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What is Social Communication?

Read time: 3 minutes

Autistic children face challenges daily, and social communication is one of the most difficult to conquer. What is social communication? Challenges in social communication are associated with autism diagnosis. However, each child is unique and is impacted to a different extent. Some children may  start an interaction, while others will prefer their peers initiate the exchange. While autistic children might show an interest in engaging with others they can still have challenges.

Don’t make the mistake of believing that autistic children do not want to interact. The key here is to support them in interacting with their peers, offering tools for adequate communication. 

Social communication is a group of skills that include both verbal and nonverbal communication, social interaction and understanding others (Children’s Minnesota) . Many people just seem to have this skill naturally. Autistics often need direct teaching in order to master this skill. 

Why is social communication difficult?

The first thing we have to remember is that many autistic children need support in learning how to communicate. Some of them may not respond when talked to while others require a bit of time to plan an answer.

Eye contact is a major issue. In our society, eye contact is a very important behaviour.  A lot of value is placed on looking ‘someone in the eye’ or showing that you’re paying attention by maintaining eye contact. Many autistic children avoid it altogether, while others find it uncomfortable.

Eye contact used to be considered an essential goal.  However, recent research and an effort to include the voices and experiences of autistic adults has decreased the value and necessity of these types of goals.  Many clinicians are adopting an approach that teaches replacement behaviours that meet the same goals as eye contact. For example, one of the biggest reasons people give eye contact is to convey that they are paying attention and understanding the other person.  Alternative behaviours, such as turning your body to the speaker, nodding, saying words like “I see”, “I know what you mean”, “I get it” all convey the same message and do not require eye contact. 

While a typical child will learn through imitation, an autistic child will likely need explicit teaching. It is important not to give up and consider the child’s point of view. If he/she cannot communicate his/her own wants and needs, frustration can easily build up.

Things to work on in therapy

Social communication represents one of the main therapeutic objectives in many ABA Therapy programs. Depending on the age of the child and his/her developmental level, the therapist will teach the child how to interact with others and interpret their behaviour correctly. With older kids, one might also work on teaching the effect one’s own behaviour has on others.

Therapy will involve teaching the child to recognize and understand social cues. As mentioned, these children do not show these behaviours instinctively and they need to learn how to adjust their behavior to fit each social context. 

Language is a huge part of social communication. Using social situations, the therapist will work on both the expressive and receptive language. Taking into account the potential of the child, they will work not only on verbal communication but also on body language and facial expressions. He/she will also teach the child to adapt his/her tone of voice when possible.

Two girls engaging in social communication, sitting on the ground in a forested area.

It is a fact that autistic children often take things literally, which can lead to frequent misunderstandings. For this reason, when appropriate, therapy will include teaching the child to understand figurative language, including metaphors.

How will therapy help improve social communication?

While the beginning might be slow, over time the child will develop their abilities to interact. They will become more confident, seeking interaction with peers. Improving social interaction skills will remain a primary aim throughout all therapeutic sessions.

As in all ABA programs, each objective will be broken down into manageable steps. Often, the therapist will provide visual support and plenty of opportunities for the child to practice the newly learned skills. Positive reinforcement makes the behaviour more likely to happen again and it has the added benefit of boosting the child’s confidence.

In time, and provided the child’s development allows it, the therapeutic objectives can become more complex. Autistic children can learn to interpret subtle non-verbal cues and also to recognize emotional responses. They can master conflict resolution and pick up the best ways to develop friendship skills. Social Communication therapy can be funded by the Ontario Autism Program.

What about non-verbal children?

Non-verbal children can communicate using various strategies, but they will need help. The therapist can teach them to use gestures or sign language to communicate and introduce augmentative and alternative communication systems.

Some autistic children might never speak. But this does not mean the gate to social communication is shut. They still have plenty of opportunities to communicate with their peers, and it is up to the therapist to find the best solution for a non-verbal child.

Conclusion

While we can improve social communication in therapy, it is also important to educate people on the challenges autistic children face in this area. It is all about accepting differences and meeting these kids on their level, welcoming and honouring any form of communication and/or interaction.

How To Choose A Speech-Language Pathologist

For parents knowing how to choose a Speech-Language Pathologist can be tricky. The diagnosis of autism often involves language delays, causing parents to wonder what steps they should take in terms of intervention. Naturally, every parent wants the best for his/her child, including in therapy.

A Speech-Language Pathologist can help your child learn to communicate more effectively. But how can you be certain you have chosen the right S-LP? What are the things you should look for and what are the right questions to ask?

Two women sitting at a table talking about how to choose a speech-language pathologist.

Things to consider in choosing a Speech-Language Pathologist

This might sound like a given but you need to choose a therapist that has experience in working with children. This kind of specialist will know how to approach the child so he/she feels comfortable. Therapy should look like play, especially for young children.

Experience is essential. A knowledgeable Speech-Language Pathologist should interact with the child through play, opting for subtle strategies to improve communication. He/she should involve the parents in the intervention. A transdisciplinary approach always guarantees the best results, and he/she should include parents at all times.

A good therapist knows that parents play a major role in the therapeutic progress the child will make. The S-LP should teach parents strategies to use at home, taking parental input and comfort level into account.

From a pragmatic perspective, you can get referrals or research for Speech-Language Pathologists online, looking at your province’s College of Speech-Language Pathologists. You can also ask your child’s paediatrician or the school counsellor for a recommendation. Other parents are also a good resource. Once you have found a therapist, be sure to inquire about certification and additional education on autism intervention.

Questions to ask when choosing a Speech-Language Pathologist :

When choosing a Speech-Language Pathologist it is normal to ask questions. It might be a good idea to start by asking about the experience that they have.

Don’t be afraid to ask about the methods used and the reasoning for choosing these. The S-LP should also be able to provide evidence supporting her/his recommendations and point you toward resources where you can learn more.

These are some questions you might ask:

  • Who will work with my child?
    • Often, the Speech-Language Pathologist is part of a transdisciplinary team, which includes a speech therapy assistant, a behavioural therapist, occupational therapist, educator and so on.
  • What are the primary objectives of intervention?
    • You will work on these together but as a general rule the principal aim is to improve communication and social interaction. In some children, feeding and swallowing issues might also be addressed.
  • How many years of experience do you have with autistic children?
    • This is not necessarily relevant, but it can help you get an idea about how knowledgeable the SLP is in this field. Follow up with some discussion about previous cases and outcomes.
  • What is your treatment philosophy?
    • You are putting your trust in a new person, so it is important to know this. A good therapist will work with the family. He/she will always take the child’s needs into account.
  • Do you use AAC (Augmentative and Alternative Communication)?
    • This is important, as it is beneficial for many autistic children at the beginning of therapy and even later on.
  • How do you gain the trust of a child?
    • Some children require time to trust a new person. A good therapist will respect the child and his/her uncertainty, putting his/her emotional well-being in first place. Therapy should be offered through a lens of caring and empathy.

Practical questions are important as well:

  • What does the initial assessment entail?
  • Can I use my insurance to pay for therapy?
  • Are your services available right now? Or do I have to join a waiting list?
  • How many hours of therapy are recommended per week? And how long is a therapy session?
  • Are parents allowed to observe therapy sessions?
  • How is the intervention plan established? Are we allowed to offer suggestions?
  • How is the progress the child has made assessed?

Do not hesitate to ask as many questions as possible, as this process will help you choose a Speech-Language Pathologist for your child. It never hurts to follow your instinct, as parents often have a gut feeling telling them they found the right person for the job.

How To Pick The Right Autism Therapy: 8 Questions

Read time: 4 minutes

Thanks to the internet, information on autism therapy is unlimited.  Some of it is very valid and helpful.  Some of it is not.  Use common sense when picking interventions or treatments to try.  If it sounds too good to be true, it just might be.

As of now, there is no cure for autism. There are lots of treatments that can teach skills and there are some medications that can improve some physical symptoms but there is no cure. That’s hard to hear as a parent and hard for me to say as a therapist.  I believe that every child is capable of learning and becoming a better version of themselves.

The interventions you choose should fit with your values and be evidence-based. Evidence-based means that different groups of researchers studied them and have repeated the results many times.  However, there are many autism therapy interventions that are not evidence-based. 

