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Autism Spectrum Disorder: Supporting Children and Youth – Module 8

Offering choice

Working Together

Introduction

The complexity of the needs of children with Autism Spectrum Disorder requires the integrated efforts of a community. This includes family, educators, health care providers, and others. It is important to facilitate collaboration among the child’s family and professionals in order to work towards established goals to best support the child and his/her family.

Who are the Team Members?

Most children are born into families with community support. When a child has extra support needs they become part of a larger community. This community may include different professionals and services such as child care centres, early intervention programs, health care services (e.g., speech-language pathologists, psychologists, physiotherapists, physicians, occupational therapists, nurses), community services (e.g., social workers), and recreational programs. Each part of the community plays a specific role and brings a different expertise to developing a good, integrated program.

Parents are the experts and guardians of their child. They live with the child and know his/her likes, dislikes, tendencies, and personality. The family’s input is essential in the development of goals for a child’s program.

A few principles to guide interactions with parents and family members:

  • Treat the parents’ views with respect. It is important to ensure that the relationship between families and professionals is collaborative and respectful.
  • Maintain an objective perspective. Every family is unique and there may be many factors involved when making decisions. Treat the family as a unit, focusing on balancing the needs of all members involved, including siblings.
  • Keep in mind that being a parent of a child with ASD brings new stresses to a family’s daily life.
  • Professionals are guides, not experts
  • Collaborative relationships involve a cooperative approach to problem solving and support. They require openness and sharing.
  • Ultimately, the family will maintain responsibility for decisions involving the child with ASD. Professionals must realize that their involvement typically constitutes only a fragment of the total picture for the child and family
  • Our goal is to create a partnership with the parents while working with the child. Creating shared goals for the child and respecting what every professional and parent/family member brings to the table helps the child to reach those goals.

Modified from Working with Families: A Developmental Perspective, 1987.

Team Members:

Family

Family members will typically have detailed knowledge about the child’s daily life. It may be helpful to obtain information about:

  • Play activities the child enjoys
  • How the child communicates at home
  • How you can communicate best with the child
  • Activities the child does not enjoy
  • Strategies that help the child to calm down
  • Rewards or reinforcers that motivate the child to learn a new skill
  • Times of the day the child prefers to rest and relax and times the child prefers to be active
  • The child’s preferences related to the following: positioning, diet, temperature, lighting, and sound level
  • Special needs related to health and development such as toileting, dressing, and grooming

It would be beneficial to maintain ongoing communication with the family about their hopes and dreams for their child and anything that may be of concern. Families are a great source of information and resources about ASD to be shared with other team members.

Clinical Psychologist

A clinical psychologist has in-depth graduate training in learning and behaviour. S/he has the necessary training to administer and interpret formal psychological tests, diagnose, and provide intervention services for individuals with ASD. Psychologists examine children’s verbal and nonverbal cognitive skills and adaptive behaviours (e.g., self-care, social, motor, play). With training in behavioural-intervention methods, they can assist in developing and teaching programs for children with ASD. They are also equipped with professional skills to provide families with coping strategies to get through stressful circumstances.

Early Interventionist

Early interventionists are trained and experienced in working with families and children with special needs. They come from a variety of backgrounds, including special education, psychology, and early childhood education. They help families identify goals and organize resources. Activities are designed by early interventionists to complement the family and the child’s routine.

Occupational Therapist

Occupational therapists focus on functional and developmental needs. They examine a child’s fine motor skills, sensory processing, visual perception, organizational difficulties, oral/motor development, and seating/mobility needs. They pay particular attention to motor planning abilities related to the development of self-care, play, and social interaction skills.

Physician

Several different types of physicians may be involved in a child’s care, depending on his/her individual needs. The family physician makes referrals to specialists such as pediatricians, developmental pediatricians, neurologists, and psychiatrists. A pediatrician has special training in children’s health needs. Pediatric neurologists, developmental pediatricians, and child and adolescent psychiatrists have additional training and experience in diagnosing and managing certain aspects of child development and behaviour. Physicians are responsible for the management of medication. Neurologists typically also become involved when a child has a seizure disorder. In different centres, one or more of these specialists may be involved in the care of children with ASD.

Social Worker

Social workers have specialized training in family functioning. They gather information about the family history, relationships, and supports. They also provide support for the management of family stress and communication. Social workers typically have a good appreciation and awareness of community supports. They are strong advocates for families to access additional financial and recreational help, respite care, and social support.

Speech-Language Pathologist

Speech-language pathologists observe, evaluate and develop interventions to promote children’s communication skills. They will examine the child’s ability to understand communication (receptive language), ability to communicate with others (expressive language), social use of language (pragmatics), ability to control their tongue, lips and jaw (oral-motor functioning), ability to produce speech sounds (phonology/articulation), pitch, loudness, resonance (voice), and smoothness of speech (fluency). The speech-language pathologist may also assess and develop interventions to promote social interaction and play skills.

Other Professionals

Many other professionals may be involved, depending on the child’s needs. Physiotherapists provide support for the development of gross motor, mobility, and play skills. Nutritionists provide counselling and support regarding the dietary challenges that are common in children with ASD. Audiologists assess hearing and ophthalmologists assess vision. Geneticists are often involved when examining possible causal factors in the child’s disorder, as well as when families are considering having more children.

In the wider community, children with ASD and their families may also benefit from extended family, informal or formal support groups (e.g., autism societies, Association for Community Living), spiritual counselling or membership in a religious community, recreational programs (inclusive or specialized), opportunities to access respite care providers, and a variety of other supports. Each family will differ in how they define the team of essential supports for their child and themselves.

