Headstart for Life

Welcome back to HeadStart for Life’s Beyond Therapy blog!

As a speech-language therapist, I help children reach their developmental communication milestones. I know if a child makes progress by observing tangible changes in their behaviour and skillset (e.g., able to sit for 10 minutes at the table, or able to request using his/her words).

There are different approaches or “doorways” to affect positive change and development, including the following approaches:

  1. Behaviour – use of rewards and punishments
  2. Cognition – changing the way of thinking
  3. Affect – supporting emotions and relating to the child

For instance, if I want a child to clean up their toys, I could take several approaches to achieve this goal, such as:

1. Provide a reward such as getting a cookie for completing the task or provide a punishment for failing to do so such as not getting a sticker (Behaviour approach)




2. Logically explain the benefits of cleaning up (Cognition approach)



3. Create a fun game to assist in cleaning up, doing it together with the child, then providing praise (Affect approach)



So you may ask, which approach would be the most effective?  While some situations call for behavioural rewards, limitations of using behavioural treatment approaches include:

  • Your child may perform only in presence of rewards
  • The core deficits may not improve with discrete skill improvement
  • Your child gains rote skills
  • Lack of generalization of skills, especially in pragmatic communication
  • Child is discouraged
  • Your child may avoid the “punisher”


I believe the most effective approach to impacting an intrinsic, lasting change is through Affect, which is one of the key ideas behind Dr. Stanley Greenspan’s DIR Floortime.  Another word for affect is ‘emotion’ or building an emotional connection.

When a child feels connected emotionally to another person, the stage is set for communication to happen.  Communication involves two parties and a desired message originating from one party being sent to the other.  There must be a connection between the two parties before any successful communication to occur.   This is the reason pre-linguistic skills such as engagement, joint attention, and shared enjoyment are fundamental.  One must first enjoy being with another person in order to desire to share an intentional message with him/her.


Brain studies have shown changes in neural pathways in children engaged in relationship-based treatment approaches.  When we as therapists and parents build a strong emotional relationship with our children, the changes are internal, we address the core deficits and impact changes on the neural level.

For children with Autism Spectrum Disorders (ASD), who have known differences in brain volume and activity, including mirror neuron systems and limbic system, it is even more important to establish and build an emotional connection because through this approach, we can make impact a change on the neural level.  A York University study done by Casenheiser, Shanker, & Steiben (2011) studied the brain activity of children with ASD who have undergone intensive DIR Floortime intervention, and results has shown a positive neural change post-treatment, such as decreased activity in amygdala and increased activity in the frontal lobe.  Studies such as the above show that for children engaged in relationship-based treatment approaches we will see changes on the neural level, which is substantial for children with ASD who have brain volume differences in some areas of the brain.


So let’s round up and conclude with the take-home message.  Spend time with your children.  Build an emotional connection with them.  In today’s busy world of technology, many of us have forgotten how to simply be present with another person in the absence of our smartphones, emails, and social media.  Our children need our undivided attention and care, and they need to feel understood, supported, and connected.  Our time investment in our children will yield positive results in their development! As parents, we would also be enriched ourselves and bring a balance to our own hectic work lives! Thanks for reading and come back to Beyond Therapy soon for our next post!

"All the information on this site is for educational purposes only and does not replace the assessment and intervention of a registered speech-language pathologist, occupational therapist or any other medical or education professional."

About Jessica

Jessica is an experienced speech and language therapist who has been working with young children with speech-language delays and Autism Spectrum Disorders. She believes in developing a nurturing relationship with each child and his/her family and strongly believes in active parent involvement in therapy sessions. Jessica uses engaging activities that are meaningful to each individual to motivate and empower them to be effective communicators. She is a mother of a toddler boy, which she believes makes her a more empathetic clinician.

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