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

December 3, 2021

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

When Do the First Signs of Autism Appear?

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

1. Avoids Eye Contact

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

2. Lacks Response to Other’s Voices

If you notice your child doesnโ€™t respond to or look at someone when theyโ€™re being spoken to, this may be a sign of autism.  Many parents assume this behaviour is associated with their child having hearing issues.  Over time, it becomes clearer that the child can hear fine and instead their behavior has more to do with being withdrawn.  When youโ€™re trying to talk to an autistic child, they probably donโ€™t seem engaged in the conversation and wonโ€™t respond in a timely manner.  For example, your child doesnโ€™t respond to their name when itโ€™s being called. Autistic people are also more sensitive to sounds and have a hard time filtering out these noises.  This means that they may be distracted by the sounds around them and are struggling to pay attention to the person talking to them.

3. Hand Flapping

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

4. Frequently Walking on Tip Toes

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

5. Trouble Controlling Emotions

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

6. Aggressive Behaviour

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

7. Rigid Play

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

8. Issues with Food and Textures

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

food issues as a sign of autism

Clothes can also be an issue for autistic kids.   Sometimes they donโ€™t like the feeling of the material rubbing against their skin.  Clothing tags can also be irritating.  To avoid these sensory issues, parents can try different clothing materials.  For example, switching to seamless materials for socks and underwear.  Tagless shirts are a great idea as well however, if you canโ€™t find any you can always flip the shirt inside out.

9. Delayed Speech

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

10. Repeating Words and Phrases

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

How Do I Know if My Child has Autism?

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

Why is Occupational Therapy Used for Treating Autism?

July 19, 2021

Read time: 5 minutes

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. 

Why is Occupational Therapy Used for Treating Autism Side by Side ABA Therapy

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.

Why is Occupational Therapy Used for Treating Autism Side by Side ABA Therapy

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.

What does masking autism mean?

May 17, 2021

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.

Image of a woman looking at herself with a negative reflection. Representing masking autism symptoms.

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.

Early Intervention in Autism Treatment

May 10, 2021

There is a lot of hype around early intervention in autism treatment. However, this hype can be very confusing. This deep dive into early intervention will help you understand the goal, how and where to access it, why it’s important and more.

What is early intervention in autism treatment?

Intervention or therapy that happens before a child enters school. Parents and caregivers work with therapists to learn skills and strategies that will help their child. Services can take many forms (in home, in daycare, in clinic). Early intervention can be delivered by a number of different professionals (speech therapists, occupational therapists, behaviour analysts, early childhood educators).

What are the different kinds of early intervention in autism treatment?

There are a number of different approaches to take that will be helpful for an autistic child – or a child who is showing red flags for autism. The approach that you take will depend on the professional that you work with. Some of the options are: a Board Certified Behaviour Analyst, a Speech-Language Pathologist, an Occupational Therapist, and an Early Childhood Educator.

If you choose a Board Certified Behaviour Analyst or Speech-Language Pathologist, you’ll potentially be using the Early Start Denver Model (ESDM). This model blends naturalistic teaching with behavioural concepts. It is a play based model that shares control between the child and the therapist. ESDM is very flexible in where it’s delivered. Some examples of therapy settings are: the child’s home, their daycare or a clinic. The Early Start Denver Model is based on a curriculum checklist that tracks a child’s skills based on typical development. From this, the therapist makes decisions about what skills should be the target of therapy.

If you live in Ontario, your child may be eligible for provincially funded Early Intervention. You can self-refer or have a professional you’re working with make the referral for you. However, the program names vary by region, so make sure you’re accessing everything that’s available.

What can we expect from early intervention?

Whenever you begin a new intervention it’s important to set goals. Likewise, when you begin an early intervention in autism treatment program you should determine what outcomes are realistic and possible for your child. As previously discussed, there is no cure for autism. The goal of early intervention should be to change the developmental trajectory of the child. If the child does not receive any intervention their developmental trajectory won’t change. With some intervention, the child’s development will more closely align with typically developing peers.

Handwritten graph of developmental trajectories of typical, autistic without intervention and autistic with early intervention in autism treatment children.

Your goal should be for the child to learn as many skills as possible. Communication, self-help/independence and play skills are all critical for very early learners. These domains should be the focus of intervention.

