We’ve all felt the implications of poor sleep before. For example, you may have felt irritable, less focused or even a little sick as a result. However, while this is an occasional issue for most of us, children (and adults) with autism and related disorders often find it harder than most to get enough sleep.
The National Sleep Foundation states that children should sleep for 9-11 hours a day, depending on their age. As an adult, we should aim for around 7-8 hours of sleep in order to thrive.
Various studies have determined that “children with ASD have a higher prevalence of sleep issues than their typically developing peers.” For example, they are more likely to develop insomnia and similar conditions. In fact, “ children with autism tend to sleep 32.8 minutes less per night than their peers”. While this may not seem to be a significant difference, an extra thirty minutes of deep sleep can work wonders for their mood and overall health.
Develop a consistent bedtime routine. Children with ASD thrive when they’re given a routine to work with, as they provide them with a sense of structure and stability. As a result, a bedtime routine can be instrumental in helping them unwind and get ready for bed. This could also mean they find it easier to drift off, especially if their head hits the pillow at the same time each evening.
Keep their bedroom cool. We all like to feel warm and cozy as we settle into bed, particularly during the winter months. However, a cooler “sleeping environment helps lower your body temperature, making it easier to experience deep sleep.” This, coupled with the fact that children with ASD are often rather sensitive to heat and temperature changes, means you should try to keep their bedroom as cool as possible.
Reduce noise. We’ll all struggle to fall asleep in noisy environments, but it can be particularly hard for children with noise sensitivities to drift off. As a result, you should find a way to make their bedroom as quiet and peaceful as possible. For example, you could take steps to soundproof their room or find comfortable earplugs they can wear at night.
Focus on their comfort. Adjusting their bedroom to match their comfort needs could also be a crucial step in ensuring your child is able to get as much sleep as possible. For example, while some children may need complete darkness in order to sleep, others may find comfort in having some kind of nightlight in their rooms. You should also try to choose bedding and pyjamas that are comfortable and don’t interfere with any sensitivity issues your child experiences. For example, you may need to avoid certain fabrics or textures, as this will otherwise limit their ability to sleep comfortably.
Discuss sleep patterns in therapy. Therapeutic interventions are a great way to help children with autism thrive in their daily lives. As a result, your therapist will likely also have some advice to hand that you can use to ensure your child is getting their recommended 9+ of sleep each night.
Get in touch today to find out more!
Often considered the sixth sense, proprioception is essential for body awareness and movement. The sensory receptors are in the muscles and joints. These receptors send messages to the brain about body positioning and the direction and strength needed for a particular movement. For example, how to precisely stack blocks without knocking them over or pouring water from one cup to another.
Development of the proprioceptive system began when your child was still in the womb. Early activities like skin-to-skin contact, tummy time, shifting weight all help babies understand where their body is and how it moves. As children develop and participate in increasingly complex activities, feedback from their proprioceptive system is essential to their success.
While all children benefit from heavy work, your child may especially make gains from activities that provide proprioceptive input if he or she:
-Is constantly on the move: Jumping, bumping, and crashing.
-Frequently knocks over construction projects such as blocks or magnetic tiles.
-Constantly seeks out bear hugs or is too rough with friends.
-Rips paper or breaks writing tools when writing or coloring from using too much force.
-Bumps into peers or furniture regularly.
Obstacle courses- Climb, crawl, hop, march. Use equipment or furniture that you already have. Place a puzzle piece at the beginning, and each time your child goes through, they will collect pieces to put together at the finish.
Hopscotch- As a bonus, this is an outstanding balance and motor planning activity. If your child is old enough, let them sketch out the board. Using chalk on the rough surface tar will also provide proprioceptive feedback.
Pull, push, or carry- Let your child pull a sibling in a wagon, push furniture, or bring a stack of books from one room to the next.
Complete chores- A great way to get consistent proprioceptive input is to build it into a routine. Designate a task for your child that involves heavy work. It could be pushing the chairs in after each meal, vacuuming, or wiping down the table. Let your child be in charge of bringing in groceries from the car or moving the laundry basket.
Try a sport- Many sports are great for getting heavy sensory input. Swimming, soccer, football, track, basketball, and gymnastics are sports children who seek proprioceptive input tend to seek out.
Chew- There are many joints and ligaments (and therefore sensory receptors) in the upper and lower jaw. Have your child eat something crunchy or try a ‘chewy’ for stimulating oral motor input that doubles as regulating.
Animal walks- Try bear walks, frog jumps, crab walks, donkey kicks, and crawling. Let your child make up new animal walks to practice forming a new motor plan while getting the proprioceptive work in.
