Behavior and Communication Approaches

Behavior and Communication Approaches

Applied Behavior Analysis (ABA)

A well-known treatment approach for people with an ASD is called applied behavior analysis (ABA). ABA is an evidence based approach, widely accepted among health care professionals and used in many schools and treatment clinics. ABA is a way of changing behavior and helping children to learn. It encourages positive behaviors and discourages negative behaviors in order to improve a variety of skills.

Manitoba Resource

St. Amant

St. Amant directs the Manitoba ABA Program for Children with Autism (MABACA). It is funded by the provincial government and provides intensive ABA treatment for children with autism between the ages of 2 to 6 years. Each child in the program receives 35 hours of therapy per week, including 27 hours with a tutor, three hours with a senior tutor, and five hours with a parent, all supervised by a clinical consultant.

St. Amant is also developing more flexible approaches to the use of ABA for those unable to commit to this level of intensity, and also helps with the transition into child care and school settings.

For more information on ABA in Manitoba, please visit these websites:

St. Amant Website: http://stamant.ca/programs/autism-services/
Government of Manitoba “Thrive”: http://www.gov.mb.ca/fs/thrive/abanalysis.html

Developmental Individual Difference Relationship-based Approach (DIR/Floortime)

DIR/Floortime is a developmental approach to supporting the learning of children with autism.  It is considered an “emerging’ approach, but new studies continue to add support to the research base. It is based on the idea that engaging interactions between parents and caregivers are the key to fostering growth through the social and development stages that all children experience. Social and emotional development are foundational to all areas of learning, and so as children progress in emotional regulation, communication and the ability to connect socially, they are able learn in other ways as well. DIR takes into account each child’s unique learning profile, and teaches parents how to use that information to engage and support their child.

Manitoba Resources

Child Development Clinic’s “Lets Get Started” Program

The Child Development Clinic runs a program based on the Floortime model called “Lets Get Started”. The team includes an Occupational Therapist, Social Worker and Early Childhood Educator facilitator. A child in this program receives 6 therapy sessions: 3 play sessions and 3 OT sessions. This service runs out of the Health Science Centre and is funded by Child Health.

For more information, contact the CDC at:
Child Development Clinic
Children’s Hospital
CK253-640 Sherbrook Street
Winnipeg, Manitoba R3A 1S1
Phone: 204-787-4379 or 204-787-2423

Autism Outreach

Autism Outreach is a departmental service run by the Government of Manitoba.  The service is offered to preschool children diagnosed with ASD in Winnipeg and rural Manitoba.  Once the child enters kindergarten they are no longer eligible for this service.

Autism Outreach uses a DIR/Floortime approach that provides families with a play-based, child-led and flexible model of support for their preschool children with ASD.  An autism specialist will complete an initial assessment and work with the family and a child development coordinator to identify goals and priorities for your child. The Autism specialist then provides training and consultation to families during regular visits, in cooperation with the child development coordinator. The child development coordinator will follow your child throughout Autism Outreach to ensure the child’s service plan and family training is meeting the child’s needs and goals. Autism Outreach programming will continue until services are no longer required, or child is no longer eligible for programming.

For more information on Autism Outreach, please contact:

Autism Outreach – Autism Specialist
100-280 Broadway
Winnipeg, MB   R3C 0R8
Phone: (204) 945-2295

Private Occupational Therapy

Some Occupational Therapists may use a DIR/Floortime framework in their intervention programs. For a complete list of Manitoba’s private occupational therapists, please visit: http://www.msot.mb.ca/find_an_occupational_therapist.aspx

Here you will find all private occupational therapists that work with adults and children in Manitoba. This website will list each occupational therapists service they provide, specialty areas, ages served, and how to get referred to the occupational therapist.

Private Speech Language Therapy

There are private speech language pathologists that use a DIR/Floortime approach when working with individuals with autism spectrum disorder. For more information of private speech language pathologists that use this approach in Manitoba, please contact:

College of Audiologists and Speech – Language Pathologists of Manitoba
1-333 Vaughan Street
Winnipeg, MB R3B 3J9
Tel: (204) 453-4539
Fax: (204) 477-1881
Email: office@caslpm.ca
Website: http://www.msha.ca

Online Learning and Support

Parents may choose to take online courses to learn and properly use the DIR/Floortime approach. Some therapists are also willing to work through a distance learning model.  These are available through: www.ICDL.com and www.stanleygreenspan.com

For more information on DIR/Floortime, please visit:

Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)

TEACCH works to understand of the effects of autism on individuals and to promote meaningful engagement in activities, flexibility, independence, and self-efficacy. A common strategy TEAACH uses is visual cues to teach skills. For example, picture cards can help teach a child how to get dressed by breaking information down into small steps.

Manitoba Resources

Currently there are no programs or services that are based off a TEACCH framework in Manitoba. This being said, there may be programs in schools or in private clinician services that make incorporate TEACCH strategies into their therapy.

If this is a framework you would like to learn more about, please visit the following website TEACCH Autism Program http://teacch.com” target=”_blank”>http://teacch.com

Relationship-Development Intervention (RDI)

Relationship Development Intervention (RDI) takes the perspective that a key feature of autism is a severe learning disability that strongly impact squality of life. These difficulties can be described as a lack of ability to make decisions in always changing, complex environments. The ability to think flexibly and to learn from one’s own experience and those of others requires high levels of thinking.

RDI®  programs teach parents how to guide their child to seek out and succeed in truly reciprocal relationships, while addressing key core issues such as motivation, communication, emotional regulation, episodic memory, rapid attention-shifting, self awareness, appraisal, executive functioning, flexible thinking and creative problem solving. This guidance opens the door for what is called dynamic thinking which creates the possibilities that your child can grow to have:

  • Problem solving skills

  • Self-regulation

  • Flexibility

  • Empathy and perspective

  • Competence and self-worth

  • Adaptability

  • Independence

  • Stronger relationships

  • And many other relationship based skills

Manitoba Resources

The Relate Program

The Relate Program is offered through the Rehabilitation Centre for Children. The program is open to children with developmental disabilities that limit their ability to speak or communicate functionally. The goal is to train parents to restore the natural guiding relationship that parents and children normally have, and to help children learn to think and interact with the world in new ways.

The gateway to the Relate program is a 7-evening seminar, Promoting Flexible Thinking and Communication with Your Child at Home, which goes through the basics of the RDI approach and helps parents get an initial idea of what’s involved. The seminar is open to all parents, regardless of diagnosis or ability level of the child. Parents who want to continue to explore these strategies more deeply, and whose children meet the entry criteria (non-speaking or severely limited in functional communication) can apply to enter the Relate Program.

For inquiries, or to register for Promoting Flexible Thinking and Communication with Your Child at Home, contact Yvonne Kash at:

Rehabilitation Centre for Children
633 Wellington Crescent
Winnipeg, Manitoba R3M 0A8
Phone: (204) 452-4311
Fax: (204) 477-5547

For more information on The Relate Program, please visit:

Certified Consultants

Currently in Manitoba, there are 3 certified consultants in RDI. If you are interested in this approach and would like more information, please contact:

Lianne Belton, O.T. Reg (MB)
Rehabilitation Centre for Children
633 Wellington Crescent
Winnipeg, Manitoba R3A 0A8
Phone: 204.453.9842
Email: lianneb@rccinc.ca

Rosanne Papadopoulos, O.T.
Discoveries in Therapy
Winnipeg, Manitoba
Phone: 204.254.3146
Email: rosanne@disconeriesintherapy.com
Web: www.discoveriesintherapy.com

Stephannie Motuz, M.S., CCC-SLP
633 Wellington Crescent
Winnipeg, Manitoba R3M 0A8
Phone: 204.453.9855
Email: stephanniem@rccinc.ca

For more information on RDI, please visit:
RDI Connect http://www.rdiconnect.com/

Occupational Therapy

Occupational therapists view the child as a whole, looking for developmental patterns and finding ways to build skills and mitigate weaknesses, so that the child is able to face life’s challenges and adapt to them. Occupational therapists develop programs to help the child become more functional in their daily life.

An occupational therapist:

  • Helps individuals gain skills needed to carry out the functions of daily life (e.g. develop dexterity in hands in preparation for learning how to print and write, learn how to blow out candles and use their tongue in different ways to help in development of speech)
  • Helps individuals learn new ways of doing things and build on their strengths and abilities (e.g. appropriate ways to play with toys versus lining them up, redirect energy that may be devoted to pacing or other repetitive behaviour into other, more socially appropriate activities, etc.)
  • Adapts the surrounding environment to increase access functionality and reduce the risk of injury (e.g. consideration furniture placement, use of exercise balls for seating, tension bands, etc.)

Manitoba Resources

Provincial Outreach Therapy for Children (POTC)

The Provincial Outreach Therapy for Children is a Government of Manitoba Program that has partnered with the Rehabilitation Centre for Children, the Society for Manitobans with Disabilities and St. Amant. The POTC program works to promote independence, functional participation and inclusion in home and community for preschool aged children through therapy services.  It offers occupational therapy services to preschool age children (ages five and under) who have a physical or cognitive disability, including autism spectrum disorder.  Children can receive services in their home or community center. The services bring together parents, siblings, child care providers, therapists and service coordinators to create a therapy program that best fits the child.

For more information, contact the phone number for the area you reside in:

City of Winnipeg South East Winnipeg Rural and Northern MB
204-975-3265 204-256-4301 204-452-4311

Manitoba Adolescent Treatment Centre (MATC)

Occupational Therapists work with individuals who have Autism Spectrum Disorder in Neurodevelopmental Services at MATC. Neurodevelopmental Services work in partnership with many agencies and services to provide a variety of psychiatric services for children with developmental disabilities and complex multi-diagnostic issues. They provide individuals who have autism and their families with assessment, consultation, education and family support.

Neurodevelopmental Services is apart of the WRHA Child and Adolescent Mental Health Program. To find out more information about the Child and Adolescent Mental Health Program, click HERE.

For more information about MATC, please visit:
Manitoba Adolescent Treatment Centre (MATC) website: www.matc.ca

Private Therapy

There are many private Occupational Therapists that specialize in working with individuals who have autism spectrum disorder. For a complete list of Manitoba’s private occupational therapists, please visit: http://www.msot.mb.ca/find_an_occupational_therapist.aspx

Here you will find all private occupational therapists that work with adults and children in Manitoba. This website will list each occupational therapists services they provide, specialty areas, ages served, and how to get referred to the occupational therapist.

For more information on occupational therapists, please visit:
Manitoba Society of Occupational Therapists http://www.msot.mb.ca/

Speech Language Therapy

The goal of speech therapy is to aid the development of communication, both on a functional level as well as on a social level. Each child’s communication needs are very different, so a speech language pathologists will tailor supports and strategies for a child’s individual profile and needs. This may include basic aspects such as vocabulary and articulation or broader goals such as encouraging interaction or the understanding of social cues and expectations. For some clients, the use of other modes of communication such as sign language, an augmented communication device or other non-vocal ways of communicating may be a consideration.

Manitoba Resources

The Hanen Centre

The Hanen Centre is a program created in 1975, located in Ontario, that helps children with ASD and literacy delays. They have a team of speech-language pathologists working with parents and caregivers to guide them in helping their children develop appropriate communication skills. The program provides parents with workshops, educational books, and support for learning ways to help their child’s communication. They also have many family-friendly resources online available for purchase.

For more information on The Hanen Centre, please contact:

Telephone: 416-921-1073
Toll Free: 1-877-426-3655 (North America only)
Fax: 416-921-1225
Email: info@hanen.org
Website: www.hanen.org

Private Speech Language Therapy

There are private speech language pathologists that work with individuals with autism spectrum disorder. For more information of private speech language pathologists in Manitoba, please contact:

College of Audiologists and Speech – Language Pathologists of Manitoba (CASLPM)

1-333 Vaughan Street
Winnipeg, MB R3B 3J9
Tel: (204) 453-4539
Fax: (204) 477-1881
Email: office@caslpm.ca
Website: http://www.msha.ca

Sensory Processing

There are many health care professionals who work with individuals who have autism spectrum disorder (ASD) using sensory integration therapy.  Many people who have ASD are overly sensitive to certain sounds, touches, smells, movement and sights. Individuals with ASD may enjoy a particular sense, and seek out that sensation seemingly to the exclusion of everything else (e.g. watching spinning fans, listening to the same story or part of a story over and over, avoiding music or other sounds, walking on tip toe to avoid placing their whole foot on the floor, etc.).

Sensory integration therapy helps the person deal with different types of sensory information that are causing problems in their daily life. This type of approach is a un-established treatment.

Manitoba Resources

Integrated Listening Systems (iLs)

iLs programs work to “re-train parts of the brain involved in learning, communicating and moving. Combining a listening program with specific visual and balance activities, iLs strengthens neurological pathways and improves our ability to learn and to process information” (iLs® brochure). The program influences senses in the human body, such as sights, hearing, smells, balance, motor movements, attention and emotional regulation. The program is created and unique to each individual, and can be used for all ages. The following occupational therapy clinic in Manitoba offers iLs:

Discoveries in Therapy
468 Academy Road
Winnipeg, MB R3N 0C7
(204) 254-3146
Website: www.discoveriesintherapy.com

For more information on iLs, please visit: iLs http://www.integratedlistening.com

Private Occupational Therapy

There are private occupational therapists who use sensory integration therapy when working with individuals who have autism spectrum disorder. For a complete list of Manitoba’s private occupational therapists, please visit: http://www.msot.mb.ca/find_an_occupational_therapist.aspx

Here you will find all private occupational therapists that work with adults and children in Manitoba. This website will list each occupational therapist’s services, specialty areas, ages served, and how to get referred to the occupational therapist.

The Picture Exchange Communication System (PECS)

Picture Exchange Communication System (PECS) is an emerging treatment – one or more studies have shown beneficial results, but more work needs to be done to prove its benefit more generally. It was developed at the Delaware Autistic Program to help children and adults with autism to gain functional communication skills. It uses ABA-based methods to teach individuals to exchange a picture card for something they want – an item or an activity or to express a feeling. As the person progresses, the pictures are replaced with symbols and eventually the symbols are combined to make simple sentences.

PECS allows a person to initiate communication and have a need immediately understood.

PECS helps the person acquire a functional communication system so that they can communicate and so that learning can expand.

*This information was retrieved from the Autism Society of Canada

For more information, please visit:
PECS Canada http://www.pecs-canada.com
Autism Society of Canada http://www.autismsocietycanada.ca

Manitoba Resources

The Open Access Resource Centre (OARC)

OARC is a program that is dedicated to enriching the lives of Manitobans with speech impairments through the use of communications devices. The Centre provides information on the types and functions of various speech devices, and operates an extensive equipment loan program. The program is funded through the Government of Manitoba- Family Services and Housing.

OARC lends communication devices for a 10-week trial to Manitobans of all ages who have challenges with speech. There is no age limit for using the OARC resources, and a referral is not required. However, experience shows that the equipment trial is most successful when an individual’s own speech therapist and service providers are involved in the initial selection of equipment, and throughout the trial period.

For more information on the OARC program, please contact:
Open Access Resource Centre
316 Tache Avenue
Winnipeg, Manitoba
Canada R2H 2A4
Phone: 1-204-949-2430
E-mail: oarc@oarc.ca
Website: http://www.oarc.ca/index.html

The Augmentative and Alternative Communication Program (ACC)

The ACC program is run through the Rehabilitation Centre for Children (RCC). This program offers support to educational teams and to parents in planning and preparing picture communication materials and devices for their children with severe oral motor speech impairment. Speech Pathologists work to evaluate children’s current communication and then create a communication plan that is specific to each child. In order to get accepted into this program, the child must be developmentally ready and graduate from The Relate Program (this program is also offered at RCC- see above in RDI section for more details).

For more information on the ACC program, please visit:

Rehabilitation Centre for Children website, available at http://www.rccinc.ca.php53-10.ord1-1.websitetestlink.com/programs-services/specialized-communications-resources-for-children/client-services/

Social Skills Training

A major area that people with autism struggle with is social development. People with ASD have a difficult time communicating with others, difficulty reading other’s emotions, knowing what is socially appropriate behavior, and understanding relationships. Clinicians including occupational therapists and speech language pathologists will work with individuals with ASD and their families to teach skills supporting the development of social interest, social initiation, social responsiveness, and understanding other’s perspective. Therapies that are most commonly seen for social skills training are:

  • Social Stories (evidence-based): Social stories have been widely used to teach individuals with ASD how to understand and interact in a variety of social situations. The stories are client specific, written in first person, and focus on an area that is a particular problem for the client. The story will step through appropriate steps that client is to follow in a social situation to teach them how to act in the future.
  • Social Script Training (emerging): Social script training involves providing individuals who have ASD specific instruction in imaginative play and conversation. The scripts will be between 1 or 2 people, and the person will have a dialogue to follow on how to appropriately speak or play with another person. It has been shown to be useful in increasing the play skills of children with ASDs.
  • Peer-Mediated Instruction (evidence-based): Peer-mediated instruction teaches individuals without ASD to engage and interact with their same age peers with ASDs in social situations. Peers will model how to appropriately act, give instruction, prompt and reinforce social interaction with their individuals who have ASD.

*This information was gathered from Evidence-Based Practices for Children ad Adolescents with Autism Spectrum Disorders: Review of the Literature and Practice Guide by Dr. Perry & Dr. Condillac (2003).*