASD occurred. The study participants were evaluated for symptoms relating to ASD, problems with their sleep, and emotional and behavioural issues. It was found that persistent insomnia was over ten times greater in autistic children than those who did not have ASD (39.3% vs. 3.6%). The autistic children were shown to develop more sleep irregularities over a period of time, with a frequency of 37.5% compared to 8.6% of the children without autism. Both groups were children aged 11-13 years. Even though only a few girls were included in the study, it was discovered that sleep abnormalities occurred less in girls than boys and their sleep problems were temporary. Those with ASD who also had ADHD were more likely to develop sleep problems.

Without question, it is clear that there is significant scientific backing that demonstrates the link between ASD and sleep problems. Sleep disturbances can, in reverse, negatively affect the symptoms of ASD, such as experiencing an increase in repetitive and/or hyperactive behaviour, lack of focus/attention, displays of aggression, and an impairment in higher brain functioning. Given all these potential issues, it is important for parents to attempt to maximize their children’s sleep habits and put routines and strategies in place that will allow their children to get the most quality sleep.  

Sleep hygiene are the practices that we use to ensure that we have good nighttime sleep and as a consequence good daytime alertness. 

Some examples of good sleep hygiene are:

  • Avoiding daytime naps
  • Establishing a bedtime routine that offers time to relax and wind down before actually trying to sleep
  • Making sure the sleep environment is comfortable
  • Going to bed and waking up at the same time each day (even on weekends)
  • Getting regular exercise
  • Avoiding blue light producing screens for an hour before bedtime

If your child is having a difficult time with sleep, contact Side by Side Therapy for a no-charge 30 minute consultation and we can brainstorm some ideas to help! 

2 Ways to Talk about Autistic People… or People with Autism

Read time: 5 minutes

Read time: 5 minutes

The subject of language is such an important factor in shaping the way we look at and interact with society. The connotations and assumptions that have been learned with language have moulded (intentionally or unintentionally) our perspectives and outlook.  These learned assumptions play a large part in influencing our way of understanding and looking at things and sadly, at times, one’s outlook can be detrimental to others. Stereotypes and labels, unfortunately, are often a misrepresentation of what some believe to be the truth and regrettably place barriers before those they view as ‘different’ or as ‘other’. We view difference as being bad. However, what does different mean and who decided this?   

When speaking on difference, the autistic community has struggled with being labelled and stereotyped as ‘different’. If we, as a society, could change our perspectives and look at autistic people not as ‘different’ or as an ‘other’, but instead see that in a lot of cases, the difference simply lies in their approach to how they cope in and interact with society. This shift in thinking could truly offer this community the respect and acceptance they deserve.  

To that note, there has been much debate and controversy surrounding the appropriate choice of language used when identifying or communicating with an autistic person.  This debate is focused on identity-first language (“autistic person”) versus person-first language (“person with autism”). Now, you may look at the above mentioned two forms of language and think these nuisances are based on semantics, however, if you look to understand and break it down the difference is not only important but rather quite clear. 

The concepts are:

  • Identity-first language which is the preferential choice of language for those within the autistic community. It is their preference for the use of words such as “Autistic” or “Autistic person” when being addressed, spoken or identified with. Since we know that autism is an inherent part of a person’s identity, it is believed that identity should be recognized first. The person cannot break away from autism. Therefore, from this perspective, identity-first language is a choice for empowerment, shared community beliefs, culture and identity.  It speaks to the fact that being autistic is nothing to be ashamed of and differences are to be respected and celebrated not criticized.

Versus

  • Person-first language has been adopted by parents, caretakers and professionals of autistic people and they use terminology such as “person with autism”. This viewpoint explains in essence, that person-first language puts the person before the disability or the condition and focuses on the merits and worth of the individual by accepting them as a person instead of a condition. This outlook taken on by caretakers, family members and professionals are based on the idea that they do not consider autism to be part of the child’s identity and therefore don’t want them to be labelled as such.      

