Using Play-Based Interventions to Increase Social and Communication Skills in Children with Autism

Erin Daugherty & Sierra Reuter Author

04/06/2023 Added

24 Plays

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2023 Conference Breakout Session

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[00:00:02.010]So welcome everybody here in person and everybody on Zoom.
[00:00:06.000]Thank you guys for attending today.
[00:00:08.460]My name is Cheyenne Taylor and I am here
[00:00:10.890]to introduce Erin Daugherty and Sierra Reuter.
[00:00:15.060]We are here for the using play-based interventions
[00:00:18.180]to increase social and communication skills
[00:00:20.550]with children with autism.
[00:00:22.980]A little bit about Erin Daugherty.
[00:00:24.990]She is a special ed education teacher working
[00:00:27.420]with various students on the autism spectrum.
[00:00:30.780]She holds a bachelor's degree
[00:00:32.700]in elementary education and special education.
[00:00:35.850]She also holds a master's in autism education.
[00:00:40.050]Erin has had an opportunity to also present
[00:00:43.110]at the 2021 Autism Conference.
[00:00:46.110]Sierra Reuter is a speech English pathologist
[00:00:49.230]serving various students on the autism spectrum
[00:00:52.440]and Sierra also serves on the northeast region ASD team.
[00:00:56.730]So everyone give a round of applause
[00:00:58.770]for both of them, thank you.
[00:01:00.639](people clapping)
[00:01:05.257]Okay, okay.
[00:01:07.590]Okay, well thank you guys for coming in person
[00:01:10.410]and on Zoom.
[00:01:12.270]The title of our presentation is using play-based
[00:01:15.090]interventions to Increase Social and Communication skills
[00:01:18.510]in Children with Autism.
[00:01:20.400]So for the sake of today,
[00:01:21.780]we're gonna talk a lot about autism,
[00:01:23.850]but many of the students in our playgroup
[00:01:26.550]may or may not have autism or any disability.
[00:01:30.450]So this can work for all your learners,
[00:01:32.526]but especially those with autism.
[00:01:39.120]All right.
[00:01:39.953]And before we start today, we're gonna be talking
[00:01:41.230]about four specific students that we do have
[00:01:44.201]permission to show you pictures and videos
[00:01:47.160]and also kind of discuss it too about them personally,
[00:01:50.790]about their experience in the classroom
[00:01:53.220]and also maybe some challenges that they have
[00:01:55.123]and some skills that they have.
[00:01:58.847]So the objectives
[00:01:59.700]of our presentation are to model various types of play
[00:02:03.210]and then also increase social interaction amongst our peers.
[00:02:07.770]We utilize a play-based therapy
[00:02:09.930]to increase their overall communication skills
[00:02:12.660]and kind of taking them a little bit further
[00:02:14.760]than just the basic requesting.
[00:02:18.000]We also use students who had AAC.
[00:02:21.180]If you're not familiar with AAC,
[00:02:23.010]is just another way to be able to communicate
[00:02:25.050]either with pictures or a voice output device.
[00:02:28.260]The four students that we're gonna talk
[00:02:29.640]about today just happened
[00:02:31.740]to all have the exact same system they used PECS
[00:02:35.940]but you can use this playgroup with students with no AAC.
[00:02:41.070]You can use it with high-tech AAC, low AAC.
[00:02:44.070]We were just lucky that all four
[00:02:45.205]of our students were utilizing PECS at the time.
[00:02:51.720]Okay, oops
[00:02:53.480]This is gonna be challenging to remember to stand here.
[00:02:55.920]So you probably already read our presentation summary,
[00:02:58.260]but just a little bit to keep going with what Sierra said.
[00:03:02.100]Individuals with autism
[00:03:03.210]and other communication disorders display deficits
[00:03:06.208]in social skills communication
[00:03:09.360]and these affect their ability to play with their peers.
