Group Therapy At THULIR

For a child to be independent and successful in his/her social environment such as home, school, peer group, etc, the child must possess social skills like communicating, sharing, waiting, turn taking, apologizing, requesting, thanking, competing, being aware of other’s needs and having age appropriate play skills. In order to develop these skills in children receiving occupational therapy at our centre, we started conducting group sessions.

Four children, two boys and girls, aged between 5 and 7 years with similar cognitive levels were taken for group therapy. All four children (referred to be in group 1) were diagnosed under autism spectrum disorders, and specifically had sensory processing issues related to bilateral integration and sequencing, and three of them had tactile defensiveness.

At the level of initial assessment, children

• Were able orient to time, place and person,
• Were able to follow simple commands
• Knew basic concepts like colours, alphabets, numbers, shapes, categories of objects, etc and were going to mainstream school.
• Were not having social skills like, greeting others without prompt, listening to others, etc
• Had problems in maintaining eye contact
• Lacked group skills like waiting, taking turns, or play with peers,
• Were not able to accept or tolerate other children’s company.

Hence group therapy was planned carrying the above mentioned problems as goals which include one activity from each of the following categories.

1. Children were asked to greet each others, parents and therapists by names with eye contact

2. Warm up activities such as jumping on trampoline, breaking soap bubbles, tapping balls/balloons ,etc were given were children were expected to stay within the given boundaries which helps to develop tolerance to touch, were asked to give chance and wait for others turn which develops sharing and waiting.

3. Activities like holding hands and jumping across rope, jumping together within hoola loop, crossing over obstacles in a line, walking together inside lycra swing, doing animal walks like crab walk, bear walk, frog jump, etc, together in a line, were given. This helps to develop skills such as doing activities together in a group, tolerating other’s touch, waiting for others to complete their task and join the group, waiting for commands and control impulsivity..

4. Activities like singing rhymes, doing action imitations, spelling words, counting numbers, reciting alphabets, were given were each child was asked to perform these tasks in turns in front of other kids and parents. This helps to develop eye contact, reduce social hesitation, and improve self confidence.

5. Activities requiring exchange of puzzles or toys among each others were given to provide opportunities for verbal communication. Concepts such as “give me”, “take it”, “thank you” and “welcome” were taught.

6. Activities like target throwing, ball catching, board games with dice, actions on commands etc were given to develop game concepts in children.

7. To teach sharing, snack time was present at the end of all sessions were each child was asked to share a piece of given snack to each other and eat once all of the get their share.

8. At last, children were taught to say “bye-bye “to each others, parents and therapists by their names.

Each of the group session would last for one hour including 7 to 8 activities from the above mentioned categories with two minutes breaks between each activity. After 8 months of group therapy children are now able to

• Greet each other without prompt
• Recognize the absence of other child
• Enjoy the presence of other kids and show emotional attachment
• Show tolerance to touch better than before
• Understand turn taking and able to wait for others turn without prompt
• Initiate activities like rhymes action imitation etc
• Verbally use “give me” , “take it”, “thank you” and “welcome” appropriately without prompt
• Point out when others did not wait or take turn appropriately
• Share and eat without prompt
• Listen and follow instruction and learn simple new games

The future goals of the group session would be to improve verbal communication, to introduce concepts of competition, winning and losing, to improve listening skills and to develop age appropriate play skills.