Abstract

Children with autistic characteristics need special considerations when helping them develop socially-appropriate behaviour. This article describes the careful planning and resulting success of using play groups to help students develop social and communication skills.

Background to Research:

Meet Natasha. Natasha is an eight year old young girl with autistic characteristics. She is intelligent. She can remember and type the credits from movies she has watched. She loves the computer and can take us places we haven't been (and may not want to be). On a good day she will come and join us during free time. She is a charming child who tries very hard to meet our expectations. But she doesn't understand what we want. She doesn't even understand that what we want can be different than what she wants. She doesn't understand why we are behaving the way we are and she doesn't understand that communication with us might help her. That's scary for her. And when she's scared she screams.

Meet Nathan. Nathan is a four year old boy who is autistic. He likes to talk when he's happy. He loves trucks and trains. He's learning to read and enjoys making silly sentences with the words he knows. He is termed a "high-functioning" autistic child. He doesn't like changes of any kind. He doesn't understand that school wants him to do things that he doesn't want to do at that time. He isn't spoilt. He really doesn't know our minds aren't identical. So he doesn't understand why we are doing what we do. And when he doesn't understand, he screams. It's easy to think he should know better. After all, at times he seems quite "normal". But my readings pointed out the danger of overestimating the ability and underestimating the needs of high functioning individuals with autism. Janzen states, "The effect of autism can be every bit as debilitating in any situation which requires social knowledge or skills. The more subtle the skill that is required, the more debilitating the effect." In fact Janzen warns us to not down play those with "high functioning" autism as to do so "sets up unrealistic expectations and endless disappointments"(Janzen, 1996, p.10)

Two very different children are in my class. Both are like the little boys in the old nursery rhyme. When they are good, they are very good, but when they are not they are... difficult. While I see the loving, pleasant side of both, the side that others notice and remember are the screams. I joined the research group hoping that I would discover and could learn to teach these children the skills that they needed to fit successfully into integrated classes so that others could see them as I did. Our schedule suggested almost daily readings from Janzen's book, Understanding the Nature of Autism. Each time I read I saw one of my students in the pages. Very early I noted in my journal, "For ages 've been learning bits and pieces of autism. This book gives an underpinning support to those bits I've learned, organizing them and presenting them in a way I can more specifically identify and understand" (Journal, 03/01/12).

After a few weeks of journaling, discussions and readings (especially in Janzen's book ) I began to gain an understanding of the very special learning characteristics of these students. Each time we met as a research group we shared how our students were reflected in our readings. The individual stories and discussions of successful and unsuccessful strategies clarified and connected my understanding to my everyday experiences. With the understanding came excitement and frustration, excitement because there are strategies (very different from "normal" teaching strategies) that will successfully support these children and frustrated because I kept discovering I was using the wrong ones. Each morning I would greet the Educational Assistants (EA's) with a "Guess what I discovered we should be doing?" Although they are very patient and willing to try new strategies even they began to threaten to hit me with the book. There was so much I was learning, and so much I wanted to share. On Feb. 5th I shared with the research group that I thought my focus for the research should be how could I teach these children the social skills they needed to integrate successfully into their peer class. By Feb. 17th I began to think I had it backwards. Rather than teach the children I needed to look at the specific supports the autistic child needed in the average classroom. But as I worked each day trying to use everything I had learned, creating supports for the situations that arose, I began to realize that it was impossible to design a list of supports that would meet even a part of the specific needs a teacher would need. I wrote in my journal,

Trying to explain to Andrew (my husband) what I feel. I think the most important concept we need to explain is that an autistic child is naturally compliant and wants to socialize. If we look at their actions from that point of view then we're not trying to stop the "bad" behaviour" -we're trying to discover what they are trying to communicate. Then I think we could get somewhere. If the adults around the child don't get that, then it doesn't matter what supports we put in place, they will fail. What a difference it would make with the child's interactions. Monday I told some students who were complaining about Natasha knocking down their snow fort that she wasn't trying to be mean, she didn't know how to play and they could show her. They were surprised, but cooperative. How much have we influenced the other children into seeing her as a child with "bad" behaviour" that we can't control, instead of someone like them who wants to play? How can I help Nathan's class accept him? Maybe I could make a social story for Nathan's class. How can I hope to capture the idea and put it on paper? I think that would be the biggest contribution (Journal, 03/02/25).

