Cleveland ABA therapy provider

Choosing the Right Cleveland ABA Therapy Provider for Your Child With Autism

ABA therapy is widely considered the gold standard treatment for children on the autism spectrum – and it’s particularly valuable when it’s intensive, starts early, and is combined with other critical interventions, such as speech therapy and occupational therapy. That said, finding the right Cleveland ABA therapy provider for your child can seem daunting – particularly if you’ve already had a negative experience.

When implemented appropriately, ABA has proven unequivocally to help children learn invaluable skills in areas like communication, self-regulation, social interactions, and self-care. It is our firm belief and practice that the best form of ABA therapy is naturalistic, play-based, and enjoyable for the child. That’s not to say we don’t challenge our patients. We do, as it’s necessary for them to gain the skills we’re trying to teach them. However, sessions that are too intense, rely too heavily on negative reinforcement, or use goals that are beyond what is realistic for a child will not only yield less progress, they may actually set your child back.

The unfortunate reality is that not all ABA therapists are cut from the same cloth, and not all clinics hold themselves to the high standards that we do at Therapy & Wellness Connection. Unlike more established fields like speech-language pathology, occupational therapy, or physical therapy, ABA therapy is less regulated.

Certified behavior analysts, or BCBAs, do have an intensive credentialing process. Among the requirements for BCBAs:

  • Earn at least a master’s degree or doctoral degree in Behavior Analysis or related field such as psychology or education, with a focus on behavior analysis – with courses covering ethical conduct, principals of behavior analysis, research and data analysis, problem identification & assessment, intervention consideration, implementation management, etc.
  • Complete a minimum 1,500 hours of relevant, supervised experience in an ABA setting.
  • Pass a national certification exam.
  • Apply for certification with the Ohio Board of Psychology.
  • Attend a Pre-certification workshop and exam on Ohio ABA regulations (as detailed in Chapter 4783 of Ohio Revised Code and the Ohio Administrative Code).
  • Renew COBA certification every two years (which requires proof of at least 23 hours of continuing education, with a minimum 4 hours of training in ethics, professional conduct, or cultural competency).

While these standards align with what one might expect in a field of professionals working one-on-one with children who have complex behavior needs and challenges, the same is not true of registered behavior technicians, or RBTs. And it’s RBTs who primarily administer Cleveland ABA therapy – under the supervision of a qualified BCBA.

RBTs are paraprofessionals. They are required to meet the basic eligibility requirements (at least 18-years-old, have a high school diploma, pass a background check, complete 40 hours of training, complete an initial competency assessment), then apply, take & pass the RBT exam, and then maintain their certification with ongoing supervision, adherence to ethics, and annual renewal. So where as it takes hundreds and lots of education to become a BCBA, RBTs are providing the frontline care with 40 hours of training.

Of course, there are many RBTs who are excellent and provide stellar ABA services to their clients. There is ample scientific data supporting the value of ABA in general. But as the number of autism diagnoses has risen steadily over the last two decades (the CDC estimates 1 in 44 children has an autism diagnosis), so too have the industries that serve them. Not every provider or clinic is as rigid about who they accept or how much oversight they receive. That can compromise the quality of care, as the value of ABA therapy rests heavily on who is administering it.

All of this can feel overwhelming for parents looking to find the best possible treatment for their child.

Our TWC Cleveland ABA therapy team has some questions parents can ask to determine whether a clinic/ABA therapy provider is right for your child:

  • What is the ratio of BCBAs to RBTs at your clinic? The lower the ratio, the better, but there may be some variation depending on their patients’ severity level.
  • What training and expertise does your staff have? As mentioned before, BCBAs must have extensive education and training, and they are the ones who will be developing treatment plans for your child. But it’s the RBTs who will be implementing them. Ask whether the providers encourages staff to undergo ongoing training. Inquire whether they have direct experience with your child’s specific challenges and needs.
  • What types of intervention are used in your ABA clinic? ABA therapy is not a one-size-fits-all approach. There are actually many different ways to administer this research-based treatment. Ask the provider about their therapy philosophy and approach. Some tend to use more discrete trial training (which is more systematic and usually involves a child sitting at a table) while others prefer a more natural, organic approach to learning. Some therapy clinics will use both, depending on the child. You will also want to know whether they use positive reinforcement. “Punishment” or negative reinforcement may be effective in altering behaviors, but it’s not necessarily the best approach – especially because when there is potential for it to be over-used or abused. Positive reinforcement should be the primary approach.
  • Does your clinic provide any other specialized services? Children on the autism spectrum may be prescribed a number of treatments, including speech therapy and occupational therapy. They may also benefit from tutoring, homeschooling, social skills groups, specialized therapies (music, equine, etc.), etc. It can be very helpful for these kids to have a “one-stop-shop” for these services. Therapy & Wellness Connection is one such place where kids can receive multi-disciplinary services and interventions.
  • What is the treatment plan? Treatment plans must be created specifically for your child, depending on a functional behavior assessment. The plan should include both proactive and reactive strategies to manage and reduce problematic behaviors and encourage socially appropriate behaviors/responses. Ideally, the plan of care is going to have clear functional goals and objectives that identify age-appropriate challenges that are both engaging and fun for the child – and most likely to be generalized into other environments. It should also include parent involvement and training, to some extent. The more carryover we can get across environments, the better.
  • What sort of safety measures are in place at your clinic? You as a parent want to know what measures are taken to prevent abuse, what the procedure is for reporting concerns with parents, how often parent observations are allowed, how inappropriate/excessive/dangerous behaviors may be dealt with, etc. You also want some insight into how secure the facility/session will be, particularly if your child is at high-risk for self-harm or elopement.

