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How to Toilet Train your Autistic Child (Part 2)

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!

Lollipops used to Toilet train at Side by Side ABA Therapy

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.

What does masking autism mean?

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.

Autism Severity Levels (DSM-5) in 2021

Read time: 4 minutes

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.

Father walking with daughter along the street. Autism severity levels aren't clear.

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.

Challenging Behaviours in Autism Treatment

Read time: 3 minutes

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.

Father carrying his toddler who is engaging in challenging behaviours.

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

There are 4 functions of behaviour.

  • ATTENTION
  • ACCESS to items
  • ESCAPE or AVOID situations
  • SENSORY or AUTOMATIC reinforcement

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.

Contact Side by Side Therapy to discuss your learner’s challenging behaviours.

How and When To Tell a Child They’re Autistic

Many parents are unsure of when or how to tell a child they’re autistic. It can be a very sensitive subject and without some thought it can be tricky conversation to navigate. Crane, Lui and Davies (2021) recently published a study. It highlighted some important themes in having this discussion. 

Important themes when telling your child they’re autistic:

Theme 1: Having open and honest conversations about autism

The first theme highlighted in Crane, Lui and Davies (2021) was Normalizing the conversations about autism symptoms.  Parents reported that by having frequent and frank discussions about the way that their lives are affected were important in creating an open dialogue. Conversations that began when the child was young helped the child avoid having preconceived ideas about what autism is. This allowed them to have their own experience without being weighed down by the ideas of others. 

Family hugging after telling child they're autistic.

Theme 2: Creating a shared understanding

Many parents of autistics either have autism themselves or share some of the autistic traits.  Showing your child that you experience the same things that they do will create a shared understanding. This gives you some ‘street cred’ when suggesting strategies for your child. The parents also discussed that sharing their lived experiences helped them to understand each other and brought trust. 

Theme 3: Positively supporting the child’s differences

Many parents noted that they preferred to use difference as opposed to disorder when describing their child’s needs. They felt that this was less stigmatizing and easier for children to understand. Each person is different and that does not decrease their intrinsic value. Refocusing their child’s attention from their challenges to their strengths was also a common strategy among the parents surveyed. 

Theme 4: Adjusting the conversations to the specific child’s needs

Many of the parents that participated in the study noted that the conversations should be specific to the child’s lived experiences and not broad and sweeping. Parents should try to identify areas of interest and capitalize on that motivation. Some referenced having autistic role models as being extremely helpful for their children. 

When should you tell your child they are autistic?

There is no rule about when is the right time to tell your child about their diagnosis. It is important to take chronological age as well as developmental age into account when deciding if your child is ready. They need to understand the meaning of the words you’re using.  However, they might be giving you clues about their readiness. When your child begins asking questions like “What’s wrong with me?”, “Why can’t I ________”, “Why is this so hard for me but everyone else can do it?” or even “What’s wrong with everyone else?!” they’re likely ready to learn about their diagnosis. 

Time of day should also play a factor in your conversation. You want to make sure you’ve got enough time to answer all of your child’s questions. The conversation shouldn’t feel rushed or interrupted. Before school or at bedtime are not ideal times for this topic.

We’re here to help you if you’d like to talk about how to tell your child that they’re autistic. Connect with us for a no charge/no obligation consultation. You can also check out of Autism FAQ for some commonly asked questions.

How To Get An Autism Diagnosis

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 child’s development? 
  • Have you brought them up to your child’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.

IBI and ABA: What’s the difference?

Read time: 3 minutes

When your child receives an autism diagnosis you are introduced to an alphabet soup of acronyms. IBI, ABA, OAP, FA, IEP, IPRC; the list is endless.  In this post you’ll learn the differences between two of the most used and often confused: IBI and ABA. 

Boy working with therapist in an IBI session for autism treatment.

What is ABA?

ABA stands for applied behaviour analysis and it is the science of learning and behaviour. There are a few laws of behaviour, very much like the laws of gravity. These rules are reliable, observable and measurable. The focus of ABA is to change socially significant or meaningful behaviour.  That  means that the goal is to improve people’ lives by helping them achieve more independence and access to the things that matter to them.

What is IBI?

IBI stands for intensive behaviour intervention. IBI is the intensive application of the science of ABA. For a program to be considered IBI, it has to occur more than 20 hours per week.  Because of the intensity, IBI programs are usually comprehensive. This means that they cover many domains of learning.  IBI programs are often recommended for children with level 2 or 3 autism (previously known as lower functioning children).