Behavioural Therapist

Many children with ASD access behavioural therapy in a group setting or on a one to one basis . Behavioural therapy can help the child to learn more appropriate behaviours and ways to express him/herself and work at decreasing challenging behaviours.

Exercise: Describing Team Members’ Roles

THINK about a child with ASD at your centre.

TRY to generate a list of the various professionals involved in the child’s care of which you are aware.

Describe your understanding of each team member’s discipline and role in the child’s care. Remember that not all information needs to be shared with everyone, so you may not be involved personally with all of the child’s team.

Click here to see a sample answer

How Does the Team Communicate?

It is helpful to have discussed methods of communication with family members before the child enters a child care centre. This ensures that the parents will know how to communicate their concerns to you when they arrive. It also helps parents to know how you will share your observations with them. It may be beneficial to consider keeping a formal record of the communication strategies a family would like to follow.

Program Plans

A program plan is a document designed to facilitate communication among members of a team that formally identifies plans for a child’s program. Different terms are applied to program plans based on the specific goals and objectives of the plan. For example, a child may have a very specific behavioural program plan to teach a particular skill.

This plan might include details such as the following:

  • Teaching Objective
  • Environment/Setting
  • Activity
  • Equipment/Material
  • Prerequisite Skills
  • Teaching Method
  • Step 1
  • Step 2
  • Step 3
  • Consequence(s) for correct performance
  • Consequence(s) for incorrect performance
  • Plan for generalization and maintenance
  • Mastery criteria

Although you may develop some specific behaviourally-based program plans, you are likely to also need a plan to cover various components of a child’s program. Routine-based program plans are often developed in conjunction with early interventionists to incorporate teaching strategies into a child’s day-to-day routine. Staff members in early childhood education centres typically develop Individual Program Plans (IPPs) or Individual Education Plans (IEPs) to describe a child’s individualized education, or centre-based program. Increasingly, as intervention teams are developed, there is a focus on the development of Individual Family Service Plans (IFSPs). As part of the IFSP development, the family, centre staff and other team members meet to create a document that focuses on the family and the child’s development across a variety of natural environments.

There are many resources available to assist families and professionals to develop IFSPs and IPP/IEPs (see end of Module). It is recommended that early childhood educators and/or professionals working with children with special needs pursue additional training to gain experience in understanding and developing these important documents. As a guideline, here is a brief outline of the features of an IFSP and an IEP that has been adapted from The Individual Family Service Plan, 2000 and Creating Useful Individualized Education Programs (IEPs), 2000.

Individual Family Service Plan (IFSP)

  • Records and guides intervention program
  • A written document to facilitate communication among team members
  • Includes information about the child’s developmental status (e.g. physical, cognitive, communication, social, and adaptive skills)
  • Includes information about the family’s strengths, concerns, priorities, and resources
  • Contains a plan to achieve goals/desired outcomes
    • Focus on developing particular skills to achieve functional outcomes
    • Procedures and timelines are identified
    • Service providers and the frequency of service delivery is identified
  • Promotes intervention within natural environments
  • Identifies a coordinator for contact as well as contact numbers for other people/professionals available for support
  • Provides a dynamic document that is regularly reviewed and revised

Individual Education Plan (IEP)/Individual Program Plan (IPP)

  • Records and guides education program
  • Creates a written document to facilitate communication between the student, family, teachers and other service providers
  • Includes information about the child’s current academic performance and may include additional information regarding strengths, weaknesses, behaviour, and school history
  • Identifies expectations regarding the child’s learning that are modified from, or alternative to, those of the typical program curriculum
  • Will include a transition plan to school and/or other appropriate services
  • Contains a plan to achieve the goals and objectives
  • Identifies aids, services (service providers and frequency of service delivery) and modifications
  • Includes information regarding how communication occurs with parents/family
  • Provides a dynamic document that is typically reviewed at least annually
  • Includes information regarding transition services

IFSPs and IEP/IPPs have many common features. The IFSP focuses more specifically on the family. The IFSP also has an emphasis on intervention in natural environments. Typically the IFSP has been developed by a team from a variety of settings and therefore facilitates communication among all those involved in a child’s life.

It is important to prepare accordingly when you work with families and facilitate or attend an IPP/IEP or IFSP meeting. The degree of preparation you need will depend upon whether you are facilitating or attending. Some of the following guidelines may be helpful for your preparation, particularly if you are the facilitator:

  • Communicate first with the family regarding its preferences for participation, a meeting time, and which individuals to invite.
  • Invite all pertinent team members (have a list of names and telephone numbers), using the input from the family.
  • Gather relevant documentation and review it prior to the meeting (e.g., reports, work samples).
  • Prepare and circulate an agenda
  • Arrange seating to facilitate communication.
  • Welcome all attendees.
  • Identify a “recorder” to take minutes of the meeting and ensure they are distributed to all members afterwards.
  • Create a positive environment and encourage each member to express his/her opinions.
  • Keep to the schedule (e.g., start and stop on time).
  • End on a positive note with documentation of the intervention plan and agreed upon date(s) for follow-up meeting(s).

Regardless of your role you are most likely to have a positive meeting when you are able to participate in an open dialogue, respect and value the input of others.

Communication Books

A communication book helps to promote two-way communication between centre staff, families, and other professionals. A home-school communication book provides an opportunity for parents to share information about a child’s home routine that may affect the child’s behaviour at the centre. For example, if a child has had a short sleep and is likely to be tired the next day you may decrease the expectations placed on the child. A communication book also provides an opportunity for you to learn about significant events the child has experienced. One may use this information to provide activities that cater to the child. For example, if you know the child went to the swimming pool on Saturday, you might notice the child’s splashing gesture (which can be elaborated), or you can talk about how the water feels.

