Registered Behavior Technician FAQs

Are you concerned about your child’s toe walking habits? Toe walking, a common concern for parents, can sometimes be associated with autism spectrum disorder (ASD). Understanding the connection between toe walking and autism is crucial for early intervention and support.

What is Toe Walking?

Toe walking refers to a walking pattern where a person walks on their toes or the balls of their feet without their heels touching the ground. While occasional toe walking in toddlers is common, persistent toe walking beyond the age of two may indicate an underlying issue.

The Connection with Autism

Toe walking is often observed in children with autism spectrum disorder (ASD). While not all toe walkers have autism, studies suggest that many children with ASD exhibit toe walking behavior. Children with Autism often have higher sensory seeking behaviors, and being up on their toes gives them deep sensory input through their feet and in their contracted calf muscles. This connection can lead to more targeted interventions and support from therapists and parents.

How Can a MetroEHS Physical Therapist Help?

Physical therapy plays a crucial role in addressing toe walking in children, especially those with autism. A skilled physical therapist can:

• ‍Assess the Underlying Causes: A physical therapist will conduct a comprehensive evaluation to identify any underlying factors contributing to toe walking, such as muscle tightness, sensory issues, muscle weakness, or lack of range of motion.‍
• Develop Individualized Treatment Plans: Based on the assessment, the physical therapist will create a personalized treatment plan tailored to your child’s needs. This plan may include stretching exercises, strengthening activities, balance training, or different sensory inputs.‍
• Educate and Empower Families: MetroEHS Physical Therapists work closely with families to educate them about toe walking and provide strategies for home exercises and activities to support their child’s progress.

Toe-walking can impact your child long-term if left untreated:

Toe walking will impact your child’s overall body positioning, posture, and muscles. With toe walking, because of these impacts, it will also change the load of the body’s joints and likely cause chronic pain as the individual ages. It is common for toe walkers to lose range of motion in their ankles, preventing them from being able to reach their heels to the ground and causing their Achilles tendon to shorten. In more severe cases, if the Achilles tendon shortens too much, the only way to regain that length is with a surgical lengthening.

Take the First Step Towards Support

If you’re concerned about your child’s toe walking or suspect they may have autism, early intervention is key. Schedule an evaluation with a qualified physical therapist who specializes in pediatric care. Together, we can help your child take confident steps towards improved mobility and independence.

Parents often ask one important question before preschool or kindergarten begins:

"Is my child ready?"

Many people think school readiness simply means knowing letters, numbers, or colors. While those skills are certainly helpful, they are only one small piece of the puzzle.

The truth is that successful classroom participation depends on many developmental skills working together.

Can your child:

✔ Follow simple directions?

✔ Transition between activities?

✔ Sit with a group?

✔ Ask for help?

✔ Play alongside peers?

✔ Manage big emotions?

✔ Hold crayons and scissors?

✔ Listen during story time?

✔ Walk safely in a classroom?

These everyday abilities often have a much bigger impact on classroom success than academic knowledge alone.

Why School Readiness Matters

The first few years of school help shape confidence, friendships, communication, and lifelong learning habits.

When children enter school with strong foundational skills, they're often able to:

• Participate confidently
• Build friendships
• Follow classroom routines
• Learn alongside peers
• Become more independent

For children with autism, these foundational skills often benefit from early, coordinated support.

Introducing Superhero Academy

MetroEHS created Superhero Academy to help children ages 2-6 develop the skills needed for preschool and kindergarten through integrated therapy.

Unlike traditional therapy where each discipline works independently, Superhero Academy combines:

ABA Therapy

Occupational Therapy

Physical Therapy

Speech Therapy

Our therapists collaborate to help children practice the same skills across every therapy session.

Instead of isolated goals, children experience one coordinated learning environment.

Learning Through Play

Every month introduces a new superhero mission.

Children learn through:

• Structured play
• Sensory activities
• Group learning
• Social interaction
• Movement games
• Classroom routines
• Communication opportunities

The result is therapy that feels fun while building real-world school skills.

The Four Hero Disciplines

Sensory Squad (Occupational Therapy)

Helping children develop:

• Fine Motor Skills
• Self-regulation
• Sensory processing
• Independence

Mighty Mover (Physical Therapy)

Helping children improve:

• Balance
• Coordination
• Strength
• Motor planning
• Confidence

Communication Champion (Speech Therapy)

Helping children build:

• Expressive language
• Listening skills
• Social communication
• Early literacy

Learning Legend (ABA)

Helping children develop:

• Classroom behaviors
• Emotional regulation
• Functional communication
• Cooperation
• Peer interactions
• Independence

Building Real School Skills

Throughout the year, children practice:

• Following routines
• Listening to teachers
• Sharing
• Taking turns
• Transitioning between activities
• Solving problems
• Managing emotions
• Communicating wants and needs
• Participating in groups
• Becoming independent learners

Every milestone helps prepare them for the classroom.

Celebrating Every Hero

Children earn Hero Badges as they master new skills throughout the year.

At graduation, every child receives a Superhero Cape or Hero Champion Medal and a diploma celebrating everything they've accomplished.

Because every child deserves to feel like a superhero.

Ready to Begin?

If your child is between the ages of 2 and 6 and has been diagnosed with autism and you’ve been interested in an ABA program, Superhero Academy may be the perfect next step.

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Q: What is the RBT certification?

A: RBT certification is a paraprofessional certificate that is in the behavioral analyst field, and you work under the BCBA or BCABA treating and providing services to our kids.

Q: What are the requirements?

A: What it takes to become an RBT here at MetroEHS is you must be 18 years old, a high school diploma, you need the 40 hours of training, and then take a competency test with the supervisor, and then you apply at the BACB website, and take a test, and become an RBT.

Q: What does the training consist of?

A: The RBT training consists of like an interactive and comprehensive 40-hour training that you work in a small group or one on one with other technicians or your BCBA. You’re out in the clinic, hanging out with the kids, learning and watching how they run programs. That could be at the table time or out in natural environment and once you understand the new words in the ABA field, you take your competency test and take the test at the website.

Q: What is the competency test?

A: The competency test is when the supervisor comes out the clinic with you and they watch how you run programs, they interview you, ask questions about the terminology and it’s pretty much just one on one time or you and the supervisor and your client to make sure you understand the terminology and what you’re actually doing and it’s highly encouraged to actually take your RBT test within 90 days of your 40 hour training. It is free of charge. You take the test at the BACB website.

Apply now!

Q: How do I maintain my credentials?

A: To maintain my credentials as an RBT here at MetroEHS, I track all my supervision hours, and I retake my competency test at the year mark or year anniversary of my RBT testing date.

Q: What are the benefits if earning an RBT certification?

A: MetroEHS offers two benefits for becoming an RBT. One is a raise and two, once you become an RBT, you have more opportunities to move up the ladder and become admin or fun stuff.