Squishes- Get comfy laying on your belly under a weighted blanket, couch cushion or provide pressure with an exercise ball. Let your child determine the amount of pressure they want and let them read or color while they relax.
Children with autism spectrum disorder, attention deficit disorder,andother developmental delays often have professionals of all different backgrounds providing strategies for their success. While occupational, physical, and speech therapy, special education, and applied behavior analysts have different focuses, these professionals often use the same foundations to help kids learn and grow. Read on for the most common behavior strategies that the whole team uses:
Teachers and parents use positive reinforcement with both neurotypical children and kids with disabilities for a valid reason. Their developing brains make stronger connections with positive reinforcement than negative. Try to catch them at their best, whether by saying hello to a friend, listening to your message, or trying something new without getting frustrated. Recognize and praise their behavior. Therapists and educators are as specific as possible with praise and positive attention based on what the child can comprehend.
It is helpful to remember that little ones lack the time and experience to understand what you expect of them. This goes for daily routines but is even more evident when children are in a novel situation. Communicate expectations to them by sharing what you want them to do (“let’s sit by a friend during snack for five minutes”) rather than the behavior you want to avoid (“we don’t take our friend’s snack.”)
This strategy is enormously helpful because it can be used before, during, or after a behavioral incident. As an adult, you know what is best for the child at a given moment. Based on that, offer the child two choices that would be appropriate for the situation. It can be as simple as “would you like the blue chair or the green chair?” The ability to make a (supported) decision empowers children, even amid a meltdown.
We wouldn’t expect most adults to be able to engage in a complex task when they are in a busy and loud office and haven’t had a break in several hours. However, we too often expect the equivalent out of children and adolescents. All children have sensory preferences that can enhance or discourage their learning behavior at a given time. Whether it is a speech-language pathologist helping a child learn to communicate their needs, or a BCBA assisting a child in attending at circle time, the environment plays a significant role in children’s behavior. If you feel dysregulated in the space as an adult, the child likely feels the same. Educators and therapists modify the environment by adding quiet areas, access to noise-canceling headphones, adding movement breaks, having the child sit near the teacher, dividing the class in half for certain activities, etc.
Modeling the correct behavior can be challenging in the heat of the moment. However, you may notice that the most experienced therapists and educators remain calm and collected during a behavioral episode. They realize that the child will become even more dysregulated if they become elevated. Try using a quiet voice, breathing deeply, and being present without outwardly judging the behavior. Sometimes, this strategy alone can help a child refocus.
The vestibular system, located in the inner ear, gives us information about how our head is oriented in space and is essential for balance. The vestibular system is closely linked to the visual system and postural control. Some children experience challenges related to the development of this system, and it may reflect in their poor balance, frequent movement-seeking behaviors, or reluctance to participate in activities that involve positional changes. Input to the vestibular system is often organizing, and effects of stimulation can last for up to eight hours!
Occupational therapists provide interventions that develop the vestibular system to help children fully participate in movement activities, whether they:
Seek vestibular input- These children love to spin, swing, and be on the move.
Have postural control challenges- Postural challenges are indicated by frequent leaning, falling out of a chair, or a child resting their body on a table surface.
Are over-responsive to vestibular input- Children in this category may be fearful of swinging, get carsick, and dislike climbing stairs.
Have perceptual challenges- Children who often appear uncoordinated or have trouble timing the movement of their body to music (such as during circle-time songs) may fall into this category.
Since there are a variety of dysfunctions possible within the vestibular system, it is best to get an occupational therapy evaluation when there are concerns. This system can be easily overloaded for over-responsive children, resulting in nausea for a prolonged period. Occupational therapists provide services and ideas for carryover in various settings so that children can be exposed to activities both in and outside of the school or clinic setting.
Playgrounds have built-in structures that are perfect for getting vestibular input. Slides provide an opportunity for children to both climb and descend in a smooth movement. Many play areas have various swing choices, giving children a chance to sit or lay down (as in a tire swing). Both spinning for a short amount of time and pushing back and forth can provide organizing input. Monkey bars work well for both climbing and hanging upside-down- an impactful way to change the position of the head.
Are you thinking it may be challenging to carry over vestibular work at home? Try this! Allow your child to sit on the couch and then hang their upper body upside-down off of it. It gives the same impact as hanging off of monkey bars and may even be more accessible to little ones who are not fond of heights. If you have an office chair on wheels, let your child explore spinning on it. Be sure to allow them to turn themselves so that they remain in control.