[00:03:12.719]So through the use
[00:03:14.010]of play we can increase their academic opportunities
[00:03:17.702]social and emotional development
[00:03:19.710]and then a lot of their language acquisition.
[00:03:23.010]So we're hoping today to give you lots
[00:03:24.540]of video demonstrations,
[00:03:27.060]visuals and then we do have some resources
[00:03:29.340]we wanna share so that you can immediately
[00:03:31.920]implement this with your learners.
[00:03:38.070]Okay, sorry.
[00:03:39.990]Okay, so we wanted to look at social skills
[00:03:43.200]and social skills can be a little overwhelming
[00:03:45.300]and maybe a little intimidating
[00:03:46.500]because it's such a wide range of skills.
[00:03:49.650]So we kind of took the time to observe our students,
[00:03:52.980]what was their current level
[00:03:54.720]and what were they having challenges with
[00:03:57.000]but then also where did they have a strong point?
[00:03:59.160]How could we take their strong skills
[00:04:01.230]and generalize them into helping them
[00:04:03.210]with the areas that they're having difficulties with?
[00:04:05.880]So where did we start and what skills did we target?
[00:04:09.540]In the past, we had worked with a wide range.
[00:04:12.630]So we both serve in elementary, I work with kindergarten
[00:04:16.530]through fifth and Miss Daugherty works
[00:04:19.110]with kindergarten and first.
[00:04:21.120]So we in the past had worked with the social group
[00:04:24.150]with video modeling and we had one kindergartner
[00:04:27.990]one fourth grader, one third, one fifth.
[00:04:29.910]So it was a wide range.
[00:04:31.590]So then we wanted to kind of take a step back
[00:04:34.170]and this year we had a lot
[00:04:36.090]of kindergartners and first graders.
[00:04:38.460]So we wanted to work on a natural play environment
[00:04:42.330]because we are getting a lot of comments
[00:04:43.710]from teachers like our student will play,
[00:04:46.141]but they'll play next to their peers or they won't interact
[00:04:49.710]with their peers or if they want to play
[00:04:51.870]and they might just kind of like stand next to their peer
[00:04:54.930]but they weren't sure what to do.
[00:04:57.432]So how could we kind of go
[00:04:59.700]past the comment or the requesting and work on advocating
[00:05:03.206]and maybe interacting and engaging with those peers?
[00:05:08.280]Yes.
[00:05:09.113]And piggybacking off that, we also had lots
[00:05:10.470]of parents when you bring up concerns at IEPs and be like,
[00:05:13.338]I just really want them to have friends,
[00:05:15.120]I really want them to play with other people.
[00:05:18.180]So that's where we got the idea
[00:05:21.690]and then we looked
[00:05:22.523]at some research so we won't get into a lot of research,
[00:05:25.680]but just know that play is very research based.
[00:05:29.220]So we kind of listed some of the studies that we looked
[00:05:31.950]at and kind of based our playgroup off of.
[00:05:34.350]And then we also, like Sierra said before, use PECS.
[00:05:37.680]So we use a lot of information from the PECS manual
[00:05:43.020]and we do have it cited at the end if you're really curious.
[00:05:47.190]So lots of benefits of play.
[00:05:49.920]So play is very important.
[00:05:51.750]Your pretend play skills help you develop fine motor
[00:05:55.260]and expressive skills.
[00:05:56.759]They help shape your cognitive development,
[00:05:59.550]your social development, emotional language development.
[00:06:04.740]So when students don't have these play skills,
[00:06:07.620]that leads to them being more rejected
[00:06:09.780]by their peers 'cause they don't
[00:06:10.890]know how to appropriately play with others.
[00:06:15.150]I know we talked, or we went to the session on,
[00:06:18.450]what was it like peer, peer approval.
[00:06:20.910]Oh yeah.
[00:06:21.743]Anyway, and a lot of things she was saying,
[00:06:23.550]I'm like that's what we wanted to accomplish
[00:06:25.590]in our playgroup.
