Pull up a bean-bag chair: MCH program helps kids with autism get ready for school
With the support of his family and Hamilton Health Sciences McMaster Children’s Hospital’s (MCH) Autism Program, four-year-old Charlie Cassan started kindergarten off on the right foot in September.
For six months leading up to his first day, he took part in MCH’s Entry to School program, which provides extra support to autistic children who will be entering the classroom for the first time. It’s an innovative approach to setting kids up for success, with two models. Kids in the program can attend practice sessions in a low-risk environment mock classroom at the hospital, or staff can come to them right in their child care programs.
Michelle Woods, early childhood resource specialist
“I had the chance to observe Charlie in his kindergarten class and he surpassed my expectations,” says Michelle Woods, an early childhood resource specialist in the program. “What I observed on that day and in speaking with his educators, he has just integrated phenomenally.”
Helping hundreds of children with school success
For any child, being in a new setting with new people away from a known parent or caregiver can be intense. For children with autism, it can be overwhelming. Having some essential communication and personal skills can make all the difference between an ongoing positive and negative school experience.
Funded by the Ministry of Children, Community and Social Services as part of the Ontario Autism Program, the Entry to School program is designed for children three to six years old who have autism and are entering kindergarten or grade one for the first time.
Invitation letters are sent to families in our region with eligible children registered in the Ontario Autism Program.
Now in its third year of service, the MCH Autism program has helped 263 children with autism transition to school in the Hamilton area.
From the children’s perspective, Woods’ role is similar to a classroom teacher. She works in one of four classrooms at MCH’s Ron Joyce Children’s Health Centre (RJCHC) that are designed to replicate a kindergarten classroom.
Woods and a team of autism therapists, a communicative disorders assistant, speech language pathologist, occupational therapist, and registered behaviour analyst help children like Charlie learn critical skills to prepare them for starting school.
From left to right: Occupational therapist Julia Brudzinski, communicative disorders assistant Lyndsay Hadall, Michelle Woods, and autism therapists Karla Wright and Catherine Benoza
Available on-site or in the community
The MCH Autism Program offers the Entry to School program both in a classroom-based model at RJCHC and through a community-based model. The program consists of six months of helping children develop school-readiness skills, followed by up to six months of transition support for children as they enter their new school environment.
“These community partnerships are amazing and allow families to flourish in spaces they are comfortable in.”
In the community-based model, the program can be delivered in a licensed child-care centre where the child is attending, EarlyON centres, and local libraries. Last spring, the program supported kids in 35 child care centres in Hamilton. About a third of families choose this integrated community model for a variety of reasons. Mostly, it allows caregivers to continue working and maintain their family’s weekly schedule.
To the children, Woods’ role is similar to classroom teacher.
“These community partnerships are amazing and allow families to flourish in spaces they are comfortable in,” says co-clinical manager Alyson Shields.
The RJCHC option is four half-days per week. Daily programming focuses on communication, play, social interaction, functional routines, behavioural self-management, pre-academics, learning, and attention. The structure mimics a typical day in kindergarten, including story time, snack time, outdoor time, and free play.
The team assesses children at the beginning of the program to develop goals and a plan for reaching them, and then again towards the end of the program. Woods is responsible for creating a curriculum that meets the unique needs of the class, and facilitating it through routines and activities.
As a program session approaches completion, Woods works with families and the child’s school to develop a transition plan. She and her team continue to support families and the school in a consultation role for six months afterwards, which may include observation visits and meetings.
Making huge strides
Charlie and his mom Melanie outside of Charlie’s elementary school
Charlie’s mom Melanie Cassan says the program was “fantastic.” She was nervous to start the Entry to School program after Charlie had tried to attend another preschool before but always had to be picked up.
Before the program, Charlie wasn’t saying any words. He couldn’t use the toilet by himself and he would often leave a designated area on his own.
By the end of the MCH Entry to School program, he was putting two words together, he was using the toilet, and he rarely had any outbursts or challenging behaviours.
“He has just integrated phenomenally.”
One key part of Charlie’s plan was using visual aids to help him communicate.
“The team had a lot of different visuals he could use like word boards and a special bracelet with key words and visuals like ‘go’ or ‘hold hands,’” says Melanie. “All of a sudden he realized he could point to something and people would know what he was saying so he didn’t have to get frustrated.”
Woods says Charlie came to the program eager to learn. “He spent lots of time requesting his clinicians to label items for him,” she says. “He would listen attentively and do his best to repeat back what he had heard. Initially these were utterances, followed by approximations, and later words.”
A whole network of support
Charlie’s family has engaged with MCH’s Autism program since 2023 and have participated in a number of programs through MCH and the Ontario Autism Program.
The family completed Pivotal Response Training, which focused on building Charlie’s communication skills and social engagement, and later, the Urgent Response Service to assist Charlie in improving his self-regulation.
“It’s so touching and I feel so privileged to be able to see Charlie in his new environment. He is doing so well.”
When Charlie was prepared to successfully transition to the Entry to School program, Melanie participated in workshops offered through Foundational Family Services, which helps parents and caregivers learn how best to support their child’s learning.
And finally, Charlie has just participated in Speech and Language Services and has continued to make strong progress in his speech and language skills.
Building relationships and skills
Melanie says Charlie loved going to RJCHC every day for the Entry to School program.
“We still see his teachers when we go to speech appointments and he runs up and gives them hugs,” she says. “They were all so friendly and welcoming and so happy to see all the kids. They made it so the kids wanted to attend.”
MCH’s Entry to School Program equips kids with autism with the skills they need to successfully enter the classroom for the first time.
As much as Charlie loved going, his peers and team loved having him there.
“Charlie was always very proud of his accomplishments,” remembers Woods. “He enjoyed gaining our attention and receiving our approval. This could be seen with a whole face smile, proud stance and often a thumbs up. As time went on Charlie gained interest in his peers. He enjoyed giving them a morning hug and would often retrieve their water bottles to offer them a drink.”
“One of my favorite memories is the day he took a particular interest in a story I was reading and decided from there on in, he was going to attend circle time. He would often prepare his own spot on the carpet in a bean bag chair in anticipation. It was obvious he was comfortable in his choice of seating as he was often leaned back with his hands behind his head.”
Rewarding for kids, parents and staff
Wood says one of the program’s greatest rewards is supporting the children to succeed in their new school environments.
“It’s such a great piece to the program for us to be able to see that,” she says. “It’s so touching and I feel so privileged to be able to see Charlie in his new environment. He is doing so well.”
Families who may be eligible for this service receive an invitation letter from the Ministry to register for the program.
Families interested in the Entry to School program can call 905-521-2100 ext. 70019 or email entrytoschool@hhsc.ca.