The controversy, therefore, surrounding the use of person-first language as recognized by many within the autistic community, is that it suggests that a person can be separated from autism.  Autism is a neurological, developmental condition that’s considered a disorder with disabling effects. It is lifelong and does not on its own cause harm or death such as another disease might (such as measles… but don’t get my started on vaccine safety). Diseases, unlike autism, are often labelled through the use of “with”, such as, “person with cancer”. Autism, on the other hand, is part of a person’s individuality and make-up which shapes a person’s way of understanding the world and interacting in it. In labelling autistic people in the same way you would someone with a disease puts autism as inherently bad just like a disease, which clearly could not be further from the truth.

Consequently, this is why those within the autistic community are fighting to change this use of language to a more identity focussed instead of disability focussed point of view. Is it too far-fetched for us to respect the wishes of those to whom we are referring  and who can, in fact, speak on real-life experience and their identity? 

By understanding the differences and connotations associated with language and its use, alongside, respecting the wishes of those that identify as autistic is crucial. When in doubt of which language should be used while engaging with the community it is best to check amongst the group and its members. If you are still unclear, then I recommend you reach out and ask. 

In my writing, I will use identity- first language, unless I am asked to do otherwise by my collaborators or the person I am writing about. This goes against my training and habits, but I want to honour the voices and opinions of the autistics who have shared their wishes with us.

Remember, language is important and impactful in so many ways and can, unfortunately, have harmful consequences if used inappropriately.  For this reason, we need to recognize the way in which we choose to use language and continue to be cognizant of its outcome, always. 

11 Ways to Keep Your Autistic Child Safe at Home (ABA Therapy in Toronto)

Read time: 5 minutes

“I just turned away for a second, he was right here!”, have said many parents in a panic when noticing their child was not in eyesight. This panic luckily is often only momentary, as the child usually reappears quickly. However, wandering by children, especially for those that have been diagnosed with Autism Spectrum Disorder (ASD), can be frequent and for the parent/caretaker this can be frightening.  Wandering is one of the top safety concerns facing a child with ASD, however, it is not the only concern to keep in mind and prepare for. Creating a plan can be overwhelming and finding a starting point may be difficult. In hopes of helping, I have provided some useful ways to assist in your planning to keep your child safe, especially within your home. 

Aba Therapy - Safety first road sign

Safety within the Home

The home can become a dangerous place for children, especially those with autism, who face greater challenges around safety, awareness of surroundings and impulsivity. Parents put security and precautionary measures in place when all children are young but it is necessary to maintain these measures longer when their child has ASD. Here are some things to keep in mind when you are creating your safety plan. 

  •  Household Toxins – Cleaning products and related hazardous materials must be locked away in a secure place.  As children are very crafty and persistent, it may be useful to lock the unsafe items in the garage, basement or any other area outside of the main living areas. 
  • Furniture – Top-heavy furniture and large electronics should be secured to the wall with brackets and straps.  Toppling furniture from climbing children is extremely dangerous and can easily occur if these heavy items have not been secured properly. 
  • Drowning – If you or a neighbour has a swimming pool, it is necessary to ensure that drowning prevention measures have been put into place.  As mentioned, with wandering being such a high concern, if a neighbour has a pool within close proximity to your home, you must communicate your concerns to your neighbours regarding the safety of your child and ask that the safety measures are put in place at their home.  Some safety measures include fences with self-closing latches, as well as keeping interesting toys/items out of eyesight to not draw the child’s attention to the dangerous area. Since drowning poses a large risk, it is important to try and enroll your child in swimming and water safety lessons, the more tools your child has the greater their success. All municipalities have bylaws with regards to swimming pools in people’s backyards.  Research what the laws are where you live to ensure that your pool (or your neighbour’s pool) is following the law. 
  • Fire – Fire safety is of the utmost importance and needs to be practiced with the whole family.  As this training includes your child with ASD, you may need to modify and tweak your plan to work with any additional needs and sensory issues that your child may have. There are a few extra things that a parent can implement to help the process.  For instance, if your child becomes upset by loud noises, you can purchase fire detectors that you can record your voice giving directions to leave the house, removing the loud noise trigger and providing familiarity through your voice. Additionally, since children with autism are more comfortable with routine and familiar places, it may be beneficial to take your child during a calm period to a local fire station so they may become familiar with the uniforms and equipment.  The hope is that these measures will prepare and help your child better manage a real-life situation. Practicing fire drills at home in the same way they do at school will also be helpful for your child to become more comfortable if ever there was a real emergency. 
  • Hot Water – As many children with ASD also have sensory issues, some children cannot perceive hot or cold temperatures and this can lead to accidental burns.  This can pose as a safety concern especially if they are using the faucet independently. Some ways to teach your child the difference between the taps both in the sink and in the shower/bath is through practicing turning them on and off. As well, another tool you can use is a sticker to symbolize the dangerous tap or area of the tap. You can also control the temperature of the water on your hot water tank. 
  • Doors – With wandering being a high concern, the use of locks may be advantageous however they may not be full-proof. As keys may be well hidden, there is still the chance that they may be found, therefore, an additional safeguard through the use of an alarm system may be beneficial. If your child does find a way to leave unsupervised, you need to be vigilant in ensuring that they are always wearing some form of identification that contains their contact and any other pertinent information.   

