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Toilet Training Sequence

Many children need support when learning new skills. Breaking a skill down into smaller steps can help a child learn one step at a time. The number of steps a skill or task is broken into depends on the needs of your child.

You may want to provide your child with a visual sequence. This is basically a series of pictures showing the steps that are necessary to complete a task. You can use real photos, line drawings, or picture symbols. When using a visual sequence, post it at your child’s eye level, point to the picture, and read the step out loud before completing the action.

You can also use the pictures to create a sequencing game of your own. Simply print the pictures, cut them out, and have your child practise putting the steps in order. You can also create a matching game by making two copies of the sequence. Glue one copy to a piece of construction paper in the correct order and have your child use the other set to match the cards.

Here’s an example of a ‘toilet training’ sequence

step 1 pull pants down

step 2 pull down underwear

step 3 sit on toilet

step 4 get toilet paper

step 5 pull up underwear

step 6 pull up pants

step 7 flush toilet

Brushing Teeth Sequence

Many children need support when learning new skills. Breaking a skill down into smaller steps can help a child learn one step at a time. The number of steps a skill or task is broken into depends on the needs of your child.

You may want to provide your child with a visual sequence. This is basically a series of pictures showing the steps that are necessary to complete a task. You can use real photos, line drawings, or picture symbols. When using a visual sequence, post it at your child’s eye level, point to the picture, and read the step out loud before completing the action. You can also use the pictures to create a sequencing game of your own. Simply print the pictures, cut them out, and have your child practise putting the steps in order. You can also create a matching game by making two copies of the sequence. Glue one copy to a piece of construction paper in the correct order and have your child use the other set to match the cards.

Here’s an example of a ‘brushing teeth’ sequence


1. Pick up the tooth brush


2. Wet the brush


3. Take the cap off the tube


4. Put paste on the brush


5. Brush the bottom row of teeth


6. Brush the top row of teeth


7. Spit


8. Rinse the brush


9. Replace the brush in the holder


10. Grasp cup


11. Fill cup with water


12. Rinse teeth with water


13. Spit


14. Replace cup in holder


15. Wipe mouth on towel


16. Screw cap back on tube


17. Place tube back in its place

Community Supports for Older Adults

The following listing is for community services and supports in the Toronto area, which welcome individuals with a developmental disability that are transitioning into older adulthood. This listing has been compiled for information purposes only. The programs have not been evaluated. Families/individuals are responsible for assessing each program to determine whether it meets their needs. Some of the programs have a fee for service.

Quickly navigate to a section:

Crisis Support
Senior-Specific Crisis Support
Community Programs
Senior’s Community Centre Programs
Day Programs and Drop in Centres
Home Care Services
Long Term Care Facilities
Volunteering
Accessible Parking and Public Transit

Crisis Support

If you need help in an emergency or you are in crisis:

  1. Visit your local emergency department or call 911
    • This is free from any pay phone
    • You don’t need to speak English to call
    • Translation is available in 140 languages
  2. Contact a general distress centre in Ontario near you (open 24 hours unless otherwise indicated)
    • Toronto Distress Centres: (416) 408-4357 or 408-HELP
    • Gerstein Centre: 416-604-2337 Languages – English, Mandarin, Cantonese
    • Telecare: 416-920-0497
    • Spectra Helpline: 905-459-7777 Languages – English, Punjabi, Hindi, Urdu, Spanish, Portuguese
    • Assaulted Women’s Helpline: 416-863-0511, Toll-free is 1-866-863-0511
    • Warm Line Progress Place: 416-960-9276 or 416-960-WARM, every day from 8pm to 12 midnight
    • Distress Centre Peel: 905-278-7208
    • Durham Crisis Line: 905-666-0483
    • Oakville Distress Centre: 905-849-4541

Senior-Specific Crisis Support

Crisis Outreach Service for Seniors (COSS)

Type of Service: Crisis Intervention
Contact Information: 416-217-2077
Location: City of Toronto
Hours: 9am to 5pm, 365 days a year
About:

  • On-call, free, mobile crisis intervention and outreach service for seniors who have suspected or diagnosed mental health concerns, including dementia, and/or addictions
  • Provides short-term response
  • Catchment: City of Toronto
  • Provides mobile crisis intervention and counselling to older adults, short-term intensive case management, harm reduction and concurrent disorders service, limited primary care and nursing, mental health and addictions assessment, counselling and referrals

Fee: No

Toronto Seniors Helpline

Type of Service: Crisis Intervention
Contact Information: 416-217-2077
About:

  • Specialized service for seniors in the Toronto Central LHIN area
  • Provides assistance in stabilizing age-related mental health and addiction crises, risk and safety assessments, immediate referrals to community mobile crisis units, and support for families and caregivers

Fee: No

Community Programs

Family Service Toronto

Type of Service: Community
Phone:

  • Office is 416-755-5565

Website: www.familyservicetoronto.org
Location: 202-128A Sterling Road, Toronto, M6R 2B7
About:

  • The Seniors and Caregivers program at Family Service Toronto can help with the challenges of growing older or caring for an aging loved one
  • Provides information and support needed to deal with issues such as overcoming isolation, caring for an aging parent, building closer ties with community, health concerns and more
  • Provides counselling (in person, by telephone, or, in exceptional circumstances, arranging for a home/community visit) on topics such as dealing with chronic or degenerative illness, stress in family relationships, bereavement, the uprootedness and difficulty of adapting to a new culture at an advanced age, caregiver stress, elder abuse, and more
  • Support groups and educational seminars available

Languages Available: English, Mandarin, and Spanish
Fee: No

Haven Toronto

Type of Service: Community
Phone: 416.366.5377
Website: http://www.haventoronto.ca/
Location: 170 Jarvis Street, Toronto ON
email: info@haventoronto.ca
About:

  • A seniors club for men over 50 that provides essentials for men of limited means
  • Provides services such as meals for $1.00, nursing care (free of charge and no OHIP card required), counselling and crisis support, educational and training workshops/programs, laundry and showers, mail, phone, and computer access, housing supports, emergency clothing and footwear, social and recreational activities, and daytime refuge

Fee: Depending on desired service, call for details

Senior’s Community Centre Programs

Community Centre Senior programs are revised each year. If you need an updated program guide, go to https://www.toronto.ca/ and in the search bar, search Toronto Fun Guide. Please note, that all of the programs listed on are for seniors specifically. Each community centre offers a wide range of recreation programs for the whole community.

If you need a caregiver to assist you with the community centre programs, call 311 and ask to register with “Adapted Programs and Integrated Services for People with Disabilities.”

If you need a discounted price because you are not over the age of 55, call 311 to start an account with “Welcome Policies”.
They will direct you to the proper office in your neighbourhood.

Scarborough District

Birkdale Community Centre

Address: 1299 Ellesmere Rd.
Phone: 416-396-4069
Cost: A $20 per year membership required. Classes are either free, or $25-$30 per class
Senior Classes: Dance, Card games, Fitness, Computer lounge, Crafts, Games, and much more. Programs are usually one day a week, for an hour for 12 weeks. A support person may be required. Will accept people under 65 for senior programs.

Burrows Hall Community Centre

Address: 1081 Progress Ave.
Phone: 416-396-4670
Contact: Lori Posner 416-396-5014 for further information
Fitness $37/10 weeks and Walking (1 hour free).
Programs are usually one day a week, for an hour (or more) for 12 weeks.
A support person may be required.

Centennial Recreational Centre

Address: 1967 Ellesmere Road
Phone: 416-396-4057
Cost: $48-$53 for 9-10 weeks (prices may change)
Open swim: Monday 9:30-10:50am, Tuesday 9:30am-10:30am, Wednesday 11:00am-12:00pm, Thursday 9:30am-10:30am, Friday 9:30am-10:30am.
Seniors shallow water work out: Wednesdays at 10:45am-11:45am and Thursdays at 10:45am-11:45am, and 3:00pm-4:00pm.
A support person may be required.

Don Montgomery Community Recreation Centre

Address: 2467 Eglinton Ave. East
Phone: 416-396-4043
Cost: Classes are either free, or $25-$40/class. A $20/year membership required.
Seniors Classes: Art studio, Fitness, Badminton, Baseball, Cards, Coffee club, Cooking, Crafts, Dance, Games, Walking, and much more!
Programs are usually one day a week, for an hour for 12 weeks.
A support person may be required.

L’Amoreaux Community Recreation Centre

Address: 2000 McNicoll Ave.
Phone: 416-396-4510
Cost: They are either free, or $25-$35/class (about 9-12 weeks). A $20/year membership required.
Seniors Programs: Dance, Badminton, Computer, Fitness, Games, Movies, and more. Programs are usually one day a week, for an hour (or more) for 12 weeks.
A support person may be required.

McGregor Park Recreation Centre

Address: 2231 Lawrence Ave. E.
Phone: 416-396-4023
Contact: Terry Chung (older adult programs) 416-396-7566
Seniors Programs: Cards (free), Dance (Free), Osteo Fitness ($69/11weeks),
Fitness passport, allows you to join any fitness class. Osteo Fitness, is usually 6 people, and the line dancing 20-30 people.

Oakridge Community Recreational Centre

Address: 63 Pharmacy Ave.
Phone: 416-338-1966
Cost: Classes are free if you are 60 years or over. A fee applies for those under 60.
Seniors Programs: Ballroom Dancing, Bingo, Cardio, Fitness, Painting, and more.
A support person may be required.

Port Union Community Centre

Address: 5450 Lawrence Ave. East
Phone: 416-396-4031
Cost: Some classes are free, others range from $25-50 for 10-12 weeks. A $20/year membership required.
Seniors Programs: Arts and crafts, Games, Fitness, Computers, Dance, and much more!
Will accept people under 60 for senior programs.
A support person may be required.

Scarborough Village Recreational Centre

Address: 3600 Kingston Rd.
Phone: 416-396-4048
Contact: Linda at 416-396-4086 for further information
Cost: Some classes are free, others range from $25-50 for 10-12 weeks. A $20/year membership required.
Seniors Programs: Art and crafts, Cards, Dance, Fitness, Games, and much more! Lots of free drop in programs. You can even come in just to watch the dancers.
A support person may be required.

Stephen Leacock Community Centre

Address: 2520 Birchmount Rd.
Phone: 416-396-4040
Cost: Some classes are free, others range from $25-50 for 10-12 weeks (prices may change). A $20/year membership required.
Seniors Programs: Art, Dance, Cards, Games, and much more!
A support person may be required.

East York District

Brown Community Centre

All programs are held at St. Johns Church.
Address: 454 Avenue Rd.
Phone: 416-392-6826
Cost: $28-$37 for a 9 week course
Seniors Programs: Bridge, Line dancing, and Pilates.
Participants can be under 60. Those under 60 might not get the half off discount, yet some exceptions are made.
A support person may be required.

East York Community Centre

Address: 1081 Pape Ave.
Phone: 416-396-2880
Seniors Programs: Low cardio fitness. $39/12 weeks
A support person may be required.

Riverdale Farm

Address: 201 Winchester St
Phone: 416-392-6794
Games Room (free)
Drop in and play games. Everyone is welcome, bring a support worker if required.

St. Lawrence C.R.C

Address: 230 The Esplanade
Phone: 416-392-1347
Bridge (free), Fitness/Cardio ($3.75 per visit) Social Club (free)
A support person may be required.

Etobicoke District

Amesbury Community Centre

Address: 1507 Lawrence Ave. W.
Phone: 416-395-0145
Seniors Programs: Chair Yoga, Gentle fitness ($28-$29/8-9 weeks)
A support person may be required.

Annette Community Recreation Centre

Address: 333 Annette St. Toronto Ontario
Phone: 416-392-0736
Seniors Programs: Osteo Fit ($42/13 weeks) Social Club (free)
Facilities include: Pool, Weight room
A support person may be required.

Centennial Recreation Centre West

Address: 2694 Eglinton Ave. West

Phone: 416-394-2475

Seniors Programs: Swimming

A support person may be required.

Domenico Diluca Community Centre

Address: 25 Stanley Rd.
Phone: 416-395-6673
Seniors Programs: Badminton (free), Friday Morning Fun (free), Tuesday and Thursday Gentle Fitness ($35/11 weeks), Walking Club (free).
A support person may be required.

Gord and Irene Risk Community Centre

Address: 2650 Finch Ave. West
Phone: 416-395-0355
Seniors Programs: Art studio ($33/9 weeks), Indoor Bocce (membership), and Gentle fitness ($37/10 weeks).
A support person may be required.

Islington Seniors’ Centre

Address: 4968 Dundas St. West
Phone: 416-231-3431
Seniors Programs: cards, bridge, table tennis, pool table. A foot clinic service.
A support person may be required.

Memorial Pool

Address: 44 Montgomery Rd.
Phone: 416-394-8731
Seniors Program: Aqua Fun. ($165/36 weeks)
A support person may be required.

Swansea Community Recreation Centre

Address: 15 Waller Ave.
Phone: 416-392-6796
Seniors Program: Gentle Fitness ($30/9 weeks)
A support person may be required.

