Strategies for Parents and Professionals That Promote Peer Interaction Skills: RDI and More

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Strategies for Parents and Professionals That
Promote Peer Interaction Skills
RDI and More

• Robert Rosenthal, Ph.D.
• and
• Trish Miron, Psy.D., LPC
• of the Growth Opportunity Center
• For 2009 BCASC Conference

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Objectives

• Learn how to assess peer interaction skills
• Learn RDI principles that promote peer
  interaction skills
• Learn methods used in groups/school that promote
  peer interaction skills

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Important 6-12 Month Developmental Milestones

• Use and respond to eye gaze, gestures,
  expressions
• Use nonverbal skills to initiate interactions,
  engage in reciprocal turn-taking, make requests,
  share interests
• Joint attention
• Imitate facial expression, novel actions, sounds

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Core Skills for Social Development

• Nonverbal behavior in interactions
• Initiate interactions
• Reciprocal turn-taking
• Make requests
• Share interests
• Imitation
• Leads to symbolic thought and play
• Out of order acquisition less spontaneous and
  flexible

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Social Cognition

• Deficits in Social Referencing
• Looking for a persons reaction- try to
  understand the socioemotional significance of
  each experience
• This develops into a theory of mind
• Others have intentions, thoughts, desires and
  feelings different from our own
• This allows for predicting and anticipating the
  social behaviors of others
• ToM plays significant role in social
  interactions you must monitor what partner knows
  and then adjust

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Peer Interaction Skills Defined

• Help navigate social communication
• All the skills needed to make interactions
  successful
• Monitor/interpret/understand social cues
• Emotional state, gestures, tone, expression
• Monitor/interpret/react to others needs
• Understand/interpret language

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Peer Interaction Skills Defined

• Reciprocity
• Understand impact of ones own behavior on others
• Social rules (unwritten rules)
• Contribute to social skills
• Initiate, maintain conversations
• Sharing
• Offering help
• Taking Turns
• Joining In

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Peer Interaction Skill Deficits

• Use of nonverbal behaviors which help to monitor
  others, and provide signals to others
• Eye gaze posture facial expression
• Sharing interests, ideas, achievements
• Show interest in others reciprocity
• Prosody volume, pitch, rhythm, rate
• Codes of conduct

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More Peer Interaction Skill Deficits

• Literal interpretations
• Rigid or inappropriate reactions
• Knowing what to say and when to say it
• Interpreting different situations and nonverbal
  cues
• Acquisition vs Performance

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Peer Interaction Skills

• Pay attention to multiple aspects of message
• Process this information
• Interpret the intent and meaning of verbal,
  nonverbal, and affective behavior
• Process message in relation to context
• Understand mental state of partner (their
  knowledge, feelings)
• Retrieve info relevant to topic
• Turn-taking
• Adapt to ongoing dynamic
• Do it all simultaneously and automatically

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Assessment of Peer Interaction Skills

• Informal methods
• Observation
• Multiple environments/settings
• Use of checklists
• Narrative
• Feedback from teachers/caregivers
• Interview
• Questionnaires

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Use Developmental Milestones

• Examine list of communication and social
  developmental milestones
• Shares social smiles (3-6 months)
• Establishes joint attention (6-12 mos)
• Combines gestures, eye gaze and words (12-18 mos)
• Comforts others (18-24 mos)
• Takes turns in play (36 mos)
• Follows rules in games (48 mos)
• Plays cooperative group games (60mos)

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Assessment of Peer Interaction Skills

• Formal methods
• Empirically-based
• Compares to same-aged peers
• Reliable and valid
• Standardized across many ages, backgrounds,
  ability
• Normative- what is expected in typical
  development
• Several raters

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Formal Assessment

• Diagnostic scales
• ADOS, ADI-R, CARS
• Adaptive behavior scales
• Vineland Adaptive Behavior Scales
• Educational assessments
• Psychoeducation Profile Autism Screening
  Instrument for Educational Planning
• Curriculum-based
• Brigance Inventory of Early Development
• Prelinguistic tools
• CHAT

