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Why is Occupational Therapy Used for Treating Autism?

Read time: 5 minutes

Many people wonder why occupational therapy is used for treating autism. Read this blog to find out!

What are your occupations?

Every day, you do meaningful activities. You play games, garden, make meals and paint. They are an integral parts of our lives. Above all they allow us to access the best parts of our life and make it meaningful for us. OT help with your professional and personal concerns if you are unable to perform daily tasks due to injury, illness, or disability.

  • Offer solutions to problems that arise from social and environmental factors.
  • Enhanced participation in communities and life.
  • Ultimately, help us live the life that we desire.

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is the most prevalent neurodevelopmental disorder. It affects about 500,000 people around the world. Autism diagnosis most often occurs in childhood. Moreover, Autism Speaks Canada predicts that 1 in 42 boys and 1 in of 189 girls will be autistic.

ASD can impact every area of a person’s life and each case is unique. Occupation performance refers to the ability to do daily activities, such as self-care and daily living. It also includes education, leisure and recreation for children. As well as their ability to communicate and socially engage. 

Why is Occupational Therapy Used for Treating Autism Side by Side ABA Therapy

What are the goals of occupational therapy?

OT’s main goal is to help clients achieve their highest level of independence. In other words, it is important to consider their personal goals, motivations and interests.

Above all OTs should:

  • Encourage participation in daily life.
  • Develop intervention plans and assess the abilities of the individual.
  • Assist children in achieving their developmental goals.
  • Encourage learning through their understanding of sensorimotor processing.
  • Fine/gross motor skills development and task analysis.
  • Recommend changes or accommodations to activities and environments.
  • Teach vocational skills and explore independent living options.
  • Assist clients in achieving independence.
  • Support clients and families with education, consultation, and advocacy.
  • Support clients in building intimate relationships through education about relationships and sexuality.
  • Participate in the inter-professional team (speech pathologists, behaviour analysts, physicians, early interventionists, social workers and educators).

How is occupational therapy used in treating autism?

Occupational therapists use their skills to improve sensory processing, emotional regulation and fine/gross motor development. Occupational therapy is a holistic approach that offers a unique perspective. They hold advanced degrees and have received a lot of training in the field. Moreover, they are highly skilled in doing assessments and in providing intervention. Occupational therapy interventions require input from family, educators, and caregivers. People transition from one setting into another with the help of occupational therapists. In other words, transitions include from home to daycare, from daycare to school, and from school to society. Occupational therapists provide support to families through education and consultation.

Why is Occupational Therapy Used for Treating Autism Side by Side ABA Therapy

Where can occupational therapists work?

Occupational therapists can be found working alongside health care professionals in many settings. That is to say these can include schools, long-term care facilities, hospitals, and community clinics. OTs also work in support services, family homes and on client health teams. Other organizations may be involved in the occupational therapy’s work, such as government policy-makers, community agencies, or care professionals.

Occupational Therapy at Side by Side

In summary, OTs play an important role on many of our client teams. Occupational Therapists can do direct treatment or consult to our ABA Therapy teams. If you’d like to discuss how we can use occupational therapy in your child’s program call Side by Side Therapy today.

Should my toddler see a speech therapist?

Read time: 4 minutes

Many new parents aren’t confident in their child’s milestone mastery. They often wonder ‘Should my toddler see a speech therapist?’ In their first two years, children accomplish many things. They learn how to walk, crawl, talk and socialize in just a few months. The expected age range for most skills that your child will learn is usually around 6-10 months. Most babies crawl between 6-10 months old, while the majority of children are able to walk by age 15.

Speech milestones are the same. Your child should be able to say their first words by the age of 1, and should know 20 words by the age of 18 months. Don’t panic if your child falls short of these goals. You may find your child slow to develop their language skills. A speech therapist could help.

Should my toddler see a speech therapist? Side by Side ABA Therapy

Side by Side Therapy can help your child if they are having difficulties with their development. Our therapists are warm and inviting, and we can help your child develop the skills necessary to live a happy and independent life. We have paediatric occupational therapists, speech therapists and behaviour analysts to help your child learn the skills necessary to face whatever challenges lie ahead.

Speech and Language

Speech therapy can be used to help your child improve their language and speech skills. While speech and language are closely related, they are quite different. Children might have difficulties with speaking, with language, with fluency or with any combination of the three.

Speech

Speech includes articulation, voice and fluency. Effective verbal skills require the integration of all three components. Articulation refers to the movement of our lips, tongue, mouth, and mouth in order to produce certain sounds. Children who have difficulty with articulation might have difficulties with the “r” and “th” sounds. Voice refers to the use of breath and vocal folds in order to produce sounds. Your child does not need to speak loudly, but they should be able and able to communicate clearly at a consistent volume. Fluency refers to the ability to speak in a rhythmic manner. 

Language

Language is the use of words and how they are used to communicate ideas and achieve our goals. It can be understood, spoken, read, and written. One or more of the skills that a child may struggle with is language.

Including:

  • What does the word mean? Some words can have multiple meanings. A bright object in the sky, or someone famous can both be considered “star”.
  • How to create new words.We can use the words “friend”, “friendly”, or “unfriendly” to mean different things.
  • How to combine words.In English, we use the phrase “Peg walked to new store” rather than “Peg walk new store”.
  • What to say at different times.We might say, for example, “Would your mind moving your feet?” If the person doesn’t move, we may say “Get off my foot!”

A receptive language disorder is when you have difficulty understanding the meaning of others’ words. Expressive language disorders are when you have trouble sharing your thoughts, ideas and feelings.

Fluency

Fluency refers to continuity, smoothness, rate and effort. In other words, how easily a person is able to retrieve words and use them. Fluency disorders like stuttering and cluttering are common in children with autism.

Should my toddler see a speech therapist?

Each child learns at their own pace and there are many milestones to reach. If your child shows any of these signs, then it might be time to consider speech therapy.

Number of words

Your 18-month-old child will use less than 20 words and 50 words by the age of 2.

Numerous sounds

Only a few sounds are required to make all words sound right. This is due to articulation.

Understanding

Most children can understand 300 words by age 2. Speech therapy may be necessary if your child is having trouble understanding simple sentences such as “Get your coat!”

Social situations

Your child speaks infrequently and struggles to use language socially. Sharing and turn taking are also important social skills that are related to speech and language development

If you’re looking for services for your child, please contact Side by Side Therapy to arrange a no-charge consultation to discuss your child’s development and needs.

Can parents do ABA therapy?

Read time: 3 minutes

Traditionally, trained professionals deliver Applied Behaviour Analysis (ABA). As a result of the COVID-19 pandemic and the skyrocketing costs of therapy, parents do ABA therapy more frequently.

On an ABA therapy team there are often 3 levels of clinicians. The Board Certified Behaviour Analyst (BCBA), the Senior Therapist (ST) and the Instructor Therapists (IT) /Registered Behaviour Technicians (RBT). The BCBA is responsible for overseeing the quality and directing the program. The ST oversees the IT/RBT. They also write the programs and do the assessment. On a traditional team, the IT/RBT deliver the therapy to the child. However, it is becoming more common for parents to receive Parent Coaching in order to implement the intervention themselves.

What is ABA Therapy anyway?

ABA is the science of learning and motivation. The goal of all ABA programs is to make meaningful changes to a person’s behaviour to help increase independence. Teaching skills and reducing challenging behaviours accomplishes this. Using a number of assessment tools, the BCBA will determine where the gaps are in the client’s learning and will design a program to fill those gaps. The BCBA will also determine the function of any challenging behaviour and will try to find replacements that meet the same need. In doing this, they’re looking to make the challenging behaviour unnecessary.

Some of the strategies used in ABA:

  • Frequent assessment and evaluation
  • Reinforcement
  • Shaping
  • Prompting and prompt fading
  • Task analysis and chaining

Can parents do ABA therapy?

The family and a BCBA will meet to discuss the child’s needs and what the family hopes to get out of therapy and coaching. The BCBA will help the family identify a goal or two. Subsequently, the BCBA will design a program that will either teach a new skill or replace a challenging behaviour with another more helpful behaviour. The BCBA will train the family in the program using Behavioural Skills Training (BST). There are 4 elements to BST: instruction, modelling, role play and feedback. That is to say, the family will be confident in their ability to implement the program. The family and the BCBA will meet weekly.

Parents are tasked with taking data, to monitor the child’s progress. Data is a foundation of ABA. In other words, all decisions should be based on and driven by data. If you’re having trouble with the amount of data that the BCBA is asking you to collect, please bring this to their attention. There are many ways to collect data and each has it’s own value and place in an ABA program.

The best ABA program will need changes and tweaks as it’s being implemented. Likewise, ABA programs must be individualized.

How do parents do ABA?

Father meeting with therapist to learn how parents do ABA.

Funding for Parent Coaching

If your child has OAP funding (Behaviour Plan Budget, Childhood Budget, Interim Funding) you can purchase parent coaching using your funding. According to the OAP website, in order for an ABA program to be funded it must be supervised by an approved Clinical Supervisor. In short, all of the BCBAs at Side by Side Therapy are eligible to supervise OAP funded programs.

How does virtual ABA therapy work?

With the end of the pandemic in sight, a lot of people are wondering if virtual ABA therapy will remain a therapy option. This post will explain what virtual ABA therapy is, how it works and some things to consider before registering your child.

Virtual vs in-person:

What is virtual ABA Therapy?

Simply put, virtual ABA therapy is ABA therapy where the sessions occur with the therapist in one location and the client in another and they’re both using a computer to communicate. Most other elements of virtual ABA are the same as in-person therapy.

The principles of ABA therapy don’t change when you’re virtual. The main elements of good therapy are:

  • Frequent assessment and evaluation
  • Reinforcement
  • Shaping
  • Prompting and prompt fading
  • Task analysis and chaining

How does virtual ABA therapy work?

For some children, virtual therapy will look very similar to in person therapy. If the child is working on academic tasks (literacy or numeracy based skills, for example) the sessions would be the same. However, if the child has difficulty attending, the therapist might need an in person supporter to prompt the child.

Some children require shorter sessions when they’re taking place virtually. It can be difficult for the child to focus on the screen and not be distracted by other stimuli in their environment. The therapist has much less control in a virtual session as they’re not able to physically prompt the child. This means that sometimes the expectations need to be altered to accommodate. For example, the schedule of reinforcement might need to be thickened (aka increased), to keep the child motivated and attending.

One of the benefits of virtual therapy is that there is no traveling required, so you don’t have to fight your child to get into the car!

Boy sitting at a desk with a tablet doing virtual ABA Therapy.

Is virtual therapy right for your child?

Things to consider before virtual therapy:

  • Does the therapist have experience delivering virtual therapy?
    • While the principles of ABA remain the same, the therapist will be using different tools and should also have a good grasp of the technology they’re using (Zoom, Teams, Google Meet).
  • What will the goals of therapy be?
    • As always, virtual therapy goals should be based on a thorough skills assessment.
    • The goals should be flexible taking the new teaching style into account.
    • Include mastery and revision criteria for each goal.
  • How long will the sessions be?
    • Having shorter more frequent sessions might be ideal for your child.
  • Do you have reliable technology?
    • You will need a computer or a tablet with a camera and a mic.
    • You will also need a stable high speed internet connection.
  • Does your child require a prompter to sit with them?
    • Some children can be entirely independent for the entire session while some need support setting up the technology. Others still require a prompter for the entire session.
    • Does the prompter need ABA training?

Virtual therapy was a lifesaver for many families during Covid19. However, many were not able to access virtual services because they were not appropriate for their child. Hopefully virtual therapy will continue to be available for those clients who benefit from it. Learn more about Side by Side Therapy’s virtual ABA program today.

