1What Can I Do At Home To Help My Child?

Family members constitute the best therapists for children. There is a lot parents can do at home. It is the therapist’s role to assess the necessities your child needs and give you home programs that boost development.

2Is My Child Going To Have An Independent Life When Growing Up?

The final goal of therapy programs is to provide input to maximize children’s potential for skill attainment, safe functional mobility, independence and participation, but it will always depend on your child’s ability to achieve during time and the reason behind his delay or disturbance.

3What Is The Difference Between CME (Cuevas Medek Exercises) And Physiotherapy?

CME is a form of physical therapy that helps children develop anti-gravity responses. The main difference is that CME holds the child’s body at the lowest point of contact that is possible in order to expose the body segments to the influence of gravity and provoke the brain’s automatic responses for movement and postural support.

4Can My Child Understand What Is Happening Around Them?

Understanding what is happening depends on the stage of development your child is in. Giving meaning to the events and objects that surround them requires the ability to understand concepts.

5Why Is My Child Crying During Physical Therapy? Is It Painful?

Children often express their perceptions through crying, especially if they haven’t developed speech. Physical therapy generally inflicts physical challenges that may be tiring or uncomfortable to the children, specifically during the early stages of therapy. Think about going to the gym, it’s not the most comfortable place is it? However, as we progress through the treatment program and as we give the child the time to adapt to the new therapist and the new setting, the crying will decrease over time.

6What Happens To My Child?

Knowing the cause of a developmental delay or disturbance is a team task. Medical doctors are typically the first medical team members in contact with your child. They run clinical interviews and request further medical testing so as to determine the cause. Medical allies, like physical therapists, psychologists, occupational, and speech therapists will find specific causes related to their field to explain the possible causes behind the delay.

7When Is My Child Going To Walk/ Will My Child Walk?

Walking is a milestone that appears between the age of 12 and 18 months. Some of the signs that predict the emergence of walking are sitting without support, pulling themselves up, walking sideways with minimal support, and the ability to stand without support. If your child has not shown any of the mentioned motor skills, predicting the possibility of walking becomes difficult. For this reason, working actively on stimulating the development of other preliminary abilities to help them develop.

8How much is ABA recommended for a child on the autism spectrum?

Research and literature show that clients with the best outcomes received 20-40 hours a week of ABA therapy.  While this sounds like a lot, we would like to indicate that ABA is not just table time and can easily be incorporated into routines, play, and social interactions.  Typically, we recommend no less than 10 hours a week of ABA when starting out, unless there are other restrictions.

9How long will we need to do ABA?

The length of time for a student receiving ABA will depend on the student’s skill level. There is not a specific time frame on how long ABA will be needed.

10What is the Intensive therapy model?

Our Intensive therapy model includes a combination of Pediatric physiotherapy, speech therapy, feeding therapy, occupational therapy and behavioral therapy depending on the unique needs of each child. The program is greater in quantity, duration, frequency, or scope than conventional therapy.

This model of therapy is usually very effective and produces fast results.

11Why do we need to fill an Intake form?

The Intake form helps us understand more about your child and discuss as a team how we can best help him/her, so we propose the right intervention needed and also be familiar with your child’s challenges before meeting him/her and have the right assessment tools ready.

12How many sessions does my child need until he/she gets discharged?

This highly depends on the child’s condition and many other factors. However you should be able to see progress within the first few weeks of the treatment.

13Why do I need a hearing test before starting Speech Therapy?

Children who have difficulties with speech or communication disorders, sometimes also have a hearing challenge that is the cause of their speech problems.

14What is the difference between NDT, CME, Suit and spider cage therapies you offer?

Those are all physiotherapy approaches that work best in combination. Also it highly depends on what the child needs and accordingly we advise which school/schools of therapy are best suited.

15What is sensory integration therapy and how it will benefit my child?

Sensory integration therapy aims to help kids with sensory processing issues by exposing them to sensory stimulation in a structured, repetitive way.

In traditional SI therapy, the OT exposes a child to sensory stimulation through repetitive activities.
The OT gradually makes activities more challenging and complex. The idea is that through repetition, your child’s nervous system will respond in a more “organized” way to sensations and movement.

