helping your child experience social success · 2016-08-14 · o expressive non-verbal language...
TRANSCRIPT
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HELPING YOUR CHILD EXPERIENCE SOCIAL SUCCESS
“We will do, and (then) we will hear.”(Exodus 24:3-7)
Dan Shapiro, M.D.Developmental and Behavioral Pediatrics
www.parentchildjourney.com
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Assessment beforeManagement
“Accurate description leads to effective prescription.”
-Mel Levine
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When social difficulty is secondary(caused by other “stuff ”)
• Difficult temperament/ behavioral style
• Attention Deficit Hyperactivity Disorder
• Executive Dysfunctions
• Verbal Language Learning Disabilities
• Mood Disorders:
• Anxiety, generalized, performance, social
• Obsessive-Compulsive Disorder
• Depression, Bipolar Illness, Severe Mood
Dysregulation
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Other secondary causes of social difficulty
• Un-even sensory profile
• Fine and gross motor weaknesses
• Involuntary movement disorders (tics, Tourette’s)
• Environmental disadvantage
• deprivation or adversity
• lack of positive social role models, social
teaching, social experience
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Primary causes of social difficulty
(Disorders of the “social brain”)
• Dyssemia/ Social Pragmatic Disorder/ Social
Communication Disorder
• Non-verbal Learning Disability
• Personality disorders
o psychopaths, sociopaths, narcissists, paranoids
• Autism Spectrum Disorders (ASD)
o Kanner-type thru Asperger-type
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Overall strategyDevelopmental, natural, experiential, individualized
• Address all causes, primary and secondary
• Meet each child at his or her developmental level
o Where (s)he’s at
o Not where you think (s)he should be
• Ensure success at current developmental level
• Set short-term goals: “Where s/he’s at + 1”
• Positive reinforcement
• Gradually fade support and space positive
reinforcement to promote independence
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• Structure (Dependence)• Familiarity• Competence/ Interest• Play skills• Partner• Group size• Time• Warm-up time• Sharing• Social awareness• Social skill• Flexibility• EQ
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STRUCTURE (DEPENDENCE)
Beginner Intermediate Advanced
tightly scripted
outlined
free improvisational
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Provide sufficient structure and
supervision
• Unstructured time should be structured up
• Direct social coaching and facilitation is
sometimes necessary
• Adults should gradually fade support to
foster social independence
• Caution: Do not fade too quickly; do not
leave a child unsupported because he or she
is “older”
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FAMILIARITY
Beginner Intermediate Advanced
frequent
infrequent/previewed
new
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Familiarity
• Limit novelty
• Preview/rehearse
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Limit novelty
• Social success derailed by
o “experiencing new things”
o anxiety, sensory overload
• Comfort zone expanded by
o old familiar activities in old familiar settings
o deliberate, incremental exposure to “new”
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Preview/rehearse
• Visual schedule
• Social calendar
• Social stories
• Cartoon conversations
• Social scripts
• Rule review
• Guided practice
• Role-plays
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COMPETENCE
Beginner Intermediate Advanced
expert
intermediate
beginner
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INTEREST
Beginner Intermediate Advanced
high
medium
low
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Select activities in areas of competence
and interest
• Social success is more likely in areas of strength
• Shared interests lead to good relationships
• Follow your child’s bliss
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PLAY SKILLS (Lifter)
Beginner Intermediate Advanced
indiscriminate
discriminative/
combinations
socio-
dramatic-
thematic
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Teaching Play Activities To Preschool Children With Disabilities: The Importance Of Developmental Considerations
Journal of Early Intervention 17, 139-159.
Provide developmentally appropriate play opportunities
Teach up to the next level
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Indiscriminate Play
◦ Actions when all objects are treated alike
◦ Such as, waving, mouthing, banging, feeling, throwing
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Discriminative Play◦ Interacting with an object in a manner consistent
with the properties of that object
◦ Such as, pushing a car, squeezing a stuffed animal, pushing buttons on a pop-up
Take Apart Combinations◦ Separating the configuration of objects
◦ Such as, taking all of the pieces out of a puzzle
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Presentation Combinations◦ Child recreates combinations of objects according to their
presentation configuration◦ Such as, putting pieces back into a puzzle
General Combinations◦ Use objects based on global properties that are shared by
many different objects◦ Such as, using an item as a container (nesting cup, bed of
dump truck) to hold a variety of objects (blocks, toy cars)
Pretend Self◦ Relating an object to self with a pretend quality◦ Such as, bringing an empty cup to one’s mouth to “drink”
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Specific Combinations (physical attributes)◦ Preserve the distinct and unique physical
characteristics of objects in constructed configurations
◦ Such as, stacking blocks, stringing beads, rolling a car down a ramp
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Child as Agent◦ Using a replica of a person or an animal along with
a prop to complete an act◦ Such as, giving a doll a drink with a cup , feeding an
animal with a spoon
Specific Combinations (conventional attributes)◦ Preserve the unique physical conventional
characteristics of objects in configuration with another
◦ Such as, placing a cup on a saucer
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Single Scheme Sequences◦ Extension of familiar actions to two or more objects◦ Such as, feeding self with a spoon then feeding a doll,
then a stuffed animal, etc.
Substitutions◦ Use one object to stand in the place of another◦ Such as, using a bowl as a hat
Substitutions without Object◦ Pretending to use something that is not there◦ Such as, shaking an imaginary salt shaker, drinking from
an imaginary cup
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Doll as Agent◦ Manipulate doll figures as if they are capable of
action
◦ Such as, moving figures as though they are walking, having a doll hold a mirror as if to see itself
Multi-scheme Sequences◦ Extend different actions on the same figure
◦ Such as, feed doll with spoon, wipe it with cloth, put it to bed
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Socio-dramatic Play◦ Adopt various familiar roles in play themes
◦ Such as, playhouse; assign role of baby, child, parent, pet, friend
Thematic Fantasy Play◦ Adopt various fantasy characters
◦ Such as, superman
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PARTNER
Beginner Intermediate Advanced
parent/sibling
older/younger
children
peers/diversity
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Choose partners
• Older or younger children may be easier
• Sometimes boys do better with girls, girls with
boys
• “What do you want to do?” before, “Who do
you want to play with?”
• Match favorite activities to specific friends
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GROUP SIZE
Beginner Intermediate Advanced
solo
“two’s
company”
larger
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Limit group size
• Social stress can increase with the number of
play partners
• Success 1-on-1 comes before success 1-on-2,
etc.
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TIME
Beginner Intermediate Advanced
short
medium
long
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Limit time
• Stop before misunderstandings, conflicts or
boredom
• Know how long your child usually lasts, plan to
end 15 minutes earlier
• “Thanks for coming, thanks for going”
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WARM-UP TIME
Beginner Intermediate Advanced
prolonged
moderate
short
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Prolong warm-up
• For those who are slow to warm-up
• “One toe in the pool at a time”
• Warm-up can range from minutes, to hours,
to days, to weeks, to months
• Gradual, gentle coaxing
• Warning for “just jump in the deep end”-types
• Consider shortening warm-up for these
children and parents
• Don’t prolong torturous transitions
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SHARING
Beginner Intermediate Advanced
attention
things
thoughts and
feelings
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Teach sharing
• Prompt to share engagement (joint attention)
• Playful obstruction to share things
• Visual communication (e.g. cartoon
conversations) to share thoughts and feelings
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SOCIAL AWARENESS(From I-It to I-Thou)
Beginner Intermediate Advanced
egocentricity
other
awareness
reciprocity
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Teach social awareness
• Teach mind-reading
• Teach active listening
• Teach receptive non-verbal language
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SOCIAL SKILLS
Beginner Intermediate Advanced
beginner
intermediate
advanced
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Teach social skills
• Some children need explicit teaching and
supervised practice
o Social norms and rules
o Sharing, collaborating, turn-taking, entering
and leaving a group
o Social problem solving; compromise and
reconciliation
o Expressive non-verbal language (signaling)
• Prosody/ tone of voice, interpersonal
space, grooming, facial expression, body
language, sarcasm, etc.
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FLEXIBILITY
Beginner Intermediate Advanced
my way
your way
our way
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Flexibility training*
• Explicitly teach flexibility as a concept
• Spaghetti noodle (raw/ cooked)
• There is no such thing as a perfect friend
• Expectations can not always be met
• “Go with the flow” for the sake of the
relationship
• Demonstrate and point out examples of
flexibility (real-life, TV, books)
• Praise and, if necessary, reward flexibility
* Kenworthy, Anthony, Werner, Unstuck and On-Target
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EQ
Beginner Intermediate Advanced
black and
white
primary
emotions
multiple
shades
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EQ development
• Teach fundamental emotions (happy, sad, angry,
and scared) and gradations (big deal, little deal, no
problem; red, yellow and green)
• Then teach subtleties (confused, embarrassed,
jealous, disbelieving, remorseful, grateful,
annoyed, frustrated) and degrees (multiple shades
of gray, 0-10)
• Move from “mean” or “nice” to understanding
the full, ever-changing array of personalities
• Nuanced emotional understanding leads to
greater tolerance of social demands and mature
coping strategies
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Temple Grandin:
Different kinds of friendships
• “You neurotypicals and your relationships!”
• Work and the good life.
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Specific considerations
• The Social Development School
• Complementary social learning
• Social skills groups
• Bullying/ teasing
• Social life begins at home
• Helping others
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The Social Development School
• Social problem solving
• Social engineering
• Social situations management
• Social responsibility
• Special social education
o Social impairment causes learning
impairment
o 504 Plans or IEPs should include specific
social goals and strategies
Peer mentoring
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Complementary social learningSupplements to real-life experience
• Dolls and toy figures
• Books: fiction, poetry, biography, history
• Pets
• Screen time (with parental supervision!)
• E-friends
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Social skills groups
• Therapeutic peer groups
• Individual psychosocial therapy
• Mainstream/inclusion social groups
o Clubs/classes/activities in shared interests
oDrama classes/theatre
o Sports
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Bullying/ teasing
• Take it seriously
o Anxiety/ depression/ suicide
o Columbine and Virginia Tech
• Map of safe zones/ high-risk zones
• Specific plans for dealing with both bully
and victim
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Social life begins at home
• Adult role models: parents,
grandparents, and teachers
• Siblings have different profiles/ needs
• The case against sibling conflict
o preventing harm
• The case for sibling conflict
o learning from experience
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Helping others
• Volunteer, teach, coach, mentor, baby-sit
• Pair with classmates or younger students
• Group volunteering (double dose of
meaningful social connection)
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Temple Grandin:
Different kinds of friendships
• “You neurotypicals and your relationships!”
• Work and the good life.
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Resources
• Attwood, The Complete Guide to Asperger Syndrome
• Brazelton, “The Case for Sibling Rivalry” in The Birth
of the Family
• Baron-Cohen, Teaching Mind-Reading to Children
• Faber and Mazlisch, Siblings without Rivalry
• Goleman, Social Intelligence
• Greenspan, Playground Politics
• LaVoie, t’s So Much Work Being Your Friend
• Nowicki and Duke, Teach Your Child the Language of
Social Success
• Winner, Thinking About You, Thinking About Me
• Gutstein and Sheely, Relationship Development
Intervention
• Jeanette Navigating the Social World
• Jed Baker, Social Skills Training, The Social Skills Picture
Book
• Bellini, Building Social Relationships