In this second post on how to toilet train your autistic child, you’ll learn about: day vs night time training, urine vs bowel training and how to leverage reinforcement. Make sure to check out last week’s blog Toilet Training Tips from ABA Therapy (Part 1) for more information and tips!
Day vs Nighttime Toilet Training:
Many children, especially boys, continue to have nighttime accidents for years after they’ve become daytime trained. Often nighttime training isn’t possible because the child’s body isn’t waking up when they have to pee. It’s not a matter of motivating the child or setting a schedule.
If your child is above age 7 and is still having consistent nighttime accidents you should consult their paediatrician.
Some strategies to avoid nighttime accidents are:
Avoid beverages 2 hours before bed
Make one or two bathroom trips before putting your child to sleep
Gently wake your child to take them to pee before you go to bed yourself
How to use Reinforcement to Toilet Train your child:
When you’re beginning to toilet train your child, you should observe their interests and preferences. We want to use the things they like the most to motivate them to learn this new skill. Children need to be ‘paid’ to put in hard work, just like adults! When you have identified their most reinforcing items you want to begin to limit access to these items. If the child knows they can get the reinforcer later (without having to do the work) there won’t be any reason to do the hard stuff.
Some parents will put the reinforcer right into the bathroom, on a high shelf. The child should be able to see it but not touch it. Be very clear and explicit with your child that they need to pee or poo in the toilet or potty if they want to gain access to the reward. Stand your ground! If they don’t engage in the desired behaviour they can try again later. Don’t give them the reinforcer unless they use the toilet!
Some examples of reinforcers used to toilet train are:
Individually wrapped chocolates (snack sized)
Jelly beans
Lolly pops
Freezies
Hot Wheels Cars
Action figures
Special priviledges
When your child is successful and uses the toilet or potty, BRING THE CIRCUS TO TOWN! You want to pair social praise with the reinforcer so that eventually you can fade the reinforcer.
Urine vs Bowel Training:
Some children have a hard time learning to have bowel movements in the toilet. There can be feelings of loss of control, sensory needs or even fear (of pain) that can inhibit a child from reliably having bowel movements in the toilet. It is often necessary to toilet train for urine first before trying to teach bowel training.
When you’re tracking your child’s toileting schedule, you should take note of if the child voided their bladder or moved their bowels. Many children have a consistent bowel movement schedule while voiding urine can be more flexible.
You might also have to use different reinforcers for urine vs bowel training. A higher level reinforcer would be used for bowel training as it’s generally more difficult for the child to master. Sometimes we use the same reinforcer but a bigger portion (instead of just a few gummies giving a handful).
Conclusion:
When a family decides to toilet train, it can be a very stressful time for everyone. Using these ABA Therapy strategies will help make the process smoother and more enjoyable. Contact Side by Side Therapy today to get some advice about toilet training.
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.
When your child gets an Autism Spectrum Disorder diagnosis there is an avalanche of information. What do the autism severity levels mean? Many families have asked me this question. Some families have a lot of support. However, some are sent on their way with a one page diagnosis letter. If you’re looking to have your child assessed here’s a list of the ways you can get a diagnosis in Ontario.
What is the DSM-5?
The DSM-5 is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The American Psychiatric Association (APA) released the DSM-5 in 2013. It is where a doctor or psychologist finds the description and criteria of all of the disorders and behavioural conditions. As medical knowledge changes the APA releases updated versions of the DSM.
With the release of the DSM-5, one of the major changes to the autism section was the combining of the communication and social impairment criteria. Another change was adding the severity levels.
What are the autism severity levels?
One of the most confusing elements of a diagnosis is the severity levels. Instead of using high and low functioning, which are ambiguous, we use the severity levels. Severity levels create a common language. This is important so there’s a standard and we all know that we’re talking about the same thing.