Autism’s symptoms often include difficulty processing sensory information such as textures, sounds, smells, tastes, brightness and movement. These difficulties can make ordinary situations feel overwhelming. As such, they can interfere with daily function and even isolate individuals and their families.

Sensory integration therapy is one technique used by occupational therapists (OTs). Through fun and play-based activities, OTs attempt to change how the brain reacts to touch, sound, sight, and movement.

Sometimes, one sensory area is over-responsive (hyperresponsive) while another needs more information (hyporesponsive). For instance, if a child’s tactile system is over-responsive, she/he may feel pain or discomfort touching something sticky. Further, she/he may completely shut down and show behavioural issues.

While every session will be different depending on your child’s needs, here is an example session with some sensory integration therapy activities.

The OT may begin the treatment session with an obstacle course which the child views as a fun challenge. However, the course was carefully designed to provide sensory input to her joints and calming pressure to her body. Large motor, physical activities are organizing to the senses, the OT may include playing in ball pits to target the tactile system. The purpose of this sensory stimulation is to regulate and prepare her/his system for the next activity.

Next comes a fun puzzle. However, the puzzle pieces may be placed into a sticky or wet substance such as slime or water beads placed into a bin.

The child often has so much fun playing the game that the child forgets she/he is placing her/his hands into the very thing she/he doesn’t like! With this sensory experience, now the child is starting to adapt her/his hyperresponsivity to the messy texture.

16What is Occupational therapy?

The American Occupational Therapy Association defines an occupational therapist as someone who “helps people across their lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).

Common occupational therapy interventions include helping children of determination to participate fully in school and social situations, injury rehabilitation, and providing supports for older adults experiencing physical and cognitive changes.

The broad spectrum of OT practice makes it difficult to categorize the areas of practice, especially considering the differing health care systems globally:

  • Children and youth
  • Health and wellness
  • Mental health
  • Productive aging
  • Geriatrics
  • Acute rehabilitation
  • Visual impairment
  • Adult rehabilitation
  • Assistive technology
  • Community based rehabilitation
  • Specialised hand therapy
17How can an occupational therapist help my child with handwriting difficulties?

Occupational therapists can evaluate the underlying components that support a student’s handwriting, such as muscle strength, endurance, coordination, and motor control.

An occupational therapist can work on the individual issues your child is struggling with and support them in overcoming obstacles and developing proper posture, strengthening their muscles, and learning to form letters correctly. An OT, offers handwriting evaluations and testing to help determine why your child is struggling with handwriting, and what strategies can support their handwriting development.

What can an occupational therapist do:

  • Demonstrate proper posture to supports the proper use of the arms, hands, head, and eyes.
  • Measure the level of physical strength and endurance.
  • Analyse fine motor control, such as the ability to hold a writing utensil.
  • Determine visual and perceptual ability that influences a child’s ability to form letter and shapes using a writing utensil.
  • Help develop and evaluate handwriting curriculums and collaborate with teachers on effective strategies.
  • Suggest home activities that promote the development of skills needed in good handwriting.
18How can I improve my child’s attention span and concentration?

Attention is the ability to obtain and sustain appropriate attention to a task. Effective attention is what allows us to screen out irrelevant stimulation in order to focus on the information that is important in the moment.
What can be done to improve attention:

      1. Repeat instructions: When you have given an instruction to a child, encourage them to repeat it back to you to ensure that the child has grasped/understood what is expected.
      2. Sensory Integration therapy: To addresses attention difficulties that are sensory in nature.
        • Obstacle courses of physical tasks such as the below:
        • Wheelbarrow walking
        • Animal walks
        • Trampolining
        • Cycling and scooting
        • Swings (forward and back, side to side, rotary)
        • Rough and tumble play / squishing or sandwiching with pillows or balls
        • Wearing a heavy backpack
        • Weighted items (wheat bag on lap while sitting or heavy blanket for sleep)
        • Chewy toys
      3. Eye contact: Get close to the child to ensure they are able to hear you and see your face; get down to their level.
      4. Simple language: Use clear, specific language when making requests and, if necessary, show them what you want them to do.
      5. Reduce background noise and distractions: To help a child maintain attention long enough to grasp the information required to complete a task.
      6. Develop Receptive Language: Improve your child’s receptive language (i.e. understanding of language) so that they are better able to understand expectations and information and are therefore better able to respond to information.
      7. Alert (Engine) program to promote self-regulation through sensory and cognitive strategies to help improve attention and concentration.
      8. Discrete skills: Activities that have a defined start and end point such as puzzles, construction tasks, mazes, and dot to dots.
      9. Narrowly focused tasks: Activities that are very specific and require very focused attention such has sorting, organising and categorising activities.
      10. Visual schedules enable a child to see and understand what is going to happen next. Schedules also help people to organise themselves, to plan ahead and thus to attention more effectively as they know the end is coming.
      11. Timers (ideally visual) help with transitions as they tell the child for how long and when they are going to have to do an activity. Timers allow us to pre-warn the child that a task or demand is coming.
19How do I know my child is ready for toilet training?

You might see signs that your child is ready for toilet training from about two years on. Some children show signs as early as 18 months, and some might be older than two years.
It might be time for toilet training if your child:

  • is walking and can sit for short periods of time
  • is becoming generally more independent, including saying ‘no’ more often
  • is becoming interested in watching others go to the toilet
  • has dry nappies for up to two hours
  • tells you with words or gestures when they do a poo or wee in their nappy
  • begins to dislike wearing a nappy, perhaps trying to pull it off when it’s wet or soiled
  • has regular, soft, formed bowel movements
  • can pull their pants up and down
  • can follow simple instructions like ‘Give the ball to daddy’.
20What is a sensory diet?

A sensory diet is a treatment that can help kids with sensory processing issues. It includes a series of physical activities your child can do at home. It has nothing to do with food. An occupational therapist can design a sensory diet routine tailored to meet your child’s needs.

Your child’s OT will observe her to see what sensory input she seeks or avoids. The OT takes those preferences into account when coming up with a routine. Here are some standard activities they draw on to create a sensory diet:

  • Jumping jacks
  • Log rolling (rolling back and forth)
  • Swinging on swings
  • Climbing ladders and sliding down slides at the playground
  • Hopping up and down
  • Push-ups (which can be modified to pushing off the wall or on their knees)
  • Bouncing on a therapy ball with feet on the ground while clapping
  • Rolling on a therapy ball on their belly, forward and backward
  • Rolling a therapy ball on their back while they lie on the ground to “make a sandwich”
  • Yoga poses like downward dog or happy baby (also known as Zen bug), holding a position for at least 10 seconds
  • Facing a wall and pushing as hard as possible (variations include standing sideways and pushing against the wall with a shoulder, or pushing while sitting with the back against the wall, holding positions for at least 10 seconds)
  • Heavy work activities at home with supervision, like sweeping/dry mopping, dusting, vacuuming, lifting and carrying grocery bags from the car into the home
  • Animal walks such as crab walk (on all fours facing sky) or bear walk (on all fours facing ground)
21What can I do at home to calm my child?

Children show behaviour when they are trying to communicate but either cannot find the words or do not understand the appropriate way to calm themselves.
Creating a calm down area is always helpful ahead of time.
What to add in calm down area:

  • Emotion cards and “I feel” card
  • Options that your child can do
  • Sensory bin, sensory toys
  • Visual timers, fidget toys
  • Breathing activities, mindfulness games
22What is feeding therapy?

Feeding Therapy is used as an intervention to help children acquire the skills for successful eating. During feeding therapy, therapists work with children to provide them with the skills they need to make meal time more enjoyable and nutritious.

If any of the behaviours below are affecting a child’s ability to safely eat, meet nutritional needs or enjoy the mealtime experience, the child may benefit from receiving a feeding evaluation.

