Tips from a TSS (Therapeutic Staff Support) Working with Children on the Autism Spectrum


Some of you may be asking what is Therapeutic Staff Support? A TSS provides one- on-one interventions to children of all ages in their home, school, or community setting. The TSS works on specific goals outlined within his or her treatment plan with the child and also with the participation of the family. The goal of the TSS is to assist the family with skills and provide materials for the family to be able to support the interventions independently without the need of a TSS. The goal of a TSS is to work their way out of their job and provide the family with the skills that they need to move on.

You may be asking what can I do as a childcare provider? Childcare providers and TSS form a partnership to work on the individual child’s goals. Many childcare providers have TSS staff coming into their center on a regular basis to work with children that attend their center. The TSS works with the child on his or her treatment plan or goals; it is the childcare provider that helps to support these goals within the childcare setting. As a childcare provider, you would engage with the child and TSS as much as possible; without giving them your full attention (because we all know that is not feasible). The job of a TSS in a childcare setting is to assist the staff in learning new skills to be able to support the child with specific interventions without the need of a TSS.


Some of the goals that a TSS may work on with the child may be safety goals, communication goals, receptive communication skills and eating goals. I went ahead and listed some examples of what the TSS may work on with the child during a typical session:

  • Safety Goal – maybe the child has difficulty remembering to look both ways before crossing the street, the TSS along with a parent or guardian would work on this skill with the child. The family and TSS may choose a busy shopping plaza to take the child to and practice looking both ways before crossing the street.
  • Communication goal – Maybe the child is non-verbal or has very little verbal skills, the goal of the TSS is to help develop their language skills by using PECS (Picture Exchange Communication Skills).This is where a TSS would have several different pictures of items for the child to be able to communicate without using their verbal skills. This is the beginning step to getting a non-verbal child to begin using some verbal skills.

  • Receptive Communication goal – Maybe the child is having difficulties internalizing what is being asked of them so as a TSS, you work on questions such as “what did you do today?” or “where did you go on vacation?”  Often times the child needs some limited verbal or extended verbal prompting from the TSS and other family to be able to answer these types of questions.
  • Eating Goal – Maybe the child will only eat a peanut butter sandwich for lunch and will not try anything new. The goal of the TSS in this situation is to help assist the parent or guardian in introducing a new food. For example, if the child will only eat peanut butter sandwiches, the family can introduce vegetables with dip to the child. Often time’s children on the spectrum have difficulties with the different textures of foods; they cause gag reflux. If the child takes one or two bites of the new food and likes the food, the parent or guardian has succeeded in adding a new food to what the child will eat.

Working with children on the spectrum is a very rewarding job, although at times it can be very stressful and tiring. I have had the opportunity to work as a TSS (Therapeutic Staff Support) for the past five years. In those five years, I have had five clients all ranging in age from three years old to fourteen years old. All of the children I have worked with have also ranged from non-verbal low functioning to very verbal and high-functioning. The amount of progress that I see in my kids every day is incredible!One of the children that I worked with in the past only spoke three words when I met him. When I was taken off of the case, because the child no longer needed me, he was able to speak full sentences and respond to questions being asked by mom with “yes” or “no” responses.

Please feel free to post your questions, comments on the blog! I would be interested in following up directly with any one that has questions about my position as a TSS.

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