We use social stories a lot in the classroom, but they really aren't designed to meet that kind of need and I knew it. I watched for similar situations on the playground where I could "turn around" a problem by "educating" the peers to provide supports. But the hit or miss method wasn't adequate. Two days later I wrote an aside in the middle of my journal entry, "If I want to increase Nathan's ability to interact with others do I want to chose a small play group to come to our room and play with Nathan" (Journal, 03/03/02). I really didn't want to. I liked clearly defined, controllable activities. How could letting kids play together help- and how would I get them to play together? Where would you begin? The first of March I began to research play groups on the internet and in the library. I discovered play groups were far more than letting kids play. Everything was carefully researched and planned, the goals, the structure of the activity, the type of supports, who made up the group and each person's role, the strategies they should use and how they should be trained. Unfortunately no one source provided what I wanted- a detailed recipe guaranteeing success. Then I had a real reason to procrastinate. I wrote in my journal, "I'm not a detail person and the play group takes so much detail I'm afraid I won't have it all right before I start. I'll have to explain to the EA's that this is a process not a finished product (Journal, 03/03/30) I was making excuses before I started. But the day of reckoning was coming. Our writing day was scheduled for April 3 and I had to at least get started so I plunged.

Research Process

I began by compiling the information that I had found in my research and on March 31, an early dismissal day, I met with the EA's and the kindergarten teacher in whose class Nathan is integrated. I presented the information I had gathered on play groups with the rest of the play group team and planned the actual details.

Philosophy behind Play groups

Autistic children lack play skills and are seen as isolates not interested in play as their attempts to join are subtle. In September I noticed that during recess Nathan would sit near peers who were playing in the sand pit with cars. He appeared not to watch as he ran his truck back and forth, but each recess he would return to an area by them. They are also seen as deviant as their attempts to socialize are clumsy and ill-timed when they do attempt to join. An example is when Natasha wrecked snow forts built by other students. There are two types of deviant behaviour: skill acquisition deficits and performance deficits. In skill acquisition deficits the skill is absent. In performance deficits the skill is present but not used. Autistic children, due to their unique characteristics have skill acquisition deficits. Schools usually classify deviant behaviour as performance deficit and promote correction strategies to increase the wanted behaviour and decrease unwanted behaviour. The methods used to increase wanted behaviour do not work with autistic children because you cannot increase what isn't there. They really aren't trying to be difficult- they don't know what you want them to do or how to do it. The methods used to decrease unwanted behaviour ( When you stop screaming you can listen to your tapes) don't work because, for the autistic child, with their special learning characteristics, it links the unwanted behaviour to a reward through a learned routine (Oh, if I scream, then stop, I get to listen to my tapes whenever I want).

Children with autism learn routines quickly and in play groups the needed communication and social skills are taught as part of a functional and natural routine Since the skills are not taught in isolation they are more easily generalized. The "interaction-orientated prompts and natural environmental tactics allow the child to develop control over communication and to be less dependent on direct intervention from adults." (Musselwhite, C.R., 1986 p.29-30)

Types of Goals

There are many resources available to help teachers select appropriate goals. This was one area where each resource had an opinion slightly different than everyone else. They ranged from simple categories to extensive lists and covered every possible skill that is needed for communication and social interactions. (Attwood and Gray, 2002, p.16; Musselwhite, 1986, p.85; Janzen, 1996, p.337; McGinnis and Goldstein, 1997, pp.91-150) Basically the experts identified three types of goals: Communication goals, social goals and self-management goals, all areas of need for the autistic child. Even with my weeding and collaborating of lists I came up with a possible fifty goals, an overwhelming number of choices. In the middle of the myriad of suggested valuable goals was one warning that it is "important that teachers select goals that will make a difference in the child's life (rather than merely being simple to implement and record)."(Musselwhite, 1986, p.30)

With that in mind the play group team discussed which goal to pick for each play group. We had completed Kathleen Quill's Assessment of Social and Communication Skills Inventory (Quill, 2000, p.54-61) for both children so we had a recent assessment of their level of social and communication skills. I had thought we would pick a goal in the communication area, but the group felt that the social goal, "How to join and accept others in a group" made more sense. As Louise put it, "After all it is a play group. If they're going to participate they have to join the group and accept another child" (Personal communication, 03.03/31). Both children would play with adults, but were not playing with peers voluntarily so it made sense. I had thought of choosing just one goal, but a second goal, sharing resources and turn taking, was so closely connected that we added that one as well.

