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Why is ABA Therapy so expensive?

Read time: 3 minutes

Imagine you’ve just been told your child has autism spectrum disorder. You rush home and start googling. You find that Applied Behaviour Analysis or ABA Therapy is the gold standard treatment for autistic children. You’re sold. That’s what you want for your child. You call some providers. You make a few appointments. At the first consultation, you ask about the cost of therapy.  The therapist explains that the fees are per hour and the total cost depends on the number of hours of therapy per week.  Oh, and don’t forget the cost of supervision (wait… what’s supervision?). At the second consultation the therapist explains the same thing, but adds on an ‘administrative fee’ that’s paid yearly. You rush home and start googling… again. Why is ABA Therapy so expensive? 

Mother researching ABA Therapy for autistic child.
Photo by Anastasia Shuraeva on Pexels.com

Here are 6 reasons ABA Therapy is costly:

Federal & Provincial reasons:

  • To begin with, Ontario doesn’t regulate Applied Behaviour Analysis.  Most of the other disciplines that work in autism treatment have regulatory colleges (Psychology has the College of Psychologists of Ontario, Speech has the College of Audiologist and Speech-Language Pathologists of Ontario, OT has the College of Occupational Therapy of Ontario etc). Nothing similar exists for Behaviour Analysts. Because there’s no regulation, getting services for your child can be like the wild west. There is the Behaviour Analyst Certification Board, but they’re not a regulatory body. 
  • Moreover, ABA isn’t considered a medical intervention and isn’t covered by OHIP or private health insurance. Again, this goes back to the lack of regulation. Considering ABA Therapy as medically necessary would mean that the government would fund it and insurance companies would pay for it. There is a movement to make autism therapy medically necessary. This change would mean that the federal and provincial governments have to fund autism therapy (ABA, as well as others like Speech, OT, Physio) at the prescribed dose. The prescribed dose would be different for each child, depending on their needs.
  •  Lastly, there aren’t enough clinicians for all the children who need them. System capacity is a big problem in Ontario. We’re in a bit of a catch 22. There aren’t enough clinicians. However, lowering the training standard for future clinicians isn’t an option. Children and families deserve the best therapists possible and that takes time and investments in education and training from the province. 

Structural Reasons

  • Many ABA Therapy programs are 1 on 1. You could be paying one person’s entire yearly salary. Group programs are less costly because the salary of the clinician is divided between the people paying for services. Some children can learn in a group setting and some just can’t.  
  • There’s more than just the therapist who works with your child. In most cases, an Instructor Therapist (IT) /Registered Behaviour Technician (RBT)  is doing the direct treatment with your child. One or two levels of clinical supervisors guides the ITs work: a Senior Therapist (ST) and a Board Certified Behaviour Analyst (BCBA) or Psychologist. Most Instructor Therapists have a college diploma or a bachelor’s degree related to ABA. Also, most Senior Therapists are working towards becoming BCBAs and have many years or experience doing ABA in a variety of settings. To become a BCBA you need to have a masters degree in ABA, complete 2000 hours of work experience and write a board certification exam. Having the layers of supervision is a way of cutting down the cost to the family (as backwards as that sounds). Most Instructor Therapists do not have the skillset to assess and design the intervention plan. However, most families do not want to spend their money on having the BCBA deliver the intervention. This is because the BCBA’s hourly rate is often 3 times higher than an Instructor Therapist. 
  • In addition, every ABA Therapy program is individualized for the child. This takes time and expertise. The basis of ABA is data analysis. And the IT, ST and BCBA should be spending time analysing the data, finding trends and making changes to ensure learning. Also, many therapists make teaching materials that are specific for the child. For example, if teaching colours and the child really likes the movie Cars, perhaps using pictures of the characters would be motivating. This individualization helps increase the rate of learning.  

Conclusion

There are a number of reasons that ABA Therapy costs as much as it does. These are just a few. Changes are needed. They will benefit the field and the children and families that access ABA services. Financial means should not be a barrier to receiving the best treatment. 

Autism in Ontario: What funding is available?

This will be the first instalment in a series about the funding for autism families in Ontario.

I’ve worked in the field of Autism and ABA therapy for 16 years. I’ve worked with a lot of children under different funding circumstances. Some (few, very fortunate) families have the means to pay out of pocket for the services that their child needs. Most families rely on provincial and federal funding to pay for therapy and other services that their child requires. When the funding is used up services are often put on hold.

According to a report released by the Ontario Association for Behaviour Analysis, the cost of supporting a child with autism can range from $26k to $130K per year.

Having my own therapy services company has allowed me to see the heartbreak of a family pausing services. Services that were improving their child’s life. Services they just cannot afford. We offer a sliding scale, we work with families to figure out payment plans, we advocate to the government. Sometimes families just don’t have another option and pausing services is necessary.

Mom sitting at desk, worrying about her child's Ontario Autism Program funding.

What autism funding is available to families?

There are a few different programs that cover some of the cost of raising a child with autism. Right now, families in the province can apply to the Ontario Autism Program for funding for their children with autism diagnoses. The funding allotments are based on age. With children under 5 years old receiving $20K and children over 6 years receiving $5K. In August, I wrote a short blog post about the OAP‘s history. The government claims to be working (but this post isn’t about politics!) towards implementing a needs-based funding model. Needs-based funding gives families the funding they need to get the therapy their child requires. Side by Side Therapy offers excellent ABA Therapy near me.

Special Services At Home (SSAH) is a provincial program that helps families pay for services both inside and outside of the home. The amount of funding that each child receives is based on what their needs are, what other services they are accessing and other available community resources. SSAH funds are meant to aid families in two broad areas: personal development & growth and respite. Also, there have been changes to the SSAH eligible expenses due to Covid19.

Assistance for Children with Severe Disabilities is a fund for low to moderate income families who have a child with a severe disability. The funds provide financial relief for families raising a child with a severe disability. The amount of funding received depends on the size of the family, the family’s income, the severity of the child’s disability and the costs associated with raising the child.

What else is out there for autism families?

Disability Tax Credit (DTC) provides tax relief to a person with a disability or their parents (if under 18) to account for some of the cost of living with a disability. To qualify, a medical practitioner has to complete a form that states that your disability is severe and prolonged.

Registered Disability Savings Plan (RDSP) is a savings plan that helps parents or others save for the future of a person with a disability. Withdrawals made from an RDSP they are not considered taxable. The beneficiary of the RDSP must qualify for the Disability Tax Credit.

Canada Disability Savings Grants (CDSG) is a matching program offered by the federal government. They will match your deposits up to 300% (Based on your income and your contribution). You must have a RDSP to qualify for the grants. Canada Disability Savings Bonds (CDSB) is the money that the Canadian government contributes to the RDSP’s of low and modest income families. You can receive up to $1,000/year with a maximum contribution of $20,000. The amount you receive is dependent on your family’s income.

Autism Ontario has some one to one worker reimbursements available for families. The child’s name is entered into a draw when the application and proof of diagnosis are submitted. Approximately 500 children receive the grant each year.

Jennifer Ashleigh Children’s Charity is available for families experiencing financial pressures of raising a child with special needs. The fund covers a variety of things from emergency costs to housing costs incurred while caring for your ill child. They also cover some therapies.

Conclusion

A parent pointed out to me that perhaps it isn’t the number of funds or the amount of money that’s available that is lacking in our province. But rather that the application process is too difficult and too confusing for many families. Come back soon to read more about the funding in Ontario.

How to use visual schedules to reduce challenging behaviour

Visual schedules can help an autistic child be less anxious. They present daily activities, as well as the sequence in which these activities will unfold. A high level of predictability brings comfort and will even reduce challenging behaviour. 

Depending on the child’s developmental level, the schedule can be made with photographs, drawings or pictures. Sometimes they can have written words or actual objects. The schedule can be displayed on a wall or on paper. For children who go to school, the schedule can be placed inside a notebook. 

Also, parents can add a todo list to each activity. This shows all of the steps the child needs to take in order for a specific task to be completed. 

Are visual schedules effective at reducing challenging behaviour in autistic children?

Yes. According to a study published on solutions to decrease challenging behaviour, the use of activity schedules can help children who have been diagnosed with autism spectrum disorder. 

The study showed that visual schedules worked for children with difficulty following rules. The authors point out that visual schedules promote self-regulation and independence.

The introduction of a visual schedule is particularly important when it comes to children who have academic demands to meet. These children sometimes have difficulties meeting these demands, and this is where the challenging behaviour commonly occurs. The visual schedule can reduce the stress experienced by parents as well as promote learning and cooperation in children. 

Example of a visual schedule on the wall of a classroom.
autism aba therapy lindsey malc side by side therapy visual schedule

Why should you consider visual scheduling? 

Visual schedules offer the perfect opportunity to teach an autistic child to complete the required activities in a day. Thanks to the todo list, you can break down a task into smaller steps, which are easier to complete. Small steps are easily achieved and provide opportunities for more frequent reinforcement.

Visual schedules offer to the child one of the things they look for the most: predictability. As they will learn to use the schedule, they will often become less anxious. Moreover, by using prompts and reinforcement, as you have been taught by your Board Certified Behaviour Analyst, you can decrease resistance and escape maintained behaviours. 

In simple terms, you can see the visual schedules as a constant reminder for your child. They will know exactly which activities to complete every day and where they will occur. Most importantly, they will know the order in which things will happen. . 

How to use visual schedules to improve your child’s behaviour 

As with any new intervention, you should expect for the child to resist the introduction of a schedule. Practice together, using plenty of praise and reinforcement.

Be patient and give your child the time they need to become comfortable with using the schedule. Keep in mind that some time might pass before they accept the visual prompt, following the routine as expected. At first, offer schedule check reminders frequently.

In time, and after plenty of practice, the child will indeed turn to the schedule, enjoying its predictability. The interesting thing is that, by predicting and in turn enjoying the activities you have included on the schedule, your little one will have fewer opportunities to misbehave. 

Be sure to acknowledge the efforts the child is making in following the schedule. Use simple phrases like “good job checking your schedule” or “nice work keeping up with the to do list”. You can give your child thumbs up, offer a smile or offer a hug. What matters is that you recognize they are trying, celebrating even the smallest achievement together.

You can try adding a preferred activity at the end of the schedule alternatively, so that he/she will understand that he/she can engage in that activity once everything else has been completed. Offer options to children who are able to choose; if your child has trouble making choices, select an activity you already know he/she enjoys. 

Will visual schedules bring a difference to our daily routine?

Once again, the answer is yes. The child will learn to follow a simple schedule, becoming more organized as a result. He/she will thrive from knowing what lays ahead, no longer feeling confused. The familiar routine presented through visual aids will genuinely reduce the level of anxiety your child feels.

