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.
I will never forget how this so called expert stood before me, straight faced , emotionless and explained how children with Autism reach their potential around age 5 after which they don't expect to see much progress or significant change and they believed this to be he case with Nick. I was so angry. I literally yelled at her "Plateaued!!!. On what planet does any human plateau at 8!" 
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