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Why is ABA Therapy so expensive?

Read time: 3 minutes

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

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

Here are 6 reasons ABA Therapy is costly:

Federal & Provincial reasons:

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

Structural Reasons

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

Conclusion

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

The 5 Benefits of Outdoor Play

Read time: 2 minutes

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

Greater Physical Health

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

Improves Behaviour and Social Skills

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

Increase Sensory Skills

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

Increase Attention Span

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

Greater Happiness

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

Check out this list of parks in the GTA!

In Conclusion

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

Ontario Autism Program Funding

The province of Ontario provides funding to families of children diagnosed with Autism Spectrum Disorder. Recently, the Ontario Autism Program (OAP) has changed many times. To learn more, read Ontario Autism Program: a short history.

Who can get the OAP funding?

To access the funding your child must:

  • have a diagnosis of autism (given by a qualified professional)
  • be under the age of 18 years old
  • live in Ontario.

To register for the OAP, you must complete and submit this Ontario Autism Program Registration Form

Meanwhile, the current program is changing from a childhood budget model to a needs-based therapy model.  Don’t worry, you do not have to register again for the OAP if you have registered before. The new program will hopefully begin in March 2021. So far, the province has not released any details of how the new program will work or who will determine each child’s therapy needs. 

As the program continues to change, autistic kids fall into 4 categories:

  • Waitlist
  • Behaviour Plan Budget (Legacy funding)
  • Childhood Budget
  • Interim One-Time Funding.

Side by Side Therapy can help guide you through the uncertainty that comes with changes in funding. Also, we work with you to make the most of your child’s funding.

child and therapist playing with blocks in Ontario Autism Program session

What can be purchased with Ontario Autism Program funding?

OAP funding can purchase: ABA services, Speech Therapy, Occupational Therapy and respite services. Side by Side Therapy offers all of these services. OAP funds can be used to purchase materials and equipment that will benefit your child’s learning. In addition, families are able to purchase a desktop computer, a laptop computer, a tablet/iPad or a smartphone to help their child. 

Also, in an effort to help families, Autism Ontario is creating an approved OAP service provider list. Side by Side Therapy BCBAs are on the approved provider list. 

Schedule a no-charge consultation with Side by Side Therapy. Let’s discuss what services are best for your child using your child’s Ontario Autism Program budget.

9 Useful Occupational Therapy in Toronto Strategies

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

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

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

Try these Occupational Therapy in Toronto activities:

#1 Exercises for fine motor skills

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

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

#2 Exercises for gross motor skills 

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

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

#3 Heavy work 

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

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



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

#4 Sensory bins

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

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

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

#5 Homemade play dough 

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

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

#6 Painting with ice cubes

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

#7 Bring nature and sorting together 

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

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

#8 Deep pressure activities

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

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

#9 Crossing the midline

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

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



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

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

Top 7 Effective Speech Therapy in Toronto Strategies to Try With Your Children

Read time: 5 minutes

Parents are often the first ones to notice that their child isn’t developing, especially in terms of communication. The lack of infant babble, the absence of eye contact and reduced interest in interaction are just a few of the features that cause one to question a potential diagnosis of autism. It is possible and often practical to begin speech therapy in Toronto before a formal diagnosis is given.

Mother and child sharing a tender moment before speech therapy in Toronto.

Autistic children might also present a limited range of facial expressions, being unable to comprehend language or show a regression (loss of words). The sooner Speech Therapy in Toronto is started, the better the outcomes are going to be. In this article, you will find a number of therapeutic strategies which might be of help. 

Speech Therapy in Toronto Strategies:

#1 Using non-verbal communication 

Interestingly, non-verbal communication accounts for 90% of all communication. Our body language, the gestures we make, along with eye contact, help us interact with other people and communicate our needs. 

A good strategy is teaching the child, through imitation, gestures that can be used daily. You can begin with gestures that are easy to imitate such as: clapping the hands, waving, stomping feet or raising arms in the air. 

#2 Oral Motor Exercises

For children who exhibit few or no facial expressions, this strategy might be quite useful. Performed regularly, it can strengthen the oral muscles, especially the ones around the mouth and jaw. 

