FOCUS Fort Myers ABA and Occupational Therapists on Expressing Feelings vs. Energy on the Autism Spectrum

As our FOCUS Fort Myers ABA and occupational therapists can explain, lots of kids with autism and ADHD have difficulty recognizing or describing their emotions. There’s actually a name for this: Alexithymia.

It’s not a medical condition in its own right, but lots of neurodivergent people describe it as very real, characterized by substantial and continued difficulty with emotional awareness. It was detailed in a recent study published in the journal Frontiers in Psychology.

Some neurodivergent people who experience alexithymia say that it’s easier to discuss feelings as levels of energy, which can seem a bit more tangible than emotions.

Our FOCUS Fort Myers ABA therapists and occupational therapists recently came across a resource created by the therapy consultants at AutismLevelUp.com that describes the various energy levels, and it inspired us to create our own visuals/explainer.

This idea of identifying energies versus feelings closely relates to the Zones of Regulation that our therapy team uses frequently. (i.e., Blue Zone 🔵 = Sad, Tired, Bored, Sluggish; Red Zone 🔴 = Mad/Angry, Scared, Out-of-Control; Yellow Zone 🟡= Frustrated, Worried, Wiggly, Silly, Excited; Green Zone 🟢= Happy, Calm, Focused, Relaxed).

Every person may have their own unique manifestations of these various zones or energy levels (i.e., one may become hyperactive when they are overly-tired – perhaps because they’re overstimulated).

The bottom line is that any time we can help kids better identify their feelings and/or energy level, the better able we are to help them learn the most effective self-regulation strategies.

Self regulation plays a key role in relationships, well-being and overall success in life. People who are able to manage their emotions and control their behavior are more prepared to manage stress, deal with conflict and achieve their goals.

FOCUS Fort Myers ABA therapy
FOCUS Fort Myers occupational therapy
FOCUS Fort Myers aba therapy

If you have questions about the Zones of Regulation, identifying energy levels, or setting self-regulation goals for your child with autism and/or ADHD, our FOCUS Fort Myers ABA therapists and occupational therapists are here to help.

FOCUS Fort Myers offers ABA therapy, occupational therapy, speech therapy, feeding/swallowing therapy, and physical therapy to kids throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Alexithymia and Autism Spectrum Disorder: A Complex Relationship, July 17, 2018, Frontiers in Psychology

More Blog Entries:

FOCUS Therapy Only Schedules Evaluations if We Have Space to Treat Your Child, Aug. 1, 2022, FOCUS Fort Myers Therapy Blog

sensory processing disorder

Understanding Sensory Processing Disorder Subtypes

The symptoms of sensory processing disorder may depend substantially on the type of sense that is impacted, how it’s impacted, and the severity experienced by each individual.

Sensory processing disorder occurs in each of our sensory systems:

  • Visual
  • Auditory
  • Tactile
  • Smell
  • Taste
  • Vestibular
  • Proprioception
  • Interoception

A person might have just one sensory system that is affected, or they could have all eight, with various different subtypes. That’s why our FOCUS Fort Myers occupational therapists drive home the message that each child with SPD needs to be individually assessed – and treatment for every child is going to look different.

Those with sensory processing disorders have difficulty interpreting the sensory input they get. They might feel overwhelmed by sensory information – or they might crave it. They might seem to be untuned to the sensory input or feelings of others. They might be described as “clumsy,” “awkward” or “delayed.”

Here, we explain the main SPD subtypes.

Sensory Modulation Disorder

Sensory modulation disorder is when a person has trouble regulating their responses to sensory stimuli. There are three types of sensory modulation disorder:

  • Sensory over-responsiveness. This is when a person may respond too soon, for too long, or too much to a type of sensory stimuli that most people find pretty tolerable or normal.
  • Sensory under-responsiveness. This is when a person might be unaware of certain sensory stimulation. They might have a delayed response to it, or their responses could be muted or with less intensity than most people might show.
  • Sensory seeking. This is when someone may be compelled to seek out sensory stimulation, but once they do, they may be ultimately unsatisfied or it only results in disorganization. At the very least, it may be seen as socially problematic.