York West Active Living Center

Address: 1901 Weston Rd.
Phone: 416-245-4395
Email: info@ywalc.ca
Website: http://www.ywalc.ca/
Are you 55+? Are you looking for action? Be a part of something big, be a part of York West Seniors! York West Senior Centre’s friendly staff and volunteers are always ready to welcome you to our bright, spacious centre. We strive to meet the needs of today’s seniors by continuously offering new programs and activities, from Osteoporosis fitness to Dancercise, Lunch & Learn to great day trips, we’ve got it all. Our affordable programs make it easy.
Must be 55+.
A support person may be required.

North York District

Barbara Frum Community Centre

Address: 20 Covington Rd.
Phone: 416-395-6123
Seniors Program: Gentle Fit ($44/12weeks)

Bernard Betel Centre

Address: 1003 Steeles Ave. West, Toronto, ON M2R 3T6
Phone: 416-225-2112
Email: reception@betelcentre.org
Website: www.betelcentre.org
The Bernard Betel Centre is a vibrant, non-profit community centre located in North Toronto with offerings for older adults (55+). We provide services and programs to over 5,000 individuals each year including fitness classes, recreation programs, educational programs, trips and travel, special events, holiday celebrations, community support services, language clubs, health and wellness, volunteer opportunities, and many more.

A support person/caregiver would need to come with the person if support was required.

Cummer Park Community Centre

Address: 6000 Leslie St.
Phone: 416-395-7803
Seniors Programs: Fun/Fit 50+ ($42.50/10 weeks)
A support person may be required.

Driftwood Community Centre

Address: 4401 Jane St.
Phone: 416-395-7944
Seniors Program: Gentle fit (free/10weeks) and social club afterwards. Usually a guest speaker comes in (For example: the police, diabetes association). Class size is about 20-25 people for one instructor.
A support person may be required.

Jenner Jean-Marie Community Centre

Address: 48 Thorncliffe Park Dr.
Phone: 416 396-2874
Seniors Programs: Arts and Crafts (free), Gentle Fit ($44/12 weeks), Social Club (free), Weight room (free)
A support person may be required.

Day Programs and Drop in Centres for Seniors

Etobicoke/York Region

ESS Support Service

Type of Service: Day program
Phone: 416-243-0127 for Intake
Location: 2245 Lawrence Ave W
Website: www.esssupportservices.ca
Email: mmolina@esssupportservices.ca
Hours: Mon-Sat 8:30 am-4:30 pm, extended hours are available
About:

  • Adult Day services at five locations for seniors who are elderly, frail, socially isolated, and people with physical and/or cognitive impairments
  • Serves Etobicoke and surrounding areas – there is no service area restriction if transportation service is not required
  • Fee includes snacks and meals, extended hours cost more
  • Round trip service for Etobicoke residents depending on availability of space

Fee: Yes

Humber Community Seniors’ Services Inc.

Type of Service: Day program
Phone: 416-249-7946
Location: 1167 Weston Rd
Website: www.humberseniors.org
email: info@humberseniors.org
Hours: Mon-Fri 10 am-3 pm
About:

  • Adults with cognitive impairment and frail, vulnerable adults
  • Serves Toronto
  • Fee includes meal and snacks – subsidies are available based on income
  • Round trip service available, call for details

Languages Available: English and Spanish
Fee: Yes

Kipling Acres

Type of Service: Day program
Phone: 416-392-2300, 416-392-2323 for Intake
Location: 2233 Kipling Ave
Website: www.toronto.ca/ltc/kiplingacres.htm
email: sgibson@toronto.ca
Hours: Mon-Fri 9 am-3pm
About:

  • Community members who are physically frail, socially isolated or who have mild cognitive impairment
  • Clients must be able to self-medicate and they cannot wander or require two-person transfers
  • Fee includes meal and snacks – subsidies are available based on income
  • Transportation is not available

Languages Available: English and Italian
Fee: Yes

Reconnect Community Health Services

Type of Service: Day program
Phone: 416-248-2050 ext 5214
Location: 2562 Eglinton Ave W Ste 202
Website: www.reconnect.on.ca/
email: info@servicesforseniors.ca
Hours: Mon-Fri 8 am-6 pm; Sat, Sun 9 am-5 pm; overnight service
About:

  • Seniors who are physically frail, have physical challenges and/or have Alzheimer’s disease and/or dementia
  • Serves Lawrence Ave W to St. Clair Ave W, Spadina Rd to the Humber River — no service area restriction if transportation service is not required
  • Adult Day Program, Alzheimer Day Program and Interlude Program (overnight)
  • Fees vary per program – subsidies are available based on income
  • Round trip transportation available

Languages Available: English; staff speak Portuguese, Spanish and Italian
Fee: Yes

Storefront Humber

Type of Service: Day program
Phone: 416-259-4207
Location: 2445 Lakeshore Blvd W
Website: www.storefronthumber.ca
email: storefronthumber@bellnet.ca
Hours: Mon-Fri 9:30 am-2:30 pm, one Sat/month
About:

  • Adult Day Programs at two locations for frail elderly, people with disabilities and people with early stage dementia
  • Serves Sheppard Ave to southern boundaries of North York, Bayview Ave to Victoria Park Ave — no service area restriction if transportation service is not required
  • Fee includes meal and snacks
  • Round trip transportation for residents of the service area

Languages Available: English, Italian, Polish, Ukrainian; staff and volunteers may speak other languages
Fee: Yes

SYME 55 Centre

Address: 33 Pritchard Avenue Toronto, ON, M6N 1T4

Phone: 416-766-0388

Email: syme55@bellnet.ca

Website: www.syme55.com

Cost: $30/year activities at extra fee
Neighbourhood Served: Anywhere in Toronto
How to get started: Come in to get a free trial membership to see if it’s a right fit.
Eligibility: For active seniors, able to bring own personal support worker, wheelchair accessible.
Programs: Exercise, Tai Chi, Yoga, Pilates, Walking & Bird Watching Clubs, Dancercise, Bingo, Ballroom Dancing, and more.

North York Region

Baycrest

Type of Service: Day program
Phone: 416-785-2500 ext 2223
Address: 3560 Bathurst St
Website: www.baycrest.org
Hours: Mon-Thurs 9 am-3:30 pm Parkland and Oceanside, Mon-Fri 9 am-3:30 pm Mountain View
About:

  • Three Adult Day Programs: Parkland for frail seniors; Oceanside for seniors with mild cognitive impairment; Mountain View for seniors with moderate to severe cognitive impairment
  • Programs are non-sectarian but oriented towards Jewish culture
  • Serves Centre Street to St. Clair Ave, Dufferin Ave to Leslie St — no service area restriction if transportation service is not required
  • Fee includes snack and meal (Parkland and Oceanside); increased fee for Mountain View program
  • Transportation available each way (Parkland and Oceanside); additional cost for Mountain View transportation

Fee: Yes

Better Living Health and Community Services

Type of Service: Day program
Phone: 416-447-7244 ext 541
Address: 1 Overland Dr
Website: www.betterlivinghealth.org
Email: info@betterlivinghealth.org
Hours: Mon- Fri 9 am-3 pm; Half days 9 am-12:30 pm or 12:30-3 pm
About:

  • For persons with Parkinson’s, Alzheimer’s, dementia, cognitive impairment and physically frail
  • Serves Sheppard Ave to Eglinton Ave, Yonge St to Victoria Park Ave — no service area restriction if transportation service is not required
  • Fee includes meal and snacks; half-day available
  • Round trip transportation available for residents of the service area

Fee: Yes

Circle of Care

Seniors with Alzheimers, Dementia or Cognitive Impairments
Address: 1600 Steeles St. West Unit: 18 (Dufferin Ave and Steeles Ave. )
Phone: 905-738-1128
Website: www.circleofcare.com
Cost: $36.00/day Subsidies are available.
Hours of Operation: Monday – Friday 9:30am4:30pm
Neighbourhood served: Transportation available (pick up and drop off) for $6 – 21 a day. *Only in the areas in between Wilson Avenue – Major Mackenzie, and Don Mills – Keele St.
How to get started: Must get a Doctor’s note to say that there has been a change in the individuals cognition. An actual diagnosis is not required.
Eligibility: Day Program for Seniors with Alzheimers, Dementia, or Cognitive Impairment. *Including seniors with a developmental disability with signs of a change in their cognition.
This is a Jewish environment, meaning that the food is kosher. Everyone is welcome!
There are 20 clients per day with a lot of staff including an onsite Nurse.

Cummer Lodge

Type of Service: Day program
Phone: 416-392-9502 for Intake
Address: 205 Cummer Ave
Website: https://www.toronto.ca/community-people/housing-shelter/long-term-care-homes/cummer-lodge/
Email: mailto:Jacalyn.Tuskin@toronto.ca
Hours: Mon-Fri 7:30 am-4 pm
About:

  • Adult Day Program
  • Persons living in the community, who are physically frail, socially isolated or who have mild cognitive impairment.
  • Clients must be able to self medicate; they cannot wander or require two-person transfers
  • Serves Toronto area
  • Fee includes meal and snacks — subsidies are available based on income

Fee: Yes

Jane/Finch Community and Family Centre

Type of Service: Day program
Phone: 416-663-2733
Address: 4400 Jane St, Suite 108
Website: www.janefinchcentre.org
Email: admin@janefinchcentre.org
About:

  • Unity in Diversity Adult Day Program
  • Various days and times; all programs are four hours
  • 10 groups are held at six different locations for mobile adults 55+
  • TTC tokens are provided

Languages Available: Mixed English (three groups), Spanish (two groups); one group Vietnamese, Cambodian, Hindi, Guyanese and Punjabi
Fee: Call for details

Lumacare

Type of Service: B.O.O.S.T. Adult Day program
Phone: 416-398-5511, Call the Community Care Access Centre at Toll free 1-888-470-2222 to apply
Address: 15 Clubhouse Crt
Website: www.lumacare.ca
Email: info@lumacare.ca
Hours: Mon-Fri 9 am-3 pm
About:

  • BOOST Day Program
  • For individuals living with stroke, or other neurological disorders, or who are frail
  • No service area restriction if transportation service is not required
  • Fee includes lunch
  • Round trip transportation available for residents of the service area (Steeles Ave W to Lawrence Ave W, Humber River to Bathurst St.)

Languages Available: English and Italian
Fee: Yes

Mary Centre Integrated Seniors

Address: Mary Centre (Bathurst & Finch) – Program offered in the community Greater Toronto Area, ON
Phone: 416-630-5533 ext.222
Contact: Tracey Berman
Email: traceyb@marycentre.com
Website: www.marycentre.com
Hours: 1 to 2 times per week
Cost: free
Helps people age 50 years and older, participate in leisure, educational, recreational and or volunteer opportunities that encourage integration with others. Each person is supported on an individual basis to match their unique interests with appropriate activities.

North York Seniors Centre

Type of Service: Day program
Phone: 416-733-4111
Address: 80 Sheppard Ave W
Website: www.nyseniors.org
Email: email@nyseniors.org
Hours: Mon-Fri 10am – 3pm
About:

  • A Day Away Club
  • Depending on availability, clients can attend two or three days per week
  • Seniors who are physically frail and/or cognitively impaired and individuals with Parkinson’s disease
  • Service area is Steeles Ave to Hwy 401, Bathurst St to Victoria Park Ave — no service area restriction if transportation service is not required
  • Fee includes meal and snacks
  • Single and round trip transportation available for residents of service area

Fee: Yes

Villa Colombo Services for Seniors

Type of Service: Day program
Phone: 416-789-2133
Address: 40 Playfair Avenue
Website: www.villacharities.com
Email: ricci@villacolombo.on.ca
Hours: Mon-Fri 8 am-4 pm
About:

  • Adult Day Program
  • Program is geared toward Italian-Canadians, 50+, with cognitive impairment due to Alzheimer’s disease, related dementias or brain injuries
  • Contact a Community Care Access Centre to apply
  • Fee includes meal and snacks — subsidies are available based on income
  • Price varies for round trip transportation within the service area Steeles Ave to St. Clair Ave, Islington Ave to Yonge

Languages Available: English and Italian
Fee: Yes

Scarborough Region

Bendale Acres

Type of Service: Day program
Phone: 416-397-7020 Intake
Address: 2920 Lawrence Ave E
Website: www.toronto.ca/ltc/bendaleacres.htm
Email: Susan.Kwiatkowski@toronto.ca
Hours: Mon-Fri 7:30 am-5 pm
About:

  • Adult Day Program – Link
  • Community members who are physically frail, socially isolated or who have mild cognitive impairment.
  • Clients must be able to self medicate and they cannot wander or require two-person transfers.
  • Fee includes meal and snacks — subsidies are available based on income
  • No transportation available

Fee: Yes

Carefirst Seniors and Community Services Association

Type of Service: Day program
Phone: 416-502-2323
Address: 3601 Victoria Park Ave Ste 209/300 Silver Star Blvd. 2/F
Website: www.carefirstseniors.com
Email: info@carefirstseniors.com
Hours: Mon-Fri 9:30 am-3:00 pm
About:
Adult Day Program