What kind of therapy does a child with autism need?

Many parents of children recently diagnosed with autism ask themselves “What kind of therapy does a child with autism need?” This blog will cover therapy options and some guidelines for what to avoid when picking a therapy model and provider.

What kind of therapy does a child with autism need?

There are many evidence based therapies for autistic children. Applied Behaviour Analysis, Speech-Language Pathology and Occupational Therapy are 3 options. Each child is different and will need an individualized therapy program. In any case, therapy should begin with an assessment that is updated regularly. Each kind of therapy will have it’s own way of setting goals but the goals should be specific to the child. The type of therapy that a child needs will likely change as they grow and learn.

What are the different therapies?

Applied Behaviour Analysis (ABA)

ABA is a scientific discipline that focuses on analysis and evaluation of social and environmental shifts to produce meaningful changes in a person’s life. One of the main ideas behind ABA is the identification of functional relationships. In other words, functional relationships are the correlation between the person’s environment and their behaviour.

ABA can be used to both teach new skills and to reduce challenging behaviours. In fact, it is very important to do both of these things when implementing ABA. When a behaviour is reduced, it needs to be replaced with an alternative that meets the same need or serves the same function. You can read more about the functions of behaviour in this post.

ABA programs can be Comprehensive (more than 20 hours per week) or Focused (between 5 and 15 hours per week). The intensity of your child’s ABA program will depend on a number of factors (age, needs, challenging behaviours, other programs or therapies etc.).

ABA can be a bit like your family doctor. ABA has lots of strategies and techniques to help with most areas of need (behaviour, communication, social skills, motor skills etc), but there are times when a specialist is required – like a speech-language pathologist or an occupational therapist.

Child playing with wooden toys. What kinds of therapy does a child with autism need?

Speech-Language Pathology (SLP)

Speech therapy or SLP focuses on a number of areas: communication, language, pragmatics (or social skills) and feeding/swallowing. Speech therapy is a very popular therapy for autism. Your child’s SLP will do an assessment to determine where your child is in terms of skills and what needs to be targeted and taught. Sometimes the SLP will do a standardized assessment (where the child’s performance is measured against other same aged peers). Other times the assessment is informal. Sessions will usually take place for an hour or two each week.

Occupational Therapy (OT)

OT can be an incredibly effective therapy for autism. The OT will look at a number of domains (or areas) when they’re assessing the child. Some examples are: motor skills, sensory integration skills, self-help/adaptive skills, even academics. OT sessions can happen anywhere: at home, at a clinic, in school even at the park or grocery store. It’s most important that the OT is able to see the child in their natural environments in order to give the best suggestions and be the most effective. Similar to Speech, OT sessions are usually an hour or two per week.

What is an interdisciplinary team in autism therapy?

Interdisciplinary teams happen when clinicians from different disciplines work together to achieve the child’s goals. For example, the OT would give strategies and set goals around a child’s sensory needs while the SLP guides the child’s language program. Both the sensory goals and the communication goals will be carried out by the ABA team, as well! Interdisciplinary teams are the best kind of therapy for a child with autism.

There are lots of decisions to be made when you’re picking a therapy for your autistic child. Let Side by Side Therapy help you understand your options and what services are available.

What Can An OT Do For My Autistic Child?

Is your child autistic? Did their doctor recommend occupational therapy? Then you’re in the right place. Read on to find out what can an OT do for an autistic child.

What is occupational therapy?

What can an OT do for my autistic child?

Occupational therapists help autistic people using evidence informed strategies. OTs can also help to change or modify the environment to help the autistic person be as successful as possible. They will do an assessment that determine skills needing improvement and what changes should be made in the environment. Increasing independence is at the heart of most OT interventions. OTs take these areas into account when designing an intervention: physical, social, emotional, sensory, vocational and cognitive.

Source: National Autistic Society

What does an OT do?

An OT will assess the child’s skills in some or more of the following domains: fine and gross motor, activities of daily living, sensory functioning, social skills. OTs use standardized assessments. The therapist will develop an individualized treatment plan for the child. Occupational therapy sessions can take place in almost any setting (daycare, school, home, clinic or hospital). Often, OT sessions are an hour long. Some goals can being targeted in group therapy (eg.: social skills) while some need individual attention (eg.: toileting).

Most kids love OT. That is to say, OT sessions are fun and are driven by the child’s interests. In other words, knowing the child’s strengths, needs and interests is a key element in good therapy.

Child during an OT session for autistic child.

What should you consider before beginning OT?

What questions should you ask before beginning OT for your autistic child?

  1. Who will be working directly with my child?
  2. How many years they been working as a OT?
  3. Where will the services take place?
  4. How often will therapy occur?
  5. What are the goals of therapy for my child?
  6. What real-life skills will my child learn?
  7. How do you help with sensory issues?
  8. How is progress measured?

The therapist should be able to answer these questions easily. Above all, you need to feel comfortable with their style and perspective.

Source: Autism Speaks

How do you pay for OT services?

Is OT covered by insurance?

Some extended health plans have occupational therapy coverage. However, each plan is different and will have specific rules and qualifiers. You should ask your plan administrator to be sure. Also, make sure to ask when your benefit year renews to make the most of the benefits!

Does OHIP pay for OT?

The Ontario Health Insurance Plan covers OT services when it is provided through:

  • Hospitals and rehabilitation centres,
  • Family Health Teams,
  • Assertive Community Treatment Teams,
  • Community Health Centres,
  • Local Health Integration Networks (LHIN) that provide access to OT for eligible clients in their homes, schools, or long-term care facilities.

There are service limits with each of these programs. More information can be gathered from the service coordinator of the program or with the OT providing your treatment.

Source: Ontario Society of Occupational Therapists

Kids during an OT session for autistic children, playing on skateboards.

What is sensory processing?

How does an OT help with sensory processing?

Sensory processing is our body’s ability to understand the information it’s getting from the environment. Teaching sensory processing is one of the things an OT can do for an autistic child. Autistic people are often over or under sensitive to their environments. For instance, they might be very sensitive to loud noises or not appear to be hurt easily. An OT will help your child identify which strategies will help them get their sensory system working in top shape. Subsequently, the OT will teach your child to identify when to use these strategies and to do them!

Source: Harkla

What is a sensory diet?

A sensory diet is a specific routine of activities that helps regulate the child’s sensory systems. Children will run through the activities at predetermined times to help them prepare for the coming activities.

Sensory diets:

  • Restructure a student’s nervous system over time so that he is better able to tolerate sensations and situations he finds challenging/distracting
  • Regulate their alertness and increase attention span
  • Limit sensory seeking and sensory avoiding behaviours
  • Handle transitions with less stress.

Source: National Autistic Society

In conclusion, there are myriad ways that an OT can help an autistic child. At Side by Side Therapy, we work as an interdisciplinary team to combine our skillsets to achieve the maximum potential for each child. Our ABA Therapy teams work closely with the SLPs and OTs to create well balanced programs that propel the child towards their goals.

Autism Severity Levels (DSM-5) in 2021

Read time: 4 minutes

When your child gets an Autism Spectrum Disorder diagnosis there is an avalanche of information. What do the autism severity levels mean? Many families have asked me this question. Some families have a lot of support. However, some are sent on their way with a one page diagnosis letter. If you’re looking to have your child assessed here’s a list of the ways you can get a diagnosis in Ontario.

What is the DSM-5?

The DSM-5 is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The American Psychiatric Association (APA) released the DSM-5 in 2013. It is where a doctor or psychologist finds the description and criteria of all of the disorders and behavioural conditions. As medical knowledge changes the APA releases updated versions of the DSM.

With the release of the DSM-5, one of the major changes to the autism section was the combining of the communication and social impairment criteria. Another change was adding the severity levels.

What are the autism severity levels?

One of the most confusing elements of a diagnosis is the severity levels. Instead of using high and low functioning, which are ambiguous, we use the severity levels. Severity levels create a common language. This is important so there’s a standard and we all know that we’re talking about the same thing.

There are 3 levels: Level 1 is equivalent to requiring support. Level 2 implies requiring substantial support. Level 3 denotes requiring very substantial support. A person can have different severity levels for each of the elements of autism. For example, a person can be Level 1 in social communication but level 2 in restrictive, repetitive behaviours.

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

How are they used?

The severity levels do not determine funding eligibility. But this might change as the province implements needs based funding. Above all, individual assessments should inform treatment decisions. Certainly, a therapist might use a severity level to pick which assessments to do. Severity levels give a glimpse of what the focus of ABA Therapy might be. That is to say that clinicians might use severity levels in guiding treatment planning.

Can autism severity levels change?

Absolutely!

As children grow and learn their needs will change. In other words, the amount of support the person needs will change depending on the environment and expectations. People are complex. That is to say there are many factors that impact their behaviour and the support they need. Often, removing one barrier can improve other areas as well. For instance, improving a child’s communication skills can (and usually does) reduce challenging behaviour.

If you have questions about your child’s diagnosis or autism severity levels and how an ABA Therapy program can help, contact Side by Side Therapy to set up a no charge consultation.

Challenging Behaviours in Autism Treatment

Read time: 3 minutes

This blog post will discuss challenging behaviours: why language matters when describing behaviour, behaviour as communication, functions of behaviour, replacements and safety when addressing behaviours.

Language matters

Challenging… problem… interfering… There are many words that describe behaviours. However, how you label a behaviour speaks to how you feel about it. Calling a behaviour a ‘problem’ gives blame to the learner. Naming a behaviour as challenging can lead to the question “Who is this behaviour challenging?”. Labeling a behaviour as interfering might lead people to ask “interfering with what?”

Like most topics in the autism and ABA world, there is controversy around this. At Side by Side Therapy, I use challenging or interfering to describe these behaviours. I feel that it helps to focus our efforts on the behaviours that aren’t helpful to the learner.

Father carrying his toddler who is engaging in challenging behaviours.

Challenging Behaviours are Communication

If we take the view that all behaviour is communication, the learner isn’t to blame for their behaviour. They’re simply communicating a need in the most effective way they have. This attitude also leads us to look for alternative ways to communicate this need. It focuses us on helping the learner as opposed to stopping the behaviour.

4 Functions of Behaviour and Replacement Behaviours

There are 4 functions of behaviour.

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

When we’re targeting interfering or challenging behaviours we must identify their function. Some behaviours serve more than one function. We can ask: What does doing this behaviour give the learner? Does it let them off the hook for something undesirable or difficult? Having this information will help us find a replacement behaviour that meets the same need but is better for the learner. Better, in this case, means: easier, safer, more efficient and more effective. It can also be more socially acceptable.

More often than not, when we’re addressing challenging behaviours, one of the first things we teach is functional communication. This can be any form of communication (spoken words, signs, picture exchange, gesture etc). What’s important is that the learner is able to use the communication independently and that it is effective in meeting their need.

Safety First with Challenging Behaviours

Unfortunately, some behaviours are just dangerous. It is critical to keep safety at the forefront of any behaviour reduction plan. The learner’s safety, as well as the other people in their environment (family, peers, staff). Sometimes (often!) the plan needs to be revised and changed. Some behaviours are merely bothersome to the people around the learner. These behaviours do not always need to be targeted for reduction.

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

Autoclitics: 4 Things to Know in 2021

This is the last blog in our series about Skinner’s verbal behaviour. If you haven’t already, you should read the other posts about MandingEchoics, Tacts and Intraverbals. This post will be about Autoclitics.

Skinner created the verbal operants which are: 

  • Echoics
  • Mands
  • Tacts
  • Intraverbals
  • Autoclitics

What Are Autoclitics?

