– FAQs –

Frequently Asked Questions

Are all Behavioral therapies the same?

Sensory Integration dysfunction or sensory processing difficulties are not caused by anything the parent did or did not do. Sensory processing difficulties are simply a weakness in that area of functioning for the child. We all have strengths and weaknesses and children do as well. If the child’s weakness in sensory processing is significant enough to interfere with a child’s self-esteem and / or ability to engage in the environment Occupational therapy services would be indicated.

At Symbiosis, we are able to provide more comprehensive and wide-ranging treatments for children who need our support. Lot of other service providers focus on one specific aspect of treatment for your child (for example, an Occupational Therapist may focus on sensory dysfunction, a Behavior Consultant might focus on behavior approaches etc.) but we take a holistic approach of treatment and which are embedded in our treatment protocols.

If we are not able to provide some of the interventions, we would let you know the options available elsewhere, so you can make an informed choice.

Yes – and it is preferable for the parents to be involved in their child’s behavior program.

Parents can help their child to generalize the learnt skills and continue using them outside of the therapy session and in different environments. However, we do not encourage parents to do the bulk of the therapy hours because of risk of burn-out.

The approach taken for teaching skills to your child will be based on a process of modelling the appropriate behavior, practicing the skill and providing constructive feedback. Each session will cover a different social skill, but children will be encouraged to continue utilizing skills from previous weeks in each session.Often we use a “reward” system with children to encourage learning and application of new skills. The reward system can be applied both in the social group setting and by parents when the child is at home.

Every child is different, so there is no “normal” duration of treatment. Notwithstanding, any behavior program is a long term treatment program that requires consistency and patience.

In most cases, most children receive treatment for 1-3 years but with a reduced model of service after some period of time after implementation of the intervention program.

Research has demonstrated that “more is better” when it comes to behavior intervention therapy. In general, our Intervention program requires a minimum of 20 hours a week for a program to be effective. This therapy could be a combination of direct intervention with the child and/or parent training session.

Your child does not need to join a social skills group but it is likely be very beneficial for them especially if they struggle with appropriate social behavior and interaction.

Your child will benefit from learning and interacting in a structured environment with their peer group. By observing and interacting with others, your child will should be able to better understand his/her own feelings as well as behaviors of others. Group settings also allow your child to practice behavior in a social setting with their peer group in a safe environment.

Occupational Therapists play an active and vital role in the development of all children. Below are a few examples of specific skills that can be addressed in children through OT intervention.

Fine Motor Skills
Children may face difficulties in using classroom supplies such as pencils, crayons, erasers, glue sticks etc. They may also find it challenging to manage fasteners such as buttons, zippers and laces. Their small hand muscles may not have the strength and coordination that is needed for those tasks. An OT utilizes the knowledge of anatomy, biomechanics and neurology to understand the missing components that may be hampering the development of a child’s hand functions. Through various therapeutic activities the child’s hands can get stronger and more coordinated, thus allowing him to experience greater mastery, increased skill and independence.

Gross Motor Skills
Children may show some delays in achieving gross motor milestones like crawling, walking, running, catching and throwing or simple jumping activities. These challenges later make it difficult for them to keep up with their peers. These children may avoid the playground, physical games or sports that other children their age find highly rewarding. An OT is the appropriate professional to address the child’s needs in this area. Please call our office to discuss what services can be provided by us to support your child.

Oral
Some children have significant difficulty with eating. They either eat a very limited repertoire of foods and / or gag very easily when trying new foods. These children are often referred to as “picky” eaters. Our therapists take a complete history of those foods that the children will eat including but not limited to taking note of the various temperatures, colors and textures the child will tolerate. Treatment for these children focuses on the sensory system that may be oversensitive and incorporates experiences with total body exploration as well as oral exploration. New foods are incrementally introduced following a protocol of what is more likely to be tolerated.

Handwriting
Handwriting skills from the basics of letter formation to taking class notes legibly can be extremely difficult for some children to learn. Occupational Therapists uncover the underlying causes of a child’s difficulty in this area. The child may have weakness, coordination deficits, sensory limitations that do not allow easy control of the pencil, visual tracking deficits or motor planning limitations. Occupational Therapists use a multisensory approach to handwriting remediation that is based on the foundations of hand anatomy, biomechanics and sensory functioning. OTs are familiar with the handwriting programs that are often utilized in your local school district and can be the expert you need to maximize their effectiveness.

Visual Perceptual and Visual Motor Intervention
From stacking blocks and doing puzzles to writing letters appropriately, a child must be able to perceive differences and relationships between objects in the environment. Occupational Therapists help children discover these relationships and begin a map of the spatial planning that is required to function in our world. All skills are learned through play as children are provided with therapeutic experiences that progress from simple to complex. Through Occupational Therapy treatment improvements have been reported by parents in a child’s handwriting, organizational skills, play skills and school performance.