There are 3 levels: Level 1 is equivalent to requiring support. Level 2 implies requiring substantial support. Level 3 denotes requiring very substantial support. A person can have different severity levels for each of the elements of autism. For example, a person can be Level 1 in social communication but level 2 in restrictive, repetitive behaviours.
How are they used?
The severity levels do not determine funding eligibility. But this might change as the province implements needs based funding. Above all, individual assessments should inform treatment decisions. Certainly, a therapist might use a severity level to pick which assessments to do. Severity levels give a glimpse of what the focus of ABA Therapy might be. That is to say that clinicians might use severity levels in guiding treatment planning.
Can autism severity levels change?
Absolutely!
As children grow and learn their needs will change. In other words, the amount of support the person needs will change depending on the environment and expectations. People are complex. That is to say there are many factors that impact their behaviour and the support they need. Often, removing one barrier can improve other areas as well. For instance, improving a child’s communication skills can (and usually does) reduce challenging behaviour.
If you have questions about your child’s diagnosis or autism severity levels and how an ABA Therapy program can help, contact Side by Side Therapy to set up a no charge consultation.
This blog post will discuss challenging behaviours: why language matters when describing behaviour, behaviour as communication, functions of behaviour, replacements and safety when addressing behaviours.
Language matters
Challenging… problem… interfering… There are many words that describe behaviours. However, how you label a behaviour speaks to how you feel about it. Calling a behaviour a ‘problem’ gives blame to the learner. Naming a behaviour as challenging can lead to the question “Who is this behaviour challenging?”. Labeling a behaviour as interfering might lead people to ask “interfering with what?”
Like most topics in the autism and ABA world, there is controversy around this. At Side by Side Therapy, I use challenging or interfering to describe these behaviours. I feel that it helps to focus our efforts on the behaviours that aren’t helpful to the learner.
Challenging Behaviours are Communication
If we take the view that all behaviour is communication, the learner isn’t to blame for their behaviour. They’re simply communicating a need in the most effective way they have. This attitude also leads us to look for alternative ways to communicate this need. It focuses us on helping the learner as opposed to stopping the behaviour.
4 Functions of Behaviour and Replacement Behaviours
When we’re targeting interfering or challenging behaviours we must identify their function. Some behaviours serve more than one function. We can ask: What does doing this behaviour give the learner? Does it let them off the hook for something undesirable or difficult? Having this information will help us find a replacement behaviour that meets the same need but is better for the learner. Better, in this case, means: easier, safer, more efficient and more effective. It can also be more socially acceptable.
More often than not, when we’re addressing challenging behaviours, one of the first things we teach is functional communication. This can be any form of communication (spoken words, signs, picture exchange, gesture etc). What’s important is that the learner is able to use the communication independently and that it is effective in meeting their need.
Safety First with Challenging Behaviours
Unfortunately, some behaviours are just dangerous. It is critical to keep safety at the forefront of any behaviour reduction plan. The learner’s safety, as well as the other people in their environment (family, peers, staff). Sometimes (often!) the plan needs to be revised and changed. Some behaviours are merely bothersome to the people around the learner. These behaviours do not always need to be targeted for reduction.
Many parents are unsure of when or how to tell a child theyโre 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 theyโre 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 โstreet credโ 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 childโs differences
Many parents noted that they preferred to use difference as opposed to disorder when describing their childโs 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 childโs attention from their challenges to their strengths was also a common strategy among the parents surveyed.
Theme 4: Adjusting the conversations to the specific childโs needs
Many of the parents that participated in the study noted that the conversations should be specific to the childโs 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 youโre using. However, they might be giving you clues about their readiness. When your child begins asking questions like โWhatโs wrong with me?โ, โWhy canโt I ________โ, โWhy is this so hard for me but everyone else can do it?โ or even โWhatโs wrong with everyone else?!โ theyโre 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.
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 childโs development?
Have you brought them up to your childโs 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.
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.
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 youโll 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 peopleโ lives by helping them achieve more independence and access to the things that matter to them.
What is IBI?