Does your child need to have a diagnosis to begin early intervention?

NO!

Beginning early intervention with your child as soon as you notice red flags is key. There is a lot to be learned for both the child and the caregivers. Waitlists for assessment and then treatment can be long. If you have an opportunity to begin therapy take it!

Each child has potential. Having early intervention for autism will only benefit your child. Reach out to us if you’d like to discuss your child’s early intervention program.

Ontario Autism Program Announcement…?

December 14, 2020

On Friday December 11th, 2020, the province published an announcement about the rollout of the newest variation of the Ontario Autism Program. The news came from Jennifer Morris, Assistant Deputy Minister, Ministry of Children, Community and Social Services. It was not the news we wanted.

Many people write about the Ontario Autism Program. You can read my blogs about the OAP, the Ontario Autism Coalition‘s website, Facebook and myriad news articles to learn more.

The Ontario Autism Program Announcement

The five pillars of the new(est) OAP are: core clinical services (therapy), foundational family services, early intervention, urgent mental health supports and service navigation. Arguably the most important and more valued pillar is the core clinical services. Sadly, this is also the most costly and will be delivered last.

Logo of Ontario Autism Program

The OAP announcement describes the upcoming ‘calls for applications’ from service providers who wish to bid to implement different pillars of the program. There was no mention of the core clinical services. It is incredibly frustrating and irresponsible for the provincial government to be focusing on these other elements of the OAP while ignoring clinical services. It is possible to implement multiple pillars at the same time.

The Conservatives decimated the program in 2018. They promised to have it fixed by April 2020. Then they said they needed another year. Now it seems as though it will be well into 2022 before we see any core clinical service funding. What do families do when their child’s one time interim funding over?

Some will argue that there is a pandemic and we cannot expect the government to focus on our issues exclusively. But I would argue that this is a problem that the government was ignoring for A LONG TIME before the pandemic began. Now is the time to support these families.

At least we should be clear on how it will be implemented and when. That’s what people expected in an Ontario Autism Program Announcement.

What’s happening now for families and providers

Because families are floating between 3 programs there is a lot of confusion. Legacy kids (mostly) get funding for the services they require – if they can find providers with clinicians available to do therapy. Childhood budget kids are using their funding and waiting for invitations to the interim one time funding. Interim one time funding families are worrying about what happens when their funding ends.

It is unconscionable that the Ford government is keeping families in the dark. ABA system capacity suffers the longer we are in limbo and chaos. Clinicians are leaving the field, for more consistent, stable work. Service providers are not able to meet the demand and waitlists continue to grow longer and longer.

How much longer will the autism community have to wait?

Red Flags for Autism: 8 Behaviours to look for

December 7, 2020

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

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

8 Red Flags for Autism

Language

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

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

No pointing or use of gestures

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

Inconsistent responding to name

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

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

Loss of previously mastered language skills

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

Social Skills

Inconsistent eye contact

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

Lack of joint attention

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

Stereotypic or Repetitive Behaviours

Unusual or repetitive behaviours with their hands or other body parts

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

Preoccupation or unusual interests

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

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

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

Conclusion

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

How To Get An Autism Diagnosis

November 30, 2020

Many parents are unsure of where to turn or what steps to follow to have their child assessed for autism. They simply don’t know where to start to get an autism diagnosis.

  • Do you have concerns about your childโ€™s development? 
  • Have you brought them up to your childโ€™s physician? 
  • Are you wondering what the process is to get an autism diagnosis in Ontario? 

At your child’s 18 and 24 month check-ups the doctor should be screening your child for autism. They’re likely using a tool called the M-CHAT-R (Modified Checklist for Autism in Toddlers – Revised). The M-CHAT-R is 20 questions about your child’s behaviour. No screening tools catch EVERY child so even if your child passes the M-CHAT-R, you can still request the doctor make a referral to a specialist for further testing.

To diagnose autism, the person will use formal assessment tools and their clinical judgement. There isn’t a blood test or a scan that you can do that will show autism. Diagnosticians need to have a lot of training and experience identifying autism.

Image of testing materials used during autism diagnosis.

Paths to an autism diagnosis

There are three ways to get an autism diagnosis in Ontario.