Using visual schedules will help your child make transitions between activities as well as between tasks within an activity. By using the todo list, and presenting the child with the exact steps to follow for an activity, you will reduce the risk of inattention and/or misbehaviour.

Using a visual schedule will give your autistic child a better chance to succeed. Challenging behaviour meets an unmet need that your child is experiencing. Challenging behaviour can be attributed to one of the 4 functions of behaviour.

What is Social Communication?

Read time: 3 minutes

Autistic children face challenges daily, and social communication is one of the most difficult to conquer. What is social communication? Challenges in social communication are associated with autism diagnosis. However, each child is unique and is impacted to a different extent. Some children may  start an interaction, while others will prefer their peers initiate the exchange. While autistic children might show an interest in engaging with others they can still have challenges.

Don’t make the mistake of believing that autistic children do not want to interact. The key here is to support them in interacting with their peers, offering tools for adequate communication. 

Social communication is a group of skills that include both verbal and nonverbal communication, social interaction and understanding others (Children’s Minnesota) . Many people just seem to have this skill naturally. Autistics often need direct teaching in order to master this skill. 

Why is social communication difficult?

The first thing we have to remember is that many autistic children need support in learning how to communicate. Some of them may not respond when talked to while others require a bit of time to plan an answer.

Eye contact is a major issue. In our society, eye contact is a very important behaviour.  A lot of value is placed on looking ‘someone in the eye’ or showing that you’re paying attention by maintaining eye contact. Many autistic children avoid it altogether, while others find it uncomfortable.

Eye contact used to be considered an essential goal.  However, recent research and an effort to include the voices and experiences of autistic adults has decreased the value and necessity of these types of goals.  Many clinicians are adopting an approach that teaches replacement behaviours that meet the same goals as eye contact. For example, one of the biggest reasons people give eye contact is to convey that they are paying attention and understanding the other person.  Alternative behaviours, such as turning your body to the speaker, nodding, saying words like “I see”, “I know what you mean”, “I get it” all convey the same message and do not require eye contact. 

While a typical child will learn through imitation, an autistic child will likely need explicit teaching. It is important not to give up and consider the child’s point of view. If he/she cannot communicate his/her own wants and needs, frustration can easily build up.

Things to work on in therapy

Social communication represents one of the main therapeutic objectives in many ABA Therapy programs. Depending on the age of the child and his/her developmental level, the therapist will teach the child how to interact with others and interpret their behaviour correctly. With older kids, one might also work on teaching the effect one’s own behaviour has on others.

Therapy will involve teaching the child to recognize and understand social cues. As mentioned, these children do not show these behaviours instinctively and they need to learn how to adjust their behavior to fit each social context. 

Language is a huge part of social communication. Using social situations, the therapist will work on both the expressive and receptive language. Taking into account the potential of the child, they will work not only on verbal communication but also on body language and facial expressions. He/she will also teach the child to adapt his/her tone of voice when possible.

Two girls engaging in social communication, sitting on the ground in a forested area.

It is a fact that autistic children often take things literally, which can lead to frequent misunderstandings. For this reason, when appropriate, therapy will include teaching the child to understand figurative language, including metaphors.

How will therapy help improve social communication?

While the beginning might be slow, over time the child will develop their abilities to interact. They will become more confident, seeking interaction with peers. Improving social interaction skills will remain a primary aim throughout all therapeutic sessions.

As in all ABA programs, each objective will be broken down into manageable steps. Often, the therapist will provide visual support and plenty of opportunities for the child to practice the newly learned skills. Positive reinforcement makes the behaviour more likely to happen again and it has the added benefit of boosting the child’s confidence.

In time, and provided the child’s development allows it, the therapeutic objectives can become more complex. Autistic children can learn to interpret subtle non-verbal cues and also to recognize emotional responses. They can master conflict resolution and pick up the best ways to develop friendship skills. Social Communication therapy can be funded by the Ontario Autism Program.

What about non-verbal children?

Non-verbal children can communicate using various strategies, but they will need help. The therapist can teach them to use gestures or sign language to communicate and introduce augmentative and alternative communication systems.

Some autistic children might never speak. But this does not mean the gate to social communication is shut. They still have plenty of opportunities to communicate with their peers, and it is up to the therapist to find the best solution for a non-verbal child.

Conclusion

While we can improve social communication in therapy, it is also important to educate people on the challenges autistic children face in this area. It is all about accepting differences and meeting these kids on their level, welcoming and honouring any form of communication and/or interaction.

Early #Autism Diagnosis: Key to Successful Intervention

The signs of autism can become noticeable around the age of 18 months. Despite this, on average, autistic children receive their diagnosis at age 4 or 5. The delay is often deliberate, hoping the child will grow out of his/her condition, or to avoid labels, such as “autistic”. Getting an early autism diagnosis for your child will only benefit them.

Unfortunately, the delay in the diagnosis equals lost years of intervention. No child recovers on his/her own from autism. It takes a lot of effort, therapy and a transdisciplinary approach to enhance the quality of life for an autistic child. The earlier the diagnosis, the more time that child will have to reach their full potential.

Taking advantage of the brain’s neuroplasticity 

The human brain possesses an incredible ability called neuroplasticity. Basically, neuroplasticity refers to our brain’s ability to adapt and change. The brain can learn and grow to overcome challenges. If a specific part of the brain is damaged or not working correctly, it can develop ways to work around the deficits. Autistic children need to start therapy as early as possible and take advantage of this ability in our brains. The older the child, the more difficult it will be for their brain to change and adapt.

To understand how beneficial early diagnosis in autism is, try not to think of the brain as a static organ. The complex organ is more flexible than we might think, adapting over time and compensating for lost functions. Regular therapeutic interventions, like ABA therapy, can help the autistic child’s brain build new pathways. 

Black toddler smiling playing with toys in a white room during an early autism diagnosis.

Early diagnosis, also beneficial for parents

Parents are usually the first to notice that their child isn’t developing as expected. Getting an early autism diagnosis can relieve distress and help parents focus on next steps. They can seek early intervention, form a support network and they can access several benefits, such as the Registered Disability Savings Program.

Taking your child to a doctor for an assessment is the first step to getting them help. Under the guidance of autism specialists, you will come up with an intervention plan and help your child learn.

Starting therapy from a young age

With autistic children, the key word is “early”. The earlier autism diagnosis and the earlier intervention, the more of a difference it will make. In therapy, the child can develop social and communication skills, and work on challenging behaviours. They will learn new skills and become more independent.

An autistic child who goes to therapy from a young age can develop their strengths, and work toward a better life quality. A diagnosis made within the first three years of life offers the best long-term outcome. Most parents only seek intervention after receiving the diagnosis, but your child can go to therapy before that. You can address worrying signs and work on teaching skills. Reach out to us at Side by Side Therapy to hear about the Early Start Denver Model, an ABA/developmental approach to teaching children with or suspected of autism.

Warning signs of autism

Each child is unique. The warning signs might differ and they might be present at various levels. 

Even though you might notice the following signs, getting an accurate diagnosis is vital. Only a specialist can determine if your child has autism and point you in the right direction. If your child gets a diagnosis, they will have access to services and programs that would otherwise not be an option.

Warning signs of autism:

  • Lack of facial expressions, child does not smile 
  • Limited or absent eye contact
  • Speech delays (no words by 16 months, no two word combinations by 24 months)
  • Does not respond to his/her name
  • Loss of previously gained skills 
  • Does not point to items of interest
  • Does not like changes (routine, environment)
  • Stereotypical gestures
  • Prefers to play alone, does not engage in pretend play
  • Echolalia (persistent repetition of words/phrases, heard recently or in the past).

Early diagnosis, the first steps of the journey

It’s hard to find out that your child has autism. But the diagnosis will give you clarity of mind and help you take the first step of the journey. Together with autism therapists and a powerful network of support, you will create a path forward for your child.

Trust your instinct, especially if you have noticed one or several warning signs. Do not wait until your child is older. Go to a specialist now. 

Things You Need To Know About Language Delays

Often autistic children have language delays. Receptive language is the ability to understand information provided by other people, either verbally or in writing. Expressive language is the ability to put our own thoughts into words, both spoken and written. Speech therapy can help your child learn these valuable skills.

Autistic children might have a language delay, meaning their communication skills are not developing as expected. This delay can affect the receptive or expressive language and, in some situations, both. When the child does not follow a typical developmental pattern, all areas of their learning and development are impacted.

Language delays add to the complexity of ASD

Language delays add to the complexity of an autism diagnosis, having a negative impact on socialization and academic performance.

When a child has poor language abilities, she might find it hard to interact with peers. Children rely on verbal cues to play and take part in games, not to mention they need to understand language to follow instructions. The struggle is complex. The child cannot use expressive language to convey her thoughts. In addition, she might have a hard time understanding explanations or directions.

Toddler sitting on mother's lap with a speech therapist discussing her language delay

Receptive language disorder

When receptive language is delayed, the ability to understand words and associated concepts suffers. During the initial assessment, the therapist will determine the level of comprehension and establish an intervention plan.

Receptive language disorder is common in autistic children, affecting their ability to understand spoken language. The child might not follow directions, answer questions, or identify various objects. she might not understand gestures and their reading comprehension might suffer.

How does therapy help?

The speech-language pathologist can help the autistic child improve her receptive language. After identifying areas of need, the S-LP will use strategies to increase the level of comprehension. During therapy the S-LP will work on expanding comprehension, identifying pictures, following instructions and more. Progress will result in a higher level of independence and participation in activities of daily living.

Expressive language disorder

Many autistic children have difficulties in expressing their thoughts using words. Very often the expressive language is more affected than the receptive. Thus, the speech-language pathologist will concentrate on helping the child with the production of sounds and words. Visual support might facilitate the learning process.

Initially, the therapist will assess the child’s ability to use spoken language. She will also assess the child’s non-verbal communication. Based on the identified weaknesses, she will develop an intervention plan.

Autistic children who suffer from an expressive language disorder might have difficulties communicating their wants and needs. For instance, they might not say when they are hungry or if they need to use the toilet. Common struggles include using appropriate gestures and facial expression, correct choice of words and asking questions.

How does therapy help?

The S-LP will work to improve expressive language. During therapy, she will use strategies to teach the child to communicate her wants and needs. As therapy progresses the child will learn to express more complex thoughts and ideas.

The therapist might also use an augmentative and alternative communication system (AAC) to increase the expression of thoughts and feelings. Some examples are PECS, high-tech systems (LAMP etc) or even sign language. For more information about AAC read this blog post.