[00:06:26.423]Like how to make our kiddos more accepted by some
[00:06:29.640]of their peers and how to like teach them some play skills.
[00:06:34.290]We also looked at a lot of research that just stated
[00:06:36.480]that communication develops quicker through play
[00:06:39.750]because it's naturally developing and naturally occurring
[00:06:44.490]and it's less demandful than like sitting at a table
[00:06:47.865]and teaching other skills like teaching colors.
[00:06:49.470]You're playing and you're learning your colors.
[00:06:52.560]And you're really following their lead.
[00:06:54.570]So they get to take the role and they get to be in charge.
[00:06:57.630]And when you're spending all day
[00:06:59.340]in school being thrown tasks
[00:07:02.280]and you're kind of just exhausted.
[00:07:03.630]So we take the opportunity to let them do what
[00:07:06.030]they want to do
[00:07:07.230]and then we just kind of mold the opportunity
[00:07:09.201]to kinda naturally create the opportunity
[00:07:13.590]to expand their length of utterances and playing.
[00:07:19.650]Okay, so there are types of plays that we looked at.
[00:07:23.430]There are a lot
[00:07:24.263]of different types of play, but these are kind
[00:07:25.800]of the ones that we were seeing our students do.
[00:07:28.530]So solitary play was we, the students playing alone,
[00:07:31.590]they have no interest of playing
[00:07:33.060]with the same toys as their peers or even with their peers.
[00:07:36.570]An onlooker.
[00:07:37.590]We had maybe two students
[00:07:39.450]in this playgroup that were on the onlooker stage.
[00:07:41.730]So they were watching other children play,
[00:07:44.147]they were interested but they just weren't sure
[00:07:46.920]that they wanted to join them quite yet.
[00:07:49.350]And then I think I'm getting feedback
[00:07:51.810]and then parallel play is playing alongside of the children,
[00:07:54.870]but you're not quite interacting yet.
[00:07:57.090]Sorry, Gabby.
[00:08:00.570]And then another stage is playing
[00:08:03.270]with related objects and acting
[00:08:05.640]with other children but not directly playing with them.
[00:08:08.880]And then our end goal was hopefully
[00:08:10.560]that our students would feel encouraged
[00:08:12.241]and want to play with peers
[00:08:14.400]and utilize the same toys and interact with those peers.
[00:08:21.540]Perfect, so there are lots of ways
[00:08:24.300]to incorporate play in your day.
[00:08:25.920]So video modeling, we used to do a lot of video modeling.
[00:08:29.280]So videos of kids playing
[00:08:30.810]with toys are showing them how to ask to play.
[00:08:34.230]Task analysis for like how to set up a train track.
[00:08:38.160]Visuals for how to play with different activities.
[00:08:42.300]The sake of the rest of our presentation
[00:08:44.130]and what we did is a structured playgroup.
[00:08:46.980]But like I said, there's no wrong way to play.
[00:08:48.930]Just play.
[00:08:54.900]Okay.
[00:08:55.890]Yep.
[00:08:57.960]All right, so like I was saying in the beginning,
[00:09:00.150]all of our students in our playgroup
[00:09:01.830]happen to be utilizing PECS.
[00:09:03.840]If you're not familiar with PECS,
[00:09:05.100]I'm not gonna go over the stage.
[00:09:06.360]But it's very specific in how you implement it.
[00:09:09.570]We both are very familiar with PECS.
[00:09:11.520]So it was nice to have someone that could assist
[00:09:14.160]with like the backstepping
[00:09:15.540]and prompting and just those cues.
[00:09:18.030]If you're not familiar with it, don't worry about it.
[00:09:20.010]You can also work with your SLP
[00:09:21.570]or reach out to someone for training in that area.
[00:09:24.120]But again, you don't have to use PECS,
[00:09:26.340]you don't have to use AAC.