Medical:

A family physician, a child’s paediatrician, a developmental paediatrician, a neurologist or a psychiatrist can all diagnose autism. OHIP pays for this assessment and it will not cost you anything. If your doctor is not able to reliably make the diagnosis, they would refer you to someone with more experience and training. Many physicians do not give a detailed report of the child’s level of functioning but will simply write a diagnosis letter. However, as with all OHIP services, there could be a wait to be assessed, especially if you need a referral.

A diagnostic hub:

There are 5 diagnostic hubs in the province. The hubs use a multi-disciplinary approach and perform standardized test. Specifically, there is usually a psychologist, an occupational therapist, a speech-language pathologist and a behaviour analyst on the diagnostic team. They will interview you and interact with your child for a few hours, usually over a few appointments. The provincial government pays for the assessment if it’s done at a hub. Nonetheless, the wait for an appointment can be OVER A YEAR. After the assessment you will receive a written report, describing your child’s behaviour and current level of functioning. Usually, the hub will have you come in for a summary meeting to discuss the findings and talk about next steps and referrals. The hub will give you a list of many resources in your community where you can turn for help.

A private assessment:

Some families choose to use a psychologist to provide the assessment and diagnosis. In fact, Autism testing can cost between $3000 and $5000. The psychologist will interview you and will do standardized tests with your child. Many psychologists use a test called the ADOS (Autism Diagnostic Observation Schedule). Often, psychologists recommend that parents not be in the room during testing. It can be very difficult for parents to watch. This is because your natural instinct is to help your child, but the point of the testing is to determine how your child behaves without assistance. Generally, the full assessment takes place over 3 or 4 visits. The first visit is a parent interview. The second and third are the testing with the child. The last appointment is usually the review of the findings and referrals.

Do you need an autism diagnosis to start treatment?

No! Every child who is not meeting their milestones would benefit from early intervention. Accessing Focused ABA , S-LP or OT services would benefit your child, especially while you’re waiting for a diagnostic assessment.

Early #Autism Diagnosis: Key to Successful Intervention

October 25, 2020

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

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

Taking advantage of the brainโ€™s neuroplasticity 

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

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

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

Early diagnosis, also beneficial for parents

Parents are usually the first to notice that their child isnโ€™t developing as expected. Getting an early autism diagnosis can relieve distress and help parents focus on next steps. They can seek early intervention, form a support network and they can access several benefits, such as the Registered Disability Savings Program.

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

Starting therapy from a young age

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

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

Warning signs of autism

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

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

Warning signs of autism:

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

Early diagnosis, the first steps of the journey

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

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

Early Start Denver Model (ESDM): Unleash Potential!

August 9, 2020

Read time: 4 minutes

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

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

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

ESDM: The earlier, the better

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

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

A better chance of addressing behavioural issues 

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

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

ESDM: Individualized intervention from an early age

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

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

Early Intervention: Families receive support early on

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

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

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

ESDM: A combination of ABA and play

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

Taking advantage of the brainโ€™s neuroplasticity 

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

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

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

Ontario Autism Program (OAP): a short history.

July 26, 2020

Early 2016

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

In June 2016

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

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

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

Changes to the OAP in 2018/2019

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

In February 2019

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

In March 2019

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

In June 2019

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

In December 2019

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

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

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

Where do families stand now?

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

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

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

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

February 10, 2020

Read Time: 5 minutes

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

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

It is important to rely on your treatment team including a Board-Certified Behaviour Analyst in Toronto (BCBA) for support and guidance as they understand just how exhausting and challenging such a diagnosis can be. Working together will help with your child and familyโ€™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 Childโ€™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 childโ€™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 childโ€™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 โ€œone size fits allโ€ 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 childโ€™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 childโ€™s physician as early as possible to investigate a diagnosis. Donโ€™t allow your childโ€™s doctor to dissuade you or convince you to โ€˜wait and seeโ€™. 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 childโ€™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 donโ€™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. Itโ€™s therefore necessary that the therapy plan includes siblingsโ€™ and parentsโ€™ 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 therapistโ€™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 familyโ€™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 childโ€™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 familyโ€™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 โ€œjust in caseโ€ 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 theyโ€™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 pajamaโ€™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 โ€œneeds -based and sustainable autism programโ€. 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 childโ€™s written diagnosis must include:

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

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

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

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

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

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

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

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