Autistic children are often picky eaters. There are many reasons that this happens. Once you’ve figured out the reason your child is picky you can use these picky eating strategies to help them overcome their pickiness. Recent research has shown that 70% of autistic children have unusual eating behaviours.
Reasons for picky eating
Many children struggle with texture, flavours and a need for sameness that can make eating a variety of foods tricky. Muscle weakness in the mouth or difficulty with sensory experiences can also impact the foods that the child will tolerate.
Try these top 5 picky eating strategies:
Allow your child to tolerate the food being around before expecting them to eat it. Try putting just a single grape on their plate or a piece of cheese without any expectation that they will eat it. The goal is to have them tolerate it.
Once your child is able to tolerate the new food, you want to gradually shape the way they’re engaging with it. For example, they might start by simply touching the food, then smelling it, then bringing it to their lips, then licking, then chewing and lastly swallowing.
3. Give choices
This is one of the best picky eating strategies! Giving your child choice and control will help them feel empowered to overcome their picky eater habits. Examples of choices you could give include: how many bites of the target food the child will have, how the target food will be prepared or who will feed the bites (the child or the adult).
4. Use Positive Reinforcement
When it comes to picky eating, it’s REALLY IMPORTANT to use positive reinforcement to encourage your child. Remember it’s not bribery if you state the expectation first and the outcome second. Think “Have three bites then we’ll watch YouTube” vs “Wanna watch YouTube? Have three bites!”
5. Don’t get into a power struggle
Eating is one of the only things your child has actual control over. There is no safe way to force your child to eat, so if they’re not willing to, it’s not going to happen. By keeping the entire experience positive and not letting it fall into a power struggle you’re helping your child to feel empowered and in control.
Who can help?
Like most challenges, an interdisciplinary approach is often the most effective. Picky eating can be addressed by ABA, Speech or Occupational Therapy. Also, before you begin trying to address your child’s picky eating, make sure to consult your child’s physician to rule out anything medical that might be going on.
“How long until they’re like other kids their age?”
Each week I speak with 10 or so parents, most of who have newly diagnosed autistic children.
These are questions that many parents ask. It’s so difficult to ask these questions and it’s equally difficult to answer them. I am always honest when I answer. I tell them that I believe that each child can make change and learn new skills but that there is no cure for autism. It’s not for me to say how ‘normal’ they will become. I try to stress to these parents that their child has so much potential and with the right mix of learning opportunities they will grow into incredible little humans.
Taking the expectation of being ‘normal’ off the table is a relief for some parents. Others aren’t ready to hear my message. They’re still grieving the loss of the child they thought they’d have. One of the most difficult things for people to handle is uncertainty. Humans are hardwired to have a plan or at least a destination. We dream of the future. When your child is diagnosed with a special need your journey takes a turn. There is a wonderful poem that conveys this message so beautifully. It’s called ‘Welcome to Holland’ and it was written by Emily Perl Kingsley in 1987.
(I need to say that no one poem or piece of writing will perfectly sum up the experience of the entire special needs parenting population. This poem should be taken for what it is, one woman’s perspective, at one point in her life. Some people will identify with it and others will not.)
What Should Parents Do?
There are a number of evidence based treatments for autism. Research the options that are available in your area and decide which aligns with your beliefs and goals. Applied Behaviour Analysis (ABA) has the most research backing it’s effectiveness for autistic children. There is also Speech Therapy that can be essential for autistic kids as well as Occupational Therapy. There is a lot of overlap between the disciplines. Sometimes your child’s needs can be addressed by the ABA team alone, but sometimes the expertise of a specialist is required. Any therapy team you work with should be open to collaboration with other disciplines that provide evidence based therapy.
Alternative Cures For Autism
As with any issue that affects a group of people, there will always be bad actors who try to dupe vulnerable people. I always caution my clients against spending resources on non evidence based interventions. Resources can be money, time and energy. Very few people have unlimited resources. When you devote resources to one treatment, automatically you’re taking resources away from the others. You want to ensure that you’re putting your resources where you’ll get the most benefit. Some examples of non evidence based interventions are: biomedical interventions (chelation therapy, autism diets, supplements) or other treatments like swimming with dolphins or hyperbaric oxygen chambers. While these treatments may have many glowing reviews look for peer-reviewed, double blind controlled studies to use as your base of information when determining if something is evidence based.
This post will describe the elements you need to consider when you choose an ABA provider for your child.
As soon as you get an Autism diagnosis the first place you turn is likely Google. When you’re reading you find again and again that Applied Behaviour Analysis (ABA) is the most recommended therapy. If you live in a bigger city, you’ve got many options to choose from – but how do you choose an ABA provider?