What are socially significant behaviours?

Socially significant or meaningful behaviours are the behaviours that matter to you and your family. Some examples are: communication, self-care (toileting, hygiene, self-feeding) and reducing challenging behaviour. Independence in these areas will allow your child to participate more fully in life.

Neither IBI nor ABA is better than the other. Some children learn best in a very structured environment (like IBI) while others learn best in a naturalistic setting (like school). Your child will make progress in both. There is a lot of research that shows that early intensive behaviour intervention has the best outcomes for young children

In an IBI program, your child will learn communication and language, social skills, play skills, pre-academic or academic skills, self-help skills, motor skills and much more.

In an ABA program, the therapy will focus on one or two specific goals that you want to address. Some parents choose to focus on challenging behaviour when doing a focused program. Also, some families find it helpful to focus on ‘high impact’ behaviours like toileting or feeding.

How do I decide which program my child needs?

Choosing which program is best for your child is a difficult decision. There are many factors that will play a role: your child’s needs, their other programs/therapies, location, finances, waitlists and your beliefs about education. You know your child best and it’s important that the therapy you choose fits your lifestyle and beliefs.  Therapy plays a big part of your life and it needs to make sense for your family. 

Working with a Board Certified Behaviour Analyst (BCBA) that you can trust is really important. The BCBA will do an assessment to figure out what skills and needs your child has. Some common assessments are: the Assessment of Basic Learning and Language Skills – revised (ABLLS-r), the Verbal Behaviour Milestones and Placement Program (VB MAPP) and PEAK Relational Training System. These are curriculum assessments that determine current skills and areas of need. They do not provide a new diagnosis. The BCBA might also do a Functional Analysis (FA) to determine the function of a challenging behaviour. Based on the results of the assessments your BCBA will make a recommendation that is specific to your child.

You should be fully aware of and give permission for each part of your child’s program. The clinical team must explain how the skills will be taught. Behaviour does not happen in isolation, so you will need to implement the same strategies outside of therapy.

Who is on an IBI/ABA team?

There are 3 levels of clinicians on an IBI team: instructor therapists, Senior Therapists and the BCBA or Clinical Supervisor. The instructors are delivering the therapy on a daily basis.  The Senior Therapist does the assessment and follows the programming to ensure that it is being properly executed and that the child is making progress. The BCBA works with the Senior Therapist to do the assessment and determine what the goals should be.  They will work together with the Senior Therapist to write the programs and train the instructors.

How much does IBI/ABA cost?

Each centre is different and ABA is not regulated in Ontario (yet!) but you can expect to pay roughly $55/hour for the Instructor Therapist, $75/hour for a Senior Therapist and $150/hour for the BCBA.  At Side by Side Therapy, we use a 10% supervision model. That means that for every 10 hours of therapy your child  will have 1 hour with either the Senior Therapist or the BCBA.

The Side by Side Therapy Process

At Side by Side Therapy we determine which of our 4 streams of ABA service (IBI/Comprehensive ABA, Focused ABA, Parent Coaching or Behaviour Consultation) will meet your child and family’s needs. We write programs specifically for each client. Each program is different.

You are able to use your Ontario Autism Program (OAP) funding with Side by Side Therapy. We will help you navigate the process and will ensure that our services fall within the OAP guidelines.

Connect with Side by Side today to schedule your free no obligation consultation.

Ontario Autism Program (OAP): a short history.

Early 2016

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

In June 2016

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

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

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

Changes to the OAP in 2018/2019

Doug Ford became the Premier of Ontario in June 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.  This freeze dramatically increased the waitlist. A few months later, Lisa MacLeod, the Minister of Children and Youth used the ballooning waitlist as the reason for making dramatic changes to the OAP Funding.  

In February 2019

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

In March 2019

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

In June 2019

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

In December 2019

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

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

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

Where do families stand now?

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

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

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

Top 6 Practical Social Skills Training in Toronto Tips!

Read time: 3 minutes

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

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

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

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

6 Social Skills Training in Toronto Tips

#1 Practicing different play scenarios 

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

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

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

#2 Imaginative Play

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

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

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

#3 Visual prompts

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

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

#4 Learning emotions 

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

#5 Social skills groups

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

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

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

#6 Gesture imitation 

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

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

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

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

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

Read time: 5 minutes

Have you ever been in a situation where the music was just too loud or the lights were way too bright? How about being in a place that was far too overcrowded and you started to feel overwhelmed and panicky? Well, this is a common feeling for those that are diagnosed with autism or Sensory Processing Disorder (SPD). SPD is related to over or under sensitivity to certain sensory stimulation such as loud noises, bright lights, tastes and touch.