Children naturally work on developing their vestibular system in outdoor spaces. Climbing up rocks or hills, log-rolling down a grassy hill, or practicing somersaults or cartwheels can all be done without special equipment. Jump-roping, riding a bicycle, and rocking on a porch swing, are also organizing activities children can do outside.
OT clinics have special tools that can target a child’s specific vestibular system needs and build skills in other identified areas of need at the same time. In these spaces, you’ll often find climbing equipment, scooter boards, balance beams, a variety of different swings, spinning boards, and more.
Special and general educators carry many roles, including observing child development from many different perspectives. A teacher may refer a student for a speech evaluation, cognitive testing, or a behavior assessment. While these performance areas seem distinct, teachers are often uncertain if they should refer a child for physical or occupational therapy since there is sometimes overlap between the two professions.
Both occupational and physical therapists are licensed professionals who graduated from an accredited program (occupational therapy is an entry-level master’s or doctorate, and physical therapy is a doctoral-level degree). In a school setting, occupational and physical therapy are added to a qualifying child’s plan to support their educational outcomes. For example, suppose a child has an abnormal gait pattern but can still navigate their classroom environment safely and efficiently. In that case, they may not qualify for school-based physical therapy.
Note: If a student’s occupational or physical therapy needs do not involve their ability to access their education, they may be a better candidate for outpatient therapy.
A physical therapist (PT) evaluates and treats a student’s physical motor skills. After evaluation, a physical therapist creates a plan of care and works with students to improve motor skills. A physical therapist may recommend adaptive equipment to enhance students’ ability to access their motor skills in the classroom. Examples of physical therapy intervention may include:
An occupational therapist (OT) also evaluates and treats students, but instead of focusing on physical motor skills, they support participation in meaningful activities. During the school day, activities might include lessons, lunch, social participation, transitions, specials, and more. An OT creates an intervention plan to build student skills, change the activity, or modify the environment for successful student participation. Some examples of occupational therapy intervention include:
Still unsure about where to send the referral? Each case is unique and some students benefit from both disciplines. Touch base with your special education director, physical or occupational therapist to discuss an appropriate evaluation.
At the Kioko Center we are passionate about providing the very best OT therapy and SLP therapy services for children and young adults. We serve the schools, therapists, and families that support them. We are a pediatric therapy organization that specializes in occupational therapy and speech therapy. Our multidisciplinary, holistic approach gives each child the best chance to realize their full potential.
Whether it be talking with co-workers around the water cooler, saying “I love you” to your spouse, sharing a joke with your neighbor, texting your brother, or sending an email to your boss, people love to communicate, it’s what we do. Communication, in all its forms, is what creates and maintains the bonds and relationships in our lives, and the ability to communicate is what defines us as being human.
Communication can be divided into three main categories: comprehension, expression, and production. Comprehension or receptive language is the ability to receive a message from someone and understand the meaning of that message whether it be spoken, written, or via gestures such as American Sign Language (ASL). Expression or expressive language is the ability to send a meaningful message to someone verbally, in writing, or by using gestures. An additional goal of expressive language is that it is socially appropriate, which means knowing what and how to say something in a given circumstance. Speech-language pathologists (SLPs) refer to the social part of language as pragmatic language. Production is how the message is created. With speech, we can think about fluency, speech sounds, and their sound quality or intelligibility. With writing, we can look at legibility, and with signs, you can think of well-formed readable signs. The goal of production is that the person you are trying to communicate with can understand your message. When something interferes with somebody’s receptive language, expressive language, pragmatic language, articulation, fluency, voice quality, or even swallowing, speech therapy can help a person to improve both communication and swallowing.
Speech therapy aims to improve a person’s communication. Speech-Language Pathologists (SLPs) are professionals who specialize in speech-language therapy. They must go through a rigorous university program, get a master’s degree, complete a 9-month clinical fellowship year (CFY) where they are under the supervision of a senior speech-language pathologist (SLP), get credentialed by the American Speech-Language-Hearing Association (ASHA) and then get their state license to practice. If you or a loved one is seeking speech therapy please make sure that the person you are considering has ASHA certification and state licensure for the state you live in.
A speech-language pathologist (SLP) will first conduct a speech-language evaluation for the client to identify how to best address the complaint. Once the evaluation is completed, the SLP will explain the results to the client or caregiver and develop a treatment plan. A treatment plan will contain goals and objectives that are created specifically for the client, explaining exactly what the client and SLP will be working on.
By completing a thorough speech-language evaluation the SLP determines what kind of speech-language difficulty the client has and the best treatment method to address it. SLPs work in a variety of settings including schools, clinics, and hospitals. In schools, SLPs work with children mostly in small groups or the classroom. In clinic and hospital settings, speech-language therapy is usually provided by the speech-language pathologist (SLP) to one client at a time.
