How URS Helped Me and My Child

When Alannah González reached out to Surrey Place’s Urgent Response Services (URS), she had run out of options and didn’t know where to turn. Her three-and-a-half-year-old daughter Eva was exhibiting violent behaviour. Her aggression was escalating. “She was scratching and biting. I was always covered in bruises and cuts,” González said. Eva also engaged in self-harm and had difficulty interacting with other children at her daycare. At one point, González took six weeks of medical leave from her job due to stress and mental health issues.

Eva was diagnosed with autism in the fall of 2022, although González said she suspected her daughter had autism before her first birthday. She noted that Eva was late to meet developmental milestones. When she started daycare, her behaviour stood out next to the other children.

“I saw other kids her age and how Eva wasn’t like them at all,” she said, adding that Eva was also “doing autism stims.”

“I knew it was autism because I grew up around it – I have family members with autism,” González said.

Once Eva’s diagnosis was confirmed, González jumped into action, registering Eva for speech therapy, occupational therapy and Social ABCs through the Caregiver-Mediated Early Years Program. But Eva’s aggression continued to escalate. During one particularly difficult episode, Eva broke her mother’s nose. That’s when Gonzalez realized she needed help.  

Urgent Response Services (URS) were the answer. The service is designed to respond rapidly to escalating behaviour in situations where the child or teen is at risk of hurting themselves or others. URS uses an approach called the mediator model, where the parent or caregiver delivers the therapy directly to the child or teen. To González, this sounded exactly like what she and Eva needed. She decided to reach out.

González expected a long wait after her initial inquiry, so she was pleasantly surprised when Surrey Place followed up quickly. Intake was an efficient process designed to get her family started immediately. González also liked that the intake process was online.

“I didn’t have to go somewhere to do it, and I appreciated that,” she said.

Shortly after intake, she got the call. Eva had qualified for URS. A behaviour therapist would meet with González and her daughter at their house once a week.

Since González had researched the mediator model beforehand, she knew that she would need to be very involved in the Urgent Response Services process. A behaviour therapist trained González in the mediator model, and it was an eye-opening experience. González learned that instead of responding to her daughter’s aggression, she should move Eva to an area without any hard surfaces or sharp objects and then give her space.

González started noticing improvements in her daughter’s behaviour after only four sessions as a client with the Urgent Response Services. Six weeks in, it was “very obvious it was helping.”

“I moved away when she started hitting, scratching, or biting me, and she responded to that right away,” said González. “[Now] she knows that this behaviour is not going to get her what she wants – that’s a big improvement.”

González also learned how to use soft transitions. For example, if Eva is watching TV and it is bath time, González will give her a bath toy and verbally prepare her for the transition. González said this technique has made a big difference in preventing challenging behaviour from occurring in the first place.

The sessions with her behaviour therapist were “warm, friendly, and fun,” which wasn’t what González had expected. She thought the sessions would involve running through a checklist or that they would have a more clinical feel.  

“I feel like [my behaviour therapist] really understood my struggle on an emotional level,” González said. “She wasn’t just there to give me a list of things to do. She connected with the struggle I was having and made me feel very understood and not judged.”

González added that Eva was happy whenever she knew her behaviour therapist was coming over after school. “The behaviour therapist built a rapport so quickly with my daughter – they just loved each other,” she said.

After finishing URS, Eva’s behaviour at home and daycare improved significantly. “Eva is a happier kid overall,” González said. “Her tantrums are shorter and less frequent, and the self-harm is almost eliminated.” At daycare, Eva has learned new skills like turn-taking and sharing with other children. Eva will soon start Surrey Place’s Entry to School program to help her prepare for kindergarten.

“I want to thank everyone who was involved with URS – it changed our lives,” González said. “I’m so grateful to everyone who helped us.” González credits the mediator model and her behaviour therapist for the improvements in her daughter’s behaviour.

“The caregiver-mediated techniques I learned have been so helpful,” she said. “I use them every day, and it works.” Other parents shouldn’t let fear of judgment stop them from accessing services like URS that can help their child, González said. Unfortunately, some parents may feel shame about their child’s autism diagnosis, and this can prevent them from getting the help they need.

“Stop caring what other people think – what your kid needs is more important,” González said, pointing to her own experience using URS.

The program has made a huge difference for both Eva and González. Eva’s new skills enable her to be more successful at daycare and at home, and González has achieved her own milestone – she is back at work full-time! Not only that, thanks to URS, she describes herself as a happier mom.

“Eva used to have bad days every day,” González said. “And now it’s more good days than bad.”

Original art by González.

One of the best parts of González’s day is picking up Eva from daycare. When she sees her mom, Eva’s face breaks into a huge smile, and she screams “Mom!”. This is a dramatic change from the days when Eva refused to leave the daycare and violently resist getting in her stroller.

“She’s happy to hold my hand and walk home nicely without escaping or screaming,” González said. “What a change!”

About Urgent Response Services

If you are a caregiver with a child who exhibits high-risk behaviours that require an urgent response, like violent thinking, aggression, or property destruction, you may be eligible for Surrey Place’s Urgent Response Services. This program can be accessed through the Ontario Autism Program (OAP). The OAP provides funding and services for children and youth under 18 with autism, along with their families and caregivers.

For support for a child with autism spectrum disorder whose needs are not urgent, please visit Surrey Place’s Autism Services page.

Who we are

Surrey Place leads Urgent Response Services for Toronto Region in partnership with 2-Spirited People of the 1st Nations, Community Living Toronto, Family Service Toronto, Geneva Centre, Holland Bloorview, Kerry’s Place, Lumenus, SAAAC, SMILE Canada and Strides Toronto.

By 2 months

Has your baby had their hearing screened? YES NO

By 6 months

Does the child?

Startle in response to loud noises? YES NO
Turn to where a sound is coming from? YES NO
Make different cries for different needs (hungry, tired)? YES NO
Watch your face as you talk? YES NO
Smile/laugh in response to your smiles and laughs? YES NO
Imitate coughs or other sounds such as ah, eh, buh YES NO

By 9 months

Does the child?

Respond to their name? YES NO
Respond to the telephone ringing or a knock at the door? YES NO
Understand being told no? YES NO
Get what they want through using gestures (reaching to be picked up)? YES NO
Play social games with you (Peek-a-Boo)? YES NO
Enjoy being around people? YES NO
Babble and repeat sounds such as babababa or duhduhduh? YES NO

By 12 months

Does the child?

Follow simple one-step directions (sit down)? YES NO
Look across the room to a toy when adult points at it? YES NO
Consistently use three to five words? YES NO
Use gestures to communicate (waves hi/bye, shakes head for no)? YES NO
Get your attention using sounds, gestures and pointing while looking at your eyes? YES NO
Bring you toys to show you? YES NO
Perform for social attention and praise? YES NO
Combine lots of sounds together as though talking (abada baduh abee)? YES NO
Show an interest in simple picture books? YES NO

By 18 months

Does the child?

Understand the meaning of in and out, off and on? YES NO
Point to more than 2 body parts when asked? YES NO
Use at least 20 words consistently? YES NO
Respond with words or gestures to simple questions (Where's teddy? What's that?)? YES NO
Demonstrate some pretend play with toys (gives teddy bear a drink, pretends a bowl is a hat)? YES NO
Make at least four different consonant sounds (p ,b, m, n, d, g, w, h)? YES NO
Enjoy being read to and sharing simple books with you? YES NO
Point to pictures using one finger? YES NO

By 2 years

Does the child?

Follow two-step directions (Go find your teddy bear and show it to Grandma.)? YES NO
Use 100 to 150 words? YES NO
Use at least two pronouns (you, me, mine)? YES NO
Consistently combine two to four words in short phrases (Daddy hat. Truck go down.)? YES NO
Enjoy being around other children? YES NO
Begin to offer toys to other children and imitate other children's actions and words? YES NO
Use words that are understood by others 50 to 60 per cent of the time? YES NO
Form words or sounds easily and without effort? YES NO
Hold books the right way up and turn the pages? YES NO
Read to stuffed animals or toys? YES NO
Scribble with crayons? YES NO

By 30 months

Does the child?

Understand the concepts of size (big/little) and quantity (a little/a lot, more)? YES NO
Use some adult grammar (two cookies, bird flying, I jumped)? YES NO
Use over 350 words? YES NO
Use action words such as run, spill, fall? YES NO
Participate in some turn-taking activities with peers, using both words and toys? YES NO
Demonstrate concern when another child is hurt or sad? YES NO
Combine several actions in play (puts blocks in the train and drives the train, drops the blocks off.)? YES NO
Put sounds at the beginning of most words? YES NO
Use words with two or more syllables or beats (ba-na-na, com-pu-ter, a-pple)? YES NO
Recognize familiar logos and signs involving print (Stop sign)? YES NO
Remember and understand familiar stories? YES NO

By 3 years

Does the child?

Understand who, what, where and why questions? YES NO
Create long sentences using five to eight words? YES NO
Talk about past events (trip to grandparents house, day at child care)? YES NO
Tell simple stories? YES NO
Show affection for favourite playmates? YES NO
Engage in multi-step pretend play (pretending to cook a meal, repair a car)? YES NO
Talk in a way that most people outside of the family understand what she/he is saying most of the time? YES NO
Have an understanding of the function of print (menus, lists, signs)? YES NO
Show interest in, and awareness of, rhyming words? YES NO
Read to stuffed animals or toys? YES NO
Scribble with crayons? YES NO

By 4 years

Does the child?

Follow directions involving three or more steps (First get some paper, then draw a picture and give it to Mommy)? YES NO
Use adult type grammar? YES NO
Tell stories with a beginning, middle and end? YES NO
Talk to try and solve problems with adults and with other children? YES NO
Show increasingly complex imaginary play? YES NO
Talk in a way that is understood by strangers almost all the time? YES NO
Generate simple rhymes (cat-bat)? YES NO
Match some letters with their sounds (letter b says buh, letter t says tuh)? YES NO