Many people wonder why occupational therapy is used for treating autism. Read this blog to find out!
What are your occupations?
Every day, you do meaningful activities. You play games, garden, make meals and paint. They are an integral parts of our lives. Above all they allow us to access the best parts of our life and make it meaningful for us. OT help with your professional and personal concerns if you are unable to perform daily tasks due to injury, illness, or disability.
Offer solutions to problems that arise from social and environmental factors.
Enhanced participation in communities and life.
Ultimately, help us live the life that we desire.
What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder (ASD) is the most prevalent neurodevelopmental disorder. It affects about 500,000 people around the world. Autism diagnosis most often occurs in childhood. Moreover, Autism Speaks Canada predicts that 1 in 42 boys and 1 in of 189 girls will be autistic.
ASD can impact every area of a person’s life and each case is unique. Occupation performance refers to the ability to do daily activities, such as self-care and daily living. It also includes education, leisure and recreation for children. As well as their ability to communicate and socially engage.
What are the goals of occupational therapy?
OT’s main goal is to help clients achieve their highest level of independence. In other words, it is important to consider their personal goals, motivations and interests.
Above all OTs should:
Encourage participation in daily life.
Develop intervention plans and assess the abilities of the individual.
Assist children in achieving their developmental goals.
Encourage learning through their understanding of sensorimotor processing.
Fine/gross motor skills development and task analysis.
Recommend changes or accommodations to activities and environments.
Teach vocational skills and explore independent living options.
Assist clients in achieving independence.
Support clients and families with education, consultation, and advocacy.
Support clients in building intimate relationships through education about relationships and sexuality.
Participate in the inter-professional team (speech pathologists, behaviour analysts, physicians, early interventionists, social workers and educators).
How is occupational therapy used in treating autism?
Occupational therapists use their skills to improve sensory processing, emotional regulation and fine/gross motor development. Occupational therapy is a holistic approach that offers a unique perspective. They hold advanced degrees and have received a lot of training in the field. Moreover, they are highly skilled in doing assessments and in providing intervention. Occupational therapy interventions require input from family, educators, and caregivers. People transition from one setting into another with the help of occupational therapists. In other words, transitions include from home to daycare, from daycare to school, and from school to society. Occupational therapists provide support to families through education and consultation.
Where can occupational therapists work?
Occupational therapists can be found working alongside health care professionals in many settings. That is to say these can include schools, long-term care facilities, hospitals, and community clinics. OTs also work in support services, family homes and on client health teams. Other organizations may be involved in the occupational therapy’s work, such as government policy-makers, community agencies, or care professionals.
Occupational Therapy at Side by Side
In summary, OTs play an important role on many of our client teams. Occupational Therapists can do direct treatment or consult to our ABA Therapy teams. If you’d like to discuss how we can use occupational therapy in your child’s program call Side by Side Therapy today.
Camouflaging or masking in autism has far reaching effects on the person. In this post you’ll discover what masking is, what effects it has on the person, why it is damaging and how to avoid it in future children.
What is masking in autism?
Masking is when an autistic person behaves in a way that is unnatural to them in an effort to seem more ‘neurotypical’.
Why would someone mask autism?
There are some simple reasons that people would mask their autism. In general, people fear things that are different. While some celebrate difference and diversity, many are unkind to those they don’t understand. It is only natural to try and hide your true self when you’ve been punished or bullied. Many autistics describe masking to fit in. However, this behaviour doesn’t stop in childhood.
There are 4 times more autistic males than females. Recently, there has been a lot of discussion if autism is really more common in males or if females are more skilled at (and more likely to) mask their symptoms. Female autistics are often diagnosed at later ages, potentially because they’ve been masking their autism symptoms. Many female autistics report only discovering their diagnoses when their own children were struggling. These women simply believed that they were different and needed to pretend to be ‘normal’.
Autistics who mask have said that it has helped them get friends and jobs. Unfortunately, masking autism has many negative downsides.
Outcomes of masking
While having friends and getting jobs might seems like excellent reasons to mask autistic symptoms there are many downsides. Autistics who mask report higher incidences of depression and anxiety. They internalize that who they are inherently isn’t good enough. That’s a horrible feeling to have. It can lead to all sorts of other problems. Some autistics relate regressions or loss of skills to masking.
Another really damaging downside of masking autism is that it leads to late diagnosis. Children aren’t receiving the help they need early on because they’re pretending to be someone they’re not. Not accessing early intervention services will have lasting impacts on the person.
Acceptance of neurodiversity: a path forward
There has been a recent explosion of awareness of autism in North America. Most people know at least one autistic person. However, this isn’t enough to inhibit people from masking. Awareness isn’t nearly enough. We have to embrace neurodiversity and create acceptance and equity in the same way we do for other differences.