A communication book also helps families know more about what the child does during the day. Children with ASD may have challenges communicating about the day’s events. Short written notes, work samples, and photographs are all helpful ways to communicate. It may be useful to talk to parents to learn which details they would be most interested in learning. It helps to be specific about the events of the day and to share accurate and positive information. For example, rather than reporting that today was a “bad day”, try to say what triggered the behaviour of concern, what the child did exactly, and how it was handled. Then you might report how you are considering managing the situation if it arises another time.

Parent Visits

It is helpful for parents to observe their child interacting with others. Having an “open door” policy so that parents feel welcome to observe their child and the program helps to encourage a collaborative approach. Other professionals may also wish to observe the child in the centre. This may provide the professional with a broader understanding of the child, and create a good opportunity for an on-site consultation about specific issues.

Communicating with the Team to Meet a Challenge

When a child is making progress with their learning objectives, the program plan team may only be periodically involved. When there is cause for concern about changes in behaviour or progress, however, the need for collaboration becomes necessary for all team members.

Members of the child’s team may decide to meet for a number of reasons. For example, they may need to revise a learning objective due to changes in progress or new behaviours. The concern must be clearly stated and communicated among the team members. Be as specific as possible in describing the ABC’s of the situation of concern, or the nature of the child’s difficulty with a particular objective (e.g., Are previous rewards no longer effective? Has the child come to rely on a specific prompt?).

In cases of behaviours you want to reduce/eliminate, use the information from your observations to evaluate the function of the behaviour. That is, carry out a functional analysis (see Module 4). This preliminary information may be invaluable in helping you to define the problem and to decide which team members’ assistance would be beneficial. You may need the parents’ permission to contact other members of the team. Consult your director if in doubt.

Exercise: Choosing a Team Member to Consult

Read the following scenario:
  • How would you begin to examine the problem?
  • What observations might you make, and what information will you need in order to develop a plan to address the problem?
  • What are your initial suggestions for changes?
  • If your initial plan does not produce an improvement in the situation within approximately two weeks, whose assistance (e.g., what professionals) might you consult? What would you expect their roles to be?

Click here to see a sample answer

Transition – Preschool to School

Transitions can be challenging for individuals with ASD. Young children and families experience a variety of transitions. The change from a child care setting to school is a significant transition for any child. For those with ASD, a smooth transition may require a higher level of planning. Successful transitions are possible with careful preparation by a committed team of parents and professional partners.

In most jurisdictions, some members of the child’s team (e.g., some health care providers and other professionals) may remain part of the child’s team when they go to school, while others (e.g., early childhood educators) will not, and a new group of providers will become involved (educators and other school-based professionals). Strong transition services prepare families and children for the move, support them during the move, and maintain contact with them to address problems that may arise after the move.

As eligibility for school entry varies across jurisdictions, the child’s parents and child care providers need to be aware of the local eligibility criteria and of the transition process in your school district.

Some school districts have established steps to follow in preparing to support a child with special needs at a school. In other districts, the process could be less formal, or based more on the experience and accessible accommodations of the particular school. Parents often require support to ensure that a plan is in place for their child’s school placement. In some communities, private schools are being established for children with special needs, including ASD. Families may need support as they explore a range of options available to them and their children. During this time there may be periods of uncertainty and additional stress for the family. Preschool educators are often experienced supporters when working with families and children with special needs and can be an asset to a child’s transitional team.

Public and professional awareness of Autism Spectrum Disorder has grown a great deal in recent years. Children diagnosed with ASD vary widely in their skills and their behaviour. The staff of any given school may be unfamiliar with the wide range of abilities and characteristics of children with ASD. Information about the individual needs of the child you are working with must determine the services provided to him/her.

It is beneficial when families provide documentation about the child’s special needs in the form of reports from professionals who have assessed them or provided intervention services (e.g., speech-language pathologist, psychologist).

Usually a transition meeting will be held in the spring prior to the child beginning school. This meeting brings together parents, preschool educators, other consultants (e.g., speech-language pathologist, occupational therapist, psychologist), and those who will be contributing to the school-based program (e.g., principal, classroom teacher, resource teacher, speech-language pathologist). The goal of this initial transition meeting should be to devise a plan to introduce the child to the school, and vice versa, in as systematic a way as possible. Other meetings will be required to develop the school-based IPP (or IEP: Individual Education Plan or Program), which is often an outgrowth of the preschool IFSP.

The child’s parents may share written reports in advance of this conference, where the focus will be on facilitating a smooth transition from preschool to school. Information from the preschool program will include a description of the setting and routines, as well as the child’s individual program plan and records of his/her accomplishments. Preschool educators have the important role of sharing their knowledge about and experience with the child in a group setting. This information is crucial in ensuring a successful transition into school. Decisions such as the type and amount of support (e.g., dedicated time from an educational program assistant) may depend on a detailed analysis of the child’s ability to learn and interact within peer groups.

Remember, successful transitions are characterized by:

  • Children’s positive attitudes
  • Parents’ positive attitudes
  • Teacher’s provision of developmentally-appropriate experiences
  • Communities that provide support – sharing, cooperating, and coordinating across agencies

Try to be mindful of the differences in how preschool and school systems operate with respect to the number of children, types of learning environments (including physical spaces) and the different administrative structures and range of professionals involved. While information from the child care setting is valuable, one cannot entirely predict how a child with ASD will adapt to the demands of the school setting, based only on their preschool experiences.