If your child has been diagnosed with autism and referred to Cleveland ABA therapy providers for services, our team at TWC can help answer any questions you have about our staff, our facility, our philosophy, and our practice.

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:

Low standards corrode quality of popular autism therapy, By Emily Sohn, Oct. 28, 2020, Spectrum News

More Blog Entries:

Cleveland ABA Therapists on Differences Between Bribery vs. Reinforcement, Sept. 10, 2022, Cleveland Behavior Therapy Blog

5 Signs Your Child May Need Akron Occupational Therapy

Akron occupational therapy helps kids with a broad range of physical, cognitive, motor, and speech deficits to develop those skills to the best of their abilities and reach their maximum potential.

Our pediatric occupational therapists at Therapy & Wellness Connection provide services in-clinic (at our Brecksville location), as well as in homes, daycares, and other settings.

Although the specific goals are going to vary based on the individual child and their diagnosis, in general our team helps kids improve the function and independence in the areas of basic life skills. Our patients are primarily kids and teens who have disabilities, injuries, or illnesses that have led to developmental delays or a loss of key life skills.

Our OT experts will carefully analyze a child’s unique abilities and goals and then design activities to help them practice and improve their skillsets.

Who Benefits From Akron Occupational Therapy?

Occupational therapy is not a one-size-fits-all practice for a single group of individuals. We treat patients with a broad range of conditions and abilities. Among them are individuals with:

  • Down syndrome
  • ASD (autism spectrum disorder)
  • Cerebral palsy
  • Fetal alcohol syndrome
  • Global developmental delays
  • Sensory processing disorder
  • Brain injuries, spinal injuries, birth injuries

OTs can treat people of all ages and at all stages of life. It’s just that our team at TWC is primarily focused on youth – from birth to 18, with career counseling/tutoring/training after that point for young adults.

Some kids may struggle just in one area or with one skill set, but sometimes they need help with a broad range of skills – from handwriting to self-care (dressing, bathing, feeding, toothbrushing, toilet training, walking) to organizing school work to successfully managing social scenarios that may not come easily.

Our Akron occupational therapists provide services that are almost entirely play-based – because that’s how children learn best! When they’re having fun, they’re infinitely more engaged and enthusiastic about tackling the task at hand.

Indicators Your Child Needs OT Intervention

Because occupational therapy isn’t as well-known of a practice area as, say speech therapy or behavior therapy, parents may not clearly recognize the need for occupational therapy intervention the way our team will. But here are some signs that you may want to raise the possibility to your child’s pediatrician (who will make the OT referral):

  1. Your child avoids (or obsessively seeks) certain surfaces, textures, food temperatures, noises, etc. This can be a sign of sensory processing disorder. Our Northeast Ohio occupational therapists can help your child overcome while making it fun. (We don’t want it to feel like work!)
  2. Your child doesn’t use both hands together when they’re playing or carrying out a task. Issues with bilateral coordination are fairly common, but they can be a hinderance as your child grows and is expected to take on increasingly difficult tasks. Trouble with fine motor skills and bilateral coordination is something our team of OTs can help them work on – and give you tips for practicing at home.
  3. Your child has a tough time dressing themselves or taking on other self-care tasks. Of course, it’s normal for their to be a learning curve with certain things like toilet training, brushing their teeth, getting dressed, etc. But if they are behind their peers in these areas, getting OT intervention now can help them “catch up” to their peers – and avoid falling further behind as the expectations only increase.
  4. Your child struggles with self-calming. All kids have tantrums from time-to-time and self-control is certainly a learned skill. But if they routinely have big reactions to small problems or have a much tougher time than their peers in gaining control of themselves and their emotions, an occupational therapist may be able to help by teaching them strategies that can serve them well in life – as challenging, frustrating situations only increase as they get older.
  5. Your child is showing signs of autism. Autism can look different from child to child, but some key indicators are delayed speech, eye contact avoidance, not responding to one’s name, a seeming disinterest in engaging socially (or socially inappropriate responses to certain stimuli), etc. Occupational therapists help kids on the autism spectrum with a broad range of physical, cognitive, motor, sensory, and social skills.

If you want to learn more about our occupational therapy services at Therapy & Wellness Connection, we’re happy to answer your questions and give you a tour of our clinic.

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:

Occupational Therapists: What do they do? Child Mind Institute

More Blog Entries:

How Cleveland Occupational Therapists Treat Tactile Defensiveness in Kids, July 16, 2022, Akron Occupational Therapy Blog

Cleveland ABA therapists

Cleveland ABA Therapists on Differences Between Bribery vs. Reinforcement

As Cleveland ABA therapists, so much of what we’re able to achieve with our pediatric patients is because of our tactical use of reinforcement. Reinforcement can be positive (game time, a sticker, a favorite song/dance, a gummy treat) or negative (typically ignoring or denying a preferred activity). Where possible, we lean toward the use of positive reinforcements. But we recognize that from the outside looking in, this might seem like bribery.

So, what’s the difference between bribery and positive reinforcement in Applied Behavior Analysis treatment for kids on the autism spectrum?

