The Positivity Spectrum Summer Camp 26 Application

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The Positivity Spectrum is committed to helping autistic children maintain consistent structure, social connection, and skill development throughout the year. In partnership with the Akron Area YMCA and the Greater Cleveland YMCA, we offer a fully inclusive, full-day, full-summer camp experience.

Through this program, qualified aides provide individualized support in a 1:2 ratio, helping each child engage safely and successfully with their peers while continuing to build executive functioning, social, and emotional skills.

Please complete this application and email all supporting documents to justyce@thepositivityspectrum.org and sarah@thepositivityspectrum.org to be considered for summer support services.

Juan Ekong *

01/22/2018 *

YYYY

8 *

Autism *

yes he does. *

Yes

Mace Mbidi-Glaou *

Option 1

Clear selection

Relationship to child *

Phone Number *

Email Address *

Preferred Method of Contact *

Phone

Required

How does your child communicate? AAc or non verbal gesture *

Verbal

AAC Device

Visuals

Other:

Are there any specific words, signs, or phrases your child uses often that we should know about? if he wants something he will grab your hand and both of you will grab it or he will get it himself and bring it to you for help opening or using itl. *

Does your child benefit from a written or visual schedule during the day? sometimes *

Yes

Sometimes

Are there any particular visual supports that help your child understand routines or expectations? not really *

Does your child require 1:1 support or constant supervision? yes *

Yes

How does your child typically respond to directions from adults or new people? pretty good *

How does your child interact with peers? pretty good *

Are there specific triggers that can cause frustration, anxiety, or meltdowns? overstimulation *

Does your child let others know when they need a break or are becoming overwhelmed? sometimes by holding hands *

Yes

Sometimes

What strategies or calming techniques work best when your child is upset? redirecting him and comforting him *

In group settings, has your child ever displayed physical aggression? (Hitting, kicking, throwing, etc.)? No *

Yes

Sometimes

Does your child elope (running off, not staying with the group)? No *

Yes

Option 1

Clear selection

Are there any known safety concerns (for your child or others) that staff should be aware of? No *

Does your child require assistance toileting? Not really *

Yes

Sometimes

Other:

Does your child need assistance managing pants (pulling up/down, zipper, buttoning)? sometimes pulling up but its rare *

Sometimes

yes he does *

Yes

Are there any sensory sensitivities related to the bathroom we should know about? (Flushing sounds, hand dryers, etc.) flushing and hand dryer *

Yes

Can your child eat independently? yes *

Does your child require any adaptive feeding equipment? No *

Does your child have any dietary restrictions? none *

Does your child have any allergies? (food, environmental, medications) allergic to chocolate *

Will your child need medications during camp hours? No *

Has your child attended a camp or group program before? No *

If yes, what supports helped them succeed/struggle?

Can your child participate in group activities with minimal support? No *

Yes

Sometimes

What activities does your child enjoy most? swimming *

What motivates or rewards your child? toys *

Does your child have any special interests or strengths? bowling *

Does your child understand and follow basic water-safety rules (staying in designated areas, listening to lifeguard instructions)? with the assistance of an adult yes *

Yes

If no, please explain how your child does with water activities.

Has your child ridden a bus before? yes *

Yes

Does your child require a 5-point harness or other safety equipment while riding? no *

Yes

Does your child have difficulty staying seated during transportation? No *

Yes

Any other information about transportation safety we should know about? N/A *

Anything else we should know to help support your child at summer camp? Not at this moment *

Which YMCA location will your child attend for summer camp? Lakewood YMCA *

Longwood YMCA

Riverfront YMCA

Lakewood YMCA

Tremont YMCA

Please indicate how you plan to pay for your child’s aide at TPS Camp? private pay *

TPS (if approved)

Private pay

ESY funds

To be considered for TPS Summer ’26, please send your child’s IEP, ETR, and a recommendation letter from a teacher or specialist. Sign your name and include the date the materials were sent to both justyce@thepositivityspectrum.org and sarah@thepositivityspectrum.org. Your application will not be reviewed until all required documents are received, and you will receive a confirmation email once everything has been submitted.

I certify that the information provided is accurate to the best of my knowledge. I understand that The Positivity Spectrum may contact me for further information about my child

Please sign parent/guardian name & date of completing the application.

Mace Mbidi-Glaou

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