[00:09:27.630]You can just have students that need to work
[00:09:29.790]on their social skills or increasing their language output.
[00:09:34.560]So our first student that we're gonna talk about,
[00:09:36.780]her level of play was parallel.
[00:09:39.180]She would frequently play with the same toys
[00:09:41.460]but she would maybe go to a table,
[00:09:43.170]like she would take those toys
[00:09:44.400]from the peers and then go sit at a different table.
[00:09:48.240]Her level of communication,
[00:09:49.680]she was at the typical requesting, so "I want an object."
[00:09:53.760]And that's usually where she was at.
[00:09:55.650]So she wasn't commenting, advocating,
[00:09:58.230]interacting with peers.
[00:09:59.370]It was just, I know communication gets me something I want.
[00:10:03.540]And then some classroom observations that we were seeing,
[00:10:06.390]but also teachers were saying,
[00:10:08.070]that she was really having difficulty being aware
[00:10:10.446]of social engagement with her peers.
[00:10:14.340]So when peers were, they wanted to engage with her,
[00:10:17.220]she would frequently ignore him and walk away.
[00:10:23.490]Student number two, he wasn't interested in playing
[00:10:26.640]with other peers or playing with the same toys.
[00:10:29.070]And in fact, he wasn't sure how to play with toys.
[00:10:33.696]He had never seen like a baby doll
[00:10:35.310]and didn't know what to do with it.
[00:10:37.110]Or like we had a race car track
[00:10:38.970]and he wasn't really sure how to use the cars on the track.
[00:10:43.990]He had no past experience with any type of AAC.
[00:10:46.749]So we introduced PECS
[00:10:48.450]and then he also was not using any verbal communication.
[00:10:51.660]So he was pre-verbal.
[00:10:53.370]So he really had some difficulties in the classroom.
[00:10:55.680]He wasn't able to advocate requests or interact with peers.
[00:10:59.280]And then he had a lot of limited function of toys.
[00:11:02.466]So in the winter we have a lot
[00:11:03.810]of indoor recess and he didn't know what to do.
[00:11:08.070]Even like during the summer or like the hot
[00:11:11.160]nicer weather, he would frequently try to sneak
[00:11:13.890]into my room instead of going to recess,
[00:11:16.024]'cause he didn't know what to do at recess.
[00:11:20.460]Student number three was what we called the onlooker.
[00:11:24.120]So he was very curious what his peers were doing
[00:11:27.960]and he would typically kind of just stand by him and watch.
[00:11:30.870]But he would wait for that peer to ask, hey, you wanna play?
[00:11:34.350]Or here's a toy you can play with it like this.
[00:11:37.860]He also had no past experience to any type of AAC.
[00:11:41.880]He had maybe about 20 words in his verbal vocabulary.
[00:11:47.520]And then some classroom observations also included
[00:11:50.349]that he wasn't independent or spontaneous
[00:11:53.220]with his interaction with teachers or peers.
[00:11:56.460]And then he had very limited social awareness.
[00:12:00.096]So he had it very difficulty accepting change.
[00:12:03.390]So if he wanted the orange Play-Doh
[00:12:05.520]and someone else had it, it was a very difficult
[00:12:08.310]for him to accept I don't get Orange Play-Doh today.
[00:12:11.040]And that threw off his whole day.
[00:12:15.690]And then our last student that we had,
[00:12:19.320]he was probably more experienced with the social side.
[00:12:23.730]So he was interested in playing with the same toys,
[00:12:25.860]but he had difficulty interacting with the peers.
[00:12:28.890]Sharing was very hard for him.
[00:12:31.080]If you had a toy I want,
[00:12:33.510]I'd would come over and take it.
[00:12:34.590]I didn't understand that we could play together.
[00:12:38.220]He was independent on PECS, he was requesting,
[00:12:41.580]he would sometimes make comments,
[00:12:44.340]but it was usually with staff.