Review

Families of children with ASD usually require many professionals to support the needs of their child and the family, but ultimately the goal is to meet the family’s needs. The collaborative efforts of team members should be directed toward empowering the family and helping to ensure that the child’s care and education match his/her needs. Good communication is a key to effective collaboration. When major transitions take place, special care must be taken to ensure that appropriate information is passed along at the right time, and in the most helpful way. Early childhood educators play a key role in providing observations of the child in a group setting, and in reporting the effectiveness of specific intervention strategies for the individual child.

Enabling Person-Directed Planning for Augmentative and Alternative Communication (AAC) Users

Enabling Person Directed Planning for AAC Users - Guide Book

The Enabling Person-Directed Planning for AAC Users guidebook, is designed to help persons who use augmentative and alternative communication take an active role in the person-directed planning process. The guidebook outlines a 5-phase process, based on established best-practices in AAC and transition planning for persons with disabilities, for developing partner communication strategies with planning recipients who use AAC.

Enabling Person-Directed Planning for AAC Users: Guidebook

Guidebook

Once you have read through the guidebook, you can download the specific toolkits (sample checklists) and blank templates that are included within the guide for use later.

Screening Tools for Information on AAC Usage

Appendix A — Toolkit

Gathering Preliminary AAC Information/Current AAC Usage

Appendix B — Toolkit

Communication Context Interview / Observation

Appendix C — Toolkit

AAC Considerations Matrix for Person-Directed Planning

Appendix D — Toolkit

Social Skills Matching Game

  1. The game can be played with 2-4 players.
  2. Place the cards face down in the middle of the players.
  3. Each player has a turn and picks up a card. The player turns the card over and acts out the activity shown on the card. (For example, if the card is hello, the child waves or says “hi “to the other players). An adult may need to help the child act out the activity.
  4. Then the player places the card on the matching square contained on his/her board.
  5. The game is over when all the players have the matching pieces on their boards.
  6. If a player turns over a card she/he already has:i.e. bubbles, she/he gives the card to a friend who does not have the card yet. The friend acts out the activity:i.e. blows bubbles and then, the player who shared the card is given another turn to find a new card.

Activities for each card:

  • Card one: Say “hi” to your friend
  • Card two: Shake hands with your friend (or the whole group)
  • Card three: Blow bubbles to a friend
  • Card four: Give a friend a high five (or the whole group)
  • Card five: Hug
  • Card six: Sing a song with your friends. The child who has the card can choose the song and everyone sings. Possible songs include: Row Row Your Boat, Ring Around the Rosie, etc.

*To facilitate socialization, it is important that an adult be involved in the game and assist

*An example of possible activity pictures depicting the activities for the matching board and cards is on page two of this document. You can create the matching board and cards using drawn pictures, magazine pictures or photographs.

Example of Pictures for Social Game Board and Cards.

(taken from the Boardmaker Program:Mayer-Johnson Co.)

Autism Spectrum Disorder (ASD)

Fact Sheet

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is one of the most commonly diagnosed developmental disorders in Canada. It is characterized by challenges with social communication skills /interaction and restricted / repetitive behaviours. Autism is known as a spectrum disorder because characteristics vary greatly from person to person and everyone with a diagnosis of ASD has a distinct set of strengths and challenges. It is estimated that around one third of people with ASD also have an intellectual disability.

The cause of autism is not yet understood but doctors believe that it is caused by a combination of genetic and environmental influences. Because autism has been found to run in families this continues to be an area of interest to researchers. ASD is considered a lifelong disorder, however, supports and services can greatly improve how individuals are affected and can improve their ability to function day to day.

How is it manifested?

Signs of autism usually appear by the time a child is 2 or 3 years of age, but it can be diagnosed as early as 12 -18 months of age.

Parents and caregivers may notice that a child has missed language milestones such as not having any language by 16 months of age or no two- word phrases by their second birthday. Some children with ASD may lose language or previously acquired skills.

Children with ASD may experience a variety of sensory sensitivities to sounds, smells, light levels and textures. They can be sensitive to the fit of their clothing and be particular about what they wear. They may refuse to wear clothing that feels too tight or loose, has sleeves that are an uncomfortable length or has irritating tags or seams. Children with ASD may appear to have a high pain threshold and may be able to tolerate extremes of temperature without showing discomfort. Sensitivity to textures can also lead to challenges with feeding as children can develop very strong preferences for certain types of foods and refuse to eat other types.

Gastrointestinal issues, seizures, disrupted sleep patterns, anxiety and depression are some of the common physical and mental health effects experienced by children and youth with ASD.

Some behaviours that parents and caregivers may observe, the child

  • may not point out or show things of interest to others. They may not attempt to get the attention of their parent or caregiver.
  • may lack eye contact with people who are unfamiliar (directing the child to make eye contact may make them uncomfortable and upset)
  • may not engage in back in forth verbal or non-verbal communication with others. They may not respond to the expressions on people’s faces and they may be observed to focus on objects.
  • may not wave or greet others spontaneously.
  • may appear to be content to spend extended periods of time on their own.
  • may not consistently respond to their name being called.
  • may avoid or ignore their peers or caregivers when they are approached and attempt to interact with them.
  • may move their hands or fingers in repetitive ways, they may rock or pace or may be seen to walk on their toes.
  • may show a lack of interest in toys or they may play in an unusual way – lining up toys, spinning or smelling them or repeatedly opening and closing a part of a toy. They may look for a prolonged period at an item and may like to hold things close to their eyes.
  • may become preoccupied with light and movement – flicking light switches, opening and closing doors or watching fans and wheels go around. It may be difficult to distract the child or get them to move on from these interests once engaged.
  • may experience difficulty with changes to their routine – they may have to perform tasks in a particular order, or they may become upset if things don’t follow the sequence.