Sensory Discrimination Disorder

The second type of SPD is sensory discrimination disorder. This is when a child may have difficulty interpreting the subtle qualities of people, places, objects, or environments. This can include:

  • Auditory discrimination disorder. This would be trouble interpreting auditory/heard stimuli.
  • Visual discrimination disorder. Trouble determining or interpreting visual stimuli.
  • Tactile discrimination disorder. Trouble interpreting stimuli that is felt or touched.
  • Vestibular discrimination disorder. This is trouble determining or interpreting stimuli that is experienced through movement of the body against gravity or through space.
  • Proprioceptive discrimination disorder. This is difficulty determining or interpreting sensory stimuli experienced through joints and muscles.
  • Gustatory discrimination disorder. This is when someone has trouble interpreting or determining sensory stimuli that is tasted.
  • Olfactory discrimination disorder. Trouble interpreting/determining smelled stimuli.
  • Interoception. Trouble interpreting internal organ stimulation. (They may not feel the need to use the toilet or they might have frequent stomachaches.)

Sensory-Based Motor Disorder

Sensory-based motor disorder is when one has trouble with motor coordination, balance, and performing skilled motor tasks.

These include:

  • Postural disorder. Someone with postural disorder would have a skewed perception of their body position. Therefore, they’d struggle with poorly-developed patterns of movements that depend on stability of the core. They would appear to be weak or have poor endurance.
  • Dyspraxia. This is when the person would have trouble thinking of, planning, or carrying out skilled movements – especially new movements they aren’t familiar with.

FOCUS Therapy Treats Kids With Sensory Processing Disorder

If your child struggles with any type of SPD, our skilled team of occupational therapists can help!

FOCUS offers pediatric occupational therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

What is Sensory Processing Disorder? March 31, 2022, By Janice Rodden, ADDitude Magazine

More Blog Entries:

Fort Myers Feeding Therapy Tips for Picky Eaters, July 24, 2022, FOCUS Therapy Blog

FOCUS Therapy Fort Myers

FOCUS Therapy Only Schedules Evaluations if We Have Space to Treat Your Child

Evaluations are an important step in the process of securing speech, occupational, physical, and/or ABA therapy for your child. But parents and caregivers should be wary of facilities that offer these evaluations while lacking capacity to immediately treat the child.

FOCUS Therapy Owner/Founder Jennifer Voltz-Ronco explains that unless her team is being called on for a second opinion of an initial evaluation, they refrain from conducting formal assessments if unable to promptly provide treatment once the evaluation is complete.

“A standardized assessment is only a snapshot in time during the child’s development,” Voltz-Ronco said. “It’s like taking a picture of a child now, and then expecting it not to change in a few months. … If your child cannot access therapy within 1 or 2 months of that evaluation, the results are no longer going to be accurate. Kids develop new skills every few months. But the longer the child goes without therapy, the more significant that standard score comparison/discrepancy to same-age peers is going to be.”

Jennifer Voltz-Ronco FOCUS Therapy Owner
Jennifer Voltz-Ronco, FOCUS Therapy Owner/Founder

Beyond this, families who rely on insurance to cover the cost of these evaluations (and they aren’t cheap) should be aware that insurers typically only cover one evaluation every six months or so. Even though clinics can utilize standardized assessments administered by another, it’s not ideal.

“Your child gets the most benefit when the team that directly observed your child’s abilities and deficits are the ones who ultimately formulate a plan of care and follow through with treatment,” Voltz-Ronco said. “In my opinion, it’s unethical for a clinic to profit from an evaluation that reveals a child is delayed or needs intervention – without providing that help.”

Types of Pediatric Evaluations FOCUS Therapy Offers

Children are usually referred to FOCUS Therapy and other therapy specialists by their primary care physician. Evaluations are typically ordered when a child is showing some developmental deficit, such as not sitting up or crawling, not talking or making regular eye contact, or red flags for a possible cognitive deficit. They could also be diagnosed with a condition that we can pretty well say for certain is going to require some combination of therapy services (such as cerebral palsy, down syndrome, vision impairments or hearing deficits).

Depending on the child’s condition and identified areas of concern, qualified therapists will be scheduled to conduct age-appropriate assessments to determine the need for therapy intervention services.