  • For adults 55+ who experience functional limitations or social isolation
  • Fee includes meal and snacks
  • Round trip transportation available for residents of the service area

SERVICE LOCATIONS & LANGUAGES

  • Scarborough: 300 Silver Star Blvd., 2/F (Languages: English, Spanish, Tagalog)
  • Scarborough: 3601 Victoria Park Ave., Suite 209 (Languages: English, Cantonese, Mandarin)
  • Richmond Hill: 9893 Leslie Street (Languages: English, Cantonese, Mandarin)

FOR MORE INFORMATION ON ENROLLMENT, PLEASE CALL:

  • (416) 847-0277 (Scarborough – Silver Star Location)
  • (416) 649-1212 (Scarborough – Victoria Park Location)
  • (905) 780-9646 (Richmond Hill Location)

Languages Available: English, Mandarin, Spanish, Tagalog, and Cantonese
Fee: Yes

Providence Community Centre

Type of Service: Day program
Phone: 416-285-3803
Address: 3276 St. Clair Ave E
Website: providence.on.ca
Hours: Mon-Fri 24 hours, Sat 7 am-5 pm
About:

  • For individuals with Alzheimer’s disease and/ or dementia; must have a diagnosis of irreversible dementia
  • Evening club and overnight stay care available
  • Serves Greater Toronto Area
  • Fee includes meal and snacks
  • Assistance with arranging transportation is available

Fee: Yes

Scarborough Centre for Healthy Communities

Type of Service: Day program
Phone: 416-847-4134
Address: 629 Markham Rd Unit 2
Website: www.schcontario.ca
Email: cssintake@schcontario.ca
Hours: Mon-Fri 9:30 am-4:00 pm
About:

  • Persons in early stage of Alzheimer’s disease or other dementia, persons with disabilities, vulnerable and at-risk seniors
  • Serves Hwy 401 to Lake Ontario, Markham Rd to Scarborough eastern limits — no service area restriction if transportation service is not required
  • Fee includes meal and snacks
  • Transportation available for residents of the service area

Languages Available: English and Greek
Fee: Yes

Senior Persons Living Connected

Type of Service: Day program
Phone: 416-493-3333 ext 299
Address: 3333 Finch Ave E
Website: www.splc.ca
Email: info@splc.ca
Hours: Dependant on program
About:

  • Living Well Day Program and Chinese Day Program, Mon-Fri 9 am-3 pm
  • Greek Day Program, Mon-Thurs 9 am-3 pm
  • Sunflower Club (Dementia and Alzheimer Program)
  • 55+, cognitively impaired or not, physically well or frail
  • Serves Denison Rd to Ellesmere Rd, Don Mills Rd to Brimley Rd — no service area restriction if transportation service is not required
  • Fees vary based on full and half-day program and inclusion of lunch
  • Transportation available for area residents depending on location, costs vary

Languages Available: English, Greek, Mandarin and Cantonese
Fee: Yes

TransCare Community Support Services

Type of Service: Day program
Phone: 416-750-9885 ext 278, Toll free 1-866-393-2079
Address: 1045 McNicoll Ave
Website: www.tcare.ca
Email: info@tcare.ca
Hours: Mon-Fri 10 am-3 pm
About:

  • Seniors, adults with disabilities and/or those who are chronically ill and individuals in early stages of dementia
  • Serves Steeles Ave to Lake Ontario, Victoria Park Ave to Port Union Rd — no service area restriction if transportation service is not required
  • Full and half-day program fees includes meal and snacks
  • Round trip transportation available for residents of the service area

Fee: Yes

Warden Woods Community Centre

Type of Service: Day program
Phone: 416-694-1138 ext 133
Address: 74 Firvalley Crt
Website: www.wardenwoods.com
Email: samanthab@wardenwoods.com
Hours: Mon, Tues, Thurs 9 am-3 pm
About:

  • For frail 55+ and persons in the early stages of Alzheimer’s disease and other dementias
  • Serves Eglinton Ave E to Lake Ontario, Victoria Park Ave to Kennedy Rd — no service area restriction if transportation service is not required
  • Fee includes meal, snacks, program supplies and transportation — subsidies are available based on income
  • Transportation is available for residents of the service area who do not have Wheeltrans access

Fee: Yes

Toronto & East York Region

Alzheimer Program – St. Clair O’Connor Community

Address: 2701 St Clair Avenue East Toronto, ON, M4B 3M3
Phone: 416-757-8757
Contact: Melody Humphrey, Program Supervisor
Cost: $15 per day. Lunch provided.
Hours of Operation: Monday – Friday 9am4pm
Neighbourhood Served: East York
How to get started: Call Melody Humphrey to start an assessment and see if the program is right for you.
Eligibility: Alzheimer patients
Small day program for seniors with Alzheimers. Different activities through out the day. Activities such as: exercise, arts and crafts, board games, music and small outings.

Call A Service Inc.

Harmony Hall Centre for Seniors
Address: 2 Gower Street, Toronto, Ontario M4B 1E2
Phone: 416-752-0101
Website: http://www.call-a-service.com/
Cost: Yearly fee of $15. Special Events are $3 – $7 extra.
Hours of Operation: 8:00am5:00pm
Eligibility: Must be 55 or older to join.
This is a drop in centre for seniors. Programs offered are: chess, snooker, table tennis, fitness, crafts, luncheons and more. Able to come by themselves, or bring a support worker. Has had individuals with a developmental disability join.

Community Care East York

Multi-service Organization
Address: 840 Coxwell Avenue Suite 101
Phone: 416-422-2026
Contact: Ask for the Intake department. They will carry out an assessment and determine which programs and services are a right fit.
Cost: $8.00 a day. More for transportation $20+ depending on the distance. A subsidy is available upon financial assessment.
Hours of Operation: 10:00am to 3:00pm
Neighbourhood Served: Bayview to Victoria Park, Danforth Ave.Eglinton Ave.(some exceptions)
Programs: Adult Day Program Chinese and Seniors Day Program
Program Highlights:

  • Transportation will be provided to and from, when needed.
  • Clients will be provided with hot lunches and snacks.
  • Recreational activities reflect client interests.
  • Space is bright, level, wheelchair accessible and secure.
  • Friendly, caring staff offer one-on-one assistance, if needed.
  • Programs are client centred, with no more than eight participants.
  • Escorted transportation is available for clients who require assistance door to door.

Corpernicus Lodge

Type of Service: Day program
Phone: 416-536-7122 ext 225
Address: 66 Roncesvalles Ave
Website: www.copernicuslodge.com
Email: zorkad@copernicuslodge.com
Hours: Mon, Wed, Thurs, Fri 8:30 am-3:30 pm
About:

  • For frail or cognitively impaired seniors 60+ and Polish speaking
  • Fee includes meal and snacks; half-day program available

Languages Available: English and Polish
Fee: Yes

Dixon Hall

Address: 188 Carlton St. Toronto
Phone: 416-863-0499 ext 3222
Website: http://dixonhall.org/seniors/#adult-day-programs
Cost: $21/day
Adult Day programs offer opportunities for seniors and adults with disabilities to connect, make new friends and take part in fun, interesting and therapeutic activities. Programming caters to individuals of varying capabilities including those who are frail, dealing with cognitive impairment, physical disabilities and illness.

Hellenic Home

Type of Service: Day program
Phone: 416-654-7700 ext 2275
Address: 33 Winona Dr
Website: www.hellenichome.org
Email: amantziounis@hellenichome.org
Hours: Mon, Wed, Fri 9 am-4 pm
About:

  • 65+; may be frail and/or cognitively impaired
  • Fee includes meal and snacks — subsidies are available based on income

Languages Available: English and Greek
Fee: Yes

Les Centres D’Accueil Héritage

Type of Service: Day program
Photo: 416-365-3350
Address: 33 Hahn Pl Ste 104
Website: www.caheritage.org
Email: gmanena@caheritage.org
Hours: Mon-Thurs 9:30 am-2:30 pm
About:

  • French speaking vulnerable adults; frail adults, individuals with dementia, individuals with physical disabilities
  • There may be a waiting list
  • Fee includes transportation, snack, lunch and activities — subsidies are available based on need
  • Adult Day Program held at two locations in Toronto, call for details

Languages Available: French
Fee: Yes

Neighbourhood Link Community Services

Type of Service: Day program
Phone: 416-691-7407
Address: 3036 Danforth Avenue, Toronto
Website: www.neighbourhoodlink.org
Email: info@neighbourhoodlink.org
Hours: Mon-Sat 9:30 am-3:30 pm; Wed, Thurs 5-8 pm (for frail and isolated seniors)
About:

  • For frail and isolated elderly and individuals with dementia (Wednesday and Friday); also for the cognitively impaired and for people with Alzheimer’s disease
  • Serves Danforth Ave to Lake Ontario, Coxwell Ave to Victoria Park Ave — no service area restriction if transportation service is not required
  • Fees vary and include meal and transportation — subsidies are available based on need
  • Transportation available for seniors living near Neighbourhood Link offices and facilities

Fee: Yes

SEAS Centre

SouthEast Asian Seniors
Address: 50 Regent Park Blvd., Street Level Unit 101, Toronto
Phone: 416-466-8842
Website: http://www.seascentre.org/
Cost: Free
How to get started: Drop in and register.
Activities, games, outings etc.

Second Mile Club of Toronto

Address: 192 Carlton St. Toronto Ontario M5A 2K8
Phone: 416-597-1812
Contact: Ask for the intake department. An assessment can be arranged.
Website: www.secondmileclub.ca
Cost: Membership $40.00/ year
Hours of Operation: 9:00am3:00pm Monday to Friday
Neighbourhood Served: Bathurst StDVP, St.Clair Ave.Lakeshore
Eligibility: All seniors welcome including seniors with Alzheimers, or Dementia. After the assessment, they will let you know if you need to bring a personal support worker with you or not.
Lunch: $5.50/day (otherwise bring your own lunch)
Transportation: $5.00/day
Set in a cozy Victorian home in the heart of Cabbagetown. This facility based support program is designed for the frail older adult, who requires specialized programs, small group activities, nutritious meals and transportation. The program provides caregiver respite & support.
Activities include: Card games, Lacrosse Group, Everyday fitness, Fitness for Arthritis, Garden Club, Special occasion parties (Holidays) BBQ and more. This Organization also has community support services and friendly visiting. (See homecare)

Senior Adult Services in the Annex

Type of Service: Day program
Phone: 416-923-8909
Address: 707 St Clair Ave W, Toronto
email: sasannex@rogers.com
Hours: Fri 9 am-3 pm, Mixed program
About:

  • 65+; may be frail
  • Call to apply
  • Fee includes lunch
  • Transportation not available

Fee: Yes

SPRINT – Senior Peoples’ Resources in North Toronto

Type of Service: Day program
Phone: 416-481-6411
Address: 140 Merton St 2nd Fl
Website: www.sprint-homecare.ca
Email: info@sprintseniorcare.org
Hours: Mon-Sat 9:30 am-3 pm; Tues, Wed, Fri 2:30 pm-7:30 pm
About:

  • 55+ living in the community; also for persons who are physically frail or who have cognitive or physical impairment
  • Day Program held at the Anne Johnston Health Station at 2398 Yonge St 2nd Fl
  • Serves Hwy 401 to Bloor St, Bathurst St to Bayview Ave
  • Fee includes meal and snacks — subsidies are available based on income
  • Transportation available for residents of the service area who have no other means of getting to and from the program; fees apply

Fee: Yes

St. Clair O’Connor Community Inc.