Mixed receptive and expressive language disorder

It can happen that both the expressive and receptive language abilities are impacted. In this situation, the speech-language pathologist will have to work on both areas, helping the child progress towards greater ease of communication. The earlier one starts intervention, the better the outcome is likely to be.

The most important thing to remember is that language impairments become visible as early as the first two years of life, when one can still take advantage of the brain’s neuroplasticity. Parents should be active in the intervention process, as they need how to communicate with their child and meet her on her level.

Patience is key in working to develop language abilities in autistic children. In the beginning, prompting and offering instructions in multiple steps might be highly beneficial. Also, one should provide the child with adequate time to respond. Visual supports can be useful in helping the child overcome any existing challenges and even to establish long-term communication.

You can read about language development milestones here.

How To Choose A Speech-Language Pathologist

For parents knowing how to choose a Speech-Language Pathologist can be tricky. The diagnosis of autism often involves language delays, causing parents to wonder what steps they should take in terms of intervention. Naturally, every parent wants the best for his/her child, including in therapy.

A Speech-Language Pathologist can help your child learn to communicate more effectively. But how can you be certain you have chosen the right S-LP? What are the things you should look for and what are the right questions to ask?

Two women sitting at a table talking about how to choose a speech-language pathologist.

Things to consider in choosing a Speech-Language Pathologist

This might sound like a given but you need to choose a therapist that has experience in working with children. This kind of specialist will know how to approach the child so he/she feels comfortable. Therapy should look like play, especially for young children.

Experience is essential. A knowledgeable Speech-Language Pathologist should interact with the child through play, opting for subtle strategies to improve communication. He/she should involve the parents in the intervention. A transdisciplinary approach always guarantees the best results, and he/she should include parents at all times.

A good therapist knows that parents play a major role in the therapeutic progress the child will make. The S-LP should teach parents strategies to use at home, taking parental input and comfort level into account.

From a pragmatic perspective, you can get referrals or research for Speech-Language Pathologists online, looking at your province’s College of Speech-Language Pathologists. You can also ask your child’s paediatrician or the school counsellor for a recommendation. Other parents are also a good resource. Once you have found a therapist, be sure to inquire about certification and additional education on autism intervention.

Questions to ask when choosing a Speech-Language Pathologist :

When choosing a Speech-Language Pathologist it is normal to ask questions. It might be a good idea to start by asking about the experience that they have.

Don’t be afraid to ask about the methods used and the reasoning for choosing these. The S-LP should also be able to provide evidence supporting her/his recommendations and point you toward resources where you can learn more.

These are some questions you might ask:

  • Who will work with my child?
    • Often, the Speech-Language Pathologist is part of a transdisciplinary team, which includes a speech therapy assistant, a behavioural therapist, occupational therapist, educator and so on.
  • What are the primary objectives of intervention?
    • You will work on these together but as a general rule the principal aim is to improve communication and social interaction. In some children, feeding and swallowing issues might also be addressed.
  • How many years of experience do you have with autistic children?
    • This is not necessarily relevant, but it can help you get an idea about how knowledgeable the SLP is in this field. Follow up with some discussion about previous cases and outcomes.
  • What is your treatment philosophy?
    • You are putting your trust in a new person, so it is important to know this. A good therapist will work with the family. He/she will always take the child’s needs into account.
  • Do you use AAC (Augmentative and Alternative Communication)?
    • This is important, as it is beneficial for many autistic children at the beginning of therapy and even later on.
  • How do you gain the trust of a child?
    • Some children require time to trust a new person. A good therapist will respect the child and his/her uncertainty, putting his/her emotional well-being in first place. Therapy should be offered through a lens of caring and empathy.

Practical questions are important as well:

  • What does the initial assessment entail?
  • Can I use my insurance to pay for therapy?
  • Are your services available right now? Or do I have to join a waiting list?
  • How many hours of therapy are recommended per week? And how long is a therapy session?
  • Are parents allowed to observe therapy sessions?
  • How is the intervention plan established? Are we allowed to offer suggestions?
  • How is the progress the child has made assessed?

Do not hesitate to ask as many questions as possible, as this process will help you choose a Speech-Language Pathologist for your child. It never hurts to follow your instinct, as parents often have a gut feeling telling them they found the right person for the job.

Autistic Teenagers and Adults Getting Jobs

Read time: 2 minutes

An autism diagnosis should not stop anyone from being a productive person and bringing his/her contribution to society. Both autistic teenagers and adults can get jobs, but they will likely need more support to achieve their goals.

Woman standing on a ladder spray painting words related to autistic teenagers and adults finding jobs.

Whether a teenager looking for his/her first job or an adult who already has some experience, there are two things to remember.

  1. You should have a job you want, one that brings you a sense of purpose.
  2. You should consider both your abilities and potential challenges.

Employment as an Autistic Teenager

If your autistic teenager is on the lookout for his/her first job, there are plenty of things you can do to help. Have a discussion about potential interests, suggest where to search for a job. When suggesting jobs, take his/her strengths into account. For instance, some people prefer working alone on the computer, while others might like routine tasks.

As the parent, you are the one who knows your child best. You know what he/she wants and what he/she would be successful in. Consider both these aspects when thinking about employment goals. Talk to the career advisor at school about things that he/she should do first, such as vocational training, internships or volunteer work.

You can help by listening to what your teenager has to say. Offer encouragement but make sure his/her goals stay realistic. Work to develop a support network which might include people capable of understanding challenges that he/she needs to overcome. School teachers, family friends or other professionals can be part of this network.

Whether in ABA therapy or at home, work on developing communication and social skills. Seek opportunities for organized activities, such as teams and clubs, as these will help your teenager prepare for a real job. Use role play to practice for job interviews, teaching your child to make eye contact, smile or shake hands with a potential employer. 

Seeking Employment as an Autistic Adult

Having this diagnosis makes job hunting more stressful. However, if you are organized and give it your best, you might end up where you desire. The first thing to do is think about what you are best at and what you like to do. Where do you see yourself? 

As access to the job market can be difficult, it might help to work with a vocational counsellor or career advisor. This person can offer you the support you need, coaching you to pursue your desired field. He/she can become part of your personal network, joining family, friends or other people who know you and want to help you. 

Even though this is not something you might feel comfortable with, social networking can pave the way for finding great job opportunities. In applying for various jobs, be sure to highlight your abilities and not the things you feel less certain of. Keep going to therapy to practice communication and social interaction skills, and find effective ways to manage job-related anxiety. 

Access Employment Programs

There are employment programs for autistic adults, which offer work experience placement and free support. Check out Reach Toronto or Ready Willing & Able. If you are not interested in these, you can pursue regular jobs. It is up to you whether you want to disclose your diagnosis. But it might help to speak about who you are, your goals and challenges. The job you choose should match your strengths.

Your resume should include a detailed work history, even if you only did internships or volunteer work. At home, be sure to practice your interview skills. You can organize a mock interview together with a friend or a family member. Sometimes it helps to watch videos of other people doing interviews. Choose jobs that you will feel comfortable doing, who bring you satisfaction, so you feel that you are bringing your contribution to society.

The world changes one step at a time

There are limited employment opportunities for autistic teenagers and adults. Statistics show that. But nothing happens overnight. Find the courage and pursue jobs, teaching potential employers to see beyond your diagnosis. Every individual is a valuable person who has something to offer, including in the professional domain. Always show potential employers what they stand to gain by hiring you and never give up! It is possible for autistic teenagers and adults to get jobs

Speech Therapy in Autism Treatment

Read time: 2 minutes

Communication represents one of the core challenges for autistic children. Speech Therapy in autism treatment is essential. They may have difficulties engaging in a conversation. Not picking up on social cues, they might find it hard to interact with their peers.

A speech-language pathologist can help autistic children improve their communication and social skills. Addressing key areas, the therapy team will help the child overcome daily challenges and learn how to function within a social context.

What are some of the challenges caused by autism?

It depends on the severity of the condition – autism is a spectrum. Some children may not understand non-verbal communication easily, while others will have trouble with spoken language. They may need help learning to read or write or engage in conversations with others.

Speech Therapy in autism treatment with a young boy and a Speech-Language Pathologist

In severe forms of autism, the speech/language impairment will be more obvious. These children might not speak at all, or they might resort to challenging behaviours to express themselves. They may not seek interaction with others or prove unable to maintain eye contact.

Red flags 

Speech/language delays are among the first noticed by parents. Many go to their paediatrician or family doctor stating their concern that the child has lost some or all of the previously gained words.

Others are worried that their child constantly repeats certain words or phrases, either heard on the spot or weeks before. This is called echolalia. It can also serve the purpose of communication. The therapist will help the child resort less to repetition and rely more on novel speech.

How can Speech-Language Pathology help?

The first thing a Speech-Language Pathologist (S-LP) does is assess communication, articulation and social skills. The S-LP will notice any red flags, and work out an intervention plan to improve the areas. The primary goal is to help the child become more communicative within the home, school and social environments.

When we say communicative, it is important to remember that might not always refer to verbal language. There are children who will use other communication methods to interact with other people, and they will need help to master these. Some examples of other methods of communcation are: sign language, picture exchange, typing/writing or high-tech speech output devices.

During S-LP sessions, autistic children might work alone or in groups. The therapist will facilitate interaction, teaching the child to use appropriate communication behaviours. The child will learn to maintain eye contact, take turns and communicate according to the context and other’s cues. They will also work to develop reading and writing skills where possible.

A non-verbal child can communicate 

You might not know this, but 90% of communication is non-verbal. If an autistic child presents severe language impairment, he/she might still communicate. Through speech-language pathology, he/she can learn alternative means of communication.

The S-LP can teach him/her to understand and use gestures correctly. Communication systems can be helpful, including those based on pictures or visual supports. Some children find it easy to communicate with the help of electronic devices. The goal is to find the best method for each child, taking his/her abilities and challenges into consideration.

What about verbal children?

Once again, the intervention depends on the language and communication difficulties the child is experiencing. All children must learn the appropriate use of language and how to have a conversations with their peers and those around them.

At more advanced levels, Speech-Language Pathology might help the child understand the complexity of language. For instance, that a word can have more than one meaning or how certain expressions are used figuratively.

Social communication, one of the primary goals of S-LP

Human beings are social creatures by nature, and autistic children do not represent an exception. With the help of S-LP, they can learn how to interact with their peers and overcome the communication their challenges.

The Speech-Language Pathologist will work with the child to adapt his/her language to the correct context. They will explore non-verbal cues in a social setting and practice with other children.

It takes time, but some children can learn to recognize verbal and non-verbal cues, improving their communication abilities. This will help them feel less frustrated. When these skills improve, the challenging behaviours often become less frequent. This will have a positive effect on the academic outcome.