One of the problems with choosing an intervention that is not evidence-based is that it takes valuable time, energy and resources away from interventions that are shown to work. Very few families have unlimited funds for therapy. Therefore it’s important to try and get the most value out of the things you can do.

Parents interviewing team for autism therapy.

Ask these 8 Questions when choosing an autism therapy or provider:

1. What research is there that supports this intervention?

Look for studies that have been peer reviewed (that means that other experts in the field have reviewed the study and can vouch for the way the study was designed). 

Anyone can write a blog or publish an article on the internet.  That is to say you want to be sure that the information you’re using comes from reputable sources like Universities (and not just your aunt’s best friend’s cousin who had the same problem as you). 

At Side by Side Therapy, we only utilize evidence-based practices in our autism therapy. 

2. What training do you and your staff have?

In Canada, there is no standard credential for behaviour therapists.  In Ontario, in order to use your provincial funding on behavioural services, the program must be supervised by a Board Certified Behaviour Analyst or a Clinical Psychologist with experience in ABA. To be an Instructor Therapist (IT), most agencies require that the candidate have a post-grad diploma or certificate in Autism and Behaviour Sciences. It is slowly becoming the standard that ITs are Registered Behaviour Technicians (RBT) but it’s not mandatory. 

At Side by Side Therapy, all of our clinicians are encouraged to maintain the highest standard for their discipline. We are actively training the next generation of behaviour analysts. 

3. How will this intervention be individualized for my child? 

There’s an expression in the autism world: “If you know one person with autism… you know one person with autism”. Each child is an individual and learns differently.  In other words how they are taught, which reinforcers and prompting procedures are used and how success is measured should all be individualized.  It is impossible to pick up a textbook or curriculum and have an ideal autism therapy program. 

4. How do you measure progress?

Some clinicians are focused on the end goal – total independence.  Some children will never achieve total independence. It’s important that the way progress is measured is meaningful to the client and family. There are different dimensions that can be used to measure progress: frequency, intensity, duration and more! 

5. How will we work as a team? 

You want to ask about how frequently team meetings are held, how to contact the clinical supervisor if you need them (phone, email, text?) and how frequently parent training sessions are held. 

Parents should be involved in every aspect of their child’s autism therapy program. 

6. What are the goals of this autism therapy – in general and for my child? 

You want to ensure that the goals of the intervention align with your goals for your child. Some programs focus on language, while others focus on challenging behaviour reduction. You want to ensure that the goals reflect your child’s needs and your beliefs about education and will be in line with your thinking. 

7. What are your feelings on stim behaviours? Should we be trying to stop them?

For many years it was believed that therapists should stop children from engaging in self-stimulating behaviours (stimming).  Many autistic advocates have expressed how damaging suppressing stims was for them. A new belief is taking hold –  as long as the stim is not hurting anyone, destroying property or stopping the child from participating in activities, it should not be addressed. No one stops typically developing people from engaging in stims as long as they’re not hurting anyone or destroying property – why should it be any different for autistics?

8. What is the process for terminating services if I do not wish to continue? 

You should never be locked into a service.  If it is not working for your child or family you should be able to openly discuss this with the team.  In Ontario, specifically, you should not be pressured to sign over your entire Childhood budget or Interim One Time Funding Cheque to a provider. 

Connect with Side by Side Therapy to schedule a no-charge/no obligation consultation to discuss our autism therapy solutions for your child.

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.

New diagnosis of autism? The most powerful things to do now.

Read time: 4 minutes

When your child get a diagnosis of autism, your world seems to dramatically change in the seconds before and after the words have been said. I have spoken with many parents who were simply not expecting the diagnosis when they went in for the assessment.  They had an image in their mind of a severely disabled person and that simply wasn’t the case for their child. 

What is the autism spectrum? 

Autism is a neurological (meaning it has to do with the brain) developmental disorder.  It affects how a child learns and develops in 3 main areas: social skills, communication skills and restrictive or repetitive behaviours.

Many people use the language ‘high functioning’ vs ‘low functioning’.  This can be very misleading. Many people think of the autism spectrum as being a linear spectrum. This representation doesn’t quite fit the autism spectrum, because there are three core symptoms of autism. There’s a newer way of conceptualizing it, that was created by Michael of 1autismdad.com in 2012. 

Imagine a blank sheet of paper with a dot in the middle.  This dot represents neurotypical development (non-asd). Near the top of the page in the middle imagine the words “communication deficits”, near the bottom left of the page imagine “social skills deficits” and on the bottom right corner imagine Stereotypic and repetitive behaviours. Each person with autism will develop needs in each of these areas differently.  You can visualize a person’s needs by how long the path is from the middle (neurotypical) to the core symptom. Some might be very impacted in the communication and social skills areas while they show very few (or none) stereotypic and repetitive behaviours. 

Autism triangle: a new way of thinking about the autism spectrum by asddad.com
Retrieved from: https://www.1autismdad.com/home/2012/03/14/visualizing-the-autism-spectrum on August 1, 2020

Top 5 things to do when your child get a diagnosis of autism: 

There are a number of resources that you can access when your child is first diagnosed.  Here are my to 5 recommendations of things to do: 

  1. Notice the small things – Your child might have difficulty with a lot of things, but try and pick out the things that your child excels at. You might need to be creative here, but it’s a good reframing exercise and will help you to focus on something positive instead of only the negative. 
  2. Reach out to others from the autism community.  There are a number of support groups on Facebook and other social media platforms.  You’ll find many people who understand exactly what you’re going through and who have been through it and survived.  It might take you a while to find your village, but once you do you’ll be so glad you spent the time to reach out. 
  3. Celebrate every victory. Learning something new might be very challenging for your child.  When they achieve a new milestone you should celebrate it loud and proud! 
  4. Create a self-care routine for yourself and your partner. You will feel compelled to spend every moment focused on your child’s therapy/friends/development. You must keep yourself healthy so you can be the best possible advocate for your child. Remember the flight attendant’s advice: always put your own oxygen mask on first.  You have to take care of yourself if you want to take care of others. 
  5. Create a team for your child.  There will be a lot of people in your child’s life: doctors, therapists, teachers, support workers and more.  You will need help to coordinate everything that needs to happen in order to set your child up for success. Find people you trust and who have values that align with your own.  

Don’t forget…

Your child is the same lovable, adorable, smart, deserving little person they were before they got a diagnosis of autism. There are times when the label is important and there are times when it is irrelevant. Try to think of the diagnosis as a path, that will lead you to treatments and strategies that will help your child. Also, having a diagnosis opens up doors for funding, supports and specialized programs.

Connect with Side by Side Therapy to discuss your options and what interventions would be best for your child and family. We offer no-charge and no obligation consultations to help guide you in making the right decisions for your child’s future.

2 Necessary Social Skills you should teach your child!

It is often said that a parent is a child’s first teacher, playing an important role where development and learning are concerned. A diagnosis of autism only reinforces this belief, in the sense that the parent will work harder to help his/her child develop strengths and overcome challenges. Social skills, specifically self-awareness and self-determination are vital to your child’s future.

You can teach social skills

Self-awareness is a difficult concept for almost all autistic children, but nonetheless, it is a social skill that they must learn and use every day. As parents, you bear the responsibility of “equipping” your children with such skills, preparing them for becoming their own advocates in adolescence and adulthood.

Parent talking to her son about his social skills.  They're both smiling.



We can empower autistic children from an early age, helping them become more aware of their own self and also to discover self-determination. Our efforts will allow them to express themselves in an capable manner, to better understand those around them and engage in suitable behavior in response. 

What are the factors affecting self-awareness in autistic children?

Autistic children might battle language and communication impairment, as well as social difficulties and sensory differences. They might exhibit stereotypical behaviors or intense interests. It goes without saying that all of these impairments will affect self-awareness. 

Imagine your child as being equipped with the wrong skills. He/she does not know how to express how he/she is feeling, and they have serious difficulty understanding others. An autistic child might not know the expected behaviors and emotions, and he/she will rarely consider how others are feeling or what they are thinking. 

Main factors affecting self-awareness are:

  • Difficulty with transitions/changes 
  • Deficits in understanding emotional exchange
  • Lack of attention to others
  • Language and social communication impairments 
  • Impaired ability to take another’s perspective

Empowering your child to develop self-awareness 

Your child has both strengths and weaknesses. As mentioned in the beginning, you can empower your child by working together on developing his/her strengths. 

