The desire for friends is universal. From babies through adults, we thrive on our connection to others. Anyone who observes an infant wriggling with delight upon seeing her mother – or watches a depressed elderly person suddenly become animated when receiving a visitor – understands this reality. But sometimes a child does not seem to develop relationships. This is the child who complains (or, even worse, does not complain) that he is always chosen last on the team. This is the child who does not get any play dates and is teased and bullied by others.
Can children with poor social skills be helped, or are they doomed to spend their lives in isolation and loneliness? In the past, it was assumed that children would “pick up” these skills some time during their childhood. Parents and teachers who tried to help a floundering child managed as best they could. Today, it is recognized that social skills are a crucial part of education, along with academics, and they are regularly taught as part of a school’s curriculum or in specialized private social skills groups. Several therapists in our community offer such groups to children.
The first thing I discovered is that teaching social skills can be approached from many different perspectives. I spoke to an occupational therapist, a clinical social worker, a speech therapist, and a special educator/behavior analyst. Although their goals are the same, each of the four addresses the problem in terms of her own background and training.
Funtime Therapy
Rivka Bogart is an occupational therapist who also works on social skills. She uses a program called Zones of Regulation. The goal of this program is to teach children how to become more aware of, and control, their own emotions, sensory needs, and level of alertness. The program helps students be more independent in their self-regulation and to understand how their behavior affects those around them.
Rivka explains to the children about the four zones green, red, yellow, and blue. Each zone represents a certain type of behavior. For example, the green zone is happy, calm, and focused, and the red zone is angry and out of control. Once the child begins to understand his/her own emotions, sensory needs, and level of alertness, they can talk about different cognitive and sensory strategies to shift zones as needed.
There are several cognitive behavioral strategies that are discussed: One of them is the “Size of the Problem,” matching our reaction to the size of the problem. For example, you wouldn’t expect someone to yell and scream if their pencil rolled off the table. “Expected vs. Unexpected Behaviors” illustrates that we behave differently in different environments (classroom vs. playground). “Flexible vs. Stuck Thinking” (aka Superflex vs. Rock Brain) teaches children to think of alternative behaviors and thoughts when reacting to a problem.
After the children have learned about the zones and the cognitive and sensory strategies, each child is taught about his or her personal tool kit, which they can use to change from one zone to another and to interact in a socially accepted way.
The child now has the vocabulary to describe how he is feeling and how he is behaving. Rivka explained how this knowledge can be used: “Imagine a child is jumping on the couch and throwing pillows during the Shabbos meal. The mother can ask him what zone he is in now. When he explains that he is in the yellow zone (wiggly and loss of self-control), she can remind him that the Shabbos table is a time for the green zone. That is the behavior that is expected at this time. She and the child now have a common vocabulary, so that the child understands what behavior is required without a lot of yelling and reprimanding.
Thrive Center
Miriam Ahuva Schecter, of Thrive Center of Baltimore, is an expert on this subject, with 20 years of experience treating children. “I am a clinical social worker and a Sandtray Therapist, so I run my groups based on the ‘relational theory’ of attachment. Different from traditional social skills groups that focus on teaching behaviors, I focus primarily on the emotional component of relationships. By building children’s self-esteem, they will develop more positive social behaviors, leading to friendships that will last. My social skill groups are limited to four participants to ensure that each child is given the chance to thrive. The idea is that the children can practice and learn the art of friendship in the group, and it will then carry over to the school and home environments. I call the groups the Friendship Hour, and I let the children know they are here to learn friendship skills. First, we learn to be our own best friend and then we can share our hearts with others.”
Miriam Ahuva uses various modalities to encourage the children to share and connect with each other. One modality is called Sandtray. Miriam explains that each child has time to build a sand world in silence, collecting objects and creating a three-dimensional miniature scene in the sand tray. After each child builds his world, the group gathers around and takes turns listening to the “story” of each child’s world. Miriam Ahuva explained to me that this is very validating to the child and builds his self-esteem. Imagine how special a child feels, when he has three peers listening attentively to his story, without interrupting.
Miriam Ahuva facilitates the groups to ensure that there is a positive social interaction. Once the child experiences friendship, she is motivated to overcome the anxiety and pursue friendships in school. This is a safe place, where each child is able not only to learn about but also practice friendship skills. As the children progress and build confidence within themselves, she allows two children to build a world together. This allows the child to practice many other skills, such as negotiating, compromising, and being flexible and assertive.
During the session Miriam Ahuva also offers positive reinforcement for positive behaviors, such as making eye contact, not interrupting, and any of the skills she is trying to teach the children. The children earn points that they can exchange for prizes.
Another technique that Miriam Ahuva implements while the children are building their sand worlds is note taking. She writes down everything the children are doing: for example, which figurines are used, how they place the objects, the color patterns that emerge, etc. Note taking itself is validating to the children. The children pick up the message that everything they do is important. That is great for their self-esteem. In addition, when everything is recorded, progress can be tracked and shared with parents. When each sand tray world is completed, a picture is taken. Eventually Miriam Ahuva makes a slide show of all the worlds, and the child feels proud of his or her accomplishments!
Miriam Ahuva strongly feels that the reason her program has been so successful is because she is not teaching behaviors that are “robotic” but, rather, allowing the child to find his or her inner voice and be a “naturally” social being.
Part of Miriam Ahuva’s program is to include the parents as an integral piece of the therapy. After three sessions, she conducts a parenting session, where she shares the skills that were taught and shows how the parents can “model” these behaviors at home.
Let’s Chat Therapy
Faige Bander is a speech language pathologist who runs social skills groups from the perspective of her expertise, language. She uses the Social Thinking Curriculum by Michelle Garcia Winner. This curriculum works on self-regulation, social emotional learning, executive functioning, perspective taking and social problem solving. “If a child doesn’t have the words to communicate and doesn’t understand body language and gestures, it becomes very difficult to navigate the world,” Fayge says. “When children do not understand the difference between the words angry, disappointed, sad, and furious, it will be difficult for them to respond appropriately to those emotions. Having an accurate language for emotions changes how you feel and how you react.”
Faige’s social skills classes are fun, and the children enjoy coming. Sometimes she will wear a strange hat or two different shoes, encouraging the children to notice and to comment on the fact that what she is wearing is unexpected, meaning it is not the right way for a teacher to dress!
Faige also uses role play, funny videos, and games to teach the children how to “read the room” and to learn what is expected and what is unexpected. The children learn that if you do something unexpected, people might not think positively about you. They might not feel comfortable around you, which will affect the way peers treat you and behave around you.
Sometimes, the groups are geared towards practicing skills that are needed in school, such as starting assignments, completing work, and following directions. Children with poor social abilities often have difficulty staying on task in the classroom setting or during activities that require focus. Fayge starts with easy assignments and goes on to harder, more complicated ones. During this type of activity, the children will be prompted to self-advocate/request assistance, appropriately help peers, attend to the task at hand, and ask questions.
Attentive Behavior Care
Miriam Newmark of Attentive Behavior Care is a BCBA, which stands for a Board Certified Behavior Analyst. She works with many other highly trained and skilled board-certified BCBAs. The name of her profession reflects the work that she does: analyzing the behavior of the children she sees. Miriam works with children on the autism spectrum. Children who are diagnosed with autism range from those who attend regular schools and function well to children who are completely disabled and non-verbal.
Miriam first evaluates the children individually to determine what deficits they have. She looks for the gaps in their social skills. Once she figures out what the problems are, she groups children with similar problems together and works with them on those deficits.
The groups are very structured and work on specific skills. Miriam feels that most troublesome behaviors are triggered by the environment. For example, if she notices that a child has trouble with non-verbal communication, meaning he doesn’t pick up on gestures and facial expressions, she will work on that specific issue, first through direct instruction and then through games and fun activities. To ensure long-lasting success, she often works in the child’s typical environment.
It was fascinating to speak to these four different women and hear about their different approaches to helping children learn to function at their highest possible level. We are lucky to have so many varied resources available to help our children. Parents can explore the options that would work the best for their family.