S-LP, helping with early diagnosis of autism

When parents have concerns about their child’s development, speech and language delays are present at the top of the list. The Speech-Language Pathologist can help with the early diagnosis of autism, recognizing the red flags associated with communication and social skills problems. The earlier the diagnosis of autism is made, the more successful the specialized intervention can be.

S-LP and the Ontario Autism Program

Your child can access S-LP services using their OAP funding (legacy funding, childhood budgets and one-time interim funding). Here is a list of eligible services and supports that can be purchased with the funding.

Read about how Side by Side Therapy can develop a transdisciplinary team to address your child’s needs and use their Ontario Autism Program funding.

The 5 Benefits of Outdoor Play

Read time: 2 minutes

With screens being stared at for hours a day by children, the benefits of outdoor play for children is being overlooked. Primary school should be a place where children can enhance the health of their minds, bodies, and emotions. Thankfully, an easy way to do this is to encourage outdoor play. There are a few practical ways to do so, such as ensuring playground design is engaging for children. We will focus on the benefits of playing outdoors, so you can see just how critical it is for their health and well-being.

Greater Physical Health

When children are running around, jumping, crawling, and handling physical objects, they are using and developing their motor skills. These are essential functions that can be greatly improved with outdoor play. Children walking a trail can get some aerobic exercise while enjoying the outdoors. When playground design is considered in terms of maximizing movement, children will burn more calories, which leads to strengthening their muscles and preventing childhood obesity. Also, they will get much-needed vitamin D, even if it’s a cloudy day.

Improves Behaviour and Social Skills

School is a place where children spend a large portion of their day. They interact with other children throughout the day, which helps develop their social skills. However, outdoor play helps shape their ability to communicate, cooperate, and organize effectively. Even at home, children can play with their siblings and friends outside in the yard, while inventing new games to play. All the practice taking turns, sharing, and developing lead to the cultivation of critical behavioural skills and is one of the benefits of outdoor play.

Increase Sensory Skills

Studies have found that children who play outside more have better long-range vision than those who are primarily indoors. The younger a child is, the more they learn through their senses. When a toddler walks down a trail, they will light up with joy when they spot a new animal or smell aromatic flowers. Jumping feet first into puddles is another favourite pastime of theirs. All of these expand, improve, and enhance their sensory skills. Your child may benefit from the input of an Occupational Therapist in the development of their sensory skills. The development of a child’s perceptual abilities is key to having excellent sensory skills.

Increase Attention Span

When children play outdoors, they become more curious about the world around them. They explore and roam according to where they want to go. These self-directed explorations lead to them having the ability to stay focused on a task for longer. Children who play outdoors in a self-directed way have more initiative to do things on their own. They are also more eager to participate in activities they have never done before. Studies have found that children who have had ADHD had seen a reduction in their symptoms after spending more time playing outdoors, in playgrounds, backyards, and other outdoor spaces.

Greater Happiness

All that running, jumping, and exploring generates endorphins, which uplift the moods of children. When there is an intricate playground design, it challenges children to exert more physical effort. This, combined with being exposed to light outdoors, improves the mood of children. Playing outdoors can be a wellspring of happiness for them.

Check out this list of parks in the GTA!

In Conclusion

These are some of the top benefits of outdoor play for children. As you can see, there are several reasons children should be encouraged to play outside. Their physical, mental, and emotional well-being will increase, while developing essential skills that will help them navigate the world they grow up in.

How to Build a Good Relationship with Your Child’s Teacher

As a parent, it is normal to have worries about your child’s academic success. How will your child integrate in the school environment? Will they establish positive relationships with their teachers and peers? These are only two questions among the many going through your head. Read on to learn how to build a good relationship with your child’s teacher.

The teacher is the number one person who can help your child integrate and achieve their full potential within the school. This is the major reason you need to build a positive relationship with your child’s educator. Together, you can set common goals and positively influence their long-term academic outcome.

In this blog, we will present a few strategies on how to build a relationship with your child’s teacher. The most important thing to remember is that teachers require time to get to know your child, so keep an open mind. Work towards the relationship you want to have and always state your goals.

How to Build the Relationship:

Use the first meeting to paint a detailed picture 

Parent building a relationship with their child's teacher in a meeting at the school.

Teachers are familiar with the diagnosis of autism. But they don’t know your child, and this is where you come in. To build a good relationship with the teacher you need to help them understand your child. Offer solutions on how to handle certain behaviours, meltdowns in particular.

Be sure to highlight your child’s strengths and what helps in interacting with them. The more information you provide, the easier it will be for the teacher to see beyond the diagnosis.

Talk about goals 

Once school starts, the teacher becomes part of the team. You need to mention the things you are working on in therapy, and how educators can reinforce them at school. It always interests teachers to help their students achieve their full potential. They will want to know about the goals you have for your child. Some teachers are open to Behaviour Consultations from the therapy team.

By informing the teacher about your child’s goals, you will develop a positive, team-based approach. The purpose is to create a team that works together, helping your child achieve new skills. Everyone on the team should be familiar with the things you want to improve or change.

Discuss communication expectations 

It is best to communicate regularly with your child’s teacher. However, remember that they are only one person who has to communicate with a lot of parents. Establishing communication expectations from the start can pave the way for a great relationship with your child’s teacher.

Some teachers prefer after school conversations, while others rely on emails and phone calls. What matters is that you ask and see what works best for both you and the teacher. When engaged in a conversation, stay on the subject. Try to place yourself in the educator’s shoes and see how hard they are working to help your child.

A plan to help the child succeed 

Work with your child’s teacher to develop a plan for how your child will achieve their goals. Modifications and accommodations can be made to the curriculum. Therefore, they should be used to make your child as successful as possible. Talk about behavioural issues and how they influence learning, and set goals based on the strengths of your child.

The key is to develop a partnership with the teacher, working towards a common aim: helping the child succeed. Ask the educator to offer his/her input and work on creating a road map for progress. Meet regularly to review the progress made and update the initial goals.

Don’t be afraid to talk about negative behaviours

Meltdowns and challenging behaviours can be part of life with autism, and teachers deserve open communication as much as anyone else. Don’t be afraid to talk about these issues, as the teacher is not there to judge your child but to help them. The teacher will be grateful that you were up front and this will help build the relationship.

It might help to discuss specific situations. Find out what caused a meltdown, and how the teacher saw fit to intervene. Have a talk about potential triggers and also about school-related behaviors that could be worked on during therapy. The more you are open about your child, the easier it will be for the teacher to relate and offer help.

Parent-teacher interview

A structured interview can be useful in developing a positive relationship with your child’s teacher. During the interview, you can talk about your child, and any issues related to his/her diagnosis. By doing this, the educator finds out more information about his/her students.

From your perspective, such an interview represents a sure way of starting things on the right foot. You can speak about emotional and behavioral difficulties, and academic goals. Depending on how much time you have available, you can also discuss how your child will integrate in the school environment.

Conclusion

It takes time to develop a positive relationship with your child’s teacher, but the effort is all worth it. The educator becomes part of the intervention team, fighting to help your child grow and overcome the challenges they face.

Interested in reading a New York Times article about how a Florida mom works to build a good relationship with her daughter’s school?

 

What is Sensory Processing Disorder?

Read time: 4 minutes

Has your child recently been diagnosed with Sensory Processing Disorder? Has your child ever had an over the top reaction to what seems to be a regular situation? Obviously, all kids can have challenging behaviour, however, some children have a hard time processing and tolerating certain physical, situational, environmental and sensory experiences. Sensory Processing Disorder (SPD) is the inability to process sensory stimuli. That means it can lead to reactions and behaviours that are disruptive to the child and those around them. Difficulty in processing sensory input can leave both the child and the parents/caretaker overwhelmed, stressed-out and anxious.  

Child with sensory processing disorder covering ears and smiling while playing outside.

SPD has made its way into mainstream culture. A quick Google Search will lead you to lots of information. Since ASD children have more difficulty processing sensory input, they may become easily overwhelmed or overstimulated by situations (i.e. bright lights, loud noises, crowded spaced) or things (i.e. textures of food or clothing). Many children with ASD also experience sensory processing problems. But SPD is not limited to children with autism. Children with ADHD or no other diagnosis at all can have SPD. Every child who has sensory difficulties will have a challenging time until their needs are identified and addressed.

SPD: Hypersensitivity vs Hyposensitivity

Sensory Processing Disorder is a neurological disorder that affects that way that a person receives and processes sensory information.   In everyone, messages from the senses are sent to the nervous system where they are processed. However, in SPD, this processing is faulty. This can lead to an uncomfortable experience for the individual. There are two kinds of sensory processing difficulties: hypersensitivity and hyposensitivity.

Hypersensitivity

Hypersensitivities can lead to oversensitivity and sensory avoiding. Several things can act as triggers to sensory meltdowns. For example, some of the triggers include crowded spaces, specific clothing, smells and textures of food, sudden or loud noises and bright lighting. 

Some hypersensitivities include:

  • Severe response to sudden loud or high-pitched noises
  • Easily distracted by background noises and movement
  • Does not like unexpected touching, hugs or cuddling
  • Uncomfortable around crowds or busy places
  • Fear of falling or getting hurt

Children that have sensory avoidance may do the following:

  • Become overwhelmed easily by places and people
  • Look for a quiet place when in crowded or noisy situations
  • Sudden noise can easily startle them
  • Bright lights can be bothersome
  • Clothing and fabric can make the child uncomfortable
  • Avoid hugging or touching others
  • Textures and smells of food can be bothersome
  • Transitions and change can be very upsetting and difficult

Hyposensitivity

Hyposensitivities can lead to under-sensitivity and sensory seeking. Often, sensory seeking children have a need for movement and have a lot of difficulty sitting still. They also like physical contact and pressure. 

Some hyposensitivities include:

  • A constant need to touch textures and people, even when it’s not appropriate
  • Lack of understanding of personal space
  • Uncoordinated and awkward movements
  • High pain threshold
  • Unable to sit still, constant movements
  • Rough and aggressive when playing with other kids

Children that are sensory seeking may do the following:

  • Constantly need to touch things
  • Be unaware of rough house playing and physical risk-taking
  • Have a high pain threshold
  • Constantly be moving and bouncing around
  • Show a lack of respect for other people’s personal space
  • Be easily distracted
  • Be clumsy and bumps into walls, trip over their own feet etc. 

It is important to realize that no two children are alike and each child’s sensory experience and coping mechanism are unique. And, your child may actually be affected by sensory issues from both categories. The journey to understanding your child’s sensory issues and ways of managing them can be an overwhelming task but there is help.  

