Date Presented 03/26/20
The BRIDGE program is presented to “bridge” the social needs of children with sensory-processing and integration challenges by providing services in dyads, triads, or quartets. This 12-session program focused on six themes: whole body listening, personal space, turn-taking, trading objects or toys, listening and communicating personal ideas, and sportsmanship. Data suggest an improvement in social skills as well as a reduction in the impact of the child’s behavior on the activities of the family.
Primary Author and Speaker: Sarah Schoen
Additional Authors and Speakers: Mim Ochsenbein, Virginia Spielmann
Contributing Authors: Andrea Valdez
PURPOSE: This study addresses the social impairments of children with sensory processing/integration challenges who are not developmentally appropriate for large groups.
RATIONALE: Children with sensory processing/integration challenges often present with deficits in social participation (Chen & Cohn, 2003). Groups are a cost-effective method of treatment that can address problems in peer interaction and engagement. However the availability of small groups is rare and may be expensive due to a lack of third party reimbursement. The BRIDGE program is designed to “bridge” the social needs of children by providing services in dyads, triads, or quartets. This novel program exposes children to basic social processes (e.g. body awareness, turn-taking, sharing and engaging) while simultaneously training parents in ways to support their children.
DESIGN: A multiple baseline, non-concurrent, repeated measures design was used to examine gains in social skills. Treatment was initiated after the collection of 3 to 6 baseline data points. Baseline data were gathered using a preplanned schedule.
PARTICIPANTS: Ten children ages 3 to 5 years participated in this program due to social challenges that were interfering with relationships at home, school and the community; five participated in two or more group conditions. All had sensory processing/integration symptoms and five met criteria for autism.
INTERVENTION: Each child participated in 12 one-hour sessions addressing 6 themes: whole body listening, personal space, turn-taking, trading objects/toys, listening/communicating personal ideas and sportsmanship. Parents participated in 3 parent-only education sessions focusing on applying strategies at home.
MEASURES: Visual analogue scales (VAS) of parent priorities were administered to measure changes in social skill behaviors at home and in the community. Pre-post changes in child behavior and parent participation were measured using the Social Skill Improvement System, (SSIS; Gresham & Elliott, 2008), the Parenting Sense of Competence Scale (PSOC; Ohan, Leung, & Johnston, 2000), and the Family Life Impairment Scale (FLIS; Briggs-Gowan, Horowitz, & Carter, 1997).
ANALYTIC METHODS: Data analysis consisted of visual inspection of graphs for each of the dependent variables for all participants. Pre post changes were examined using Wilcoxon Signed Ranks Test.
RESULTS: Significant changes in mean level and slope were most consistently noted for two VAS questions across phases of the program; “My child made friends and interacted well with peers” and/or “My child took turns in conversation”. All of the children made improvement in at least one VAS question on the questionnaire, with the range of scores from 1 to 6 areas of improvement. Other VAS questions that showed change included following rules in play and having concern for other’s feelings. Although not significant, improvement was reported in the social skills subtest of the SSIS (p = .068) and there was a reduction of impairment on the FLIS (p = .059). No change was noted on the PSOC (p = .916). The greatest degree of change was noted from dyad to triad with a leveling off of abilities in the quartet phase.
DISCUSSION: Findings suggest the BRIDGE is a promising program for developing social skills and reducing the impact of the child’s behavior on the activities of the family. Prosocial behaviors including communication, cooperation, assertion, empathy, and self-control improved using this graded, social interaction approach.
CONCLUSION: Therapists should consider a graded approach to interventions for the development of social skills in preschool children. Social programs that combine child participation along with parent training show potential for maximizing positive outcomes.
References
Briggs-Gowan, M. J., Horowitz, S. M., & Carter, A. S. (1997). The Family Life Impairment Scale. New Haven, CT: Yale University, Department of Psychology.
Chen, H.-F., & Cohn, E. S. (2003). Social participation for children with developmental coordination disorder. Physical & Occupational Therapy in Pediatrics, 23(4), 61-78. doi:doi:10.1080/J006v23n04_05
Gresham, F. M., & Elliott, S. N. (2008). Social Skills Improvement System: Rating Scale Manual. Bloomington, MN: Pearson Clinical Assessment.
Ohan, J. L., Leung, D. W., & Johnston, C. (2000). The Parenting Sense of Competence scale: Evidence of a stable factor structure and validity. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 32(4), 251.