[00:12:45.900]He would go up to the staff
[00:12:47.400]and talk to them and say, "Hey, Billy has that toy I want."
[00:12:51.210]Okay, well go tell Billy.
[00:12:52.718]Go interact and play with Billy.
[00:12:56.700]Perfect.
[00:12:58.470]All right, so we have our students now what?
[00:13:01.800]How did we start?
[00:13:02.760]Where do you go?
[00:13:03.593]What do you do?
[00:13:04.680]So we started off with observing.
[00:13:06.960]Let them go play,
[00:13:08.340]see what they kind of gravitated towards.
[00:13:10.560]And then we would pick our vocabulary based on that.
[00:13:13.560]So we wanted to make sure our end goal was generalizing.
[00:13:17.160]'Cause right now we're in the special education classroom.
[00:13:20.610]Well, yeah that's great.
[00:13:21.960]We're teaching skills.
[00:13:22.980]But how do we take those skills and then put 'em
[00:13:25.710]towards the classroom, indoor recess, bringing them home,
[00:13:29.220]letting them play with their siblings,
[00:13:31.320]going outside, going to birthday parties,
[00:13:34.230]how do we get them there?
[00:13:36.150]So we started with a very structured environment.
[00:13:39.780]We started with the communication wall
[00:13:41.970]and those are key pictures that we have velcroed
[00:13:45.540]onto the plate and then they can take 'em
[00:13:48.000]off and put 'em on their own sentence trip.
[00:13:50.400]They all had their own communication book
[00:13:54.190]because this isn't going with them
[00:13:56.040]into the classroom and this isn't going with them home.
[00:13:59.250]So we wanted to make sure they understood,
[00:14:01.230]I can use my visuals, I can use my voice
[00:14:03.360]I can use anything to communicate.
[00:14:06.840]Right, so we did an adult modeled playgroup.
[00:14:10.650]So we would model everything.
[00:14:13.470]And we used this procedure to increase cognitive,
[00:14:15.990]social, fine motor and communication skills.
[00:14:18.660]So what I think is fun about the rest of our presentation
[00:14:20.880]it's just like it's what we did, it's what worked.
[00:14:24.720]So we're not claiming to be like super experts at this,
[00:14:26.627]but it is, we did get some really good results.
[00:14:29.550]So we kind of wanted to just come
[00:14:30.690]and share it with everybody.
[00:14:32.520]So hopefully you see that too.
[00:14:36.390]Our next video, we did a lot of adult modeling.
[00:14:39.810]The problem with that was it's really hard
[00:14:41.310]to take a video of us playing.
[00:14:43.890]So we don't have a ton of videos of this,
[00:14:45.480]but just know that that's how we got the results we wanted.
[00:14:47.820]A lot of like Ms. Reuter, this cow says move
[00:14:50.850]and then like just a lot of,
[00:14:52.350]we played and then taught them how to play.
[00:14:55.440]So an example.
[00:15:02.393]Dear mama.
[00:15:04.691]Ms. Daugherty.
[00:15:06.638]Pass me the ball.
[00:15:10.782]Throw me the ball.
[00:15:16.590]So in this video you can see that
[00:15:20.970]We're over animated, we're excited, we're playing.
[00:15:23.790]And then we modeled what it would kind of look like.
[00:15:26.250]Hey, pass me the ball.
[00:15:27.960]And they're all like, oh, pass me the ball.
[00:15:29.610]I want it too.
[00:15:30.510]So some of these videos are from,
[00:15:32.460]they've been in playgroup for a while,
[00:15:34.170]but you're also gonna see videos
[00:15:35.520]from the beginning of where they started.
[00:15:38.190]But this one, after I caught the ball,
[00:15:41.580]I kind of just stood there really awkwardly and I waited.
[00:15:44.430]We kind of get in the habit of I know my student,
[00:15:47.160]I know what toys they like, I know what they want.