Who is affected?

In 2018 the National Autism Spectrum Disorder Surveillance System (NASS) released the statistic that 1 in 66 Canadian children and youth aged 5-17 are diagnosed with ASD. Boys receive the diagnosis 4 times more frequently than girls although the ratio is likely closer to 3:1 as research suggests that girls with ASD, especially those without accompanying intellectual disability may be missed under current diagnostic procedures. Girls have also been found to be diagnosed with ASD at significantly later ages than boys.

How is ASD diagnosed or detected?

The first step in diagnosing ASD is for the family to discuss their concerns with child’s doctor or pediatrician. The doctor or pediatrician will refer the child to a developmental pediatrician for a formal developmental assessment to assess the following areas: social, cognitive, communication and motor skills. ASD is diagnosed when a combination of specific behaviours, communication delays, and/or developmental disabilities is confirmed.

In 2013, the American Psychiatric Association published the Developmental Statistical Manual 5th edition (DSM–5). In previous editions individuals could be diagnosed with Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The DSM-5 now encompasses all four diagnoses under the umbrella of Autism Spectrum Disorder.

If the child receives a diagnosis of autism spectrum disorder, they will receive an accompanying severity level: Level 1 (requiring support), Level 2 (requiring substantial support), or Level 3 (requiring very substantial support).

Resources:

Autism Ontario

Autism Ontario provides information about programs and services available to people with a diagnosis of autism in Ontario. Links are provided to different chapters in regions of the province with local information and events. https://www.autismontario.com/

They also provide a newsletter that can be signed up for using the link below. https://www.autismontario.com/newsletter

Autism Speaks Canada

Autism Speaks Canada is a national Canadian charity that offers information and support to persons with autism and their families. https://www.autismspeaks.ca/

Geneva Centre for Autism

The Geneva Centre for Autism provides programs, training and resources for people with an autism diagnosis as well as their families and caregivers. https://www.autism.net/

They also offer a newsletter that you can sign up for using the link below. https://www.autism.net/newsletter

Ontario Government

Ontario.ca is the official website of the Ontario Government. The most up to date information on the Ontario Autism Program can be found at the link below. https://www.ontario.ca/page/ontario-autism-program

SNOW Inclusive Learning & Education

SNOW is a branch of the Inclusive Design Research Centre at OCAD University that focuses on Inclusive Education and Learning. They provide information and training about technologies and inclusive practices for both in and outside of the classroom. https://snow.idrc.ocadu.ca/

Surrey Place

Surrey Place supports children and adults living with developmental disabilities, autism spectrum disorder and visual impairments.

They also provide Coordinated Service Planning for children and youth with multiple and/or complex special needs and their families through the support of a Service Planning Coordinator. https://www.surreyplace.ca/

The content contained in this document is for general information purposes. It is not the intention to diagnose or treat a child.

All About Me

Creating Books to Share Experiences

Making a book with your child can be a special and enjoyable experience for both of you. It can increase your child’s self-esteem, while providing opportunities to develop his language and fine motor skills. When the book is finished, it will be a lasting memory for your child and family.

What is an “All About Me” Book?

An “All About Me” book can be created for your child. It is a special book that tells a child’s life story. Photographs, or mementos, of special events and milestones can be added to the book at any time. Celebrating your child’s accomplishments is important because it builds self-esteem and motivates him to continue learning. Finally, creating an “All About Me” book shows your child that he is loved, unique and special.

“All About Me” Book Contents

To get you started, we have created several sections that can be included in your child’s “All About Me” book. The book is an on-going project that you and your child can complete over time. Depending on your child’s interests and attention span, you may wish to include only a few sections. Here is a brief description of each section:

Hello!

This page should include a recent picture of your child.

My Birthday

If you have a copy of your child’s birth announcement you can add it to this section. You may also want to add a picture of him on each birthday.

My Family

You may want to have a page for each family member that includes their name and a photograph. Close friends can also be included in this section.

My School

Once your child starts school, you may want to add class photos. You can also add programs from school events, such as concerts, in which he has participated.

My Favourites

This is a great place to add information on your child’s hobbies and interests.

I Can!

A record of your child’s accomplishments can be kept in this section. Each time he reaches a goal, such as taking his first steps, tying his shoelaces or achieving another goal that he’s been working on, a new page can be added.

How to Make the Book

You will need:

  • a computer and printer
  • a blank scrap book
  • photographs or pictures from magazines
  • crayons, markers and stickers
  • glue

Steps:

  1. Print the pages for the book found at the end of this document.
  2. Glue the first page to the cover of the scrap book.
  3. Complete each page by filling in the blanks and decorating the pages with crayons, markers and stickers. When there is space for a picture, either glue a photograph in the square, or have your child draw a picture.
  4. Add each completed page to the scrap book.

Hints:

  1. If you don’t have a scrap book on hand, you can make your own. Use some construction paper to make a cover, punch holes on each page, and attach it all together by tying a piece of string through all of the holes.
  2. Make sure to leave some blank pages in each section. This way you can add extra pictures later on.
  3. Whenever you add new pictures to the book, write a short sentence about what is happening, or who is in the picture.
  4. The use of photographs is suggested because it makes the book more personal. However, if you do not have many photographs, you and your child can draw pictures, or cut them out of magazines.