IBI stands for intensive behaviour intervention. IBI is the intensive application of the science of ABA. For a program to be considered IBI, it has to occur more than 20 hours per week. Because of the intensity, IBI programs are usually comprehensive. This means that they cover many domains of learning. IBI programs are often recommended for children with level 2 or 3 autism (previously known as lower functioning children).
What are socially significant behaviours?
Socially significant or meaningful behaviours are the behaviours that matter to you and your family. Some examples are: communication, self-care (toileting, hygiene, self-feeding) and reducing challenging behaviour. Independence in these areas will allow your child to participate more fully in life.
Neither IBI nor ABA is better than the other. Some children learn best in a very structured environment (like IBI) while others learn best in a naturalistic setting (like school). Your child will make progress in both. There is a lot of research that shows that early intensive behaviour intervention has the best outcomes for young children.ย
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 childโs needs, their other programs/therapies, location, finances, waitlists and your beliefs about education. You know your child best and itโs 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.
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.
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 โnew and improvedโ version of the OAP. This plan provided Childhood Budgets to autistic children. The budgets were based on the childโs 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 childโs 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 โget 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 childโs 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 โLegacy 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.
In describing the early features of autism, many specialists mention poor social interaction. Autistic children do not naturally gravitate to their peers, failing to take part in group activities or make friends.
Many autistics need social skills training in Toronto in order to learn social skills. There are, however, a number of strategies that can be used for this purpose. When these skills develop the overall quality of life will definitely improve โ which should always be our end goal.
Autistic children might lack social play skills, seeming to prefer to be alone. It is important to remember that we cannot know for certain that this is their preference, but rather might be a function of a skill deficit – they may simply not have the skills and knowledge to appropriately interact.
6 Social Skills Training in Toronto Tips
#1 Practicing different play scenarios
Play skills can involve social interaction but, like any other skill, they require practice. So, take your childโs favorite toys, and create different play scenarios. You can create a scene of a farm or play with cooking utensils. A stuffed toy can be used to practice various skills, such as feeding or dressing.
An added bonus about this type of activity is that you can teach the child to take turns and follow rules. In case of smaller children, it might be a good idea to opt for games that involve movement. Prompts can be offered to support the learning process, and every achievement, no matter how small, should be praised.
Interactive play is a skill that is taught as part of the Social Skills Training in Toronto curriculum.
#2 Imaginative Play
In order to play with peers, autistic children must be able to engage in role play and pretend. As a parent, you can practice these skills at home, choosing games that are simple and fun. Young children often enjoy pretending to be their favourite animals or characters.
If the child is older, and there are no significant cognitive delays, you might opt for a situation that requires a problem to be solved. For example, you can pretend a toy has been lost, asking the child to be a detective and help you find it.
Pretend play is an important skill that is included in the social skills training in Toronto curriculum.
#3 Visual prompts
There are many children who learn better with the help of visual prompts, especially when it comes to complex skills. You can use pictures to discuss social situations and teach the child appropriate behavior. Use the pictures as a way to remind your child of the expected behaviour. It is much easier to eliminate visual prompts than verbal prompts.
Allow your creativity to run free and turn the learning experience into a game.
#4 Learning emotions
To improve your childโs social skills, you might consider helping the child develop an emotional vocabulary. You can use pictures, moving on from simple examples, such as someone feeling sad or happy, to more complex possibilities, such as acting surprised, bored or confused.
#5 Social skills groups
Nothing beats practicing a skill as close to reality as possible. For this reason, you should consider social skills groups, where the child has the opportunity to practice interaction with other autistic and neurotypical peers, on a regular basis.
Every parent is free to decide whether the group will contain only autistic children or a mix and there is value in each option. Another important tip would be not to overly schedule the activities but rather opt for free play, trying not to intervene too much. There needs to be a goal for the group and the activities that are selected should endeavour to support that goal.
