Social Emotional Support: Who, what, and when

Note: This segment is Part 1 of a Series on Social Emotional Support by a Behavior Analyst

 

First, here are some ways Dr. Kolu’s clients have benefited from Social Emotional Support:

Individuals

• A client with Rett’s Syndrome learned new ways to greet peers, ways to play with toys, and how to eat with a spoon and fork

• A client with severe autism learned to pull up his pants and participate more fully in dressing himself

• A client with mild autism learned to ask friends to play

• A client with Rett’s learned to use a button to request food and later to make choices 

• A client with Angelman’s Syndrome learned to request everyday items by pointing instead of banging his head

• A client with Autism learned to look at his family members, talk, and practiced preschool readiness skills

• A client with PDD-NOS learned to use words instead of hitting others and screaming

• A client with severe anxiety and autism learned coping strategies for the playground instead of running screaming away when other children or dogs arrived

Families

• A family with a client with autism learned ways to include their child in church and community outings

• A family with two children with autism learned to provide deep pressure regularly, instead of after self injurious behavior. This decreased head banging and increased hugs at appropriate times!

• A family with one child with autism learned to encourage language for the 2 year sibling (who was not making sounds at the beginning of therapy).

• A family with a child with autism and other genetic disorders learned to expand the interests of their child beyond a single video and book to many interactive toys

Community Members

• A daycare staff learned to teach students how to respond to their peer who was challenged with Rett’s Syndrome. Children learned to wave, give high fives, and exchange toys or crafts materials, while the student with Rett’s learned to wave back, give high fives, and play instead of pulling their hair.

• Montessori school teachers learned to encourage more independent and healthy eating habits for a learner who struggled with food refusal.

• Preschool teachers learned ways to include a child with autism in play with his neurotypical peers

• Preschool therapists learned to manage behavior, incorporate social interaction, and use both timing and motivation more effectively in their SLP, OT, and PT sessions with a child with Angelman Syndrome. After introduction of a behavior analyst to the team, all therapists were educated in how to use consistent strategies to facilitate their individual specialty work with the child. Disruptive and aggressive behavior decreased as appropriate alternatives were supported by the entire team’s strategies.

• Preschool teachers, therapists and family members learned ways to prevent inappropriate, unsafe, and injurious behavior.

What is Social Emotional Support? Who benefits from S/E?

In this context, S/E support is a specific type of support provided to children birth to 3 who experience delay, or risk for delay, in the area of social emotional development. For example, I support many families whose children experience language delay, difficulties learning to interact with others, or using self-help skills at appropriate developmental pace. Children in these families can be at risk for S/E delay when behavioral challenges grow into barriers that affect the family’s interaction, or prevent the child from interacting fully with his or her community. However, early social emotional support builds a foundation of preventative environments that foster behavioral wellness. 

Social Emotional Support for children with Autism… and children without Autism

Other families I support are raising a child diagnosed with Autism or related challenges, or are affected by Autism elsewhere in their family. The presence of an Autism Spectrum or related challenge can make it more likely that children and their siblings could benefit from therapeutic Social Emotional Support. However, we can also support typically developing children whose families have faced traumatic or difficult experiences that result in challenging interactions between children and family members, difficulties eating, talking, or playing with others. Social emotional support can help families teach a child healthy ways to express his or her feelings, communicate his or her needs and wants, and learn from the natural environment. At the same time, family members receive support and education to practice proactive, preventative, supportive strategies for future challenges.

Social Emotional Support in Colorado

In Colorado, families with young children (0-3 y/o) affected by special needs can connect with their local Child Find agency to find out more about how children can receive these services. (Our local community centered board, Imagine!, has a great list of many community resources and phone numbers including local Child Find offices here.) Social Emotional support can be part of a child’s IFSP, or Individualized Family Service Plan, which documents the services a child needs before he or she turns three. Social Emotional support is only one of the services covered by Early Intervention Colorado. As needed, children can also receive Speech and Language Therapy, Occupational Therapy, Physical Therapy, Developmental Intervention and more.