Wandering

As wandering is one of the main safety concerns facing many parents of autistic children, it is necessary to take steps to reduce or eliminate this risk. 

Here are some ways to help keep your child safe from wandering: 

  • Understanding your child’s wandering triggers – Some children with ASD may wonder out of curiosity such as distractions from the park, train tracks, the beach – while other children wander to get out of a certain environment, such as ones that may be stressful, loud, bright, chaotic, etc. It’s important to know which type of wanderer your child may be to better understand how to avoid the behaviour. 
  • Keep your home secure – As mentioned previously, the security of your home is of the utmost importance in helping to eliminate wandering.  Locking doors, hiding keys and setting up an alarm system are tools that can be used to help in securing your home. 
  • Keep practicing and modifying communication and behaviour strategies – Teaching your child to request to go somewhere can be a very functional replacement behaviour for wandering. Helping your child learn self-calming strategies to use when they find themselves in stressful, boring or frustrating situations will help in them self-regulate and can potentially avoid wandering. Through trial and error, you will be able to find what works best for your child in these particular situations. 
  • Setting expectations are important – All parents know how difficult it can be preparing and accomplishing an outing, it can be even more difficult for a parent of an autistic child.  It is therefore imperative to outline and set your expectations with your child. You will need to communicate the plan, which can include approximate timelines and rules to be followed with your child and any other accompanying family members/caretakers. If everyone is on the same page and understands the expectations, the outing will likely be a more positive experience. 
  • Identification and monitoring technology are essential tools – Since many children with ASD are unable to easily communicate, these identification and monitoring tools are extremely helpful in tracking a wandering child. Having your child wear a form of identification (such as a bracelet/necklace, GPS, marked information on clothing, medical alert tags) will ensure that should your child get lost and be unable to communicate, all their relevant information (name, address, phone number, medical needs, etc.) is available to get them help.  

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The first step to help ease the worry around safety and a child with ASD is having an emergency safety plan in place. Evaluating and determining what your family needs to be safe and protected at home, school and the community will provide a helpful guide to protect your family for the dangers that exist. An example of an emergency safety plan can be found at family wandering emergency plan

The checklist below will provide you with a practical starting point.  

Safety Plan Checklist:

  • You need to determine if your child wanders, runs away or gets lost in a crowd?
  • You will need to evaluate areas such as home, school or community activities for safety concerns? 
  • Once areas of safety concerns have been reviewed, you will need to ensure that preventative measures have been put in place in all of those areas.
  • You should purchase wearable identification containing important contact and medical information that will always be worn by your child.
  • You should communicate with your neighbours and community that your child is autistic and may have special needs to be aware of (i.e. wandering).
  • You should communicate with your child’s school to create a plan which ensures that safety skills are included in their Individual Education Program (IEP). 
  • You should communicate with the local emergency service providers and let them know that your child may be at risk at given times.

Remember, if your child should wander:

  1. Stay calm
  2. Call 911
  3. Search nearby Water first
  4. Implement your emergency safety plan

Top 10 Sensory Friendly Places in the Greater Toronto Area to Take your Child with Autism

Read time: 5 minutes

Have you ever been in a situation where the music was just too loud or the lights were way too bright? How about being in a place that was far too overcrowded and you started to feel overwhelmed and panicky? Well, this is a common feeling for those that are diagnosed with Sensory Processing Disorder (SPD). SPD is related to over or under sensitivity to certain sensory stimulation such as loud noises, bright lights, tastes and touch. It is a condition that affects the way the brain receives and responds to information concerning our senses and has been found to create either an over or under sensitivity to certain things within our environment.  Those that suffer (children specifically for the purposes of this article) with SPD often receive a comorbid diagnosis that may include Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD). 