Autoclitics are a complex verbal operant. They function to modify or give further detail about the meaning of the other verbal operants in a sentence. There are 4 types: descriptive, qualifying, quantifying and relational. If you’d like to read more about the different types of autoclitics check out this website. Autoclitics give information about the other parts of the sentence. For example in the sentence “I think that it’s going to snow tomorrow.”, the phrase ‘I think’ is an autoclitic because it refers to the certainty with which it might snow tomorrow.

How Do We Teach Autoclitics?

Once the other verbal operants have been acquired and are consistently being used appropriately, it might be appropriate to teach this new verbal operant. The research is still out on the best way to teach them. What we do know is that it’s important not to teach them too early. Learners need to have very robust mand and tact repertoires before we begin introducing autoclitics. One strategy to teach them is to establish parity. That means to model appropriate use of autoclitics and their meanings. One way to avoid rote responding is to avoid teaching carrier phrases (e.g.: “I want”, “I see”, “I hear” etc). By teaching multiple component mands the child will be better equipped to use autoclitics.

How Long Will It Take To Learn To Use This Verbal Operant?

Each learner has a their own pace. It’s not possible to predict how long it will take a learner to master a skill. However, it is clear that with solid foundational skills and lots of practice it is possible to master most skills.

Two girls laying in the grass, reading and talking using autoclitics in their language.

Why Do We Teach Autoclitics?

Understanding this type of verbal operant and using it correctly will enhance a learner’s ability to communicate. By understanding the speaker’s meaning more clearly they will be better positioned to respond to mands and tacts. An ability to use autoclitics in a learner’s speech allows them to be more clearly understood and helps others to act on their mands and tacts.

If you’d like to discuss your child’s language program, please connect with us at Side by Side Therapy to learn more. We offer ABA Therapy programs and Speech Therapy to help maximize your child’s language skills.

Intraverbals: 4 Things To Know in 2021

This week’s post continues the series on Skinner’s Verbal Behaviour. If you haven’t already, you should read the other posts about MandingEchoics and Tacts. This post will tackle Intraverbals.

To recap, Skinner created the verbal operants and they are:

  • Mands (requesting)
  • Echoics (repeating what is heard)
  • Tacts (labeling)
  • Intraverbals (Answering questions or conversations)
  • Autoclitics (phrases that impact the other operants)

What are Intraverbals?

Intraverbals are the verbal operant that happens in response to another’s verbal behaviour. Basically, that means that the words, comments, phrases we use to reply to another person. In other words, intraverbals are conversations we have with others.

How do we Teach Intraverbals?

At the beginning, intraverbals as taught with songs using a fill in the blank format. Some learners need visual supports for prompting. You can use this assessment by Dr. Mark Sundberg to get an idea of where your learner’s skills are:

For example:

  • Instructor: (Holding a picture of a star): “Twinkle, twinkle, little ______”
    • Learner: “Star”
  • Instructor: “Head, shoulders, knees __________”
    • Learner: “And toes!”

Once the learner has mastered fill in the blanks, ‘WH’ questions can be used in expanding the learner’s intraverbal repertoire.

For example:

  • Instructor: “Where do you sleep?”
    • Learner: “In a bed.”
  • Instructor: “What is your sister’s name?”
    • Learner: “Avery”

Why questions are generally kept until the end of an intraverbal program because they’re the most difficult to learn.

Two boys smiling who have large intraverbal repertoires.

How long will it take to learn them?

As with all the verbal operants, the time it takes to master intraverbals will vary depending on the learner. Once the child has a strong mand and tact repertoire, it is appropriate to begin teaching this new verbal operant. There are many phases to this skill and it can become quite complex. This verbal operant isn’t generally mastered in a short time.

Why do we teach intraverbals?

Having a large intraverbal repertoire will help the leaner to engage in conversations. That is to say, that knowing how to respond to questions will allow the learner to be more sociable. Many learners spontaneously learn to ask questions once they have learned to answer them. Importantly, asking questions demonstrates to other our interest in them and helps build relationships.

If you’d like to discuss your child’s language program, please connect with us at Side by Side Therapy to learn more!

Tacting: 4 Things To Know

This week’s post continues the series on Skinner’s Verbal Behaviour. If you haven’t already, you should read the other posts about Manding and Echoics. This post will tackle Tacts and tacting.

  • To recap, Skinner created the verbal operants and they are:
    • Mands (requesting)
    • Echoics (repeating what is heard)
    • Tacts (labeling)
    • Intraverbals (Answering questions or conversations)
    • Autoclitics (phrases that impact the other operants)

What Are Tacts?

Another word for tact is label. It is important for people to know the names of items so they can clearly communicate about them. When an instructor holds up an item and asks ‘What is this?” the learner will respond with the name of the item. Learners can label the things they see, hear, smell, feel or taste.

How Should We Teach Tacting?

Similar to the other verbal operants, when teaching tacts the first step is to gauge the child’s motivation. Once you know what you’ll be using as reinforcement (paired with social praise), you can hold up the item and say “What is this?” If it is a new target, you want to immediately give the learner a prompt (errorless teaching) to avoid accidentally reinforcing an error. If the learner responds correctly, you can reinforce. It would sound something like this:

Errorless Trial:

Instructor: (Holding a car) “What’s this? Car.”

Learner: “Car.”

Instructor: “Awesome job, it is a car!” (Gives car to learner to play with)

Regular Trial:

Instructor: (Showing picture of a dog) “What animal?”

Learner: “Dog.”

Instructor: “That’s right! This is a dog!” (Gives learner token and high five)

Some children have a difficult time learning to label items when the question “What is this?” is asked. Some of the issues that could arise are the child repeating the question or the answer being given only when the question is posed. As a way to avoid these problems, it is a good idea to mix trials so that sometimes the instructor only holds up the item being tacted with an expectant look on their face to indicate to the child that a response is expected.

Common 300 word noun list for tracking tacting in autism and aba therapy.

How Long Does It Take To Learn To Tact?

This depends on the learner. Each person will learn at their own pace. What happens in some cases is bursts of new vocabulary being learned at once with time between the bursts to consolidate the language. Typically developing children will have between 200 and 1,000 words by the time they’re 3 years old. Here is a list of the first 300 nouns that are commonly learned.

Why Do We Teach Tacting?

Tacting expands the learner’s vocabulary. Teaching them to label the things in their environment will help them expand their world. They will be able to speak about things with specificity. This is helpful so they’re not reliant on phrases like “that one” or more general categories to identify things.

Tacting can be tricky for some children to learn. Reach out to Side by Side Therapy if you’d like to discuss your child’s language development.

Top 5 Myths about ABA

Every day we hear fake news. Sometimes it’s hard to tell fake news from real news. When you’re choosing a therapy to help your child having real news is vital. Here are the top 5 myths about ABA briefly explained.

Top 5 Myths about ABA Explained:

Myth 1: ABA is only for autism.

While ABA is most well known for it’s use with autistic children there are many other applications. ABA can be used to address a wide variety of conditions: ADHD, substance abuse, anxiety and anger, traumatic brain injury are only a few. There is also a lot of really neat use of ABA in business and sports. The Florida Institute of Technology has a certificate program in Organizational Behavior Management (OBM). OBM addresses performance management, safety systems and behavioural systems analysis.

ABA is in classrooms around the world every day. But it’s not called ABA… it’s just called teaching!

Myth 2: ABA is all about drills at the table

Old-school ABA was drills at the table. However lots of research in education shows that young children learn best through play. As the decades pass and research continues, new naturalistic interventions are becoming common, like the Early Start Denver Model and Pivotal Response Treatment. Generalization is also becoming an integral part of all good ABA programs. The child needs to show the skills across settings, people and materials in order for it to be useful. Generalization doesn’t happen exclusively at the table.

Myth 3: ABA is only effective when it’s more than 40 hours per week.

This is one of the most widespread myths about ABA. Early research showed that ‘intensive’ programs of 40+ hours each week were the most effective. However a recent study showed that there was no difference in outcomes between 15 and 25 hours/week of therapy. It is very common to see children in 6-15 hours of therapy each week with great results. Comprehensive ABA is 20+ hours of therapy per week. It’s comprehensive because it delivers a full curriculum. 5-19 hours of therapy per week is called Focused ABA because it focuses on specific skills and teaches those to mastery.

Myth about ABA: It's all about drills at the table.

Myth 4: ABA uses food as a bribe.

A big part of ABA is using positive reinforcement. We want to encourage the behaviours we want to see again. A surefire way to do this is by using positive reinforcement. By adding desirable things to the environment after a behaviour occurs you make it more likely that the behaviour will happen again. Anything can act as a reinforcer, as long as it makes a behaviour more likely to happen again. Sometimes that’s food, but more often it’s toys, praise and privileges. The ABA team should always be developing new reinforcers to keep the person motivated.

Myth 5: ABA will fix the autistic child.

ABA teaches skills and reduces challenging behaviour. This leads to improved quality of life. Autism is a neurological disorder. It has no cure. However, there is still plenty to be hopeful about. All children have the potential to learn and grow. It’s not about reaching a specific milestone, but rather about becoming the best that they can be.

Myth about ABA: It will cure your autistic child.

Conclusion

Finding the right therapy for your autistic child is vital to improving their (and your) quality of life. Don’t be led astray by the fake news. ABA is one of the most studied and effective treatments for your child.

How to choose an ABA Provider

This post will describe the elements you need to consider when you choose an ABA provider for your child.

As soon as you get an Autism diagnosis the first place you turn is likely Google. When you’re reading you find again and again that Applied Behaviour Analysis (ABA) is the most recommended therapy. If you live in a bigger city, you’ve got many options to choose from – but how do you choose an ABA provider?

Here are 5 things to consider when you choose an ABA provider:

Home or centre based?

There are many benefits to both home and centre based programs. What you need to decide is: which will benefit your child and be most manageable in your life?

In home based programs, the clinicians come to your house for each therapy appointment. Generally, a responsible adult has to be home with the child and clinician during sessions. You can see what the clinician is doing and how they’re teaching your child. You can participate in therapy sessions. Depending on the age and goals of the child, the clinicians might need a desk or table that’s free from distractions. Home based programs typically focus on using the toys and materials you have in your home to do the programming. This is a great strategy because it will allow you to continue the interventions when the therapist leaves.

Clinic based programs allow you to drop your child off and get things done while they’re in therapy. Your child will have access to a lot of novel toys and games. There will likely be peers around for social skills programming and they will hopefully learn to be a bit independent as they’re away from you and the ‘safety’ of home. Clinic based therapy sessions can often mimic school more closely than home based sessions can.

Black father and son laying on a bed reading about how to choose an ABA provider.
Black father laying on bed with son searching on a laptop.

Credentials and Supervision

In Ontario, behaviour analysis is not a regulated profession. The title ‘Behaviour Analyst’ is not protected like psychologist or social worker. Anyone can say they’re a behaviour analyst. That’s a terrifying thought.

There is a certification board that credentials Behaviour Analysts. It’s called the Behavior Analyst Certification Board. To become a Board Certified Behaviour Analyst (BCBA) the candidate must have completed an approved graduate degree, completed 2000 hours of supervised work and passed a board exam. To utilize provincial funding for evidence based behavioural services (aka: ABA!) the program must be overseen by a BCBA.

It is vital when you choose an ABA provider that there is a BCBA on the team who will ACTUALLY SPEND TIME WITH YOUR CHILD. It is not enough to have a BCBA who simply signs off on the reports. They should spend a minimum of 2 hours each month supervising and monitoring your child’s progress. The BCBA also trains the front line staff on the interventions.

Some agencies employ Senior Therapists to take over some of the supervision of the BCBA. Often, senior therapists are in training to become BCBAs. This is totally okay, as long as the BCBA remains involved. At Side by Side Therapy, we do 10% supervision (for every 10 hours of ABA a client has they will have 1 hour of supervision). That’s a reasonable standard to look for when you choose an ABA provider.

Reviews and Recommendations

Rely on word of mouth. Other families have walked your path and can often be reliable sources of information when you choose an ABA provider. Most businesses have Google reviews that you can read. Also, there are many support groups on Facebook or other social media platforms that can provide recommendations for ABA providers in your area. You can also ask for references when you’ve narrowed down your search to a few providers.

Parent or caregiver involvement

Instructing parents not to participate in therapy is a huge red flag. There is no reason that you should not be in the room or able to watch what’s happening (whether in a home or centre based program).

Parent training is vital to a child’s success. You must learn the strategies and techniques that will be most effective for your child. One of the best ways to learn is called Behavioural Skills Training (BST). There are 4 steps in BST: instruction, modelling, rehearsal and feedback. You need to practice the skills with the clinician there to provide feedback in order to learn them.

You should also have an equal voice in the direction of the programming and how the programs are chosen. Each ABA program is ABA is individualized to each client so it is important that your family’s goals and values are taken into account when creating the programming. The goal development should be guided by two things: the curriculum assessment and your input.

Interdisciplinary Team

While ABA is the most evidence based intervention for Autism, there is definitely an important role for the other disciplines to play in your child’s autism therapy. Speech-Language Pathology, Occupational Therapy, Recreation Therapy and respite all bring valuable insights and skills to the team.

Bringing an excellent team together with clinicians from multiple agencies is possible, but it is WAY easier to have everything under one roof. Choosing an ABA provider that is open to collaboration with other disciplines is super important.

Questions to ask when choosing an ABA provider

  • What does a typical session look like?
  • How do you measure success?
  • How frequently are revisions made to the programming?
  • Who does parent training? How often is it done?
  • What is your philosophy on punishment?
  • What training do the instructor therapists have?
  • How many years have you been a BCBA?

Call or email Side by Side Therapy today to schedule a no charge/no obligation consultation to learn about our ABA program or for advice on how to choose an ABA provider.

Autism in Ontario: What funding is available?

This will be the first instalment in a series about the funding for autism families in Ontario.

I’ve worked in the field of Autism and ABA therapy for 16 years. I’ve worked with a lot of children under different funding circumstances. Some (few, very fortunate) families have the means to pay out of pocket for the services that their child needs. Most families rely on provincial and federal funding to pay for therapy and other services that their child requires. When the funding is used up services are often put on hold.

According to a report released by the Ontario Association for Behaviour Analysis, the cost of supporting a child with autism can range from $26k to $130K per year.

Having my own therapy services company has allowed me to see the heartbreak of a family pausing services. Services that were improving their child’s life. Services they just cannot afford. We offer a sliding scale, we work with families to figure out payment plans, we advocate to the government. Sometimes families just don’t have another option and pausing services is necessary.

Mom sitting at desk, worrying about her child's Ontario Autism Program funding.

What autism funding is available to families?

There are a few different programs that cover some of the cost of raising a child with autism. Right now, families in the province can apply to the Ontario Autism Program for funding for their children with autism diagnoses. The funding allotments are based on age. With children under 5 years old receiving $20K and children over 6 years receiving $5K. In August, I wrote a short blog post about the OAP‘s history. The government claims to be working (but this post isn’t about politics!) towards implementing a needs-based funding model. Needs-based funding gives families the funding they need to get the therapy their child requires. Side by Side Therapy offers excellent ABA Therapy near me.

Special Services At Home (SSAH) is a provincial program that helps families pay for services both inside and outside of the home. The amount of funding that each child receives is based on what their needs are, what other services they are accessing and other available community resources. SSAH funds are meant to aid families in two broad areas: personal development & growth and respite. Also, there have been changes to the SSAH eligible expenses due to Covid19.

Assistance for Children with Severe Disabilities is a fund for low to moderate income families who have a child with a severe disability. The funds provide financial relief for families raising a child with a severe disability. The amount of funding received depends on the size of the family, the family’s income, the severity of the child’s disability and the costs associated with raising the child.

What else is out there for autism families?

Disability Tax Credit (DTC) provides tax relief to a person with a disability or their parents (if under 18) to account for some of the cost of living with a disability. To qualify, a medical practitioner has to complete a form that states that your disability is severe and prolonged.

Registered Disability Savings Plan (RDSP) is a savings plan that helps parents or others save for the future of a person with a disability. Withdrawals made from an RDSP they are not considered taxable. The beneficiary of the RDSP must qualify for the Disability Tax Credit.

Canada Disability Savings Grants (CDSG) is a matching program offered by the federal government. They will match your deposits up to 300% (Based on your income and your contribution). You must have a RDSP to qualify for the grants. Canada Disability Savings Bonds (CDSB) is the money that the Canadian government contributes to the RDSP’s of low and modest income families. You can receive up to $1,000/year with a maximum contribution of $20,000. The amount you receive is dependent on your family’s income.

Autism Ontario has some one to one worker reimbursements available for families. The child’s name is entered into a draw when the application and proof of diagnosis are submitted. Approximately 500 children receive the grant each year.

Jennifer Ashleigh Children’s Charity is available for families experiencing financial pressures of raising a child with special needs. The fund covers a variety of things from emergency costs to housing costs incurred while caring for your ill child. They also cover some therapies.

Conclusion

A parent pointed out to me that perhaps it isn’t the number of funds or the amount of money that’s available that is lacking in our province. But rather that the application process is too difficult and too confusing for many families. Come back soon to read more about the funding in Ontario.

How to use visual schedules to reduce challenging behaviour

Visual schedules can help an autistic child be less anxious. They present daily activities, as well as the sequence in which these activities will unfold. A high level of predictability brings comfort and will even reduce challenging behaviour. 

Depending on the child’s developmental level, the schedule can be made with photographs, drawings or pictures. Sometimes they can have written words or actual objects. The schedule can be displayed on a wall or on paper. For children who go to school, the schedule can be placed inside a notebook. 

Also, parents can add a todo list to each activity. This shows all of the steps the child needs to take in order for a specific task to be completed. 

Are visual schedules effective at reducing challenging behaviour in autistic children?

Yes. According to a study published on solutions to decrease challenging behaviour, the use of activity schedules can help children who have been diagnosed with autism spectrum disorder. 

The study showed that visual schedules worked for children with difficulty following rules. The authors point out that visual schedules promote self-regulation and independence.

The introduction of a visual schedule is particularly important when it comes to children who have academic demands to meet. These children sometimes have difficulties meeting these demands, and this is where the challenging behaviour commonly occurs. The visual schedule can reduce the stress experienced by parents as well as promote learning and cooperation in children. 

Example of a visual schedule on the wall of a classroom.
autism aba therapy lindsey malc side by side therapy visual schedule

Why should you consider visual scheduling? 

Visual schedules offer the perfect opportunity to teach an autistic child to complete the required activities in a day. Thanks to the todo list, you can break down a task into smaller steps, which are easier to complete. Small steps are easily achieved and provide opportunities for more frequent reinforcement.

Visual schedules offer to the child one of the things they look for the most: predictability. As they will learn to use the schedule, they will often become less anxious. Moreover, by using prompts and reinforcement, as you have been taught by your Board Certified Behaviour Analyst, you can decrease resistance and escape maintained behaviours. 

In simple terms, you can see the visual schedules as a constant reminder for your child. They will know exactly which activities to complete every day and where they will occur. Most importantly, they will know the order in which things will happen. . 

How to use visual schedules to improve your child’s behaviour 

As with any new intervention, you should expect for the child to resist the introduction of a schedule. Practice together, using plenty of praise and reinforcement.

Be patient and give your child the time they need to become comfortable with using the schedule. Keep in mind that some time might pass before they accept the visual prompt, following the routine as expected. At first, offer schedule check reminders frequently.

In time, and after plenty of practice, the child will indeed turn to the schedule, enjoying its predictability. The interesting thing is that, by predicting and in turn enjoying the activities you have included on the schedule, your little one will have fewer opportunities to misbehave. 

Be sure to acknowledge the efforts the child is making in following the schedule. Use simple phrases like “good job checking your schedule” or “nice work keeping up with the to do list”. You can give your child thumbs up, offer a smile or offer a hug. What matters is that you recognize they are trying, celebrating even the smallest achievement together.

You can try adding a preferred activity at the end of the schedule alternatively, so that he/she will understand that he/she can engage in that activity once everything else has been completed. Offer options to children who are able to choose; if your child has trouble making choices, select an activity you already know he/she enjoys. 

Will visual schedules bring a difference to our daily routine?

Once again, the answer is yes. The child will learn to follow a simple schedule, becoming more organized as a result. He/she will thrive from knowing what lays ahead, no longer feeling confused. The familiar routine presented through visual aids will genuinely reduce the level of anxiety your child feels.

Using visual schedules will help your child make transitions between activities as well as between tasks within an activity. By using the todo list, and presenting the child with the exact steps to follow for an activity, you will reduce the risk of inattention and/or misbehaviour.

Using a visual schedule will give your autistic child a better chance to succeed. Challenging behaviour meets an unmet need that your child is experiencing. Challenging behaviour can be attributed to one of the 4 functions of behaviour.

Early #Autism Diagnosis: Key to Successful Intervention

The signs of autism can become noticeable around the age of 18 months. Despite this, on average, autistic children receive their diagnosis at age 4 or 5. The delay is often deliberate, hoping the child will grow out of his/her condition, or to avoid labels, such as “autistic”. Getting an early autism diagnosis for your child will only benefit them.

Unfortunately, the delay in the diagnosis equals lost years of intervention. No child recovers on his/her own from autism. It takes a lot of effort, therapy and a transdisciplinary approach to enhance the quality of life for an autistic child. The earlier the diagnosis, the more time that child will have to reach their full potential.

Taking advantage of the brain’s neuroplasticity 

The human brain possesses an incredible ability called neuroplasticity. Basically, neuroplasticity refers to our brain’s ability to adapt and change. The brain can learn and grow to overcome challenges. If a specific part of the brain is damaged or not working correctly, it can develop ways to work around the deficits. Autistic children need to start therapy as early as possible and take advantage of this ability in our brains. The older the child, the more difficult it will be for their brain to change and adapt.

To understand how beneficial early diagnosis in autism is, try not to think of the brain as a static organ. The complex organ is more flexible than we might think, adapting over time and compensating for lost functions. Regular therapeutic interventions, like ABA therapy, can help the autistic child’s brain build new pathways. 

Black toddler smiling playing with toys in a white room during an early autism diagnosis.

Early diagnosis, also beneficial for parents

Parents are usually the first to notice that their child isn’t developing as expected. Getting an early autism diagnosis can relieve distress and help parents focus on next steps. They can seek early intervention, form a support network and they can access several benefits, such as the Registered Disability Savings Program.

Taking your child to a doctor for an assessment is the first step to getting them help. Under the guidance of autism specialists, you will come up with an intervention plan and help your child learn.

Starting therapy from a young age

With autistic children, the key word is “early”. The earlier autism diagnosis and the earlier intervention, the more of a difference it will make. In therapy, the child can develop social and communication skills, and work on challenging behaviours. They will learn new skills and become more independent.

An autistic child who goes to therapy from a young age can develop their strengths, and work toward a better life quality. A diagnosis made within the first three years of life offers the best long-term outcome. Most parents only seek intervention after receiving the diagnosis, but your child can go to therapy before that. You can address worrying signs and work on teaching skills. Reach out to us at Side by Side Therapy to hear about the Early Start Denver Model, an ABA/developmental approach to teaching children with or suspected of autism.

Warning signs of autism

Each child is unique. The warning signs might differ and they might be present at various levels. 

Even though you might notice the following signs, getting an accurate diagnosis is vital. Only a specialist can determine if your child has autism and point you in the right direction. If your child gets a diagnosis, they will have access to services and programs that would otherwise not be an option.

Warning signs of autism:

  • Lack of facial expressions, child does not smile 
  • Limited or absent eye contact
  • Speech delays (no words by 16 months, no two word combinations by 24 months)
  • Does not respond to his/her name
  • Loss of previously gained skills 
  • Does not point to items of interest
  • Does not like changes (routine, environment)
  • Stereotypical gestures
  • Prefers to play alone, does not engage in pretend play
  • Echolalia (persistent repetition of words/phrases, heard recently or in the past).

Early diagnosis, the first steps of the journey

It’s hard to find out that your child has autism. But the diagnosis will give you clarity of mind and help you take the first step of the journey. Together with autism therapists and a powerful network of support, you will create a path forward for your child.

Trust your instinct, especially if you have noticed one or several warning signs. Do not wait until your child is older. Go to a specialist now. 

Speech Therapy in Autism Treatment

Read time: 2 minutes

Communication represents one of the core challenges for autistic children. Speech Therapy in autism treatment is essential. They may have difficulties engaging in a conversation. Not picking up on social cues, they might find it hard to interact with their peers.

A speech-language pathologist can help autistic children improve their communication and social skills. Addressing key areas, the therapy team will help the child overcome daily challenges and learn how to function within a social context.

What are some of the challenges caused by autism?

It depends on the severity of the condition – autism is a spectrum. Some children may not understand non-verbal communication easily, while others will have trouble with spoken language. They may need help learning to read or write or engage in conversations with others.

Speech Therapy in autism treatment with a young boy and a Speech-Language Pathologist

In severe forms of autism, the speech/language impairment will be more obvious. These children might not speak at all, or they might resort to challenging behaviours to express themselves. They may not seek interaction with others or prove unable to maintain eye contact.

Red flags 

Speech/language delays are among the first noticed by parents. Many go to their paediatrician or family doctor stating their concern that the child has lost some or all of the previously gained words.

Others are worried that their child constantly repeats certain words or phrases, either heard on the spot or weeks before. This is called echolalia. It can also serve the purpose of communication. The therapist will help the child resort less to repetition and rely more on novel speech.

How can Speech-Language Pathology help?

The first thing a Speech-Language Pathologist (S-LP) does is assess communication, articulation and social skills. The S-LP will notice any red flags, and work out an intervention plan to improve the areas. The primary goal is to help the child become more communicative within the home, school and social environments.

When we say communicative, it is important to remember that might not always refer to verbal language. There are children who will use other communication methods to interact with other people, and they will need help to master these. Some examples of other methods of communcation are: sign language, picture exchange, typing/writing or high-tech speech output devices.

During S-LP sessions, autistic children might work alone or in groups. The therapist will facilitate interaction, teaching the child to use appropriate communication behaviours. The child will learn to maintain eye contact, take turns and communicate according to the context and other’s cues. They will also work to develop reading and writing skills where possible.

A non-verbal child can communicate 

You might not know this, but 90% of communication is non-verbal. If an autistic child presents severe language impairment, he/she might still communicate. Through speech-language pathology, he/she can learn alternative means of communication.

The S-LP can teach him/her to understand and use gestures correctly. Communication systems can be helpful, including those based on pictures or visual supports. Some children find it easy to communicate with the help of electronic devices. The goal is to find the best method for each child, taking his/her abilities and challenges into consideration.

What about verbal children?

Once again, the intervention depends on the language and communication difficulties the child is experiencing. All children must learn the appropriate use of language and how to have a conversations with their peers and those around them.

At more advanced levels, Speech-Language Pathology might help the child understand the complexity of language. For instance, that a word can have more than one meaning or how certain expressions are used figuratively.

Social communication, one of the primary goals of S-LP

Human beings are social creatures by nature, and autistic children do not represent an exception. With the help of S-LP, they can learn how to interact with their peers and overcome the communication their challenges.

The Speech-Language Pathologist will work with the child to adapt his/her language to the correct context. They will explore non-verbal cues in a social setting and practice with other children.

It takes time, but some children can learn to recognize verbal and non-verbal cues, improving their communication abilities. This will help them feel less frustrated. When these skills improve, the challenging behaviours often become less frequent. This will have a positive effect on the academic outcome.

S-LP, helping with early diagnosis of autism

When parents have concerns about their child’s development, speech and language delays are present at the top of the list. The Speech-Language Pathologist can help with the early diagnosis of autism, recognizing the red flags associated with communication and social skills problems. The earlier the diagnosis of autism is made, the more successful the specialized intervention can be.

S-LP and the Ontario Autism Program

Your child can access S-LP services using their OAP funding (legacy funding, childhood budgets and one-time interim funding). Here is a list of eligible services and supports that can be purchased with the funding.

Read about how Side by Side Therapy can develop a transdisciplinary team to address your child’s needs and use their Ontario Autism Program funding.

How to Build a Good Relationship with Your Child’s Teacher

As a parent, it is normal to have worries about your child’s academic success. How will your child integrate in the school environment? Will they establish positive relationships with their teachers and peers? These are only two questions among the many going through your head. Read on to learn how to build a good relationship with your child’s teacher.

The teacher is the number one person who can help your child integrate and achieve their full potential within the school. This is the major reason you need to build a positive relationship with your child’s educator. Together, you can set common goals and positively influence their long-term academic outcome.

In this blog, we will present a few strategies on how to build a relationship with your child’s teacher. The most important thing to remember is that teachers require time to get to know your child, so keep an open mind. Work towards the relationship you want to have and always state your goals.

How to Build the Relationship:

Use the first meeting to paint a detailed picture 

Parent building a relationship with their child's teacher in a meeting at the school.

Teachers are familiar with the diagnosis of autism. But they don’t know your child, and this is where you come in. To build a good relationship with the teacher you need to help them understand your child. Offer solutions on how to handle certain behaviours, meltdowns in particular.

Be sure to highlight your child’s strengths and what helps in interacting with them. The more information you provide, the easier it will be for the teacher to see beyond the diagnosis.

Talk about goals 

Once school starts, the teacher becomes part of the team. You need to mention the things you are working on in therapy, and how educators can reinforce them at school. It always interests teachers to help their students achieve their full potential. They will want to know about the goals you have for your child. Some teachers are open to Behaviour Consultations from the therapy team.

By informing the teacher about your child’s goals, you will develop a positive, team-based approach. The purpose is to create a team that works together, helping your child achieve new skills. Everyone on the team should be familiar with the things you want to improve or change.

Discuss communication expectations 

It is best to communicate regularly with your child’s teacher. However, remember that they are only one person who has to communicate with a lot of parents. Establishing communication expectations from the start can pave the way for a great relationship with your child’s teacher.

Some teachers prefer after school conversations, while others rely on emails and phone calls. What matters is that you ask and see what works best for both you and the teacher. When engaged in a conversation, stay on the subject. Try to place yourself in the educator’s shoes and see how hard they are working to help your child.

A plan to help the child succeed 

Work with your child’s teacher to develop a plan for how your child will achieve their goals. Modifications and accommodations can be made to the curriculum. Therefore, they should be used to make your child as successful as possible. Talk about behavioural issues and how they influence learning, and set goals based on the strengths of your child.

The key is to develop a partnership with the teacher, working towards a common aim: helping the child succeed. Ask the educator to offer his/her input and work on creating a road map for progress. Meet regularly to review the progress made and update the initial goals.

Don’t be afraid to talk about negative behaviours

Meltdowns and challenging behaviours can be part of life with autism, and teachers deserve open communication as much as anyone else. Don’t be afraid to talk about these issues, as the teacher is not there to judge your child but to help them. The teacher will be grateful that you were up front and this will help build the relationship.

It might help to discuss specific situations. Find out what caused a meltdown, and how the teacher saw fit to intervene. Have a talk about potential triggers and also about school-related behaviors that could be worked on during therapy. The more you are open about your child, the easier it will be for the teacher to relate and offer help.

Parent-teacher interview

A structured interview can be useful in developing a positive relationship with your child’s teacher. During the interview, you can talk about your child, and any issues related to his/her diagnosis. By doing this, the educator finds out more information about his/her students.

From your perspective, such an interview represents a sure way of starting things on the right foot. You can speak about emotional and behavioral difficulties, and academic goals. Depending on how much time you have available, you can also discuss how your child will integrate in the school environment.

Conclusion

It takes time to develop a positive relationship with your child’s teacher, but the effort is all worth it. The educator becomes part of the intervention team, fighting to help your child grow and overcome the challenges they face.

Interested in reading a New York Times article about how a Florida mom works to build a good relationship with her daughter’s school?

 

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.

Early Start Denver Model (ESDM): Unleash Potential!

Read time: 4 minutes

The brain has a unique property called neuroplasticity. This means that our brains are constantly able to change and grow. Children under 5 years old have the easiest time with neuroplasticity. Even when the child has been diagnosed with autism, it is possible to make significant gains that are life changing. We can achieve this through early intervention. Specifically by using the Early Start Denver Model, we can begin even before a diagnosis is made. 

Child playing with is mom during an Early Start Denver Model session.

Within a therapeutic environment, the autistic child presents a higher chance of developing language, cognition, and social interaction abilities. We can teach skills to overcome the challenges associated with the autism diagnosis. But the essential thing is for the intervention to begin early on.

ESDM: The earlier, the better

Developmental specialists recommend the therapy to start as early as possible, as this leads to the best outcomes. Parents should not wait for the diagnosis but seek the help of a therapist as soon as they have suspicions about their child’s development. 

The sooner we start the intervention, the better the outcome is likely to be. Parents might struggle to accept the diagnosis, but they should waste no time in pursuing therapy.

A better chance of addressing behavioural issues 

Autistic children often have challenging behaviours which become more challenging over time. Addressing challenging behaviours is generally easier in younger children because they don’t have a long learning history. Having a long learning history means that the behaviour has been reinforced for a long time. Similar to a habit, behaviours with long learning histories are hard to break.

If there are challenging or non-adaptive behaviours present early intervention can replace them with alternative behaviours. The key is teaching replacement behaviours that meet the same needs but are more effective. For example, if a child is taught that they will get your attention if they cry, they will keep crying. They do this because that strategy works. But if you reward a child for using another strategy (e.g.: a word approximation, directed eye gaze or pointing) they will use the new behaviour instead. And then the challenging behaviour will fade away.    

ESDM: Individualized intervention from an early age

The therapist will develop an individualized intervention plan, based on the child’s needs, behavioural issues and the use of the Early Start Denver Model Curriculum Checklist. The Curriculum Checklist is a list of skills that are divided into levels that represent different ages.  The therapist uses the Curriculum Checklist to assess your child’s strengths and areas of need relative to same age peers. The purpose of the intervention plan is to help the child develop a wide range of skills including: attention, communication and interaction. 

As mentioned above, a structured environment will offer opportunities for learning. It facilitates the growth of skills, while it allows the therapist or parent to monitor the progress being made on a consistent basis. The therapist can adjust the plan as necessary, but the chief goal will remain the same: the child learns through play while having fun.

Early Intervention: Families receive support early on

As parents of special needs children, especially autistic children, it is normal to feel helpless and frustrated. Early intervention, though, can be highly beneficial for the entire family. It can provide support early on, reducing the amount of stress parents experience. Having an action plan and strategies to use will help parents to feel empowered and as though they are taking action. 

It is vital that the parents are also implementing the strategies and using therapeutic interventions with their children. The child has a limited number of hours with the therapist each week but many more hours with their parents. These hours should be maximized! 

What matters is that they capture the attention of the child and pursue communication. Being creative and silly will go a long way. 

ESDM: A combination of ABA and play

An experienced therapist will give the child time to become accustomed to the unfamiliar environment, chaining skills together to create a smooth session. It takes time to build the relationship, and only then will the therapist focus on addressing behavioural issues, cognitive and speech delays, etc.

Taking advantage of the brain’s neuroplasticity 

We see the best results up to the age of five years, as that is when the child’s brain is most malleable. We can unleash the learning potential in therapy and limit the effects of the autism diagnosis. As a result, the overall quality of life can improve, thanks to the newly learned skills. 

The benefits of early intervention using the Early Start Denver Model in autistic children are obvious. The earlier the child enters a structured, therapeutic environment, the better his/her progress will be. Parents should actively collaborate with the therapist, practicing taught strategies at home and helping their children unleash their full potential.

To learn more about how Side by Side Therapy can help your child with an Early Start Denver Model program, please connect with us!

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.

Ontario Autism Program (OAP): a short history.

Early 2016

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

In June 2016

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

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

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

Changes to the OAP in 2018/2019

Doug Ford became the Premier of Ontario in June 2018. He brought a new government, changing from a Liberal government to a Progressive Conservative majority. In September 2018, the Ford government quietly instituted a pause on new service offers to children on the waitlist.  This freeze dramatically increased the waitlist. A few months later, Lisa MacLeod, the Minister of Children and Youth used the ballooning waitlist as the reason for making dramatic changes to the OAP Funding.  

In February 2019

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

In March 2019

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

In June 2019

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

In December 2019

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

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

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

Where do families stand now?

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

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

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

Respite Services in Toronto: Top 10 Benefits

What is Respite in Toronto

Respite is caregiving for special needs children that allows a primary caregiver to have a break. Raising an autistic child is a multifaceted experience and even though it comes with many joys, there will be plenty of challenges. Parents might put their own needs aside, focusing on their child and their therapies. 

In taking care of a child who is on the autism spectrum, you might enter problem-solving mode and forget about yourself. Respite in Toronto might be something to consider, offering short-term relief from being the primary caregiver. Respite in Toronto is more than babysitting.  A trained caregiver with experience in your child’s specific needs will be there to support your child (and you!). What are some of the benefits associated with Respite in Toronto? Keep on reading and find out!

During a Respite in Toronto session,  young boy plays in nature with a respite worker from Side by Side Therapy.

How will you benefit from Respite?

#1 A reduced level of stress

Parents of autistic children report significant levels of stress, which in turn affects both their physical and emotional health. Respite gives one the opportunity to take a break, without guilt, from the pressure of it all. 

#2 Feeling less frustrated

There will be many moments in which you will feel proud of your child but there will also be situations when things seem to be stuck. Frustration can build up, leading to anger, resentment and hopelessness. Respite relieves such feelings, contributing to improved well-being. 

#3 Time to socialize

Autistic children have packed schedules – therapy, school, play dates, to name a few! These activities leave parents unable to spend quality time with others that they love. By opting for respite in Toronto, you will finally have some free time to check in on and hang out with your family and friends. There are plenty of fun activities that you can do while your child is receiving respite!

#4 A healthier relationship with your child

Spending all of your time with a child who has many specific and oftentimes intense needs can be draining. Dealing with tantrums, refusals or meltdowns, you might lose sight of your child’s positive traits. Some time away will allow you to see your child with fresh eyes, reminding you of the things that matter.

#5 Interaction with other people (for the child)

An autistic child’s circle of people is often limited to family, a few friends and the teachers and therapists that they have. In choosing to participate in Respite in Toronto, you will also offer the child a chance to interact with new people in a new setting. This might be hard (for each of you) at first but it will be a great opportunity for your child. 

A young child plays with bubbles during a Respite in Toronto session with Side by Side Therapy

#6 Free time (for you!)

We all love our children and we want the best for them. It’s only natural when given a diagnosis of autism, however, we might naturally put ourselves in second place and dedicate every minute to the child’s development. Respite gives one the opportunity to pursue personal interests, without feeling guilty. 

#7 A break from the daily routine 

Respite can help both the parent and the child to get a break from the daily routine. Children might be taken to the park or other activities while parents can do whatever they wish. Some parents use respite to get errands done, do something social or just sleep! They can recharge their batteries, looking after themselves for a change.

#8 A different perspective

Sometimes, the therapies chosen for autistic children do not offer the expected results. A plateau might occur in the therapy process causing disappointment and stress. When you opt for respite you get the time and distance you need to get a fresh perspective. 

#9 Involving the child in new activities

Even if you have planned your child’s schedule to the last detail, there will still be a lot of activities and opportunities that you haven’t thought of. By accessing respite services, such as the ones we offer at Side by Side Therapy, you can involve your child in new things and help him discover rewarding experiences. 

#10 Preservation of your identity

As the parent of an autistic child, you might have forgotten about who you are apart from your child. The person who you used to be. The things that give you purpose. This is why you should take advantage of the break offered by respite in Toronto, using the time to do some self-care. 

Looking for respite in Toronto? We are glad to help. Connect with Side by Side Therapy and we will make an appointment for a 30 minute no-charge consultation, so we can discuss respite and other therapeutic solutions. The province of Ontario will provide funding for families to access services.  Read more about respite funding here.

Parents often feel guilty for needing time away from their children. There’s no reason to feel guilty. You can use the time to do the things you love, get a fresh perspective on things and meet your friends and family. As for your child, he benefits from excellent care, discovering new people and activities. It is a win-win!

Top 6 Practical Social Skills Training in Toronto Tips!

Read time: 3 minutes

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

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

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

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

6 Social Skills Training in Toronto Tips

#1 Practicing different play scenarios 

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

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

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

#2 Imaginative Play

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

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

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

#3 Visual prompts

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

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

#4 Learning emotions 

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

#5 Social skills groups

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

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

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

#6 Gesture imitation 

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

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

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

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

3 Applied Behaviour Analysis Tips to Get your Child Wearing a Mask

In these changing times, due to COVID-19, we have had to change our behaviour in a lot of uncomfortable ways. We’ve done this to follow the rules and recommendations set out by the government and public health officials.  The field of Applied Behaviour Analysis has a lot to offer to help!

One of the recommendations is the wearing of masks while out in public where physical distancing isn’t possible. Wearing masks may be uncomfortable and foreign to most adults. Parents of autistic children have been particularly concerned with how to get their children to safely and effectively wear masks.

Parents of children that have sensory issues already know how the struggle of the basics such as underwear and socks! Now with the expectations of wearing masks, there is the introduction of yet another stressor (for both child and parent!).

Create a plan based in Applied Behaviour Analysis:

Developing a plan to help desensitize your child to masks is essential. It is best to work with your therapy team to ensure you are taking the right steps for your child.

As changes in routine can be more difficult for children on the spectrum, I am providing you with these guidelines as a starting point.

If you don’t have a therapy team, feel free to reach out to Side by Side Therapy for a no-charge consultation. 

Here are 3 helpful tips to encourage mask wearing:

Make your Expectations Clear

Explaining to your child what you expect regarding mask-wearing will help to clearly outline what needs to happen and why.  It may be helpful to use the “If-Then” or “First-Then” language approach.  For instance, “If you want to go outside, then you have to wear your mask”. “First we put your mask on, then we can go to the store”. 

Boy sitting at desk wearing a mask after using applied behaviour analysis to learn to tolerate the mask.

Reinforcement and Praise

One of the foundations of ABA is reinforcement. Since wearing a mask is a huge accomplishment for your autistic child, it’s important to provide tons of reinforcement and praise. This will help make wearing a mask as motivating as possible. A few suggestions are:

Mom fixing a mask on her daughter using the principles of applied behaviour analysis.
  • Purchase a mask that has a preferred character or personalized touch on it.
  • Provide a favourite reward for wearing the mask for the agreed-upon time.  Remember, start slow so you can work to build up your child’s tolerance. 
  • Initially, you could have your child wear the mask while doing their favourite activity, such as playing on their iPad or Lego. 
  • When you have your first practice run in public you should do something fun! Going to your child’s favourite place or visiting loved ones are great ideas.  

Work on your child’s mask tolerance

Mask tolerance is going to be a challenge for a lot of autistic children and it is necessary to make the experience as fun and pleasant as possible.  This can all start with having your child, pick out their own material or mask while paying special attention to their sensory needs.  Once you have chosen a mask that you feel will be appropriate for your child, your next step is to create a plan of action for introducing and then successfully wearing the mask. 

The field of applied behaviour analysis suggests adopting three strategies to help in the desensitization of mask-wearing: Pairing, Shaping and Chaining. Read more about ABA terms and meanings.

Pairing

Pairing is a way that introduces unfamiliar objects, in this case a face mask, to a person. Present the unfamiliar object at the same time as a preferred object and the pleasant qualities of the preferred object are transferred to the unfamiliar one. To make the mask seems fun and welcoming present it to your child at the same time as you give reinforcers. It can take many presentations before the unfamiliar object becomes ‘paired’ with the preferred one. Once your child becomes comfortable holding it, it is then time to introduce shaping. 

Shaping

Shaping takes place once your child has become familiar and comfortable with the mask, and at this time, you can then, using the same positive reinforcers, have your child begin to gradually engage more and more with the mask. For example the process in a shaping procedure for mask wearing might be to:

Mom and son using the applied behaviour analysis concept of pairing.
  • Hold the mask;
  • Bring the mask close to their face;
  • Then touch the mask to their face;
  • Allow you to pull back the elastic bands or bring the ties around to the back of their head;
  • Fitting the mask to their head. This piece may need to be started in very short increments. You may want to use a visual timer to help cue your child to how much time is left. 

After your child engages in each step without challenging behaviour you need to reinforce their efforts. This may seem easy and straightforward but it may take some practice and many trial runs before success is achieved. As you know, practicing and learning a new skill takes patience, so too will becoming comfortable with mask-wearing. Be sure to initially practice pairing and then shaping at home or in a safe environment and once the comfort level is achieved you can try it out in public. And remember, your ABA therapist is always available to guide you and provide you with the resources you need to help manage this challenging situation.   

Chaining

Chaining is the idea of putting a number of behaviours together to create a sequence (or chain). In this example, a chain for mask wearing would include washing hands before putting the mask on, securing the mask to the head, wearing the mask, removing it safely, putting it in the trash or washing machine and washing hands again.

Chaining is a helpful way of teaching complex behaviours that happen in a specific order each time.

As wearing a mask can be difficult and uncomfortable in general, the challenge, unfortunately, may become magnified for those that have sensory challenges such as autistic children.  Therefore, it is important to work with your therapy team to come up with a plan and strategies to help your child manage successfully wearing a mask.

ABA in Toronto: 9 Life-Changing Benefits for Autistic Children

Read time: 3 minutes

ABA stands for applied behaviour analysis. It is a form of therapy based on the sciences of behaviour and learning. In some, it will lead to remarkable progress, helping them acquire an important number of skills. ABA is the most widely studied and most effective therapy for autism and related developmental disorders. 

Why should you consider ABA in Toronto for your child?

We have gathered nine of the most important reasons why one could benefit from this type of therapy. ABA in Toronto focuses on teaching socially significant behaviours, meaning behaviours that have a high probability of being important and pivotal to the child and family. 