The specifics of the evaluation may vary, but they are generally going to include:

  • A look at case history, including medical status, education, socioeconomic, cultural, and linguistic backgrounds, and information from other providers.
  • Child and/or parent interview.
  • Review of the child’s auditory, visual, motor, and cognitive status.
  • Standardized and non-standardized assessments of specific aspects of speech, non-spoken language, swallowing function, cognitive communication, etc.
  • Assessment of self-care and/or self-awareness.
  • Skilled observation. This is where we keenly observe an accurately record a child’s abilities and behaviors.

There are several different types of standardized tests (including the ADOS test for autism screening, which FOCUS Therapy also provides).

“If a parent wants a second or third opinion after their child has been evaluated by a school or another provider, that’s one thing,” Voltz-Ronco. “But they’re most likely going to pay for that out-of-pocket – and they’re going to understand the purpose upfront. But if parents are looking for action, to get the ball rolling on the therapy interventions that a child needs, then the clinic conducting the assessment should be able to provide that.”

Not all of them do. Therefore, it’s incumbent on parents to ask the question before scheduling the assessment.

“We’ve gotten calls from parents of children who were evaluated other clinics, only to be told after the fact that the clinic did not have the ability to treat their child,” Voltz-Ronco said. “They were told to just call around and see what other clinics may be able to use the report generated from their assessment. That, to me, is not ethical.

“It’s a situation where parents need to be aware of this issue, and make sure they are asking the question upfront: ‘If I schedule this assessment and my child needs treatment, do you have the capacity to provide that treatment?’ If not, I would advise parents to move on and find a place with the capacity and willingness to do both.”

FOCUS offers ADOS testing and other standardized assessments in Fort Myers and throughout Southwest Florida for children who may need speech therapy, occupational therapy, physical therapy, or ABA therapy. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Assessment and Evaluation of Speech-Language Disorders in Schools, American Speech-Language Hearing Association

More Blog Entries:

ADOS Testing, FOCUSFlorida.com

sensory meltdown

Tantrum or Sensory Meltdown? Fort Myers ABA Therapists Explain

When working with kids who have varying sensory struggles, it can be difficult to tell the difference between a tantrum or a sensory meltdown. Our Fort Myers ABA therapists recognize that it often takes some detective work to differentiate. But determining which is which is important when formulating the most effective response.

A sensory meltdown can be especially tough to identify because a child’s sensory thresholds can vary from day-to-day or even hour-to-hour.

Some behaviors that may be present in BOTH:

  • Screaming
  • Kicking
  • Name-calling
  • Hitting
  • Crying
  • Hiding or avoidance

Tantrums, however are typically a response to a child not receiving something they want or an anticipated outcome. Sensory meltdowns, meanwhile, stem from sensory overload, with reactions being to the big feelings that the overload can cause.

In the case of a meltdown due to sensory issues, parents may need to formulate a strategy that plans ahead, rather than simply react to the meltdown when it happens. That means meeting their sensory needs through a sensory diet (unique to each child) that can help them avoid feeling completely overloaded and overwhelmed.

We need to look carefully at the sorts of things that can trigger a sensory meltdown. Some possible meltdown triggers can include:

  • Being overly tired or hungry.
  • Generally not feeling well. (This can stem from illness, food sensitivity, overheating, etc.)
  • Being expected to “hold it together” for long periods of time, such as going to summer camp, school, or on play dates.
  • An abrupt change in routine – anything outside of the ordinary – can set off sensory overload.

Because the overload may not be immediate, it can sometimes appear like a meltdown “came out of nowhere.” But there is almost always a source when we look very carefully at the “antecedents,” or events that occurred prior to the meltdown. You may even have to go back a few days to pinpoint the cause.

Toddlers and preschoolers may be especially prone to tantrums because they do not have the motor, language, or problem-solving skills to work through some of their frustrations on their own. They may have an emerging desire to be independent, without having the skills to actually BE independent. They might have emerging language skills, and thus are unable to communicate what they actually want or need. They may have big feelings, but lack the prefrontal cortex development to emotionally regulate. They may have a growing understanding of the world around them, but also a lot of anxiety about how to move through it.

Tantrums usually only end when a child gets what they want or when they’re rewarded for better behavior.

Meltdowns, on the other hand, only end when the child tires out or the sensory input is altered. They stem from what we sometimes refer to as a “physiological traffic jam” in the central nervous system. There is too much overstimulation and feeling limited in your ability to “exit.” This can trigger a “fight or flight” response.

As parents, therapists, teachers, and caregivers, it’s important to recognize that the behaviors we’re seeing are not controllable behavioral reactions. Rather, they are physiological responses. This is why our Fort Myers ABA therapists and occupational therapists put such emphasis on identifying which is which so that you can appropriately respond.

With tantrums, you need to recognize the motivation or purpose, reinforce positive behavior, and build skills for success.

Meltdowns, however, can sometimes be avoided when we use visual schedules, social stories, and checklists to help kids know what is expected. There are no surprises or question marks. Reducing the unexpected changes in routine is going to reduce the overall stress that can trigger a meltdown.

We also recommend routine sensory diet activities, like scheduling quiet time or offering them breaks for sensory input.

Parents and teachers should also be able to recognize signs of a child’s distress. This could be covering their ears or rocking back-and-forth or humming or bolting from the room. Once you are able to quickly recognize the signs of overstimulation, you can respond to help them regulate before reaching the meltdown stage.

FOCUS offers pediatric ABA therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Expert Ways to Help Tame Tantrums and Manage Meltdowns, June 18, 2021, By Alescia Ford-Lanza, MS, OTR/L, ATP, Autism Parenting Magazine

More Blog Entries:

Study: Less than 1/2 Kids With Autism Undergo Early Intervention Therapy, July 30, 2022, FOCUS ABA Therapy Blog

autism early intervention therapy

Study: Less than 1/2 Kids With Autism Undergo Early Intervention Therapy

Early intervention therapy for autism is crucial to optimal long-term outcomes for children on the spectrum. “Early intervention,” defined as a combination of speech therapy, occupational therapy, physical therapy, nutrition/feeding therapy, and ABA therapy, should ideally begin before age 3 to be the most effective. Yet a new study found that more than 50 percent of children with autism do NOT get the critical early intervention that has been proven to lay the foundation for yielding the best sustained results.

Researchers at Rutgers University analyzed the early intervention participation of kids with autism in one state, and found less than half were receiving early intervention therapies before turning 3.

The study, published in JAMA Pediatrics, revealed income and racial disparities unfortunately played a role in how likely children were to have access to early intervention. Study authors opined that the issue was likely worse in other states.

As our FOCUS Therapy Fort Myers team understands it, the researchers analyzed data from the New Jersey Autism Study, a monitoring system that was set up by the Rutgers New Jersey Medical School, focusing on the records of some 23,000 kids. They identified approximately 4,000 8-year-olds diagnosed with autism. Of those, only 1,890 of them had participated in early intervention therapy services. This was true even though these services are required by federal law under the Individuals with Disabilities Education Act.

To identify where the disparities were most prominent, the team analyzed information on wealth indicators (median household income, primarily) and discovered that kids who lived in areas with higher incomes were 80 percent more likely to have access to early intervention autism services than kids who lived in lower-income neighborhoods. They also learned that Black and Hispanic children were less likely to enroll in these services compared to their white counterparts.

Study authors stressed that understanding socioeconomic and cultural barriers to both early diagnosis and these essential therapy services are important components of helping improve education and access.

Early Intervention Therapy Key to Addressing Child Development Concerns

Fort Myers ABA therapists

Fort Myers ABA Therapists’ Tips for Supporting Siblings of Kids With Autism

Autism Spectrum Disorder (ASD for short) is now diagnosed in 1 in 44 children in the U.S. As a broad range of conditions characterized by deficits in social skills, speech, communication, repetitive behaviors, and other challenges, the ripple effect of the condition impacts more than just the individual diagnosed. In fact, home carryover of early intervention therapies (speech, occupational, and ABA) is most effective when everyone in the home is committed to following our recommended strategies.

Our Fort Myers ABA therapists recognize that families – and neurotypical siblings in particular – may struggle with anxiety, depression, and social difficulties, as outlined in a recent study. On the flip side, researchers also found that children with autism who have a neurotypical older sibling tend to have better social skills than those who did not.

The key is striking a balance, and ensuring that both children are supported – and given the tools to understand each other.

A child with autism may, inevitably, demand more of a parent’s time, energy, focus, and resources. This may leave siblings of kids on the spectrum feeling as if they are being overlooked. It’s important to validate and address these feelings so that it doesn’t grow into a much larger issue as time goes on.

Southwest Florida ABA therapy

5 Steps to ABA Therapy in South Florida

ABA therapy is considered the gold standard treatment for kids with autism spectrum disorder (ASD). But the process of starting this therapy is not as simple as calling and setting an appointment. There are several steps that must be taken to initiate the process.

It begins by recognizing the early signs of autism, and sharing these concerns with your child’s pediatrician. Doctors should screen all children at 18 months for risk of autism as a matter of routine – but parents absolutely can bring concerns to their doctors at any point. Signs of autism can be clearly identified as early as 12-months-old.

The doctor will then initiate a referral for a full assessment, known as ADOS testing. This test must be administered by a qualified provider. FOCUS Therapy does provide ADOS testing for children in Southwest Florida. The results of the ADOS test are then shared with a pediatric specialist, who ultimately makes the diagnosis and then issues a referral for early intervention services – such as ABA therapy, speech therapy, and occupational therapy.

If your child is under the age of 3 in Florida, they may qualify for early intervention services through a state program called Early Steps. This can serve as an important stop-gap, given that many private therapy clinics that offer Applied Behavioral Analysis in Southwest Florida have waitlists.

Our ABA therapy services at FOCUS Therapy are conducted one-on-one, in-clinic with experienced professionals called RBTs (registered behavior technicians), with oversight from a BCBA (Board Certified Behavior Analyst) and physician specialist.

If you have questions about autism screening, ADOS testing, or ABA therapy in Southwest Florida, our trusted team of therapists, coordinators, and insurance billing professionals can help.

FOCUS offers ABA Therapy and ADOS testing in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

What Are the Early Signs of Autism? HealthyChildren.org, American Academy of Pediatrics

More Blog Entries:

5 Fort Myers ABA Therapy Techniques, May 24, 2022, Fort Myers ABA Therapy Blog

Fort Myers ABA therapy

5 Fort Myers ABA Therapy Techniques

Behavior therapy – specifically, applied behavioral analysis, begins with understanding the science of behavior. At our Fort Myers ABA therapy clinics, we use this understanding to employ specific strategies proven to help children with autism and other conditions achieve their goals – ultimately allowing them to gain greater independence and engage more fully with the world around them and people in it.

As explained by the American Psychological Association, ABA therapy is an evidence-based practice, meaning it’s supported by peer-reviewed literature. It identifies the motivation behind the behavior before addressing it with one or more proven strategies.

Each Fort Myers ABA therapy plan of care must reflect what reinforcements are most effective with that specific child, with clear goals we want to see them meet within a set time frame. Our ABA therapy team then works with kids one-on-one with them – day after day, week after week, and month after month, and sometimes year after year. We want to see them thriving in all environments – from home to school to play dates to community events – to the fullest extent of their capabilities.

Most all strategies involve some use of the ABC’s of behavior. That is, we study the Antecedent, then the Behavior itself, then the Consequence. By studying each element, we can determine what is the motive or what’s being communicated by that behavior – and then change either the antecedent or the consequence with the goal of altering the behavior.

Top Fort Myers ABA Therapy Techniques

Fort Myers ABA therapy
ABA Therapy Fort Myers

Understanding ABA Therapy

Understanding ABA therapy is critical for anyone whose child has been recently diagnosed with Autism Spectrum Disorder, or ASD.

As our Fort Myers ABA therapy team can explain, ABA is short for “applied behavioral analysis,” and it involves utilizing the science of behavior to help children with autism in producing socially significant improvements in behavior. We apply proven behavioral science principles to increase or decrease targeted behaviors, with the ultimate goal of bringing about meaningful change to the child.

We work to identify behaviors that are observable and measurable, and then use empirically-validated, research-based strategies to help them make strides in overcoming challenging behaviors and increasing those that are helpful in daily life. We also teach and and help them practice critical life skills, such as social communication, emotional regulation, sensory integration, and executive functioning.