Type of Service: Day program
Phone: 416-757-8757
Address: 2701 St. Clair Ave E
Website: www.scoc.ca
Email: info@scoc.ca
Hours: Mon-Fri 9 am-3:30 pm
About:

  • For frail seniors, persons in early/moderate stage of dementia and stroke recovery patients
  • Fees for full and half-day program includes meal and snacks — subsidies available based on income
  • Uses Harmony Hall ride service for East Toronto clients 416-752-8868

Fee: Yes

St. Stephen’s Community House

Type of Service: Day program
Phone: 416-925-2103 ext3110
Address: 340 College St
Website:
Email: tirene@sschto.ca
Hours: Tues, Thurs (mixed), Fri (Chinese) 9 am-2:30 pm
About:

  • Multicultural Integrated Adult Day Service
  • For frail or isolated 55+; also for persons with cognitive impairments and early stage Alzheimer’s disease
  • Serves Davenport Rd to Queen St W, Dufferin St to University Ave. — no service area restriction if transportation service is not required
  • Fees vary depending on client’s income — subsidies are available based on income
  • Transportation available for residents of the service area; cost is included in daily fees

Languages Spoken: English, Cantonese, Mandarin and Portuguese
Fee: Yes

West Neighbourhood House (formerly St. Christopher House)

Type of Service: Day program
Phone: 416-532-4828 ext 146
Address: 248 Ossington Ave
Website: www.westnh.org
Email: info@westnh.org
Hours: Mon-Fri 8 am-6 pm, Sat 9 am-5 pm
About:

  • Adult Day Program and Enhanced Adult Day Program
  • 55+; Enhanced Adult Day Program for frail seniors and those 55+ with a cognitive impairment and/or physical disability
  • Serves Bloor St to Lake Ontario, Roncesvalles Ave to Yonge St. — no service area restriction if transportation service is not required
  • Fee includes meal, snacks and transportation — subsidies are available based on income
  • Round trip transportation available for residents of the service area

Languages Available: English, Portuguese, Italian, Cantonese and Mandarin
Fee: Yes

West Toronto Support Services

Type of Service: Day program
Phone: 416-653-3535
Address: 1709 Bloor St. West. 2nd Floor
Website: https://wtss.org/services/adult-day-services/
Email: info@wtss.org
Hours: Mon-Fri 9 am-4:30 pm
About:

  • For cognitively impaired or frail 55+ and adults with disabilities
  • Serves St. Clair Ave W to Bloor St W, Humber River to Bathurst St; boundaries may vary for some programs — no service area restriction if transportation service is not required
  • Fee includes meal and snacks
  • Round trip transportation available for residents of the service area

Languages Available: English; staff speak other languages
Fee: Yes

WoodGreen Community Services

Type of Service: Day program
Phone: 416-572-3575
Address: 815 Danforth Ave Ste 100
Website: www.woodgreen.org
Email: cccentralintake@woodgreen.org
Hours: Mon-Fri 9 am-2:30 pm
About:

  • Two Adult Day Programs at different locations for frail seniors and people with dementia
  • Eglinton Ave E to Danforth Ave, Bayview Ave to Victoria Park Ave; Danforth Ave to Lakeshore Blvd E, Don Valley Pkwy to Coxwell Ave. — no service area restriction if transportation service is not required
  • Fee includes meal, snacks and transportation for residents of service area — subsidies are available based on income

Languages Available: English, Cantonese and Mandarin
Fee: Yes

Seniors Home Care Services

It is a good Idea to start with the Health Integration Networks (LHINs) http://www.lhins.on.ca/

Bayshore Healthcare

Address: 345 Bloor Street E (Greenwin Square), Unit 1B
Phone: (416) 927-7850
Website: www.bayshore.ca
e-mail: clientservices@bayshore.ca
Toronto Neighbourhoods Served: Entire GTA
Services Available: PSW (personal support), home support, DSW (developmental service workers), RSW (rehab support), Nursing, Occupational Therapy, Physiotherapy, Speech-Language Pathology, Funding Investigations
Cost: $23/hour for PSW, up to $65/hour for Nursing. Everything is 1 hour minimum. Free funding investigation.
How To get started: call for a free in-home assessment

Canes Community Care

Phone: 416-743-3892
Contact: Contact to book a free home assessment to develop a plan.
Website: www.canes.on.ca
Neighbourhood Served: Etobicoke, Brampton, Orangeville, and Malton
Services:
Personal Care: (Trained) Personal Support Worker assists with daily living care. (Bathing, hygiene, meal time assistance)
Homemaking: (Light housekeeping) vacuuming, dusting, meal preparation, clean up, general cleaning. Grocery Shopping.
Respite Care: Personal Support Worker comes into the home to relieve caregiver.
Seniors Luncheon: various Locations in Northern Etobicoke (extension 240)
Caregiver Support: Service to caregiver. Individual support and group sessions.
Friendly Visiting: a volunteer is matched with a senior for regular social visits in client’s home. (FREE) (416-743-3892 ext.234)
Home at Last: Assistance with returning home from the hospital.

Carefirst Seniors and Community Services Association

Address: 300 Silver Star Blvd.,Scarborough, Ontario M1V 0G2
Phone: 416-502-2323
Website: www.carefirstseniors.com
Cantonese/Chinese speakers
Private Care Service: Light housekeeping. $16.50/hr
Personal Support: $21.00/hr

Central Neighbourhood House

Address: 349 Ontario Street
Phone: 416-649-1000
Contact: Sabah Hassan, Manager, Supportive Housing, ph:416-649-1000 ext 1213, shassan@cnh.on.ca
Kathy Jay, Client Care Manager, ph:416-649-1000 ext 1163, kjay@cnh.on.ca
Website: www.cnh.on.ca
In home services and respite.
Cost: Cost depends on the individual’s financial situation. Could be $10-25/hr
Neighbourhood Served: Area served in between Bloor, Lakeshore, Yonge and DVP. If referred by C.C.A.C then serves the areas in between Ossington -Victoria Park and South of Bloor including the Toronto Islands.
How to get started: Apply by calling, through C.C.A.C, or through the City of Toronto.
Home Services: Laundry, cleaning, help with shopping, Personal Support Workers.
Respite: In-home caregiver relief.

Circle of Care

Address: 4211 Yonge St Ste 401, Toronto, ON M2P 2A9
Phone: 416-635-2860
Website: www.circleofcare.com
How to get started: Call and ask to speak with the intake department. From there you will go through an assessment to see if the organization is the right fit.
Transportation, personal care, homemaking, home support, constant care companion, nursing services

Dixon Hall

Address: 58 Sumach Street. Toronto, ON M5A 3J7
Phone: 416-863-0499
Website: www.dixonhall.org
Email: info@dixonhall.org
Cost: $9.00/hr. Minimum 2 hours per visit.
Neighbourhood Served: River St. – Church, Carlton – Lakeshore
How to get started: Call Dixon Hall and request services, or apply through C.C.A.C
Eligibility: 55+ or unless referred by the C.C.A.C.
Light housekeeping, in home or group home. Dusting, moping, light meal preparation, small errands, bed making if requested.

Home and Community Care (Central Local Health Integration Network)

Phone: 416-222-2241
Website: http://healthcareathome.ca/central/en
How to apply: call the number and they will arrange an assessment in order to determine specific needs.

  • Arrange in home health and social services
  • Placement in Long Term Care homes
  • Respite Services

They have contracts with other agencies.

Prices from the Ministry of Long Term Care

Private room: $2,599.11/month / Semi-Private Room (2 people): $2,193.65/month / Basic Room (around 4 people): $1,819.53/month.

Humber Community Seniors Service

Address: 1167 Weston Road Toronto, ON
Phone: 416-249-7946
Website: www.humberseniors.org
Cost: $36/3 hr. 3 hour minimum
Neighbourhood Served: The Humber River- Bathurst St. and Lawrence Ave- Bloor St.
Home Help: Light housekeeping, light food prep, light grocery help.
Transportation Service: Transportation to social, medical, help with groceries.
Fee for service

Lumacare Services

Address: (Main Office) 497 Wilson Ave. North York, Ontario M3H 1V1
Phone: 416-398-5510
Contact: Ask for Intake department.
Website: https://lumacare.ca/
Neighbourhood Served: Areas between Bathurst St – Humber, Steeles Ave. – St.Clair Ave
How to get started: Downsview Services for Seniors will conduct an assessment to make sure client gets appropriate care.
Personal Care: Dressing, feeding, meal preparation, and light housekeeping.
Home support: Light house keeping and help with grocery shopping.

Meals on Wheels

For a complete list of Meals on Wheels programs in Toronto go to www.211toronto.ca and search using ‘meals on wheels’

North York Seniors Centre

Address: 80 Sheppard Ave. West, North York, ON M2N 1M2
Phone: 416-733-4111
Website: www.nyseniors.org
Cost: $17.80/hr minimum 1.5 hours. Subsidies available
Neighbourhood Served: Area between: Bathurst-Victoria Park, Steeles – 401.
Eligibility: 55+ (or with a disability)
Home Care and Respite: Light housekeeping , medication monitoring, personal care, transportation, grocery shopping, and more.

(NHI) Nursing and Homemakers Inc.

Address: 2347 Kennedy Road Suite 204 Scarborough ON M1T 3T8
Phone: 416-754-0700
Website: www.nhihealthcare.com
Cost: Depending on the needs can range from $20 or $25/hr
How to get started: Call to have an over the phone assessment, and then set up a physical in-home assessment.
A private nursing, respite and homecare service.

Reconnect Community Health Services

Address: 2562 Eglinton Ave. West Ste 202
Phone: 416-248-2050 ext. 5214
Website: www.reconnect.on.ca
Cost: $12/hour minimum 2 hours every 2 weeks.
Neighbourhood Served: Map (see service area 2) Approx. *South of Lawrence, East of Dufferin, West of Bathurst North of St.Clair West.
*West of Dufferin, North of St.Clair, East of Keele, South of Rogers Road.
How to get started: Call the intake department to set up an assessment.
Eligibility: Need to sign up to the waiting list.
Services Include: Light housekeeping, laundry, meal preparation, assistance with banking, shopping, errands, companionship, personal care including assistance with personal hygiene, light exercise, and medication reminders.

Scarborough Centre for Healthy Communities

Home Help and Homemaking
Address: 629 Markham Rd Unit 2, Toronto, ON M1H 2A4
Phone: 416-847-4122
Website: www.schcontario.ca
Cost: Cost depends on a case by case basis

Neighbourhood Served: (In Scarborough) Brimley- Steeles Ave.
How to get started: Call and request to speak with home help and home making
Eligibility: Seniors that need light housekeeping, vacuuming, dusting, moping, changing bed sheets, laundry and bathroom cleaning.

In Home Respite
Cost: Cost is determined by a case by case scenario
Neighbourhood Served: Brimley – Steeles Ave.
How to get started: Call and request to speak with respite services. A home assessment will take place.
Eligibility: Seniors that need light Respite. no overnight services.

Scarborough Centre for Healthy Communities

Transportation to medical appointments
Phone: 416-847-4134
Cost: $10 round trip.

  • advance booking. limited wheelchair van, so book far in advance if possible.
  • Not for emergencies
  • Bring a Personal Support Worker with them if required

Neighbourhood Served: Scarborough

S.P.R.I.N.T Senior Peoples’ Resources in North Toronto

Address:(head office) 140 Merton Street, 2nd. Floor, Toronto, ON M4S 1A1
Phone: 416-481-6411
Email: info@sprintseniorcare.org
Website: https://sprintseniorcare.org/
Cost: Depends on service. Subsidies are offered.
Neighbourhood Served: All of North Toronto
How to get started: Call and ask about home care services, respite, transportation, or friendly visiting.
Eligibility: for all seniors
A very large agency with a variety of services available which helps seniors live at home independently.

Storefront Humber

Address: 2445 Lakeshore Blvd. West, South Etobicoke
Phone: 416-259-4207
E-Mail: sfh@storefronthumber.ca
Website: http://www.storefronthumber.ca/
Contact: Call intake worker, to set up an assessment to determine individuals needs.
Cost: Is based on sliding scale.
Home Services and Respite: Light housekeeping, personal care, etc.
5 different dinning locations throughout south Etobicoke. ($2 a day)

Spectrum Health Care

Address: 2 Bloor St.
Phone: 647-952-0322
Website: www.spectrumhealthcare.com
Cost:Contact for fee schedule

Neighbourhood Served: All of Toronto (South of Steeles Ave.)
How to get started: Call and inquire, or apply through the C.C.A.C.
Respite Care, Post Surgery, Rehabilitation, Wound Care

TransCare Community Support Services

Address: 1045 McNicoll Avenue,Toronto, ON M1W 3W6
Phone: 416-750-9885
Email: info@tcare.ca
Contact: ask for home care department
Website: www.tcare.ca
Cost:

  • Personal Care Service $17/hr min. 1 hour
  • Home care Services $14/hr min 2 hours.

Neighbourhood Served: Scarborough
How to get started: Call and inquire about home care and personal support services
Eligibility: Seniors, Seniors with Alzheimer’s, Dementia, and other disabilities.
Personal care: Showers, hygiene, light house cleaning and light meal prep
Home care: must provide own cleaning supplies. *no bleach.

VHA Home HealthCare

Address: (Head Office) 30 Soudan Ave., Suite 500 Toronto, ON M4S 1V6
Phone: 416-489-2500
Website: www.vha.ca
Cost: $24.50/HR
Neighbourhood Served: all of GTA
In home nursing (registered nurses), homemaking, personal support. Respite services as well.

Vidal Home Care

Address: 1 Yonge St #1801 Toronto ON M5E 1W7
Phone: 416-734-4967
Contact: info@vidalhomecre.com
Website: www.vidalhomecare.com
Cost: $22/hr
Neighbourhood Served: Toronto and surrounding cities; Mississauga, Burlington, Oakville, Richmond Hill, Markham, North York
Eligibility: Private pay
Services Include: Home care services, personal care, grooming, light housekeeping, meal preparation, transportation, respite.

WE CARE Home Health Services

Address:(Head Office) 3300 Bloor St. West, West Tower, Suite 900, Toronto
Phone: 1.866.729.3227
Website: www.cbi.ca/web/we-care-home-health-services
Cost: $22.50/hour minimum 3 hours per visit.
*Free home care assessment
*Homemaking and personal support services. Nursing care.