The first goal of every speech-language pathologist (SLP) is to create a relationship or “build rapport” with the client. It’s essential that the SLP has patience, empathy, and caring for the client they are working with to help the client make the most progress possible. Most oftentimes speech-language goals are not achieved overnight, therefore the SLP needs to be respected by the client to get through the tough work that is speech-language therapy.
Practice is the ultimate treatment for speech and language disorders. If a child has difficulty with articulation, the speech-language pathologist (SLP) will spend time teaching them how to produce the correct sounds. The speech therapist will make the sounds and encourage the child to learn to imitate them.
That entails mimicking the speech therapist’s (SLP) movements of the lips, mouth, and tongue to produce the desired sound. Mirrors can be useful in this situation. The SLP can instruct a child to make these speech sounds when looking in the mirror. Speech therapists find this process more enjoyable when using games.
SLPs employ techniques that are adapted to the specific needs of each child. Some of the techniques are:
Speech and language are essential to the human experience. Speech therapy can help people improve their communication skills which will improve their overall life experience. While speech-language therapy typically is not a “quick fix”, through consistent speech therapy sessions with an ASHA certified speech-language pathologist, amazing, life-changing progress can be made.
Speech-language therapy is recommended for almost everyone diagnosed with an autism spectrum disorder. This makes sense because most children with autism have impaired communication that requires assistance. Even those with high functioning autism can benefit from speech-language therapy.
Speech therapy is the treatment of speech and communication disorders; thus, it is a broad field. Speech therapy may assist children with stuttering or lisps in accurately pronouncing words. Speech therapy also helps children with developmental disabilities in understanding and using spoken language in a social environment.
A certified speech-language pathologist (SLP) is a communication specialist who must have a master’s degree. That professional may work in a private setting, a clinic, a school, or an institution, or as part of an educational team. They employ various tools and therapies, including toys and play-like treatment, as well as formal tests and speech curriculum.
Autism spectrum disorder is most commonly identified in early childhood, while communication abilities are still developing. To varying degrees, the condition makes it difficult for children to communicate. Some children may not speak or have limited speaking ability, while others communicate in great depth about specific topics.
According to studies, two out of three children with autism improve their communication abilities and understanding of spoken language when identified early and receive appropriate treatment. According to research, those who receive ongoing speech treatment are more likely to progress
Speech therapy can help children with autism improve their spoken language, enhance nonverbal abilities, and learn to communicate in new ways. SLPs can teach parents how to improve their child’s communication skills in various ways that are suited to the child’s abilities, communication situations, and family requirements.
For children with ASD, there are a variety of evidence-based treatment options, including Augmentative and Alternative Communication (AAC), activity schedules/visual supports, computer-assisted learning, video-based instruction, behavioral interventions, cognitive behavioral therapy, play-based interventions, social communication/social skills interventions, literacy interventions, relationship-based interventions, parent-implemented interventions and coaching and routines-based intervention.
Speech and language therapy is essential for children with ASD so that they may reach their potential. Speech-language therapy can be delivered to these children in person or online.
However, it is crucial to highlight that there are several advantages to delivering this service online since teletherapy provides opportunities that are not available with in-person therapy. Families can assure a favorable outcome with online speech therapy by considering the following factors:
Parent Coaching – Caregivers of children with ASD can learn to connect with their children by participating in online speech therapy. The SLP can collaborate closely with the family to create a treatment plan that includes tactics and activities for eliciting effective communication. The SLP has the advantage of working with the parent in their home environment. Furthermore, parents are their child’s primary educators from birth. It is highly beneficial to the child when their parents constantly repeat the same language modeled by their SLP.
Sensory Input – Many children with autism struggle to comprehend the sensory information they get from their surroundings. Changing the visual, aural, and tactile signals that a child receives increases their attention span and participation. Simple modifications, such as altering the lighting brightness or the volume of a video, may make a big difference in the quality of an online therapy session.
Use Real Objects – A common misperception that only digital items can be used in online therapy. The utilization of real objects in the environment will assist young children, especially those with ASD. This form of tangible learning is ideal for the development of functional communication in everyday situations like mealtimes. Your child’s SLP can educate you on utilizing toys, books, and ordinary things in your house to help your child learn new words.
Movement – Another misconception regarding online therapy is that a child must sit and pay attention in front of the computer for the whole therapy session. While attention is necessary, flexibility is critical. During therapy sessions, including movements into a language exercise, such as singing “Row, Row, Row Your Boat” while having the child motion and rock their body back and forth, helps enhance a child’s attention while also enhancing their language learning ability.
Children with autism experience speech and language impairments that range from mild social language impairment to entirely non-verbal. With that in mind, here are some speech therapy approaches available that your child’s SLP may teach you so that you can continue to work with your child at home..
Picture Exchange Communication System (PECS)
PECS is an AAC (alternative augmentative communication) method that teaches functional dialogue. PECS is a picture-based communication system for children with autism. The concept is that a child is encouraged to use pictures to ask for something and then trade them for what they ask. PECS can be a relatively simple way to begin; but, if the system works well for your child, you can add pictures and eventually build sentences. It can sometimes assist nonverbal children in developing their spoken language. Your child’s SLP will set up the system and guide the family with how to use it.
Play & Social Interaction
Play therapy is an excellent approach to encourage communication in autistic children. Play can assist children with autism in connecting with others and expressing themselves in meaningful ways. Basic floor time is a simple but effective style of play. To foster engagement, sit on the floor with your child and let them play with an object while replicating what they do. The goal is to build a game that you and your child could play back and forth to promote communication. To get their attention, you could play some enjoyable activities like blowing bubbles or rolling a ball. If they enjoy the game, they will try to communicate with you that they are enjoying it and ask for more.
Intensive Interaction Therapy
Intensive interaction is a technique of autism speech treatment that communicates through body language. The concept is that by monitoring and reflecting on the child’s behavior, the person participating in the intensive connection tunes the child in and builds emotional involvement. For instance, if your child moves, you imitate it or replicate it if they make an expression. With turn-taking and response, you should be able to create a connection and develop an interaction.
To summarize, speech therapy for children with autism provides a means to improve their communication skills. Families can get treatment for their children either in person or online. When looking for treatment, make sure you identify a speech-language pathologist (SLP) who is licensed, ASHA certified, and has experience with children on the autism spectrum. Your child’s SLP will work with you on developing an individualized plan to improve your child’s communication.
Online Certifications for Pediatric Occupational Therapists
In the past year, many special certification programs for occupational therapists have moved to an online platform. You can get access to excellent professional development without having to travel, miss work, or give up your weekend to participate in an engaging workshop! The following programs are offering the chance to get a specialty certification from the comfort of your own home.
Astronaut Training
Hone your sensory expertise by participating in an Astronaut Training workshop. The Astronaut Protocol involves the integration of the vestibular, auditory, and visual systems. The webinars are live and occur over the course of two consecutive days. Content includes an overview of pathways and functions of the related sensory systems, clinical observations, assessments, demonstrations, labs, and treatment planning. The registration price includes the protocol handbook and certification to immediately begin utilizing the program.
DIRFloortime
DIRFloortime is an evidence-based intervention strategy that allows parents, caregivers and professionals to build strong relationships to promote healthy child development. The model is comprehensive and has an emphasis on the child’s strengths and interests. To obtain a DIRFloortime Basic Certificate you must complete the DIR 201 course. The live online classes are available for different time zones with early morning and evening sessions available for busy professionals.
Learning Without Tears
The popular workshops for occupational therapists have moved online! Learning Without Tears (formerly known as Handwriting Without Tears) is now offering live virtual sessions for their handwriting workshops. Class topics include pre-writing, printing, cursive, hybrid handwriting instruction, and handwriting assessments. To become certified you will need to take four courses, complete an in-service presentation, take an exam and complete two case studies.
Therapeutic Listening
This live webinar will teach you how to implement Therapeutic Listening strategies into your everyday practice with a special emphasis on areas of sensory development, postural control, and respiration. The course content includes a review of anatomy and physiology, a look into current research, clinical case studies and problem solving. Certification is earned after successful participation in this course.
Board Certification in Pediatrics (BCP)
Do you have significant experience in the area of pediatrics? You may be ready to take the exam for board certification. Eligibility requirements for this AOTA certification include current certification, three years of practice in a pediatric setting, at least 3,000 hours of pediatric practice within the last five years, and at least 500 hours of providing direct occupational therapy to pediatric clients.
Certified Autism Specialist
Similar to AOTA’s board certification in pediatrics, the credential of Certified Autism Specialist is granted to professionals who have at least two years of experience working with the autism spectrum population, 14 related continuing education hours within the last two years, and pass a competency exam. A list of accepted CEUs that are available online and accepted for the certification are found here.
At the Kioko Center we are passionate about providing the very best OT therapy and SLP therapy services for children and young adults. We serve the schools, therapists, and families that support them. We are a pediatric therapy organization that specializes in occupational therapy and speech therapy. Our multidisciplinary, holistic approach gives each child the best chance to realize their full potential.
