Author Archives: Courtney

Tips for Increasing Appropriate Play Skills

Children on the Autism Spectrum often do not engage in appropriate play.  Play may involve manipulating a toy inappropriately or playing with only one part of a preferred item (the wheels, for example).   They may explore toys but rarely play them according to their function. Pretend play and social play are often limited as well.

When teaching appropriate play, start with simple toys and/or activities. Be aware of the items or activities that the child already finds fun.  Pair new play skills with fun things!  For example, if the child loves a particular movie, play the movie in the background as they explore a new toy.  If they really love chips, give them chips intermittently as they look at the pictures of a new book or turn on their favorite song and give them praise as they explore a new play set.  Pairing new play skills with items or activities that are already fun will make new play behaviors fun as well.  It will then be more likely that the child will want to play appropriately again in the future.

Once they show interest in a new item and/or activity, model appropriate play.  Show them how to push the buttons, drive the car across a track, or turn the pages of a book.  If they spontaneously imitate any of these behaviors, make sure to reinforce with already established fun activities (such as edibles, praise, movies, etc.).

These tips are also beneficial for teaching social and pretend play.  Pair social and pretend play with fun things!  Model these behaviors and be sure to reinforce with established fun activities when the child emits any of these appropriate skills.    Siblings can be an essential part of the modeling process and can help deliver reinforcing items and activities as well.

Allow the child to naturally explore their environment.  Don’t force the child to engage in appropriate play behaviors as this may make new behaviors aversive. Remember to pair, model, and reinforce!

Laura Britton, BCBA

increasing appropriate play skills

increasing appropriate play skills


Autism… Real Awareness

We recently did an information session and were asked a question about “tolerance”… here are some of our thoughts on the topic.

With autism on the rise (now 1 in every 50 children diagnosed) I feel it is important to help educate people about autism.

Autism is a neurological disorder that affects a child’s ability to communicate and interact with others.  Autism is also a spectrum disorder so the symptoms of autism can range from mild to severe.  Because autism affects a child’s ability to communicate effectively, a child may engage in “meltdowns” as a way to communicate with others. Children with autism may sometimes seem “withdrawn” from others or have a difficult time tolerating loud noises.

You may be in a grocery store and see a child crying in the aisle for a toy or eating in a restaurant and see a child covering his ears because the noise is too loud.

If you happen to be somewhere in the community and see something like this, please keep in mind the child is not being “naughty” and his or her parents are NOT bad parents or have poor parenting skills.  The child may, in fact, have autism and struggling to cope with his or her environment.

Having a child with autism can be challenging at times.  However, each child with autism is also incredibly special and unique! Remember, there is nothing “wrong” with a child with autism.  A child with autism is just different….and there is nothing wrong with being different….because being different can actually be a good thing!  So please help support children and families touched by autism and help spread the word about autism awareness!

autism awareness

spreading real autism awareness!

Brain Development in children with autism: Importance of Early Intervention

In a study, it was suggested an MRI may aid in the early diagnosis of autism, thus stressing the importance of early intervention.

The study found children with autism show a faster development of grey matter in the brain (often in an 18 month span) compared to typical children in which the process often takes many years.  This rapid growth in such a short period of time may be too fast for the brain to handle and cause the brain to fail to make many neural connections.   Because of this, the infant may struggle when interpreting his or her environment and instead withdraw from the world.  Not until growth rate of the brain begins to slow down will the child begin to possibly use the useful neural connections and no longer use the connections that are not.

However, often by this time, the brain’s neural plasticity has already begun to decrease (causing the brain’s neural pathways to harden) making it even more difficult at this point for the brain to form new connections.

autism awareness series on autism treatment

April Autism Awareness month blog series

Effective Feeding Therapy using ABA principles

Sometimes children with autism have feeding problems.  They may refuse to eat food, have difficulty swallowing, eat only a limited number of foods, or have sensory issues related to food color, taste, or texture.  In addition, mealtime tantrums may occur frequently.  When this happens, feeding therapy may be necessary to improve quality food intake and keep your child healthy.

Some feeding therapy programs will often use negative reinforcement to decrease feeding problems.  For example, a therapist will present to the child a non-preferred food item and repeat the demand “eat” or “take a bite” until the child complies.  In this case, the child is only allowed to escape the feeding therapy session once they have consumed the bite of food.  The child’s attempts to escape are often blocked and cries ignored.

However, we prefer to use more positive techniques in order to prevent mealtimes from becoming aversive to the child.   We believe there are more painless ways to work on feeding issues and keeping feeding enjoyable-as it should be!

We often use techniques such as positive reinforcement, shaping, desensitization and food chaining to increase healthy eating.  Instead of making a child eat a non-preferred bite of food, we break it down into small steps and reinforce gradual progress.  For example, the child may first touch a small bite of food before the therapist reinforces this behavior.  Then the therapist may require the child to put the food to their lips, and even lick the food before requiring the child to put the food in their mouth.  Overall, it moves at a pace comfortable to the child and often takes the tears out of eating.



How PT can help biomechanical foot issues in children


It has come to that time of the year when we are celebrating Physical Therapy Month in October.  We would like to take this opportunity to educate parents on a very common biomechanical foot issues that may be treated here at MOSAIC Children’s Therapy.  The foot conditions are called over pronation and over supination.

As a physical therapist, over pronation is much more common, but we see and treat both conditions in our clinic.

When we take a step, the outer edge of our heels hits the ground first and our feet normally roll inward to absorb part of the impact.  According to the Stretching Institute, this is called normal pronation.  Conversely, as you lift your foot and push off for a new step, the foot rolls outwards so that the toes and forefoot can retain traction. This is…

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The Importance of Early Intervention

To get straight to the point, intervention should start as early as possible. My advice for parents is if you notice your child is not developing and meeting important developmental milestones, it is best to talk to your child’s doctor and explore services available instead of hoping “they’ll grow out of it” over time.

Why is it important to deal with the issue right away?

Because, unfortunately, the longer you wait, the more difficult it can be down the road. The earlier a problem is identified; the more effective an intervention can be. Research shows that children who receive intensive early intervention services are likely to make more progress and have better long-term outcomes. In fact, the long-term benefits of early intervention can decrease the costs of lifetime care by over two-thirds (Jarbinks and Knapp, 2001). In addition, some children who participate in early and intensive ABA for 2 or more years acquire sufficient skills to participate in regular classrooms with little or no additional support by kindergarten or first grade.

Small children are “sponges”. As their brains are developing their neural plasticity allows them to begin quickly learning new skills. Over time, as we age, this plasticity begins to decrease with age. This doesn’t mean that older children can’t still learn through intervention, because they can. Instead, it just means, as we age, learning patterns are formed, and it can be more difficult to change behavior due to a longer history of reinforcement. (I will get off my behavioral soapbox now)

Early intervention is key! Seek treatment now and get better results!

Early intervention is key!

The facts are out there.  The rates of autism are on the rise and to quote Autism Speaks, “1 in 88 can’t wait”.  Early intervention is key.

Did you know the average IQ gains for children with autism in effective early behavioral intervention programs is around 17 points higher?

So why wait?  It is best to get your child help as soon as possible.

Children who receive early intervention can show tremendous gains in areas such as language skills and social skills.

If you feel your child is missing important developmental milestones in his or her development, don’t wait and hope it goes away.  Get help immediately.  Early intervention services are available for children under the age of 3.  In fact, Doctors are diagnosing children with autism as early as 1 year old.