West Toronto Support Services

Address: 1709 Bloor St West 2nd Fl, Toronto, ON M6P 4E5
Phone: 416-653-3535
Contact: Intake for housekeeping and meals on wheels.
Website: wtss.org
Cost: Service fee
Neighbourhood Served: St Clair Ave W (north) to Bloor St W (south), Humber River (west) to Bathurst St (east) * also Bloor St W (north) to Lake Shore Blvd W (south), Humber River (west) to Roncesvalles Ave (east) * boundaries may vary for some programs
How to get started: Call to inquire about the home support services.

Yorkminster Park Meals on Wheels

Address: Yorkminster Park Baptist Church, 1585 Yonge Street, Toronto, ON M4T 1Z9
Phone: 416-482-0549
Email: info@ypmealsonwheels.com
Website: ypmealsonwheels.com
Cost: Hot meals $4.95, Week supply of frozen food $28
Neighbourhood Served: MountPleasent- Bathurst St.Clair Ave.-Lawrence Ave.

Long Term Care Facilities for Seniors

It is a good Idea to start with the Health Integration Networks (LHINs) http://www.lhins.on.ca/

Home and Community Care – Central Local Health Integration Network

Phone: 416-222-2241
Website: healthcareathome.ca/central/en
How to apply: Your first step is to call our main phone number 310-2222.

  • Arrange in home health and social services.
  • Placement in Long Term Care homes
  • Respite Service.

They have contracts with other agencies.

Prices determined by the Ministry of Long Term Care

Long term Care directory: Long Term Care Directory

Volunteering

Toronto Seniors’ Forum

Type of Service: Volunteer (Social & Political)
Email: neighbourhoods@toronto.ca
Website: https://www.toronto.ca/community-people/get-involved/community/toronto-seniors-forum/
Address: 100 Queen St. W., Toronto, ON, 15th Floor, East Tower, City Hall
About:

  • The Toronto Seniors’ Forum is a volunteer group that engages seniors in Toronto in the workings of local government
  • The Toronto Seniors’ Forum gives a voice to seniors not often heard
  • Dedicated members work to ensure the City of Toronto meets its commitment to provide services equitably to all senior residents
  • The Seniors’ Forum meets once a month

Accessible Parking and Public Transit

Ontario Ministry of Transportation

Type of Service: Transportation (Provincial)
Phone: Service Ontario 416-235-2999, Toll Free 1-800-387-3445
Website: www.ontario.ca/page/get-accessible-parking-permit
About:

  • Individuals who have difficulty walking can apply for an Accessible Parking Permit from the Ontario Ministry of Transportation
  • Eligibility for an accessible permit needs to be certified by a recognized health practitioner
  • For an application, call the Ontario Ministry of Transportation, download a copy from www.mto.gov.on.ca (see “printable forms”) or visit any Service Ontario Centre
  • Parking regulations are enforced by the City of Toronto.
  • For details on parking exemptions for holders of accessible parking permits visit www.toronto.ca/transportation/parking or call 311.

City of Toronto Transportation Services

Type of Service: Transportation (Municipal)
Phone: 311
Website: www.toronto.ca/services-payments/streets-parking-transportation/walking-in-toronto/accessible-streets/accessible-parking-permits
>About:

  • A permit holder or driver operating a vehicle for the purpose of transporting an accessible permit holder who displays a valid accessible parking permit is exempt from signed prohibited parking areas, signed on-street permit parking areas, signed parking limits and unsigned maximum three-hour limit on all city streets
  • Exemptions such as parking on signed rush hour routes and parking on private property or Green P parking lots apply
  • See the website for more information and a full list of exemptions, or call 311
  • To have a disabled parking space or sign installed near your home, call 311 to submit a service request — the request will be forward to the Traffic Operations Manager in your area who will verify your information
  • The address of your permit must match your place of residence

Toronto Transit Commission (TTC)

Type of Service: Transportation (Municipal)

Phone:

  • Information on fares, routes, schedules and service 416-393-INFO (4636)
  • Elevator Service Status Line 416 539-LIFT (5438)
  • TTY 416-481-2523

Website: www.ttc.ca

About:

  • Call or visit ttc.ca for information about accessibility, routes and service disruptions
  • Reduced fare for seniors 65+
  • Lift or ramp-equipped buses and low-floor buses currently serve all 170 bus routes
  • Accessible buses and bus stops are marked with the blue international wheelchair symbol
  • The Request Stop program is available to passengers travelling alone by bus 9 pm-5 am
  • Request Stop allows any customer feeling vulnerable to get off the bus between regular TTC stops — request Stop not available on streetcars for safety reasons

Wheel Trans Trip Reservations

Type of Service: Transportation (Municipal)

Phone:

  • 416-393-4222
  • RideLine Automated Touch Tone Service 416-397-8000
  • Priority Line 416-393-4311
  • TTY 416-393-4555

Website: www.ttc.ca/WheelTrans/index.jsp

About:

  • Wheel-Trans provides door-to-door accessible transit service for persons with physical disabilities using accessible buses, contracted accessible and sedan taxis
  • Registered users are eligible for Wheel-Trans based upon their level of physical functional mobility in the home, within the area immediately surrounding the home and in the community at large, as well as permanency of disability
  • Eligibility is not based on particular disabilities, general health or income
  • Service is provided anywhere within the City of Toronto for a regular TTC fare
  • Customer Service and Wheel-Trans registration is available weekdays from 8 am-4 pm
  • Call 416-393-4111 or e-mail wheeltrans.customerservice@ttc.ca
  • Reserve online at mywheel-trans.ttc.ca between 5 am-11 pm
  • All Wheel-Trans applicants are required to attend an in-person interview to determine eligibility

GO Transit

Type of Service: Transportation (Municipal)

Phone:

  • 416-869-3200
  • Toll free 1-888-438-6646
  • TTY Toll free 1-800-387-3652

Website: www.gotransit.com

About:

  • Regional public transportation service for the Greater Toronto and Hamilton Area of Southern Ontario
  • Wheelchair accessible
  • The price of a trip is based on the distance travelled and the passenger category (adult, student, senior or child)
  • Frequent riders can buy discounted tickets and passes
  • 65+ pay half the adult single-ride fare

VIVA/York Region Transit

Type of Service: Transportation (Municipal)

Phone:

  • Toll free 1-866-668-3978
  • TTY 905-881-5167
  • TTY Toll free 1-866-276-7478

Website: www.yrt.ca

About:

  • Connects Markham, Richmond Hill, Vaughan, Aurora and Newmarket and links York Region with the TTC subway system
  • Wheelchair accessible

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Visiting the Art Gallery of Ontario

The AGO is a large gallery with all kinds of works of art from all over the world and right here in Canada and Toronto. Expect to be challenged to think about the world we live in by experimental contemporary artists from Canada and the world. There is something for everyone.

The AGO welcomes everyone. We like to talk about our collection, but we also enjoy hearing what you think too, because art affects everyone in a different way, and the AGO is your gallery. No matter who you are or where you are from, everyone has something important and interesting to say about the art. Here are a few tips to make sure you get the most out of your visit to the AGO:

Where is the AGO?

  • The AGO is located at 317 Dundas Street West. You can get to it using the Dundas Street car, or by walking west from St. Patrick’s subway station.

When can I visit, and what is the cost?

  • The gallery is open Tuesday to Sunday, 10:30am – 5pm, except for Wednesday when it’s open to 8:30 pm.
  • Click here for admission information . On Wednesdays, the gallery’s permanent collection is FREE from 6:00 pm – 8:30 pm (Wednesday evenings can be very busy!)

What can I do at the AGO?

  • Make your own (self-guided) tour. FREE maps are available at the front desk to help you plan what you want to see.
  • Join a FREE guided tour with one of our Gallery Guides. Mini-tours are 30 minutes, and occur daily at 11:30 am and 2:30 pm. Highlight tours are 1 hour, and occur daily at 1 pm. Tours begin in Walker Court. Occasionally, there are special tours at the AGO.
  • Do you like to sketch or draw? Bring a notebook and a pencil and draw what you see or create your own original pieces.
  • Explore, explore, explore. We are always getting new exhibits, and adding to our collection, so there is always something new to see at the AGO. Click here to find out about new exhibits at the AGO .

A trip to the AGO isn’t just about the pictures on the walls or the sculptures on the floor; there is so much more to see and do.

Here are some suggestions to get you started:

  • City watching: the AGO has incredible views of the city. From the light and airy Galleria Italia, you can look down on Dundas Street West and watch the streetcars and people go by. You can also walk up to the fifth floor and get a birds-eye view of Toronto from the staircase.
  • Relaxing and thinking: the AGO is full of open, airy, well-lit spaces that are perfect for relaxation. Have a seat on one of our comfortable chairs and rest as you watch other visitors go by.
  • Experiencing: many visitors come to the AGO to see the building and its interesting spaces. Take a close look at the architecture of Galleria Italia and Walker Court, and wind your way up and down our twisting staircases.
  • Shopping: visit the AGO’s shop for interesting items and art books. You do not need a ticket to visit the shop.
  • Programming: Sometimes, the AGO puts on special events. These include artists’ talks, art classes, or special exhibitions. Often, there is an extra cost associated with these special events. Click here to learn more about special events at the AGO .
  • Eating: if you get hungry while you’re at the AGO, there are many places to eat:
    • CaféAGO, for smaller foods, at the concourse level. There is no set menu, but the café usually has cookies, muffins, salads, sandwiches, and beverages. You do not need a ticket to the AGO to visit caféAGO.
    • Espresso Bar, for light refreshments. There is no set menu, but coffee, tea, and light snacks are for sale. The Espresso Bar is located on the 5th floor and has incredible views of the city. You do need a ticket to the AGO to visit the Espresso Bar.
    • If you’d like to bring your own food, you can eat it in the Community Gallery Lunchroom, which is on the concourse level, in between caféAGO and the Thomson Ship gallery. Food can’t go into the galleries, but we can hold on to your food for FREE at the coat check until you’re ready to eat in the Community Gallery Lunchroom.

How can I help protect the art?

Art – whether it’s paintings, drawings, or sculptures – is very delicate and often very old. We have a team of employees who protect the art, but we need your help in setting a good example for other visitors. There are a few things to remember about visiting the gallery.

Things that can hurt the art:

  • Fingers and hands: we have invisible oils on our skin and touching the paintings or sculptures will cause damage.
  • Backpacks: people often forget they are wearing a backpack, and can accidentally back into a painting or sculpture and damage it. Backpacks need to stay out of the galleries, but you can leave them for FREE at the coat check, and pick them up when you’re finished your visit.
  • Bags: small bags are allowed into the gallery, but if they measure larger than 14 inches x 14 inches x 6 inches, they can’t go into the galleries. You can leave it for FREE at the coat check.
  • Coats: there is no dress code at the AGO, and coats are allowed in the galleries. However, to make your visit more comfortable, you can leave your coat at the coat check if you want. It costs $1.00 to leave your coat at the coat check.
  • Umbrellas: Large umbrellas cannot go in the galleries. You can leave your umbrella for FREE at the coat check, or bring a small one that fits into a pocket or small bag.
  • Food: food can be messy, and it can attract bugs and small rodents. Food can’t go into the galleries, but there are lots of places to eat in the AGO (we’ll talk more about this below). You can leave your food for FREE at the coat check.
  • Drinks: like food, drinks also attract bugs and small rodents, and people can slip and fall if liquids are spilled. Drinks can’t go in the galleries, but there are water fountains all over the building.
  • Photographs: photos cannot be taken in the galleries, but you can take pictures of Walker Court and Galleria Italia.

If I have a question while at the AGO, who can help me?

  • Gallery Guides: if you want to know more about a painting or a sculpture, you can ask a Gallery Guide. Gallery Guides are all over the AGO, and they love to talk to visitors about the art. You can find them by the orange lanyard they wear around their neck.
  • Information Guides: if you have questions about the architecture, or need help in finding your way around the AGO, you can speak with an Information Guide. Information Guides also wear an orange lanyard around their neck.
  • Security Officers (PSOs): make sure the art and AGO’s visitors stay safe. They can also help you if you are looking for something at the AGO. They wear a grey suit and a blue shirt.
  • AGO staff: you can talk to any member of AGO staff if you have a question. AGO staff wear a blue lanyard around their necks.
  • We also love to hear from our visitors before or after their visit, so please contact us if you have any questions or concerns! Click here for our contact information .

Is the AGO accessible?

Emotion Dice Game

Help your child learn about emotions by playing the “Emotion Dice” game. You can take turns throwing the dice and naming the emotion that comes up. You can also take turns acting out the emotion.

Instructions:

  • Cut out the dice template.
  • Fold along the lines.
  • Tape the edges together to form a dice or cube.

Flip Flop Over the Top Sequence

Many children need support when learning new skills. Breaking a skill down into smaller steps can help a child learn one step at a time. The number of steps a skill or task is broken into depends on the needs of your child.

You may want to provide your child with a visual sequence. This is basically a series of pictures showing the steps that are necessary to complete a task. You can use real photos, line drawings, or picture symbols. When using a visual sequence, post it at your child’s eye level, point to the picture, and read the step out loud before completing the action.

This is a fun way for children to learn how to put their coats on. Just follow the steps below. If your child is unable to bend down or sit on the floor, you may want to put the coat on a low table before working on this sequence.

  1. Place the coat on the floor or table with the hood and sleeves flat. If the coat doesn’t have a hood, make sure the label is clearly visible. You can put a colourful sticker on the label if it is small or difficult to see.

  2. Child stands behind the coat’s hood or label.

  3. Child places his arms in the sleeves of the coat. You may have to help him by keeping the sleeves straight.

  4. Flip! Child puts his arms straight out.

  5. Flop! Child lifts his arms up over his head.

  6. Over the Top! Child brings his arms back down and the coat is on! You may have to help him pull the coat down.

The first step is the key to getting the coat on properly. When your child is comfortable with the Flip Flop Over the Top steps, you can show him how to position the coat on his own.

Starting School

This workshop discusses the process for registering your child for school, and easing the transition to school.

Autism Spectrum Disorder: Supporting Children and Youth – Module 5

Developing Communication Skills

Introduction

Communication is one of the core areas of difficulty for individuals with Autism Spectrum Disorder (ASD). We often think of speech as the main form of communication. Communication, however, involves much more than simply talking. A child may use words but they may not be intentional, in context, or understood by the child. A child may also be able to communicate non-verbally but not use speech.

Communication consists of verbal as well as nonverbal behaviours that take place in a social context. It includes a child’s ability to understand (receptive language) as well as to convey ideas (expressive language). A behaviour becomes communication when there is a desire to send a message to another person. The message may be sent by using words, gestures, facial expressions, tone of voice, body language, or through other means such as pictures or sign language.

Communication

Communication refers to the verbal and nonverbal behaviours that a person uses in order to convey a message to another person.

Some keys points about communication:

  • It can be verbal (e.g., speaking) or nonverbal (e.g., pointing).
  • It is intentional in that the person must “intend” to send the message.
  • Communication is person-to-person, occurring in a social context.

The Development of Intentional Communication

Children who have not yet learned the power of communication are unaware that what they do or say has an effect on those around them. For example, a newborn baby who cries does not intend to convey a message to its mother that s/he is hungry, but cries out of distress. A mother, however, often interprets the crying as communicating hunger despite the infant’s lack of intent. It is the mother’s response to the behaviour (crying) as intentional that sets up the interaction, which is the context for the development of intentional communication. Mothers have intentional communication with their infants – they play both parts in the conversation. In typically-developing children, pre-intentional communication soon becomes intentional and by the second year most children are able to intentionally communicate.

During the first year, typically-developing infants acquire behaviours they can use to communicate their needs to others. They learn, for example, that by crying an adult will attend to him/her, that smiling and making noises gets adult attention or that an adult will say a word when they pick up an object. Regardless of the form of communication used (reaching, pointing, vocalizing), intent is demonstrated when you understand that what you say or do has an effect on someone. When a message is sent with a purpose, and with an expected outcome, the communication is intentional. Intentional communication involves the ability to persist with that behaviour until the desired effect has been reached.

Children with ASD do not develop intentional communication as quickly. Pre- and non-intentional communication may be predominant for some time even after a child has developed some speech.

Some purposes of early communication that are not intentional include:

  • Practising a skill
  • Reacting to an enjoyable or unpleasant experience
  • Obtaining desired objects
  • Soothing one’s self

Examples:

  • Repeating words when no one is around
  • Reaching toward a desired toy on a shelf when no one is present or looking

Reasons to Communicate

There are three main functions of communication:

  • Behaviour Regulation
    This is the earliest emerging function of communication. It involves requesting and protesting to satisfy immediate physical needs.
    Examples:
    • Asking to be fed
    • Trying to acquire a toy that is out of reach
    • Objecting to having one’s nose wiped
  • Social Interaction
    Communicative behaviours that involve initiating, responding to, maintaining or ending social interactions.
    Examples:
    • Greetings/farewells (“Hi”/”Bye”)
    • Showing off
    • Requesting to play games such as peek-a-boo
  • Joint Attention
    Communicative behaviours direct someone else’s attention to something that you are already attending to (an object, event or topic). Joint attention is critical to word learning, when labels are provided while both adult and child are focused on the same object.
    Examples:
    • Commenting and pointing (“Look”)
    • Requesting information while pointing (saying “What’s that?”)
    • Providing information to someone while looking at the same item (“That’s a red truck”)

Exercise: Early versus Intentional Communication

Indicate which of the following behaviours are examples of early communication (EC) and which are intentional communication (IC).

BehaviourECIC
A child has difficulty opening a container of candy. S/he bites the container, throws it, begins to cry, and eventually walks away from it. His/her mother is sitting next to him/her.
A mother offers her child a glass of juice and the child shakes his/her head “No”.
A mother is talking on the phone and her child is behind her reaching for his/her train on a top shelf.
A father tries to participate with his son who is building a tower of blocks. When the father attempts to place a block on top, the child looks at him and then pushes the block away.
A child is reciting phrases from his/her favourite movie while sitting at the table.
A child walks into the kitchen and says, “Do you want a cookie?” (No one is nearby).
A child who is thirsty takes her brother by the hand and leads him to the refrigerator.

Click here to see a sample answer

How Can Communication Occur?

There are a variety of means by which messages can be delivered. The following are some communication modes:

  • Motoric
    Motoric means physically moving a person/object (e.g., the child takes your hand and puts it on a toy that s/he wants you to activate.)
  • Gesturing
    Gesturing involves moving a body part to convey a message such as pointing and/or eye gazing (e.g., pointing to milk and then looking at the adult and waiting).
  • Vocalizing
    Vocalizing entails using sounds to communicate (e.g., the child cries to draw the adult’s attention).
  • Signing
    Signing encompasses using either a formal or informal system of hand signs.
  • Using Objects
    Using objects refers to passing/moving an object to communicate (e.g., passing a cup to another person to request a drink)
  • Pictures/Line Drawings
    Picture communication includes using photos / line drawings that represent real objects (e.g., child passes a picture of a cracker to indicate that s/he would like a cracker to eat).

(Adapted from Autism: Interventions and Strategies for Success, 2001)

Communication Characteristics and Skills in ASD

There are a number of communication characteristics common to children with ASD. It is important to recognize the large range of communication skill levels among this population of children.

Communication Characteristics of Children with ASD

Communication CharacteristicExample
Understanding / ComprehensionInconsistent responses
Over-reaction or under-reaction to environmental stimulation
Literal interpretation (e.g., If told to “hop out of the car”, literally tries to hop when getting out of the car)
Non-verbalSome children may not acquire verbal language
Limited intentional communication
Limited use of eye contact
Lack of joint attention
Limited gestures
VerbalReversal of pronouns (“You want a drink” instead of “I want a drink”)
Echolalia *Focus of a conversation is based on own interests and fact-based
WrittenMay display hyperlexia** (precocious reading)
Using Language in Appropriate Contexts(Pragmatics)Conversations and interactions lack typical “give and take”
Unaware of others’ nonverbal cues (e.g., unable to judge a listener’s understanding by the expression on their face)
Limited ability to take another person’s perspective
Limited ability to interact or communicate with others around their interests
Difficulty with understanding the appropriate distance (personal-space boundaries) and orientation relative to a communicative partner (being face to face)Limited ability to initiate, maintain and/or end conversations and social interactions
Limited ability to shift topics of conversationTendency to interrupt others
Difficulty providing clarifications when a person does not understand
EmotionalLimited display and understanding of facial expressions
Mismatch between emotional expression and situation (e.g., may laugh when a person is hurt)
Difficulty understanding the emotions of others

(Adapted from The Denver Model Treatment Manual, 2001)

* Echolalia

Echolalia refers to the repetition of what another person says which includes sounds, words, and phrases. Echolalia may be immediate. This refers to when the child repeats words/phrases immediately after hearing them.

Echolalia may also be delayed. This refers to when a child hears words/phrases but may not repeat them until days/weeks/months later.

** Hyperlexia

Hyperlexia refers to an unusually well-developed early ability to decode written words, significant difficulty in understanding and using verbal language, and challenges in social interactions. This usually becomes apparent without the child having been taught explicitly to read.

Hyperlexia is a characteristic that is observed in some children with ASD, and occasionally in other conditions. This ability to remember letter patterns seems to be related to the visual learning style of children with ASD.

Variability in Communication Skills in ASD

Children with ASD vary greatly in their communication skills. Some children with ASD are non-verbal, some have limited vocabulary, and some are verbal with extensive vocabularies. Echolalia may be used by children with ASD to communicate or without purpose. As well, children may communicate for a very limited number of purposes (e.g., to request or protest), or they may communicate with many intentions (e.g., to greet, to show, to comment). Regardless of their level of communication ability, what children with ASD have in common is difficulty in communicating effectively.

How and Why a Child Communicates

In order to help a child to communicate more effectively, you must be aware of his current communication abilities.

How is the child communicating? (Mode)

  • Screaming
  • Throwing
  • Gestures
  • Facial expressions
  • Looking at things
  • Taking your hand and leading you
  • Pointing
  • Through pictures
  • Making sounds
  • Using words/sentences

Why is the child communicating? (Function)

  • To protest
  • To refuse
  • To respond
  • To greet
  • To get someone’s attention
  • To comment
  • To ask questions
  • To express feelings
  • To pretend

Strategies to Help a Child Communicate

After observing a child with ASD and gathering information, goals can be developed and strategies selected to increase communication skills.

The following goals and strategies are categorized based on whether the child’s communication is intentional/non-intentional or verbal/non-verbal.

1. Working on Early Communication Skills with a Child with ASD

Children with ASD who are early communicators need help in understanding that their behaviour can affect another person. A goal for a child at this level might be that the child will communicate a desire for something (e.g., a toy, a drink, to go outside). If the child has some verbal language the goal might be for him/her to say the word within an appropriate context. If the child is non-verbal the goal might be for him/her to point to a picture that indicates the desired outcome or object.

Strategies to Help a Child Develop Intent

  • Cause and Effect Activities
    Activities that demonstrate cause and effect relationships help to develop intent. They demonstrate to the child that doing one thing causes another thing to happen. Examples of cause-effect toys are those activated by pushing a button or a switch and pop-up/wind-up toys.
  • Use Highly Motivating Actions and Objects
    In order for a child to communicate, s/he must be motivated to do so. If a child really likes an activity such as swinging, you can start by teaching him/her to request, or make choices involving the desired activity. See Module 3 for a way to survey object and activity preferences/rewards.
  • Give the Child a Reason to Communicate
    You can often anticipate what a child wants, especially when you know the child well. If, however, you attend to his/her need before a request, this removes the need to communicate. If you briefly delay meeting the child’s needs. s/he has a reason to communicate in order to get what s/he wants. Communicative temptations encourage a child to ask for “more”, “help”, or an activity/item by name such as “book.” For example, placing favourite items or food out of the child’s reach can encourage him/her to ask for them using whatever means that s/he can – e.g., pointing, sounds, single words, or a phrase. Reward the child by providing the item when s/he attempts to make a request or uses the means you are teaching. Always give the child time to request the activity (wait up to 10 seconds). Accept word approximations at first from non-verbal children. Reward any form of intentional communication to encourage and motivate for continued use.

Communication Skills for the Non-Verbal Child with ASD

Children with ASD may require a variety of methods both to express their thoughts and to understand what others are communicating. The term “augmentative and alternative communication” (AAC) is used to refer to alternative communication methods that can support a child’s efforts to communicate. Augmentative and alternative communication methods can be unaided or aided, using objects or devices. Examples of unaided methods of communication include gestures, facial expressions, vocalizations, and sign language (such as American Sign Language). Examples of aided forms of communication include the following: handing to an adult a cup to signal being thirsty, pointing to pictures on a communication board or in a book, and activating a device that provides auditory output.

Please note: The type of augmentative and/or alternative communication system used by a child is identified and the implementation is monitored by a registered Speech and Language Pathologist.

After determining how the child communicates (gestural, motoric, etc.), it is important to decide whether a more consistent and efficient form of communication can be used. For example, if the child often communicates by screaming or leading you by the hand, another system of communication would be more appropriate. As well, if the child does not yet speak, he needs to use another communication system, either in addition to or instead of his current means.

Below are some of the unaided ways that a nonverbal child with ASD might communicate:

  • Gestures
    Gestures can include pointing or looking, as well as shaking or nodding your head, pushing items away or waving “Hi/Bye.”
  • Facial Expression
    Expressions can include requesting, protesting, declaration of feelings (e.g., happy, sad, upset, etc.)
  • Vocalizations
    Vocalizations can include requesting for attention, refusing, affirming, greeting
  • Sign Language
    Early signing can include requesting, protesting, refusing, greeting, etc.

The following are some of the aided ways that a nonverbal child with ASD might communicate:

  • Object Manipulation
    Can include reaching for items, grabbing items, handing items to adult to request, throwing items to indicate protest/refusal/dislike
  • Pointing to Pictures
    Pointing to pictures requires the child to point to or tap the picture to communicate. The pictures may be photos, drawings, or symbols.
  • Picture Exchange Communication System (PECS)
    PECS is a program developed by Bondy and Frost specifically to teach a child to initiate communication using visual symbols. It involves systematically teaching the child to give a visual/picture to someone to communicate, when words are not yet reliably used for this purpose. The use of PECS requires training for those who are working with the child; consultation with a Speech-Language Pathologist is recommended.
  • Voice Output Aids
    These devices have a button that the child can activate to play a pre-recorded message. This message communicates what the child wants, or allows him to participate in an activity. For example, the child presses the button and the device says, “I want tickle”, or plays a line of a song to enable the child to “sing along.”

2. Working with a Child with ASD Who Shows Intentional Communication

Expanding the Functions of Communication

The child may be nonverbal or verbal but as long as s/he means to send messages to others, s/he is showing intentional communication. As stated above, communication takes place for a variety of reasons. Observing the child provides you with ideas as to why s/he is communicating. Your goal can then be to expand the purposes for which the child communicates. The functions of communication are as follows:

  • Behaviour Regulation
    Communication can be used to regulate a child’s immediate physical needs. To develop communicative behavioural regulation, you have to provide opportunities to request or protest during the daily routine.
  • Social Interaction
    These are behaviours that initiate, respond to, maintain, or end social interactions.
  • Joint Attention
    This communicative behaviour involves the child being able to direct the attention of another person to an object or event.

Expanding Reasons to Communicate

Expand a child’s reasons for communicating:

  • Identify the best setting or time to implement the strategies (e.g., snack time, circle time, one-on-one time). This may vary depending upon the functions on which you are working. For example, greetings will be practised most naturally on arrival at the centre, or when returning to a particular room. Snack time provides many chances to practise requesting food or drink.
  • Identify what you want the child to say, taking into account what is developmentally appropriate for the child and for the language used by his peers. For example, when a 4-year-old child wants a peer to join in a game, s/he may say, “Come on!” instead of “Do you want to play?”
  • Encourage generalization by providing a lot of opportunities, with different people, in a variety of contexts, during the child’s daily routine.

Working with a Child who Uses Echolalia

One strategy for managing echolalia in children is to model phrases from the child’s perspective. For example, instead of saying, “Are you okay?” when the child falls down, say “I’m okay”, or “I hurt my knee”. The child will then repeat an appropriate phrase from his own perspective. If you are consistent with this, the next time the child falls down, he will have learned and may say, “I’m okay”.

Strategies to Improve Understanding

Working on the child’s receptive communication is as important as working on expressive communication. Children with ASD have difficulty processing auditory/verbal information, as well as making sense of their environment.

The following strategies can help a child’s understanding (also see Module 2):

  • Predictability/Routine
    Being predictable with your actions and creating predictable routines helps a child to understand what is going to happen next. This helps the child to understand what s/he is supposed to do in different situations. It also provides repeated opportunities to engage the child with language that describes what will happen in a context s/he will understand.
  • Using Visual Supports
    Most children with ASD are primarily visual learners. The use of visual aids, therefore, enhances their understanding. Visual schedules can reduce anxiety, provide concrete reminders, and/or describe the steps in a task.
  • Combine Words and Gestures
    Use gestures/actions when speaking to children. For example, point to a chair while asking the child to sit down, or show a picture of snack food while saying “Time for snack”. Instead of pictures, real objects can also be shown to children who need a more basic representation of the item. Written words can be shown to children who can read.
  • Structure the Environment
    Remove or decrease distractions such as materials that are not related to your teaching/learning goals. This allows the child to better focus and to understand what is expected of him/her. Arrange the seating so that the child can better attend to the topic or task. Refer to Module 2 for other suggestions.
  • Simplify What You Say, Emphasize Key Words, and Repeat!
    Simplifying what you say means talking at the child’s level of understanding. If the child is only able to understand short sentences, adjust what you say to match this. Try to be consistent and concise when speaking.

    When you emphasize key words in a phrase, you are developing the child’s ability to understand the meaning of the request/demand/comment. Key words can be emphasized by saying them more loudly, using a different tone, pausing slightly, or making your voice more animated. To support the child’s ability to generalize the use of the word in multiple environments, use the same word for every applicable.

    For example,
    Doing simple imitation exercises such as waving, touching nose or ears, clapping will prompt the child to look at you and copy responses. This will also encourage the child to look at his/her communicative partner and to try different imitations such as vocalizations and gestures.

    Next module: Developing Functional Play and Adaptive Behaviour

    Autism Spectrum Disorder: Supporting Children and Youth – Module 4

    Setting Goals and Teaching New Skills

    Introduction

    Children with a diagnosis of ASD have a profile of strengths and challenges. An understanding of the child’s current skills and the setting of educational goals are necessary first steps to be taken prior to addressing the building of new skills. The plan will include the prioritized skills selected for focus on and the adaptations necessary to meet the needs of the child. Breaking the learning of skills into smaller steps allows the child to achieve success while minimizing frustration. Clear and meaningful instructions will support the child’s development and ability to establish the skill.

    Setting Goals

    Setting Initial Priorities

    When developing the educational plan, the first step is to determine the priority goals for the child. The team should be comprised of parents and educators. Avoid developing goal plans with unrealistic goals so that you and the child can see progress and experience success.

    Here are some guidelines to think about when choosing a target skill to teach:

    • What skills has the child achieved in each area of development? The next natural step is to build upon the existing skills in a developmentally appropriate pathway. For example, a child can sit on a trike and push him/herself forward using his/her feet on the ground. The next step would be for the educator to place the child’s feet on the pedals. The adult can support the turning motion of the child’s feet.)
    • What skills would the family like the child to learn? It is very important to consider the family’s goals so that they can be incorporated into the learning environment. Working as a team will provide consistent strategies which will benefit the child. Generalization will more easily occur between settings when there is a shared approach by all team members.
    • What are some everyday tasks and routines that require support?
    • What skills would you like the child to learn? What do you feel is important? Is there a particular behaviour that you would like to change? For example, sitting for circle time.
    • Some children have particular interests that may provide an opportunity to expand skills. Keep in mind that if the interest is restrictive and/or repetitive, you will want to expand the child’s skills to include other aspects. For example, if a child chooses to play with trains only, you may want to add people to the trains, or trains to the sensory table, or another creative activity.
    • What skills can be taught at the program? Some skills may take longer to establish while others will be easily acquired.

    Developing a Plan and an Outline of How the Teaching will Occur

    When working toward specific goals, an educator should keep in mind the following points:

    • What time of day is best for teaching a particular skill?
    • What location is best for teaching?
    • What modifications may be needed?
    • What materials will you need for teaching (including reinforcements)?
    • What kinds of group activities can be adapted to include a teaching component?
    • How will you convey to the child that teaching sessions are going to happen during the week (e.g., calendar, transition cards)? Refer back to Module 2 for information that will be helpful here.
    • Where will the individual support plans and other information about the teaching sessions be kept? It will be important for other staff and the child’s family to have access to this information in order to be consistent.
    • With whom will you be consulting regarding the child’s learning and programming (**including outside resources, see Module 8).

    Task Analysis

    What is the best way to teach these new skills? While all children are unique, we know that many children need support in the following areas when learning a new skill:

    • Organizing the steps
    • Sequencing the steps
    • Mastering the steps
    • Gaining motivation to master the steps
    • Generalizing the new skill to new people, places, and conditions

    Organization and Sequencing through Task Analysis

    It is sometimes necessary to break down a complex skill into smaller steps or actions in order to meet the learning needs of the child. The number of steps involved in a task analysis and the instructions used will depend on a child’s ability. Skills that have already been mastered do not need to be included as part of the task analysis. Provide the child with adequate time to master each step in the sequence.

    For example, a task analysis for a spoon-feeding chain could be:

    • pick up the spoon
    • put spoon into the food in the bowl
    • scoop food onto the spoon
    • lift spoonful of food from the bowl
    • put the food into the mouth

    While the above may work for one child, another child might need much more detailed steps. For example:

    • reach for the spoon
    • grasp the spoon
    • pick up the spoon, etc.

    Once you have a task breakdown that is workable and yet flexible enough to change as you get a better sense of the child’s learning style you are almost ready to get started. First you will want to learn more about the proven teaching technique known as Chaining.

    Chaining

    Teaching a skill using chaining is commonly recommended if the child can only perform some of the steps, consistently skips steps, or is completing steps out of order. Backward chaining refers to teaching a skill beginning with the last step and then teaching the immediately preceding steps one at a time until the entire skill has been mastered. For example, when teaching a child a new 4-piece puzzle, leave 3 pieces intact in the puzzle and have the child place the last one. Once the child successfully places the last piece, present the puzzle with 2 pieces missing for the child to complete. Finally, provide the child with the puzzle with 3 pieces missing. Forward chaining involves teaching a skill beginning with the first step, and then teaching each successive step one at a time until the entire skill has been learned. For example, have a child place the first piece into a puzzle (with the other spaces blocked off). Once this is established, provide the puzzle with two pieces to be placed and so on.

    Giving Effective Instructions

    Tell me and I forget.
    Show me and I remember.
    Involve me and I understand.
    Chinese Proverb

    As educators, adults spend a great deal of time telling children what is expected of them in one-to-one teaching situations or in groups.

    Giving effective instructions is an important skill to develop. It sets the stage for the child to be able to respond appropriately. Younger children with ASD, or those with limited language, often have difficulty understanding instructions which can make it harder for him/her to respond or act as expected.

    What tends to happen when we give long detailed instructions is that children respond by:

    • Staring
    • Not attending
    • Doing something else while you are talking
    • Looking away
    • Making sounds / vocalizing

    The following are some suggestions for providing effective instructions:

    • establish that the child is paying attention
    • be in close proximity to the child
    • give short, simple directions (e.g., “walking feet”)
    • give one direction at a time
    • state the direction in a positive manner
    • give extra assistance if necessary and allow the child time to process the instruction
    • tell, do not ask (e.g., “Time for bus” rather than “Want to get on the bus?”)
    • repeat, practise and praise – make this approach a habit or routine as it will assist the child in acquiring the skill

    Prompting

    “Prompts” are hints or clues that can be used to help a child respond appropriately. When a child feels able to successfully complete tasks it will be more fun to practise and learn new skills.

    When to Use a Prompt

    Prompts can be used when the child is not able to successfully complete a task or activity independently. They are used only when needed to facilitate independence and learning.

    It is helpful to use the least intrusive, most natural prompt and to fade out the prompt as soon as possible.

    Types of Prompts

    There are many different types of prompts to choose from, and you will likely use all of them in various teaching situations.

    Prompts fall into the following categories:

    • Verbal prompts – provide a verbal instruction, cue, or model of the correct response. Remember to use statements rather than questions.
      Example:
      “Puzzle or shape sorter” (Verbal instruction)
      “Want puzzle” (Models the correct response)
    • Modeling – demonstrate the correct response to the child
      Example:
      Show how to comb your hair
    • Physical prompts – physically guide the child through all or part of the desired response (hand over hand)
      Example:
      Hold the child’s hand on the comb and help to comb his/her hair
    • Gestural prompts – actions such as pointing to, looking at, moving, or touching an item to indicate the correct response
      Example:
      Point to the circle in a group of shapes while saying “Circle”
    • Position cues – the correct item is placed in an advantageous position in relation to the child
      Example:
      Put the red square closer to the child than the blue square and say “Give me the red square”

    Giving Verbal Prompts

    • State the child’s name before giving the instruction.
    • Give directions only when the child is paying attention. Get down to his/her level.
    • Give directions slowly.
    • Use directions that take no more than one or two words or simple phrases.
    • Use clear and concise directions as they should direct, not distract.
    • When giving directions, use words that the child understands.
    • Verbal instructions may be more effective when accompanied by a gesture.

    Using Modeling Effectively

    Modeling will only be beneficial if the child is able to imitate.

    • Model each step before asking the child to do it.
    • Model bigger steps as the child gets better at imitating and remembering.
    • Modeling is most effective when it is done slowly and with careful exaggeration.

    Using a Physical Prompt

    At the beginning of using a physical prompt, the educator is doing all the work. As the child improves, gradually reduce the physical assistance.

    For example, gain eye contact with the child, let them know that you are about to hold their hand and supportively move them through the motions you are teaching. As time progresses and the child begins to understand the requirements of the task, you can move to holding the child’s hand less securely and less often. Continue to gauge the amount of support that the child requires. You may then only need to touch the child’s wrist, or forearm until the skill is established.

    Determining Which Prompt to Use

    Many children with ASD need a great deal of physical prompting, particularly when learning a completely new skill. Start with the least intrusive prompt and move towards more guidance as needed.

    • Verbal
    • Gesture
    • Model
    • Physical – Partial
    • Physical – Hand over Hand

    Start with the least intrusive prompt if you are teaching a skill the child has previously experienced and you wish to foster more independence and spontaneity.

    Use a physical prompt if this is a new skill for the child, or move towards a physical prompt more quickly if s/he has had little practice with it.

    Modeling and physical guidance are often the most effective prompts at the beginning, particularly for children with ASD who have difficulty with language.Accompanying a verbal instruction with a demonstration or guidance can be a very powerful teaching tool.

