Authored Article by Dr. Isha Soni, Senior Occupational Therapist, Centre Head, Lexicon Rainbow Therapy and Child Development Centre, Pune
Few children show developmental delays and concerns due to various childhood developmental disorders like Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Down Syndrome, Learning Difficulties like dyslexia, and another global developmental delay. These children often seek Early Intervention through various therapies like Occupational, Speech Therapy, and Remedial Education. These sessions are highly customized for each child, and one on one basis as every child has a different profile despite the same diagnosis. There is no one size fits all approach. Usually, children continue these personalized sessions for 6 months to 1 year.
After they have made significant gains in attaining the missing milestones in motor, speech, social and communication domains, most of them are ready for school and social integration. But is it as easy as it sounds?
Autistic children often find it easier to connect with adults as there is always an extra benefit of being understood by the adult. But in the peer group, children of a similar age do not have that amount of patience or understanding. Children of these age groups already have shorter attention spans and quickly shift their attention to what’s happening around them. Also, the neurodiverse child may get overwhelmed, socially anxious, and doesn’t know what to do next. They have difficulty picking social cues, connecting them, and continuing what is being spoken by their peers. They want to socialize, but don’t know “how”!!That’s the time when group sessions help a lot and make this transition easier.
Group Therapy sessions are conducted for both Speech and Occupational Therapy. In these sessions, children of similar profiles are included in smaller groups of 2 or 3. These sessions are facilitated by qualified professional therapists where they have “pretend” situations using techniques of “role play and modeling.” These situations often represent the school, birthday parties, a supermarket, or a playdate. When left alone in daily situations,, they may not know how to use their recently acquired skills in these real-life situations. Hence, modelling the correct behaviour, listening patiently, speaking appropriate language and using non verbal gestures are practised in these sessions. Often children find it very interesting and playful being in a group and follow the instructions of their therapists which they are able to then generalize in their real life. Many times, presence of another child motivates them to perform .
Stories, structured play , games and cooperative play are often used in these sessions. Children learn skills like turn taking, beginning conversations, topic maintenance, following lead, understanding humour, emotions, and social communication rules in these sessions which mimic the daily life situations.
Similarly classroom situations are also rehearsed. The skills targeted in this scenario are sitting in one place for longer duration, taking instructions in group, following 2-3 step instructions, writing, colouring, turn-taking, holding conversation on that particular topic, staying in present and not zoning out.These sessions make them ready for integration into a classroom with many students.
These children often have difficulty maintaining their personal physical space. Its important for them to recognise the same while talking to their friends, teachers, caregivers and helpers. Children having difficulty in maintaining social boundaries and often go too close, touch in inappropriate places to get someone’s attention while trying to communicate. Identifying and knowing their personal physical space is taught and practised too in the group sessions.
“The Social Thinking Program” is also an excellent approach to teach children more about non verbal gestures, cues and body language. In this the child is explained how to use his body while trying to enter / exit a group, showing interest in the ongoing conversation, reading others non verbal cues, being present and not thinking about their favourite topic like cars/ dinosaurs while in the group. This program is suitable for children 8 years and above with a decent progress in social and communication domain.
“Lego Therapy” is also an interesting group therapy approach which encourages speech and communication in children having interest in lego. These sessions are facilitated and supervised by a professional trained in the same.
All these activities help to increase social participation and reduce social anxiety in children . This promotes their social participation and makes integration into community easier which is the ultimate goal.