Your “All About Me” book is ready to share!

Using the “All About Me” Book to Build Communication Skills

Develop Your Child’s Sense of Self-Awareness

Self-awareness is an important skill for any child to develop because it helps him understand that other people are different and separate from him. When a child has a sense of self-awareness, he will be able to communicate more successfully with other people.

Self-awareness involves:

  • Recognizing your face in the mirror or in a photograph.
  • Responding to your name when someone calls you.
  • Understanding that people need “personal space”.
  • Recognizing your name in print.
  • Understanding that everyone has different needs and feelings.

When creating the “All About Me” book with your child, encourage him to point to himself in photographs. Prompt him by asking, “Where are you?”, or “Where’s Jimmy?” If your child needs help, take his hand and point to his picture and say, “There you are!”, or “Look! It’s Jimmy!”

Once your child is able to identify himself in photographs, he can practise finding and naming family members and friends.

Making Choices

Encourage your child to make choices by looking at, pointing to, or telling you which item he wants to include in the book. This will provide him with opportunities to practise making eye contact with you and to learn ways in which questions can be asked and answered. To begin, it is best to present your child with two choices.

Here are some choices your child can make:

  • Which pictures or photographs to use.
  • Where to glue a picture.
  • What colour crayon to use.
  • Which stickers to use.

When he reaches school or goes to child care, your child may be better able to make choices and to share during play and other activities with his friends.

Increase Vocabulary

As you complete the book together, emphasize words with which your child is unfamiliar, to help him understand what they mean and to learn how to say or sign them. Talk about what is happening in each of the photographs that you are adding to the book. As you describe each photograph, emphasize the important words and point to them. For example, “Grandma is sitting under a tree.”

Here are some word categories:

  • Actions: in, out, on, under, sit, stand, walk, run, eat, drink
  • Activities: draw, paint, game, swim, cook, music, play
  • People: mom, dad, teacher, friend, brother, sister
  • Objects: book, bike, t.v., radio, doll
  • Places: home, school, park, library

For familiar words for your child, you can point to a person, object, or place and ask him to name it. “Jimmy! Who’s under the tree?” Another option is to say a word and ask him to point to it in the picture. “Jimmy, can you show me the tree?”

Conversation Aid

If the whole family is involved in creating “All About Me” books, your child will have many opportunities to participate in conversations by sharing materials and experiences with his brothers and sisters.

While gathering information to include in each section, you can try asking your child some questions. Here are some common social questions other children or adults might ask your child. For example:

  • How old are you?
  • What’s your name?
  • What games do you like to play?

Your child may not be able to answer these questions on his own, or right away.

You may want to coach him in answering a few basic ones. If your child communicates verbally, ask the question, then provide the answer yourself.

Keep answers as short as possible. For example, “Jimmy, how old are you?” Wait at least 5 seconds for your child to respond. If he doesn’t, you can say his age, “Four”. If your child communicates nonverbally, you can show him how to answer with a simple gesture. For example, holding up fingers to show how old he is.

Using the “All About Me” Book to Build Fine Motor Skills

By encouraging your child to help you put together his “All About Me” book you can also work on fine motor skills, such as gluing and pasting pictures, writing his name or cutting out pictures and shapes.

Gluing or Pasting

Pour some glue into a small container and encourage your child to apply it using a popsicle stick. Show him how to dip the popsicle stick into the glue and spread it on the paper. Point out how glue goes on the back of the picture. If a popsicle stick is too narrow for your child to grasp, try using a paintbrush with a wide handle. Some children do not like the stickiness of glue, or getting their hands messy. If this is the case, try using a glue stick.

Drawing and Writing

If your child has difficulty grasping narrow pencils or crayons, they can be enlarged with hair curlers or clay. You can also purchase some thicker or “chubby” crayons for your child. Depending on your child’s skill level, you can guide him to:

  • Hold a crayon or pencil and make marks on the paper.
  • Colour inside lines.
  • Make lines or circles.
  • Trace or practise printing letters.

If your child is interested in printing and writing, you can show him how to print his name. Start by printing his name and having him trace the letters, on his own, or with some help.

Cutting

Make sure you have a pair of plastic, child-safe scissors. Show your child how to hold a pair of scissors and make cutting motions before giving him some paper to cut. Once he is able to do this, sit beside him and hold out a thin piece of paper for him to cut. When he is able to cut on his own, have him cut out the larger shapes. You can help to cut out the smaller shapes, or finer details.

Download the All About Me template

Acquired Brain Injury

Fact Sheet

What is Acquired Brain Injury?

Acquired Brain Injury (ABI) is a non-degenerative injury to the brain that has occurred since birth. It can be caused by an external physical force, or by a disturbance of the regular metabolic order.The term “Acquired Brain Injury” includes traumatic brain injuries such as open or closed head injuries, and non-traumatic brain injuries such as those caused by

  • strokes and other vascular accidents
  • tumours, infectious diseases
  • hypoxia
  • metabolic disorders (e.g., liver and kidney diseases or diabetic coma)
  • toxic products taken into the body through inhalation or ingestion

How is it manifested?