Parents have an amazing power, in the sense that they can help their children understand not only how the world functions but also how they should function in that world. Self-regulation will appear as a natural result, allowing the child to advocate for himself/herself, especially in difficult situations.

Activities/solutions for improved self-awareness from study.com

  • Drawing a bug on paper and adding pictures of things that “bug” him/her – encourage the child to be as specific as possible, adding foods, animals, etc. 
  • Glue a photograph of your child to a piece of paper and ask them to draw things he/she is good at; images might be used for non-verbal children. Encourage the child to reflect on his/her strengths. 
  • Yes/no – read your child simple sentences, waiting for his/her answer. If non-verbal, use gestures to signify approval or negation. Examples: “I like to eat…”, “I prefer (toys)”, “My favorite activity is…” The goal of this activity is to help your child be able to identify their preferences and communicate them to others. 
  • Mirror self-awareness – working in the mirror, together with your child, to develop self-recognition; the more you work, the more aware the child will become of his/her body and its position in space. Work on gestures and making eye contact as well. 

Self-determination 

This is also a critical skill to achieve, as it will guarantee independence in adolescence and adulthood. Research has confirmed that it plays an important part in academic success, as well as in personal life. Social skills can predict the capacity for self-determination – as a parent, you need to work on these every day. 

How to help your child achieve self-determination 

  • Provide your child with opportunities to make decisions and then follow through with them even if you know the outcome might not be ideal.
  • Teach your child the specific behaviours for specific situations, and do not make the assumption that an autistic child will know the correct behaviour without being taught.
  • Be patient and offer concrete examples of the behaviour you expect to see. Tell your child what to do, not only what not to do. Give your child plenty of opportunities to observe adequate behaviour.
  • Practice, practice and practice. Do not expect for your child to learn social skills automatically, but rather keep in mind that learning requires both observation and practice. Offer your child the support he/she needs, and plenty of encouragement. 
Parent and child working on sharing as a social skills.  They are sharing some building blocks.



While it is true that applied behaviour analysis can help autistic children develop a lot of valuable skills, you have to remember that in many autistic children, skills don’t automatically generalize. The skills learned in therapy must be practiced at home in order to be solidified and maintained. The earlier you teach self-awareness and self-determination, the easier it will be for your child to advocate for himself/herself later in life.

Autism and Memory: Can you guess the amazing superpowers of a child with autism?

Read time: 4 minutes

This post was written by Dr. Tracy Alloway. She is an award-winning psychologist, professor, author, and TEDx speaker. She has published 13 books and over 100 scientific articles on the brain and memory. Her research has also been featured on BBC, Good Morning America, the Today Show, Forbes, Bloomberg, The Washington Post, and Newsweek, and many others.

Autism is characterized by a difficulty to recognize and respond appropriately to social and emotional cues, which causes problems with social interactions. Yes, they have unique strengths that can give them an advantage in certain areas. Watch a clip.

Working Memory and the Brain: from Understanding Working Memory

The brain of a child with autism develops differently from children without it. Recent research has found that the prefrontal cortex (PFC), the home of working memory, is one of the brain regions most affected by autism. Initial results show that the PFC of a child with autism has a much greater volume of neurons, up to 67% more. One possible explanation for this excess growth is that the genes controlling neuron development are overactive, resulting in greater brain volume. Exactly how this is related to autistic behavior is unclear at the moment, but the link an abnormal PFC and autism suggests that there may be a working memory connection to the behavior. (Courchesne & Pierce, 2005).

Children with autism also display less activation in the PFC when they are asked to remember and process information. This pattern seems to be evident regardless of the nature of the task. In one experiment they were asked to process letters, in another, shapes, and in another, faces. In all instances, the result was the same: there was less activation in the PFC for children with autism than in those without it.

The study with faces, also found that children with autism tend to analyze facial features like objects, rather than in light of social relationships, which may explain their trouble interpreting social nuances (Koshino et al., 2005; 2008).

Furthermore, when a child with ASD is presented with two tasks and has to focus on one while ignoring the other distracting task, their brain activity reveals that they do not actually shift their attention to the more important information (Luna et al., 2002). They have a difficult time determining what information is important.

In the classroom, some students with ASD might appear to struggle with certain memory-heavy activities. However, this may be connected to their difficulty in knowing what they should focus on, rather than a working memory deficit per se.

Working Memory is linked to AUTISM

The working memory profile of the student with ASD depends on whether they are low or high functioning. In some cases, high functioning students can have an above-average verbal working memory, while low functioning students perform at the same level of a student with a specific language impairment. In general, low functioning ASD students also have a poorer working memory than their typically developing peers do.

However, even high functioning ASD students can display verbal working memory problems. In my own research, I found that the type of material they have to remember provides us with a clue to their working memory profile. They struggle in particular with abstract information like nonsense words or new vocabulary. Why? One explanation is that when they are presented with abstract ideas that they have to both process and remember, they spend too long trying to comprehend the material and so forget what they need to do.

For example, during a verbal working memory test, Daniel, a 14-year-old with ASD, was presented with the sentence: Dogs can play the guitar. Daniel spent a long time thinking about the sentence before finally answering “True”, because “you can train a dog”. As a result of the lengthy time spent deliberating the answer, he forgot the final word in the list of sentences (Alloway, Rajendran, & Archibald, 2009).

The strategies they use to remember information can also over-burden them. Studies confirm that when remembering information, high-functioning ASD individuals do not use their long-term memory, visual strategies, or even contextual clues. Instead, they rehearse things over and over again. While this can be useful in remembering short sequences of information, it is ultimately a time-consuming and inefficient strategy to simply keep repeating things. These students are aware of their own memory problems. Alistair, a high-functioning 13-year-old, commented that he had “number overload” when he failed a test that required him to repeat numbers in backwards order.

Now, let’s look at their visual-spatial working memory profile. The majority of individuals with ASD do not have deficits in this area.  In one task, students are shown a matrix with dots that appear in random locations and they have to recall their location in a backwards sequence. Both my own research, as well as other studies, confirms that students with ASD do as well as their peers without autism. In the classroom, this means they should be able to remember information that is presented visually. 

Cover of a book written by Tracy Alloway about a child with autism




To find out more about the memory superpowers of a child with autism, check out Dr. Alloway’s new children’s book here.

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References

Alloway, T.P., Rajendran, G., & Archibald, L.M. (2009). Working memory profiles of children with developmental disorders. Journal of Learning Difficulties, 42, 372–82.

Courchesne, E.,  & Pierce, K. (2005).  Brain overgrowth in autism during a critical time in development: implications for frontal pyramidal neuron and interneuron development and connectivity. International Journal of Developmental Neuroscience, 23, 153-170.

Koshino, H., et al. (2005). Functional connectivity in an fMRI working memory task in high-functioning autism. Neuroimage, 24, 810–821.

Koshino, H., et al. (2008). fMRI investigation of working memory for faces in autism: visual coding and underconnectivity with frontal areas. Cerebral Cortex, 18, 289-300.

Luna, B., Minshew, N.J., Garver, K.E., Lazar, N.A., Thulborn, K.R., Eddy, W.F., & Sweeney, J. (2002). Neocortical system abnormalities in autism: an fMRI study of spatial working memory. Neurology, 59, 834-840.

Autism Spectrum Disorder and Sleep Problems

Read time: 4 minutes

If reading’s not your thing, watch this YouTube video instead!

Research shows that children with autism spectrum disorder (ASD) tend to experience other problems that go hand-in-hand with ASD, which are known as comorbid conditions. This research estimates that the number of children with ASD who would qualify for also having a comorbid condition is approximately 70-80%. The range of comorbid conditions that exist can affect an individual’s mental and physical health, as well as impact them neurologically and medically. Some examples of how these comorbid conditions can manifest include an atypical reaction to one’s surroundings, sleeping disorders such as insomnia, and poor muscle development.

Child with autism spectrum disorder sleeping at her desk, with pencil in hand.

It is very common for children to go through a stage where they don’t sleep through the night. This is actually a normal stage within a child’s physical and cognitive maturation. However, it is a stage that, should it be persistent, is detrimental to not only their health and development, but also their daily functioning. This can affect how they interact with others on a daily basis, especially in children with autism spectrum disorder. Researchers have also demonstrated that insomnia, on its own, tends to worsen the symptoms of ASD and lessens an individual’s ability to thrive in their life.