Since SPD is so prominent in children especially for those that also suffer from the additional disorders, life can become difficult for not only the child but for the parents and caretakers as well.  This sensory sensitivity can be very debilitating and sadly can turn a task as simple as going to the grocery store into a very difficult undertaking. Here in the Greater Toronto Area (GTA) in Canada, some companies have caught on for the need to provide alternative accommodations for those that live with special needs like  SPD, ASD & ADHD etc. These establishments have collaborated with autistic focussed organizations to find ways to modify their businesses to provide a sensory-friendly environment.  

Child plugging her hears and shutting her eyes tight.
It’s easy to become overwhelmed by the sensory stimuli in the environment. These GTA attractions are working to help your child manage these times.


Below you will find some of the places around the GTA that are now offering these sensory-friendly settings.

1. Ontario Science Centre – 770 Don Mills Road, Toronto, ON M3C 1T3The Ontario Science Centre offers Sensory-friendly Saturdays on the first Saturday of every month from 3 – 7 p.m. They have partnered with Geneva Centre for Autism and other organizations to offer sensory-friendly events and programs. Sensory-friendly Saturdays were created to provide an environment that is inclusive, respectful and accessible. Their program is available to everyone and is appropriate for all ages and abilities. 

The following dates are set for 2020:

February 1, March 7, April 4, May 2, June 6, July 4, August 1, September 5, October 3, November 7 and December 5 
For more information please visit their website at: https://www.ontariosciencecentre.ca/showsandexperiences/368/ 

2. Toronto Zoo – 361A Old Finch Avenue, Toronto, Ontario, M1B 5K7

The Toronto Zoo has developed a downloadable app specifically for those with ASD. This app called MagnusCards (for more information please visit http://torontozoo.magnuscards.com/) was created to provide a structured, step-by-step program that has a game-like design which helps teach a variety of life skills through the use of the app. This app is believed to provide empowerment and a welcoming environment for those living with autism and other cognitive special needs.  The five-card decks include information on entering the zoo, Indo-Malaya, Tundra Trek, African Rainforest Pavilion, and Getting Help.      

For more information please visit their website at: http://www.torontozoo.com/tz/accessibility 

3. Cineplex Movie Theatre – Variety of Locations

Cineplex theatres offer “Sensory Friendly Screenings”, which includes a “lights up and volume down” environment.  In partnership with Autism Speaks Canada, Cineplex provides an atmosphere that allows those individuals with ASD or those who suffer from sensory sensitivities the opportunity to enjoy new releases at the theatre.  The website states that these screenings will take place approximately every 4 – 6 weeks on Saturday mornings at 10:30 AM, however it is best to check your local theatre in case any changes have taken place. 

For more information please visit their website at: https://www.cineplex.com/Theatres/SensoryFriendly 

4. Royal Ontario Museum (ROM) – 100 Queen’s Park, Toronto ON, M5S 2C6

The ROM has teamed up with Autism Ontario to create a “ROM Sensory Friendly Guide”, where they provide helpful tips for visiting. The guide speaks on different areas in the museum that could affect someone with sensory issues (such as loud noises, lighting, scents, temperature, sloped floors and crowded areas). It also outlines where there are quiet areas around the museum. 

For more information please visit their website at:

https://www.rom.on.ca/en/visit-us/accessibility/rom-sensory-friendly-guide-for-visitors

5. Ripley’s Aquarium of Canada – 288 Bremner Boulevard, Toronto, ON M5V 3L9, CANADA

Ripley’s Aquarium of Canada is the first autism certified attraction in Canada.  This Certified Autism Center has been designated by the International Board of Credentialing and Continuing Education Standards (IBCCES) after completing comprehensive autism awareness and sensitivity training.  Ripley’s Aquarium is committed to ensuring that their visitors with ASD and other sensory sensitivities have the greatest time while at the attraction. The staff have undergone extensive training and each exhibit integrates some form of IBCCES sensory guidelines (https://www.ripleyaquariums.com/canada/files/2019/04/Sensory-Guides-Final.pdf) which provides the guests with additional information regarding the sensory impacts at each display or activity.  Please check out their website for dates and times as they will be hosting several additional sensory-friendly days that include quiet spaces, music-free environments and increased lighting. 