  • unable to concentrate
  • misunderstands instructions
  • forgets instructions
  • tires easily
  • has difficulty learning new information or concepts
  • has difficulty planning complex tasks
  • has difficulty organizing ideas
  • has difficulty organizing school materials
  • has difficulty getting started on tasks
  • is easily distracted by surrounding activities

Brain injury may occur in one of two ways:

  1. Closed brain injuries occur when there is a non-penetrating injury to the brain with no break in the skull. A closed brain injury is caused by a rapid forward or backward movement and shaking of the brain inside the bony skull that results in bruising and tearing of the brain tissue and blood vessels. Closed brain injuries are usually caused by car accidents and falls. Shaking a baby can also result in this type of injury (Shaken Baby Syndrome).A concussion is a mild type of closed Traumatic Brain Injury (TBI), caused by a bump, blow or jolt to the head or body which causes the brain to move back and forth in the skull. Without attention, diagnosis and treatment, the damage to the brain does not have the opportunity to recover, and can easily worsen.
  2. Penetrating, or open head injuries occur when there is a break in the skull, such as when an object pierces the brain.

Who is affected?

According to Brain Injury Canada 160,000 Canadians sustain brain injuries each year. Incidence (and reporting rates) are rising. Over a million Canadians live with the effects of an acquired brain injury. About 50% of all acquired brain injuries in Canada are caused by falls and motor vehicle accidents.

The Think First National Injury Prevention Fundation reports that thirty per cent of all traumatic brain injuries are sustained by children and youth, many of them while participating in sports and recreational activities.

The incidence and prevalence of brain injury outnumbers breast cancer, spinal cord injury, multiple sclerosis and HIV/AIDs combined.

Each year, two million people in the U.S.A. experience a brain injury, and 99,000 suffer from long-term disability. Over five million people today are living with an ABI-related disability.

Recovery:

Most studies suggest that once brain cells are destroyed or damaged, generally, they do not regenerate. Recovery after a brain injury can take place in some cases. However, as other areas of the brain compensate for the injured tissue, the brain learns to reroute information and function around the damaged areas. The exact amount of recovery is not predictable at the time of injury and may be unknown for months or even years. Each brain injury and rate of recovery is unique. Recovery from a severe brain injury often involves a prolonged or life-long process of treatment and rehabilitation.

In spite of the fact that survival rates have increased with advanced trauma services and improved treatment options the impact of an acquired brain injury is widely felt by the survivor, family, caregivers, their communities, and in fact, the country as a whole.

Additional Resources:

HEALTH CARE AT HOME

http://healthcareathome.ca
Local Health Integration Networks (LHINs) provide one-stop access to health and personal support services to help individuals live independently in their homes or assist them in making the transition to a long-term care facility. They also provide information about, or link individuals to, services available in the community. Anyone can make a referral – a family member, caregiver, friend, physician or other health care professional.

ONTARIO BRAIN INJURY ASSOCIATION (OBIA)

www.obia.ca
The Ontario Brain Injury Association’s Caregiver Information Support Link (CISL) is a program, supported by the Ministry of Health, donations and other fundraising activities, to assist persons living with the effects of injury to the brain. This FREE service offers support, empowerment, advocacy and education to survivors, family members and friends. Staff can assist with issues such as rehabilitation, long-term care, housing and employment, auto insurance, disability benefits, worker’s compensation benefits, etc. Brain injury survivors and their caregivers (family, friends, etc.) are invited to become members of OBIA. This FREE membership is available after completing an annual questionnaire. The CISL questionnaire is a tool that measures an individual’s level of community integration and disability.

CANADIAN HEALTH NETWORK (CHN)

https://www.canadianhealthcarenetwork.ca/
The Canadian Health Network (CHN) is a national, bilingual health promotion program. The CHN’s goal is to help Canadians find the information they are looking for about how to stay healthy and prevent disease. The CHN does this through a unique collaboration – one of the most dynamic and comprehensive networks in the world. This network of health information providers includes the Public Health Agency of Canada, Health Canada and national and provincial/territorial non-profit organizations, as well as universities, hospitals, libraries and community organizations.

THINK FIRST NATIONAL INJURY PREVENTION FOUNDATION

https://parachute.ca/en/
The Think First Foundation provides onsite or online chapter training to hospitals and health related facilities. It offers programs to students of all ages: “Street Smart”; the “Safety Super Hero” and thought-provoking programs with VIP speakers –Voices For Injury Prevention – who explain how a traumatic injury needlessly changed their life.
Think First is your resource for educational material and resources; injury prevention programs for all grade levels; training and injury prevention involvement. Think First has joined with Safe Communities Canada, SMARTRISK, and Safe Kids Canada to create Parachute, a national, charitable organization dedicated to preventing injury and saving lives.

The content contained in this document is for general information purposes. It is not the intention to diagnose or treat a child.

Tips for Transitions from Elementary School

Transitioning your child from elementary school to junior high school or high school can be a daunting task for many parents. For the parent of a child with an intellectual disability, it can be even more difficult. You need to realize that no school is going to be “perfect”. Every parent has a different vision of what they want for their child and for their child’s education. Each child is different and their needs are different.

When looking for a junior high and/or high school, networking with other parents can be useful. You may also wish to consult with your child’s current teacher and principal. Talk to the elementary school principal prior to the Identification Placement Review Committee (IPRC).

Remember, you know your child best, but you should try to involve your child as much as possible in the decisions as this is one of the most important decisions that will affect their future.

Decide together what you both would like to see your child doing in high school while keeping the bigger picture of what they may be interested in doing after high school in mind.

The following are some suggestions you may wish to think about when looking for a junior high or high school:

Start checking out high schools 2-3 years before your child is going to graduate.

This will give you an idea of what is available and will help you decide when the time actually arrives.

Don’t limit yourself to your community high school.

Visit high schools within a reasonable distance from your home. Nowadays, many students diverge out of their community to attend the high school that will best meet their needs.