[00:15:49.740]They like red Skittles.
[00:15:51.210]Okay, they don't have to ask.
[00:15:53.790]We want them to not become prompt dependent
[00:15:56.910]and wait for us to say, what do you want?
[00:15:58.560]Oh you want a red Skittle?
[00:15:59.460]You like the red Skittle?
[00:16:00.293]I know you like the cars.
[00:16:01.680]So I waited.
[00:16:02.790]It's really uncomfortable and it's awkward,
[00:16:04.650]but it creates them to be independent
[00:16:06.390]and initiate that request.
[00:16:11.670]So like Ms. Reuter talked about,
[00:16:14.370]we picked themes for the week.
[00:16:16.440]That's something we learned that we had to do early on
[00:16:18.368]after the first day when we just kind
[00:16:20.280]of gave them all the toys and some kids went to the kitchen,
[00:16:22.890]some kids went to the race car like okay,
[00:16:24.690]so we have to narrow this to provide
[00:16:26.687]some specific vocabulary.
[00:16:30.780]So we're gonna just talk
[00:16:31.830]about some of the themes that we did.
[00:16:34.080]So the first thing that we did a lot of was board games.
[00:16:37.350]So so many skills can come outta playing board games.
[00:16:41.190]So cognitive skills.
[00:16:42.540]We worked on counting.
[00:16:43.710]We worked on one-to-one,
[00:16:45.426]we worked on our colors in Candy Land.
[00:16:49.416]And you can incorporate so many other
[00:16:50.370]like sight words and other skills into board games.
[00:16:53.070]But still having fun and playing
[00:16:55.290]and then lots of fine motor skills.
[00:16:57.210]You'll see that in a couple other slides.
[00:16:59.340]Putting the pieces on the board
[00:17:01.320]and holding cards and things
[00:17:02.970]that took us a long time to figure out how to manipulate.
[00:17:07.360]Okay, and then there are tons of opportunity
[00:17:10.890]for communication and social skills.
[00:17:13.470]Board games are very difficult
[00:17:14.910]because I have to wait, I have to take a turn.
[00:17:17.100]I might not win and I don't want to lose.
[00:17:20.790]I might not get the red game piece.
[00:17:22.740]So being able to work on those skills
[00:17:26.880]turn taking self-advocacy.
[00:17:28.770]Hey, you got to go first yesterday.
[00:17:31.080]Do you think I could go first today?
[00:17:33.000]Or hey, we played High Ho Cheerio today
[00:17:35.280]and I would really like to play shoots and ladders tomorrow.
[00:17:38.190]You think we could maybe switch it up a little bit?
[00:17:41.220]And then really expanding on the length of utterance,
[00:17:43.560]going past that typical requesting working
[00:17:45.960]on commenting, throwing in adjectives
[00:17:48.450]and position words.
[00:17:51.000]Yeah, and I think what was fun about me being the teacher
[00:17:52.979]and her being the SLP is like I was really worried
[00:17:55.860]about games that had the cognitive pieces
[00:17:57.900]and the fine motor pieces
[00:17:59.280]and then she would find activities that had
[00:18:01.260]the social skills and communication
[00:18:02.580]and we just made it work and it was a lot of fun.
[00:18:06.630]So hi ho Cheerio.
[00:18:09.180]The OT came into our room one day
[00:18:10.848]and we were playing this and she was like, this is fabulous.
[00:18:12.720]I'm like, yeah, the little tiny cherries
[00:18:14.580]on the little tiny tree.
[00:18:16.260]Also, Abby, this one is your game still.
[00:18:17.910]So if you want it back
[00:18:18.810]it still says fists are on the side of it.
[00:18:24.836]And his little card says "I won" on it.
[00:18:28.140]So just some specific vocabulary.

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Using Play-Based Interventions to Increase Social and Communication Skills in Children with Autism

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