Running social skills groups for preschool and elementary-aged children with autism can be a daunting task. When you are working with an entire group of wiggly ones, it can be challenging to meet the individual needs of each child. I have developed a four-step process that helps me stay organized when I’m designing groups and conducting sessions.
1. Assess and observe
A comprehensive assessment of each child allows you to establish baselines and determine goals. Use a standardized evaluation (such as the Diagnostic Evaluation of Language Variation pragmatic subtest) and/or informal assessment (for example, Stanley Greenspan and Serena Wieder’s Floortime Observation Checklist found in “The Child With Special Needs”) to evaluate each child’s language, social and emotional developmental levels.
Individual observation helps you establish baselines prior to placing the child in a group. I begin with a structured game, and then transition to engaging the child in pretend play.
During the structured activity, I note:
Does the child facilitate turn-taking?
What level of prompting is required to create a continuous flow of interaction?
During pretend play, I first observe the child and follow his lead, noting which skills the child demonstrates without prompting: initiation, sequencing, cohesive storytelling, dialogue between characters, perspective-taking, problem-solving, emotional thinking and flexibility.
I don’t plan every activity prior to each session. Instead, I let the group select the games, so the children can work on their negotiating, compromising and conversation skills.
After five or 10 minutes, I facilitate the play to see how much prompting the child needs to create a sequential and cohesive story and to gauge the child’s problem-solving abilities:
Can the child generate a logical or creative solution when presented with a challenge? For example, if I say, “I hurt my leg! What should we do?”—does the child say to get a Band-Aid?
Can the child generate alternative solutions if the first one won’t work? For example, if I say I’m out of Band-Aids, does the child suggest I go to the store or to the doctor?
I then identify the child’s breaking point, and how the child displays it: avoidance, resistance, or showing signs of disregulation.
How many problems can I present before the child reaches his breaking point?
If I increase my affect and become very emotional during play, can the child play along or does he become disregulated? For example, I say, “I’m eating pizza. You can’t have any! Get away from my pizza! It’s mine!” How does the child handle this type of heightened emotional situation? Does it overwhelm him, or can he continue in the play and reason with me?
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Jessie Ginsburg is a speech-language pathologist and owner of Pediatric Therapy Playhouse, a multidisciplinary clinic in Los Angeles.