Existing research shows that there is a strong tendency for those with autism spectrum disorder to have  problems with establishing proper sleep patterns and that they are impacted to a much greater degree than neurotypical children. Additionally, the studies also reveal that those with autism spectrum disorder are at a much higher risk of developing these sleeping disorders than neurotypical peers. The number of those with autism spectrum disorder who have trouble sleeping ranges anywhere between 44-86%. This is contrasted by the overall child population, where only 10-16% experience sleeping problems. 

Many autistic children who experience difficulties regulating emotions and behaviour are shown to also exhibit difficulties with their sleep. A past study of Asperger syndrome and other forms of autism discovered that the children who had persistent insomnia displayed greater emotional and behavioural symptoms than children without sleep disturbances. Parallel conditions are also known to disrupt sleep, some of which include gastrointestinal irregularities, stimulants, attention deficit hyperactivity disorder (ADHD), and anxiety. 

Young girl sleeping

A study found in the academic journal Autism looked at the frequency that sleep issues in children with symptoms that are commonly associated with autism spectrum disorder occurred. The study participants were evaluated for symptoms relating to autism, problems with their sleep, and emotional and behavioural issues. It was found that persistent insomnia was over ten times greater in autistic children than those who did not have ASD (39.3% vs. 3.6%).

The autistic children were shown to develop more sleep irregularities over a period of time, with a frequency of 37.5% compared to 8.6% of the children without autism. Both groups were children aged 11-13 years. Even though only a few girls were included in the study, it was discovered that sleep abnormalities occurred less in girls than boys and their sleep problems were temporary. Those with ASD who also had ADHD were more likely to develop sleep problems.

Without question, it is clear that there is significant scientific backing that demonstrates the link between autism spectrum disorder and sleep problems. Sleep disturbances can, in reverse, negatively affect the symptoms of autism spectrum disorder, such as experiencing an increase in repetitive and/or hyperactive behaviour, lack of focus/attention, displays of aggression, and an impairment in higher brain functioning. Given all these potential issues, it is important for parents to attempt to maximize their children’s sleep habits and put routines and strategies in place that will allow their children to get the most quality sleep.  

Sleep hygiene are the practices that we use to ensure that we have good nighttime sleep and as a consequence good daytime alertness. 

Some examples of good sleep hygiene for autism spectrum disorder are:

  • Avoiding daytime naps
  • Establishing a bedtime routine that offers time to relax and wind down before actually trying to sleep
  • Making sure the sleep environment is comfortable
  • Going to bed and waking up at the same time each day (even on weekends)
  • Getting regular exercise
  • Avoiding blue light producing screens for an hour before bedtime

If your child is having a difficult time with sleep, contact Side by Side Therapy for a no-charge 30 minute consultation and we can brainstorm some ideas to help! 

Autism Home Safety: 11 Useful Strategies

Read time: 5 minutes

“I just turned away for a second, he was right here!”, have said many parents in a panic when noticing their child was not in eyesight. This panic luckily is often only momentary, as the child usually reappears quickly. However, wandering by children, especially for children with autism spectrum disorder, can be frequent and for the parent/caretaker this can be frightening. 

Wandering is one of the top safety concerns facing a child with autism spectrum disorder, however, it is not the only concern to keep in mind and prepare for. Creating a plan can be overwhelming and finding a starting point may be difficult. In hopes of helping, I have provided some useful ways to assist in your planning to keep your child safe, especially within your home. 

Safety first road sign for children with autism.

Safety within the Home for Children with Autism

The home can become a dangerous place for children, especially those with autism, who face greater challenges around safety, awareness of surroundings and impulsivity. Parents put security and precautionary measures in place when all children are young but it is necessary to maintain these measures longer when their child has autism. Here are some things to keep in mind when you are creating your safety plan. 

  •  Household Toxins – Cleaning products and related hazardous materials must be locked away in a secure place.  As children are very crafty and persistent, it may be useful to lock the unsafe items in the garage, basement or any other area outside of the main living areas. 
  • Furniture – Top-heavy furniture and large electronics should be secured to the wall with brackets and straps.  Toppling furniture from climbing children is extremely dangerous and can easily occur if these heavy items have not been secured properly. 
  • Drowning – If you or a neighbour has a swimming pool, it is necessary to ensure that drowning prevention measures have been put into place.  As mentioned, with wandering being such a high concern, if a neighbour has a pool within close proximity to your home, you must communicate your concerns to your neighbours regarding the safety of your child and ask that the safety measures are put in place at their home. 
  • Some safety measures include:
    • Fences with self-closing latches
    • Keeping interesting toys/items out of eyesight to not draw the child’s attention to the dangerous area.
    • Enrolling your child in swimming and water safety lessons (if possible).
  • All municipalities have bylaws with regards to swimming pools in people’s backyards.  Research what the laws are where you live to ensure that your pool (or your neighbour’s pool) is following the law. 
  • Fire – Fire safety is of the utmost importance and needs to be practiced with the whole family.  As this training includes your child with autism, you may need to modify and tweak your plan to work with any additional needs and sensory issues that your child may have. There are a few extra things that a parent can implement to help the process. 
    • For instance, if your child becomes upset by loud noises, you can purchase fire detectors that you can record your voice giving directions to leave the house, removing the loud noise trigger and providing familiarity through your voice.
    • Additionally, since children with autism are more comfortable with routine and familiar places, it may be beneficial to take your child during a calm period to a local fire station so they may become familiar with the uniforms and equipment.  The hope is that these measures will prepare and help your child better manage a real-life situation.
    • Practicing fire drills at home in the same way they do at school will also be helpful for your child to become more comfortable if ever there was a real emergency. 
  • Hot Water – As many children with autism also have sensory issues, some children cannot perceive hot or cold temperatures and this can lead to accidental burns.  This can pose a safety concern especially if they are using the faucet independently. Some ways to teach your child the difference between the taps both in the sink and in the shower/bath is through practicing turning them on and off. As well, another tool you can use is a sticker to symbolize the dangerous tap or area of the tap. You can also control the temperature of the water on your hot water tank. 
  • Doors – With wandering being a high concern, the use of locks may be advantageous however they may not be full-proof. Keys may be well hidden but there is still the chance that they may be found, therefore, an additional safeguard through the use of an alarm system may be beneficial. If your child does find a way to leave unsupervised, you need to be vigilant in ensuring that they are always wearing some form of identification that contains their contact and any other pertinent information.   

Wandering in Autism

As wandering is one of the main safety concerns facing many parents of children with autism, it is necessary to take steps to reduce or eliminate this risk. 

Here are some ways to help keep your child safe from wandering: 

  • Understanding your child’s wandering triggers – Some children with ASD may wonder out of curiosity such as distractions from the park, train tracks, the beach – while other children wander to get out of a certain environment, such as ones that may be stressful, loud, bright, chaotic, etc. It’s important to know which type of wanderer your child may be to better understand how to avoid the behaviour. 
  • Keep your home secure – As mentioned previously, the security of your home is of the utmost importance in helping to eliminate wandering.  Locking doors, hiding keys and setting up an alarm system are tools that can be used to help in securing your home. 
  • Keep practicing and modifying communication and behaviour strategies – Teaching your child to request to go somewhere can be a very functional replacement behaviour for wandering. Helping your child learn self-calming strategies to use when they find themselves in stressful, boring or frustrating situations will help in them self-regulate and can potentially avoid wandering. Through trial and error, you will be able to find what works best for your child in these particular situations. 
  • Setting expectations are important – All parents know how difficult it can be preparing and accomplishing an outing, it can be even more difficult for a parent of an autistic child.  It is therefore imperative to outline and set your expectations with your child. You will need to communicate the plan, which can include approximate timelines and rules to be followed with your child and any other accompanying family members/caretakers. If everyone is on the same page and understands the expectations, the outing will likely be a more positive experience. 
  • Identification and monitoring technology are essential tools – Since many children with autism are unable to easily communicate, these identification and monitoring tools are extremely helpful in tracking a wandering child. Having your child wear a form of identification (such as a bracelet/necklace, GPS, marked information on clothing, medical alert tags) will ensure that should your child get lost and be unable to communicate, all their relevant information (name, address, phone number, medical needs, etc.) is available to get them help.  

