Akron ABA therapists

How Our Akron ABA Therapists Work With Occupational Therapists to Provide Kids Optimal Care

When it comes to treating a child with developmental delays, disabilities, or injuries, it’s important to keep in mind that a child is a whole person. What we mean by that is that when we’re treating a child with complex needs or conditions, it would be easy for therapists in separate disciplines to focus only on the symptoms/skills they specifically are treating. But a “whole child” approach taken by our Akron ABA therapists, occupational therapists, and speech therapists considers that these systems are all interconnected – and we can make faster, more meaningful progress when we collaborate and work together.

ABA therapy (applied behavioral analysis) is an evidence-based therapy that is utilized to treat children with autism and certain other conditions with a focus on social communication, disruptive/harmful behaviors, motor skills, and more. The general thinking is that whenever a behavior is followed by something of value (in a sense, rewarded), it’s more likely to be repeated. That works both ways. Behavior that is unhelpful or dangerous can be unintentionally “rewarded” by certain outcomes (attention, avoidance, etc.). By the same token, ABA looks at the child’s motivation behind the targeted behavior and then seeks to alter the consequence, depriving them of the “reward” for unhelpful behaviors while rewarding those behaviors that are helpful/expected.

Occupational therapy, meanwhile, helps individuals achieve specific goals that involve engage in meaningful activities of daily living. That could mean anything from teeth brushing to handwriting to avoiding major meltdowns when moving from one activity to the next.

When ABA and OT professionals work together in a clinical setting, it improves the child’s overall success. therapists are able to be in constant communication with those in other disciplines about the child’s progress, methods that aren’t working, cross-promoting skills that are being targeted in both disciplines, and each providing useful strategies that the other finds most effective.

Every child’s treatment plan at Therapy & Wellness Connection is tailored to that individual, with a focus on how we can lay the foundation needed to help them build the skills necessary to succeed in everyday activities – from self-care to school to making new friends to learning how to regulate their own emotions. When both occupational therapists and ABA therapists work together (or at least, coordinate their strategies), they can each help reinforce the lessons the other is trying to teach. Both are most effective when provided in a way that is playful in an environment that is both safe and fun.

Both disciplines approach therapy with similar goals and methods. For example, occupational therapists will break down mechanical processes of certain tasks so that the child has an easier time correcting their current approach (or developing a new skill) so that they can ultimately achieve their goal. In behavior therapy, Akron ABA therapists break down each task into a smaller steps, one-at-a-time.

Both work to address sensory processing disorders in similar ways as well. A person with sensory processing issues may have extreme aversions (or penchants for) certain sensory stimuli – lights, sounds, tactile pressure, textures, tastes, crowds, etc. This can manifest itself in different ways.

For example, a child who has a major sensitivity to lights and sounds may have a really difficult time in a grocery store. Akron ABA therapists will look at the behavior (a meltdown) and try to determine, “What is the motivation?” In this case, perhaps it is avoidance. The meltdown gets them out of the bright, loud environment. They then look to see how they can alter the antecedent (what happens right before) and the consequence (what happens right after) to modify or extinct the behavior. In this situation, they may see whether a visual schedule (helping them know exactly what to expect and for how long) or possibly some sort of adaptation (headphones, sunglasses, etc.) may help avoid the meltdown. Alternatively, they may initiate a positive reinforcer for the child engaging in short periods of time in bright or louder environments, gradually building up their tolerance level – and empowering them to communicate when a situation is becoming too overwhelming and they need a break.

Similarly in occupational therapy, the therapist will use a sensory integration approach to help kids gradually desensitize (or learn to better “read” the sensory input they are receiving) to certain stimuli. It’s done of a period of weeks, months, or even years, little-by-little. OTs also work toward helping these kids be able to advocate for themselves and more effectively convey when something is uncomfortable, painful, or difficult. When OTs and ABA therapists collaborate, they can each reinforce the goals of the other with the same child.

Given that so many children with autism spectrum disorder have both behavioral and sensory issues, it makes a lot of sense for us to initiate a cross-disciplinary approach that will set the stage for our kids to be successful and have the highest quality of life possible.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Applied Behavior Analysis, Psychology Today

More Blog Entries:

How Long Will My Child Need to Be in Cleveland ABA Therapy? Dec. 23, 2022, Akron ABA Therapists’ Blog

Cleveland occupational therapist

7 Ways a Cleveland Occupational Therapist Can Help Your Child

If your child has been referred to a Cleveland occupational therapist, you may be wondering why. After all, it’s not as if kids have “occupations” – right?

In fact, they do!

A child’s occupation is to learn, grow, and play. When a child struggles to master the skills needed to accomplish these tasks, a Cleveland occupational therapist can help.