Occupational Therapists can help

Occupational Therapists (OT) are trained in sensory regulation and can help to understand, identify and manage sensory stimuli issues. Accordingly, they can provide helpful tips, resources and supplies. For example, an OT might suggest a sensory diet to ease the anxiety and discomfort of your child. In effect, These strategies help children to manage their emotions and behaviours through specific activities and self-regulation techniques. 

Children with sensory processing disorder playing in sensory bins made by an occupational therapist.

Identifying and managing a child’s sensory difficulties will allow the child to cope with SPD. As a result, having a handle on their sensory triggers will provide them with the opportunities to use tools and strategies that will aid in their successful social interactions and day to day well-being.

How To Pick The Right Autism Therapy: 8 Questions

Read time: 4 minutes

Thanks to the internet, information on autism therapy is unlimited.  Some of it is very valid and helpful.  Some of it is not.  Use common sense when picking interventions or treatments to try.  If it sounds too good to be true, it just might be.

As of now, there is no cure for autism. There are lots of treatments that can teach skills and there are some medications that can improve some physical symptoms but there is no cure. That’s hard to hear as a parent and hard for me to say as a therapist.  I believe that every child is capable of learning and becoming a better version of themselves.

The interventions you choose should fit with your values and be evidence-based. Evidence-based means that different groups of researchers studied them and have repeated the results many times.  However, there are many autism therapy interventions that are not evidence-based. 

One of the problems with choosing an intervention that is not evidence-based is that it takes valuable time, energy and resources away from interventions that are shown to work. Very few families have unlimited funds for therapy. Therefore it’s important to try and get the most value out of the things you can do.

Parents interviewing team for autism therapy.

Ask these 8 Questions when choosing an autism therapy or provider:

1. What research is there that supports this intervention?

Look for studies that have been peer reviewed (that means that other experts in the field have reviewed the study and can vouch for the way the study was designed). 

Anyone can write a blog or publish an article on the internet.  That is to say you want to be sure that the information you’re using comes from reputable sources like Universities (and not just your aunt’s best friend’s cousin who had the same problem as you). 

At Side by Side Therapy, we only utilize evidence-based practices in our autism therapy. 

2. What training do you and your staff have?

In Canada, there is no standard credential for behaviour therapists.  In Ontario, in order to use your provincial funding on behavioural services, the program must be supervised by a Board Certified Behaviour Analyst or a Clinical Psychologist with experience in ABA. To be an Instructor Therapist (IT), most agencies require that the candidate have a post-grad diploma or certificate in Autism and Behaviour Sciences. It is slowly becoming the standard that ITs are Registered Behaviour Technicians (RBT) but it’s not mandatory. 

At Side by Side Therapy, all of our clinicians are encouraged to maintain the highest standard for their discipline. We are actively training the next generation of behaviour analysts. 

3. How will this intervention be individualized for my child? 

There’s an expression in the autism world: “If you know one person with autism… you know one person with autism”. Each child is an individual and learns differently.  In other words how they are taught, which reinforcers and prompting procedures are used and how success is measured should all be individualized.  It is impossible to pick up a textbook or curriculum and have an ideal autism therapy program. 

4. How do you measure progress?

Some clinicians are focused on the end goal – total independence.  Some children will never achieve total independence. It’s important that the way progress is measured is meaningful to the client and family. There are different dimensions that can be used to measure progress: frequency, intensity, duration and more! 

5. How will we work as a team? 

You want to ask about how frequently team meetings are held, how to contact the clinical supervisor if you need them (phone, email, text?) and how frequently parent training sessions are held. 

Parents should be involved in every aspect of their child’s autism therapy program. 

6. What are the goals of this autism therapy – in general and for my child? 

You want to ensure that the goals of the intervention align with your goals for your child. Some programs focus on language, while others focus on challenging behaviour reduction. You want to ensure that the goals reflect your child’s needs and your beliefs about education and will be in line with your thinking. 

7. What are your feelings on stim behaviours? Should we be trying to stop them?

For many years it was believed that therapists should stop children from engaging in self-stimulating behaviours (stimming).  Many autistic advocates have expressed how damaging suppressing stims was for them. A new belief is taking hold –  as long as the stim is not hurting anyone, destroying property or stopping the child from participating in activities, it should not be addressed. No one stops typically developing people from engaging in stims as long as they’re not hurting anyone or destroying property – why should it be any different for autistics?

8. What is the process for terminating services if I do not wish to continue? 

You should never be locked into a service.  If it is not working for your child or family you should be able to openly discuss this with the team.  In Ontario, specifically, you should not be pressured to sign over your entire Childhood budget or Interim One Time Funding Cheque to a provider. 

Connect with Side by Side Therapy to schedule a no-charge/no obligation consultation to discuss our autism therapy solutions for your child.

IBI and ABA: What’s the difference?

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.

Early Start Denver Model (ESDM): Unleash Potential!

Read time: 4 minutes

The brain has a unique property called neuroplasticity. This means that our brains are constantly able to change and grow. Children under 5 years old have the easiest time with neuroplasticity. Even when the child has been diagnosed with autism, it is possible to make significant gains that are life changing. We can achieve this through early intervention. Specifically by using the Early Start Denver Model, we can begin even before a diagnosis is made. 

Child playing with is mom during an Early Start Denver Model session.

Within a therapeutic environment, the autistic child presents a higher chance of developing language, cognition, and social interaction abilities. We can teach skills to overcome the challenges associated with the autism diagnosis. But the essential thing is for the intervention to begin early on.

ESDM: The earlier, the better

Developmental specialists recommend the therapy to start as early as possible, as this leads to the best outcomes. Parents should not wait for the diagnosis but seek the help of a therapist as soon as they have suspicions about their child’s development. 

The sooner we start the intervention, the better the outcome is likely to be. Parents might struggle to accept the diagnosis, but they should waste no time in pursuing therapy.

A better chance of addressing behavioural issues 

Autistic children often have challenging behaviours which become more challenging over time. Addressing challenging behaviours is generally easier in younger children because they don’t have a long learning history. Having a long learning history means that the behaviour has been reinforced for a long time. Similar to a habit, behaviours with long learning histories are hard to break.

If there are challenging or non-adaptive behaviours present early intervention can replace them with alternative behaviours. The key is teaching replacement behaviours that meet the same needs but are more effective. For example, if a child is taught that they will get your attention if they cry, they will keep crying. They do this because that strategy works. But if you reward a child for using another strategy (e.g.: a word approximation, directed eye gaze or pointing) they will use the new behaviour instead. And then the challenging behaviour will fade away.    

ESDM: Individualized intervention from an early age

The therapist will develop an individualized intervention plan, based on the child’s needs, behavioural issues and the use of the Early Start Denver Model Curriculum Checklist. The Curriculum Checklist is a list of skills that are divided into levels that represent different ages.  The therapist uses the Curriculum Checklist to assess your child’s strengths and areas of need relative to same age peers. The purpose of the intervention plan is to help the child develop a wide range of skills including: attention, communication and interaction. 

As mentioned above, a structured environment will offer opportunities for learning. It facilitates the growth of skills, while it allows the therapist or parent to monitor the progress being made on a consistent basis. The therapist can adjust the plan as necessary, but the chief goal will remain the same: the child learns through play while having fun.

Early Intervention: Families receive support early on

As parents of special needs children, especially autistic children, it is normal to feel helpless and frustrated. Early intervention, though, can be highly beneficial for the entire family. It can provide support early on, reducing the amount of stress parents experience. Having an action plan and strategies to use will help parents to feel empowered and as though they are taking action. 

It is vital that the parents are also implementing the strategies and using therapeutic interventions with their children. The child has a limited number of hours with the therapist each week but many more hours with their parents. These hours should be maximized! 

What matters is that they capture the attention of the child and pursue communication. Being creative and silly will go a long way. 

ESDM: A combination of ABA and play

An experienced therapist will give the child time to become accustomed to the unfamiliar environment, chaining skills together to create a smooth session. It takes time to build the relationship, and only then will the therapist focus on addressing behavioural issues, cognitive and speech delays, etc.

Taking advantage of the brain’s neuroplasticity 

We see the best results up to the age of five years, as that is when the child’s brain is most malleable. We can unleash the learning potential in therapy and limit the effects of the autism diagnosis. As a result, the overall quality of life can improve, thanks to the newly learned skills. 

The benefits of early intervention using the Early Start Denver Model in autistic children are obvious. The earlier the child enters a structured, therapeutic environment, the better his/her progress will be. Parents should actively collaborate with the therapist, practicing taught strategies at home and helping their children unleash their full potential.

To learn more about how Side by Side Therapy can help your child with an Early Start Denver Model program, please connect with us!

New diagnosis of autism? The most powerful things to do now.

Read time: 4 minutes

When your child get a diagnosis of autism, your world seems to dramatically change in the seconds before and after the words have been said. I have spoken with many parents who were simply not expecting the diagnosis when they went in for the assessment.  They had an image in their mind of a severely disabled person and that simply wasn’t the case for their child. 

What is the autism spectrum? 

Autism is a neurological (meaning it has to do with the brain) developmental disorder.  It affects how a child learns and develops in 3 main areas: social skills, communication skills and restrictive or repetitive behaviours.

Many people use the language ‘high functioning’ vs ‘low functioning’.  This can be very misleading. Many people think of the autism spectrum as being a linear spectrum. This representation doesn’t quite fit the autism spectrum, because there are three core symptoms of autism. There’s a newer way of conceptualizing it, that was created by Michael of 1autismdad.com in 2012. 

Imagine a blank sheet of paper with a dot in the middle.  This dot represents neurotypical development (non-asd). Near the top of the page in the middle imagine the words “communication deficits”, near the bottom left of the page imagine “social skills deficits” and on the bottom right corner imagine Stereotypic and repetitive behaviours. Each person with autism will develop needs in each of these areas differently.  You can visualize a person’s needs by how long the path is from the middle (neurotypical) to the core symptom. Some might be very impacted in the communication and social skills areas while they show very few (or none) stereotypic and repetitive behaviours. 