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The first step to help ease the worry around safety and a child with autism is having an emergency safety plan in place. Evaluating and determining what your family needs to be safe and protected at home, school and the community will provide a helpful guide to protect your family for the dangers that exist. An example of an emergency safety plan can be found at family wandering emergency plan

The checklist below will provide you with a practical starting point.  

Safety Plan Checklist:

  • You need to determine if your child wanders, runs away or gets lost in a crowd?
  • You will need to evaluate areas such as home, school or community activities for safety concerns? 
  • Once areas of safety concerns have been reviewed, you will need to ensure that preventative measures have been put in place in each of those areas.
  • You could purchase wearable identification containing important contact and medical information that will always be worn by your child.
  • You should communicate with your neighbours and community that your child has autism and may have special needs to be aware of (i.e. wandering).
  • You should communicate with your child’s school to create a plan which ensures that safety skills are included in their Individual Education Program (IEP). 
  • You should communicate with the local emergency service providers and let them know that your child may be at risk at given times.

Remember, if your child should wander:

  1. Stay calm
  2. Call 911
  3. Search nearby water first
  4. Implement your emergency safety plan

If you would like help establishing your safety plan, please contact us.

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

Read Time: 5 minutes

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

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

It is important to rely on your treatment team including a Board-Certified Behaviour Analyst in Toronto (BCBA) for support and guidance as they understand just how exhausting and challenging such a diagnosis can be. Working together will help with your child and family’s success both at home and at school.

Here are some helpful tips to try when your child gets an autism spectrum disorder diagnosis:

1.  Become an Expert in your Child’s Needs, Likes and Dislikes

Each child with autism spectrum disorder is different and we need to embrace, understand and support their differences. This can be achieved through research and asking questions about autism spectrum disorder and more specifically your child’s individual needs. As each child is unique, you must remain open minded about their experience of having autism. Once you gain some knowledge you will then be able to ask insightful questions to help build the best treatment plan for your child. 

The best place to start is with your child’s family physician, they will be able to refer you to an autism consultant who can work with you to develop a team. Your physician should also be able to provide you with useful resources such as finding the best Applied Behaviour Analysis (ABA) therapist or group including Board Certified Behaviour Analysts (BCBA) for your child. Remember finding the right therapist may take time and patience. There is no such thing as “one size fits all” in a treatment plan. 

2. Find Help through Technology

As technology has become an integral resource within our society, it has become a very useful tool for parents of children with autism spectrum disorder. Firstly, a vast array of knowledge and research regarding your child’s diagnosis and treatment can be gained through the internet. Secondly, technology is also used as a resource for community building through social media including parenting groups and intervention discussion forums.  Here there is an opportunity to seek the support and experiences from parents in similar situations and professionals in the field. These communities are amazing and can help one to realize they are not alone. 

Lastly, and perhaps most importantly, technology holds a critical use for autism spectrum disorder children that have communication difficulties and is used as a tool to remove this barrier. AAC (Alternative and Augmentative Communication) gives a voice to children who cannot speak using tablets or computers with specialized apps that utilize text or image to speech technology. These are sometimes called SGD (Speech Generating Devices). 

3. Get Intervention as Soon as Possible

Parents that feel that their child might have autism spectrum disorder should speak with their child’s physician as early as possible to investigate a diagnosis. Don’t allow your child’s doctor to dissuade you or convince you to ‘wait and see’. With an early diagnosis and then prompt invention parents are able to start working towards helping their child to address interfering behaviours and increase communication skills.

Intervention is most effective in younger children. If your child’s interfering or challenging behaviour (e.g.: outburst in public) is addressed and dealt with early on, then the hope is that through reinforcing positive or desirable behaviour, the child will eventually be independent in the future in the same situations. Positive outcomes are possible for older children as well, so don’t give up if your child is older when they begin to receive treatment. 

4. Ensure your Child’s Treatment is a Family Affair

An autism spectrum disorder diagnosis not only affects the diagnosed child but it affects the entire family. It’s therefore necessary that the therapy plan includes siblings’ and parents’ opinions and experiences. Since schedules and rules set out in the plan will put expectations on the entire family, their input and buy-in is imperative for the success of the program.

It is also vital that family members are involved in the treatment plan to ensure that generalization occurs. This means that your child is able to demonstrate all the skills they are learning in new settings and with new people instead of only with the treatment team. It may become a balancing act for you, however with support, consistency and careful consideration and execution of the therapist’s recommendations your day-to day routines will become less overwhelming. 

5. Trust your BCBA, Treatment Team and the Process

As mentioned, finding the right BCBA and program can be a difficult journey, however, once this is accomplished you will soon see that you are on the right path. As your child is unique in their needs you must remain optimistic and open-minded. There will be necessary tweaks and adjustments along the way and through trial and error, you will certainly see positive changes.

Finding a team that suits your family’s needs and expectations is extremely important. You will also need to ensure there is a constant flow of communication between your family and your child’s BCBA so that modifications can be implemented and changes made whenever required. 

6. Celebrate the Successes

As you continue to fill your toolbox with more tips and knowledge it will open the door for greater success. At times there may be a lot of growth and positive changes and at others, there may be little or none. It is important to stay focused on the positive and reflect on the successes and celebrate them frequently. Continuing to stay on course and provide consistent routines and expectations for your child. The more you celebrate the successes the more likely it will be that you feel good about your child and family’s future. 

7. Make Safety a Top Priority

The challenges and long-term responsibilities that come with an autism spectrum disorder diagnosis can be additional stress placed upon an autism parent. To help ease the sense of being overwhelmed it is important to get organized and put proper measures into place for a “just in case” situation (for example, looking into life insurance for family members). As children with autism can engage in more dangerous behaviour (wandering, mouthing and self- injury) a safety plan is essential.

It is necessary to develop a plan to address these safety risks with your treatment team. For example, you should ensure that your child always carries or wears identification, especially if they are a wanderer. A simple google search will yield many options for safety tools for your child with autism spectrum disorder.

8. Work on Establishing a Good Sleep Routine

One of the challenges many children with autism spectrum disorder face is difficulty sleeping. Poor sleeping can exacerbate some of the challenging behaviours associated with autism such as impulsivity, compulsions, hyperactivity and physical aggression.  Good sleep hygiene is vital to providing your child with quality restful sleep.

Keep in mind a few things while creating a routine, for instance: maintaining consistent times for going to bed and waking up; how much light is in their bedroom while they’re trying to sleep; ensuring your child has enough play time during the day and not too much screen time prior to bed; perhaps instituting a wind-down quiet period before bed; taking sensory issues into account, i.e. itchy pajama’s, white noise etc.  

If your child has recently received an ASD diagnosis and you are looking for ways that the Ontario Government can support you, please know that changes to the Ontario Autism Program are in the process of being established. They are working towards creating a new “needs -based and sustainable autism program”. Eligibility for this program has the following criteria:

To register for the Ontario Autism Program, your child must:

  • be under age 18
  • currently live in Ontario
  • have a written diagnosis of autism for a qualified professional

Your child’s written diagnosis must include:

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

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

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

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

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

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

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

Applied Behaviour Analysis: 59 Terms and phrases translated for easy understanding

Read time: 7 minutes

Therapist and child doing applied behaviour analysis.

There are so many terms and acronyms that you’ll be encountering when you enter the world of applied behaviour analysis. It can be very confusing, especially because some of the words that are commonly used in ABA are used with another meaning in common language. I’m going to give the definitions in terms of children but they can be applied to anyone (adult or child).

Applied Behaviour Analysis Definitions of Common Words/Phrases:

ABA Therapy: Applied Behaviour Analysis is the application of the sciences of learning and behaviour to teach, increase or decrease behaviours that are meaningful to the client and their family. 

ABLLS-r (The Assessment of Basic Language and Learning Skills – revised): This is a tool that is used as an assessment, curriculum guide and skill tracker when doing applied behaviour analysis. It was created by Dr. James Partington. Similar to the VB MAPP, it tests whether the child has specific language skills. The skills that are measured are sequenced from easiest to most difficult.  There are 25 domains, some of which include: expressive language, receptive language, writing, imitation, fine and gross motor skills. 

