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Reflections...

12/29/2020

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As I reflect on 2020, it is with mixed emotions. The obvious overwhelming dark cloud that is Covid is hard to ignore when looking for bright spots. So much loss of life occurred from this pandemic.  RNH suffered the loss of one of our own, Karen Schroedel, to cancer. I also suffered a personal loss in the tragic death of my dear nephew.  I know many, many people who lost beloved family members and friends this year.
This year started out bright with my middle daughter, Nora marrying the love of her life, Joe, on February 29 in a dramatic, lavish wedding that would be the last big party of 2020 for most of our family and friends. So glad to have seen most of the people I love in one room that day!
It was heartbreaking to close RNH on March 12, 2020 after the governor closed the schools and issued a stay-at-home order. This shut down occurred just weeks before the 4-year anniversary of the ribbon cutting for the first RNH brick and mortar office.  We tried tele-therapy, and it worked for some kiddos, but certainly not all.
On June 1 we reopened with precautions and protocols. The kids flourished and we knew this was the right decision We moved to our stunning new location on August 1 and we finally felt like we were home. The benefits of having all three disciplines together is evident in the progress our kiddos are making.
Our team has grown. As of January 4, we will have 19 therapists providing services to our families and one office person.  From 1 employee to 20 in less than 5 years.  The team we have now is so strong, devoted, and united. It is staggering to me to see these incredible women change lives daily.
 I rarely “toot my own horn”, but every time a parent tells me I have changed their lives, I have given their child a voice, I gave them hope when they were hopeless, or as one cherished Mom says they often say “Thank God for Donna”, I am humbled. It simply takes my breath away.
As I say goodbye to 2020,  I suggest we all be kind, give grace, and leap. If you believe and you do what’s right, the net will surely appear.

Author

Donna Rowan Culley is the founder/owner of Reaching New Heights and is an experienced Speech Language Pathologist with a specialty in Autism. She is passionate about helping nonverbal children find their voice.

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May 27th, 2020

5/27/2020

 

An Occupational Therapist's Wish List!

12/10/2019

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Author

 Kylie Enders is an OT at Reaching New Heights who loves "craftivities" and figuring out activities to meet a kiddo's sensory needs! Kylie is offering free screenings to see if your kiddo would benefit from OT!  Questions about fine motor, sensory, handwriting, feeding? Contact Kylie at kylie@reachingnewhts.com 

Feeling like the holiday season crept on you this year? Don’t worry. It did for me too. And if you’re anything like me, you’re still looking to finish up your shopping. Here are some great ideas for gifts for children of any age that will encourage sensory play and exploration, as well as important developmental skills. Plus, all of these toy ideas are screen free! I’ve linked an Amazon list at the bottom of this blog post which includes some of the toys listed below for easy shopping and even more ideas.

Babies
- Ball ramp or ball popper
- Ring stacker
- Play table
- Play cubes
- Sit to stand walkers
- Poppin’ Pals
- Push and spin toys

Toddlers
- Shape sorters
- Mega blocks
- Mr. Potato Head
- Stack and Sort boards
- SpinAgain stacker
- Laugh and Learn Piggy Bank

Preschoolers
- Inset puzzles with knobs
- Art supplies & easel (paints, markers, crayons, dry erase, etc.)
- Pretend play sets (kitchen, tool bench, doll house, dressup,)
- Games! There are so many, but here are a few examples
         o Chutes and Ladders, Ants in the Pants, Candy Land, Let’s Go Fishin’, Zingo
- Play Doh
- Duplo blocks
- Magna-Tiles

Elementary
- Lego’s
- Game Suggestions:
         o Any games listed in the preschoolers category, Kerplunk, Guess Who, Don’t Break the Ice, Uno, Blink, Twister, Trouble, Sorry, Perfection, Connect 4, Perfection, Spot It

All Ages
- Play tunnel
- Mini trampoline
- Floam
- Slime kits
- Kinetic Sand (turn this into a super fun sensory bin!)
- Books


Amazon Link:   http://a.co/0alA2Ez
Happy holidays and happy shopping!
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Blurred lines...

9/3/2019

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Author

Heather Closen is a mother of two young boys, living in Lakewood with her hubby and kiddos. Heather balances her life between motherhood and providing behavioral therapy as a BCBA. Sometimes the lines blur between "Mom" and "BCBA"! Questions about Behavioral Interventions at Reaching New Heights? Contact Heater at heather@reachingnewhts.com.

Last Tuesday, I took my son to Pre-K Orientation. It was great – we met his teachers, became acquainted with his new school building, saw the playground, spent time in his new classroom, and met some of his new friends. On the way out, we practiced saying “goodbye” at the door I’d drop him at the following morning, and he was all smiles. He was so excited for school!
That night, we talked about his teachers, how excited he was for the reading corner and the blocks center and explained to his dad and brother about how he’d be dropped off and wave goodbye with a smile. We placed the bright magenta parent ID tag in my car, looked at the calendar with the next day’s events, and read a social story about going to school (child of a BCBA and Special Education teacher – what can I say?). Before bed, we re-read the social story, and ended with “The Kissing Hand” – a great story about a baby raccoon’s first day at school. He was still so excited for school.
Then came Wednesday morning. We woke up, had his favorite breakfast, and took his annual back-to-school photos by the front porch. His grandma arrived to watch his little brother, and we hopped in the car to drive to school. When we arrived, he started getting a little nervous. He said the school seemed too big. I assured him he’d met his teachers and seen the classroom – it was just one short hallway to get there – no worries. But then the bell rang and the teachers came out to get the students. He panicked. He clung to me and began to cry. He wouldn’t leave my side. I went through the schedule – reminded him that I’d be back to get him in just a couple hours. I used all the tricks I have up my sleeve to make transitions more seamless. Nothing worked – he clung tighter and cried harder. His teachers offered that I could come to the classroom, but I didn’t want to reinforce the negative behavior (again – kid of a BCBA…), so instead, I walked into the building with him. He still clung tight and said “Don’t leave me!” through tears. It was terrible. Finally, when the last parents had left, I looked pleadingly through tear-filled eyes at his teacher and said, “you can take him”. I gave him one last kiss and a big squeeze, and said, “have a great day! I’ll see you soon!” with as much excitement as I could muster. As she pried his sweet fingers off me, she said, “I’ll text you” and I hoped that I’d hear soon that he was smiling and enjoying school.
I held myself together on my way back to the car, and somehow made it safely to the McDonald’s parking lot before crumbling. It was awful.
But – he was fine. I got a text from his teacher within 15 minutes that included a picture of my smiling boy saying he was having a great morning. When I picked him up, he told me he “loved school”, but that he just felt a little sad at first. The next morning, and every morning since, he’s kissed me goodbye at the door and run up the stairs excitedly and completely on his own.
As our kids go back to school, it’s important to remember to give them all the tools we have to help them transition – things like talking about changes, using calendars and agendas, reading social stories, and having special little traditions to look forward to at pick-up time. But, even when all those tricks are in place, it’s still not always easy...and that’s okay. Hold strong for your kiddo – let them see you as a strong front who is confident that they’ll love school and have so much fun. Remember that each day is a new day. Keep in close touch with your child’s teacher and show your child that they are a safe person.
Talk to us and let us help develop interventions to assist with transitions (and reinforcers for great days at school). And if all else fails – text us from the McDonald’s parking lot…we’ve been there, too.
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SCHOOL’S OUT FOR SUMMER!

6/20/2019

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Author

Heather Closen is a Board Certified Behavior Analyst who is passionate about having balance in her busy "Mom life".  Heather uses systems to organize her family life as well as the ABA department at RNH.
Contact Heather at heather@reachingnewhts.com

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Depending on what school district your child attends, you’re anywhere from 1-3 weeks into Summer 2019! Welcome!...and I feel your exhaustion! As a mom, I know that summertime, in its essence, is fun and carefree, but when you’re spending time with littles it can end up being stressful, tiring, and tough on families. For kids, especially kids with autism or sensory defenses, the lack of routine that accompanies summertime can be overwhelming and draining. As parents, we can help our kids establish a routine that will help the entire family get the most out of a summertime together!
· Make a calendar
  •  Try using a whiteboard weekly calendar to lay out the activities for the week. Sit down on Sunday night with your children and talk about everything that will be happening. You may even want to write different activities in different colors (i.e., all the INSPIRE days are written in blue, and all the “family nights” are written in green.) OR, if your kids are older, you could give each of your children a different color to write their own activities on the shared calendar. This sense of preparedness may alleviate some of the anxiety that comes along with a change in routine.
· Establish a weekly routine
  • As an ex-Kindergarten teacher, I love alliterations. I try to have daily themes both at work and at home and use alliterations whenever I can. Think “Musical Monday” and either make a musical instrument or visit a music therapy class. Or, “Try Something New Tuesday” and visit a new place each week…get the idea?
· Give your kids responsibilities
  • Most children, if they’re in school, have a certain level of responsibility in the classroom. They can handle simple responsibilities around the home, too…and might actually enjoy them. Depending on your child’s age, they could help empty the dishwasher, take out the trash, sweep the floor, clean up the toys by their category, make their bed, or sort the laundry.
· Reinforce the behavior you want to see
  •  As parents, it’s so easy to only say something when your kids are misbehaving, or if you need to correct them. This gets wearing on both kids and parents. Challenge yourself to notice, praise, and encourage the behavior in which you want your children to engage. And, if you have to redirect (because, let’s be real – that’s parenting), make sure to immediately praise the wanted behavior so your child knows that they did the right thing!
These few tips are just the tip of the iceberg – see what I did there? – but are sure to get you going in the right direction. Do what works for your family – but keep in mind that most of us, adults included, thrive with some sense of routine. And, if you or your family is struggling with establishing a summer routine, reach out! The therapists at RNH are happy to help!
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​“But my child doesn’t need a job”

5/20/2019

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Author

Bridget is our senior Occupational Therapist at Reaching New Heights. She is excited to try to shed some light on her profession! Bridget loves helping kiddos with their fine motor, social emotional regulation, and sensory needs! In her free time, Bridget enjoys playing softball and hanging out with her fur baby!

Occupational therapy…”hmm, yeah, I have heard of it”..”but, umm...what is it that you do again?”
“You help people get jobs right?”...
“Wait...you’re a pediatric occupational therapist?​
​ "Well….why would children need jobs?”

If I had a nickel for every time I have heard a similar conversation I would be RICH! SO...what is occupational therapy and what do we do when it comes to a population of children? First off, we don’t help your child get a job, however, we can help provide skills that one needs for a job in the future. Instead, we enjoy being called the specialists that are going to teach your child how to use their brain and hands together while sitting upright in a chair. Let’s begin with what our brain and hands are doing. Think about how much you do with your hands throughout a day. We button up our shirt, we feed ourselves with a spoon, we grab our seat belt to lock in place, we hold a cup to drink our large coffee out, we write to-do lists with a pen, we pick up the small M & Ms as a midday snack, we tie our tennis shoes to walk our dog...okay, you see where I am going with this. Everything we do with our hands begins with a plan in our head and is then executed with movements of our body, this is called motor planning. This motor planning allows us to accomplish everything we do in a day...which explains the brain part. But now our hands, too?? I promise I will make it simple. Our arms and hands make all of these activities possible through how we move, grasp, and manipulate items in our everyday life. Period. So as occupational therapists, we help to coordinate what our brain and hands are doing and provide the tools needed for your child to be able to control their upper body movements and manipulate objects to complete necessary activities across their environments. “Okay...but upright in a chair?” “What?!” Well, that takes us to the “foreign language” part of occupational therapy... What do I mean by saying upright in a chair? We do focus a lot on what our arms and hands are doing, but we can’t even begin to observe that if we aren’t sitting upright in a chair, or sitting pleasantly on the ground, or having enough balance to stand up tall, right? This is where the sensory approach comes in. I know when we think about sensory we think about our five main senses we learned in elementary school: touch, taste, smell, sight, hear...but did you know there are actually 8 sensory systems in our bodies? The last three that we don’t learn about are vestibular (knowing where our body is in space), proprioceptive (movement of our muscles and joints in relation with the rest of our body), and interoception (what our internal organs are feeling) systems. All of these systems work together in order for us to sit in a chair, stay in a chair, and attend in a chair. “Okay...so what? We have 8 sensory systems...what does that have to do with occupational therapy?” Well, I will tell you. Occupational therapists are magical masters in finding how your child processes sensory input coming in from all directions, then we provide fun activities that helps the child process that input better (without them even knowing it, WHAT?!), and then the child learns how to attend to their teacher or you, control their emotions, sleep better, or EVEN SIT UPRIGHT IN A CHAIR without falling or causing disruptions. We all have sensory needs and we all process these systems differently. A lot of the time, for adults, we learn how to regulate without help...such as tapping a pencil or a foot in a meeting, chewing gum, doing a midday stretch, etc. We have just naturally learned what is going to help us stay awake or attend to someone or something. “So...how do I know if my child may need occupational therapy?” Great Question! Some things to look for: ● Trouble holding items (such as spoon/fork, writing utensil, etc) ● Maintaining a grasp on such items ● Uninterested or avoid activities with small manipulatives (beads, cutting, writing) ● Does not use both hands/sides of body ● Trouble finding objects in a background ● Handwriting difficulties ● Picky eating ● Avoids messy play ● Avoids movement (climbing, swinging, etc) ● Seeks movement constantly ● Seeks tight hugs, consistently pushing/falling into you ● Requires specific clothing and clothing materials ● Seems to require their name to be called a few times before noticing ● Enjoys chewing/biting objects ● Avoids loud/ busy places ● Loses balance easily I know...you’re thinking “maybe some of these things happen but I am just not sure if it is normal or if it means anything more than just being a kid.” Well, GREAT NEWS. Here, at Reaching New Heights, we offer FREE, yes…..I said FREE, screenings to assess if your child might need more help from the brain and hand specialists, the magical sensory masters. Feel free to contact me with any questions/concerns or comments at bmoran@reachingnewhts.com
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“WHAT THE…PEC?!”

4/23/2019

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Author

Victoria Harrison is a Speech Language Pathologist who has found a passion for working with nonverbal children, especially those with a diagnosis if Autism. Victoria custom makes PECS books for these children and LOVES seeing them learn the POWER OF COMMUNICATION!  Victoria, recently married, just bought her first house and is excited to start making it "home".

My kid won’t talk, what do I do now?! The answer may be PECS! 
Here is why I am SO EXCITED about PECS at Reaching New Heights, and why you may be just as excited as I am! 
 
The introduction of PECS has been a game changer for several of the children I work with. The main reason that PECS WORKS is because it decreases the neurological demand on the child (they are able to just focus on removing/exchanging an icon to communicate). It also works because it teaches the child that COMMUNICATION IS POWER! They typically learn very quickly that by requesting items, they are able to get what they want much faster. The third amazing thing is that it does not inhibit verbal communication, it promotes it, mainly because they learn that communication is power and by talking, they can achieve even more! 
 
One child that comes to mind came to Reaching New Heights with no verbal communication. I wanted to introduce a tool that would encourage him to communicate, but would also act as a resource for him to request his wants/needs in different contexts! PECS seemed like the perfect tool! I started using this with him and within 2 weeks he was independently removing the icon(s) and exchanging them for desired items (e.g., he would exchange a “car” icon for a toy car). I brought his caregiver in to observe a session and trained her on PECS so that they could start to use this amazing resource at home!  
 
(Did I mention that I made him his own PECS to utilize at home, that is personalized and catered to his specific needs?! We can do this for any child that comes to Reaching New Heights and excels with PECS!!) 
 
Now he is able to seek out his PECS in the therapy room and bring icon(s) to the SLP to request desired objects. It was so exciting to see his progression with PECS and to see him gain functional communication! 
 
One of the greatest things about Reaching New Heights is our ability to collaborate with other fields/professions. As a team, speech therapy, occupational therapy, and ABA discussed PECS and the benefits it could have for this child if we all use it. Now he is able to use his own PECS in all of his therapy sessions to tell others the things he needs!   
 
PECS can be such an amazing tool for so many different children. Communication is so important, and PECS is an amazing resource that can help children begin to use their voice and learn all the wonderful things they can accomplish with communication! Come see us at Reaching New Heights to see all the amazing things your child can accomplish with PECS!! 
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ABA...the new kid on the block!

3/18/2019

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Author

Laina Culley is a licensed teacher who is simultaneously working on  her Master's Degree in Special Education, Moderate - Intensive and her coursework for BCBA certification. She is a Registered Behavior Technician at Reaching New Heights and is passionate about her work with children.

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​ABA is sort of the new kid on the block when it comes to services for children with autism, and the other kids on the block sometimes aren’t welcoming us with open arms. Personally, I find that very confusing.

When ABA began, things weren’t perfect. The focus was on Discrete Trial Training (DTT), and therapy sessions were far more rigid. DTT sort of goes like this…
Therapist: “What’s this?”
Child: “Dog”
Therapist: *gives child an M&M*
Therapist: “What’s this?”
Child: “Bear”
Therapist: *gives child an M&M*

Hm… yeah. I would be skeptical if someone spent 2 hours doing this, too. This was the focus in the 1970’s. Just like every field, we have evolved and improved. Quite frankly, if a child will sit at a table nonstop for 2 hours doing discrete trials, they probably don’t need ABA… Good ABA therapy is more play-based, and the focus is teaching socially significant behaviors that will improve the child’s quality of life over time.

Everything that a living organism does, is behavior. From blinking to communicating to running, it is all behavior. An occupational therapist may feel we are stepping on her toes when we practice cutting, and a speech pathologist might feel the same way when we work on requesting. But, here’s the thing. The child will be better off if we ALL support each other. By carrying those skills over from therapist to therapist, the child is going to learn to generalize what they are working on. Isn’t that our goal? A child doesn’t only speak with the speech therapist or use their fine motor skills with their OT. It would be unethical not to program for generalization! As the Behavior Department, we will never claim to be experts in the physiological side of speaking or to understand the intricacies of the sensory system (unless we have the credentials to back it up), but we CAN help the child grow in the behavior side of these skills (because remember, it’s all behavior!).

Our ABA department was created because there was a need for parents and children to have a team of therapists all working together. It takes a village. Speech, OT, and ABA all together under one roof is an incredible thing, and our clients are better off because of it. Our OTs help us with their specialty, and the SLPs help us with theirs. We even have RNH staff meetings so we can teach each other! We celebrate each other’s victories and offer/receive advice when asked for it. We are better therapists because we work together instead of against each other. Parents of children who are receiving services at Reaching New Heights reap the benefits of our collaborative culture. How can that be beat?

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Treating the WHOLE CHILD!

1/29/2019

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​This is a catch phrase that parents often hear in therapy office, IEP meetings, websites.  But what does it really mean beyond the obvious, literal sense?
I recently was referring to the old parable about the blind men and the elephant. If you’re not familiar with it, it tells of six blind men that came across an elephant. However, each man only touched one part of the elephant and thus created his own version of reality from that limited experience and perspective. One man, who touched the elephant’s side, likened it to a wall while another touched the tusk and determined that elephant is like a spear. It goes on with the trunk being a snake, the leg being a tree trunk, the ear a fan, the tail a rope. Limited perspective made them miss what an elephant truly is.
The most valuable times of my career as a Speech Language Pathologist have been when I was part of a multi-disciplinary collaborative team where we all learned from the other professional’s perspective and insight. I especially had a strong collaborative relationship with a most incredible Occupational Therapist during my time in the schools. The insight that I gleaned from her influences me daily and I often think, what would Julie do?
There certainly are some children who truly have a single, outlier difficulty that only requires one discipline. This might be a child with a lisp, or a child with fine motor deficits but no other needs. However, many of the children we see are more involved with sensory, behavioral, and functional communication needs. All of these factors contribute to the overall disorder or diagnosis of the child. Is the behavior preventing the child from communicating or are the behaviors a physical manifestation of the frustration of not being able to communicate? Are the behaviors a result of sensory issues such as visual or auditory distractions or difficulty self-regulating? Every behavior has a function. (Read last February’s blog!)
A child is not a static, one dimensional being and it is critically important to get different eyes on the child to create a comprehensive plan. This is why I am beyond thrilled to be adding our new ABA Therapy department to the Reaching New Heights. The behavioral approach differs from Speech and OT that are heavily based on theories of development. What works for one child may not work for another. Our team of experienced, diverse therapists is here to help the parents navigate through the maze of interventions. And all of the therapists will become better through working together and treating the WHOLE CHILD!

Author

Donna Rowan Culley is a Speech Language Pathologist, owner of Reaching New Heights, Crazy Cat Lady, and admitted Word Nerd! 

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Surviving the Holidays!

12/9/2018

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​It’s a crazy, fun, hectic, and overall special time of year as the holidays are quickly approaching. For you this might mean tons of family time, parties, big dinners, decorations, shopping, holiday music, lights, shows, etc. These all seem like exciting activities, but if you have a child with ASD it may be overwhelming for them and stress inducing for you. Children with ASD can be overstimulated by a variety of things during the holidays such as the loud music, crowds of people, bright lights, strong scents, social situations and gatherings, just to name a few.  My best advice is to be prepared for these challenges!  Here are a few proactive strategies you can use for yourself, family, strangers, and a child with ASD.

  1. Social Stories- Write a holiday story with your child as the main character that will prepare them for all that is to come with the holidays.  Tailor it to fit you and your child’s needs by teaching them what they can do if faced with a certain situation. For example, if you know your child’s trigger is being around large crowds of people, write about how you will be going to crowded stores and attending large dinners with your extended family. Include photos of all your family members, as well as pictures of stores to help them as much as possible. [SS1] Offer them replacement behaviors of what they can do if they do feel overwhelmed. Social stories can be made simply by using a word document, or if you are tech savvy, try making one through an app on your phone.  If you are unfamiliar with social stories, I recommend following The Autism Helper, http://theautismhelper.com/behavior-social-stories/.
  2. Bring Your Tool Belt- Let’s be honest, Christmas time can be sensory overload for a lot of people, not just children with autism.  If you know your child’s triggers will be tested, bring your “tool belt” filled with all the materials you can use to provide support for your child.  Stack your purse, car, and/or bag with reinforcements, visual supports (such as your social story), fidget toys, headphones, sunglasses, music, blankets, etc. to use before a trigger may occur.  The key is to be proactive, not reactive, so you can alleviate a behavior before it even starts! 
  3. Educate-A lot of people do not understand autism and what the symptoms may be.  Since you may be seeing a lot of distant family and friends who are not familiar with your child’s needs and diagnosis, try and educate them beforehand so they won’t have any “expectations” of your child’s behavior. Send an email out, call (if you have the time) or write up a quick bullet point list of things they can do to help alleviate your child’s holiday experience or better yet, help them with their behavioral goals.  For example, if your child doesn’t like to be touched, include this in your list so family members don’t go in for a big hug or expect to be kissed upon arrival.  Offer different ways to greet them, such as a wave, high five, fist bump, thumbs up, or even just eye contact or a simple hello.  Or you can also take advantage of these situations by practicing your child’s behavioral goals. If your child needs help with appropriate social greetings and comments, probe these situations by having your family ask them social questions and observe your child’s responses.  There are so many social goals you can practice during the holidays!
 
These are just a few ideas you can use to make your holidays run smoother. I look forward to sharing more ABA techniques with your families once the ABA Department opens up in February 2019.  Until then, Happy Holidays!
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AUTHOR
Betsy Soshnik is a Board Certified Behavioral Analyst at Reaching New Heights. Betsy is passionate about helping children and families overcome obstacles and improve the qualtity of their lives. S
he has 7 years experience providing ABA services to clients ages 2-19 years old. Betsy enjoys spending time with her husband, son George and daughter Audrey. ​

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