Autism triangle: a new way of thinking about the autism spectrum by asddad.com
Retrieved from: https://www.1autismdad.com/home/2012/03/14/visualizing-the-autism-spectrum on August 1, 2020

Top 5 things to do when your child get a diagnosis of autism: 

There are a number of resources that you can access when your child is first diagnosed.  Here are my to 5 recommendations of things to do: 

  1. Notice the small things – Your child might have difficulty with a lot of things, but try and pick out the things that your child excels at. You might need to be creative here, but it’s a good reframing exercise and will help you to focus on something positive instead of only the negative. 
  2. Reach out to others from the autism community.  There are a number of support groups on Facebook and other social media platforms.  You’ll find many people who understand exactly what you’re going through and who have been through it and survived.  It might take you a while to find your village, but once you do you’ll be so glad you spent the time to reach out. 
  3. Celebrate every victory. Learning something new might be very challenging for your child.  When they achieve a new milestone you should celebrate it loud and proud! 
  4. Create a self-care routine for yourself and your partner. You will feel compelled to spend every moment focused on your child’s therapy/friends/development. You must keep yourself healthy so you can be the best possible advocate for your child. Remember the flight attendant’s advice: always put your own oxygen mask on first.  You have to take care of yourself if you want to take care of others. 
  5. Create a team for your child.  There will be a lot of people in your child’s life: doctors, therapists, teachers, support workers and more.  You will need help to coordinate everything that needs to happen in order to set your child up for success. Find people you trust and who have values that align with your own.  

Don’t forget…

Your child is the same lovable, adorable, smart, deserving little person they were before they got a diagnosis of autism. There are times when the label is important and there are times when it is irrelevant. Try to think of the diagnosis as a path, that will lead you to treatments and strategies that will help your child. Also, having a diagnosis opens up doors for funding, supports and specialized programs.

Connect with Side by Side Therapy to discuss your options and what interventions would be best for your child and family. We offer no-charge and no obligation consultations to help guide you in making the right decisions for your child’s future.

Ontario Autism Program (OAP): a short history.

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 2019. 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.

Respite Services in Toronto: Top 10 Benefits

What is Respite in Toronto

Respite is caregiving for special needs children that allows a primary caregiver to have a break. Raising an autistic child is a multifaceted experience and even though it comes with many joys, there will be plenty of challenges. Parents might put their own needs aside, focusing on their child and their therapies. 

In taking care of a child who is on the autism spectrum, you might enter problem-solving mode and forget about yourself. Respite in Toronto might be something to consider, offering short-term relief from being the primary caregiver. Respite in Toronto is more than babysitting.  A trained caregiver with experience in your child’s specific needs will be there to support your child (and you!). What are some of the benefits associated with Respite in Toronto? Keep on reading and find out!

During a Respite in Toronto session,  young boy plays in nature with a respite worker from Side by Side Therapy.

How will you benefit from Respite?

#1 A reduced level of stress

Parents of autistic children report significant levels of stress, which in turn affects both their physical and emotional health. Respite gives one the opportunity to take a break, without guilt, from the pressure of it all. 

#2 Feeling less frustrated

There will be many moments in which you will feel proud of your child but there will also be situations when things seem to be stuck. Frustration can build up, leading to anger, resentment and hopelessness. Respite relieves such feelings, contributing to improved well-being. 

#3 Time to socialize

Autistic children have packed schedules – therapy, school, play dates, to name a few! These activities leave parents unable to spend quality time with others that they love. By opting for respite in Toronto, you will finally have some free time to check in on and hang out with your family and friends. There are plenty of fun activities that you can do while your child is receiving respite!

#4 A healthier relationship with your child

Spending all of your time with a child who has many specific and oftentimes intense needs can be draining. Dealing with tantrums, refusals or meltdowns, you might lose sight of your child’s positive traits. Some time away will allow you to see your child with fresh eyes, reminding you of the things that matter.

#5 Interaction with other people (for the child)

An autistic child’s circle of people is often limited to family, a few friends and the teachers and therapists that they have. In choosing to participate in Respite in Toronto, you will also offer the child a chance to interact with new people in a new setting. This might be hard (for each of you) at first but it will be a great opportunity for your child. 

A young child plays with bubbles during a Respite in Toronto session with Side by Side Therapy

#6 Free time (for you!)

We all love our children and we want the best for them. It’s only natural when given a diagnosis of autism, however, we might naturally put ourselves in second place and dedicate every minute to the child’s development. Respite gives one the opportunity to pursue personal interests, without feeling guilty. 

#7 A break from the daily routine 

Respite can help both the parent and the child to get a break from the daily routine. Children might be taken to the park or other activities while parents can do whatever they wish. Some parents use respite to get errands done, do something social or just sleep! They can recharge their batteries, looking after themselves for a change.

#8 A different perspective

Sometimes, the therapies chosen for autistic children do not offer the expected results. A plateau might occur in the therapy process causing disappointment and stress. When you opt for respite you get the time and distance you need to get a fresh perspective. 

#9 Involving the child in new activities

Even if you have planned your child’s schedule to the last detail, there will still be a lot of activities and opportunities that you haven’t thought of. By accessing respite services, such as the ones we offer at Side by Side Therapy, you can involve your child in new things and help him discover rewarding experiences. 

#10 Preservation of your identity

As the parent of an autistic child, you might have forgotten about who you are apart from your child. The person who you used to be. The things that give you purpose. This is why you should take advantage of the break offered by respite in Toronto, using the time to do some self-care. 

Looking for respite in Toronto? We are glad to help. Connect with Side by Side Therapy and we will make an appointment for a 30 minute no-charge consultation, so we can discuss respite and other therapeutic solutions. The province of Ontario will provide funding for families to access services.  Read more about respite funding here.

Parents often feel guilty for needing time away from their children. There’s no reason to feel guilty. You can use the time to do the things you love, get a fresh perspective on things and meet your friends and family. As for your child, he benefits from excellent care, discovering new people and activities. It is a win-win!

9 Useful Occupational Therapy in Toronto Strategies

Using strategies from occupational therapy in Toronto will be helpful to autistic people who often have sensory processing issues. They might exhibit poor impulse control, be unable to handle self-care tasks or show reduced awareness of social cues.  

A diagnosis of autism should always guide the parent toward a multidisciplinary approach in terms of intervention  and occupational therapy (OT) should definitely be on the team! Keep reading and discover some fun and useful the activities that grew out of OT.

Child writing using a pencil grip in an occupational therapy in Toronto session.

Try these Occupational Therapy in Toronto activities:

#1 Exercises for fine motor skills

The purpose of these exercises is to strengthen the tiny muscles of the fingers and hands in general. The more often they are performed, the better the fine motor skills are going to be. 

For instance, a great occupational therapy activity would be to take an ice cube tray and put cotton balls in each ice cube opening. Your child can pick up the cotton balls with his/her fingers, tweezers or tongs. 

#2 Exercises for gross motor skills 

As a general rule, when addressing gross motor skills try to find activities that require the child to use his/her whole body. The goal is to focus on the larger muscle groups (arms, legs, core).  Building coordination, flexibility and stamina in these muscle groups is really important. 

Here is a simple exercise you can try. Take balls of different sizes, colors and textures, and place them around a room. Ask the child to retrieve each ball, using different types of movement: crawling, skipping, jumping and climbing. 

#3 Heavy work 

Another hidden gem from the OT world is heavy work. Activities that require the usage of major muscle groups can help children develop their gross motor skills even further. Heavy work activities have been shown to be calming for many children. They help the child understand and coordinate their body. You can ask the child to push a heavy object, pull on a rope or carry various items from one point to the other. 

Boy taking out the trash after an Occupational Therapy in Toronto session



One can push a laundry basket or a wheelbarrow filled with toys, carry a box loaded with toy cars or even engage in outdoor activities, such as digging, shoveling or raking. 

#4 Sensory bins

The sensory bin remains one of the easiest and fun activities to try. Many autistic children are sensitive to certain textures so this exercise is a great way to address this issue. You provide opportunities for your child to gradually become desensitized to different textures. 

Child's hand playing in multicoloured rice during an occupational therapy in Toronto session

You can fill several different containers with objects of various textures, including rice, beans, corn, cotton balls, and beads, asking him/her to explore each. Be creative! There are endless possibilities of what you can put into a sensory bin. 

#5 Homemade play dough 

Making homemade playdough isn’t only an occupational therapy activity! This activity serves not only as a teaching opportunity but it also offers a way to acquire valuable skills. This is an easy recipe to try. Once you’ve made the dough, you can use cookie cutters, kids knives or other toys to cut and make shapes. 

A simple activity, it will help with sensory exploration, improvement of visual skills and direction following. Some children like adding different scents to the dough (vanilla, mint, lemon etc.).  

#6 Painting with ice cubes

Take an ice cube tray and fill it with water and watercolor paint. Place in the freezer for a few hours. Give the frozen cubes to the child to use to paint. You can paint on regular paper or try coffee filters for an added sensory element. 

#7 Bring nature and sorting together 

Sorting and nature exploration represent two activities that many children enjoy and you can easily combine them. Just go outside and gather rocks, flowers, leaves and twigs, then ask the child to sort what you have gathered. 

The game of sorting nature can also facilitate the development of problem-solving skills, expand language as well as logical thinking. 

#8 Deep pressure activities

Many OTs will advocate for the use of deep pressure to calm children (and adults too!) Deep pressure can be used in children who have frequent meltdowns or tantrums, having a calming effect and offering much-needed tactile input. In all children, it is vital to ensure that you have consent before touching them. In children who are sensitive to touch, however, it must be performed gradually. 

You can take a blanket and roll up the child, burrito-style, or ask him/her to lie on the floor, placing pillows on his/her body. A large ball can be used to go over the child’s body, avoiding the head area. Bear hugs and squishes are other examples! 

#9 Crossing the midline

Crossing the midline is an important part of motor development, and something some autistic children struggle with. Crossing midline means being able to reach across the body (from left to right and right to left). Imagine that your body is divided down the middle with an imaginary line.  Using your right hand to scratch your left thigh is an example of crossing midline.  

Young Boy stretching his arm across his body during an occupational therapy in Toronto session.



Playing clapping games with a partner or a game of Simon says are great ways to practice crossing midline. 

These are some of the activities recommended for children diagnosed with autism. If you are looking for occupational therapy in Toronto, we are more than pleased to help you out. Call us for a free consultation and we will schedule an appointment as soon as possible. 

Top 6 Practical Social Skills Training in Toronto Tips!

Read time: 3 minutes

In describing the early features of autism, many specialists mention poor social interaction. Autistic children do not naturally gravitate to their peers, failing to take part in group activities or make friends. 

Many autistics need social skills training in Toronto in order to learn social skills. There are, however, a number of strategies that can be used for this purpose. When these skills develop the overall quality of life will definitely improve – which should always be our end goal.

Two children playing together after social skills training in Toronto by Side by Side Therapy.

Autistic children might lack social play skills, seeming to prefer to be alone. It is important to remember that we cannot know for certain that this is their preference, but rather might be a function of a skill deficit – they may simply not have the skills and knowledge to appropriately interact.