Some behaviours have to be targeted (because they’re dangerous). However, most ‘typical’ autistic behaviours don’t need to be addressed. If we created a world that was accepting of difference, it wouldn’t matter that the person didn’t look at your eyes for extended periods of time, or talk about the topics that interest you. We would recognize and celebrate the intrinsic value that each person brings to our lives.
One of the clinical indicators of autism is stereotypic and repetitive behaviours (AKA: stims or stimming). Stimming in autism is movements or other behaviours that are either calming or alerting. Most of the time it is not a problem and does not need to be stopped or changed.
Each person has specific behaviours or habits (stims) that they find comforting or alerting. When you’re nervous maybe you twirl your hair or rub your hands together. Maybe you bounce your leg to wake up when you’re tired. When you’re concentrating maybe you stick your tongue out of your mouth. Autistic people also do these same things, sometimes in a more obvious way. Common autistic stims are rocking back and forth, flapping hands, toe walking or spinning in circles.
When and why do autistic people stim?
Autistic people stim at the same times that other people do. Some autistic self-advocates explain that stimming helps them block out distractions to help them concentrate, while others say “it just feels really good”. Neurotypical people will sometimes avoid stimming in specific situations (for example, not fidget and bounce around while at the dentist, despite being nervous). It can difficult for autistics to stop stimming, especially when upset or nervous.
Some autistics say that stimming helps them regulate their emotions or to generate awareness of their bodies. Another really interesting function of stims is to communicate emotions or arousal to others in a non-verbal way.
In the show Love on the Spectrum, one of the show’s cast, Olivia, says stimming is “…a massive build-up, with a pleasant release” (Episode 4).
What should be done about autistic stimming?
Many autistic self-advocates have shared that being told to stop stimming is very damaging. Stimming can be intrinsic to the autistic and to expect them to change part of themselves because it makes us more comfortable is just wrong.
No one is telling a neurotypical kid to stop playing with their hair or to stop drumming their fingers on their leg. The same rules should apply for autistics.
There are times however, when stimming can be dangerous or disruptive to the autistic’s quality of life. For example, some people will injure themselves or others while stimming. If a stim is interrupting the autistic from engaging in activities that they need to do (like sit in a chair to learn) then alternative stims should be found. A BCBA would work with the family to identify the function of the stimming behaviour and would find replacements. An OT might suggest a sensory diet, if the stimming serves a sensory function.
Many parents are unsure of when or how to tell a child they’re autistic. It can be a very sensitive subject and without some thought it can be tricky conversation to navigate. Crane, Lui and Davies (2021) recently published a study. It highlighted some important themes in having this discussion.
Important themes when telling your child they’re autistic:
Theme 1: Having open and honest conversations about autism
The first theme highlighted in Crane, Lui and Davies (2021) was Normalizing the conversations about autism symptoms. Parents reported that by having frequent and frank discussions about the way that their lives are affected were important in creating an open dialogue. Conversations that began when the child was young helped the child avoid having preconceived ideas about what autism is. This allowed them to have their own experience without being weighed down by the ideas of others.
Theme 2: Creating a shared understanding
Many parents of autistics either have autism themselves or share some of the autistic traits. Showing your child that you experience the same things that they do will create a shared understanding. This gives you some ‘street cred’ when suggesting strategies for your child. The parents also discussed that sharing their lived experiences helped them to understand each other and brought trust.
Theme 3: Positively supporting the child’s differences
Many parents noted that they preferred to use difference as opposed to disorder when describing their child’s needs. They felt that this was less stigmatizing and easier for children to understand. Each person is different and that does not decrease their intrinsic value. Refocusing their child’s attention from their challenges to their strengths was also a common strategy among the parents surveyed.
Theme 4: Adjusting the conversations to the specific child’s needs
Many of the parents that participated in the study noted that the conversations should be specific to the child’s lived experiences and not broad and sweeping. Parents should try to identify areas of interest and capitalize on that motivation. Some referenced having autistic role models as being extremely helpful for their children.
When should you tell your child they are autistic?
There is no rule about when is the right time to tell your child about their diagnosis. It is important to take chronological age as well as developmental age into account when deciding if your child is ready. They need to understand the meaning of the words you’re using. However, they might be giving you clues about their readiness. When your child begins asking questions like “What’s wrong with me?”, “Why can’t I ________”, “Why is this so hard for me but everyone else can do it?” or even “What’s wrong with everyone else?!” they’re likely ready to learn about their diagnosis.