Composition of group

Our play groups were comprised of three different individuals, the autistic child, the peer and a facilitator. The autistic children, of course, were already chosen by virtue of being in my class. They met the qualifications of having "learned to value interactions with an adult" and to "tolerate structured play with a peer" (Janzen, p.341) in a short, closed end activity with lots of adult support.

The peer would take more careful selection. Before I had researched play groups I had thought to double the mileage of the group by choosing peers who also would benefit from practice with social and communication skills. However, the list of characteristics for the peer is specific and fairly extensive. They should have age-appropriate play skills, be socially active as play partners, have good receptive and expressive communication, be reliable in following instructions, have the ability to attend for fifteen minutes, be willing to participate and have parental permission, have good attendance and academic record, have an absence of negative history, be popular with peers and, if possible, have similar interests. Nathan's peer shared a love of cars and trucks. It was more difficult to specify Natasha's interests so the two girls we chose had broad ranges of interest including active past times.

After selection and permission received, the peers would need some training. Again the amount of training suggested varied. One researcher actually conducted sixteen training sessions consisting of watching videotapes, discussions, role-playing, worksheets and play practices.(Choi, 2000) That extreme was not feasible. In fact I couldn't really see training the younger peer in any formal way as he was only four. I decided to have the facilitators guide him as necessary. The older peers would need some guidance ahead of time and after the March 31st meeting I made a list of what I felt were the most important things they needed to know as they participated in the group. I wanted them to be natural, but to use less language and more gestures. I also hoped to show them how to use parallel talking, describing what they were doing as they did it to help their partner understand the process of the activity and point out the natural cues to attend to. Above all, I wanted the peer to realize the need to be patient and unalarmed by my student's reactions.

I wanted all of us to be able to be facilitators although I knew that the majority of the time it would be one of the EA's, Laurel or Louise. Many of the skills needed by the facilitator were ones that we were already trying to practice as a result of reading and study on the research team. Again, the research on play groups gave a very specific description of the facilitator's role. They interpret verbal and non-verbal interactions for both their student and the peer. They are always working towards increasing the child's independent response to natural cues. Autistic children, because of their inability to pick out the significant stimuli in the environment, do not focus on the natural, important cues. Facilitators are supposed to prompt, but in a way that points out natural cues. This was an area where I had been weak, often supporting the child with my cues, a process which ended up with the child being more dependent, not less dependent on me. Reflecting on my readings in Janzen's book I had written, "I just begin to think I know something-I read some more and realize how little I know. I'm not sure I'm using natural cues and prompts in the most effective way. I tend to use extra prompts" (Journal, 03/02/02). I didn't have a clear picture of what was meant by "natural prompts" and at the Feb. 5th meeting of our research group I shared my lack of confidence in this area . Alan clarified it this way, "When T. yells at R. , 'Don't look at me! He's looking at me teacher! I don't want him to look at me!' and R. stops- that's a natural prompt. If you say, 'R. Doesn't like you looking at him. Stop,' that's not a natural prompt."(Personal conversation, 03/02/05).

The facilitators use parallel talking to bring attention to social cues such as body language. ("Mary is smiling. She's happy that you shared your toys with her.") Reflective listening is used to help when the student is anxious. ( "You look worried. Your toy fell on the floor. Are you afraid you have lost it? (Pause) You can say, 'Help me find it.'") They gradually lessen the support that they give.