6 Social Skills Training in Toronto Tips

#1 Practicing different play scenarios 

Play skills can involve social interaction but, like any other skill, they require practice. So, take your child’s favorite toys, and create different play scenarios. You can create a scene of a farm or play with cooking utensils. A stuffed toy can be used to practice various skills, such as feeding or dressing. 

An added bonus about this type of activity is that you can teach the child to take turns and follow rules. In case of smaller children, it might be a good idea to opt for games that involve movement. Prompts can be offered to support the learning process, and every achievement, no matter how small, should be praised.

Interactive play is a skill that is taught as part of the Social Skills Training in Toronto curriculum.

#2 Imaginative Play

In order to play with peers, autistic children must be able to engage in role play and pretend. As a parent, you can practice these skills at home, choosing games that are simple and fun. Young children often enjoy pretending to be their favourite animals or characters. 

If the child is older, and there are no significant cognitive delays, you might opt for a situation that requires a problem to be solved. For example, you can pretend a toy has been lost, asking the child to be a detective and help you find it. 

Pretend play is an important skill that is included in the social skills training in Toronto curriculum.

#3 Visual prompts

There are many children who learn better with the help of visual prompts, especially when it comes to complex skills. You can use pictures to discuss social situations and teach the child appropriate behavior. Use the pictures as a way to remind your child of the expected behaviour.  It is much easier to eliminate visual prompts than verbal prompts. 

Allow your creativity to run free and turn the learning experience into a game.

#4 Learning emotions 

To improve your child’s social skills, you might consider helping the child develop an emotional vocabulary. You can use pictures, moving on from simple examples, such as someone feeling sad or happy, to more complex possibilities, such as acting surprised, bored or confused. 

#5 Social skills groups

Nothing beats practicing a skill as close to reality as possible. For this reason, you should consider social skills groups, where the child has the opportunity to practice interaction with other autistic and neurotypical peers, on a regular basis. 

Every parent is free to decide whether the group will contain only autistic children or a mix and there is value in each option. Another important tip would be not to overly schedule the activities but rather opt for free play, trying not to intervene too much. There needs to be a goal for the group and the activities that are selected should endeavour to support that goal. 

A group of children smiling after a social skills training in Toronto group at Side by Side Therapy.

#6 Gesture imitation 

Autistic children often do not use gestures purposefully and they might not understand our gestures either. Gestures can be learned using imitation and the use of prompts. You can begin with simple gestures, such as waving goodbye, nodding your head or blowing a kiss. After a gesture is learned in imitation it should be generalized to the natural environment so your child will begin to use it without prompting and in the correct contexts.

Once these gestures are learned, you can move on to more complex ones, including physical actions and pretend play. For instance, you can pretend you are drinking a glass of water. Do not hesitate to use spoken words, finding a way to match them to the gestures you are teaching the child. And, remember, all should be done through play!

Hands together doing a cheer after social skills training in Toronto by Side bySide Therapy.

When it comes to social skills training in Toronto, we are proud to offer this foundational skill set to all of our clients. Contact Side by Side Therapy to set up your child’s no-charge consultation. We will discuss not only social skills training in Toronto but also the other therapeutic solutions we offer.

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

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.

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

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!

Respite Services in Toronto for ASD Parents

Read Time: 3 minutes

With the weather finally getting warmer and the hope that the Ontario “stay at home” order will be lifted, parents are becoming optimistic that these days of isolation may soon be behind us.  Parents can begin planning how they will access respite services in Toronto. Parenting is hard on the best days especially for those that have autistic children, throw in a pandemic and life becomes more challenging and overwhelming than ever before. 

Couple at lake at sunset, enjoying the time that their child is in respite services in Toronto.

Understandably, parents need a break in order to successfully care for their children; taking care of themselves will guard against burn-out, stress and fatigue. Accessing respite as opposed to just a regular babysitter will also allow parents to go out on a date or take a break without stressing and worrying about their child’s well-being while they are away. 

Benefits of Respite Services in Toronto

Respite services in Toronto are available to come to your home and provide specialized caregiving to your child or children and youth that have special needs including Autism.  Respite services provide flexible short-term temporary care and relief, depending on your specific needs, which is essential for supporting parents with child/youth with special needs.  Allowing parents to have time to engage in self-care, rest, see friends and most importantly, spend time together, will undeniably help parents to be more successful and calmer caretakers.  

When the restrictions are lifted, parents need to take this opportunity to reconnect and take a well-deserved break. Parents, especially those of Autistic children, may have found a strain on their relationship due to the overwhelming commitments around caregiving, especially during these unprecedented times.  In realizing this, it is important, now more than ever, to use respite services in Toronto to take the time for each other to reenergize and connect.

Below are some suggestions of fun date ideas to do in the GTA:

Laser Quest is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



Laser Quest – After being cooped up for so long, if you are looking for a fun and interactive activity, that is reasonably priced, then Laser Tag is a great option.  They have many locations around the GTA from Toronto East, Mississauga, Brampton, Richmond Hill and Whitby. For more information please visit their website at https://www.laserquest.com/

Formula Kartwary is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



Formula Kartways Located in Brampton, Formula Kartways is a go-karting venue to fulfill your thrill-seeking needs. If you enjoy the need for speed or some friendly competition with your partner, then this is the perfect date place.  The great thing is that you don’t need to be good at go-karting to have a great time! For more information please visit their website at http://formulakartways.com/

Axe Throwing at Batl Axe  is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



BATL Axe Throwing – If you are looking for a way to release some of the pent-up energy accumulated during your stay home during the pandemic, then axe throwing is the perfect solution. This incredibly fun activity has various locations around the city.  Try it out, you will surely not be disappointed!  For more information please visit their website at https://batlgrounds.com/

Cineplex Cinemas is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



Cineplex Cinemas – There is no better way to escape from reality than through the experience of a movie.  Going to the movies is a classic pastime and a great way to spend time with your partner.  With many locations around the GTA, you will undoubtedly find a movie that will sweep you away on date night! For more information please visit https://www.cineplex.com/

Visiting High Park is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



High Park – As Toronto’s largest public park, there are many amazing things to do in this vast, lush, beautiful outdoor playground. The park offers activities such as hiking trails, a few eateries, a picnic area, a zoo, a lakefront, to just name a few. What a terrific way to become reacquainted with your partner in an outdoor majestic environment. All you have to do is arrive, take a breath, relax and enjoy!  For more information please visit their website at http://www.highparktoronto.com/

Visiting the Distillery District is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



The Distillery District – Tucked away in the Toronto East-End, what was once a historic distillery district, is now a community made up of a mix of old and new, resulting in an amazing urban gem. While at the Distillery you will find cobblestone pathways that lead you to quaint art galleries, shops and restaurants. There are also often all sorts of events going on, which indeed, keeps the district full of energy and life. 

For more information please visit their website at https://www.thedistillerydistrict.com/

In conclusion:

Remember, parents are humans with important needs too.  Luckily, respite services are available to help make life easier and provide opportunities for partners to re-energize and reconnect. Take a break, go on a date, you know you deserve it!  

If you would like to discuss respite services in Toronto, please contact us to set up a no-charge consultation today. 

Autism Parenting: What does an autistic child need? A confident parent!

Watch this video for a quick synopsis of this blog!
Family of four, a man and a woman and a son and a daughter.  The daughter appears to have autism.

Confidence is not a parenting skill parents are born with, but rather a skill that is learned over time. Being the parent of a child with autism can challenge our confidence, but you must understand that this skill is vital in helping your children live better lives. 

When you show your children that you are confident, as parents, you make them feel safe. Each child needs to feel that their parents can help them express themselves and handle everything thrown in their direction. 

The diagnosis of autism, of course, will change your life and the way you will parent. But it will also give you added motivation to fight for your child and the life he/she deserves to live. You will not always have the answers and there will be plenty of times when you will have to show yourself as confident, despite feeling lost, confused or scared. 

How do you become a more confident autism parent? 

We have a couple of suggestions for you. The message to take home is: confidence is not necessarily always having a response to a certain situation. It is more about being there for your child, no matter what, and especially when he/she is having a hard time. 

Positive thinking 

Even though this is not necessarily an autism parenting secret, it is something we often forget. Living with autism, and the sometimes difficult behaviours presented by a child with this diagnosis, it is easy for parents to fall into a path of negative thinking and lose confidence along the way.

Positive thinking, on the other hand, can help you to become more confident in your skills and your parenting abilities. It can be useful when it comes to the way you respond to challenging situations.

You are not a bad parent

Every parent has been there. You felt inadequate, believing that your children deserve better parents. Just because your child has autism, does not mean you are a bad parent. 

Whenever you feel terrible, like you have failed your child, remember this – children need love above all else. They need us to be present and show them how to live in a world that seems foreign. 

Do not be afraid to ask for help

If you feel like your confidence has been shattered, it is time to get help. This can come from a family member, a friend or even a mental health professional. You might find help in joining an autism parent support group. Your child most likely benefits from therapy, so you should not hesitate to use this form of support as well. Respite might represent an option for you, so that you can have some time for yourself. In time, you will become a more confident parent, one who is calm and supportive of his/her child. 

Don’t bend to peer pressure

Autistic children have meltdowns and tantrums, and these often take place in public. If possible, try to go home or choose a private place to help your child calm down. Do not allow others to dictate what you should do, and keep in mind that getting the child out of the respective environment will be quite useful. All children have tantrums, and it just happens that it’s your child’s turn today.  Many parents are kind and empathetic in these situations, so just ignore the ones who aren’t!

Be present

A lot of parents make the mistake of thinking that they must always find a solution to a potential challenging situation the child is going through. Sometimes, this only adds pressure, causing your confidence to go down. 

Instead of forcing yourself to come up with an answer, try to be there for your child. Do not let your confidence suffer, but rather offer your physical presence and this should be enough. Help your child calm down by being calm yourself. 

Control your emotions

It goes without saying that no two children are the same, especially when  they are autistic. Anger can only damage your confidence, since it will cause you to feel out of control. If the situation seems impossible to handle, it might be best to take a step back. Always try to acknowledge your emotions, but without giving into them. 

Conclusion

What does an autistic child need? A confident parent! It might take time and you will make plenty of mistakes along the way, but you need to work on becoming more self-reliant. The bolder you are, the easier it will be to become the advocate your child needs for a better life.

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

Autism Spectrum Disorder (ASD) affects a great number of children and often these children have difficulty communicating and, in some instances, cannot verbalize their needs or thoughts at all.  In addition to having an applied behaviour analysis team these children benefit from speech therapy.

This by no means, should suggest, that these children understand less, but 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, for many ASD children, they do not have this option and sadly, therefore, have a greater challenge to having their needs and wants understood. 