Occupational therapists in general help people of all ages and in a variety of roles and settings. It’s a broad discipline, but if you had to boil it down to a single definition, it is an evidence-based approach that assists people in accomplishing the things they want or need to do in order to be as functional and independent as possible.

When it comes to children, occupational therapists (or OTs, as we call them) are most commonly called to help those with developmental delays, disabilities, and serious injuries in learning (or relearning, in the case of an injury) to master tasks like self care, social communication, regulating emotions/managing transitions, fine & gross motor skills, and functioning/thriving in academics and extracurriculars.

Our approach is play-based – both because we love kids and want them to love learning, but also because there’s a mountain of peer-reviewed research that shows it’s the most effective way for kids to engage and learn.

Some of the primary skills we help children to master:

  • Fine and gross motor skills. Gross motor skills are those that involve the larger body muscle groups. These are the muscles used for crawling, walking, jumping, running, catching or kicking a ball, etc. Fine motor skills are those that require the strength and coordination of smaller muscle groups of the hands and fingers. These are needed for important tasks like eating, brushing your teeth/combing hair, tying shoes, drawing, writing, etc. Fine and gross motor skills are used all day every day, and a Cleveland occupational therapist can help a child learn to conquer these tasks for maximum independence.
  • Self-care. For kids with disabilities or delays, this refers to the ability to take care of oneself in day-to-day routines. From grooming to feeding, to dressing to toileting – all of these things take practice. This is true for neurotypical kids as well as those who are atypical; it’s just that the latter needs a bit more practice, and perhaps a different approach to the teaching of it.
  • Sensory processing. If your child has a difficult time tolerating a variety of foods (to the point where they’re only eating four things), expresses extreme irritation at wearing different fabrics, can’t tolerate the bristles on a toothbrush long enough to clean their teeth, struggles with sensitivity to light, sound, or crowds – all of these are indicators of sensory processing disorder. (These are sensory avoidance behaviors, but it can go the opposite way as well, with kids going out of their way to seek extra sensory input.) Of course everyone has their preferences and dislikes. But sensory processing disorder can make it difficult for kids to navigate through everyday tasks safely and successfully. A Cleveland occupational therapist can help them overcome the issues causing impediments or risks through fun games and exercises.
  • Executive functioning. This is the set of skills that allow a person to do things like pay attention, get organized, initiate a plan, follow a sequence of events, remember important details. A lot of neurotypical kids struggle with these as well, but those with conditions like autism spectrum disorder, ADHD, or Down syndrome may have an especially tough time. We break it all down into smaller steps and give them plenty of patience and practice.
  • Play and social skills. Interacting with others (adults and peers) in a variety of settings is critical not only for kids to be able to thrive at school and throughout the community, but also for a child’s mental and emotional health, as well as their physical safety. Making friends, engaging in play, understanding what’s expected of them in a classroom versus at the kitchen table, knowing when someone is being deceptive/tricky/unkind – these are things that kids learn over time. Those with developmental delays and disabilities may need additional help and time to learn these things.
  • Overall stability and strength. Being able to sit upright, maintain balance, walk steadily, firmly grip a pencil – these are all foundational skills necessary to completing important everyday tasks. An OT works with your child to help strengthen key muscle groups and improve their coordination so that they can more easily maneuver throughout their day.
  • Visual perceptual and visual motor skills. These are the skills needed to interpret visual input and give it meaning. This is something neurotypical kids learn to do fairly quickly, but some kids with delays and disabilities may struggle with it – and it can impact their ability to play, read, write, etc.

If you have questions about how an OT might help your child, we’re happy to provide insight and help you figure out where to start.

Therapy & Wellness Connection – your connection to a life without limitations – provides occupational therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

What Is Executive Function? And How Does It Relate to Child Development?, Harvard University, Center on the Developing Child

More Blog Entries:

Tactile Defensiveness Treatment from Our Akron Occupational Therapists, Dec. 29, 2022, Ohio Occupational Therapy Blog

Akron ABA therapy

What Makes Akron ABA Therapy Effective for Kids With Autism?

Providers of Akron ABA therapy understand well why it’s considered the gold standard for treatment for children with autism spectrum disorder (as well as a few other conditions like Down syndrome). But there are many schools of thought when it comes to this relatively newer practice area, so it’s perfectly understandable that parents and caregivers would ask, “What makes ABA therapy so effective?”

We should start by pointing out the obvious: People on the autism spectrum tend to process information a bit differently than others who are considered “neurotypical.” Autism is considered a developmental disability associated with differences when it comes to learning, moving, or paying attention, as well as challenges with social communication, sensory processing, and variations in routine. It’s a broad spectrum, so not every child or challenge is the same, and it can also vary depending on the environment.

Akron ABA therapy – applied behavioral analysis – is an approach to treatment rooted in the proven scientific methodologies of respondent and operant conditioning with the goal of altering behaviors of social significance. That’s a mouthful, but basically, it’s trained behavior specialists using a formulaic approach to studying behaviors that may be holding the child back in life, and determining how we might help them gradually let go of those by using one-on-one positive reinforcement over a period of weeks, months, or years.

The goal is not to change the child. We accept kids with autism as they are. What we strive to do is help them more effectively navigate the world around them.

ABA often focuses on skills that are part of independence and success in everyday life. It will vary depending on the child, their age, and how their challenges are impeding their independence and quality of life. These can include things like:

  • Extreme sensitivity to certain sensory stimuli that can make it tough to carry out basic grooming.
  • Intense fixation/focus on things to the extent that it impedes social engagement.
  • Stringent reliance on routines that can impede the ability to transition from one thing to the next without major outbursts.
  • Inability to focus long enough to benefit from classroom instruction, even in a modified classroom.

Behavior technicians, who are supervised by board-certified behavior analysts, may work on things like teeth brushing, eating a variety of foods, getting dressed, improvement of tactile tolerance/sensitivity, self-awareness and understanding “the size of a problem,” having conversations, making friends, reading emotions, advocating for their needs/wants, etc. If issues like self-harm or elopement are a concern, we can help formulate strategies to help reduce those occurrence or severity.

This is done by breaking down these larger skills into smaller, more manageable steps.

This all probably seems quite serious, but one of the reasons our Akron ABA therapy approach is so effective is because it is play-based. There’s a ton of research to back this, and the crux of it is: Kids remember the skills they learn when it’s fun. The positive reinforcements are child-led so that it’s always engaging. If they’re interested in music or certain characters or animals or toys – we try to incorporate those as much as possible. It doesn’t mean every day is easy breezy or there are never tough moments. But patients and therapists form a trust over time that ensures the child feels safe and respected and heard – and happy – while they’re working on these skills.

Lastly, the most effective pediatric ABA therapy doesn’t start and end with the child. The best programs are those that incorporate the concerns, ideas, and feedback of parents, other caregivers, teachers, doctors, etc. Ultimately, we want the skills being taught to carry over across environments – whether that’s at home, school, worship, community outings, and just being out in the real world. We can help parents and other stakeholders by providing strategies to apply when certain challenges arise (role play, modeling, redirection, etc.) so that there is consistency across environments. That is ultimately what is going to help the child absorb the lessons we’re imparting faster.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Efficacy of Interventions Based on Applied Behavior Analysis for Autism Spectrum Disorder: A Meta-Analysis, May 2020, Journal of Psychiatry Investigations

More Blog Entries:

How Long Will My Child Need to Be in Cleveland ABA Therapy? Dec. 23, 2022, Akron ABA Therapy Blog

Akron child speech delays

Speech Delays Higher Among Ohio Kids Whose Early Years Were During Pandemic

Kids in Ohio (and across the world) who were born or spent some of their earliest years as the COVID-19 pandemic swept the globe are now showing signs of developmental delays. In particular, researchers are noting higher rates of communication and speech delays, motor skill delays, and behavioral delays. It’s been most widely noted among children who are now toddlers all the way up to preschoolers.

As Akron pediatric speech therapists, we have also seen an uptick in parents and caregivers expressing concern for children who are not meeting all the key developmental milestones identified as typical for other kids their age.

This emerging trend has been reported anecdotally, but also in an increasing body of research. An analysis in Ohio looked at speech delays among children in a dozen central Ohio neighborhoods. Prior to the pandemic, approximately 27 percent of kids ages 3 to 5 tested by a Columbus non-profit speech and hearing center failed the speech-language assessment. Post-pandemic, that number shot to 52 percent.

Some other examples include:

  • A study by pediatric neurologists published last fall in the British Medical Journal Archives of Disease in Childhood found that babies in the U.K. born between March 2020 and May 2020 had a more difficult time communicating at 1 year of age compared to those born between 2008 and 2011. Most babies by 9 months are pointing at objects, and by 1 year, are saying their first words. Of the older infants, 90 percent could articulate numerous words at age 1, compared to 77 percent of those born during the pandemic. The share of 1-year-old infants who pointed to objects also fell from 93 percent to 84 percent. The percentage who waved goodbye also dropped, from 94 percent to 88 percent. A quarter of the younger cohort had never met a child their own age by their 1st birthday.
  • Two studies – one by the Rhode Island Hospital and another by the nonprofit LENA Foundation – found that babies born during the pandemic vocalized less and engaged in fewer interactions compared to those born prior to the pandemic. Theories on causation ranged from lack of exposure (just generally being exposed to fewer human interactions involving face-to-face communication – play dates, library story times, daycare, family gatherings, etc.), increased caregiver stress, and excess screen time in many homes where parents had to work while also caring for their children. It’s also possible that early intervention screening was not at optimal levels for kids in many areas. (The Columbus non-profit speech & hearing center referenced early is one of many centers across the U.S. that weren’t conducting screenings face-to-face – or at all – during the better part of 2020.)
  • Researchers at Columbia University published a study showing that babies born in New York City from March to December of 2020 had markedly less developed social and motor skills by 6 months than babies born earlier.
  • Chinese researchers published their findings in the journal Frontiers in Pediatrics in 2021 showing substantially delayed fine motor skills among babies born in 2020, and communication & speech delays in kids who turned 1 at some point in 2020.
  • A study published last year by educators in the United Kingdom found an uptick in problem behaviors, such as hitting and biting, as well as trouble acclimating to large group socializations. This was particularly problematic among 4- and 5-year-olds who were between 0 and 2 when the pandemic first broke out.

Part of the reason these issues are so concerning – and should not be ignored- is because of what we know about early childhood development and the importance of early intervention. There is an explosive amount of brain growth, neural connectivity, and learning that goes on in the first three years of live, continuing usually until around the age of 5. If there is an issue, identifying and addressing it as soon as possible is associated with the best long-term outcomes.

This is why we urge parents and caregivers who suspect their child may be delayed with speech, language, communication, social skills, motor skills, or behavior skills to seek a referral from your child’s pediatrician for closer evaluations. It doesn’t mean there’s anything “wrong.” But the longer we take to address delays, the further behind a child can get. Intervening with speech therapy, occupational therapy, physical therapy, or sometimes ABA/behavior therapy as early as possible yields the best results.

Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Speech and Language Developmental Milestones, National Institute on Deafness and Other Communication Disorders

More Blog Entries:

How Cleveland Speech Therapists Help Treat Preschool Language Disorders, Dec. 10, 2022, Akron Speech Therapy Blog

tactile defensiveness

Tactile Defensiveness Treatment From Our Akron Occupational Therapists

Tactile defensiveness, sometimes referred to as touch sensitivity, is a type of sensory processing disorder that involves a hypersensitivity to touch. Kids with tactile defensiveness may be extremely uncomfortable with certain sensations that others may not give a second thought: Tags on their shirts, carpet under their bare feet, certain food textures, messy play, or even hugs. Kids with tactile defensiveness may have an especially tough time with self care tasks like brushing their teeth, getting a haircut, having their nails clipped, etc.

As our Akron occupational therapists can explain, when a child (or adult) has this hypersensitivity to touch, they may go out of their way to avoid those sensations, or else have an outsized reaction when they do come in contact with them.

Think about it this way: If you get a stone in your shoe, it’s going to be super annoying. It may even hurt. It’s agitating to the point you will probably stop what you’re doing to take it out. For kids with tactile defensiveness, some of the everyday sensations we’re used to and take for granted feel like that stone in the shoe. The feel of those things triggers the brain’s protective fight, flight, or freeze response. For some, it can even be painful.

Treatment for tactile defensiveness often involves a strategic, gradual build up of pressure and varied proprioceptive sensory input to help reduce sensitivity – and ultimately make it easier for the person to navigate the world around them without suffering extreme discomfort or disruptive meltdowns.

Specifically, we may incorporate:

  • Activities that involve firm pressure. For example, we may do “burrito rolls” in yoga mats. We may recommend weighted vests, weighted blankets, or weighted lap pads.
  • Animal walks. This doesn’t even need to be an elaborate setup. We can turn a simple walk to the bathroom into an opportunity to get some extra tactile input by frog jumping, bear crawling, crab walking their way there. These types of activities are really effective for vestibular and proprioceptive input. Working these muscles can also help with self-regulation and calming.
  • Baking or crafts. The goal here is to encourage the child to become more confident in exploring different textures with their hands. Both baking and crafts can get super messy when you have a child “helping,” but that can also be part of the fun. Describe the sensations as they’re feeling it, encourage them to tell you about it as they squish, squeeze, pour, press, stir.
  • Oral motor tools. If your child struggles with brushing their teeth, there are oral motor devices that can be used to help desensitize them to the feeling of bristles, etc.

If your child struggles with sensory processing – and specifically tactile defensiveness – our experienced Akron occupational therapy team can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Tactile Defensiveness and Impaired Adaptation of Neuronal Activity in the Fmr1 Knock-Out Mouse Model of Autism, July 2017, The Journal of Neuroscience

More Blog Entries:

Handwriting Helpers From Our Cleveland Occupational Therapy Team, Oct. 27, 2022, Akron Occupational Therapy Blog

Cleveland ABA therapy

How Long Will My Child Need to Be in Cleveland ABA Therapy?

No two children on the autism spectrum are the same, In turn, the methods, intensity, and duration of the Cleveland ABA therapy they receive will be specifically tailored to the individual. That said, we know many parents want to know – at least roughly – how long their child is going to need therapy. Rather than outline a set number of hours or months or years, we point to specific goal posts – the biggest being an indicator of their functional ability and independence in everyday tasks.

Applied behavior analysis (ABA) is recognized as an effective treatment for kids on the autism spectrum, and sometimes those with other conditions like ADHD, oppositional defiant disorder, obsessive-compulsive disorder, Down syndrome, etc.

Most kids with autism will start ABA therapy sometime between the ages of 2 and 6 – with doctors and Cleveland ABA therapy providers agreeing that the earlier we start, the better. But as for how long it’s going to last, there is no magic number. What we can say unequivocally is that both intensity and duration (i.e., “the dosage”) of therapy are significant predictors of how well kids master their learning objectives.

This is well-established, but just as an example, a study published in 2017 in the peer-reviewed journal Translational Psychiatry examined the effectiveness of ABA therapy in varying durations for nearly 1,500 children ranging from age 18 months to 12 years, as measured by their mastery of skills ranging from social communication to self-regulation. The study found that both intensity and duration of therapy was positively correlated with better long-term outcomes in mastered learning objectives in areas like language, academics, adaptive behavior, and self-care.

Of course, it’s not expected that a child will receive behavior therapy indefinitely.

On average, it’s safe to say kids just starting Cleveland ABA therapy will receive anywhere from 20 to 40 hours weekly. The exact amount depends on things like the child’s age, condition severity, insurance coverage, parental ability, etc. This amount can be naturally reduced – or increased – over time as needed to ensure the child is receiving what they need to make progress on their goals.

We often start at a high intensity level – particularly during the first couple of years – and then taper off as the child gradually masters certain skills – sustainably and across different environments.

Some indicators we look for when assessing whether to reduce or discontinue ABA therapy are things like:

  • Confidence in the child’s stage of functioning and independence for their age.
  • The child is learning from the environment without the need for direct instruction.
  • Parents and teachers are able to manage and reduce problem behaviors without additional support of a behavior therapist.
  • The child is likely to benefit from a different educational environment (that isn’t one-on-one).
  • Key goals have been met, and target skills mastered.
  • The child is able to generalize their skills to different environments.
  • New skills are acquired and mastered without requiring direct intervention and instruction.

Ending ABA therapy is often a major transition for kids, teens, and young adults. Our team works with parents, teachers, and others to make that transition as smooth and successful as possible.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder, September 2017, Translational Psychiatry

More Blog Entries:

Cleveland ABA Therapists Explain Our Aim for Generalization of Skills, Nov. 2, 2022, Northeast Ohio ABA Therapy Blog

Akron ABA therapist

Akron ABA Therapist on Responding to Difficult Behaviors of Child With Autism

One of the most significant challenges for parents of a child with autism is concern for their child’s well-being when difficult behaviors that are aggressive, self-injurious or socially isolating. As an Akron ABA therapist can explain, there is no one-size-fits-all “right way” to respond to difficult behaviors. It’s important to carefully look at what may be motivating the child to engage in this behavior and also what occurs right after that could be unintentionally reinforcing it.

Understanding the “why” is key to being prepared with a better response – one that involves keeping the child and others safe, and incorporates strategies to help reduce future occurrences and reinforce more appropriate means of communication.

Some of the difficult behaviors commonly reported by parents of children on the autism spectrum:

  • Scratching
  • Biting
  • Kicking
  • Headbanging
  • Face-slapping
  • Hair-pulling
  • Excessive scratching or rubbing
  • Refusal to cooperate
  • Screaming and yelling
  • Throwing things

In a survey of 2,300+ published in the journal Pediatric Reports, roughly 40 percent of individuals on the autism spectrum currently or in the past have engaged in both aggressive and self-injurious behavior. The duration, severity, and frequency of these behaviors vary across the autism spectrum.

Why Kids With ASD Engage in Challenging Behaviors

It’s important to point out that usually, the child is not intentionally trying to test your patience or hurt anyone. And this is why “punishment” isn’t usually the best way to handle it because it’s not a matter of being “bad” or “spoiled” (no matter what kind of snide remarks you may hear from others if you’re unfortunate enough to be dealing with an episode in a public space).

A fair amount of research over the last five decades has revealed that comorbidities are a significant contributing factor in such behaviors. One of the most commonly cited comorbidities associated with these behaviors is impaired interoception, which is when a person has trouble perceiving their own internal body signals. (This condition isn’t unique to people on the spectrum, but it is fairly common among them.)

As an Akron ABA therapist can tell you, all behavior – at the core – is a form of communication. In ABA, we work to alter behavioral outcomes by studying the triggers and consequences/rewards and then consistently modifying one or both of those. But when issues with interoception are part of the “why” for the behavior, it can be tougher because the behavior itself is intrinsically physically rewarding, providing a measure of sensory input or relief.

Other possible behavior triggers include:

  • Transitions
  • Sudden or unexpected changes (in plans, activities, expectations, etc.)
  • Frustration or anxiety
  • Poor social and communication skills
  • Difficulty focusing
  • Mental and/or physical fatigue
  • Executive functioning trouble

When you know this “why,” you can start looking at ways to reduce the chances of a trigger, as well as having a “toolbox” handy to respond quickly and effectively.

Addressing the Antecedent

In ABA, the antecedent is the first element of the “ABC’s of behavior science.” (The others are behavior and consequence.) The antecedent is the “trigger” or what happens right before the behavior occurs. Because kids with autism can’t always effectively express exactly what it is that they need or that’s causing them stress/pain/discomfort, etc., we have to carefully look for patterns of behavior to determine the specifics of what’s setting them off.

Armed with knowledge of the underlying issue, you can:

  • Have a plan. You know your child struggles with transitions. You can help reduce this difficulty (and the odds of a meltdown) by preparing them with verbal and visual cues, timers, social stories, etc. so that they don’t feel so “taken off guard” when they must move from one activity to the next.
  • Adjust the environment. Your child can still have meaningful or necessary experiences without experiencing them the exact same way as everyone else. Adaptations to account for sensory overload (headphones, sunglasses, chewable jewelry, etc.) can go a long way. Other adaptations can help ensure the environment is one that allows for engagement that is both calm and safe.
  • Be picky about events. If your child struggles mightily with crowds, a theme park vacation may not be the best idea. Or if you do decide to go, perhaps limit the amount of time spent or distance traveled in a single go. Another example might be a child’s birthday party. If you don’t want to skip it entirely, maybe come early or later and only stay for a certain period of time.
  • Have tools ready. Come prepared with tools to help them cope if they do start to feel overwhelmed. These can include fidget toys, electronic device with a favorite game app, “heavy work” exercises, etc.
  • Give them choices. Providing the child with a sense of control can go a long way toward helping reduce challenging behaviors. You aren’t just telling them what to do and expecting they will, but instead giving them a choice about how to engage. For example, not doing homework may not be an option – but they can choose to either do it at their own desk vs. the kitchen table, or they can choose to do it alone vs. with parent helping.
  • Designate safe spots. If you know certain places or scenarios are tough for your child, figure out in advance where they or both of you can go to self-regulate before continuing.

Adjusting the “Consequence”

The word consequence has a negative connotation, but that’s not necessarily what we mean here. It is simply: What happens immediately after the behavior? What is the child getting in return for their behavior? Is there a way to alter the consequence so that the child no longer finds engaging in that behavior to be an effective means of accessing that outcome?

When you work with an Akron ABA therapist, you’ll find the goal is to focus on supporting behaviors that are safe, productive, and boost the child’s confidence, while not supporting those that are harmful or socially isolating.

One approach that’s often effective when we’re trying to “extinct” a problem behavior is to avoid drawing attention to it. That often seems counterintuitive to many parents at first – because your instinct is to immediately tell them to stop, etc. But as long as the behavior isn’t dangerous, ignoring it entirely can be effective – especially if the behavior is attention-seeking. At first, this approach may actually trigger an increase in the behavior (referred to as a “behavioral burst”), but it will ultimately wane as the child learns they are not getting the desired outcome by engaging in it.

If you have questions about how to address the challenging behaviors of your child on the autism spectrum, working with an Akron ABA therapist can go a long way toward helping to identify the underlying cause and develop an effective response.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Understanding Challenging Behaviors in Autism Spectrum Disorder: A Multi-Component, Interdisciplinary Model, July 2022, Journal of Personalized Medicine

More Blog Entries:

How Our Brecksville ABA Therapists Use Social Stories to Help Kids With Autism, Nov. 3, 2022, Akron ABA Therapy Blog

preschool language disorders Cleveland

How Cleveland Speech Therapists Help Treat Preschool Language Disorders

Most babies and toddlers will understand what is being communicated with them long before they’re able to clearly communicate back. All kids develop speech and language skills at varied paces, but some struggle more than others with understanding what is being said to them (receptive language) and expressing their thoughts to others (expressive language). Children with these difficulties may be diagnosed with one of several preschool language disorders, which our Cleveland speech therapists help to treat.

An estimated 7 percent of Americans have some form of language disorder, according to the American Speech-Language Hearing Association (ASHA).

Specifically with regard to preschool language disorders, these are usually identified when a child is between the ages of 3 and 5. Sometimes there is a specific cause, such as autism, cerebral palsy, hearing loss, intellectual disability, Down syndrome, etc. But in some cases, there’s no clear explanation. Language disorders can be treated by our Northeast Ohio speech therapists even if we don’t know the precise cause.

In identifying preschool language disorders, speech-language pathologists will assess whether the trouble is receptive or expressive – or both.

Signs of a receptive language disorder include difficulty with things like:

  • Following directions.
  • Answering questions.
  • Deciphering non-verbal language, such as gestures, nods, shrugs, and pointing.
  • Knowing now to take turns in a conversation.

Indicators of an expressive language disorder would include trouble with things like:

  • Naming objects.
  • Learning songs and rhymes.
  • Stringing together words in a sentence.
  • Using the correct pronouns in conversation.
  • Gesturing.
  • Asking questions.
  • Starting – and maintaining – a conversation.
  • Adjusting their speech for the time, place, and person settings. For instance, they might not recognize that they need to use a louder voice outdoors or that they should speak differently to the teacher than they would a peer.

Kids with preschool language disorders may also have a really tough time with early reading and writing skills, such as telling a basic story (beginning, middle, end), naming numbers and letters, or pointing to/identifying persons, places, or things in a book.

It’s worth noting that a language disorder is different than a speech or speech sound disorder (though it is possible for a child to have both). They’re closely-related – but distinct – skills. While language is the whole system of communication (words, symbols, written, spoken, gestured, use of body language, etc.), speech is the actual sound of spoken language. Speech is specific to oral communication, i.e., talking.

Speech trouble is often a matter of mechanics (coordinating use of the jaw, lips, tongue, vocal tract, etc. in a very specific way to correctly produce sounds). With language, there’s often some neurological component at the core.

Treatment for Preschool Language Disorders

If a child is showing signs of a language disorder, it is not a good idea to “wait-and-see.” Initiating treatment with a speech-language pathologist as soon as possible will have the best long-term results. The younger a child is, the more plasticity they have in their neural connections – and the easier it will be for them to forge new neural pathways that will help them overcome their language difficulties. Treatment can begin as early as 18 months (sometimes even before that, if the child has a condition like Down syndrome that is well-established at birth or soon after).

At Therapy & Wellness Connection, we provide 1-1 speech therapy for children who struggle with language, and we also offer regular small group sessions so kids get additional practice and reinforcement with their peers.

Most pediatric language therapy interventions involve consistent training of some specific language skill, followed by positive reinforcement. Kids often learn most effectively when treated within a social context. The intensity and duration of therapy will depend on the resources (and insurance) available, as well as the child’s specific needs, abilities, and age.

If you think your child may have a preschool language disorder, reach out to our dedicated team of speech therapists in Northeast Ohio to discuss the steps necessary to schedule a formal evaluation.

Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Preschool Language Disorders, ASHA

More Blog Entries:

Brecksville Speech Therapy Team on Social Pragmatic Communication Disorder, Nov. 2, 2022, Cleveland Speech Therapy Blog

Brecksville ABA therapists

How Our Brecksville ABA Therapists Use Social Stories to Help Kids With Autism

Children with autism spectrum disorder often have a difficult time mastering important life skills related to social interactions, communication, and transitioning from one activity to the next. They also tend to be more visual learners, meaning they may struggle to follow auditory directions. Our Brecksville ABA therapists have found that social stories are a great way to bridge the gap and effectively teach key skills.

A social story is a visual tool that accurately describes a skill, context, concept, or achievement and incorporate 10 specific criteria. These include having a defined purpose or goal, identifying the most critical information on a certain topic, having a clearly defined title, body, and conclusion, writing that’s in a supportive, positive, and literal voice, and crafting descriptive sentences that answer the basic WH questions. They also incorporate visual aids – graphics, pictures, or sometimes even pictures of the child themselves engaged in the activity or a picture of the exact place where the activity will/would take place. First person language (i.e., “I go to the store”) is often used, but not always.

The concept for social stories was around long before they were called that, but credit is usually given to teacher Carol Gray, a mother of four kids with autism who was looking for ways to help her students as well as her own kids with things like transitions to recess and what to expect in a line.