Here are 5 things to consider when you choose an ABA provider:
Home or centre based?
There are many benefits to both home and centre based programs. What you need to decide is: which will benefit your child and be most manageable in your life?
In home based programs, the clinicians come to your house for each therapy appointment. Generally, a responsible adult has to be home with the child and clinician during sessions. You can see what the clinician is doing and how they’re teaching your child. You can participate in therapy sessions. Depending on the age and goals of the child, the clinicians might need a desk or table that’s free from distractions. Home based programs typically focus on using the toys and materials you have in your home to do the programming. This is a great strategy because it will allow you to continue the interventions when the therapist leaves.
Clinic based programs allow you to drop your child off and get things done while they’re in therapy. Your child will have access to a lot of novel toys and games. There will likely be peers around for social skills programming and they will hopefully learn to be a bit independent as they’re away from you and the ‘safety’ of home. Clinic based therapy sessions can often mimic school more closely than home based sessions can.
Credentials and Supervision
In Ontario, behaviour analysis is not a regulated profession. The title ‘Behaviour Analyst’ is not protected like psychologist or social worker. Anyone can say they’re a behaviour analyst. That’s a terrifying thought.
There is a certification board that credentials Behaviour Analysts. It’s called the Behavior Analyst Certification Board. To become a Board Certified Behaviour Analyst (BCBA) the candidate must have completed an approved graduate degree, completed 2000 hours of supervised work and passed a board exam. To utilize provincial funding for evidence based behavioural services (aka: ABA!) the program must be overseen by a BCBA.
It is vital when you choose an ABA provider that there is a BCBA on the team who will ACTUALLY SPEND TIME WITH YOUR CHILD. It is not enough to have a BCBA who simply signs off on the reports. They should spend a minimum of 2 hours each month supervising and monitoring your child’s progress. The BCBA also trains the front line staff on the interventions.
Some agencies employ Senior Therapists to take over some of the supervision of the BCBA. Often, senior therapists are in training to become BCBAs. This is totally okay, as long as the BCBA remains involved. At Side by Side Therapy, we do 10% supervision (for every 10 hours of ABA a client has they will have 1 hour of supervision). That’s a reasonable standard to look for when you choose an ABA provider.
Reviews and Recommendations
Rely on word of mouth. Other families have walked your path and can often be reliable sources of information when you choose an ABA provider. Most businesses have Google reviews that you can read. Also, there are many support groups on Facebook or other social media platforms that can provide recommendations for ABA providers in your area. You can also ask for references when you’ve narrowed down your search to a few providers.
Parent or caregiver involvement
Instructing parents not to participate in therapy is a huge red flag. There is no reason that you should not be in the room or able to watch what’s happening (whether in a home or centre based program).
Parent training is vital to a child’s success. You must learn the strategies and techniques that will be most effective for your child. One of the best ways to learn is called Behavioural Skills Training (BST). There are 4 steps in BST: instruction, modelling, rehearsal and feedback. You need to practice the skills with the clinician there to provide feedback in order to learn them.
You should also have an equal voice in the direction of the programming and how the programs are chosen. Each ABA program is ABA is individualized to each client so it is important that your family’s goals and values are taken into account when creating the programming. The goal development should be guided by two things: the curriculum assessment and your input.
While ABA is the most evidence based intervention for Autism, there is definitely an important role for the other disciplines to play in your child’s autism therapy. Speech-Language Pathology, Occupational Therapy, Recreation Therapy and respite all bring valuable insights and skills to the team.
Bringing an excellent team together with clinicians from multiple agencies is possible, but it is WAY easier to have everything under one roof. Choosing an ABA provider that is open to collaboration with other disciplines is super important.
Questions to ask when choosing an ABA provider
What does a typical session look like?
How do you measure success?
How frequently are revisions made to the programming?
Who does parent training? How often is it done?
What is your philosophy on punishment?
What training do the instructor therapists have?
How many years have you been a BCBA?
Call or email Side by Side Therapy today to schedule a no charge/no obligation consultation to learn about our ABA program or for advice on how to choose an ABA provider.
Each child develops at their own pace. However, there are general guidelines, called milestones, that are used in monitoring if your child is progressing. When a child doesn’t meet their milestones, it can be a red flag for autism. Red flags don’t necessarily mean your child will be diagnosed, but they are considered when determining if further assessment is needed.
Red flags for autism are divided into 3 categories. These categories align with the 3 diagnostic domains for autism: language, social skills and repetitive and stereotypic behaviours.
8 Red Flags for Autism
No words by 18 months or no two-word combinations by 24 months
Most children will have 10 words by the time they’re 18 months old. These words might not be complete but will be easy to understand and consistent. By 24 months many children are using two-word combinations. These combinations are often a name + item to make a request (e.g.: “Julia Milk”, “Daddy bed” etc.)