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Rating Scales

• Test of Problem Solving (TOPS)
• Functional Communication Profile (FCP-R)
• Australian Scale for Aspergers Syndrome (ASAS)
• Gilliam Autism Rating Scale
• Asperger Syndrome Diagnostic Scale
• Assessment of Social and Communication Skills for
  Children with Autism (Quill)
• Sohn-Grayson Rating Scale

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Targeting New Skills

• Any not consistent yet below their dev level
• Any not consistent at their dev level
• Focus on social referencing skills
• Attending to, deciding what is salient,
  interpreting and adjusting to cues
• Examine different settings, people
• Use assessment data
• Keep log of inappropriate behavior/situations

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RDI Terminology

• Instrumental interactions
• Means to an end scripts
• Experience sharing
• Share a part of oneself
• Social (emotional) referencing
• Emotional coordination
• Information processing and evaluating
• Co-regulation

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More RDI

• Dynamic intelligence
• Emotional referencing
• Social coordination
• Declarative language
• Flexible thinking
• Relational information processing
• Foresight and hindsight

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RDI Principles of Treatment

• Limit language
• Respond less to verbal and more to nonverbal
• Manipulate environment for success
• Guided participation
• Spotlighting
• Productive uncertainty
• Co-regulation

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Practice, Rehearsal, Reinforcement

• In vivo after meltdown, review scenario and
  rehearse alternative choices
• Before any social activity
• Play-dates
• Family get-togethers
• School functions
• Trips to store
• Keep track- notes, charts
• Rehearse, acting as peer
• Reinforcementfeedback
• Older kids- self-monitor

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Climate for Success- Home

• Floor Time-engagement
• Teach social codes of conduct pragmatics
• Social stories (Carol Gray)
• Comic book conversations (Carol Gray)
• ToM Whenever your needs impact them, get them to
  answer why you might behave that way, or what you
  may have been through

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Climate for Success- Home

• Mind-reading (Howlin, Baron-Cohen)
• High tech training
• Voice recording/video tape
• TV shows/videos
• Social skill training software
• School Rules!

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Parent Activities

• Emotions Scrapbook (pictures, words, interviews)
• Social skills workbook
• Do-Watch-Listen-Say (Quill) Boardmaker
• Role plays
• Dont respond to needs too quickly- wait for and
  encourage their initiation
• Scaffolding

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Climate for Success- School

• IEP goals and SDIs
• Autistic support and inclusion
• Peer mentors
• Social stories
• Communication
• Teachers must tell when more appropriate social
  skills would have helped
• Teachers- figure out students perspective
• Unstructured times
• Explore concept of friendships

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Climate for Success- Clinic

• Must have parent support
• Find therapist who knows autism
• Toddlers-young children
• Parent-centered
• Engagement
• Latency-aged
• Parent and child centered
• Focus on codes of conduct and reciprocal
  conversation skills
• Adolescents
• Show interest self-esteem/anxiety/depression

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Climate for Success- Groups

• Show interest
• Any activity is used as a means for peer
  interaction practice
• No tolerance for meanness/intimidation
• Balance between off-task/on-task
• Videotape sessions
• Get feedback
• Nonverbal games
• acting class activities guess the expression

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More on Groups

• Team-building activities
• Review developmentally appropriate social skills
• Always review WHY it is so important, focusing on
  ToM others will want to be your friend
• Review inappropriate behavior (Mr. Bean)
• Role play many different situations
• Prepare story/play where they are hero
• Structure routines

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More on Groups

• Encourage disclosure
• Review skills/codes of conduct in games
• Immediate review of offensive comments
• Activities that improve conversation skills
• Let them create new games
• Focus on bullying
• Teach hidden curriculum (Myles)
• Adolescents- intimate relationships