This Scribble was scribbled by Annie Bland (Speech and Language Therapist and Chatty Tots Coordinator at TCP). 

Here at the Children’s Place, we run a variety of small groups called ‘Chatty Tots’ to address speech, language and social communication difficulties.

Determining whether a child would benefit from group therapy is a complex process based on the child’s needs, the design and focus of the group and whether they would be a good fit with an already established group. Group therapy may not be beneficial for all children or appropriate at a particular time, but for those children who are determined to be a good fit for one of our groups, there are many unique opportunities and benefits.

Our groups provide an opportunity for children to apply skills learned in the one on one setting to a supported environment with their peers.  Our ultimate goal as Speech and Language Therapists is the generalisation of skills to the child’s natural environments. Small group environemtns can be a great in-between step for a lot of our children who may have accomplished or achieved their goals in the one on one setting but who continue to need an extra bit of support with their skills outside this environment.  Gaining confidence in practising their skills in a group setting can help them to use these skills in other environments outside of our clinic doors.

Groups are also a good way for our children who have difficulties with social interaction or communication to practice and develop skills such as greeting their peers, taking-turns and having meaningful peer interactions. As developing peer relationships is often what is most valuable to our clients with social communication difficulties (and their families), I thought I would share a few ideas on how to facilitate interactions in small groups which is often the first step in developing peer relationships.

Manipulating the environment

Manipulating the environment in the group setting is one of the main ways we encourage interactions in our groups. As the group is often the first step for many of our clients after one on one therapy, creating a supported environment in which children are motivated to interact is often necessary.  The eventual goal is that the manipulation will be faded as manipulating the external environment is not as easily achieved and we want to best prepare our children for their interactions in other environments, such as at home or at school.

To manipulate the environment, we may plan an activity in which a highly motivating toy or game is in another peer’s possession, encouraging the child to request the item from the peer.  We also might choose particular turn-taking games that we know most children will enjoy and that require the children to interact. During turn-taking style games, we may manipulate these even further by taking out parts of the game such as only providing one hammer in ‘Don’t break the Ice’ so that children have to request for their hammer for their turn. We also might choose a game that requires dice or a spinner so that when a child wants to take their turn, they have to ask for that essential game piece from a peer.  Another one of our favourite ways to manipulate the environment is by creating obstacle courses in which one ‘obstacle’ requires a peer’s help (e.g. balancing on a beam or pushing a peer on a scooter) or in which the child has to request an item from a peer such as a piece of a puzzle.

 

Choosing highly motivating items

In our groups, we take the time to determine what is motivating for each of the children so that we can ensure they will be interested in group games and activities and have the desire to interact with their peers. Some children may be motivated by a particular game, while others may be more interested in singing songs or playing  group games such as Duck Duck Goose. For others, it may be particular items, which we can then incorporate into group activities by hiding these items and playing hide and seek where peers have to both give and request clues from each other about where items are located.  It is often when a child is truly motivated and highly engaged that we see more natural interactions begin to occur and is when less prompting and support is required from our SLTs.  Determining each child’s motivation is a crucial part of encouraging interactions among peers.

 

Modelling and prompting

At TCP we have found it very important to both model and prompt children during their interactions in our small groups. Some children may not know how to initiate an interaction or what they could say to a peer when they want to interact. Others may have learned how to do these things, but might not be ready to apply these skills independently in the group setting.  Time is taken to evaluate what each child may need as the type and level of support will depend on the child. Some children respond quickly to an adult or peer model alone while others may need more supported prompting and fading in order to interact with their peers.  We may provide a full sentence verbal prompt of what a child could say to their peer (e.g. “Can I have the apple?”) and then eventually fade this to a single word (e.g. “Can…”) and then maybe just a visual cue (“pointing to a peer with the apple”). How quickly this prompting and fading occurs is unique to each child. We also might simply model an interaction by asking one of their peers “Can I have a turn?” and seeing how the child responds. It is also important to see what our children have learned and can do independently, so we always incorporate a few minutes of free play into our sessions so we can see how peer interactions are developing and make a plan for moving forward.

While the ideas shared above are drawn from our Chatty Tots groups here at TCP, the strategies for facilitating interactions can be implemented in other environments such as at home with siblings or during play dates and can even be shared with your child’s teachers at school to best support your child in their peer interactions.

Please enquire if you think your child may benefit from one of our small groups here at TCP or if you would like any additional reading!