Accuracy: How close to the target something is or how correct it is. 

Acquisition Target: A target that is currently being taught.  This is a behaviour or skill that has not been learned yet. 

Adjusted Age: This refers to the age of your child based on their due date. For example, if your child was born 6 months ago but was 2 months early, they would have an adjusted age of 4 months. Doctors or therapists will sometimes use adjusted age when speaking about the development of your child.  People usually stop referring to adjusted age when the child is around 2 years old. 

Antecedent: In applied behaviour analysis an antecedent is what happens before a behaviour. Think of it like the trigger for the behaviour.  

Aversive: A stimulus that your child finds unpleasant or bothersome.  Aversives can be used as a punisher to decrease behaviour or the removal of an aversive can be used as a reinforcer to increase behaviour.  Your therapists should not be using aversives in your child’s programming without having a discussion with you and gaining your consent.

Behaviour: This is what the child does. Behaviours have to be measurable and observable. 

Behaviour Intervention Plan (BIP): This is a plan that will target the reduction of challenging behaviour for your child. They should always include: a specific definition of the behaviour, antecedent strategies, reactive strategies, a replacement behaviour and a mastery criteria.

Board Certified Behaviour Analyst (BCBA): This is a masters or PhD level therapist who has completed the requirements (specific courses, over 1500 hours of work experience and passed a credentialing exam) of the Behavior Analyst Certification Board.  

Chaining:  In applied behaviour analysis chaining is when a skill is broken down into steps and then the steps are taught in isolation then brought together to form a longer sequence (or a chain). You can forwards chain (teach the first step then the second and so on), backwards chain (prompt all steps except the last, then prompt all steps except the last two and so on) or you can teach the whole chain (fade prompting across each step of the chain at one time). 

Chronological Age:  This refers to the amount of time your child has been alive. Even if they were born prematurely, this is the number of days/months/years that they’ve been on the planet. 

Clinical Supervisor (CS): In Ontario, a CS is the BCBA who is responsible for overseeing your child’s ABA program.  They make clinical decisions (decisions about what and how to teach) and collaborate with you and the rest of your child’s team in supporting your child as much as required. 

Consequence: In applied behaviour analysis, this is what happens immediately after a behaviour.  Consequences are neither good nor bad, they simply follow a behaviour. 

Deprivation: When your motivation for something is really high because you haven’t been exposed to it in a long time.  When you stop using or consuming something your desire, your need for that item grows. 

Developmental Age: This is the age at which your child demonstrating most of their skills. Doctors and researchers have set all of the developmental milestones to specific age windows.  For example, most children learn to speak in two-word sentences at around 18-24 months. Your child’s developmental age is the age at which they’re functioning emotionally, physically, cognitively or socially. Developmental age is not always correlated to chronological age.

Discrete Trial Training: This is a method of presenting the child with small segments of learning that are repeated, known as trials. Often the skill is presented in 5 or 10 trial blocks.  The blocks are repeated a few times a day until the child can demonstrate the skill without prompting. 

Discriminative Stimulus (SD): In applied behaviour analysis this is the demand, request or question that elicits a specific response.  The presence of an SD signals the availability of reinforcement.  

Duration: The length of a behaviour.  

Echoic: A verbal operant meaning repeating.  When the speaker repeats what they heard from someone else.  For example, when a father says “bedtime” and the child repeats “bedtime”. In applied behaviour analysis programs, echoics are usually one of the first language goals targeted.

Expressive Language: This describes our ability to use language, gestures and writing to express ourselves. 

Extinction Burst: A rapid escalation in the frequency, intensity and/or duration of a behaviour once the reinforcement for this behaviour has been removed.  Usually, the pattern during extinction is that there is a small reduction in the behaviour, a big spike and then the behaviour disappears completely. There is something known as spontaneous recovery, which can happen after extinction is used.  The child will test the waters and re-engage in the challenging behaviour that has previously been extinguished. By sticking to the plan and not reinforcing the behaviour, spontaneous recovery is usually short lived. 

Extinction: When you intentionally stop reinforcing a behaviour with the goal of reducing that behaviour. For example, if you don’t answer the phone when someone calls, they will eventually stop calling you.  Often leads to an extinction burst.

Fine Motor Skills: These are the skills that require movement and coordination of the small muscles of the body, specifically the muscles of the hands.  Cutting, writing and pointing are all fine motor skills. 

Functional Analysis or FA: This is a highly specialized process that BCBAs use to determine the function of the behaviour targeted for intervention.  By manipulating reinforcement the BCBA will see if they can influence the behaviour. By controlling the reinforcement for a behaviour, you’re able to determine the function of the behaviour and can create function based replacement behaviours. One specific type of FA is called IISCA (Interview Informed Synthesized Contingency Analysis), it was created by Dr. Greg Hanley. 

Functional Behaviour Assessment or FBA: This is a process for hypothesizing the function of a behaviour that is being targeted for intervention. In an FBA the BCBA does some or all of the following: observes the behaviour, completes interview style questionnaires and takes data. 

Generalization: When your child is able to demonstrate a skill using novel materials, with novel people and in novel environments. All ABA skill acquisition programs should have generalization steps built into the program because generalization does not always happen automatically. 

Gross Motor Skills: These are the skills that require movement or coordination of the large muscles of the body, specifically the muscles of the arms, legs and trunk. Walking, running and sitting are all gross motor movements. 

Intervention: This the strategy that will be used by the team to change a behaviour or teach a skill. Intervention is another word for program. 

Intraverbal: A verbal operant meaning conversation.  When the speaker responds to another person’s language in a conversational way. For example, if someone asks you “What’s your favourite colour?” your response “Red” would be an intraverbal. 

Latency: In applied behaviour analysis, this is the time between when an instruction is given and the beginning of the behaviour.  

Maintenance: When a skill or behaviour is able to be demonstrated long after it was originally taught and with less reinforcement than was used during teaching.  Sometimes a skill will be ‘moved to maintenance’ this means that the child will be asked to demonstrate the skill on a regular basis to avoid losing it.  Often there is a maintenance schedule that the applied behaviour analysis team will use to practice the learned skills so that they are not forgotten. 

Mand: A verbal operant meaning request.  When the speaker uses a word to make their needs known.  For example, saying “apple” when you want to eat an apple. Mands can be requests for objects, people or attention.  Mands can also be requests for the removal of something you don’t like. 

Mastery: The requirement for something to be considered learned.  Mastery criteria are always set before the behaviour is taught.  Often in applied behaviour analysis programs mastery criteria is 80% correct (or above) over 3 consecutive days with different instructors and novel stimuli. 

Natural Environment Teaching (NET): A form of applied behaviour analysis where learning occurs naturally or incidentally in the child’s typical environment.  Examples of programs that are best run in the NET are tooth brushing or feeding programs run at a family table during meal times. 

Negative Reinforcement: When something is removed from the environment that makes a behaviour more likely to happen again in the future. In applied behaviour analysis, negative reinforcement is not the same as punishment.

Neutral Stimulus:  Something in our environment that does not affect our behaviour.  We have not associated that object or event with anything else. 

Positive Reinforcement:  When something is added to the environment that makes a behaviour more likely to happen again in the future. 

Program: The specific strategies that will be used to change a behaviour or teach a skills. Each skill should have it’s own program description. Program is another word for intervention. 

Prompt Hierarchy: These are the graduated steps that a therapist will use to methodically remove support for a child to be able to perform a skill independently. Having a prompt hierarchy in place is important in order to ensure that all team members are using the least intrusive prompt required. An example of a most to least prompt hierarchy is: full physical, partial physical, verbal, gestual, modeling, pointing, gaze and no prompt (independent). 

Prompting: These are the strategies that are used to help a child learn a new skill. Generally, BCBAs will put a prompt hierarchy in place to guide the therapists in how to support the child. 

Punisher: Anything that makes a behaviour less likely to happen again in the future. 

Punishment:  A procedure that is used to decrease the likelihood that a behaviour will happen again in the future.  Punishment weakens behaviour. Your child’s therapy team must gain your consent before implementing punishment procedures in their applied behaviour analysis programming.

Rate: This is how many times a behaviour is displayed within a specific time frame.  Rate is always described in relation to time. For example, 7 incidents per day or 2 incidents per minute. 

