A long time ago I was working for two different autism companies at the same time. In one company, I was a Behavior Therapist; this was before Registered Behavior Technician (RBT) was a thing so that is what we were called. In the other company, I was a Speech-Language Pathologist (SLP). This was a great learning experience because I was doing individual work in the ABA program and groups as an SLP.
One of the children I worked with in the ABA program joined the social skills group I was running as an SLP. Years prior to this, he had one of the most severe cases of apraxia I have ever seen. For example, if I gave him an instruction to clap his hands, he could do it. Stomp your feet. No problem. But if I said “do this” and he had to imitate me on command, he couldn’t do it. With intensive work, eventually this issue resolved. However, it still took two years of intensive ABA before he said his first word. The great thing is, he not only learned to produce single words, but to speak in sentences. He even got to a point where he learned how to comment in addition to manding (requesting).
The problem was this thing called pragmatics. To say it simply, pragmatics is the part of language that involves knowing what to say and when to say it. He had the language down and he could talk. Fantastic. When he stood on the Candyland box in the middle of his first group and said proudly, “I am standing on a box,” I was proud of him for commenting. However, he needed more help with the pragmatics component of language. With practice, he learned to get the game out of the cabinet, set it up and play the game with a peer. This is the result of intensive one-on-one ABA and practice in small, structured groups. You might be thinking, “this sounds great, but how do I even begin to develop something like this?” Here are some ideas to get you started:
Organize physical space
The physical space of the group is just as important as the social skills curriculum. This may seem like something secondary you can throw together last minute, but it is not. When working with children, it is crucial to set up the space to be conducive to learning. This is especially the case when working with children diagnosed with autism. If you have good working relationship with an Occupational Therapist (OT), this would be a good time to reach out to that person about this. They know way more about this than I do. However, I know not everyone has access to an OT in their program; so I can tell you some things I know from experience. If you take a look at the picture above, notice how big the chairs are and how the children’s feet are not touching the floor. Some of them are sliding down the chairs and look uncomfortable.
In contrast, look at the teacher and how her hips, knees and ankles are at a 90 degree angle. You need chairs for little people to allow them to have this position as well. I learned this (among many other things) from trainings I did through TalkTools workshops, books, and videos (www.talktools.com). Seating makes a big difference in how kids attend in both individual and group sessions. You may decide to have children sit on the floor instead of chairs. I think a mix of sitting on chairs and the floor is good so the kids can learn to do both. The important thing is that everyone has their own, defined space. If they are sitting on the floor, make sure each child has their own carpet square or circle. In addition to seating, keep distractions to a minimum. For example, have materials organized and ready to go in a locked cabinet; don’t over decorate the room and walls with unnecessary things; and be mindful of using scented products that could feel overwhelming to a child with autism. A scent that may smell good to you, could feel like torture to a child who is sensitive to certain smells. This could affect their ability to learn and you might not even realize it.
Create and follow a consistent group structure
I know you are limited on time and money, so don’t over complicate this. A good group will be like a well-written letter. It will have an introduction or greeting, content broken down into different paragraphs, and a conclusion. For example, the kids come in and sit down for a circle time and practice greetings. You have a hello song that you sing every time so that all of the children can eventually learn it and participate. I have seen teachers show pictures of each student to the group and practice all of their friend’s names.Talk about the schedule for that day (e.g., circle time, game, snack, art, bye). Simple.
Set general goals for the group and individual goals if possible
At a minimum, there should be general, consistent goals for every phase of your group. If you do not have a social skills curriculum, just think about what a child will likely encounter in a classroom. For example, they will need to sit in a circle, say hi and bye to friends, play turn-taking games, eat at a table next to other children, and ask for things. Not only are general goals practical, they are helpful in managing your data tracking system. You cannot run a successful group if you are trying to take data on every single thing the entire time. Have some general goals and figure out a manageable way to track progress. Once you have the hang of that, it will be possible to have more individualized goals. An individualized goal could be a speech goal developed by a child’s SLP. Maybe the BCBA or RBT is taking data on each child saying “hi” independently during their turn at circle time, manding (requesting) during snack and activity time and the SLP is teaching and taking data on Johnny correctly producing /f/ in single words throughout the group. Every setup is different, so you will need to work within the confines of your particular situation.
Plan a novel group activity every session
Children tend to make progress in groups with a consistent routine. Children with autism, in particular, need the repetition and practice presented in a predictable format. Let’s say every group starts with circle time and each child is prompted to say “hi.” If you change this up too much every time, it could make it difficult for the child to learn that skill. So in that case, you want the expectation of saying “hi” during that point in circle time to stay constant. However, you can have the “game” or “activity” time be something novel, for example. If you are short on time, you can do something really simple as pictured above: children taking turns asking for pieces of a toy. If you have more time to plan, you could prepare an art activity and have children ask for the different pieces to complete the project.
Plan for administration time
If you are the person who is in charge of some or all of the business and administrative part of your company, offering social skills groups to families can be challenging. This is especially difficult for someone who is in charge of everything, including creating the group and running it! I know you are out there and I feel your pain. Before you start offering this service, be aware that there are a lot of moving parts that you may not think of until you are in the thick of it. You can’t plan for everything. There are things that will happen that you would never had imagined if you tried! Regardless, put some simple policies and procedures in place and add to it as time goes on. Do not start with nothing and think you will put something together later. That is a recipe for disaster. Do something. Even if you start with one page. A few things to consider are: payment arrangements (pay per group or package), absence policy (is there a refund if child absent in group or do parents pay regardless of attendance), and progress reports (do parents get a note every session or a progress summary at the end?) You will think of more. If you don’t get it all right the first time, that’s okay. Keep improving upon what you build and you will get there!