She wants him to have "toys" that really aren't toys or items meant to be played with.

She wants him to be on a snack/treat based diet.

She wants you do do SPECIAL.

SPECIAL costs more.

I'd go about it like this...

"Ya know Mary, I thought about what the new requests lil Johnny needs. This is a higher level of care. In order for me to do this, I'm going to need you to supply these sensory items and they need to be approved items to play with and your rate will go up $75 a week to provide this level of service."

OR

"Ya know, Mary. I thought about what you said and unfortunately I can't meet the needs little Johnny now needs. I think you're going to need to find a nanny or a small group so your requests can be fulfilled."

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