OUR COMMITTMENT TO EVIDENCE BASED PRACTICE
What is evidence based practice?
Evidence based practice is the conscientious, explicit, and judicious use of current
best evidence in decision making.
What is current best practice?
Best practice is a technique or methodology that, through experience and research,
has proven to reliably lead to a desired result. A commitment to using the best
practices in any field is a commitment to using all the knowledge and technology at
one's disposal to ensure success.
HOW EXCELERATE V.2 EMPLOYS BEST PRACTICE TO ACHIEVE RESULTS:
Why does the EXCELERATE V2 Programme utilize Group Therapy?
Research has documented that three out of four children with a learning disability
have inadequate social interactions with their peers (Evans, Axelrod, & Sapia,
2000). Children with disabilities often experience negative social relationships and
are commonly rejected by or isolated from their peers (Clarke & Kirton, 2003).
These children spend more time interacting with their teacher than with their peers,
thus further reducing opportunities to develop age appropriate social and
communication skills. It has been suggested that proximity is important in
developing and maintaining friendships, such that children who are withdrawn or
seated away from classmates are less likely to make friends (Goldstein & Morgan,
2002). For this reason, EXCELERATE V.2 utilizes group therapy as a means of
enhancing and facilitating children’s social interactions with their peers.
But My Child Won’t Participate in Group Activities!
Beukelman and Mirenda (1998) argued that the first step to increasing
communication, and therefore socialization, is to increase meaningful participation
in natural contexts. “Participation is the only prerequisite to communication.
Without participation, there is no one to talk to, nothing to talk about and no reason
to communicate” (p. 269). The participation patterns of typically developing peers in
relevant environments need to be assessed and compared with those of the child.
EXCELERATE V.2 interventions are then designed to increase the participation levels
of the child with difficulties, to match peer levels more closely.
Can Parents Be Involved In The Intervention Process?
Parents are encouraged to be involved as much as possible through the intervention
process. Working effectively with parents means that they are supported and
assisted in coping via an individualized approach (Berry, 1987). It is well
documented that parental styles of interaction are linked with communication skill
development in children (Siller & Sigman, 2002). Social interactions begin with
infants synchronizing their behaviour with their caregiver, and intentional
communication and social interaction skills develop through the use of social
games (Light et al., 2002). This social closeness is crucial for the development of
later social skills, with research documenting the importance of developing
caregiver skills in this area (Warren, Yoder, & Leew, 2002). Warren et al. (2002)
have also pointed to the importance of developing the skills of caregivers to
increase adult responsivity and provide an optimal environment for highly
responsive caregiver–child interactions through the use of specific teaching
techniques. These techniques include arranging the environment, giving
communicative temptations, close face-to-face contact, following the child’s
attentional lead, and contingent motor and vocal imitation. This highlights the
importance of parent training to ensure optimal parent-child interactions.
EXCELERATE V.2 provides tailored parent training programs to suit every family and
child’s unique and changing needs.
What Does the EXCELERATE V.2 Programme Focus On and Why?
EXCELERATE V.2 focuses on developing functional communication skills, with the
main focus on the four functions fulfilled within communicative interactions (Light,
1989):
· expression of needs/wants (e.g. requests)
· information transfer (e.g. comments)
· social closeness (e.g. social routines, social games)
· social etiquette (e.g. greetings and farewells)
It is important that social skills intervention includes skill development in all four
areas from an early age. Traditional intervention strategies have often been directed
towards expression of needs/wants and social etiquette, whereas social closeness
is now emerging as the glue that holds it all together (Light, Parsons & Drager,
2002). EXCELERATE V.2 views all four functions as inextricably linked and
facilitates development of all four communicative functions to ensure holistic
communication development.
EXCELERATE V.2 also focuses on achieving successful interactions. A number of
individual and environmental factors account for the success or failure of a social
interaction. For example, studies have shown that the level of communicative
behaviours in children with autism varies significantly across speaking partners
(Rydell & Prizant, 1995). There appears to be a tendency to attribute problems
solely to the child’s cognitive differences; however this would be a naive
assumption. According to Quill (1995) social interactions can also fail due to a lack
of congruence between the child’s abilities, unique personality traits, the demands
of the situation and social partners – factors which are often overlooked.
EXCELERATE V.2 takes all these factors into consideration and utilizes them to
enhance both adult-child interactions and child-child interactions.
My Child Won’t Interact With People
Current literature in the area of early communication is suggesting that the
development of social interactions in presymbolic or preintentional communicators
is best achieved through social games (Aud Sonders, 2003; Nind & Hewett, 1994,
2001). The interaction needs to be of interest to the beginning communicator,
involve reciprocal turn taking by both participants, be sustainable over multiple
exchanges and allow the beginning communicator to participate in multiple ways by
using gross rather than discrete behaviours. The interaction needs to have a clear,
repetitive structure that can be repeated over time. Of utmost importance,
caregivers need to be provided with support in interpreting the beginning
communicator’s behaviours consistently and responding appropriately.
EXCELERATE V.2 successfully incorporates these factors to achieve current best
practice methodologies in the area of enhancing social interactions.
Will The Skills My Child Learns Generalize To Everyday Interactions?
Brown and Conroy (2002) identified three fundamental strategies for planning
generalization and maintenance of young children’s social interactions:
· Taking advantage of natural communities of reinforcement – this relies on
the presence of responsive peers and adults.
· Training diversely – this includes training across multiple exemplars (e.g.
training multiple peers and adults), training loosely (e.g. embedding
interventions within routine activities) and using indiscriminable
contingencies (e.g. fading prompts, delaying reinforcement and sequential
modification of environments). It also utilizes retraining techniques.
· Incorporating functional mediators – that is, common stimuli or verbal
behaviour that are presented in nontraining contexts. This can be as simple
as the presence of an adult associated with a previous history of
reinforcement.
These strategies are successfully implemented within the EXCELERATE V.2 program
to promote effective generalization.
My Child Won’t Play With Others
The primary business of young children is play. Play skills contribute to social and
emotional development, and improved performance in language, reading and
writing (Hendler Lederer, 2002). Increasing participation in play activities
automatically increases the quality and quantity of communication opportunities
(Beukelman & Mirenda, 1998). Research indicates that children with social-skills
difficulties are less likely to initiate play, more frequently engage in isolated and toydirected
behaviours (and less in social-interactive play), are more dependent on
concrete toys for play and play with a smaller variety of toys (Westby, 1988).
Observations of children’s play can provide therapists with information regarding the
child’s social knowledge and cognitive skills in a naturalistic setting (Westby, 1988).
Research has shown that the availability of certain types of materials influences
young children’s interactions more than others. Brown and Conroy (2002) found that
limiting the amount of space available promoted interactions when combined with
other strategies. Other factors such as toys and materials, physical room
arrangements, therapist-implemented structure for play activities and the presence
of socially sophisticated and responsive peers have been found to promote peer
interactions among preschool children. EXCELERATE V.2 implements these
strategies successfully to develop children’s interactive play skills.
My Child Has No Friends
Friendships are the foundation for children’s social development and are a
significant part of a child’s life (Westby, 1988). Children with social skills difficulties
have difficulty forming friendships. However, it does not follow that teaching
appropriate social skills will automatically enable the child to develop friendships.
Children also need to be taught specific relationship and friendship skills (Brown &
Conroy, 2002). Children need to feel that they belong to the community of the
classroom for friendships to develop. According to Goldstein and Morgan (2002),
withdrawing children from class for individual therapy does not foster this. This is
another reason why group therapy really is the key to improving social and
friendship skills.
Goldstein and Morgan identified three factors that may serve as determinants of
friendship: ability, proximity and similarity. For preschool children with limited
experience, similarity usually refers to physical characteristics (e.g. age, sex,
ethnicity) and interventions need to emphasize similarities among children to foster
friendships. Goldstein and Morgan also referred to a study in which sharing,
suggesting a play activity, affection, assistance and rough-and-tumble play had a
high probability of evoking a positive response from a peer in a preschool
environment. Children who use these social interaction skills are more likely to be
accepted by their peers. EXCELERATE V.2 employs these findings to assist children
in creating and maintaining friendships.
|
|
