Social Skill Groups with toddlers and parents offer many advantages. These small groups provide parents the opportunity to talk with families who share similar concerns and a place to practice new skills to help their children. In the group, there is a sense of community and understanding. It is a safe place for families to learn and support each other. Parent Child Groups provide:
- Parent-to-parent ongoing support
- Professional coaching in a safe environment for parents to practice skills
- A platform where a child’s skills can increase in a variety of areas: communication, socialization, play, and behavior
- Opportunities for child and parent to explore new experiences in a safe, supportive environment
- Encouragement to increase consistency in the use of new strategies
- A platform to experience of how techniques work over time
- An atmosphere that encourages positive and fun play experiences for parent and child together
- Directed observation for parents to notice the positive changes in their child
- Help and emotional support in time of crisis
- Reinforcement for positive coping behaviors
- A base for sharing information, ideas and resources
- Resources and support in dealing with educational, medical and other service agencies
- An opportunity to relieve loneliness and form new friendships
The groups create a platform for parents to practice skills, raise concerns, give suggestions, enjoy their children, explore and play together.
The children who attend the Achieving Milestones of WJCS Parent Child Group programs are ages 18 months to 5 years with different needs but who often have not been in social settings with other children who have challenges interacting with other children. Parents’ concerns range from communication limitations such as the child not using words to express him/herself or social/play concerns, such as limited turn taking skills, throwing of toys or inadequate attention to complete a simple puzzle. The group provides a natural social environment for learning to take place.
We would like to introduce you to two of the children who have attended the groups, an overview of the approach used and then a few of the changes seen in these children.
Meet Brandon, a 20-month-old boy with big, engaging eyes who loves to move. His mother was concerned about his lack of speech and had him evaluated through the Westchester County Department of Health’s Early Intervention Program. He was found eligible for services to help him with communication, play and social skills. It was soon recommended he attend one of the Achieving Milestones Parent Child Groups. When Brandon started attending the group, he moved around the room grabbing any items he could find such as markers, toys, etc. He had difficulty focusing in order to sit and play. He climbed on the table and chairs, did not respond to commands and wandered the room during most activities even snack, his favorite time. His mother reported that everyone at home would immediately say “no” and take things from him that he had grabbed which often resulted in tantrums. Every evening as the family settled down to relax and watch television, Brandon took the remote and played with the buttons and changed the channels. Family members yelled “no” and took the remote from him triggering a tantrum. This was a daily occurrence. Brandon was a challenge at home and in group!
Meet Sarah, a shy two-year-old. At nine months Sarah had muscle weakness and was not crawling or rolling as expected. When Sarah’s mother had her evaluated through the Westchester County Department of Health Early Intervention Program, she was found eligible for services. Sarah started to receive physical and occupational therapy services at home. Later speech services were added. When Sara was 2.3 years old it was recommended that she enroll in the Parent Child Group to help with social skills and play in a group setting. Sarah had not been with other children for a play group because her mother was concerned that she could not tell someone what she wanted, that she did not play much with toys and often grabbed or threw toys. When Sarah first attended the group, her mother was very concerned that she would hurt another child. Sarah had many sensory fears and was not able to touch any mushy, soft materials such as play dough, bath foam or finger paints. Food intake also was limited due to similar sensory discomforts with food.
To help the children and parents we use an effective, proven approach developed by Dr. Alan Kazdin from Yale University called Positive Behavior Management (PMT). In order to implement the practice, we determine the best PMT strategy for each child and create an individualized program using the ABC’s planning approach: antecedent, what happens before the behavior; behavior and consequence, what happens right after the behavior occurs. All behaviors serve a purpose, whether to self-soothe, avoid, seek attention, etc. Parents and therapists work together to understand the child’s behaviors and make an effective plan tailored to each child’s skills and needs.
Two of the techniques used in PMT are “positive framing” and “active ignoring.” An example of positive framing is stating the desired behavior such as “feet on the floor” instead of yelling “No. Get down.” The child learns what the expected behavior is as the message is clear, and receives support and attention for accomplishing the desired behavior.
When Brandon would climb on a chair he was given the direction “feet on floor” with gentle physical assistance to guide him off the table or chair. After one month in the program, he responded to the verbal prompt without the physical cue to sit on the chair. Within two months, he rarely climbed onto the chair and no longer onto the table.
The technique of “active ignoring” means that although an adult is nearby, always making sure the child is safe, direct attention to the child is withdrawn. So, we may sit near the child but we would not look at the child or speak to the child except to state a positive expectation such as, “When you are calm, we can go to the playground.”
During our group we set aside time for parents to meet separately with the social worker. At this time the children are in a play group with another professional (special education teacher or speech or occupational therapist) in a connecting room. The doors are often open and the children can “check in” with their moms as needed during the initial adjustment period, usually a few sessions. If the child goes back to the adult area after the child appears comfortable to play and stay in the play area, this behavior may be considered attention seeking rather than the need to check in with the parent. Coaching support for “active ignoring” is provided for the parent to avoid responding to the child through conversation or eye contact. Parents are encouraged to continue with their conversation among the adults. Within a few minutes we observe the child starts to look around the room for something else to do and then returns to the play area. The frequency of the child’s visit to the mom’s group decreases over time as there is no attentional reinforcement or reward for this behavior.
When parents tell us that the suggestions are working at home, then we know we have been successful! Brandon’s mom told us that at home they provided a substitute toy for Brandon and although he got upset, it did not last long. He now had something else to play with other than the TV remote. Family members stopped yelling “no” so stress was markedly decreased at home!
When we ask parents what they like about the Achieving Milestones Parent Child Groups they say, “Meeting friends for us!” We hear that even after the group has ended parents continue to get together, which is one of the many goals of parent connections!
As for the progress of the children, changes often occur within one to three months. After three months we noticed Brandon sitting through the entire snack time (10 minutes). He would request “more cracker” and he was singing some of the words to the circle time songs. Brandon no longer climbs onto the table or chair. And Sarah has stopped throwing toys and enjoys pretend play with dolls and a stuffed dog! Sarah has made handprints with finger paints and plays with our home-made playdoh! These are positive sensory, play and social experiences!
Note: Names are changed to protect the confidential nature of the program.
For information, please contact Susan Miron, Director by phone at (914) 922-9333, fax at (914) 922- 9336, or by email at smiron@wjcs.com.
WJCS is an approved provider of EI Services and is under contract with Westchester County to deliver EIP services which are funded and regulated by the NYS Department of Health and Education and in Westchester by the County Department of Health (DOH). Milestones is a New York state program funded by Westchester County. In order to access the EI Program children must be referred to the Westchester County at 813-5094.
Children’s eligibility is established by state-approved agencies that have an active contract with the DOH. Once eligibility is established, the County will arrange for a service provider to deliver approved services. All such services are identified in collaboration with the parent and DOH. Services are provided at no out-of-pocket costs but health insurance will be accessed for reimbursement. If services are delivered in a day care, nursery school or other community setting, the parent is responsible for paying any costs associated with such settings.
Achieving Milestones, a program of WJCS provides therapy services through the contract with the Westchester County Department of Health for children birth to five. For children who do not meet the eligibility criteria or who may be seeking services outside of the WCDOH EI, or School District’s Preschool Special Education program, private pay options are available. Social skills groups are located in New Rochelle, Yorktown and Yonkers. Other services are provided at similar locations and within the home and community.