Time of day should also play a factor in your conversation. You want to make sure you’ve got enough time to answer all of your child’s questions. The conversation shouldn’t feel rushed or interrupted. Before school or at bedtime are not ideal times for this topic.
We’re here to help you if you’d like to talk about how to tell your child that they’re autistic. Connect with us for a no charge/no obligation consultation. You can also check out of Autism FAQ for some commonly asked questions.
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.
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.
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.
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.
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.
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
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.
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.
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?
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.
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.
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
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.
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.
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.
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.
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.
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.
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:
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.
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.
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!
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.
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.
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.
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!
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.
#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!
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.
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.
#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.
#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.
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.
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).
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.
#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.
#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.
#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!
Finding out that your child has autism is probably one of the most difficult things in the world for a parent. You might go through a period of denial, believing that there has been a mistake. Then you might have a period of grief and loss, thinking about the way things would have been. You might cry about the loss of your “healthy” child, feeling all sorts of negative emotions. Using the resources available from autism therapy in Toronto can help you right from diagnosis.
Accepting your autistic child as he/she is can be a liberating experience. The moment you stop fighting the diagnosis of autism, you will be in a better place to support your child’s needs. By embracing his/her uniqueness, you will be better able to make decisions and pursue the strategies and supports that your child requires.
Embracing the atypical
Do you love your child less because he/she is on the autism spectrum? The answer is clearly no. But parents are human beings nonetheless and they tend to turn into saviors, wanting for their autistic children to be “typical”.
In truth, your child needs to be loved, first and foremost. You have to embrace the atypical and be accepting of who he/she is. Remember that you are your child’s greatest advocate. Acceptance is a gradual process and one that will help you fight for your child.
Why is denial the first response?
In a beautifully written piece for The Autism Society, Dr. Robert Naseef says: “Acceptance is not about giving up or resignation, but rather learning to live with something that is hard to face.”
You received the diagnosis, but, deep down, you likely already knew something was not right. There are few parents who can accept this diagnosis and think about solutions on the spot. Most parents automatically go to denial as a first response – this is a defence mechanism, one that we have selected to keep pain at a distance.
Even if your child has been confirmed to be on the autism spectrum, he/she is still your child. And you should try and see the diagnosis as the start of a journey, the one toward helping your little one achieve his/her maximum potential. Accessing autism therapy in Toronto is one way to help them.
Instead of fighting the diagnosis, it is best to accept it and learn how to live with it. Let go of the things you imagined and celebrate your child, and his/her abilities. The diagnosis will only help you cater more effectively to his/her needs and provide the needed support. A diagnosis can also help you access provincial funding for autism therapy in Toronto. You will have a happy child as a result and feel less stressed in your parenting.
Autism is neither good nor bad
Are you familiar with the concept of radical acceptance? It refers to accepting something as it is, without fighting it. Acceptance is the first step to creating a plan. You have to acknowledge that something has to be done before you can create a plan to tackle it. When it comes to autism, this concept can be very freeing and can help you advocate for your child. Autism is neither good nor bad, and it is certainly not the only defining characteristic that your child has.
Therapeutic solutions, such as autism therapy in Toronto, can help your child learn new skills and achieve new levels of potential. At home, you will have to work with him/her as well but make sure that you leave plenty of time for fun. Spontaneous play, led by your child, can be of tremendous importance. Do not insist for typical play, as this can only cause frustration. Follow your child’s lead and interests.
Do not send the “you are broken” message
Even if an autistic child is non-verbal, you have to pay attention to your words and to your gestures. If you are constantly pushing for normality, you are sending a message that they are somehow “broken” or “damaged”. While it is not possible to separate autism from the child, you have to refrain from seeing your child exclusively from that autistic perspective.
Challenge yourself to accept your child, with the good and the bad. Try not to see your child’s skill deficits as permanent, there is always something to be learned or a way to improve a skill or situation. Use their needs as a jumping off point for new learning and skill development.
A message to take home about autism therapy in Toronto
There will be plenty of moments when you will feel challenged, wanting things to be ‘normal’. In those difficult situations, remind yourself that autistic children are, first and foremost, children. And like all children, they need our love to thrive.
Stop thinking about the things that are “missing” and embrace the child you have. Celebrate each small success and avoid comparing your child with others. With the help of a team of therapists, create a personalized plan using all the avenues available at autism therapy in Toronto, making sure that you are actively involved in the therapy process. You have the insight into what is important to your child and family and should feel comfortable to direct the therapy team towards achieving those goals.
Contact Side by Side Therapy to have a no-charge 30 minute consultation to discuss the best options for your child.
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.
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– 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 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/
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 – 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/
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/
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.