Here’s our Cleveland ABA therapists generally outline the difference:

  • Bribery is what takes place when a child has already started engaging in a problematic or unexpected behavior and then something like screen time or a special treat is offered in an effort to get them to stop engaging that behavior. It’s not really used as a learning moment or opportunity for a child to gain a new set of skills or engage in a different pattern of behavior. Bribery often stems from a one-time interaction where a child gets some sort of preferred item, food, or activity in exchange for changing their behavior. It might be effective in the short-term (which is why so many parents use it!) but that behavior is going to happen again and again – and won’t change unless you offer the same/similar “bribe” to offset it. Ultimately, it’s the child who maintains control in this scenario.
  • Reinforcement occurs when the preferred item or activity is given only after – and contingent upon – the expected/appropriate behavior change. That might sound really similar to bribery, but we’re delivering the reinforcement only after we see the child “change the channel” and their behavior as a means to increase that behavior.

To illustrate the difference, let’s give a dinner time example.

Let’s say you’ve spent time preparing a meal for your family and place it in front of your child and encourage a bit. The child immediately bursts into tears, throws themself on the ground, and demands chicken nuggets. You respond, “If you will stop crying, I’ll go make you some nuggets.” The crying stops, the child gets their nuggets – win-win, right?

Except that was bribery. It “fixed” the immediate issue, but the same scenario is going to happen again and again – and your child isn’t going to eat their dinner if they know chicken nuggets are on the table as on option – if they have a “big reaction.”

Instead, our Cleveland ABA therapists would recommend a reinforcement approach. Take a deep breath. Then rather than wholly giving in to the child’s demands, make them this deal: You will make chicken nuggets. Plan to do so ahead of time, in fact, if you know this is likely to be a point of contention. Then you use the chicken nuggets as the reinforcer. You require first a bite of dinner in exchange for each chicken nugget. With this tactic, you are reinforcing the expected behavior (eating the dinner you prepared) with the reinforcer (they chicken nugget they really want).

In the end, the goal of “bribery” is for the person giving the “bribe” to get what they want. But with reinforcement, the goal is ultimately to benefit the child/learner.

When we talk about reinforcement tactics in ABA, we sometimes hear from parents that they are reticent to “bribe” their child to do what’s expected of them in the first place. But this is where they are confusing bribery with reinforcement.

Look at this way: If what you’re doing is not effective, trying something new may be necessary. And reinforcement involves a bit of planning on your part. You know your child is likely to take issue with the dinner you prepared. Set them up for success by motivating/teaching them upfront.

Cleveland ABA Therapists Tips for Parent Positive Reinforcement

As ABA therapists, our sessions take a fair bit of planning to ensure we’re targeting the goals/skillsets of each child with whom we’re working. But parents can use some of these same basic strategies at home to help facilitate desired results.

A few ideas:

  • Catch” expected behaviors. You may already be planning to provide your child with some type of treat, like game time or some chocolate. All the better if you can do so after “catching” them engaged in expected/appropriate behavior that you want to target or encourage. The more you do this, the more expected behaviors you’ll see.
  • Make sure you’re targeting an appropriate behavior to reinforce. You want to be sure it’s something your child is actually capable of. Start with easier tasks and then work your way up to more challenging skills. Remember: You want to set them up for success and improve their confidence that they can reach their goals!
  • Keep an eye out for warning signs. In ABA, one of the first things we learn is to study the “ABC’s” of behavior. This involves carefully observing the antecedent (what happens right before an inappropriate behavior), the behavior itself, and then the consequence. By altering either the antecedent or consequence, we can help children alter behaviors and gain new skills. Watching out for warning signs is knowing what antecedents are likely to trigger a meltdown or other inappropriate behavior that you’re trying to target. Go into situations you know may be triggering prepared with tools to help reinforce when they engage in expected/appropriate behaviors.

In the event a tantrum or meltdown occurs, it’s important to wait until they are in a calmer place before initiating any sort of reinforcement. (They’re unlikely to be able to respond much at all when they’re in such a heightened, emotional state.)

When they do start to calm down and get a reign on their emotions: Praise them for it! This is positive reinforcement to. Praise them using their calm-down strategies (deep breaths, counting to 10, squeezing their palms, etc.). Then when they are truly calm enough to engage in meaningful communication, you can outline the terms of the reinforcement (i.e., three bites of dinner = 1 chicken nugget).

If you have questions about the difference between positive reinforcement and bribery and how best to implement positive reinforcement at home, our dedicated Cleveland ABA therapists can help.

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, Autism Speaks

More Blog Entries:

How Our Cleveland ABA Therapists Teach Kids With Autism Personal Hygiene Skills, Aug. 11, 2022, Cleveland ABA Therapy Blog

Cleveland speech therapy kids

Cleveland Speech Therapy: School vs. Private Services

Parents whose children have been referred for Cleveland speech therapy may wonder whether they truly need to seek out private therapy – particularly if they can access services through their child’s school.