Ratio: This is the number of responses required before a reinforcer will be delivered. It is possible to have either a fixed ratio (for every 5 responses reinforcement will be delivered) or a variable ratio (on average reinforcement will be delivered every 5 responses – sometimes it is delivered after one response and other times it is delivered after 9 responses). 

Receptive Language: This describes our ability to understand the words that are spoken to us. 

Registered Behaviour Technician (RBT): This is a credential offered by the Behavior Analyst Certification Board.  An RBT is a person who practices applied behaviour analysis under the close and ongoing supervision of a BCBA. RBTs are not allowed to practice independently (without supervision) because they have not met the standards set by the BACB for that level of work. 

Reinforcement: A procedure that is used to increase the likelihood that a behaviour will happen again in the future.  Reinforcement strengthens behaviour. 

Reinforcer: Anything that makes a behaviour more likely to happen again.  

Response: An observable and measurable behaviour.  Often applied behaviour analysis folks talk about response classes, or groups of behaviour that fit into a category. 

S-Delta: A stimulus whose presence indicates that a behaviour will not be reinforced.  For example, an “out of order” sign on an elevator will decrease the likelihood that you’ll push the elevator call button. 

Satiation: When your motivation for something is really low because you’ve been exposed to it too much.  This happens when you use a reinforcer too frequently or in amounts that are too big. 

Schedules of Reinforcement: The frequency that reinforcement is delivered. There are fixed and variable schedules as well as ratio and interval schedules. Fixed Interval (FI) schedules provide reinforcement for the first example of the target behaviour after a predetermined amount of time has expired. Fixed Ratio (FR) schedules provide reinforcement after a specific number of correct responses (think of a token board). Variable Interval (VI) schedules provide reinforcement after an unpredictable amount of time has passed. Variable Ratio (VR) schedules provide reinforcement after an unpredictable number of responses have been given.

Scrolling: Rotating through a set of answers when you don’t know the specific answer. For example, if you showed your child an apple and asked “what’s this?” If your child was scrolling they would say “Orange, ball, tomato, apple”.  This happens if the prompting procedure is not applied correctly. Scrolling can happen with any of the verbal operants, not only tacting/labeling.

Self-Injurious Behaviour (SIB): Actions that the child does that cause injury to themself. Hitting oneself, biting oneself and headbanging are examples of self-injurious behaviour. 

Stims/Stimming: Self-stimulatory behaviour. These are some of the repetitive or stereotypic behaviours that a person with autism might engage in. For example, hand flapping, rocking and repeating movie scripts are all stims. Some people with autism report that they engage in stimming because they’re either under or over responsive to sensory stimuli and it helps to balance them. 

Tact: In applied behaviour analysis this means a label.  When the speaker names what they see or perceive in the environment. For example, smelling pie and saying “pie” or hearing a dog barking and saying “dog”. 

VB MAPP (Verbal Behavior Milestones Assessment and Placement Program): This is a curriculum assessment that is based on Skinner’s Verbal Behaviour. It was created by Dr. Mark Sundberg.  Similar to the ABLLS-r it tests whether the child has specific language skills. The sections or domains of the assessment are based on Skinner’s verbal Operants. The assessment is divided into 5 parts: Milestones Assessment, Barriers Assessment, Transition Assessment, Task Analysis & Supporting Skills and Placement & IEP Goals. 

Verbal Behaviour: A branch of applied behaviour analysis based on the work of B.F. Skinner.  Skinner identified verbal operants or different parts of our language, each serving a different purpose or function.  There are many verbal operants but the basic ones are: mands, tacts, echoics and intraverbals. 

If you’re embarking on your applied behaviour analysis adventure and would like to discuss anything with us, please contact us for a no-charge 30 minute consultation.

Functions of Behaviour: Luckily it’s always one of these 4

Info graphic listing the 4 functions of behaviour: attention, escape, access to tangibles and sensory

Read time: 3 minutes

When developing behaviour intervention plans, behaviour analysts investigate the environmental conditions that create opportunities for challenging behaviours to happen.  We look at the functions of behaviour.

In other words, we look at the antecedents (or what is happening before a behaviour) and the consequences (or what is happening after a behaviour) to determine how the behaviour is maintained.

Behaviour analytic researchers have shown that there are 4 main functions of behaviour that perpetuate every behaviour. Sometimes a behaviour will serve one function but more often it can serve many.  Functions of behaviours can also change over time. The 4 functions of behaviours are: access to tangibles, access to social attention, escape or avoidance of undesired situations and automatic reinforcement (sensory).  

The functions of behaviour don’t always equal their topographies

Sometimes it can be easy to confuse the function of a behaviour with it’s topography. Topography is the description of what the behaviour looks like not why it is occurring. For example, to say that someone is chewing is describing the topography of their behaviour not the function.

Once the functions of a behaviour have been discovered the behaviour analyst will develop a replacement behaviour that meets the same need, is easier and is 100% effective. Another important aspect of changing behaviour is to stop reinforcing the target behaviour.

If your child is engaging in an attention seeking behaviour, say calling out in class without raising their hand, the replacement behaviour could potentially be teaching the child to raise their hand to have the teacher call on them. In order for this replacement behaviour to take hold, the teacher has to be committed to always call on the child when they raise their hand and to ignore all instances of calling out. If the teacher continues to reinforce the calling out behaviour, there will be no reason for the child to stop.  

It’s important to remember that reinforcing doesn’t only mean being positive about something.  In applied behaviour analysis, when you reinforce something you’re simply making it more likely to happen again. If a child is engaging in a behaviour that is maintained by escape and you put them in a time out you are reinforcing their escape maintained behaviour, even though being in a time out is not fun.

If a child doesn’t like to eat their vegetables and swears at the dinner table and is sent to their room as a consequence the child’s swearing behaviour is being reinforced because they were allowed to escape or avoid eating their vegetables.  The child has learned that by swearing they will be sent away from the table and will not have to eat their vegetables.

Often the way to change behaviour is to do the opposite of the function while replacing the target behaviour with an alternative.  If the behaviour serves the function of escape or avoidance you would not allow the child to escape or avoid the situation. If the child is gaining attention from the behaviour you would want to limit attention (ignore the behaviour, not the child). If the behaviour allows the child to gain access to something tangible you would want to not allow access.

There are many ethical debates about whether it is okay to intervene in self-stimulatory behaviours (flapping, pacing, jumping etc). I believe that we should not stop someone from doing something simply because of how it looks to others.  Typically developing people engage in self-stimulatory behaviours (humming, playing with their hair, fidgeting) and no one is putting a behaviour interventions in place to stop them. If a sensory maintained behaviour is dangerous (self-injury) or disruptive then there needs to be intervention and a replacement behaviour should be established. 

 Click here to read about the elements of a behaviour intervention plan.

If you would like some help determining the functions of your child’s challenging behaviour contact Lindsey by phone at 1.877.797.0437 or by email.

Applied Behaviour Analysis

What is Applied Behaviour Analysis (ABA)? 

What is Applied Behaviour Analysis (ABA)?

The overall goal of applied behaviour analysis is to make meaningful changes in a person’s life by increasing desired behaviours and decreasing interfering behaviours.  Applied behaviour analysis can be used to remove barriers that are limiting a client by allowing them to lead more independent lives. Applied behaviour analysis is one of the most effective interventions for treating Autism Spectrum Disorder. Using a variety of strategies, the applied behaviour analysis team utilizes reinforcement to increase the likelihood that the client will engage in desired behaviours. 

Who is on an Applied Behaviour Analysis Team?

Clinical Supervisor (a Board Certified Behaviour Analyst or a psychologist)
Supervising Therapist (depending on the size of your team)
Registered Behaviour Technicians/Instructor Therapists
Parents

It is important for all therapists working with a client to be in contact to align practices and goals. Consider including S-LP, OT and teachers to the applied behaviour analysis team for meetings and troubleshooting.



What does Applied Behaviour Analysis Therapy Look Like?

Autism Applied Behaviour Analysis Therapy Lindsey Malc Side by Side Therapy boy and therapist




There are a number of different approaches that might be utilized when doing applied behaviour analysis therapy.

