Thursday, November 1, 2012

Choosing A Social Skills Program; Not as Easy as I Thought


When Nicky was three, I thought social skills would be the easiest of his many interventions. I thought the hardest and more important therapy was ABA, specifically DTT.  Social skills seemed so simple, easy breezy, anyone could do it.  I mean how hard it could be to get a child to play, follow your lead, and learn how to greet someone. Boy was I WRONG!!  Please understand, I am not minimizing ABA. ABA has been critical to Nick's development and both interventions are equally necessary for out kids. I a pointing out that I was simply wrong in thinking ABA was a more difficult intervention than social skills. In time I learned that in DTT Nicky was asked to repeat the same tasks over and over until he mastered it.  A good therapist followed a very specific program, executed only that program, measured results and did not do anything outside of the program trials. On the other hand, with social skills the therapist had to be constantly on the lookout for those unique opportunities in every situation to help the child build skills. A good social skill therapist is always looking for and creating teachable moments, vs following a specific program design. When you consider how different each of our kids are, you start to understand how much it work it takes to successfully address social skills.  Then there’s the reality that all social skills programs are not created equal. That said, no matter where your child is in the process, please read this great breakdown from Dr. Pam Wiley from LA Speech and Language. 

Social Skills Programs: Aren't they all the same?

The answer is “No. They are absolutely not the same.” It is not uncommon for a parent to enroll their child in a social skills program and then suddenly leave in disappointment. Most often it’s because parents thought that the program was something that it wasn’t. Common complaints are too structured, too much playing, unqualified staff even though the site administrator has impeccable credentials, or even staff members who demonstrate poor social skills. We’ve heard it all! The question then becomes how do you know which program is the right one for your child?
It’s really important for parents and professionals to be aware of the different types of programs and their specific focuses and approaches used to stimulate and promote positive social interactions. The four main types are language, behavior, sensory, and play and in this blog I will provide generalinformation on each of them.

Language Based
A language based program focuses primarily on the use of the verbal and nonverbal aspects of language. These programs offer structured and unstructured opportunities for your child to communicate effectively in a naturally occurring manner. The goal is to encourage children to use their words to communicate their feelings and thoughts, to understand the feelings and thoughts of others, and to learn the rules of social communication referred to as pragmatics which includes turn-taking, eye contact, topic maintenance, and other nonverbal dimensions of communication.
Like most programs, a language based program will also address challenging behaviors and sensory issues but these typically are secondary to the speech and language focus. A child best suited for this type of program is a child who has some language but does not use it consistently or appropriately, the child who wants to have friends but is unable to communicate effectively enough to connect with them, the child who is so “precocious” that s/he turns their peers off, or the child who is described as a social loner and disinterested in their peers. A speech and language based program is most effective for these types of children.
Language based social skills programs are led by Masters level or licensed/certified SLP’s who ideally should have training and experience providing services to children with ASD and other special needs.
Behavior Based
Another approach to social skills training is based on a behavior model. This model addresses social skills using a procedure called ABA or Applied Behavioral Analysis. These programs typically use a behavior modification approach to design and implement effective instruction. Programs may use floor time and other behavior based approaches to teach social skills. Behavior based programs ideally should be led by a behavior or cognitive psychologist who possesses training and experience working with children with ASD and other special needs. A behavior based approach is especially helpful for the child who has difficulty with joint attention and engagement.
Sensory Based
A sensory integration model is designed for children who may have abnormal responses to sensory stimulation. Therapy typically incorporates a variety of sensory movements, relaxation techniques and strategies to teach the child to self-regulate his/her sensory system.
Language is incorporated in this approach but sensory integration is the primary focus. This type of program is provided by a licensed and certified occupational therapist who has training and experience working with children with ASD and other special needs. A sensory based program is especially helpful to the child who fidgets excessively and engages in persistent spinning or movement as well as the child who is hyper or hypo sensitive to touch.
Play Based
The fourth type of social skills program is a played based program. The model is grounded in a philosophy which places an emphasis on the importance of play in childhood (Wolfberg, 2003). Children come together to play under the guidance of a qualified adult play facilitator. The program is effective.
Regardless of the type of program you select it’s important to consider how the skills are generalized to everyday situations. Lastly, probably the most important part of the equation is your role as the parent. It is critical that you are also involved in the training so that you are able to facilitate the carryover of the social skills objectives on a daily basis in the home, school, and the community. L.A. Speech offers social and pre social language skills programs on Tuesday, Wednesday (drama social skills) and Saturday. I encourage all of you to do your homework and find the best fit for you and your child.

2 comments:

  1. What an informative post. It is so true that all social skills programs are not the same. Each one focuses on different aspects of the development of social skills. At Learning on the Log, we emphasize the need for each child to interact, relate, and communicate with peers and family through sensory and floor-time play. Our goal is for each child to build meaningful relationships through social skills. Thank you for sharing this! Even though everyone must look for what best fits their child, one thing remains constant: the need for children to learn social skills so they can contribute their happiness and ideas to this world!

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  2. I am an ABA therapist and am currently writing a FBA intervention plan for peer-relational social skills/reciprocal conversation skills. My plan entails 3 "phases": intensive DTT to start, followed by video modeling, and naturalistic play opportunities (scheduled play dates + community outings to playgrounds, parks, etc. to allow for interaction with oher children). A good ABA program encompasses multiple modalities to promote generalization to real-life scenarios.
    JB

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