The answer will certainly depend on a number of factors, including:

  • The age of your child. (Early intervention before age 5 may be ideal, but schools aren’t going to offer those services until they are enrolled as students
  • The nature of their condition/deficits. Treatment for some diagnoses, such as autism, will begin as early as possible -and may need to be intensive. If a child is on the severe end of the spectrum, they may need intensive services (such as full-time ABA therapy and educational assistance) before they can function/thrive in a typical school setting. However, if their condition, deficit, or challenge is relatively mild, they may just fine in a school setting. Often, they may benefit from both public school and private services.
  • What sort of Cleveland speech-language therapy services are available at the school. The criteria used for Ohio school districts to determine whether special services or accommodations should be extended to a student through an IEP (individualized education plan) or a 504 Plan differs from the criteria that medical doctors and private therapy clinicians might use to determine a plan of care. Whereas school districts are going to analyze how the child’s condition or deficits impacts their ability to function academically, our Cleveland speech therapists are going to be looking at treatment from the “whole child” perspective. We’ll want to know how their condition impacts them not only in a school environment, but also at home, with friends/family, while engaged in recreation or in other aspects of community.

It’s been our experience that many children we treat at Therapy & Wellness Connection benefit from services both from our private therapy clinic as well as in school.

In terms of professional capability of the Cleveland speech therapy services you will get in public schools versus at a private therapy clinic, the speech therapists are going to have very similar education, credentials, and likely experience. The speech-language pathologists (SLPs) at your child’s school as well as the one at their private clinic will have an undergraduate and/or graduate degree involving clinic therapy experience and extensive coursework pertaining to a broad range of speech & language development disorders and effective treatments. (Those who have only completed undergraduate coursework/criteria are speech-language pathology assistants, while those with a graduate degree will pass the praxis exam, complete a Clinical Fellowship Year, and ideally hold a Certificate of Clinical Competence – or CCC – from the American Speech-Language Hearing Association.)

We can attest to the fact that there are some amazing SLP-As and SLPs in our Northeast Ohio public schools (we’ve hired more than a few from local school districts!). That said, school SLPs generally only have a limited amount of one-on-one time with your child. Speech therapy work at school may take place in more of a group setting, so they aren’t getting as much individualized treatment. And although there may be some variation from district-to-district depending on local school funding, in general, the SLPs and SLP-As at schools are often very busy, on tight schedules, and working with limited resources.

Meanwhile in private speech therapy, your child gets the full attention of their SLP for the duration of each session – usually about one hour and conducted here in our Brecksville clinic or at the child’s home, daycare, or other setting. The more intensive the therapy schedule, the faster your child is going to master the skills targeted in their plan of care.

Needs and Qualifications for Speech Therapy

In a school setting, the SLP will consider the following when weighing whether services are appropriate:

  • Standardized testing results.
  • Classroom communication skills.
  • Communication deficits that negatively impact their academic performance.

But as we mentioned previously, private Cleveland speech therapy is going to base the needs assessment on factors beyond academic performance. We’re going to look at how communication issues impact the child’s life in all areas.

The frequency, duration, location, and setting are going to vary between school speech therapy and private clinic speech therapy. Your child’s IEP or 504 plan is going to dictate how many hours of services they receive per week, but it’s generally going to be much less than what is recommended by a private speech therapist – simply because they’ve got a lot of other children to treat also in that same time block. (It’s not uncommon for schools to have only one SLP per grade level, school, or even district.)

The terms of the school’s IEP are reviewed and updated annually, in collaboration with the parents/caretakers, the child’s teachers, and specialists like SLPs, occupational therapists, ABA/behavior therapists, and intervention specialists.

Plans of care for private speech therapy are often reviewed and updated every few months.

How Do I Know if My Child Needs Additional SLP Services?

Although that’s a tough question to ask without assessing your child’s unique condition and needs, in general, a child will likely benefit from private speech-language therapy services in Northeast Ohio if:

  • They do not qualify for school-based speech therapy due to the fact their disorder doesn’t have a major impact on academics.
  • Parents/caretakers have ongoing concerns about the child’s use of language, comprehension of language, articulation (ability to say words clearly), voice, fluency, or social skills.
  • The child is better able to concentrate during one-on-one therapy sessions.
  • They are not receiving speech services from which they may benefit on long breaks (summer, winter, etc.).
  • Your child has a condition or disorder (ex: Apraxia of speech, feeding/swallowing problems, etc.) that requires a specialized therapy technique or specially-trained speech-language pathologists.

If you are considering private speech therapy services in Northeast Ohio, we can set up a consultation, exam, and schedule.

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:

Information for School-Based SLPs, ASHA

More Blog Entries:

Ohio Kindergarten Readiness Skills: Is Your Child Developmentally Ready? July 20, 2022, Cleveland Speech-Language Pathology Blog

Akron tutors special education

We Provide Akron Tutors and Homeschool Help for Kids With Special Needs

Our Akron tutors know that no two students learn the exact same way. Yet classroom instruction across Ohio is largely uniform and rigid. That can lead a lot of headaches and heartaches – especially if a child has disabilities, developmental delays, or some other medical diagnosis (Down’s syndrome, cerebral palsy, autism, ADHD, etc.) that often correlates to academic difficulty.

But even when parents know their child is not thriving in the public education system, they may feel powerless because they lack the time and resources to be able to homeschool them or the experience to effectively tutor them.

With the new 2022-2023 school year soon upon us, it’s a good time to remind parents and caregivers in Northeast Ohio that there are academic supports available for your child, as well as alternatives to either the traditional education model, homeschool at home, or virtual school.

At Therapy & Wellness Connection, our highly-qualified and specially credentialed teachers provide tutoring and homeschool instruction to kids with special needs at our Brecksville clinic.

Homeschool classes are held each weekday from 10 a.m. to 3 p.m. in our clinic. Our flexible, project-based curriculum takes your child’s unique learning style into account – while still meeting state standards and goals. In addition to core subjects like English, Math and Science, we also offer dance, music, and equine therapy. And all this is on top of the speech, occupational, and ABA therapy services we offer. We also provide before-and-after care.

Akron tutors offer academic help for kids with special needs in Northeast Ohio.

Our tutors (who provide assistance in reading, math, and handwriting) are all certified in the Wilson Language Training program. If you’re not familiar, it’s essentially a multi-sensory approach geared toward helping kids with learning disorders like dyslexia and conditions associated with delays and other challenges.

Educational programs at TWC are overseen by intervention specialists who have earned master’s degrees specifically studying how to design differentiated studies for kids with IEPs (individualized education plans). These professionals are employed full-time at local school districts, but are contracted by TWC to develop individualized lesson plans specifically for each of our students.

No More Battling With the School District to Do What’s Right for Your Child

“Part of the reason I decided early on to prioritize special education alternatives and supports at my clinic was because I had heard so many horror stories from parents who had been battling for years with their child’s school district to get even basic accommodations – let alone the tools they needed to thrive,” Therapy & Wellness Connection Owner/Founder Jaclyn McClymont said. “I wanted to be a resource to help these kids and these families finally get the kind of individualized, enriching education experience that would allow them not simply to get to the next grade level, but to truly reach their best potential.”

Our Akron tutors provide a safe, supportive environment that balances learning with fun and opportunities to more actively learn through discovery and exploration, rather than requiring them to sit still and stare at a chalkboard all day.

We teach kids of all ages and all abilities, allowing them to learn successfully at their own pace. We use lots of visual calendars, songs, graphic organizers, etc. Tasks get broken up into smaller, more manageable components that optimize both success and retention.

If you have questions about our services, we’re happy to provide answers & insight!

Additional Resources:

Frequently Asked Questions About Homeschooling, Ohio Department of Education

More Blog Entries:

How Brecksville Homeschooling Can Benefit Kids With Special Needs, September 2020, Akron Tutors and Alternative Homeschooling Blog

Cleveland ABA therapists teach kids hygiene skills

How Our Cleveland ABA Therapists Teach Kids With Autism Personal Hygiene Skills

Most kids struggle at first with independently maintaining good personal hygiene. Kids on the autism spectrum may have a tougher time with it than most. Our Cleveland ABA therapists can help.

It’s important to understand why kids on the spectrum might have more significant difficulties with things like handwashing, teeth-brushing, and washing their body in the bath or shower. Much of it relates directly back to their diagnosis. Some of the skills needed to independently maintain one’s hygiene include:

  • Fine motor skills.
  • Time management/organization.
  • Attention to a non-preferred task.
  • Executive/cognitive functioning.
  • Sensory regulation.
  • Receptive language skills (understanding the directions being communicated with them).
  • Ability to follow multi-step directions.

Some of the key personal hygiene skills we really want kids to master (even if they take some additional time to do it) are:

  • Cleaning/brushing one’s hair.
  • Handwashing.
  • Nose blowing.
  • Toilet training.
  • Oral hygiene (teeth brushing, mouth washing, floss, dental checkups).
  • Nail care (trimming and cleaning fingernails and toenails).
  • Skin care (may vary from child-to-child).
  • Managing periods (for those menstruating).

These are things many of us adults simply take for granted as being simple, everyday chores we don’t think twice about. However, when you truly break each one down into all the individual steps – from recognition of an issue to proper completion – these tasks are more complex than they initially seem.

We like to try working with kids on the spectrum at a very young age on these issues because the earlier we start, the greater their self-sufficiency by the time they reach their teens. Not only is good personal hygiene vital to one’s health and well-being, but poor hygiene is a social stigma that can quickly lead to a child becoming socially ostracized.

Depending on the severity of their condition, your child may continue to need assistance with certain personal hygiene tasks even as they get older. However, the more independence they can gain, the better off they will be in the long-run.

Cleveland ABA Therapists Use “Chaining” to Teach Hygiene Skills to Kids With Autism

Our primary approach when we’re working to teach kids on the autism spectrum how to maintain their personal hygiene is a behavioral therapy technique called “chaining.” It involves breaking down a certain skill into the very smallest parts possible, teaching those skills independently, and then “chaining” them together.

For example, let’s say we’re trying to teach toothbrushing. Kids with autism may have strong sensory aversions to having bristles and toothpaste in their mouth – or even near their face. What we may do is start by working with them just to touch the toothbrush. Eventually we’ll work our way up incrementally to get them comfortable with having the toothbrush in their mouth. Then with moving it around. Then with a little toothpaste.

When we start with the smallest components of a task, it gives the child real success – and confidence – every time they master each little step.

Parent Practice for Personal Hygiene

Lots of parents will prefer to handle certain personal hygiene skills like bathing and toilet training at home. Our Cleveland ABA therapists can help coach parents through these processes, providing tips, visual supports, and reinforcement during our sessions.

Some basic tips we have:

  • Create daily routines. When kids know what to expect, they have an easier time engaging in a task, even if it’s not preferred. Kids on the spectrum especially thrive on routine. Ensuring when possible that these tasks are done at the same time in the same order with the same tools will allow the child to stay better regulated during these tasks and offer more opportunities to practice.
  • Use visual supports. These would be pictures that represent a certain activity, routine, or schedule. If they can read, their might be large, bold, simple text. Visual supports help to create structure and guidance and can reduce anxiety, frustration, and challenging behaviors. Our ABA therapy team can also help parents create a “social story” that the child can read throughout the day or week to help reinforce the lessons you’re trying to teach.
  • Prompting and fading. Prompts are actions that help a child complete a certain task or demonstrate a certain behavior. Prompts can be a verbal instruction or a physical gesture or a visual support. You might start off with a lot of prompts early on when you’re first trying to teach a skill. Then later, as the child begins mastering certain key elements of the task, you can start to “fade” those prompts.

If you are struggling to help your child with autism master certain personal hygiene tasks, our Northeast Ohio ABA therapy providers can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Brecksville-Broadview Heights, Cleveland, Akron, 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 Approach to Cleanliness Training to Support Bathroom Hygiene among Children with Autism Spectrum Disorder, February 2018, Behavior Analysis in Practice

More Blog Entries: Stimming with Autism: FAQ With Our Cleveland ABA Therapists, July 24, 2022, Cleveland ABA Therapy Blog

Cleveland feeding & swallowing therapy

Early Intervention Cleveland Feeding & Swallowing Therapy Boosts Long-Term Prognosis

Children with feeding and swallowing disorders are at high risk for substantial health, learning, and social challenges. But when treated early with Cleveland feeding & swallowing therapy in a speech therapy clinic, kids can overcome their unique difficulties and go on to thrive.

As explained by the American Speech-Language and Hearing Association, feeding disorders include problems with sucking, chewing, eating from a spoon, or drinking from a cup. Swallowing disorders (formally known as dysphagia) involve trouble moving liquids or foods from the mouth to the throat, esophagus and/or stomach. Issues can also be the result of sensory processing difficulties, which can lead to extreme food aversions, based not just on taste, but texture, temperature, smell, and visual appearance. Kids with autism especially struggle with this.

Cleveland feeding & swallowing therapy can help to treat these disorders, which often stem from other medical conditions like prematurity/low birth weight, reflux, breathing issues like asthma, cleft palate or lip, muscle weakness in face/neck, certain medications, and conditions like Down’s Syndrome, cystic fibrosis, cerebral palsy, and meningitis. Sometimes, though, feeding and swallowing problems have no clear cause at all.

Some telltale signs intervention may be needed are when the child:

  • Isn’t gaining weight or growing.
  • Refuses to eat or drink.
  • Cries, fusses, or arches back when feeding.
  • Spits up or throws up a lot.
  • Has difficulty breathing when they’re eating and/or drinking.
  • Coughs or gags when trying to chew.
  • Has a raspy voice or gurgles during or right after meals.

When Cleveland feeding & swallowing therapy is recommended, it’s typically administered by experienced speech-language pathologists. Our overarching goal is going to be facilitating and supporting safe and adequate nutrition and hydration for each child. We are specially trained to:

  • Evaluate whether the child’s chewing skills are developmentally appropriate and if they’re moving their tongue correctly.
  • Help babies improve the ability to suck from a bottle, drink from a cup, or coordinate simultaneous breathing and eating.
  • Help older babies and toddlers learn to chew properly and feed themselves.
  • Encourage a more varied diet by creating a fun, positive, safe environment where we slowly introduce new foods, tastes, textures, and smells.

The duration and frequency of feeding & swallowing therapy will depend on the child, with special considerations for their age, attention level, degree of impairment, cognitive function, physical abilities, and family schedule.

In some cases (particularly for kids with complex feeding problems), we may need to incorporate an interdisciplinary approach, meaning we collaborate with a team of professionals from experts, from ENT doctors to occupational therapists to nutritionists.

Therapy & Wellness Connection – your connection to a life without limitations – provides speech therapy and feeding & swallowing 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:

Feeding and Swallowing Disorders in Children, ASHA

More Blog Entries:

Akron Speech Therapy Treatment for Tongue Thrust, July 10, 2022, Cleveland Feeding & Swallowing Therapy Blog

Akron speech therapists learning disabilities

How Akron Speech Therapists Can Help Kids With Learning Disabilities

Learning disabilities are disorders that impact one’s ability to:

  • Understand or use spoken or written language.
  • Complete mathematical calculations and equations.
  • Coordinate movements.
  • Direct attention.
  • Engage in higher-level skills like time planning, abstract reasoning, organization, and long/short-term memory.

The term “learning disabilities” isn’t a singular issue or disorder, but rather a catch-all for more specific conditions, such as dysgraphia, dyslexia, ADHD, etc.

Because all this can have a negative impact not only in academics, but on social relationships, it’s important for parents and caregivers to reach out for help – the sooner the better. This may include tutoring and other educational supports. In some cases, speech therapy and occupational therapy can help too.

As our Akron speech therapists can explain, a learning disability does not necessarily mean a child has a low intelligence quotient (IQ). In fact, most people with learning disabilities are either average or above-average intelligence. (This is part of what sets these kids apart from those with a global developmental delay.) conditions stem from genetic and/or neurobiological factors that impact brain functioning to the extent that one or more cognitive processes related to learning are impeded.

Kids with learning disabilities tend to have unexpected underachievement, despite receiving a lot of support. Their conditions are life-long, but the earlier we can intervene, the greater likelihood we can help redirect those neuro pathways in the brain.