How can Speech Therapy help?

If you are a parent of an ASD child that is non-verbal or struggles with communicating, this can be very stressful and overwhelming.  It is important to know that there is help. To date, numerous tools and programs have been developed to aid in these communication and language development barriers. 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 children with communication and language developmental issues. These systems can be added to your child’s existing speech therapy programs, however, they can 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. 

These AAC systems give your child access to their right to communicate and helps to ensure that their needs are being heard, taken into account and addressed. 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 social and support network. 

Here is a breakdown of the types of AAC Unaided and Aided & Low and High Tech

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. 

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. PECS is a program where 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 care-giver) 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).

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. 

Three examples of apps that can be paired with designated devices or used on tablets or iPads to become SGDs are:



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 – This is a mobile app used on an iPad or tablet that’s currently in beta testing. It was 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.  Linggo 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 adjusting. 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, 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 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 of being 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 developing your child’s communication skills using AAC or otherwise, please contact us to set up a no-charge consultation today. 

Top 10 Fun Autism and Sensory Friendly Places in the Greater Toronto Area

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 autism or 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 have (children specifically for the purposes of this article) SPD often receive a co-occuring diagnosis like Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD). 

Since SPD is so prominent in children especially for those that also have 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 with autism 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 autism and sensory-friendly settings.

Autism or Sensory Friendly Attractions in Toronto

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: https://www.youngpeoplestheatre.org/about-ypt/accessibility/

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. 

10 Fun Occupational Therapy Activities to do at Home During Physical Distancing With Kids

We know how difficult it can be for an autistic child to spend all of his/her time inside the house. The Covid-19 pandemic has forced us to think outside of the box, finding occupational therapy activities to keep our children on the right path during social distancing. 

As a parent, you are well aware that social distancing has led to a disrupted routine, with your child suffering in the process. In an effort to help you, we have gathered several occupational therapy activities to try at home and have some fun. Are you ready? Let’s go!

Occupational Therapy Activities to Try:

Occupational therapy activity- sensory bottles.




#1 Making a sensory bottle 

This is a simple activity, which offers enjoyment long after it has been done. All you have to do is take a plastic bottle and fill it with water, food colouring, glitter, marbles or anything else that comes to mind. Involve your child in the decision process, and remember to use as many items as possible for a higher visual appeal. 

Occupational Therapy painting with vegetable pieces







#2 Painting with veggie slices

Painting can stimulate different senses, helping your child stay focused. Begin by cutting slices of colorful veggies, such as bell peppers, cucumbers or potatoes. You can then ask your child to dip the veggie slices in paint, pressing them on a piece of paper or a disposable cup. It is a simple yet fun activity to try!

Occupational therapy activity-  sensory bins







#3 Sensory Bins

This is an occupational therapy activity for improving your child’s sensory skills, bringing him/her in contact with various textures. You will need a plastic box or even a tub, which can be filled with balls, beans or beads. The next step will be to place as many toys in there as the space allows it, asking your child to find them, one by one. 

Occupational therapy activity- scent jars






#4 Guess the scent 

Take a number of small containers and add different ingredients with a specific smell. You can use spices from the kitchen, but make sure these are easy to recognize. Ask your child to close his/her eyes and try to guess the scent. Opt for pleasant smells, as these can also induce a state of relaxation. 

Occupational therapy activity- toys in  ice blocks





#5 Getting a toy out of ice

Fill a plastic box with water, then add some toys and place it in the freezer. Keep adding water, until you form a complete ice block. You can use food colouring to make different coloured layers of water. You can then work together with your child to get the toys out, using a hammer or other useful tools. Tip: fill a spray bottle with warm water to get the ice to melt faster.

Occupational therapy activity- homemade playdough





#6 Making scented playdough

If you want to stimulate your child’s sense of smell, you might also want to consider this activity. Homemade playdough is easy to make, requiring simple ingredients, such as flour, salt, cream of tartar, water, oil and food coloring. Once it is ready, just separate it into bowls and add different essences – vanilla, ginger, lemon, cinnamon or almond. Here’s a playdough recipe with just a few ingredients.

Occupational therapy activity-  obstacle course







#7 A fun obstacle course

The great thing about this occupational therapy activity is that you can use anything in your home to create the obstacle course. You can place tape on the floor to offer your child a sense of direction, as well as add items that make the course more complex (such as a hula hoop or a jump rope). For gross motor skills, practice animal walks (hopping, wiggling or jumping). 

Occupational therapy activity- mirror or imitation games





#8 Imitation Games

For autistic children, it can be difficult to mimic another person’s movements. Mirror exercises can be of great help, not to mention they can be easily turned into a fun activity. Stand face-to-face with your child, asking him/her to mimic your movements (head, arms, trunk, and legs). This occupational therapy activity will increase coordination and body awareness. 

Occupational therapy activity- animal pose yoga





#9 Yoga animal poses

Yoga can help children, including those that are autistic, to calm down and find their inner peace. You can teach your little one several poses – the wide-legged standing forward bend can be imagined as an elephant swaying his trunk, while the plank pose can be taken for a crocodile. The downward-facing dog pose can remind the child of a bear, while the cat pose resembles a tiger. 

Occupational therapy activity- scavenger hunt






#10 Indoor scavenger hunt 

The indoor scavenger hunt is an activity in which the whole family can participate, being beneficial from multiple points of view: development of gross and fine motor skills, problem solving and social interaction. It can represent a challenge for the autistic child, especially if you choose objects that he/she is uncomfortable with, but, with your help, he/she will enjoy the activity. 

These are only a couple of the occupational therapy activities which you can consider doing with your child at home. As you have seen, these are easy and fun, and they will offer you an opportunity to relax in a time where uncertainty seems to be defining. 

Contact us to book your 30 minute no-charge consultation today if you need help finding activities that your child would enjoy.

Autism: what’s more important equality or equity?

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 and Memory: Can you guess the amazing 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.

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. 

Cover of a book written by Tracy Alloway about a child with autism




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

**

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 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.

Autism Awareness Day is only a starting point

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.

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

Applied Behaviour Analysis isn’t all we do – we’re adding 5 amazing disciplines!

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 applied 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 applied behaviour analysis 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 applied behaviour analysis, speech therapy, occupational therapy, therapeutic recreation, psycho-educational assessments 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:

Applied Behaviour Analysis (ABA):

Boy and therapist doing applied behaviour analysis therapy in Toronto

A therapy based on the science of learning and behaviour. At Side by Side, the main goal of ABA Therapy in Toronto 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). applied behaviour analysis can also be used to teach academics. 

Possible goals: 

  • Responding to name
  • Sorting items 
  • Reading

Speech Therapy (SLP):

A therapy that revolves around increasing speech, language, social communication, cognitive communication and swallowing disorders. Speech Therapy in Toronto involves 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

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 Therapy in Toronto 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

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. Therapeutic Recreation in Toronto 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

Respite:

Respite in Toronto is 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 

Psycho-Educational Assessments:

autism aba therapy lindsey malc side by side therapy doing therapy with a therapist


If your child requires a psycho-educational assessment in Toronto to determine his or her learning needs, our psychometrist can help you. We will walk you through the entire process and will provide you with recommendations for services and strategies that your child will benefit from. We can also help you convey your child’s needs to their school.

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: How to have great transitions – 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 spectrum disorder (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 to help those with autism transition:

Kids with autism sitting in a group at school. All smiling with hands raised to answer a question.
  1. Use Natural Breaks – Using natural breaks is one method that can ease transitions naturally for those with autism.  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 activity had an end point, this allows the child to feel closure and more willingness to move onto the next event. 
Child with autism playing with dinosaurs.
  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!  
Child with autism and parent talking.
  1. Objects or Songs – Using a physical object can help your child with autism 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.       
Child with autism smiling, a closeup.
  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.  

A sand timer, used in autism treatment to visually represent the time for a student.
  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 those with autism. 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. 
Parent or therapist doing a yoga routine with a child with autism.
  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: How to have great transitions – Part 1

Read time: 4 minutes


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

Toddler with autism smiling looking directly at the camera.

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 those with autism spectrum disorder.

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) influences 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 autism spectrum disorder 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 autism spectrum disorder child thrive. The first step in dealing with transitions is dealing with the associated worry around transitions. Understanding how your child’s autism spectrum disorder is impacting their 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 with autism before, during and following transitions is the absolute greatest support you can provide them. 

When strategies are used to help autism spectrum disorder 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.

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 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. 

11 Tips to Help Those with Autism Transition

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

  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. 
  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 autism spectrum disorder 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. 
  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.
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. 
  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!

Autism Spectrum Disorder and Sleep Problems

Read time: 4 minutes

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

Research shows that children with autism spectrum disorder (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.

Child with autism spectrum disorder sleeping at her desk, with pencil in hand.

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 cognitive 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 autism spectrum disorder. 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 those with autism spectrum disorder 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 those with autism spectrum disorder are at a much higher risk of developing these sleeping disorders than neurotypical peers. The number of those with autism spectrum disorder 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. 

Young girl 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 autism spectrum disorder occurred. The study participants were evaluated for symptoms relating to autism, 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 autism spectrum disorder and sleep problems. Sleep disturbances can, in reverse, negatively affect the symptoms of autism spectrum disorder, 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 for autism spectrum disorder 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! 

Autistic People or People with Autism: 2 Completely Opposing Perspectives

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?   

Autistic community targeted as different

When speaking on difference, the autistic community has struggled with being labelled and stereotyped as ‘different’. You can read about autism spectrum disorder here. 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.  

Couple arguing about whether to use person first or identify first language, meaning whether to say person with autism or autistic person.

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 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 focused instead of disability focused 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. 

Autism Home Safety: 11 Useful Strategies

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 children with autism spectrum disorder, can be frequent and for the parent/caretaker this can be frightening. 

Wandering is one of the top safety concerns facing a child with autism spectrum disorder, 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. 

Safety first road sign for children with autism.

Safety within the Home for Children with Autism

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 autism. 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
    • Keeping interesting toys/items out of eyesight to not draw the child’s attention to the dangerous area.
    • Enrolling your child in swimming and water safety lessons (if possible).
  • 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 autism, 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 autism also have sensory issues, some children cannot perceive hot or cold temperatures and this can lead to accidental burns.  This can pose 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. Keys may be well hidden but 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 in Autism

As wandering is one of the main safety concerns facing many parents of children with autism, 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 autism 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 autism 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 each of those areas.
  • You could 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 has autism 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

If you would like help establishing your safety plan, please contact us.

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

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

Read time: 5 Minutes


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 resources page to find links to valuable information about autism spectrum disorder.

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

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

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

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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