6. Chuck E. Cheese – Various locations around the GTA

Chuck E. Cheese offers a sensory-friendly experience the first Sunday of every month at participating locations, this includes opening doors two-hours before their regular opening times.  The organization realizes that the Chuck E. Cheese experience can be overstimulating and therefore wanted to provide an opportunity for those that suffer from sensory sensitivities to come out and have fun with well-trained staff.  As it is their mission to provide an event that allows “ALL kids to be a kid”.

For more information please visit their website at:

https://www.chuckecheese.com/events/sensory-sensitive-sundays

7. Skyzone – Various locations around the GTA

Skyzone offers activities such as trampolining and jumping along with a wide variety of other programs. At Skyzone, visitors are provided with a fun experience that allows them to burn off energy in an extremely fun way.  Skyzone offers sensory-friendly hours which provides a calmer, toned-down jumping experience for those with special needs. 

For more information please visit their website at:

https://www.skyzone.com/programs/sensory-hours

8. Sobeys – Various locations around the GTA

As mentioned, tasks for which most would think is simple such as grocery shopping can be an anxiety-ridden experience for both a child with ASD and their parent/caretaker.  Grocery stores can have a lot of sensory stimuli such as loud music, bright lights and crowds which can be overwhelming for a child that suffers from sensory sensitivities. Sobeys has taken notice of this issue and has now created an accessible and inclusive sensory-friendly shopping experience.  To accommodate the sensory needs, Sobeys provides every week, a two-hour shopping window where they eliminate almost all the in-store lights and sounds. Some of the sensory sensitivity measures taken by Sobeys are turning down the lights, turning off scanners, lowering music, having staff members speaking in softer tones and holding off on any announcements. According to Sobeys, the sensory sensitive shopping takes place currently on Wednesdays from 6 p.m. to 8 p.m.  Please check with your local Sobeys for up to date information on dates and times. 

For more information please visit their website at:

https://www.blogto.com/eat_drink/2019/09/sobeys-sensory-friendly/

9. Young Peoples Theatre – 165 Front Street East, Toronto M5A 3Z4

Young Peoples Theatre offers “relaxed performances” where the performances are the same however there is a more relaxed atmosphere relating to noise levels and movement.  The sensory sensitive measures include the house lights being adjusted so that they are not as dark as they normally would be. They have also created designated relief areas where you can go if a break is needed.  For the ease of your child’s visit the theatre has also created a visual visiting guide that can be looked over with your child prior to your arrival to help eliminate any fears or surprises that could arise. 

The visual guide can be found at:

10. Upper Canada Village – 13740 County Road 2, Morrisburg, Ontario

Upper Canada Village is nestled up in Morrisburg Ontario and offers visitors an exciting experience of what life was like back in the 1860s.  Through transporting back in time, visitors are able to explore authentic buildings, activities and the people of the time. Upper Canada Village offers ASD sensory-friendly Sunday mornings where a child with sensory sensitivities will be able to enjoy the attractions is a less chaotic and overwhelming environment. They provide some helpful tips on their website for visiting the village with a sensory sensitive child.

For more information please visit their website at:

https://www.uppercanadavillage.com/events/asd-sensory-friendly-sunday-mornings/

Enjoying fun and memorable experiences is so important for children and even though your child may suffer from sensory sensitivities it is comforting to know that particular companies are working towards creating inclusive and accessible environments for ALL children to feel welcome and be able to enjoy their time. 

8 Things To Do to Help Your Child Succeed with an Autism Diagnosis

Read Time: 5 minutes

The word autism in a magnifying glass.

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 (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 for facing an ASD diagnosis and treatment:

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

Each child with ASD is different and we need to embrace, understand and support their differences. This can be achieved through research and asking questions about ASD 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 ASD. 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 ASD 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 be on the spectrum 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 ASD 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 alongside an ASD 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.   

8. Work on Establishing a Good Sleep Routine

One of the challenges many children with ASD 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