Using evidence-based techniques, our speech therapists will identify the different language-based skill deficits (i.e., oral language, information processing, attention, memory, reading, and writing) and engage the child in various exercises (in the form of games) to help boost their performance in ways that carry over to the classroom.

Consistent, early intervention speech therapy can help kids with different learning abilities become more capable of receptive language (understood what’s being communicated with them) and expressive language (communicating with others).

Occupational therapy can help in these areas too, as well as practicing things like organization skills, attention and self-regulation, and handwriting. We also offer social groups for kids of all ages to provide more opportunities to practice social-emotional learning. Where it is beneficial, we may also recommend classroom adaptations to better accommodate the child’s learning style.

It’s long been the motto of our therapists and homeschool educators and tutors at Therapy & Wellness Connection that if kids aren’t learning the way we teach, we need to teach the way they learn.

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:

Types of Learning Disabilities, Learning Disabilities Association of America

More Blog Entries:

Why Our Cleveland Speech Therapists Teach Kids How to Make Inferences, June 14, 2022, Akron Speech Therapy Clinic Blog

Cleveland ABA therapists

Stimming with Autism: FAQ With Our Cleveland ABA Therapists

Our Cleveland ABA therapists are far from the only ones who are well-informed on the fact that restricted interests and repetitive behaviors are among the primary criteria for defining autism in diagnostic criteria. What is less common knowledge, however, is the fact that this can encompass a very broad range of traits that can appear in a vast array of varying combinations and with different levels of severity. Stimming, a common behavior among people with autism, can be generally be understood as a form of repetitive behavior – but it gets a little more complicated than that. And understanding WHY people do it is important to informing how we approach it in therapy, at home, at school, and in everyday life.

Repetitive behaviors are among the first to appear in very young children with autism. They’re often apparent for people across the spectrum, but they may be more obvious or pronounced in those with cognitive deficits. However, they are less studied (and therefore less understood) than the other primary identifier of autism: Social and communication difficulties.

What Exactly is Stimming – and How is it a Repetitive Behavior?

Stimming can be thought of as a subset of repetitive movements.

It can involve things like:

  • Spinning
  • Flapping hands
  • Snapping or flicking fingers
  • Twirling
  • Rocking
  • Repeated verbalizations
  • Fiddling with objects

They’re categorized as a repetitive behavior because the person engages in them over and over again in a given time or place.

Does Stimming Behavior Have a Function?

The word “stim” is short for “self-stimulatory behavior.” Some Cleveland ABA therapists and other professionals shy away from categorizing the function as solely self-stimulatory, there may be intensified pressure on the person with the diagnosis to suppress them. And this may not be a good thing because, as people with autism will often say themselves, stimming can serve important functional purposes to their own mental health and physical well-being.

This is important to note because historically, parents, teachers, and others have labeled stimming behaviors as “disruptive” or “inappropriate.”

But there’s a growing body of evidence that stims can help people with autism relieve themselves of sensory overload. In turn, this helps them better cope with intense anxiety, avoid meltdowns, and express their emotions.

Others say that engaging in stimming helps them to generate or hang onto a sense of body awareness. It may also help them focus their concentration when they’re feeling otherwise overwhelmed. Further, it may be a means of communicating their emotional or mental state to others when using words to do so is difficult.

So forcing kids not to engage in stimming may be unhealthy, ultimately causing more harm than good.

Of course, different people on the spectrum may have different purposes for different stims – and it may even shift from time-to-time in the same individual, depending on what’s happening around them.

In some cases, it can be harmful to themselves or others. For instance, if a repetitive behavior stim involves banging their head against a wall, that can’t continue.

There is also, of course, the potential for social alienation or academic/professional consequences for engaging in stims.

Should I Be Encouraging or Suppressing My Child’s Stimming?

This answer to this question truly comes down to the behavior, the individual, and the setting.

Years ago, the common consensus was to eliminate these behaviors – sometimes in ways that were extreme (and often incredibly harmful) such as powerful antipsychotic drugs or physical interventions.

It’s really important for parents, teachers, Cleveland ABA therapists to come together as a team to discuss whether certain stimming behaviors truly need to be addressed, or whether there’s an opportunity for better education/awareness/accommodations in service of what’s best for the child.

When there is a repetitive behavior stim that appears to be disruptive or if it’s preventing the person from participating in meaningful activities, educational opportunities, or relationships, then we may want to start by analyzing the function of that behavior. From there, we can figure out if there’s a way to help them meet their needs or serve that function without impeding their everyday lives.

For example, let’s say the stim is spinning in circles and it’s preventing a child from participating in their preschool class instruction and it’s disrupting the other students. We study the “why” of the behavior, and determine it’s helping the child to soothe their anxiety when their in the classroom and feeling overstimulated. We may be able to suggest another calming action or behavior that they can engage in that is less disruptive. Sometimes, having regular movement breaks and sensory input can help reduce this anxiety/need for the stim in the first place.

In that scenario, we do not categorize the stim as “bad.” In fact, we recognize it’s serving an important purpose. We respect and meet the needs of the individual with an alternative that helps them to still engage in their daily lives and avoid adverse consequences to their education and peer relationships.