The exercises can be practiced with a  mirror, so your child is able to see what their face looks like when they make the specific movements.  You can get some ideas of exercises from this Youtube Channel: Speech Therapy Practice. They have a series of different videos depicting different exercises you can try with your child. 

#3 Animal noises 

A fun beginning step to teach vocal speech might be to try and have the child make animal noises, especially if the child is motivated by animals. Capitalizing on this motivation might be helpful in engaging your child in doing the difficult work of learning to make the sounds. 

Various toys or books can be used to introduce the child to animal sounds. As his/her interest becomes visible, you can move to more complex games – perhaps you can create a toy barn or an animal train, having fun in the process. Be patient and have fun. 

#4 Singing songs

Very few children dislike music. Singing can help the child to learn new vocabulary, rhythm and even new topics or ideas.  

In choosing songs, it is important to take into account not only the current communication abilities of your child, but also their cognitive level. Nursery rhymes are a great place to start for younger children but older children can be introduced to all kinds of music. 

#5 Technology as basis for communication

We are lucky to live in an age where technology is advanced, creating opportunities for us to help autistic children communicate. Augmentative and alternative communication represents an option for children with limited or no functional speech, allowing them to communicate desires, needs, preferences, dislikes and comment. 

There are devices that contain recorded messages, which the child can use with the push of a button. As progress is made, these messages can become more complex. A low tech alternative is a picture exchange communication system.  You can read more about Alternative and Augmentative Communication in this blog I wrote at the end of April. 

#6 Learning how to sequence and tell a story

This is a strategy which is generally used in children with more advanced receptive language, allowing them to continue to develop their language. You would present them with images of the parts of a story, and ask them to put them in order.

For example, you might provide a picture of an empty glass with a carton of milk beside it, another picture with a full glass of milk and a third picture with half the glass of milk drank by a child in the picture. 

In opting for this activity, you would choose to begin by presenting the stories or situations that your child has experienced. This makes it more concrete and is easier for the child. In time, he/she can do this activity alone, or even draw his/her own pictures to tell a story. Many children enjoy ‘authoring’ their own stories. 

#7 Pretend play

Pretend play is a difficult skill for an autistic child to achieve but, with perseverance, it will help improve many aspects of the child’s development. On the plus side, it helps with social interaction, reinforcing communication again and again. 

The strategy would be to choose some of the child’s favorite activities, expanding on their existing sounds, words or sentences. Once you’ve identified what your child is doing naturally, you want to encourage the next step.

For example, if your child is building towers with blocks, you might begin labeling the colours of the blocks or dividing the blocks into colour groups to make red buildings and blue buildings.  You could also create a road (by laying the blocks side by side instead of on top of each other) to expand their play. 

With expanded play comes the opportunity for you to model expanded language use. The more you speak to the child, the more likely it will be for new words to appear in his/her vocabulary. 

These are some of the strategies that might be used in promoting speech and language development in autistic children. We offer speech therapy in Toronto, as well as a number of other useful therapies: Applied Behaviour Analysis, Occupational Therapy and Recreation Therapy – do not hesitate to contact us for a no charge consultation.

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

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

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

Occupational Therapy Activities to Try:

Occupational therapy activity- sensory bottles.




#1 Making a sensory bottle 

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

Occupational Therapy painting with vegetable pieces







#2 Painting with veggie slices

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

Occupational therapy activity-  sensory bins







#3 Sensory Bins

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

Occupational therapy activity- scent jars






#4 Guess the scent 

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

Occupational therapy activity- toys in  ice blocks





#5 Getting a toy out of ice

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

Occupational therapy activity- homemade playdough





#6 Making scented playdough

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

Occupational therapy activity-  obstacle course







#7 A fun obstacle course

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

Occupational therapy activity- mirror or imitation games





#8 Imitation Games

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

Occupational therapy activity- animal pose yoga





#9 Yoga animal poses

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

Occupational therapy activity- scavenger hunt






#10 Indoor scavenger hunt 

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

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

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

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