Some examples are:

  • Discrete Trial Teaching/Training
    • Each step of a skill is isolated and taught in a series of trials.
    • Situations are contrived to maximize the opportunities for specific targets to be addressed.
  • Natural Environment Teaching
    • Teaching takes place in the natural environment (in the kitchen, on the playground etc).
    • Fosters generalization.
  • Verbal Behaviour Intervention
    • Focuses on teaching effective communication skills
    • Based on Skinner’s Analysis of Verbal Behaviour

How the intervention looks will depend on the goals of the program. In discrete trial training programs, the child and therapist will likely be sitting at a desk or table. While in a natural environment teaching session the child and therapist might be at the park.


How does applied behaviour analysis work?

Applied behaviour analysis is based on the sciences of learning and behaviour. Specific ‘laws’ of behaviour have been identified through scientific research that allow Behaviour Analysts to predict how a person will behave. Behaviour Analysts use this knowledge to facilitate learning.

Reinforcement

 autism Applied Behaviour Analysis therapy lindsey malc side by side therapy two girls playing on a tablet for reinforcement.

In behavioural terms, reinforcement is anything that will make a behaviour more likely to occur again in the future.  Reinforcement can be accomplished by adding something to the environment (positive reinforcement) or by removing something from the environment (negative reinforcement). 

* People sometimes confuse negative reinforcement with punishment but they are two separate behavioural principles.  

Some examples of positive and negative reinforcers are:

Positive

  • Getting a high five after finishing a difficult math problem
  • Having an ice cream after eating all the veggies on your plate
  • Getting an email with praise after making a big presentation at work

Negative

  • Drying wet hands (the water is removed from your hands and you’re likely to dry them again when they get wet in the future)
  • A loud alarm turns off after you buckle your seat belt (the alarm is annoying and you are likely to buckle up again in the future)
  • Removing an undesired food item from a child’s plate when they cry (the child is likely to cry again at the next presentation of that food item)

Punishment

In applied behaviour analysis a punishment is anything that makes a behaviour less likely to occur. Similar to reinforcement, there is positive punishment (adding something undesirable to the environment) and negative punishment (removing something desirable from the environment). While punishment is effective in behaviour change, much research has shown that reinforcement is longer lasting and more effective in changing behaviour.

Watch this clip from the Big Bang Theory which describes the difference between reinforcement and punishment.

Shaping

Shaping a behaviour occurs when we reinforce successive approximations of a behaviour. In order to be able to change behaviour opportunities for reinforcement have to be present. In shaping, you are making it more likely that an opportunity will present itself.

For example: Your minimally verbal child has recently begun to say an /m/ sound when they want milk. If you waited until they said the entire word ‘milk’ you would not have the opportunity to reinforce them. By shaping their response (and reinforcing each time they say ‘mmmm’) you are creating many occasions for reinforcement and learning.

Chaining

Chaining occurs when you string shorter behaviours together to form a longer continuous behaviour. There are 3 types of chains: forward, backward and total task.

The first step when chaining a skill is to do a task analysis. A task analysis is a procedure used to break down a complex task into it’s smaller parts.

For example: A Task Analysis for Making the Bed:

  1. Gather clean linens.
  2. Remove dirty linens from bed and pillows.
  3. Put clean pillow cases onto pillows and put aside.
  4. Put fitted sheet onto mattress.
  5. Put flat sheet on top of fitted sheet, on mattress. Pull up to align with top of the bed.
  6. Put blanket on top of flat sheet. Pull up to align with top of the bed.
  7. Place pillows on bed.
  8. Put dirty linens in the laundry.

Forward Chains: you teach the first step in the chain to independence before moving onto the second step. You would prompt the rest of the chain.

Backward Chains: you prompt all of the steps until the last step, which is the target. You teach the last step to independence before moving the target to be the second last step.

Whole Chains: you teach each step of the behaviour chain at once. This type of chaining procedure is effective when the child has a number of the skills required but is not yet completely independent.


Types of applied behaviour analysis interventions

There are 3 main types of interventions in applied behaviour analysis:

Antecedent Strategies (Prevention)

By changing the environment, we can avoid behaviours from happening altogether.

For example: You know that you always get hungry and distracted at 3pm, resulting in overeating at dinner time. You might prepare a snack to eat at 2:45 to avoid these behaviours. By changing the environment you have reduced the likelihood that the behaviour will occur.

Consequence Strategies (Intervention)

These strategies lay out how people will react when the targeted behaviour occurs.  Having a formal intervention plan will create consistency among staff or family members and will help change to happen quickly.  Having a formal intervention plan also removes any ambiguity about when to reinforce behaviour.

For example: You want to address your child’s pencil throwing behaviour during table work. After some discussion, you and the behaviour analyst hypothesize that your child is throwing to escape an undesired task demand. Together, you agree that when your child throws his pencil during table work you will respond by giving him another pencil. You will redirect him to continue his work and he will not be allowed to escape the task demand. You will also know when to reinforce his non-throwing behaviours.

Skill Building (Intervention)

These protocols are developed to teach new skills or to make existing skills more complex. 

For example: You want to teach your son to do the laundry. You would create a task analysis of doing laundry and decide if you wanted to use forward, backward or whole chaining. You would assess whether your son has the prerequisite skills to be successful before beginning the laundry instruction.


Data Collection

Data collection is an integral part of every applied behaviour analysis program. There are many kinds of data that might be tracked:

  • Frequency: how often a behaviour occurs
  • Duration: how long a behaviour lasts
  • Latency: how long it takes to start a behaviour
  • Rate: how many times something happens within a predetermined time frame
  • Antecedent-Behaviour-Consequence: what are the contingencies that are maintaining a behaviour

Data is used to make decisions in applied behaviour analysis. Each applied behaviour analysis program will have a specific data collection procedure with stated mastery criteria. Behaviour analysts take data to track success but also to be alerted when a program is not effective.

11 Essential practice elements of applied behaviour analysis

As stated by the Behaviour Analysis Certification Board (page 11) the following are 11 essential practices that should be present in every applied behaviour analysis program.

  1. Comprehensive assessment
  2. Focus on current relevance and future relevance of behaviour targets
  3. Isolating small units of behaviour to change to build towards substantial behaviour change
  4. Analysis of data specific to behaviour targets
  5. Purposeful intervention to manage the social and learning environment to maximize learning and minimize challenging behaviours
  6. Use of function based interventions
  7. Use of treatment plans that are individualized, specific and based in behaviour analytic theory
  8. Consistent application of treatment protocols across time and implementers
  9. Frequent re-assessment, evaluation and adjustment of treatment plan
  10. Direct support, modeling and training for family members and other team members
  11. Supervision by a Board Certified Behaviour Analyst

To read the definitions of a list of frequently used terms in applied behaviour analysis click here.

What is Applied Behaviour Analysis (ABA)?

The overall goal of applied behaviour analysis is to make meaningful changes in a person’s life by increasing desired behaviours and decreasing interfering behaviours. Applied behaviour analysis can be used to remove barriers that are limiting a client by allowing them to lead more independent lives. Applied behaviour analysis is one of the most effective interventions for treating Autism Spectrum Disorder. Using a variety of strategies, the applied behaviour analysis team utilizes reinforcement to increase the likelihood that the client will engage in desired behaviours.

Who is on an Applied Behaviour Analysis Team?

Clinical Supervisor (a Board Certified Behaviour Analyst or a psychologist) Supervising Therapist (depending on the size of your team) Registered Behaviour Technicians/Instructor Therapists Parents It is important for all therapists working with a client to be in contact to align practices and goals. Consider including S-LP, OT and teachers to the applied behaviour analysis team for meetings and troubleshooting.

What does Applied Behaviour Analysis Therapy Look Like?

There are a number of different approaches that might be utilized when doing applied behaviour analysis therapy. Some examples are: Discrete Trial Teaching/Training Each step of a skill is isolated and taught in a series of trials. Situations are contrived to maximize the opportunities for specific targets to be addressed. Natural Environment Teaching Teaching takes place in the natural environment (in the kitchen, on the playground etc). Fosters generalization. Verbal Behaviour Intervention Focuses on teaching effective communication skills Based on Skinner’s Analysis of Verbal Behaviour How the intervention looks will depend on the goals of the program. In discrete trial training programs, the child and therapist will likely be sitting at a desk or table. While in a natural environment teaching session the child and therapist might be at the park.

Continue reading “Applied Behaviour Analysis”

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