What are common ways S/E support fits into a child’s program or IFSP?

S/E strategies on a child’s IFSP are often ways to help a caregiver manage behavior, encourage language and communication, and support appropriate rich interactions with learning environments and people. Often, the strategies are used to empower the other therapists on the team: by addressing behavioral challenges and the ways they interact with language and social interaction, the behavior analyst can “free up more time” for other therapists and family members to provide more therapeutic interaction with children.

Children with autism often benefit from naturalistic teaching of skills across many domains, peer mediated instruction (involving siblings and community peers in therapeutic interactions), and teaching (or providing opportunities for practicing) specific skills that are missing or not fluent. Read more about the evidence-based strategies recommended by EI Colorado when autism and related challenges are present, in Early Intervention Colorado’s Autism Guidelines. A Behavior Analyst can help a team understand when, where, and how to incorporate these “evidence based” strategies in collaboration with a child’s other therapists. 

Who can provide Social Emotional Support?

A Board Certified Behavior Analyst (or BCBA) is qualified to provide Social Emotional Support in Colorado during early intervention. As a BCBA-D or doctoral level BCBA, I provide services directly in the family’s home or community with the child, caregivers, and occasionally, the child’s other therapists. The behavior analyst may collaborate with providers including the child’s family, Speech and Language therapists, occupational therapists, physical therapists, and medical or mental health professionals if needed. There are many other kinds of providers of S/E, and readers can learn more about them here.  

When should S/E be provided?

Earlier the better: Prevention is cheaper and more effective than reacting 

When community childcare providers and families learn preventative techniques that promote language and social interaction, they also gain strategies that will be useful soon, if not right away, to minimize, respond to, and support children through, behavior challenges. If a child could benefit from social emotional support, it’s a myth that a family or team should wait until it gets worse. Ask for help now. Even before a child turns one, s/he could benefit by caregivers learning ways to provide social emotional support.

What if it’s too late? My child’s already turned 3.

It is never too late to learn more about healthy social emotional development, or to support a family member’s behavioral wellness. The impacts of intervention for increasing language, play, social skills, are more powerful the earlier it begins, but these skills can be supported no matter when the intervention starts. Cusp Emergence offers behavioral wellness intervention and support across the lifespan.

Transitioning past age 3

In Colorado, S/E support – at least that part of S/E that is covered under Part C services by the IFSP- ends at age 3. But a child’s needs do not end on his or her birthday, and neither does a family’s need for support. Early intervention providers generally do their best to provide a great transition report that a school team can use moving forward if preschool is appropriate. 

Doing more to support a family through transitions

Families especially benefit from transition booklets that are prepared by their S/E therapist, in family/community-friendly language. I call these my “Go Team Timmy” booklets. They explain, using pictures and simple instructions and examples, how to keep meeting children’s needs after intervention ends. One email from a grateful parent came to thank me after she took her son on vacation to visit family. At three, he did not speak and had poor motor control, and his hair-pulling and biting had been so severe and challenging that other children avoided him. This was especially sad, because he loved other children and his goal was their affection! Thankfully, the behavioral strategies had been effective in teaching him alternative ways to get children’s attention. He just needed practice, and he needed prepared play partners who were ready to use compassionate easy strategies to help him give high fives instead of grab peers’ hair. So I was thrilled to read that the young mom had sent the booklet ahead of time to her aunts and uncles before the visit. Young cousins read it with their parents and learned how to hold out their hands and give high fives, how to encourage play, and how to have more fun with the child. “Even though one of the cousins had a HUGE bow in her hair,” wrote his mom, “Timmy never grabbed it! They played and laughed and had a great time.”

Educating those important to a family and community, not just the child

Education and transition booklets can also help prepare community members such as teachers, day care providers, grandparents, respite providers and babysitters, how to support a child when the therapist is not there.

 

Stay tuned for more on strategies to support Social Emotional Support through the lifespan!