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.
It is often said that a parent is a child’s first teacher, playing an important role where development and learning are concerned. A diagnosis of autism only reinforces this belief, in the sense that the parent will work harder to help his/her child develop strengths and overcome challenges. Social skills, specifically self-awareness and self-determination are vital to your child’s future.
You can teach social skills
Self-awareness is a difficult concept for almost all autistic children, but nonetheless, it is a social skill that they must learn and use every day. As parents, you bear the responsibility of “equipping” your children with such skills, preparing them for becoming their own advocates in adolescence and adulthood.
We can empower autistic children from an early age, helping them become more aware of their own self and also to discover self-determination. Our efforts will allow them to express themselves in an capable manner, to better understand those around them and engage in suitable behavior in response.
What are the factors affecting self-awareness in autistic children?
Autistic children might battle language and communication impairment, as well as social difficulties and sensory differences. They might exhibit stereotypical behaviors or intense interests. It goes without saying that all of these impairments will affect self-awareness.
Imagine your child as being equipped with the wrong skills. He/she does not know how to express how he/she is feeling, and they have serious difficulty understanding others. An autistic child might not know the expected behaviors and emotions, and he/she will rarely consider how others are feeling or what they are thinking.
Main factors affecting self-awareness are:
Difficulty with transitions/changes
Deficits in understanding emotional exchange
Lack of attention to others
Language and social communication impairments
Impaired ability to take another’s perspective
Empowering your child to develop self-awareness
Your child has both strengths and weaknesses. As mentioned in the beginning, you can empower your child by working together on developing his/her strengths.
Parents have an amazing power, in the sense that they can help their children understand not only how the world functions but also how they should function in that world. Self-regulation will appear as a natural result, allowing the child to advocate for himself/herself, especially in difficult situations.
Activities/solutions for improved self-awarenessfrom study.com
Drawing a bug on paper and adding pictures of things that “bug” him/her – encourage the child to be as specific as possible, adding foods, animals, etc.
Glue a photograph of your child to a piece of paper and ask them to draw things he/she is good at; images might be used for non-verbal children. Encourage the child to reflect on his/her strengths.
Yes/no – read your child simple sentences, waiting for his/her answer. If non-verbal, use gestures to signify approval or negation. Examples: “I like to eat…”, “I prefer (toys)”, “My favorite activity is…” The goal of this activity is to help your child be able to identify their preferences and communicate them to others.
Mirror self-awareness – working in the mirror, together with your child, to develop self-recognition; the more you work, the more aware the child will become of his/her body and its position in space. Work on gestures and making eye contact as well.
This is also a critical skill to achieve, as it will guarantee independence in adolescence and adulthood. Research has confirmed that it plays an important part in academic success, as well as in personal life. Social skills can predict the capacity for self-determination – as a parent, you need to work on these every day.
How to help your child achieve self-determination
Provide your child with opportunities to make decisions and then follow through with them even if you know the outcome might not be ideal.
Teach your child the specific behaviours for specific situations, and do not make the assumption that an autistic child will know the correct behaviour without being taught.
Be patient and offer concrete examples of the behaviour you expect to see. Tell your child what to do, not only what not to do. Give your child plenty of opportunities to observe adequate behaviour.
Practice, practice and practice. Do not expect for your child to learn social skills automatically, but rather keep in mind that learning requires both observation and practice. Offer your child the support he/she needs, and plenty of encouragement.
While it is true that applied behaviour analysiscan help autistic children develop a lot of valuable skills, you have to remember that in many autistic children, skills don’t automatically generalize. The skills learned in therapy must be practiced at home in order to be solidified and maintained. The earlier you teach self-awareness and self-determination, the easier it will be for your child to advocate for himself/herself later in life.
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 ASDchildren, 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 ASDchild 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.
AACis 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 andAided & 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.
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.
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 – 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 teamwill 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
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 Therapyteam, 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.
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.
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
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.
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.
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:
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:
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:
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:
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.
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:
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.
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.
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.
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.
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.
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.
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.
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:
Talk about and prepare for transitions before they happen.
Give warnings about upcoming transitions.
Create visual schedules.
Give options to increase feelings of control.
Here are the last 6 tips to help those with autism transition:
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.
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!
Objects or Songs – Using aphysical 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.
Use Appropriate Forms of Rewards – Usinga 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.
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.
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.
This post is quite long, so it will be divided into two parts for your reading pleasure!
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.
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:
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.
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.
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.
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.
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.
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.
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.
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!
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.
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.
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.
“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 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.
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:
Search nearby water first
Implement your emergency safety plan
If you would like help establishing your safety plan, please contact us.
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:
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: