Chris was just a few weeks from his third birthday when his parents contacted the Centre. Diagnosed with autism, Chris had delayed motor skills and challenging behaviours that included hair pulling, head banging, and a constant need to be near his mother. Concerned for his well-being, his parents were anxious to begin services with the Centre.

When we first met Chris, we discovered a little boy who had difficulty standing and walking. Unable to stay upright, he leaned against a chair. He crawled up stairs and had to be carried over curbs. He was completely non-verbal and did not babble. During his formal intake session, Chris sat on the floor, screaming and crying. We had serious concerns about how we could prepare him for his preschool that he would begin in a few short months.

With the clock ticking, we began Chris’s program.

The occupational therapist (OT) focused on Chris’s motor challenges, working intensely with his parents to teach him to transition from crawling up and down stairs to walking, first by holding onto his mother’s hand, and eventually by holding the rail. We used his favourite toys that played music or lit up, placing them at the top or bottom of stairs to encourage his progress. His family took him for walks outside regularly and he practiced going up and down curbs. His strength improved and we worked on motor and visual coordination through basic ball play.

While the OT worked on Chris’s motor skill development, other team members addressed his behavioural challenges and his speech, so that when preschool started, he would be able to participate as much as possible and be included in activities the other children would be doing. Using the toys he loved, we increased the length of time he could be away from his mother from two minutes to an hour. Using evidence-based approaches including Pivotal Response Treatment, Chris’ Speech and Language Pathologist supported his family so that they could be confident in using a variety of strategies to support his communication development. With each new day, Chris became better prepared for his first day of preschool. His family rehearsed the car trip to school. They and the Centre’s team talked to Chris about preschool and he was introduced to the Educational Assistant who would work side-by- side with him in his preschool.

After month of hard work and patience, Chris started preschool. All the practice and support he received from his family and the Centre made his transition to his new environment a success.

Chris is now using one to two words in both English and the family’s home language. He asks for items that he wants, he answers simple questions, and he labels a variety of items he sees in his environment.

In November, the Centre’s OT visited Chris at his preschool to discover that he was occasionally crawling at school. With the Centre doing Chris’ home and school program we were able to ensure consistency between both environments. The OT identified the most successful strategies used at home, and educated the school personnel on how to use these to support and encourage Chris to walk all the time in preschool.

Chris has now experienced two years in an inclusive, supportive preschool program. He has progressed from needing a full time Educational Assistant to support most of his activities in the classroom, to being able to do many typical preschool tasks on his own. He can independently sit alongside peers at circle time, he references his teacher and peers, and he answers questions about the calendar and weather. He has expanded his play, from spinning objects only, to learning to play with a wide variety of toys – from cars on ramps to board games to pretend cooking in the kitchen. He is seeking out peers to dance with them when the music comes on and he takes turns when playing games. Chris has advanced his interest in numbers and letters and can read 3 digit numbers. He can spell familiar words and even recognizes several sight words.

These achievements have set him up for success for the acquisition of early reading and numeracy skills in his Kindergarten year. His mother and classroom teacher comment on how his increased confidence will carry forward to other new experiences as well. Chris and his family will continue to need support over the next several years to reinforce his skills and help him learn new ones. The Centre will work collaboratively with Chris’ family and the school to ensure a consistent and successful approach. Chris and his family are now on the right track. They feel prepared for his entry into an inclusive kindergarten program this fall and are looking forward to a successful year.