#6 Gesture imitation
Autistic children often do not use gestures purposefully and they might not understand our gestures either. Gestures can be learned using imitation and the use of prompts. You can begin with simple gestures, such as waving goodbye, nodding your head or blowing a kiss. After a gesture is learned in imitation it should be generalized to the natural environment so your child will begin to use it without prompting and in the correct contexts.
Once these gestures are learned, you can move on to more complex ones, including physical actions and pretend play. For instance, you can pretend you are drinking a glass of water. Do not hesitate to use spoken words, finding a way to match them to the gestures you are teaching the child. And, remember, all should be done through play!
When it comes to social skills training in Toronto, we are proud to offer this foundational skill set to all of our clients. Contact Side by Side Therapy to set up your childโs no-charge consultation. We will discuss not only social skills training in Toronto but also the other therapeutic solutions we offer.
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.
Itโs easy to become overwhelmed by the sensory stimuli in the environment. These GTA attractions are working to help your child manage these times.
Below you will find some of the places around the GTA that are now offering these autism and sensory-friendly settings.
Autism or Sensory Friendly Attractions in Toronto
1. Ontario Science Centre โ 770 Don Mills Road, Toronto, ON M3C 1T3The Ontario Science Centre offers Sensory-friendly Saturdays on the first Saturday of every month from 3 โ 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 โ 361A Old Finch Avenue, Toronto, Ontario, M1B 5K7
The Toronto Zoo has developed a downloadable app specifically for those with ASD. This app called MagnusCards (for more information please visit http://torontozoo.magnuscards.com/) was created to provide a structured, step-by-step program that has a game-like design which helps teach a variety of life skills through the use of the app.
This app is believed to provide empowerment and a welcoming environment for those living with autism and other cognitive special needs. The five-card decks include information on entering the zoo, Indo-Malaya, Tundra Trek, African Rainforest Pavilion, and Getting Help.
For more information please visit their website at: http://www.torontozoo.com/tz/accessibility
3. Cineplex Movie Theatre โ Variety of Locations
Cineplex theatres offer โSensory Friendly Screeningsโ, which includes a โlights up and volume downโ 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 โ 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) โ 100 Queenโs Park, Toronto ON, M5S 2C6
The ROM has teamed up with Autism Ontario to create a โROM Sensory Friendly Guideโ, 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. Ripleyโs Aquarium of Canada โ 288 Bremner Boulevard, Toronto, ON M5V 3L9, CANADA
Ripleyโs 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.
Ripleyโs 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 โ 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 โALL kids to be a kidโ.
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 โ 165 Front Street East, Toronto M5A 3Z4
Young Peoples Theatre offers โrelaxed performancesโ 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 childโs 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 โ 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.
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 familyโs 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 Childโs 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 childโs 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 childโs 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 โone 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 childโs 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 childโs physician as early as possible to investigate a diagnosis. Donโt allow your childโs doctor to dissuade you or convince you to โwait 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 childโs 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 donโt 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. Itโs 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 therapistโs 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 familyโs needs and expectations is extremely important. You will also need to ensure there is a constant flow of communication between your family and your childโs 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 familyโs 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 โjust 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 theyโre 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 pajamaโs, 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 โneeds -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 childโs written diagnosis must include:
your childโs full name and date of birth
the date of your childโs assessment
a statement indicating that the child meets the diagnostic criteria for autism spectrum disorder
the qualified professionalโs 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:
As a parent raising a child with autism spectrum disorder, you are faced with many difficulties and daily challenges which require adjustment in your parenting skills to include flexibility, patience, understanding and strength. You need to become very aware of your childโs specific needs while all along ensuring your own wellbeing and mental health.
It is important to realize that no two children with autism (as with all children) are the same. This therefore requires you to have the flexibility and open-mindedness to try numerous strategies and techniques to find the best fit for your child and family. This discovery may take some time and will include ups and downs, however, with persistence and the help of your childโs team you will find the path that will provide the direction necessary to seek positive change.