Today, our Brecksville ABA therapists use and recommend social stories to help with all kinds of scenarios. Some examples include (but aren’t limited to):

  • How to use the bus
  • Using or sharing toys
  • How to talk to friends
  • Staying in the house
  • Wearing a seatbelt
  • Understanding personal space
  • Keeping your hands to yourself
  • Listening to teachers
  • Eye contact/staring
  • Using your words
  • What to do with big emotions
  • Going on a trip (or to the doctor, grocery store, airplane, movies, etc.)
  • Hitting, shouting, licking, spitting, biting, etc.
  • Asking nicely
  • Saying “No Thank You”
  • Not using potty words
  • Eating at the table
  • Brushing teeth
  • Using the potty

Social stories are a way that we explain social situations to kids on the autism spectrum to help them learn what they can expect in these scenarios – and what is expected of them. And while they were initially developed for kids with autism, they have turned out to be helpful for kids with other conditions like learning disabilities or intellectual disorders.

How Do Brecksville ABA Therapists Create Effective Social Stories?

Although not every story will work for every kid on the spectrum for every situation. In fact, part of the reason they work so well is because they are highly individualized. Social stories are a great tool for many people with autism because it can be tough for them to pick up on social cues that others notice naturally. Things like body language, eye contact, gestures, facial expressions – these are often difficult to read for kids with autism.

Although anyone can technically write a social story, it’s a good idea to get help from your child’s Brecksville ABA therapists when doing so. We help identify not only the activity with which the child is struggling, but also the specific skills they need to work on, and how we can break down the components of that activity to small, understandable bits.

Keeping it simple is really important. We want to make sure we’re focusing on very specific skills laid out in a very straightforward order with brief explanations as to the reasoning.

The stories can then be read to the child on an ongoing basis – and if possible, right before the event, as a reminder. As the child begins to understand the social situation and what is expected, the story can be phased out.

Research has shown that social stories can have a positive impact on the behavior of children with autism, though we like to also incorporate the use of other reinforcement tools, such as role play, feedback, and video modeling.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

The Effectiveness of Social Stories among Children and Adolescents with Autism Spectrum Disorders: Meta- Analysis, September 2016, By Mourad Ali Elissa Saad, Dean, College of Education, Arees University, International Journal of Psycho-Educational Sciences

More Blog Entries:

Choosing the Right Cleveland ABA Therapy Provider for Your Child With Autism, Sept. 19, 2022, Brecksville ABA Therapists Blog

Akron occupational therapy

When Should Kids Learn to Button & Zip? Akron Occupational Therapy Insight

Learning to zip, button, and use “fasteners” for dressing is a key self-care skill. Multiple times every day, we’re zipping jeans, buttoning shirts, zipping coats, buttoning pajamas, etc. We don’t expect kids to learn all this overnight, but as our Akron occupational therapy team can explain, mastering these skills to the point of being able to handle them without the aid of a parent or teacher is key to a independence.

For kids with developmental delays and disabilities, acquiring these skills may take a bit longer. Our Akron occupational therapy team can help.

Although every kid develops at their own rate, the general consensus is that typically developing kids will:

By age 2:

  • Unzip zippers with large tabs.
  • Pull a zipper up if an adult holds the bottom tight.
  • Unbutton larger buttons of 1 inch or more.

By age 3:

  • Unbutton 3 large buttons, even if they don’t do so in the exact right order.

By age 4:

  • Unzip and unsnap clothing while wearing it.
  • Close the front snap on their clothes.
  • Button and unbutton while wearing a front-opening garment.

By age 5:

  • Open all fasteners on any piece of clothing.
  • Hook and zip up on their own.

By age 6:

  • Can hook and zip on their own while wearing clothes.

There will of course be some variations – even among typically-developing children – but it’s important to bear in mind that each set of skills requires children to master other prerequisites. For example, a child without a neat pincer grasp (where the thumb touches the index finger while picking up a small object) is necessary before you can have any expectation that a child can start to take on zipping and buttoning.

Why Our Akron Occupational Therapy Team Prioritizes Button and Zipper Mastery

What’s the big deal with buttons and zipper? Occupational therapy is an area of practice concerned with helping people of all ages and abilities gain and maintain independence and success in the tasks of daily life. The ability to dress your own self is a matter of independence, and part of the “occupation” of daily living.

When we see a child is struggling to button, zip, and fasten, we look to see where are the skill deficits. Often, it’s one of the following areas with which they’re having difficulty:

  • Hand-eye coordination.
  • Visual skills.
  • Pinching and grasping.
  • Motor planning.
  • Sequencing.
  • Bilateral coordination.
  • Trouble paying attention.
  • Low frustration tolerance.
  • Lack of exposure or practice.

Once we’ve identified where the trouble spots are, we can incorporate “play time” exercises that will help kids gain confidence and work up to these skills.

If your child has ongoing struggles with these or other skills necessary for independence, our Akron occupational therapy team at Therapy & Wellness Connection can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides occupational therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Developmental Milestones: Dressing Skills, Children’s Hospital of Orange County

More Blog Entries:

5 Signs Your Child May Need Akron Occupational Therapy, Sept. 17, 2022, Akron Occupational Therapy Blog