If you have questions about your child’s stimming or how to handle it, our dedicated Cleveland ABA therapists can help.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Brecksville-Broadview Heights, Cleveland, Akron, 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 Stimming: Repetitive Behaviors with a Purpose, Dec. 7, 2020, American Psychiatric Association

More Blog Entries:

5 To-Dos After Cleveland Autism Diagnosis, May 13, 2022, Cleveland ABA Therapy Blog

Ohio kindergarten readiness

Ohio Kindergarten Readiness Skills: Is Your Child Developmentally Ready?

Kindergarten is the new first grade. At least that’s been the conclusion after research the last few years into Ohio kindergarten readiness and standard developmental milestones that public schools expect kids to have by the time they start school.

Our Cleveland occupational therapists and homeschool teachers at Therapy & Wellness Connection are familiar with this research, including a longitudinal study that came out more than a decade ago compared kindergarten readiness standards in 1998 to those in 2010. They found that the standards for entering kindergarten in 2010 were on par with what was expected of first-graders in the 1990s. For example, in 1998, about less than one-third of teachers thought their students should know how to read entering kindergarten. By 2010, that figure jumped to a whopping 80 percent. Researchers expressed astonishment at the magnitude of changes in classroom expectations just in this 20-year window.

Standards for Ohio kindergarten readiness have only continued to climb. It’s one of the reasons our occupational therapists and intervention specialists are such ardent preachers of early intervention therapies if it appears a young child is falling behind developmentally. The sooner developmental delays and issues are addressed, the less farther behind they will continue to fall. They won’t have as much “catching up” to do by the time they reach kindergarten age.

Ohio kindergarten readiness speech therapists Cleveland occupational therapists

What is Required for Ohio Kindergarten Readiness?

Every year, public school districts are in the Buckeye State are required to administer the Ohio Kindergarten Readiness Assessment Revised (KRA-R) to all first-time kindergarten students at the start of each school year. The test is not traditional pencil and paper, but rather looks at the child’s knowledge and abilities across four areas: Language and Literacy, Mathematics, Physical Well-being and Motor Development, and Social Foundations.

Some of what proctors are assessing:

  • Language and Literacy: Make predictions/ask questions about the text of interactive read-alouds after looking at the title, cover, illustrations/photos, graphic aids or texts.
  • Math: Count to identify how many objects in a set, compare categories with comparisons vocabular (greater than/less than, same/equal to, etc.).
  • Social Skills: Can interact with peers in pretend play, plan and coordinate roles and cooperation.
  • Physical Well-Being and Motor Development: Demonstrate locomotor skills with control, coordination, and balance during active play (hopping, jumping, running, etc.)

Your child’s scores on this test are going to determine how ready they are for kindergarten instruction, though it can’t be used to prohibit them from starting. But kids who develop stronger age appropriate behaviors, skill, and knowledge when they start kindergarten are going to be more likely to excel on their academic track.

Developmental Milestones to Pay Attention to as Your Child Approaches Kindergarten

Developmental delays of all ages should be promptly addressed at the time you notice them, some developmental milestones you should pay careful attention to as your child reaches kindergarten age:

  • Do they speak clearly? Kids need to have a base-level of communication in order to thrive in kindergarten. They need to be able to articulate their thoughts clearly and be able to understand when others are communicating with them. Not only will this help academically, but will help them to form stronger connections with their peers. If your child is approaching kindergarten and struggles forming sounds or words, seems confused when directions are given, doesn’t ask questions like other kids their age, or otherwise seem delayed, they may need some additional help. Speech-language disorders are pretty common around preschool age, but it’s a good idea to seek a consultation with a speech therapist if this is the case.
  • Do they understand questions? It’s important that kids are able to understand how to ask basic who-what-when-where-why questions, and be able to answer them in return.
  • Do they recognize their numbers and letters? They don’t necessarily need to have a mastery of the alphabet or be doing algebra, but schools will typically expect them to know how to count to 10 and understand basic math concepts (greater/less than, etc.). And they should be able to recognize most letters and associate sounds with some of them.
  • Do they understand the basic concept of time? This is a tough one for a lot of kids, but it’s not really about being able to tell time. Your child should, however, have a basic understanding of before, now, soon, yesterday, tomorrow, later, etc.
  • Can they tell a story? They’re not expected to be little Shakespeares, but they should be able to tell simple stories with what most would recognize as a beginning, middle, and end.
  • Can they recognize patterns? Can they recognize patterns in shapes, sizes, numbers? This will be important to basic math concepts.
  • Do they have basic fine motor skills? They don’t necessarily need to know exactly how to hold a pencil and write when they enter kindergarten, but they should be able to pick up a marker and reliably make marks on the paper. If your child is struggling with these skills, take time to practice with them every day – coloring, using utensils, pouring juice, etc. to help them build up their muscle strength and coordination. (There are TONS of fun crafts too that require fine motor skills that you can incorporate too. The more fun you make it, the faster your child will learn!)

Keep in mind that all kids develop at different rates. If your child hasn’t reached every single milestone, that’s Ok. A little extra practice may go a long way. But if you find they’re still struggling the closer you get to kindergarten age, you may want to talk to your pediatrician about a consultation with a speech therapist and/or occupational therapist to help bolster these skills. We want them ready to take on the world!

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:

Ohio Kindergarten Readiness Assessment, Ohio Department of Education

More Blog Entries:

Late Talkers” Who Get Early Intervention Speech Therapy Have Better Long-Term Outcomes, April 13, 2022, Cleveland Speech Therapy & Occupational Therapy Blog