Boy with autism playing with toys during ABA in Toronto


#1 Play

Autistic children often play in a stereotypical manner, engaging in repetitive behaviours. Through ABA in Toronto, they can be taught how to engage in spontaneous play, using a wide range of toys and learning to take turns. 

The therapist might facilitate the learning experience, prompting the child with the appropriate behavior. The therapist can also teach leisure skills, helping one develop a hobby, or an interest for personal enjoyment. 

Girls playing together learning social skills in ABA in Toronto


#2 Social Skills 

If a child already has good language skills, ABA in Toronto would be useful in teaching the necessary social skills for making friends. The more one practices social situations, the easier it will be to interact with peers in real life. 

ABA in Toronto can help the child develop additional skills (i.e: sharing, turn-taking, rule following etc) which might be useful for daily interaction with other children. These skills are addressed using structured play dates, social games and role play, among other strategies. 

Boy learning to brush his teeth in ABA in Toronto


#3 Activities of Daily Living (ADLs) 

For an autistic child, going through the normal routine can be challenging. In ABA in Toronto, he or she can learn and practice the tasks associated with the routine, including dressing and feeding. 

In teaching how ADLs should be performed, the therapist will take into account the child’s gross and fine motor skills, as well as their cognitive and speech skill levels. At-home practicing can help to jumpstart generalization and maintenance. 

Boy demonstrating independence learned in ABA in Toronto


#4 Independence

A big part of ABA in Toronto involves helping the child communicate more effectively. As the language skills develop, it will be less challenging to interact with peers. 

The child will learn how to handle situations by him/herself, developing the necessary confidence for more complex tasks and to be more independent. Positive reinforcement is used to foster skills, so that the child is less reliant on his parent or caregiver. 

Alphabet toy laid out in ABA in Toronto session


#5 Academics

Autistic children can struggle from an academic point of view, requiring help in that learning as well. ABA in Toronto can help develop reading and writing skills, as well as mathematical abilities.

The strategies used in therapy can and should be implemented not only at home but also in the classroom. Many classrooms are built on a foundation of ABA, without even intending to be. Most good teachers utilize the principles of ABA (even if they don’t call it ABA). 

Cartoon of boy saying "I need", self-advocacy skill learned in ABA in Toronto


#6 Self-Advocacy 

All children grow and become adults. As the child advances in age, ABA in Toronto will be useful in teaching self-advocacy – it will teach the child to speak up for him/herself, asking for what s/he needs. All children need to learn to become self-advocates.

Even in non-verbal children, ABA therapy can teach the child how to communicate immediate needs, preferences and how to protest and stop undesired situations. 

Girl with autism sitting on ground after ABA in Toronto session


#7 Quality of Life

As mentioned at the beginning, ABA in Toronto aims to improve socially significant behaviour. All of the things that the child will learn in therapy will contribute to a better overall quality of life. Even though the days might seem long and the therapy sessions will require a lot of dedication, in the end, you will have a child who likes his/her life. 

By fostering independence, language and social interaction, just to name a few, ABA empowers the child and his/her family. 

Parent learning with son during ABA in Toronto therapy session


#8 Parent Involvement and Learning

As a parent, it is normal to want your child to reach his/her full potential. In autistic children this path to reaching full potential can seem impossible. ABA can help parents benefit from a positive change in themselves, teaching them the skills needed to fight for their children. 

Taking part in therapy sessions, you will learn how to help your child develop useful skills and assess the progress he/she has made. The therapist can also guide the at-home teaching process. 

Parents looking happily at their child after ABA in Toronto therapy session


#9 Renewed Optimism

Sometimes, parents have a hard time seeing the strengths of their autistic child, as they rather concentrate only on the challenges their children face. ABA can help to highlight these strengths and transform them into learning opportunities. You will see your child being successful in ABA in Toronto and it will give you a new lens with which to view your child. 

During the ABA therapy sessions, you might also learn what motivates your child, allowing you to use these preferences later on to teach or maintain skills outside of a therapy session. 

If you are looking for ABA in Toronto, we recommend you connect with us. We can talk more about the services we offer and schedule a no charge consultation to assess your child’s needs. Looking forward to hearing from you!

The Value of Using Autism Therapy in Toronto for Support with an Autism Diagnosis

Read Time: 5 minutes

Finding out that your child has autism is probably one of the most difficult things in the world for a parent. You might go through a period of denial, believing that there has been a mistake. Then you might have a period of grief and loss, thinking about the way things would have been. You might cry about the loss of  your “healthy” child, feeling all sorts of negative emotions. Using the resources available from autism therapy in Toronto can help you right from diagnosis.

Accepting your autistic child as he/she is can be a liberating experience. The moment you stop fighting the diagnosis of autism, you will be in a better place to support your child’s needs. By embracing his/her uniqueness, you will be better able to make decisions and pursue the strategies and supports that your child requires.  

Mom hugging autistic son after discovering autism therapy in Toronto.

Embracing the atypical 

Do you love your child less because he/she is on the autism spectrum? The answer is clearly no. But parents are human beings nonetheless and they tend to turn into saviors, wanting for their autistic children to be “typical”. 

In truth, your child needs to be loved, first and foremost. You have to embrace the atypical and be accepting of who he/she is. Remember that you are your child’s greatest advocate. Acceptance is a gradual process and one that will help you fight for your child. 

Why is denial the first response?

In a beautifully written piece for The Autism Society, Dr. Robert Naseef says: “Acceptance is not about giving up or resignation, but rather learning to live with something that is hard to face.”

You received the diagnosis, but, deep down, you likely already knew something was not right. There are few parents who can accept this diagnosis and think about solutions on the spot. Most parents automatically go to denial as a first response – this is a defence mechanism, one that we have selected to keep pain at a distance. 

Even if your child has been confirmed to be on the autism spectrum, he/she is still your child. And you should try and see the diagnosis as the start of a journey, the one toward helping your little one achieve his/her maximum potential. Accessing autism therapy in Toronto is one way to help them.

Instead of fighting the diagnosis, it is best to accept it and learn how to live with it. Let go of the things you imagined and celebrate your child, and his/her abilities. The diagnosis will only help you cater more effectively to his/her needs and provide the needed support. A diagnosis can also help you access provincial funding for autism therapy in Toronto. You will have a happy child as a result and feel less stressed in your parenting. 

Autism is neither good nor bad

Are you familiar with the concept of radical acceptance? It refers to accepting something as it is, without fighting it. Acceptance is the first step to creating a plan. You have to acknowledge that something has to be done before you can create a plan to tackle it. When it comes to autism, this concept can be very freeing and can help you advocate for your child. Autism is neither good nor bad, and it is certainly not the only defining characteristic that your child has. 

Therapeutic solutions, such as autism therapy in Toronto, can help your child learn new skills and achieve new levels of potential. At home, you will have to work with him/her as well but make sure that you leave plenty of time for fun. Spontaneous play, led by your child, can be of tremendous importance. Do not insist for typical play, as this can only cause frustration. Follow your child’s lead and interests. 

Do not send the “you are broken” message

Even if an autistic child is non-verbal, you have to pay attention to your words and to your gestures. If you are constantly pushing for normality, you are sending a message that they are somehow “broken” or “damaged”. While it is not possible to separate autism from the child, you have to refrain from seeing your child exclusively from that autistic perspective. 

Challenge yourself to accept your child, with the good and the bad. Try not to see your child’s skill deficits as permanent, there is always something to be learned or a way to improve a skill or situation.  Use their needs as a jumping off point for new learning and skill development.   

A message to take home about autism therapy in Toronto

There will be plenty of moments when you will feel challenged, wanting things to be ‘normal’. In those difficult situations, remind yourself that autistic children are, first and foremost, children. And like all children, they need our love to thrive. 

Stop thinking about the things that are “missing” and embrace the child you have. Celebrate each small success and avoid comparing your child with others. With the help of a team of therapists, create a personalized plan using all the avenues available at autism therapy in Toronto, making sure that you are actively involved in the therapy process. You have the insight into what is important to your child and family and should feel comfortable to direct the therapy team towards achieving those goals. 

Contact Side by Side Therapy to have a no-charge 30 minute consultation to discuss the best options for your child.

Respite Services in Toronto for ASD Parents

Read Time: 3 minutes

With the weather finally getting warmer and the hope that the Ontario “stay at home” order will be lifted, parents are becoming optimistic that these days of isolation may soon be behind us.  Parents can begin planning how they will access respite services in Toronto. Parenting is hard on the best days especially for those that have autistic children, throw in a pandemic and life becomes more challenging and overwhelming than ever before. 

Couple at lake at sunset, enjoying the time that their child is in respite services in Toronto.

Understandably, parents need a break in order to successfully care for their children; taking care of themselves will guard against burn-out, stress and fatigue. Accessing respite as opposed to just a regular babysitter will also allow parents to go out on a date or take a break without stressing and worrying about their child’s well-being while they are away. 

Benefits of Respite Services in Toronto

Respite services in Toronto are available to come to your home and provide specialized caregiving to your child or children and youth that have special needs including Autism.  Respite services provide flexible short-term temporary care and relief, depending on your specific needs, which is essential for supporting parents with child/youth with special needs.  Allowing parents to have time to engage in self-care, rest, see friends and most importantly, spend time together, will undeniably help parents to be more successful and calmer caretakers.  

When the restrictions are lifted, parents need to take this opportunity to reconnect and take a well-deserved break. Parents, especially those of Autistic children, may have found a strain on their relationship due to the overwhelming commitments around caregiving, especially during these unprecedented times.  In realizing this, it is important, now more than ever, to use respite services in Toronto to take the time for each other to reenergize and connect.

Below are some suggestions of fun date ideas to do in the GTA:

Laser Quest is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



Laser Quest – After being cooped up for so long, if you are looking for a fun and interactive activity, that is reasonably priced, then Laser Tag is a great option.  They have many locations around the GTA from Toronto East, Mississauga, Brampton, Richmond Hill and Whitby. For more information please visit their website at https://www.laserquest.com/

Formula Kartwary is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



Formula Kartways Located in Brampton, Formula Kartways is a go-karting venue to fulfill your thrill-seeking needs. If you enjoy the need for speed or some friendly competition with your partner, then this is the perfect date place.  The great thing is that you don’t need to be good at go-karting to have a great time! For more information please visit their website at http://formulakartways.com/

Axe Throwing at Batl Axe  is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



BATL Axe Throwing – If you are looking for a way to release some of the pent-up energy accumulated during your stay home during the pandemic, then axe throwing is the perfect solution. This incredibly fun activity has various locations around the city.  Try it out, you will surely not be disappointed!  For more information please visit their website at https://batlgrounds.com/

Cineplex Cinemas is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



Cineplex Cinemas – There is no better way to escape from reality than through the experience of a movie.  Going to the movies is a classic pastime and a great way to spend time with your partner.  With many locations around the GTA, you will undoubtedly find a movie that will sweep you away on date night! For more information please visit https://www.cineplex.com/

Visiting High Park is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



High Park – As Toronto’s largest public park, there are many amazing things to do in this vast, lush, beautiful outdoor playground. The park offers activities such as hiking trails, a few eateries, a picnic area, a zoo, a lakefront, to just name a few. What a terrific way to become reacquainted with your partner in an outdoor majestic environment. All you have to do is arrive, take a breath, relax and enjoy!  For more information please visit their website at http://www.highparktoronto.com/

Visiting the Distillery District is a wonderful activity to do while your child is being provided excellent respite services in Toronto with Side by Side Therapy



The Distillery District – Tucked away in the Toronto East-End, what was once a historic distillery district, is now a community made up of a mix of old and new, resulting in an amazing urban gem. While at the Distillery you will find cobblestone pathways that lead you to quaint art galleries, shops and restaurants. There are also often all sorts of events going on, which indeed, keeps the district full of energy and life. 