    How Long to Use Prompts

    If the child can perform a step correctly with only a verbal instruction, you are ready to move on and fade out the prompts. If not, you still need to use prompts for showing and guiding the child.

    Prompts are most often associated with teaching in a one-to-one setting but they can easily be used with the child in a group setting as well. Some examples of prompting during a group setting are:

    • Encouraging a child to ask another child to play by modeling “Can I play?’”
    • Helping a child to participate in circle time by giving them a gentle touch on their arm accompanied by saying “Your turn.”

    It is important to ensure that the child does not become dependent upon a prompt. The ultimate goal is for the child to complete this task independently without the dependency of needing a prompt. Once a child is able to complete a task independently, it will build their self-esteem and confidence to try other tasks.

    Reinforcement

    In a teaching situation, we want to reinforce appropriate responses in order to increase the likelihood that the child will respond again in the same way.

    Used properly, reinforcers can be very powerful tools for changing behaviour.

    When to Give Reinforcement

    When asked to perform a task, there are four ways a child can respond:

    • Attempt to escape the demand
    • Avoid the demand
    • Make some attempt at the task, require more support
    • Obtain positive feedback for performing the task

    If you reinforce the child’s attempts when introducing new skills, the attempts are associated with positive feedback which continues to motivate the child.

    Reinforcers

    Types of Reinforcers

    • Social Reinforcers
      Attention, touching, praise – this involves looking or smiling at the child, commenting on the activity the child is doing (“You’re colouring”) or (“You’re standing in line”) and give a “high five”.
    • Edible Reinforcers
      Very small portions of food or drink. Many programs do not allow this type of reinforcer. It is typically used when a child has no known activity preferences.
    • Activity Reinforcers
      Activities that the child likes to do are reinforcing. A successful teaching strategy is to employ the use of: “First, less preferred activity, then preferred activity.” For example, “First shoes on, then bicycle.”
    • Using Tokens
      Tokens offer a tangible reward (e.g., stickers, stamps) every time the desired behaviour occurs. These can be exchanged later for a bigger reward (e.g., ice cream, a new book).

    Key Points to Remember About Reinforcement:

    • Reinforcers need to be meaningful for the child in order for them to modify behaviour. For example, if you give a child a “high five” for cleaning up but “high fives” are not that exciting to the child, this will not be motivation to maintain that cleaning up behaviour you want to see again.
    • Reinforcers are most effective when they are given immediately following the desired response.
    • What works one day might not be reinforcing the next day. Interests change and you need to vary your reinforcers and make them exciting.
    • When you are working on a new skill, reinforce it all the time. You can start fading reinforcers (as you fade prompts) as the child gets better at the task. Reinforce only successes, then every few successes, then less often, then rarely.

    Measuring Change and Keeping Records

    Once you start teaching, or trying to introduce a replacement behaviour, you will want to know whether the behaviour is improving and what skills the child is learning. You will want to be able to measure the change that is happening and to keep a record of that improvement.

    Describing actions with numbers (e.g., It takes Jacob 10 minutes to get in line and stand quietly.) helps you to explain how much of a challenge something is, or how much improvement has occurred (e.g., It now takes Jacob 4 minutes to get in line and stand quietly).

    Remember that when trying to increase an appropriate behaviour (e.g., eye contact, interaction with other children), more time or more often is the goal. When trying to decrease an inappropriate behaviour (e.g., pinching or screaming), less time and less often is the goal.

    Decide whether you want to record how often a given behaviour occurs or for how long it occurs. If the behaviour occurs a few times a day, and each occurrence is short, you may want to keep track throughout the day.

    If the behaviour happens very frequently, however, or takes place over long periods, you may want to choose some specific times during the day when the behaviour is typically observed, and only record during that time.

    Records of Behaviour Change (see Module 3)

    There are many ways to keep records of behaviour change. You can make a graph, keep a tally of counts, keep a general communication book where you write down your observations, or keep a chart the records percentages and scores.

    The important thing is that however you choose to keep track of change, you understand your system and that those who work with the child and the child’s family understand it as well. You also want to keep it in an accessible place for easy use throughout the day.

    Next module: Developing Communication Skills

    Autism Spectrum Disorder: Supporting Children and Youth – Module 3

    Observing and Understanding Behaviour

    Introduction

    Why use observation?

    All teachers need to develop skills as observers. They need to see and record as accurately and as objectively as possible what is happening in different situations. Teachers learn most about children by studying their behaviour directly. By learning to observe with objectivity, to make careful notes, and to go over the notes thoughtfully, a teacher increases his/her understanding of a child’s behaviour. Systematic observations made by sensitive and knowledgeable educators are more powerful than any other technique in determining a child’s strengths and needs. Knowing what to observe and consistently recording the information for later reference as critical to good observation. Observations can be done unobtrusively in the child’s classroom setting as s/he interacts with teachers, plays, and participates in regular transitions such as meal times. At other times, situations may have to be contrived to provide information about specific behaviours. What is being observed determines whether the observation can be natural or contrived. We observe children to determine their level of interest in, and response to. the environment, their ability to solve problems, communication skills, motor functioning, and social skills.

    Observing Behaviour

    Key to all observation techniques is a clear set of definitions regarding what is being observed. For example, if tantrums are to be observed, what constitutes a tantrum must be specified. What does a tantrum look like? How will you know it is occurring? Does a tantrum involve whining, turning away, crying, hitting, throwing things, refusing attempts to comfort, or some combination of all these things? Prior to the observation, the categories and their definitions must be developed, and all those using the observational instrument must be trained and skilled in its use.

    There are a number of things to consider when making your observations:

    • Define the specific behaviour
    • Maintain objectivity and do not interpret what is happening
    • Describe the behaviour you see and try not to label, (e.g., Describing a child as shy does not tell us what s/he did. We want to know that when another child approached him/her and said “hi” the child stood, looked at the floor, and said nothing).
    • Determine whether the specific behaviour that you are observing requires observation in a variety of settings or a specific environment. Keep in mind that children with ASD behave differently in different environments and can be affected by other variables (e.g., visual and auditory stimuli, use of visual supports, individual, small, or large group play).

    Types of Observation:

    Several strategies are used to structure information gathered during observations. These may include event recording, time sampling, checklists, rating scales, and coded observations. Observations are best performed in a child’s natural setting such as their home or classroom and, if possible, by a person who is familiar with the child.

    Issues and cautions to consider when using observational techniques include:

    • select target behaviours
    • define target behaviours in observable terms
    • define the criteria to be used in judging occurrence or nonoccurrence
    • select no more than two targets to observe at one time
    • keep coding on data sheet simple and efficient (refer to linked documents for data collection)
    • know specifically what the observation is to reveal (for example, you may have a special purpose in mind, such as trying to discover how a certain child approaches other children)

    With the advancement in technology in the classroom setting, specialized equipment such as audio/video recorders may assist you in this process. It is important to be aware of your centre’s policies/procedures regarding consent of taping/recording within the classroom setting.

    Event Recordings: These may be continuous, narrative records of the child’s behaviours and responses or a detailed recording of a single event. For example, behaviours such as temper tantrums may occur regularly. It is important to capture the details of the antecedent condition (what happens right before the tantrum occurs), the behaviour during the tantrum, and the consequent events (what happens immediately after the tantrum) in order to develop appropriate management and treatment plans.

    Time Sampling: Often called interval recording, is used when behaviours occur more frequently and the observer is interested in the frequency of occurrence. To develop a more complete picture of a child’s behaviour you may decide to observe the child using a time sampling approach. Prior to the observation, you need to develop a form for recording observations and select the times you want to observe. Forms are usually quite simple and are typically divided into smaller intervals of 15 seconds to 1 minute. Behaviours may be preprinted on the form so that the observer can record what is occurring during each interval. The observation period may last from several minutes at different times throughout the day to an hour or more every day for several weeks. At the end of the observation period, the percentage of time that the child has spent displaying the behaviours of interest can be determined.

    Checklists and Rating Scales: These can be used to determine the presence or absence of a particular skill or behaviour or to rate the quality of the behaviour or setting. Checklists of developmental milestones can be used. Children are observed at play to determine which skills they have mastered, which are emerging, and which remained to be learned.

    Coded Observations: These are often used to study multiple interactions or behaviours occurring within a specified period of time. In observations of this kind, the behaviours of interest are specified prior to the observations. The number and types of behaviours can range from very few, simple behaviours to many complex interactional patterns.

    How Often Are You Going to Record the Behaviour?

    If a behaviour happens just a few times a day for shorter periods of time, you may wish to keep track of it throughout the day. If a behaviour happens frequently or for long periods of time, you may wish to pick specific times during the day when it typically happens. Count or time the behaviour only during these designated times. As a general rule, if the behaviour occurs more often than once in 15 minutes, you want to record only at specified times.

    Understanding Why Children Behave in Particular Ways

    What is behaviour?

    Behaviour is anything that a person says or does. It is any action that we can SEE or HEAR. Here are some examples of behaviour:

    • Smiling
    • Throwing a ball
    • Crying
    • Scratching
    • Talking

    Behaviour also has a “function” or purpose. It can be a way to meet our needs, or to help us to communicate. Sometimes, when a person cannot communicate, they rely on behaviour to take the place of speaking. A child may use behaviour as a way to let you know:

    • “Hey, how about some attention?”
    • “It’s too loud in here.”
    • “Leave me alone!”
    • “I’m tired.”

    What is meant by challenging behaviour?

    Challenging behaviour can put the health and safety of a child, and those around him/her, at risk. It can also interfere with a child’s learning. Sometimes, behaviour is a challenge because it happens far too much, or not enough. It may take many forms, such as:

    • yelling, screaming, or shouting
    • hitting, kicking, or punching
    • running away
    • spitting or biting
    • throwing things
    • ignoring people, pretending not to hear them

    Before one can start changing a behaviour one has to define the behaviour that needs to change. This is important, especially if you are working with a team so that everyone is looking for the same thing. For example, Sara runs from the snack table and attempts to leave the classroom. This gives everyone an understanding of the challenging behavior. Once defined, you can move into assessing the function and how to create more appropriate behaviours.

    Why do children engage in challenging behaviours?

    As mentioned above, all behaviour happens for a reason. It is important to better understand why a child is behaving or acting in a certain way and to determine the function or purpose of the behaviour. Simply put, what does s/he “get” for behaving in this way?

    The function of behaviour can be categorized: to obtain or avoid someone or something, objects, activities; to obtain or avoid attention, or to obtain or avoid sensory stimulation. In some situations, a child might behave in a challenging way in order to make himself more comfortable. Some children can be very sensitive to the sounds, smells, sights, or textures around them. They may look for specific ways to experience sensations they enjoy, or avoid sensations they dislike. It may be more difficult to figure out behaviour that serves the purpose of trying to obtain or avoid sensory stimulation.

    Examples of the four functions of behaviour:

    • Access to Tangible Objects: Behaviours are used to gain access to desired objects
      • Escape or Avoidance of Objects or Activities: Behaviours are used to allow a child to delay or avoid doing something that has been requested of him/her.
        • Attention Seeking: Behaviours are used to gain the attention of adults or peers.
          • Sensory Seeking: Behaviours are used for self-stimulatory or soothing effects.

            Antecedents, Behaviour, and Consequences, or the ABCs

            Understanding and changing a child’s behaviour is never simple. Describing the behaviour of concern, and gathering relevant information about when it occurs and under what conditions are the first steps to achieve success.

            Antecedent is something that comes before a behaviour, and it may trigger that behaviour.

            Behaviour is anything an individual does.

            Consequence is something that follows the behaviour.

            The ABC Functional Assessment Card is a recording system that is extremely valuable in helping to gather and analyze information to help change behaviour.

            blank ABC template

            The first step is to carefully select and “define” a specific challenging behaviour. Defining a behaviour requires describing exactly what is seen and/or heard. The definition should be specific, observable, and measurable. It may be useful to print the definition of the behaviour right on the top of the ABC card.

            The next step is to fill out a separate ABC Card each time the defined behaviour occurs.

            Analysis of the ABCs:

            It is important to look for any patterns or common trends, such as patterns in the days of the week, or times of the day when the challenging behaviour occurs. Note when the behaviour does not occur as this may give additional clues about contributing factors.

            Questions to ask include:

            • Is the behaviour happening during the same activity and/or with the same materials?
            • Does the behaviour occur with specific people? (e.g., mom, educators)
            • Are there certain events or conditions that lead up to or happen before the behaviour? These events are called triggers, or antecedents.
            • Is there a consistent consequence? What happened after the child behaved in a certain way? Consequences can be positive or negative. Behaviours that are followed by a positive consequence (something the child considers pleasant, e.g., smiles, desired toys, stickers, “good job”) are more likely to recur. Negative consequences (something the child considers unpleasant, e.g., the loss of a privilege, being ignored) can decrease the probability that a behaviour will occur in the future.
            • Does the behaviour stop after a particular consequence? If this is consistent, does it mean anything about the function or purpose of the behaviour?
            • Consider other personal factors that may be influencing the behaviour such as illness, fatigue, or hunger.
            Next module: Setting Goals and Teaching New Skils
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