What to do
Choosing the therapy, strategy or support that is right for your child depends on their needs
There is an explosion of therapies, strategies, programs and accessories for supporting individuals with sensory and social communication differences and autism. Going shopping for these without a plan is like going grocery shopping without a recipe or idea of when you will actually make the meal. You don't really know what you are going to get and you'll have both missing and wasted ingredients.
​
Once you've identified your child's needs, you can choose the therapy or strategy that best addresses those. There will still be a process of trial & error but you will save yourself time, money and emotional energy if you know what you are trying to achieve.
​
While targeted speech & language, occupational, listening or other therapy may be required but a lot of the effort will be put in my parents and the school. Therefore integrating the below into daily, natural routines with clear goals is critical for the long-term outcome.
​
It all boils down to keeping calm and playing!
Therapies, Strategies & Transactional Supports
Listed below are different options which have been used successfully and could work for your child & your family. Its about working smarter not harder and augmenting any targeted therapy sessions with actions/modifications in natural settings (home/school/community) and routines. Because of the complex needs of these individuals, there is no silver bullet and there will be setbacks, but the accumulation of efforts in the right place will have long-lasting positive outcomes.
Social Communication & Interaction
Priority: Create motivation to socially engage
Fostering social communication & interaction involves laying the building blocks identified by the Neuroscience of Human Relationships.
​
1) Attachment & Falling in love with social world (Pre-words)
2) Seeking connections with language & focus on people when objects begin to compete for attention (Language development)
3) Succeeding in a range of social settings & with peers (Conversation)
​
Before beginning any strategy of therapy its critical to understand stage of development which aligns to SCERTS
​
In stage 1, a responsive environment that attends to a baby's/child's needs, plays with them, cuddles, makes faces & smiles, gazes in their eyes will help create attachment. A baby that is under responsive to social stimuli at this stage may appear very calm and quiet and people may comment, "Such a good baby". Speak to your GP if your child is not meeting non-verbal communication milestones. They can perform checks, especially hearing,
​
In stage 2, this is when parents usually notice a real difference as their child starts to talk and interact. At this stage priority is to focus games on people, get child to notice those around them and develop short sentences with noun+verb.
Model & exaggerate facial expressions
Play games with eye contact such as eye spy or guess where I'm looking
Include toy people in games, i.e. playmobile figurines in trains/cars
When you speak with your child, use noun+verb sentence, i.e. instead of look at the train that boy is playing with say, "the boy is playing with the train"
Use the child's interests to engage with them
Use visuals for communication (see examples from SCERTS) - use pictures instead of words to communicate. Picture sequences to follow Noun+verb structure
Read books with children in them and focus on the child in the book
The book, Talkability is great for this stage.
A good relationship with a sibling/cousin/child that is around a lot can be incredible valuable
Take photos throughout the day and then in the evening, look at them together for your child to share their day.
Play in small groups at school incentives by teachers
Social stories illustrating greetings, goodbyes and simple engagements.
Speech & Language Therapy at home or nursery can be extremely effective at this stage.
PECS can be used for children who are non-verbal but able to communicate using pictures.
​
In stage 3, the child has a motivation to engage but may need help knowing how to.
Encourage playdates with children with similar interests
School can help encourage friendships
Provide lots opportunities to engage in different settings - at school, home, cafe, etc
Use the child's interests to engage with them
Continue using visuals for communication
Social Skills groups are useful at this stage
Social stories for older children
Social interaction during meal times
Family board games are great for learning turn-taking, rules, & dealing with winning/losing
Talkability book has good strategies
Speech & language therapy in small groups is beneficial
Encourage independence
Limit use of technology
​
Importantly, across all these stages, your communication should be:
​
Clear
Using a calm voice
Move your body down to their level
Limit instructions that have multiple demands, actions (i.e. get up, brush your teeth, go to the toilet and put your clothes on) - say them 1 at a time or use a visual sequence to illustrate.​
Give the child time to process and answer
Limit use of technology when you are together - really be present for your child
All of the above require the child to be in a state ready to engage socially. In the next sections on Emotional Regulation, we will look at tips and strategies.