At FOCUS Therapy, we have two Fort Myers clinics where we provide both ADOS testing and ABA therapy for children in Southwest Florida.

FOCUS offers pediatric ABA therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

What is Applied Behavior Analysis? June 23, 2021, Medically Reviewed by Jabeen Begum, WebMD

More Blog Entries:

Top 4 Benefits of In-Clinic ABA Therapy, April 4, 2022, Fort Myers ABA Therapy Blog

FOCUS Therapy evaluations

Why FOCUS Asks Parents to Stay in the Waiting Room During Evals, Sessions

FOCUS Therapy in Fort Myers conducts a range of in-depth evaluations for children who have been referred for speech, occupational, physical, or ABA therapies as well as ADOS testing. During our evaluations and therapy sessions, we rarely allow families to directly participate – but we have evidence-based reasons for our position.

During evaluations, we want to ensure every child receives an assessment that is as accurate as possible because that is what is going to allow us to:

  • Determine whether the child needs therapy.
  • Calculate the frequency/level of therapy that might be recommended.
  • Make a strong case to the relevant insurer(s) about the medical necessity of the therapy.

Parents, when present in the room during FOCUS evaluations, can unwittingly stand in the way of those goals. Why? Mainly because children rely on their caregivers when things get tough – to help them, to comfort them, to make it better. When a child is struggling in a certain area, such as communication or independence with self-care skills, our clinicians need to independently observe the particulars.

Parent input is a key aspect of our evaluations, but we need to see for ourselves, too. Jennifer Voltz-Ronco, MS-CCC/SLP and FOCUS Therapy Owner/Founder, explained that when a child is accompanied by a parent during the direct observation portion of the assessment, parents often interfere without intending to do so or even realizing it.FOCUS Therapy

“For example, in speech evaluations, parents might talk to the child or give clues to help their child ‘get the right answer’,” Voltz-Ronco explained. “We might ask the child to point to an object out of an array of 3-4 items by saying, ‘Show me the cup.’ Standardized testing requires that we be very specific in how we present these items – and with the requirement that we wait. And while we wait, we’re looking to see how long it takes them to process the directive and what they do. Will they look at us to see if we’re looking at the object? Will they point to it or make a face if they’re unsure? They might associate a cup to mealtime and instead point to a cookie. If the child looks to our face to get a clue, that would indicate social awareness and joint attention – key pre-linguistic communication skills. If there is a delay in their response, there may be an auditory processing issue. If they grab the first thing in reach, they may have impulsivity issues. Watching a child while they’re thinking tells us so much. But parents in the room might think the evaluator presumes the child doesn’t know the answer, so they interject. They say to the child, ‘You know what a cup is, like the blue sippie cup you have at home.’ Unfortunately, what that does is give the child numerous opportunities to hear the word, ‘cup,’ and in many standardized tests, we aren’t allowed to repeat the word or give a description or synonym. So with that, we lose the opportunity to see what we needed to see, and must in turn score the response incorrectly – which impacts the overall results.”

She went on to explain that often the key responses FOCUS therapists are looking for aren’t necessarily what an untrained observer may presume.

What’s more, some children can become what we call “prompt dependent.” That means the child looks to the parent to prompt them (to take an action, answer a question, etc.) – even if they don’t necessarily need the prompt. Many of our team members are parents ourselves, so we wholeheartedly understand how difficult it is to wait for your child to “do it themselves.” It is actually instinctual to intervene when we see or sense our child needs help. But during these evaluations, this intervention – however slight – can actually prove more of a hindrance when what we’re seeking are accurate results.

We DO Want Parents Involved in Their Child’s Therapy Journey

Although it is important for parents to remain outside the room during evaluations, this does not mean we lack transparency or that we don’t want parents involved at all in the therapy process. In fact, we get the best results from therapy when parents are fully engaged!

But we discourage direct engagement during the evaluation process and therapy sessions because we want to ensure our findings are accurate and that your child gets the true level of support they need.

While we want parents to be involved in consultation, goal-setting, education, and carryover, we strongly advise parents against sitting in during therapy sessions for the following reasons: