Fostering Friendship An expert explains how SLPs can encourage social interaction among preschool-age peers. Overheard
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Overheard  |   May 01, 2016
Fostering Friendship
Author Notes
  • Amy Donaldson, PhD, CCC-SLP, is an associate professor in the Department of Speech and Hearing Sciences at Portland State University. Her research focuses broadly on social communication and perception of social competence in children with autism spectrum disorder (ASD). She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education. adonald@pdx.edu
    Amy Donaldson, PhD, CCC-SLP, is an associate professor in the Department of Speech and Hearing Sciences at Portland State University. Her research focuses broadly on social communication and perception of social competence in children with autism spectrum disorder (ASD). She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education. adonald@pdx.edu×
Article Information
Development / Swallowing, Dysphagia & Feeding Disorders / Special Populations / Autism Spectrum / School-Based Settings / Language Disorders / Social Communication & Pragmatics Disorders / Attention, Memory & Executive Functions / Overheard
Overheard   |   May 01, 2016
Fostering Friendship
The ASHA Leader, May 2016, Vol. 21, online only. doi:10.1044/leader.OV.21052016.np
The ASHA Leader, May 2016, Vol. 21, online only. doi:10.1044/leader.OV.21052016.np
Anne Stevens: I frequently try to facilitate social interaction with kindergarteners at snack time, but it seems like there’s barely enough time for the students to chew and swallow their food, let alone fit in some comments (without food in their mouths, that is!). Any suggestions? Thanks.
Amy Donaldson: Time is always tricky—however, I think that eating is a very social activity, or at least it has the potential to be. As such, it really might be an opportunity to discuss with your team [the idea of more social engagement] by giving more time in your daily routine to snack time. I think that we need to think about the goals and function of each of the tasks/activities of the school day and ensure that we are capitalizing on them—snack can serve multiple functions, and social engagement is a key component!
Amy Shoemaker: I was curious if you could give an example of how you would write a reciprocity goal within a clinical setting?
Donaldson: I always follow the same format because I’m a behaviorist at heart, and I believe that your behavioral objective is your roadmap to good data collection, and good data collection is your key to effective intervention. As such, I use this formula: condition, individual, behavior, criteria, measurement. So, I need some baseline data and other information to write the behavioral objective. (One other thing to note: I never write a behavioral objective that a child can’t achieve with independent, spontaneous performance within one term.) So, I might write something like, “Within a natural play activity with a peer, Amy will respond to her peer’s communication bids in four out of five opportunities as measured by two probe sessions and one treatment session.” Probe data is taken outside of the teaching paradigm, and treatment data is taken within intervention (see research in the American Journal of Speech-Language Pathology by Lesley Olswang and Barbara Bain). We cannot tie our intervention effectiveness to our treatment if we use treatment data alone—we must use probe data to ensure that it is our intervention that is responsible for change.
Allison Slone: Can you talk about natural/intrinsic reinforcers?
Donaldson: Of course. Sometimes people are surprised to learn that I’m a behaviorist—they have a misunderstanding about applied behavior analysis (ABA) as a science, and they have only been exposed to one methodology of ABA; thus, they think that it is only drill-based, adult-directed and very highly structured. ABA is simply the science of understanding human behavior—your Starbucks coffee card is a token economy reward system.
I am a Vygotskian, who believes that we learn from each other in a social manner, but I also believe (as Sally Rogers says) that ABA is just good teaching. I use both of these principles in my teaching; I can add structures and support when a child is struggling to learn something, but for the most part I start with something that is highly motivating for them. We all learn better when we are engaged in highly preferred activities or using highly preferred objects. So, what I mean by intrinsic reinforcers is to use the object of interest as the teaching context—that is, identify the motivating object/activity and teach using that object/activity. Then there is no need to introduce an outside object as a “reward.” In the video that you saw in my presentation of the brothers, they told us that they enjoyed watching WWE wrestling. So, we went and bought WWE wrestling characters so that we could implement teaching within a highly preferred context. It’s that simple.
Patricia King: My question concerns intrinsic motivation. Most children, even those with severe impairment, will find pleasure in communicating with peers. Children with severe ASD often lack that pleasure response and receive no intrinsic reinforcement. How have you worked with these few kids?

“It is up to us as clinicians to really reinforce the peers/siblings about their use of strategies because they will often not get the response from the child with special needs right away.”

Donaldson: I truly believe that everyone has something that motivates them. I’ve worked with many severely impacted children in my career and there have been times when I’ve had to do a reinforcer assessment every 30 seconds. What does that mean? It means I have a big box of cool light-up toys and sensory gadgets that may be appealing to kids that I use to try to engage them in simple social interactions, and I may have change it up because they may lose interest very quickly, but I know that they have something that motivates them. Also, note that food is a primary reinforcer; however, that doesn’t mean that I can’t join in the eating! Remember, snack can be social—I always eat with kids. “Oh, this is good! Yum!” I trade foods. I spill the drink—we clean it up. I create multiple opportunities for us to engage around the snack time together. Sometimes it might be challenging to find what motivates them, but I have confidence that we can do it! We are all motivated by something. My motto is that I never try to take something away from a kid; instead, I try to entice them into joining what I have—to be more engaging! To be fun!
Theresa Meredith: I am interested in the concept of a “Peace Wall,” but I can’t picture it. Could you provide a brief description of one? Or could you provide a resource that has a picture of a sample? Thank you.
Donaldson: It starts with group instruction around social communication skills—both strategies for negotiating conflict as well as prosocial behaviors and emotion regulation. This instruction can happen in the large group (say, at circle time), but is also reinforced across the day through direct instruction at small group times. Also, incidental teaching, so that the kids really learn the concepts.
There is always a visual that is associated with each skill, so that the children understand the symbolic representation of the skill and know what the symbol means. Then these symbols are put on the wall—the Peace Wall—and the teaching team models for the children how they can go to the wall if a situation occurs (e.g,. conflict) and independently self-select a symbol to resolve the issue. Again, this can be taught on multiple levels and through multiple means—large group, small group, direct instruction, incidental teaching. One of the reasons this works so well when partnered with the buddy program is that peer mediation is at play. One buddy typically is able to support the other peer in working through this system at the start, particularly if you are partnering a child with special needs with a typically developing (TD) peer. Hope that helps.

“I never force a child to play with another child, nor do I bribe a child to do so.”

Slone: Do you think a Peace Wall or something similar would be equally effective if adapted for upper elementary students?
Donaldson: Absolutely! I think one of the major reasons that bullying is so prevalent today is that we are not focusing enough on social communication across the curriculum. I have seen this successful in many classrooms (or modifications of this) at upper grades. I could envision modifications through use of discussion roundtables, journaling, mentoring, etc. Yes, yes, yes!
Cheryl Kreiman: When starting a peer-mediation method in a preschool classroom, does any information go home to the parents about the program?
Donaldson: I would absolutely advocate that all families are kept informed and support classroom activities. I think it’s important in inclusive classrooms that everyone understands the mutual benefit to learning that occurs within such environments. As such, I think that it should be part of any discussion about teaching practices. I’m not sure peer mediation needs to necessarily be singled out; however, it should certainly be discussed as one of the strategies used in an inclusive environment, just like other strategies. I think it’s great for all families to understand how their children are learning!
Biji Philip: My question pertains to the logistics of running a peer-mediated intervention program. How many “teaching sessions” did you need for a TD peer to master the skills required for the peer interaction? Secondly, have you tried this intervention with minimally verbal children with ASD whose cognitive and language impairment is so significant that even the use of an AAC is challenging for them to communicate with it? At times they may be wrapped up in their stereotypical behaviors/rigid routines and fail to respond to communication bids by their peer. How do you train the TD peer to respond to the “non-response” of their peer with ASD?
Donaldson: The number of sessions will depend upon the peers. We tend to teach one strategy at a time because we want to ensure that the peer/sibling feels comfortable and confident (and that we have the data to demonstrate mastery in use of the strategy). Our data suggest that siblings learned an average of 2.5 strategies in 10 weeks (two sessions/week) with a range of two to six strategies learned.
Your other question is really key—it is up to us as clinicians to really reinforce the peers/siblings about their use of strategies because they will often not get the response from the child with special needs right away. Our natural tendency will be to facilitate the child with special needs and turn our attention away from the peer—don’t do it! You must reinforce the peer/sibling first! Otherwise they will not persist in using the strategy. So make sure you really are responsive to the peer to support their use of the strategy, then you can support the child with special need’s responsiveness. It’s a bit of a handful at first and works best if you have another team member who might be able to help you team up, especially when you’ve just taught a new strategy.
Ruth Roman-Jimenez: How do you know which child to pair when the child has poor social communication? Do you pair with the highly social or the typical normal child? Also, how do you get the special needs child to engage in social center with their buddy if they show no interest and the buddy begins to show frustration?
Donaldson: You ask a very important question. My main goal is relationship building; therefore, a match is a key component. I look for kids who want to be together. As such, I will certainly ask teachers and other team members, but really it’s up to the kids themselves. I never force a child to play with another child, nor do I bribe a child to do so (“Joey, you can have an extra 10 minutes of computer time if you play with Amy”). We would instantly create an inequity by doing so, and this is not the foundation of a relationship. I look for children who have shown an interest in playing with each other and then—probably the most important part—I find an activity that they both like and I make it fun! Short and sweet are key as well!

“I very rarely work on social communication skills without a peer or sibling because I want to make sure what I’m doing is going somewhere other than that clinic room!”

Karla Pierce: Activities to promote social interaction in the classroom and during therapy sessions are common. However, have there been any outside activities that you have found to be successful with children with ASD in particular?
Donaldson: I think outside activities are key. We need to be really thoughtful about outdoor play—it’s big and often unstructured time. This can be really disorganizing for children with special needs. Having a designated space and a structured game, with a distinct beginning, middle and end (like an obstacle course or relay race), seems to work well. Other good outdoor activities are simply modifications of indoor activities—move the sensory table outdoors and do “messy” sensory activities: bubble water, shaving cream, etc. Again, what’s most important is to use a play schema that is familiar to the child. A child with ASD needs to be exposed to a new play schema three times to fully understand it (even something as simple as blowing bubbles), so be thoughtful about how you demonstrate tasks and new activities. Perhaps take something from the OT gym to the outdoor playground so that the transition is only one step in terms of context, rather than learning a whole new schema in a really overwhelming space.
Madeleine Paul: What do you recommend for peer mediation in a clinic setting? Do you include siblings?
Donaldson: Yes! Our SocialsibS project came out of my years of clinical practice—that’s exactly what I would do in a clinical setting. In my view, I very rarely work on social communication skills without a peer or sibling because I want to make sure what I’m doing is going somewhere other than that clinic room! In a clinic setting, I have parents bring in peers from the neighborhood, from soccer, church, school, wherever—you get the idea. It’s just important that these are kids that the child has regular interactions with during their day/week. I’ve never had a problem with parents recruiting kids!
Wendy Walker: My question is about initiation: I have a student who has developed reciprocity but never initiates without a prompt. Could you share some suggestions for how to target this skill?
Donaldson: Initiation—yes, that’s tricky. I find that for those kinds of kids, we really just need to put all kinds of amazing things in their environment so they are compelled to talk—and then be quiet! I love to go to the Dollar Store—they have a bunch of funky, crazy things that I just place around my room or that I hold in my hands and look at or try to make into crazy shapes, and then I wait. If that doesn’t work, then I look at what the child is looking at and I use that as an initiation, and I comment on that to show the child that his eye contact is a joint attention bid and I’m interested in what draws his attention (e.g., “Oh, you’re looking at that picture. That’s a cool airplane!”)—and then again I wait. But I don’t ask questions.
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May 2016
Volume 21, Issue 5