No pointing or use of gestures
Pointing is a very important skill. It allows a child to share their thoughts and interests in a non-verbal way. Most children point with their whole hand at first (reaching) but will eventually begin to extend their index finger to point. Likewise, gestures allow us to understand a child’s meaning without spoken language.
Inconsistent responding to name
By about a year old, your child should be consistently looking when you call their name. Responding to their name demonstrates that the child is able to divide their attention from what they’re doing when they hear a specific auditory cue.
Loss of previously mastered language skills
One of the biggest red flags for autism is a regression in language skills. Regression is when a child has mastered a skill but is then unable to demonstrate the same skill. Many parents of children with autism describe their child’s language development as typical until around 2 years of age, when the child lost the words, comprehension, pointing and gestures they were using.
Inconsistent eye contact
Many children with autism do not make eye contact naturally. In fact, adults with autism have said that eye contact can be painful or anxiety provoking. This goes beyond shyness.
Lack of joint attention
One of the red flags for autism is the inability to show joint attention. Joint attention happens when a child and their communication partner use gaze and gestures to divide their attention between a person and an interesting object or event.
Stereotypic or Repetitive Behaviours
Unusual or repetitive behaviours with their hands or other body parts
One of the red flags for autism is moving hands and the body in general in unusual ways. Some children will wave their fingers near their eyes, flap their hands, rock their body or walk on their toes.
Preoccupation or unusual interests
Another red flag for autism is intense preoccupation with non-toy items. Some children become very attached to random objects (a spoon, a block, a piece of clothing) and will become upset if it is removed.
What to do if you notice red flags for autism in your child
While none of these red flags for autism are enough to get a diagnosis on their own, it is important to notice them. When a child’s displaying a combination or stops making gains make an appointment with your paediatrician for advice and potential referrals.
With screens being stared at for hours a day by children, the benefits of outdoor play for children is being overlooked. Primary school should be a place where children can enhance the health of their minds, bodies, and emotions. Thankfully, an easy way to do this is to encourage outdoor play. There are a few practical ways to do so, such as ensuring playground design is engaging for children. We will focus on the benefits of playing outdoors, so you can see just how critical it is for their health and well-being.
Greater Physical Health
When children are running around, jumping, crawling, and handling physical objects, they are using and developing their motor skills. These are essential functions that can be greatly improved with outdoor play. Children walking a trail can get some aerobic exercise while enjoying the outdoors. When playground design is considered in terms of maximizing movement, children will burn more calories, which leads to strengthening their muscles and preventing childhood obesity. Also, they will get much-needed vitamin D, even if it’s a cloudy day.
Improves Behaviour and Social Skills
School is a place where children spend a large portion of their day. They interact with other children throughout the day, which helps develop their social skills. However, outdoor play helps shape their ability to communicate, cooperate, and organize effectively. Even at home, children can play with their siblings and friends outside in the yard, while inventing new games to play. All the practice taking turns, sharing, and developing lead to the cultivation of critical behavioural skills and is one of the benefits of outdoor play.
Increase Sensory Skills
Studies have found that children who play outside more have better long-range vision than those who are primarily indoors. The younger a child is, the more they learn through their senses. When a toddler walks down a trail, they will light up with joy when they spot a new animal or smell aromatic flowers. Jumping feet first into puddles is another favourite pastime of theirs. All of these expand, improve, and enhance their sensory skills. Your child may benefit from the input of an Occupational Therapist in the development of their sensory skills. The development of a child’s perceptual abilities is key to having excellent sensory skills.
Increase Attention Span
When children play outdoors, they become more curious about the world around them. They explore and roam according to where they want to go. These self-directed explorations lead to them having the ability to stay focused on a task for longer. Children who play outdoors in a self-directed way have more initiative to do things on their own. They are also more eager to participate in activities they have never done before. Studies have found that children who have had ADHD had seen a reduction in their symptoms after spending more time playing outdoors, in playgrounds, backyards, and other outdoor spaces.
All that running, jumping, and exploring generates endorphins, which uplift the moods of children. When there is an intricate playground design, it challenges children to exert more physical effort. This, combined with being exposed to light outdoors, improves the mood of children. Playing outdoors can be a wellspring of happiness for them.
These are some of the top benefits of outdoor play for children. As you can see, there are several reasons children should be encouraged to play outside. Their physical, mental, and emotional well-being will increase, while developing essential skills that will help them navigate the world they grow up in.
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.
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.
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.
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.
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.
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.
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.
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:
#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.
#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!
#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.
#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.
#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.
#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.
#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).
#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.
#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.
#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.