At the same time the facilitators must monitor the interactions for many reasons. While the ability to learn routines quickly is a strength of autistic children, it has a flip side. We had learned through experience that anything done in the same way twice became part of the child's routine whether it was a functional part or just rote. One of the problems was if we supported in the same way twice that became as much of the routine as the functional part and the child could not go on to the next part of the routine without our nonfunctional intervention. As well as being very frustrating it certainly did not help the child develop independence. Therefore one of the most important things to monitor was the development of rote routines. The facilitators also had to watch for ways to expand the activities for next time, assess the correct moment to end the activity so that the child was stretched but not pushed too far, and assess the activities to guide the teacher and facilitator in making changes required to ensure skill growth. I had found examples of several forms to help with the last task, but the play group team judged them as too detailed and they were afraid that too much attention would be taken by filling out the form. In the end we developed a very simple tally sheet for targeted behaviours with a space for additional comments. While keeping all of the above in mind Janzen concludes her list of the facilitator's role by warning that what the facilitator does not do is dominate , ask questions looking for specific answers or give "intrusive" reinforcers such as "Good talking" (Janzen, p.340) It seemed like a daunting role, but the process would be a learning one for us as well. Fortunately we are a close knit team and the mutual support and respect we share enabled us all to attempt the process.

Preparation

Having discussed the methodology of play groups the EA's and I proceeded to plan the specifics. While I had a basic plan in mind, working as a group to discuss the details meant that potential problems were identified and missed details were caught. We chose a symbol to represent the play group time, made small ones for the children's schedules and large ones to mark the play area as we moved it. We set up a bin system that would hold the individual activities and arranged a permanent place for the bins to be stored. We decided on a area in the classroom that could be designated clearly with coloured tape as the floor play area. We chose a time for the group which would enable us to remove most, if not all, of the other children from the room so there would be less distractions. We discussed a visual support system that would enable the child to eventually follow the routines independently. We planned the use of simple stick figure visuals to introduce the activity each time. We discussed the use of a "play book" to summarize and record for each child the events of the play group. The most difficult part was the choosing of the activities. We needed several as they had to be varied, interesting, purposeful, balanced in type (not all sorting) and ones that would encourage the development of the targeted skill. It was suggested that the activities should be structured with a clear beginning and ending. Board dice games are easy to introduce in the classroom and are of interest to most children. But these kinds of games have no obvious purpose for the autistic child and therefore have little attraction for them. We weren't certain what activities would increase their stress level to an intolerable level so this made us extra cautious. As well we had to be careful not to choose an activity that would be a very high motivator, such as putting together a train track and running a train around it for Nathan, as that would be too difficult to share. We also had to remember that the structure of the activity is to support the autistic child. It is not the focus of the activity. The child's acceptance of a peer as play mate and interaction with them is the focus and the activity must serve that purpose, not replace it. In the end we came up with a few possibilities for each, based on what was of interest to them. Some were activities we hadn't done with them and as they should be ones that the child understands and has done individually with an adult first, they became the basis of their activities outside of the play group. The exercise made me examine the type of play and social activities I planned for these children each day. It was all too easy to schedule familiar ones that I knew would meet little resistance. Again the play group affected my planning for the rest of the day.

We now were ready to begin. We had our permission '' parents. We introduced the "play book" through another activity and made the decision to start with Nathan.

Nathan's Play Group

Our first day was April 4th. The play group began by fulfilling Murphy's law- whatever can go wrong, will go wrong. Prior to the play group Nathan had been in the kindergarten room for music. The plan was that Natasha would be out of the room for gym. She had just begun changing for gym and the new process was usually accompanied by a lot of loud agitation. I would have the rest of the older children in the library to do their work. A support person had phoned earlier and asked if he could come and observe Nathan that day. I had agreed, but stated that it must be before 10:50 or in the afternoon. I didn't want any distractions. The toys needed for the activity were in two bags, half for Nathan and half for Aaron so they had to share, in the play group bins. Everything was covered I thought. There would be a calm, quiet, empty classroom with no distractions for Nathan to begin this new process.

Music ended early. Nathan returned to the classroom with Aaron. Natasha was protesting loudly. The other students weren't finished their activity and I didn't have the supplies needed for the next activity gathered. I hurriedly gathered the supplies and directed them across the hall to the library. The library (which I had booked) had another class in it and they came back- loudly. I quickly talked to the teacher in the library and agreed to use her room. Nathan's facilitator bravely began. As I again lined up the rest of the students, who were of course by this time quite excited with all the activity, I saw the support person coming in. I quickly sent a message to the office telling them to redirect him to my group and moved out of our class with little hope that Nathan would participate at all in the play group after that beginning.

