Grandview Kids

Every Child And Youth Living Life At Their Full Potential

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Getting to know… our Social ABCs Coaches

Autism Program

Grandview Kids is the lead agency for the Ontario Autism Program – Durham (OAP-D), a local partnership providing programs and services to children and youth with Autism.

In 2021, the OAP-D was selected by the Province of Ontario to offer Caregiver-Mediated Early Years Program as part of the Ontario Autism Program. Grandview Kids offers one of three programs in the Durham Region, known as the Social ABCs.

After several months of intensive fidelity training, four members of Team Grandview have successfully become Social ABCs coaches through Holland Bloorview Kids Rehabilitation Hospital.

Portrait of Grandview Kids Speech-Language Pathologist, Rosie Bakhurst
Rosie Bakhurst, Speech-Language Pathologist

Rosie, what was it like becoming a Social ABCs coach? How did the fidelity process impact your own practice?

For me, becoming a Social ABCs coach was really eye-opening! I have been a clinician for many years but this was a very different way of providing coaching for parents. Social ABCs provides supportive, in-the-moment coaching. We identify the impact on the child and it was amazing to see the difference in parents’ skills with this style of coaching, as well as their confidence!

In order to become a Social ABCs coach, once you’ve completed the training, you must submit “coaching fidelity” videos of you implementing the program to the Holland Bloorview Team. The team reviews the videos with you so that you can see how you’re doing and how to improve. The fidelity process really allowed me to see what was working with my coaching and where I needed to make changes to better impact my families.

Grandview Kids, Speech-Language Pathologist, Kathiga Karthikaikumar
Kathiga Karthikaikumar, Speech-Language Pathologist

Kathiga, how did the fidelity process impact your practice?

It is often hard to capture the success of parent strategies in a concrete way. I think the fidelity process really helped highlight the importance of ongoing evaluation to help guide the focus of the remainder of the sessions. It also helped me work towards an end goal.

Vareesha Khan, CDA

Vareesha, what has been the most significant benefit of the program?

The most significant benefit has been watching the immediate change in parents’ skills and confidence within themselves during the seven-week program. In this short time, we really get to work with parents to build a close bond with them and build a sense of community as they get to interact with other parents in the weekly parent sessions. This program really focuses on positive self-building and growth. The most empowering message a parent told me in a coaching session was:

“Thank you for giving me the confidence to be able to interact with my child and connect with them on a level I never thought was possible.”

Grandview Kids CDA, Karen Jagne
Karen Jagne, CDA

Karen, what have you seen as the most significant benefit of the program?

The most significant benefit to the Social ABCs program has been empowering families to connect with their kids in new ways! We have had parents say that their child won’t play with them, or doesn’t acknowledge them, and by the end of the program, they are smiling and laughing together!! Families have varying levels of success with the program, but across the board, we have seen improved connections, which build the foundation for future learning.

Karen, what do you want others to know about Social ABCs?

Social ABCs is a positive, gentle program, that teaches children how to coordinate their voice and attention to keep fun interactions going. It also teaches parents strategies to connect and share smiles and laughs with their children – building the foundation for future social interactions.

Grandview Kids is proud to offer the Social ABCs as a caregiver-mediated early years program. If your family has received a letter of invitation from the Ministry of Children, Community and Social Services, visit https://grandviewkids.ca/caregiver-mediated-programs/ to learn how you can enroll in the Social ABCs.

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Written by Grandview Kids’ Autism Therapy Team

Using sign language can be an excellent way to promote language and social interaction for children experiencing a delay in their communication skills.

Using Sign Language for Children with Delayed Speech or Language Skills

Benefits of using signs

  • Reduce frustration: sign language can give your child a way to express themselves and may reduce frustration or challenging behaviours that can result when they do not have another way to communicate.
  • Teaches the power of communication: For example: “if I use the sign for ‘more’ I can make Mommy or Daddy jump up and get me more blueberries. This is pretty great!” This can be very helpful for children with Autism or children who are reluctant to communicate.
  • Increase understanding: when parents model a sign AND say the word, this helps build your child’s understanding. For example: pairing the sign for diaper and the word ‘diaper’ gives your child another “tool” to build their understanding.
  • Teaches imitation: copying actions, gestures, sounds, or words is an extremely important skill for language development. Teaching signs is one way to work on imitation in a motivating and rewarding way.
  • Builds foundational language skills: children often demonstrate an improvement in their nonverbal language (gestures, pointing, giving an object, leading by the hand) before we see an improvement in their verbal language.
  • Takes away the pressure: children can often feel the pressure we unintentionally put on them when we are so motivated to hear those first words. Using signs can take the pressure off using words. Sometimes this is just what your child needs to start using words!

Common myths

If my child is using signs it will slow down their language development.

My child can speak. They’re just lazy. I don’t want to teach them the “lazy” way to communicate.

Using sign language means we are “giving up” on speaking.

Here’s the TRUTH

If your child could easily use words they would already be doing this. Children who aren’t talking aren’t lazy. Using language is tough for a lot of kids! Using alternative communication means (including sign language) does NOT prevent your child from learning language. In fact, it may support your child in learning to speak. We want to think of using signs as being a bridge to support your child in reaching their full communication potential.

Tips to start introducing sign language at home

1. Pick a few signs: You do not have to use a sign for every word you say. In fact, picking too many signs can be overwhelming. Aim to start with 2-4 meaningful signs.

2. Always say the word while you’re modelling the sign.

3. Learn the sign you want to teach your child. There are lots of online resources and videos available to help you learn the signs. It is ok to adapt this sign if it is too difficult for your child to do.

For example, the sign for “water” involves tapping your mouth with 3 fingers. Your child might start to tap their mouth with their whole hand – this is great progress!

4. Incorporate these signs into routines.

For example, think of familiar routines that already happen each day in your home such as getting dressed, brushing hair and eating a meal.  Pick 1 sign that you could teach your child within these different routines such as ‘get dressed’ or ‘eat’ and use the sign and the word each day during these routines. 

5. Use communication temptations to motivate your child to communicate.

For example, place a favourite food item or small toy in a clear container with a lid to encourage your child to request ‘help’ or ‘open’.  When giving your child a snack and drink, only give them a little bit at a time so your child will be motivated to request ‘more’ or ‘juice.’  Place a favourite item on a shelf where your child can see it but can’t reach it to encourage him/her to request ‘help’ or the name of the object such as ‘baby’ or ‘puppy.’

6. Model, model, model: your first job is to just MODEL the signs with no expectation for your child to copy. You may have to model the signs for a few weeks before you get a response. Model and WAIT to give them an opportunity to copy without any pressure for them to do so.

7. Gently help your child to sign: after you have modelled the sign MANY times you can begin to gently help your child make the sign.

For example, you may guide their hands together for the sign “more.”

8. Tell everyone about the signs: make sure you inform anyone looking after your child of the signs they are using and what they look like (they might not look exactly the same as you or I would make the signs). This can include Grandparents, babysitters, daycare providers, and other therapists. It is very exciting and rewarding for your child when a new person recognizes and responds to their sign!

Ideas of signs to start with

  1. Signs that can be used across activities. Examples might include: more, open, help, eat, all done.
  2. Highly motivating signs. What is your child’s favourite thing? Examples might include the name of a favourite toy.
  3. Signs of toys, foods, objects, or activities that your child enjoys on a daily basis. Examples might include: ball, bear, baby, book, milk, water, juice, cookie, or sing. 

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Written by Grandview Kids Autism Therapy Assistant, Brittany

Are you finding it challenging for your child to move from one activity to the next? How about one place to the next?

Explaining transtions

It sounds like transition strategies may be of some help—but first, what are transitions?

Illustration of mother speaking while her son hides behind her timidly.

Simply put, transitions are changes. These changes may be small such as daily routines like toileting, bedtime, mealtimes, moving locations within the house, or switching activities. Transitions can also be major such as changing schools, moving houses, or entering into lockdowns.

If you notice that transitions are challenging during day-to-day routines and activities, try out some of these strategies to make the transition smoother for everyone involved!

Illustration of little boy kissing his mother on her cheek.

Strategies

  1. Give a warning, maybe 2, prior to the transition occurring to help prepare your child for what is about to happen; warnings may include using visual timers, sound timers, or gestures.
  2. Ensure once you’ve given an instruction (e.g., “it’s time to eat dinner”) that instruction is followed through.
  3. Offer choice when possible (choice of next activity, choice of where to sit, choice of materials, etc.).
  4. Plan for changes, or challenges (e.g., make sure you have time to follow through).
  5. Praise your child for doing all the little things (e.g., “nice listening the first time”, “Great job cleaning up”).
  6. Use visuals or help your child as necessary throughout the transitions.
  7. Be consistent! Consistency is KEY, this includes consistency amongst caregivers, expectations, and following through.

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Written by Grandview Kids Autism Therapy Assistant, Brittany, and Behaviour Consultant, Arjana

Social narratives provide comfort for their readers as they walk them through unfamiliar places and events. These stories vary in how much detail is provided and how they are presented (i.e., a story with just text versus with text and pictures).

What are social narratives?

Social narratives are visual stories that represent an upcoming event and the associated behaviours and expectations that accompany that event. In addition to expectations of the event, desired responses are also described in the story.

For example, a social narrative might discuss a trip to the dentist. This story may have pictures of the dentist’s office, the dentist, the appointment room, and will describe what will happen during a visit to the dentist. The level of detail for the narrative will depend on the skill level of the child; the pictures within the narrative may be real-life photos or animated pictures. The expectations of the visit may be extremely detailed such as including the length of the appointment to each step of the appointment. For some individuals, pictures may not be necessary, and text alone is sufficient to explain the upcoming event.

Illustration of mother reading to her two kids sitting in her lap

Writing a successful social narrative

The narrative should be written in first-person so that the individual reading the narrative is reading “I” statements to explain what is going to happen and what the appropriate/expected responses are. The narrative should also use clear, concise, and descriptive language, so as to paint a picture of the upcoming event for the reader

Illustration of kids introducing a new friend to the group

Examples of social narratives

Sometimes social narratives may be called social scripts, or Social Stories™, which is a trademarked term. Examples of social narratives include but are not limited to:

  • Doctor visits
  • New schools/classrooms/teachers
  • Social situations (making friends, joining in play)
  • Riding the bus
  • Leaving the home
  • Using nice words
  • Keeping hands to ourselves

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Written by Grandview Kids Autism Therapy Assistants Pamela and Deidre

You may have heard the word in a variety of contexts, and you could be wondering…what is reinforcement? Is it a reward? A bribe? Well, two of our Autism Therapist Assistants are here to give you a crash course!

Reinforcement IS:

  • Used to increase or decrease the likelihood of certain behaviours occurring in the future (behaviour is anything a person does such as: eat, sleep, print, clap, yell or even communicate)

Reinforcement MUST:

  • Be meaningful to the individual, and should be given immediately after the behaviour you want to increase (the longer you wait, the less effective it is!)
  • Include the learner’s preferences such as: food, attention, activities, compliments (great job!), actions, sounds, drinks, scents, items (stickers), and people (seeing parents).
Illustration of little boy holding a two-scoop ice cream cone.

“But my child has such limited preferences!”

  • If a child has limited preferences, try exploring new toys, sensory play and activities.
  • Sometimes an item or activity may not be instantly reinforcing, the child may need to be taught how to use the toy or may need more time to interact with it. Modeling how to use a new toy may encourage the child to try it. When in doubt, try to explore and have fun and follow your child when looking for new reinforcers. Try pairing new items with known preferred items/activities to increase the value of the novel item.

Reinforcement looks different for everyone!

Illustration of a boy playing with a fidget spinner.

There are two types of reinforcement:

  1. Positive reinforcement: something is presented that is pleasant (e.g., giving a sticker).
  2. Negative reinforcement: something is adversely taken away (e.g., the sound of your alarm clock stopping when you hit snooze).

Be aware of these hidden reinforcers that maintain behaviours! Sometimes, we may reinforce certain behaviours in children without realizing it. For example, if a child is yelling and the teacher gives the child attention, the attention may reinforce the child and increase the likelihood he will scream when seeking attention in the future.

Illustration of a little boy sleeping.

Reinforcement needs motivation!

Motivation is the reason someone is doing something. A child must be motivated by the ‘reinforcer’ chosen when teaching a new skill or behaviour. Motivation is what makes the reinforcer valuable. If the child is not motivated, they will be less likely to engage in the desired behaviour (e.g., making a verbal request). It is important always to explore possible reinforcers to ensure a child’s reinforcement repertoire is diverse! Spend time following your child’s lead as a way to find activities, items and games that will motivate a child and become a reinforcer.

THE MYTH- REINFORCEMENT IS BRIBERY

BUSTED! Bribery is offering a preferred item or access to a desirable activity to influence the behaviour in the moment. A bribed behaviour occurs only after receiving the item or activity first, and it does not result in a future increase in responding.

BRIBE FIRST, THEN DESIRED BEHAVIOUR.         

As you learned above, reinforcement is delivered following the desired behaviour, and it increases the likelihood of the behaviour occurring again.

BEHAVIOUR FIRST, THEN REINFORCEMENT.

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Written by Grandview Kids Autism Therapy Assistants Kayla and Jessica

You just sought treatment for your child to support behaviour management or skill development. AMAZING! You just took the first step to be an involved parent in your child’s treatment. However, your involvement should not stop there.

As clinicians, we strongly encourage you to partake in parent training.

Illustration of mother teaching her daughter sign language.

You might be asking yourself why this is recommended. Behaviour change should last over time, appear in environments other than where it was taught, and transfer to untaught behaviours. A way to ensure maintenance and generalization of new skills or lower levels of inappropriate behaviours is to help teach you as the caregiver to implement the strategies used by the clinician in treatment. How do we do this?

We use a technique in Applied Behavioural Analysis called Behavioural Skills Training (BST). Now you might be wondering what BST is? BST is a widely used and scientifically proven method to help teach new skills. This strategy is also beneficial for children, parents, caregivers and the like and is a vital part of parent training. BST is a treatment package made up of four specific components:

  1. Instruction
  2. Modelling
  3. Rehearsal
  4. Feedback

For your child to be most successful and get the most out of therapy, they need to practice their goals at home. Therefore, the clinician will use BST to teach the caregiver the steps and strategies used in their child’s treatment to maintain and generalize these skills while at home or in other environments.

Being an active and involved caregiver in your child’s treatment can have many positive effects. Things such as feelings of increased competency and self-efficacy, higher confidence in yourself when it comes to parenting, and even lower levels of parental stress. Remember, YOU are an essential part of your child’s treatment. You are the expert on your child and know them the best. Having you involved will make it easier for you and allow your child to transition with more ease from a clinical setting to other environments (e.g., home, school, grocery store, grandparent’s house).

Illustration of kid boy stacking blocks with his mother sat behind him.

Three tips and tricks to help with parent training

1. Ask questions

During a session, parents will have a chance to observe and trial some of the strategies therapists use. If a parent has a question, they are encouraged to ask so when they go home with their child, they have a full understanding of what we are trying to accomplish as a whole and not just within that session.

2. Practice the strategies at home

Have you ever tried something and then not practiced it again until the following week? What happens when you try it again? Does it feel overwhelming or that you have to start from scratch? This is what it might feel like for our children after being taught a new skill and not having the opportunity to practice in their natural environment.

Life can get busy, and sometimes we don’t have as many opportunities to practice our strategies, and that’s okay. However, making an effort to provide these opportunities for our children (and us as the caregiver) will help make our children more successful, advancing them even further as they learn new skills at a quicker speed. More practice = more success.

3. Be consistent

Consistency is KEY. The more we do something, the better we get at it. Set time aside to practice skills, even if it’s 10 minutes a day or every other day.

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