The Nuts & Bolts of The Friends Program
PerSPECStives
The Friends Program is designed to enhance the children’s development in the following areas:
Social interactions with their peers – Children with AS can often be seen either walking on the perimeter of the playground engaged in a monologue about an area of special interest, engaged in a solitary play next to their peers, or in an argument with a peer over the game “rules”. These challenges occur most frequently during free play activities, on the playground, during group projects, and at snack or at lunchtime.
Play in collaboration with their peers – Many of the children’s play themes are short, repetitive, and “delayed” compared to their vocabulary and wealth of information, and often based on themes that they have memorized from a favorite book or video. The children need help in expanding their symbolic play themes and then learning how to develop joint play ideas with peers.
Emotional Regulation – The children typically express a very limited range of affect such as pleasure and anger and may oscillate between them very quickly. They need help understanding feelings, expressing these feelings, and how to “read” them on other people’s faces in natural contexts.
Communication/Pragmatic Language – The expressive language skills that are used in daily social communication with peers (i.e., getting the other person’s attention before talking to them, circles of communication with peers maintaining eye contact and a theme in conversations, turn – taking).
Sensory Regulation – Children on the Autistic Spectrum/Asperger's Disorder often have Sensory Regulatory Defensiveness to different sensory stimulation. For example they may speak very loudly but get upset when they go into a room they feel is too loud. They may love hugging others very tightly but get upset if another child accidentally bumps against them. In the Friends Program we have often found that their defensiveness decreases as they become more comfortable and less anxious in the group. We always work collaboratively with the occupational therapists that the children are seeing so that we give the child consistent messages.
The Children’s Groups
The children’s groups provide the clinicians with the opportunity to address these goals in a “natural setting” with peers. Each group includes a theme-based table activity, transition to circle time, group “discussion” and communication activity, facilitated unstructured play with peers, transition to the playground, facilitated outdoor activities with peers, transition to snack time, and transition back into the room for a closing circle with the parents. A wide range of therapeutic interventions address the goals including a behavior program that focuses on a specific target behavior for the group or an individual child.
The Parents' Group
The parents spend part of each session observing the children with the group therapist with special attention given to different aspects of the therapeutic process and how it pertains to specific children. Parents address how difficult it can be to observe one’s child in the area(s) where he/she has the most difficulty, social interactions with peers. Following the observation the parents talk about the difficulties and successes they have experienced over the previous week, ask questions about how to handle a past or upcoming situation or a recent article on related issues, and get support and feedback from fellow parents and the clinician. The group also provides an opportunity to examine the wide range of feelings and concerns that parents experience when parenting a child with developmental challenges like Asperger’s, concerns that often extend beyond the identified child. For many parents the group is the only place where they discuss Asperger’s Syndrome.
Inclusion Criteria
Over the years, we have learned that it is important that the child have had an evaluation and the diagnosis of Asperger’s, or R/O of Asperger’s, or PDD-NOS with an average IQ, in order to guarantee that the group will correctly address the child’s needs. We also know that it is very stressful for a parent to participate in the program before their child has gone through the evaluation process since they tend to have one foot in and the other foot out, always wondering if this diagnosis fits their child. This is a process that all parents of a young child diagnosed as having AS go through, numerous times, but they are at a different level than those who have not had the assessment. The program also requires a clinical interview to make sure that the child “fits” into the group in order to guarantee that the interventions are appropriate for their needs.
Location: As do our schools we feel that in-person services are more effective than online. We will begin the program outside of Dr. Laurie's office as long as the weather and light allow. The office has windows, fan, and filtered air. We expect parents to be fully vaccinated as are all the staff and we will all wear masks. Snacks will be in individual bags. We will continue to track the COVID situation and will meet virtually, if warranted.
Payment: The parents pay for the group at the beginning of each month. The parents receive a monthly bill that they may submit to their insurance plans. Many parents are able to get partial reimbursement from various plans.
Social interactions with their peers – Children with AS can often be seen either walking on the perimeter of the playground engaged in a monologue about an area of special interest, engaged in a solitary play next to their peers, or in an argument with a peer over the game “rules”. These challenges occur most frequently during free play activities, on the playground, during group projects, and at snack or at lunchtime.
Play in collaboration with their peers – Many of the children’s play themes are short, repetitive, and “delayed” compared to their vocabulary and wealth of information, and often based on themes that they have memorized from a favorite book or video. The children need help in expanding their symbolic play themes and then learning how to develop joint play ideas with peers.
Emotional Regulation – The children typically express a very limited range of affect such as pleasure and anger and may oscillate between them very quickly. They need help understanding feelings, expressing these feelings, and how to “read” them on other people’s faces in natural contexts.
Communication/Pragmatic Language – The expressive language skills that are used in daily social communication with peers (i.e., getting the other person’s attention before talking to them, circles of communication with peers maintaining eye contact and a theme in conversations, turn – taking).
Sensory Regulation – Children on the Autistic Spectrum/Asperger's Disorder often have Sensory Regulatory Defensiveness to different sensory stimulation. For example they may speak very loudly but get upset when they go into a room they feel is too loud. They may love hugging others very tightly but get upset if another child accidentally bumps against them. In the Friends Program we have often found that their defensiveness decreases as they become more comfortable and less anxious in the group. We always work collaboratively with the occupational therapists that the children are seeing so that we give the child consistent messages.
The Children’s Groups
The children’s groups provide the clinicians with the opportunity to address these goals in a “natural setting” with peers. Each group includes a theme-based table activity, transition to circle time, group “discussion” and communication activity, facilitated unstructured play with peers, transition to the playground, facilitated outdoor activities with peers, transition to snack time, and transition back into the room for a closing circle with the parents. A wide range of therapeutic interventions address the goals including a behavior program that focuses on a specific target behavior for the group or an individual child.
The Parents' Group
The parents spend part of each session observing the children with the group therapist with special attention given to different aspects of the therapeutic process and how it pertains to specific children. Parents address how difficult it can be to observe one’s child in the area(s) where he/she has the most difficulty, social interactions with peers. Following the observation the parents talk about the difficulties and successes they have experienced over the previous week, ask questions about how to handle a past or upcoming situation or a recent article on related issues, and get support and feedback from fellow parents and the clinician. The group also provides an opportunity to examine the wide range of feelings and concerns that parents experience when parenting a child with developmental challenges like Asperger’s, concerns that often extend beyond the identified child. For many parents the group is the only place where they discuss Asperger’s Syndrome.
Inclusion Criteria
Over the years, we have learned that it is important that the child have had an evaluation and the diagnosis of Asperger’s, or R/O of Asperger’s, or PDD-NOS with an average IQ, in order to guarantee that the group will correctly address the child’s needs. We also know that it is very stressful for a parent to participate in the program before their child has gone through the evaluation process since they tend to have one foot in and the other foot out, always wondering if this diagnosis fits their child. This is a process that all parents of a young child diagnosed as having AS go through, numerous times, but they are at a different level than those who have not had the assessment. The program also requires a clinical interview to make sure that the child “fits” into the group in order to guarantee that the interventions are appropriate for their needs.
Location: As do our schools we feel that in-person services are more effective than online. We will begin the program outside of Dr. Laurie's office as long as the weather and light allow. The office has windows, fan, and filtered air. We expect parents to be fully vaccinated as are all the staff and we will all wear masks. Snacks will be in individual bags. We will continue to track the COVID situation and will meet virtually, if warranted.
Payment: The parents pay for the group at the beginning of each month. The parents receive a monthly bill that they may submit to their insurance plans. Many parents are able to get partial reimbursement from various plans.