Forty minutes later I returned with my group, and the visiting support worker to our classroom for lunch. I stood in the door to talk with him and turned to ask how the play group had gone. To my surprise Nathan was sitting with Aaron eating lunch. The facilitator's report described what had happened:

"After showing him the new calendar sign and the area where the play group would take place we went over the little story card (describing in pictures the activity) with them. They took the bins and quickly began to play. The task was to make a corral for the horses. They had blocks and one dump truck and two horses. Nathan started to build by himself and we redirected him to play with his friend. The boys were good about staying in the marked off area. After they had completed the task they began on their own to play horse and horse doctor. They communicated with each other and seemed to enjoy each others' company. The boys played together for twenty-five minutes. When the timer went off to indicate play group was over Nathan asked if Aaron was going to stay with us. Prior to play group Nathan had been invited to watch a short video in the kindergarten room. When I said Aaron was going back to kindergarten, but Nathan was also welcome to go he readily went. Nathan stayed in the kindergarten room until lunch time (approximately ten minutes). Mrs. Purins said it was time for lunch and Nathan asked me if Aaron could eat lunch with him. I said that would be fine but he needed to ask Aaron. When Nathan asked Aaron he was happy to join us. I also had Nathan ask Mrs. Purins if it were okay for Aaron to eat in our room. The boys ate lunch together and also played outside for the noon recess together. To sum it up play group was a success" (03/04/04).

The tally sheet showed that during the actual play group Nathan had initiated contact four times and had replied to Aaron's contacts either through an action or a statement four times. Most of the statements were directly related to the activity. Both boys had made one "social" comment. Nathan had obviously accepted Aaron and had shared the resources so the temptation was to immediately choose more advance goals. The play group team discussed the idea and concluded that one success did not guarantee continued success. We decided to continue with the same goals. As goals become established the research on play groups suggests that the facilitator sabotage events by causing a problem which the children must solve together to complete the activity. The play group team decided that after we were certain the goals were reached we would "sabotage" the activity before going on to another goal.

During the next play group on April 8th the frequency of interactions stayed the same and they were all directed to the activity. The children were taking turns outside using a plane launcher. At one point Aaron ended up with Nathan's plane, a situation to which he always reacted strongly- yelling and even physical protest. Here was a natural sabotage. That enabled the facilitator to prompt him to solve through asking, not just protesting. As the play groups continued the interactions increased and adjustments were made. During third play group on April 10th the facilitator prompted Aaron to ask Nathan to his room for lunch. Nathan agreed, but when he reached the classroom he expressed the desire for Aaron to return with him to our room. The facilitator was able to encourage him to stay on the condition she stay. She did, but kept her distance.

We decided to work towards Nathan staying in the kindergarten room without a facilitator for lunch. This necessitated the development of a system which he would use to indicate that he was returning to our room when he felt it necessary. (It isn't always possible to immediately get the teacher's attention and if Nathan feels he needs the safety of our room because of increasing pressure he needs an easy, reliable routine.) Nathan's tendency to turn to the adult for help was noted on April 14th and we began emphasizing the need to seek help from the partner. On April 16th we decided to use an activity which we had not had time to introduce beforehand. Louise reported, "Nathan had to keep coming to me to know what to do because he had not done that activity before. We shouldn't do it that way. It defeats the purpose." (Journal, 03/04/16) Generally the interactions between the two boys increased and Nathan took a bit of the role as leader. Louise noted on April 22nd that being removed from the distractions of the classroom and having to deal with only one peer enabled Nathan to communicate with Aaron on level similar to his communication with us. (Journal, 03/04/22). She also noted at the same time that when another child attempted to join, Nathan would not allow it. So we decided we would need to increase the group. (Personal communication, 03/03/22). Again this is not a quick process. The choice of the other two children would take consideration. We would have to make sure the activity chosen is very familiar and is suited to four. At each step of the way we have found that the interactions during the play group itself lead us to planning the next steps.

Natasha's Play Group

With Nathan's play group well under way I began the process of starting Natasha's group. On April17th I met with the two girls who had been chosen as peers. I explained that Natasha was smart and wanted to play with others, but didn't know how. I also explained that too much talking confused her and she had difficulty saying what she wanted so they would need to use shorter sentences and be patient. Natasha had enjoyed playing an active game called "Don't Break the Ice" and I had chosen it for the first activity of play group. I had brought the game along and I demonstrated how they could use parallel talk to help Natasha understand what she was to do. They each took a turn role playing the activity. They were naturals and I was encouraged. I asked them to be patient and to not quit trying even if Natasha seemed upset. They left confident and eager to begin.

April 23rd was Natasha's first play group. I had planned it for after her gym period which normally is a positive time for Natasha. Unfortunately something had happened in gym to upset her. She had been playing a new computer game before she went to gym and she wanted to return to it. We redirected her to her schedule which showed she had play group next. I went and got her peer and removed the rest of the class so there would be no distractions. Natasha participated but kept saying "Bye" to everyone, including Stacy, her peer. She even at one point kicked Stacy's chair, something she used to do, but which we now see only rarely when she is very upset. She tried to take all the turns and had to be prompted to hand over the hammer. However, the facilitators felt encouraged because at the end of the session she did hold the bag out to Stacy to put the cubes in and she gave the bag to Stacy to put away. When her teacher checked with Stacy later that day to find her reaction Stacy said that it went well, but Natasha was very noisy. Although we did not have the immediate success we had with Nathan we felt even that small step showed that the play group would be an effective way to help Natasha gain the social and communication skills she needs to interact more positively with her peers and lessen her frustration.

Conclusion

Although I approached the use of play groups with apprehension I feel it has been a beneficial experience for many reasons. Previously I understood the importance of equipping autistic children with social communication skills. After all, there is little value in learning the academic math and literacy skills if they cannot function in the everyday activities of society. While I used task analysis and role play to teach these skills to the older children, these methods would not work with Nathan and Natasha, partially because of their age and mostly because of their specific needs. Play groups provided a venue to teach these skills in a natural, effective way. Nathan made progress quickly. Evelyn Purins, his kindergarten teacher, commented, "I see the spin off effects. Nathan is now sitting down on the carpet with the others instead of separating himself and sitting with his EA. Some of the more thoughtful kids are inviting him to join their group during play time. I think it's working very well. Yesterday he didn't want to participate in music, but he still wanted to be here. He actually went with the Co-op student who he hasn't worked with and painted. But he kept an eye on what we were doing" (Personal communication, 03/05/28). Natasha usually takes longer to adjust and the positives we did see assure me that we are on the right track. After Natasha protested the presence of her peer quite loudly one day I asked Laurel if she wanted to let the play group go until fall. She thought for a moment and said, " She's still vocal, but she doesn't kick as much. I'd like to keep going. She is making progress. And it's good for Stacy , too. She's learning how to communicate with her more non-verbally so Natasha isn't threatened." (03/05/28).

We have had to make adjustments as we go along, but the team approach and our brainstorming makes this task easier. We help keep each other on track, making sure we don't lose sight of our stated goals and are sensitive to when we need to make changes.

I think one of the biggest and unplanned benefits is the way it has affected the rest of my program. Through the research group I had developed a better understanding of the characteristics, needs and supports for autistic children. Through implementation of the Play Group I had to put into practice what I had learned. I no longer saw situations in the classroom as individual specific events, but rather as part of a broader picture. And I began to respond differently. Rather than simply reacting to the situation first and assessing and reflecting later I am beginning to be able to intuitively reflect while the action is happening and adjust my response to the holistic need. When you work with autistic children you have to recognize that there will always be times when your action was unsuccessful, but the number of times I have to say, "I did that wrong," is lessening.

Play groups will remain a regular and central part of my program.

Bibliography:

Attwood, T., and Gray, C. (2002) "Understanding and Teaching Friendship Skills" Geneva Centre International Symposium 2002

Choi, S. (2000) " Let's Play: Children with Autism and Their Play Partners Together [online] Available from www.isec2000.org.uk./abstracts/papers_c/choi_1.htm

Janzen,J.E. (1996) Understanding the nature of Autism: A practical guide. San Antonio TX: Therapy Skill Builders.

McGinnis,E., and Goldstein, A.P. (1997) Skillstreaming the Elementary School Child New Strategies and Perspectives for Teaching Prosocial Skills. Champaign, Illinois: Research Press.

Musselwhite, C.R. (1986) Adaptive Play for Special Needs Children San Diego, Cal. College-Hill Press.

Quill, K.A. (2000) DO- WATCH- LISTEN- SAY. Toronto, Canada: Paul H. Brookes Publishing Co.