For more information please visit their website at https://www.thedistillerydistrict.com/

In conclusion:

Remember, parents are humans with important needs too.  Luckily, respite services are available to help make life easier and provide opportunities for partners to re-energize and reconnect. Take a break, go on a date, you know you deserve it!  

If you would like to discuss respite services in Toronto, please contact us to set up a no-charge consultation today. 

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

Read time: 5 minutes

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

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

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

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

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


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

Autism or Sensory Friendly Attractions in Toronto

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

The following dates are set for 2020:

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


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

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

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

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

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

3. Cineplex Movie Theatre – Variety of Locations

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

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

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

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

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

For more information please visit their website at:

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

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

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

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

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

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

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

For more information please visit their website at:

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

7. Skyzone – Various locations around the GTA

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

For more information please visit their website at:

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

8. Sobeys – Various locations around the GTA

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

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

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

For more information please visit their website at:

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

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

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

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

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

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

For more information please visit their website at:

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

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

World Autism Awareness Day: April 2, 2020

Add Your Voice to the Giant Autism Billboard for World Autism Awareness Day
Add Your Voice to the Giant Autism Billboard for World Autism Awareness Day

World Autism Awareness Day is today, which means it’s a great time to contribute to the Giant Autism Billboard (see it here). It’s a thought-provoking project centred around the importance of autism awareness, and it stems from the belief that the sharing of lived experiences is a great way to help others gain a better understanding of neurodiversity.

The Giant Autism Billboard, an online collaboration that invites autistic people of all ages as well as their family members, caretakers, and doctors to condense their life experience and advice about autism into one pearl of wisdom to share with the world, the idea, thought, or message they most feel represents their experience. Finding a way to distill life with neurodiversity into one statement is no mean feat, but it has inspired many voices throughout the autism community to offer their unique input.

Autism Awareness Day is only a starting point

The large collaborative project serves to illustrate an idea that’s central to autism awareness, which is that no two neurodiverse people are alike and no one’s experience with autism is exactly the same. This helps to create an understanding of autism as a spectrum of behavioural differences which are experienced uniquely, defying negative stereotypes and embracing the idea that neurodiversity can bring skills in addition to challenges. The project celebrates the voices of those affected, acknowledging that they are most able to provide true autism awareness and amplifying their voices to contribute to the cause.

The Giant Autism Billboard will be featured on the We The Parents website during the month of April, which has been designated as World Autism Awareness month. The site was founded in 2017 by parents Neve and Keane as a welcoming, judgement-free resource which parents can look to for advice, and takes special interest in supporting families affected by autism.            

I have contributed and I hope that you will as well.

Lindsey

Autism: How to have great transitions – Part 1

Read time: 4 minutes


This post is quite long, so it will be divided into two parts for your reading pleasure!

Toddler with autism smiling looking directly at the camera.

Transitions happen many times throughout our day and for the most part, as adults, we don’t necessarily even realize how often. While these transitions may not seem noticeable or bothersome to us, they are in fact quite difficult for most children and especially for those with autism spectrum disorder.

Being able to effectively transition between activities in our daily routines is imperative to leading a successful life: at home, school or at a job. Transitions include any change, big or small, such as a change of activity (especially from a fun one to a less enjoyable one), environment or teacher.

Autism Spectrum Disorder (ASD) influences the way children process and interact within their environment and presents communication challenges, sensory issues and deficits in social skills.  All these challenges have an impact on the child’s ability to smoothly make transitions. It can be difficult for autism spectrum disorder children to shift attention or change from the comfort of their routine. These difficulties and stressors can lead a child to experience agitation, sadness or anger.  

All of these concerns need to be considered and addressed in order to help your autism spectrum disorder child thrive. The first step in dealing with transitions is dealing with the associated worry around transitions. Understanding how your child’s autism spectrum disorder is impacting their transitional issues, sensory sensitivities and concerns combined with creating a plan will better help your child to manage their worry connected to transitions.

Being prepared and well equipped to assist your child with autism before, during and following transitions is the absolute greatest support you can provide them. 

When strategies are used to help autism spectrum disorder children with transitions you can expect: a reduction in transition times; behaviours will improve during transitions; there will be less need for adult reminders and participation in school and community excursions will become easier.

Sometimes, creating a plan for your autistic child can feel like you’re trying to solve a calculus equation.

In the preparation of your plan, it is important to understand what transitional issues you are dealing with, including your child’s sensory needs.  By observing your child for 3 – 5 days and jotting down each time your child gets frustrated or angered you will have a better understanding of what is going on. This review should include identifying the patterns and triggers that led up to the problems transitioning.

For instance, does your child not like being interrupted to move onto the next activity if they are still working on the present one?  Do line-ups and busy hallways at school make it difficult for your child? Is there sensory stimulation such as bright lights or cold temperatures that may impact them and therefore affect the transition? Once you have identified the transitional issues then you can move towards creating a plan to account for these barriers. 

Transitional strategies are methods that can help autistic individuals manage during times of change or disruption in activities, routines or situations. As challenges can exist at any point during the transition, it is helpful to go over the techniques before, during and after a transition. This preparation strategy can (and probably should) be explained verbally and/or visually with the hopes of increasing predictability and maintaining consistency in their routine. 

Your child must realize that transitions are not punishments and should therefore not be thought of as such. Instead, your child should understand that they are required throughout the day in order to follow the daily schedule. Having the parent, caregiver or teacher show excitement in moving through transitions may help in easing your child’s worry and the challenging behaviour they exhibit. With your enthusiasm alongside your well thought out plan and tons of praise and encouragement, in time, you will see changes that are heading in the right direction. 

11 Tips to Help Those with Autism Transition

Here are 11 useful tips and strategies to use in the development of your plan; they are the stepping stones to helping ease your autism spectrum disorder child’s transitions:

  1. Prepare & Talk About Transitions – To help in ensuring a smooth transition, it is useful to plan out and discuss the plan with your child and support them before, during and after the transition. It is easier to deal with and manage your behaviour when you know what to expect. For instance, if you know you only have an hour at the zoo, then you should discuss this with your child prior to arriving. Knowledge is power and if your child knows what to expect the element of surprise will be removed and this will likely help with the transition. 
  1. Time Warnings – Providing time warnings prior to a transition is quite helpful.  This allows the child to be aware that a transition is coming up shortly and can then better prepare themselves. Therefore, half an hour before the change of an event you can start to give 30, 15, and 5-minute warnings. As these verbal warnings may be too abstract for some autism spectrum disorder children, especially when time-telling is not yet learned, it is suggested to use a concrete tool such as a clock or a timer that can visually help to alert your child of the upcoming transition.  This visual tool can be reassuring during an unenjoyable activity as it shows the child that there is an end in sight. 
  1. Countdowns – To go alongside the time warning strategy, it is also helpful to give final countdown notice.  So, instead of expecting your child to move right into the next transition once the final 5 minutes have finished, giving them a 10-second further countdown will continue to help with the transition.  Even though you may have provided the time warning, which may seem enough, the transition may still seem sudden to a child with difficulty transitioning. Adding in the additional and final 10-second countdown will certainly make your expectations clear. If visual tools are more effective then you can show your child a visual that has a countdown from 10-1. As you’re counting down you remove the numbers until your visual is empty and your child knows that the transition is imminent. This final countdown method can also be useful when doing unfavourable tasks such as cutting nails, bathing or brushing teeth as the child will know the end is near which helps with their coping.
Picture from
Pocket of Preschool
  1. Create Visual Schedules – A visual schedule is a very useful tool when managing transitions. The schedule helps to reinforce the predictability that your child requires alongside outlining the events in a way that your child can review throughout the day. As autistic children often thrive with routine and consistency this visual method helps them see things in a format that they can clearly understand and remember especially if out of the ordinary things are going to happen. Being able to understand what the schedule holds can create opportunities for the empowerment of your child as they may be able to move through the transition on their own without coaching or reminding. 
  1. Offer Options – Just like adults, children like choices. Having options gives them a feeling of empowerment and control. Therefore, offering two realistic choices allows your child to feel part of the decision.  For instance, when getting ready to leave the park you can ask would your child prefer to play on the slide or the swings in their last 5 minutes at the park. Achoice can be as simple as asking would they rather skip or walk to the washroom.  It is surprising how willing children are to participate when choices are offered.

Come back next week to read the second part!

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.

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.

Lindsey Malc: Inspired Founder & Clinical Director

Read time: 2 minutes

Hello, my name is Lindsey Malc. I’m the founder and Clinical Director of Side by Side Therapy. In 2013, I became a Board Certified Behaviour Analyst. I have spent my entire career working with children with special needs and their families.  I have extensive experience in clinical as well as community settings. I have worked primarily with autistic children but have considerable experience working with typically developing children with challenging behaviour as well. 

I graduated with a Master of Applied Disability Studies degree from Brock University. I also hold an Honours Bachelor of Social Work degree from Lakehead University. I worked for many years at Zareinu Educational Centre (now known as Kayla’s Children Centre).  At Zareinu, I held many positions, from classroom assistant to Behaviour Analyst.  In my 14 years at Zareinu, I was fortunate to learn from a trans-disciplinary team of therapists who were passionate about helping our students achieve their maximums. Working with Psychologists, Speech-Language Pathologists, Occupational Therapists, Physiotherapists, Social Workers, Special Education Teachers, Early Childhood Educators and Recreational Therapists provided me with a very well rounded understanding of and respect for these vital disciplines. 

How I, Lindsey Malc, can help your child and family

I offer 4 services based on your family’s needs.  

I will help you better understand how you and the environment are impacting and maintaining your child’s behaviour.  Using Applied Behaviour Analysis, I will provide you with alternatives and help guide you to effective ways that you can change your child’s behaviour. Looking at the antecedents, behaviours and consequences will be the starting point for this service.  We will meet weekly or biweekly and will discuss what has happened since our last meeting. I will ask you to take some data because it can be difficult to remember everything and then analyze the information and identify patterns.  

I work with private schools or daycares to identify the function of challenging behaviour and to develop intervention plans that will be effective and easy to implement. Individual programs or class-wide behaviour interventions can be developed.  Realistic data tracking and follow up are provided.  These meetings can happen weekly, bi-weekly or monthly depending on your needs.

If your child with autism or other developmental disability is struggling with a specific skill or skill set, I can develop a targeted intervention to address this need.  I would develop the intervention and teach you or a caregiver how to implement it. We will meet weekly or bi-weekly. Manageable data collection would be an integral part of this intervention with the goal of empowering you to implement the same strategies to address future goals as they arise. 

If you’re looking for a comprehensive ABA Therapy program, to address all areas of your child’s development I can be the Clinical Supervisor for your child’s ABA program.  I qualify as a Clinical Supervisor for the Ontario Autism Program and am listed on the  OAP provider list.  I will complete a curriculum assessment and develop all of the teaching programs and targets for your child’s ABA program. I am happy to work with you to develop your child’s treatment team and to train the staff in all of the behavioural interventions that they will be implementing.  Supervisions would occur either weekly or monthly, depending on the supervision structure of your ABA team.

Professional Services

If you are pursuing BCBA or BCaBA certification, I am also available to supervise all of part of your experience hours.

Photograph of Lindsey Malc, Behaviour Analyst

I would be happy to discuss your ABA Therapy programming needs. Please don’t hesitate to contact me.

Call me: 1-877-797-0437

Email me

Thanks for your time and I look forward to working with you to address your child’s special needs.

Lindsey Malc, BCBA

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