  • Difficulty chewing foods, typically swallowing food in whole pieces.
  • Difficulty swallowing foods or refuses to swallow certain types of food consistencies.
  • Refuses to eat certain food textures or has difficulty transitioning from one texture to another texture (ex: from bottle feedings to purees, from purees to soft solids or mixed textured foods).
  • Gags on, avoids or is very sensitive to certain food textures, food temperatures and/or Flavors.
  • Struggles to control and coordinate moving food around in mouth, chewing and preparing to swallow food.
  • Fussy or irritable with feeding.
  • The child seems congestion during feedings or after.
  • Frequently coughs when eating.
  • Gags and chokes when eating.
  • Frequently vomits during or immediately after eating or drinking.
  • Refuses or rarely tries new foods.
  • Pushes food away.
  • Has difficulty transitioning from gastric tube (G tube) feedings to oral feedings.
  • Negative mealtime behaviours (infant cries, arches, pulls away from food; child refuses to eat, tantrums at mealtimes or “shuts-down” and does not engage in mealtime).
  • Infant demonstrating signs of difficulty with coordinating the suck/swallow/breath pattern during bottle or breastfeeding.
  • Feeding time taking longer than 30 minutes for infants, and 30 to 40 minutes for toddlers or young children.
  • Known to be a “picky eater” who eats a limited variety of foods or consistencies.
23For Feeding Therapy, When do I see an occupational therapist and when do I see a speech therapist?

A feeding disorder, in infancy or early childhood, is a child’s refusal to eat certain food groups, textures, solids or liquids for a period of at least one month, which causes the child to not gain enough weight, grow naturally or cause any developmental delays.

For the treatment of feeding difficulties in children, it is always advisable to get assessed by an occupational therapist for any oral motor weakness, if there are any sensory issues or to get assessed by a speech and language therapist, if the child has purely feeding difficulties whose underlying cause is unknown.

24What is ABA?

Applied Behavior Analysis (ABA) is the application of the principles of behavior to make socially significant changes in the lives of our students and their families. We do so by observing, interacting, and analyzing our students in their environment.

ABA is an evidence-based approach to teaching where data collection, on-going analysis, and constant modification of teaching procedures are implemented to ensure students’ progress.

25What is BCBA?

The Board Certified Behavior Analyst ®  (BCBA ® ) is a graduate-level certification in behavior analysis. BCBA conducts assessments, creates the individualized program, conducts on-going monitoring and analysis of students’ progress.

26Who is an RBT?

Registered Behaviour Technician (RBT) is a paraprofessional who carries out the individualized program for students and works closely with the supervision of the BCBA.

27Does ABA work for autism?

ABA is a science that can be applied to a variety of skills and applications.  If you are not seeing progress in your child’s program, you may want to consider other applications in ABA that fit better for your family.

We would like to aim for students to make progress on the target skills within 3-4 weeks of consistent introduction of the program. Modifications will be made if progress is not being made.

28What do ABA sessions look like?

Programs are individualized and are customized for each student. ABA sessions start with establishing a rapport between student and therapist. Then skills are practiced in accordance with students’ programs. This includes many applications in ABA such as Discrete Trial Training (DTT), Natural Environment Training (NET), prompting, positive reinforcement, and much more.

29What is the right age to start ABA with?

ABA can be applied to toddlers as young as before the age of 2 or as soon as there is a sign of developmental disorder. Early intervention is crucial.

30Is ABA only for young children?

ABA can be applied to toddlers as young as before the age of 2 through adulthood.

31Where are ABA sessions conducted?

ABA sessions can be provided at homes, at schools, in centers and in the wider environment.

32Can you teach social/independent skills through ABA?

ABA is applied to increase a variety of skills and where the priority aims for students to be independent.

33Does ABA cater to the educational needs of my child?

ABA targets to increase focus and attention towards tasks and assist in overcoming challenges students’ face in educational setting such as schools.

34What will be my role (parent) in my child’s ABA?

Parent support and continuous participation is important for consistency of progress for students. Parent training will be provided for continuation of ABA in all environments.

35Why do we need an assessment to start ABA?

To identify the root causes of challenging behaviors in children or adolescents on the autism spectrum, we use language and behavior assessments. This well-established approach has been demonstrated effective by empirical research and extensive experience. Based on the information from these assessments, our Board Certified Behavior Analysts (BCBAs) will select appropriate interventions and design an individualized treatment plan that works for both your child and your schedule. Our consultants will also help you implement the treatment plan.

Behavior Assessment

We begin by extensively evaluating your child’s current communication skills, barriers to communication, and his or her pre-academic, social and self-help skills. The information we gather forms the basis for your child’s individualize.

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