​
You can also check out ILS therapy based on Stephen Porges work. It aims to train the middle ear by removing low frequency sounds in musical tracks. The theory is that this non-invasive therapy tunes the ear to be more attentive to human voices, making social interactions & communication easier for the child. You can find therapists who offer it on the ILS website.
Emotions & Emotional Regulation
Priority: Foster a sense of safety & predictability
The SCERTS framework identifies two main types of emotional regulation: mutual-regulation & self-regulation. We all use both in our daily lives. Mutual regulation is when a social partner helps, i.e. a responsive adult soothing a crying child or "talking therapy". Self-regulation is motor soothing, going for a walk, taking deep breaths or using a stress ball to alleviate stress or using our cognitive abilities to calm the butterflies in our stomach.
​
For individuals with social sensory differences, providing information in a visual (non-social) manner and creating structure in daily activities is critical. Therefore, the following are useful for this:
​
Visual planners
Visual Timetables
Timers
Now & Next Cards
​
Teaching emotions & providing a means of communicating emotions is important:
​
Read books about feelings
Use a feelings book or emotional keyring to aid in expression
Visuals with a traffic light system for Zones of Regulation or the Incredible 5 point scale can be used effectively to judge current state and likeliness of a smooth activity or challenging behaviour.
​
The above are examples of transactional supports that we can use to help create predictability using non-social stimuli. They can be incorporated into daily routines, including task completion and transitions.
​
Therapies such as Cognitive Behavioural Therapy can be used with older children.
​
Equally important is how we adapt the daily routines to encourage a regulated state. Individuals with sensory & social differences have higher levels of anxiety and experience sensory overload; therefore we as parents, need to conscious of the demands we are placing on the child. Sometimes less is more and we may need to adjust our expectations.
Some useful concepts to consider when placing demands on our children:
​
The Anxiety Bucket
Tolerance level vs. Demand
Consider Meltdowns as PANIC Attacks
What is your state of mind?
What state is child in? Calm & Engaged, Fight/Flight or Shutdown.
​
There are lots of parenting courses for dealing with challenging behaviour and meltdowns.
Getting to the root of the anxiety and really understanding the cause of the behaviour is essential. The PDA website has an excellent overview for dealing with demand avoidant behaviours.
Tracking behaviour using the ABC Chart or other CBT tool can help identify the triggers.
​
The last set of therapies/activities to consider are those that the child enjoys and can help them reduce anxiety:
​
Yoga therapy
Aromatherapy
Singing
Art therapy
Being in nature
Having a warm bath
Massages
Body & Sensory
Priority: creating a sense of safety & optimal bodily arousal
As we saw in the prior sections, there is a direct link between the gut and the brain (GBA/Vagus nerve), so supporting a healthy diet and gut is essential. The following can be helpful:
​
Allergy testing
Seeing a nutritionist
​
Beyond the gut, an Occupational Therapist can assess your child's sensory needs and provide a sensory diet. A sensory diet is made up of activities that a child can do at home to ensure their sense are getting the input they need. There are endless activities that kids can do - basically its old-fashioned playing! Activities that include partner work as well are particularly beneficial as they provide social interaction as well.
Transactional supports can be used to help balance the sense. These can include:
​
1) Noise cancelling earphones for noise (usually low-frequency) sensitivity
2) Chewlery (Chewable Jewelry) for those who seek oral soothing
3) Heavy blankets or tight t-shirts for those who need more pressure
4) Wedges or vibrating pillows
​
You can buy these online or see link on the Resources page.
​
Sports, exercise and extracurricular activities also support sensory modulation. The following are particularly beneficial:
​
Swimming
Yoga
Pilates
Martial Arts
Gymnastics
Singing
Arts
Playground
Board games
​
When you think about an activity for your child, take into consideration the environment, level of engagement & skills required, noise levels, etc. Use the Person in Context visual support developed by SCERTS collaborator, Amy Laurent, to help guide your choice.
​
A well regulated body promotes well-being and importantly, a feeling of safety which supports activation of the social engagement system, development of fine and gross motor skills and a strong physical body.