Here are 10 helpful tips to try with your child with autism:
1. Donโt make comparisons
Every child is unique and faces their own challenges. It is important to not compare your child with siblings or classmates. All children develop at their own pace and react to situations differently. Situations that donโt cause one child to bat an eye might be devastating for another. Comparing your childโs behaviour to that of others can cause your child to feel guilty for something that might be out of their control.
2. Help your child realize when they need a break
When your child with autism starts to feel frustrated, it is important for them to be able to identify their emotions and to be able to access the tools that will help them to calm and regulate their emotions. You can teach your child the tools they need in order to seek a break in a calm, comfortable and safe environment. This break will provide a safe place to allow them to calm down whichever way works best for them. This skill is crucial for all children but specifically for children with autism.
3. Listen to your child calmly and do your best to understand
Dealing with any young child can be quite difficult and trying to rationalize with them often is not successful, this is especially true of children with autism where there are language skill deficits. This ongoing challenge often leads parents to become frustrated and overwhelmed.
As a parent, it is crucial to maintain calmness (regardless of how difficult the situation becomes) to prevent escalation in the childโs behaviour. If you can calmly understand your childโs perspective you may then be able to adjust your methods so that youโre working with our child instead of against them.
4. Help your child apply new skills to different situations (generalization)
Many children with autism donโt generalize their learning, meaning that they cannot apply a skill in novel situations. They might be able to use the bathroom at home but seem unable to use a public washroom, for example. It is important to practice the same skills in different situations and through repetition. Your child will eventually learn to apply them more easily regardless of the circumstances.
5. Keep an open mind
Our life experiences dictate our perspective and how we view the world. This simple fact can get in the way of understanding our childโs experiences. Neither yours nor your childโs beliefs are wrong. It is therefore important that you as a parent of a child that looks at the world differently is open-minded. Through tolerance and acceptance, you will be better able to understand your childโs point of view as well as acknowledging that there are alternatives and various approaches to helping them.
6.Maintain a sense of humour
Some of your childโs behaviours may not initially (or ever) fit within societal norms and may be perceived as unconventional. As mentioned earlier, these are only perceptions that we have been taught, if you were to look at the difference with an alternative lens using humour, youโll likely find that you are bothered less and feel less judged.
7. Never underestimate how much your child understands
There is a difference between receptive language (what we understand) and expressive language (what we can communicate with words, sign language, picture exchange or augmentative communication). Many children with autism have difficulty with expressive language while their receptive language falls within normal development. This means that they cannot express all the things they understand. There may appear a lack of understanding but this is likely not the case.
As mentioned, it is important to be open-minded and this involves looking into therapeutic methods and techniques to help your child. ABA therapy has been established as one of the most effective methods in working with children with autism. It is important that your ABA team is lead by a BCBA (Board Certified Behaviour Analyst). You should investigate the ABA providers in your area because not all people practice in the same way.ย ABA should be individualized to the child so if youโre concerned about a specific aspect of your childโs ABA therapy, you should feel confident to bring it up with your provider.ย
9. Work with the school and be an advocate for your childโs needs
School plays a large and critical role in your childโs development. Your relationship with the school is important as your child will require additional services, support and programs. These additional resources can and should be provided through the educational system. If you feel that the school is not recognizing your childโs additional needs or working with you for your childโs betterment then you need to advocate for them. You know what is best for your child and it is up to you to convey your needs and concerns. Ongoing communication and feedback will help keep you and the school on the same page and will align every player on your childโs team.
10. Take a break yourself and seek support
Raising an autistic child may come with many challenges however on the flip-side it comes with many rewards. You need to remember to be kind to yourself, know you are an amazing parent doing your best in a demanding situation. You need to ensure that you are in a place that you can handle and manage all that is needed of you. Donโt take everything onto yourself, reach out to your support network frequently. Seeking help will take care of yourself and in turn you will be the best parent you can be.
Check out the Autism resources page to find links to valuable information about autism spectrum disorder.