Watch for open houses at the schools; there are tours and information nights for both parents and students. If your child is not able to attend with their class, make sure they have the opportunity to go with you. Talk to your child about their impressions and feelings of this new school environment and listen carefully if they are expressing concerns or asking questions. If you can’t answer the questions, try to get the answers from the appropriate school board personnel.

Have a list of questions to ask.

Examples: What types of programs do they have? How many students in the program? Do they offer inclusive as well as segregated settings?

Have the current school set up or accompany you on a visit to the feeder school.

If you are looking to enroll in a school that is not the feeder school, the principal may not be able to facilitate the visit.

Plan your visit for first thing in the morning.

You can learn a lot about a school by the way the students enter the school. Some schools are noisy, some are calm.

When going on a school visit, take someone along.

Write down your impressions and gut feelings then discuss them with your friend. Complete writing about one school before you visit the next one.

Develop a relationship with the school you feel is the best choice.

Establish a contact person for the school.

There is the possibility of turn over in staff and funding changes.

What you saw the first time might not be in place when your child is ready to go. Keep up to date on any changes.

Ask what you can do to prepare your child for high school.

What goals can be worked on at elementary school and at home?

Supporting Children in Their Steps Towards Independence

Children who know how to look after their self-care needs are proud of themselves. This sense of pride and accomplishment is important in building a child’s self-esteem. Each of your child’s steps towards independence should be applauded no matter how small!

  • “No more diapers!”
  • “I can sip from a cup!”
  • “Great work! You sat in the chair for five minutes!”
  • “Wow! You used your pictures to let Daddy know you want to use the washroom!”
  • “I can tie my shoelaces!”

Parents sometimes have a difficult time knowing when their child is ready to participate more in his self-care. This is especially the case when a child has special needs. Most parenting books that outline child development milestones are written with the typically developing child in mind. If your child has special needs, focus on the progression of skills rather than the age at which a child is ‘supposed’ to be able to do something. It also helps to follow your child’s lead. For example, if he likes to watch you wash the dishes and enjoys the soapy bubbles, you could start teaching him how to wash his hands.

For many adults, it is tempting to jump in and help a child who appears to be struggling with a self-care task. Sometimes adults are quicker to offer assistance when a child has special needs because they assume that he needs help. We often forget that part of learning, for both children and adults is to struggle.

In order to be able to take care of himself, a child should have the physical ability to carry out the activity. Children with physical disabilities might find it difficult to complete certain tasks without some assistance from a friend or adult. Your child should also know when and who to ask for help. In a school setting, just knowing that someone is available to help can ease a child’s anxiety about taking care of himself.

While some children will ask for help when they need it, others may struggle in silence. Let’s use the example of a child who is trying to put on his boots to look for some behaviours that can help determine whether he is:

Truly struggling with the task OR
Trying to ‘figure things out’.

He is probably trying to ‘figure things out’ if he:

  • Appears to be talking himself through the process, “Foot in boot.”
  • Follows a visual sequence through the process.
  • Is testing different solutions to the problem such as taking his foot out of a boot if it doesn’t fit properly and trying the other boot.

He is probably struggling if he:

  • Appears angry or frustrated.
  • Looks from shoe to boot without taking any action.
  • Repeatedly does something incorrectly such as putting his right foot in wrong boot.
  • Looks at, or, gestures to those around him.

If a child is struggling with a self-care task, an adult can help by simply stating, “I see you want to put your boots on. ”Suggestions or help can be offered by asking, “Can I help?” or saying, “Try……” or “Let’s try…..” When help is offered in a warm and friendly manner, it maintains a child’s selfesteem. We must always consider whether we are asking or expecting a child to complete a self-care task before he is ready. If a child repeatedly experiences great difficulty, has frequent accidents, or is unable to complete a self-care task, it is best to give him all the support he needs to be successful.

When your child requires assistance or has the occasional accident, it is important to let him know that these things happen to everyone. If a child feels punished for wetting his pants or spilling food, his self-esteem may suffer. You can assist your child by helping him wash and change into clean clothing. When your child spills food, try to include him in the cleanup even if it is only to hand you a paper towel. As your child gets older, he will know that he is responsible for cleaning any messes he makes.

Some children may resist becoming more responsible for their own self-care. They may show this by refusing to participate in their self-care or deliberately having ‘accidents’. Receiving care from a parent or a loved one is very comforting for children. If your child is experiencing a lot of changes in his life or wants to spend more time with a particular adult, he may ’resist’ independence in order to maintain the security of receiving care. Preschoolers often ‘forget’ new independence skills they have learned when a new baby is in the house.

The road to independence can sometimes be rocky but setting small, realistic goals and having a sense of humor can make it smoother for both you and your child.

About Kids Health

The Hospital for Sick Children has recently launched AboutKidsHealth.ca – providing support for children and youth and promoting the best health outcomes and the best quality of life for children and their families.

Marcella and Me inclusion stories

Marcella and Me

This is an inclusion story describing the experiences of a young girl’s typical day in a child care program. Her best friend is Marcella she requires additional supports in the classroom. The story explains how the program is adapted to include Marcella in every aspect of the daily routine.
Download a PDF of the book
Order a bound copy of the book online

Marcella and Music

A sequel to “Marcella and Me” that demonstrates specific strategies for teachers to use during circle time. For example, how to keep children’s attention and how to promote greater participation in group times are explored. Picture symbols and sign language signs are included for directions and songs.
Download a PDF of the book
Order a bound copy of the book online

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