Our Therapists work with children to maximize each child’s potential by providing individualized sensory-motor challenges that require a child to perform with a little more skill each time. Children learn and improve their motor skills through therapeutic play. In addition, when children engage in motor challenges, they not only learn the skills, which are stored as the “joint and muscle memory” but also this learning have a great impact on their social & emotional development, self-esteem and peer relationships.

Our therapists utilize a play based individualized approach that helps each child thrive. All our children look forward to come for their therapy sessions every week as they realize that the therapist understands their needs and will help them develop their skills. Our children simply view their therapy sessions as “play” with a special person in a fun filled environment.

Since therapy is play, it looks like play. The child is not aware that with every activities, the therapist has a therapeutic goal in mind and is moving towards those goals within each and every session. Many of the “equipments” are usually available in therapy catalogs however others are highly familiar and can be utilized in a new therapeutic way. Each treatment session is planned and customized for an individual child’s needs, goals and engages the particular child’s inner drive.

Occupational Therapy interventions can last from 3 months to few years depending on the severity of the child’s needs, parent’s goals and observable progress. The parent is given a choice to make informed decision after discussion with the therapist regarding the frequency and duration of service.

Occupational Therapy interventions can last from 3 months to few years depending on the severity of the child’s needs, parent’s goals and observable progress. The parent is given a choice to make informed decision after discussion with the therapist regarding the frequency and duration of service.

We believe that if a child has a difficulty that is interfering with his /her daily functioning it makes sense to get a “trainer”. This holds true for sensory-motor functioning. If a child has a difficulty with sensory – motor functioning, an Occupational therapist can make a definite difference in the child’s daily life. The teacher and the parent may not know how to intervene to help and as a result the concerns may not resolve. “Practicing” a skill may help with that one skill but therapists are trained to understand the foundational skills that may be interfering. Our therapists work on the foundational skills so that a child can independently begin to master his / her environment.

We believe that if a child has a difficulty that is interfering with his /her daily functioning it makes sense to get a “trainer”. This holds true for sensory-motor functioning. If a child has a difficulty with sensory – motor functioning, an Occupational therapist can make a definite difference in the child’s daily life. The teacher and the parent may not know how to intervene to help and as a result the concerns may not resolve. “Practicing” a skill may help with that one skill but therapists are trained to understand the foundational skills that may be interfering. Our therapists work on the foundational skills so that a child can independently begin to master his / her environment.

It is believed that 95% of children on the autism spectrum have sensory integration difficulties. Children on the spectrum typically have a different way of perceiving the environment. This different sensory perception can interfere with the child’s ability to attend, have peer relationships and can interfere with learning. This alternate way of perceiving the environment can be highly distracting resulting in paying attention to less relevant stimuli rather than focusing on the stimuli that are necessary to complete a task.

There are many strategies that can be provided to a parent to help their child at home. Once a therapist gets to know your child, a home program can be provided that includes exercises, activities and suggestions that take into consideration your individual child’s current level of functioning. If you have not yet started therapy, an initial evaluation can be performed and you can be provided with ideas of what you can do at home.

We Are Here for You

Book a consultation today, let’s create a customized plan for your child’s growth

Shalini Das

Director, Board Certified Behavior Analyst,Occupational Therapist

Shalini is one of the co-founders of Symbiosis Pediatric Therapy. She currently oversees the clinical and administrative departments of Symbiosis. Shalini has more than 25 years of experience working with children with autism and developmental disabilities.

Shalini completed her Master’s degree in Occupational Therapy specializing in Pediatric Neurology in 2000. She also has her Masters degree in Special Education with a focus on Applied Behavior Analysis from The Pennsylvania State University.Shalini is listed in the RASP list as a Behavior Consultant and an Occupational Therapist.

Shalini has extensive clinical experience with assessment and program development that is designed to treat challenging behaviors, build communication, and functional life skills. Some of the team-based intervention which she incorporates are the Applied Behavioral Analysis (ABA), Early Start Denver Model (ESDM), SCERTS, DIR®/Floor time model, etc.

Shalini has trained & supervised several teams of therapists, parents, and other professionals on evidence-based behavioral strategies to improve the quality of life for the children. She also assists with the development and implementation of evidence-based treatment approaches, in addition to providing clinical guidance and mentorship to the Behavioral intervention team.

Shalini is certified to administer the Sensory Integration and Praxis Test (SIPT) from the University of Southern California and in Neuro-Developmental Therapy (NDT) from NDT Association, USA. She also enjoys working with children in Symbiosis embracing different therapy models while viewing the challenges faced by the children through the developmental framework.

Shalini is the mother of two children and understands the importance of considering the needs and wants of all members of the family when establishing therapy goals. She spends her spare time with her children and husband, reading, traveling, and cooking different recipes from around the world.