It is a condition that affects the way the brain receives and responds to information concerning our senses and has been found to create either an over or under sensitivity to certain things within our environment.  Those that have (children specifically for the purposes of this article) SPD often receive a co-occuring diagnosis like Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD). 

Since SPD is so prominent in children especially for those that also have additional disorders, life can become difficult for not only the child but for the parents and caretakers as well.  This sensory sensitivity can be very debilitating and sadly can turn a task as simple as going to the grocery store into a very difficult undertaking.

Here in the Greater Toronto Area (GTA) in Canada, some companies have caught on for the need to provide alternative accommodations for those that live with special needs like  SPD, ASD & ADHD etc. These establishments have collaborated with autistic focussed organizations to find ways to modify their businesses to provide a sensory-friendly environment.  

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


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

Autism or Sensory Friendly Attractions in Toronto

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

The following dates are set for 2020:

February 1, March 7, April 4, May 2, June 6, July 4, August 1, September 5, October 3, November 7 and December 5 


For more information please visit their website at: https://www.ontariosciencecentre.ca/showsandexperiences/368/ 

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

The Toronto Zoo has developed a downloadable app specifically for those with ASD. This app called MagnusCards (for more information please visit http://torontozoo.magnuscards.com/) was created to provide a structured, step-by-step program that has a game-like design which helps teach a variety of life skills through the use of the app.

This app is believed to provide empowerment and a welcoming environment for those living with autism and other cognitive special needs.  The five-card decks include information on entering the zoo, Indo-Malaya, Tundra Trek, African Rainforest Pavilion, and Getting Help.      

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

3. Cineplex Movie Theatre – Variety of Locations

Cineplex theatres offer “Sensory Friendly Screenings”, which includes a “lights up and volume down” environment.  In partnership with Autism Speaks Canada, Cineplex provides an atmosphere that allows those individuals with ASD or those who suffer from sensory sensitivities the opportunity to enjoy new releases at the theatre. 

The website states that these screenings will take place approximately every 4 – 6 weeks on Saturday mornings at 10:30 AM, however it is best to check your local theatre in case any changes have taken place. 

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

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

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

For more information please visit their website at:

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

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

Ripley’s Aquarium of Canada is the first autism certified attraction in Canada.  This Certified Autism Center has been designated by the International Board of Credentialing and Continuing Education Standards (IBCCES) after completing comprehensive autism awareness and sensitivity training. 

Ripley’s Aquarium is committed to ensuring that their visitors with ASD and other sensory sensitivities have the greatest time while at the attraction. The staff have undergone extensive training and each exhibit integrates some form of IBCCES sensory guidelines (https://www.ripleyaquariums.com/canada/files/2019/04/Sensory-Guides-Final.pdf) which provides the guests with additional information regarding the sensory impacts at each display or activity. 

Please check out their website for dates and times as they will be hosting several additional sensory-friendly days that include quiet spaces, music-free environments and increased lighting. 

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

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

For more information please visit their website at:

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

7. Skyzone – Various locations around the GTA

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

For more information please visit their website at:

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

8. Sobeys – Various locations around the GTA

As mentioned, tasks for which most would think is simple such as grocery shopping can be an anxiety-ridden experience for both a child with ASD and their parent/caretaker.  Grocery stores can have a lot of sensory stimuli such as loud music, bright lights and crowds which can be overwhelming for a child that suffers from sensory sensitivities.

Sobeys has taken notice of this issue and has now created an accessible and inclusive sensory-friendly shopping experience.  To accommodate the sensory needs, Sobeys provides every week, a two-hour shopping window where they eliminate almost all the in-store lights and sounds.

Some of the sensory sensitivity measures taken by Sobeys are turning down the lights, turning off scanners, lowering music, having staff members speaking in softer tones and holding off on any announcements. According to Sobeys, the sensory sensitive shopping takes place currently on Wednesdays from 6 p.m. to 8 p.m.  Please check with your local Sobeys for up to date information on dates and times. 

For more information please visit their website at:

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

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

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

The visual guide can be found at: https://www.youngpeoplestheatre.org/about-ypt/accessibility/

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

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

For more information please visit their website at:

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

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

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