Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
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 focuses on six themes: whole-body listening, personal space, turn-taking, trading objects and toys, listening and communicating personal ideas, and sportsmanship. Data suggest an improvement in social skills and a reduction in the impact of the child’s behavior on the activities of the family.
Primary Author and Speaker: Sarah A. Schoen
Additional Authors and Speakers: Mim Ochsenbein
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. However, the availability of small groups is rare. The BRIDGE program, ‘bridges’ the social needs of children by providing services sequentially in dyads, triads, and quartets. This program exposes children to basic social processes while simultaneously training parents.
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. Each child progressed through one of the following scenarios: 1) dyad to triad, 2) dyad to triad to quartet or 3) triad to quartet. Inclusion was based on a comprehensive occupational therapy evaluation documenting sensory processing/integration symptoms as well as social challenges that were interfering with relationships at home, school and the community. Five participants also met criteria for autism. Intervention: Each group consisted of 12 one-hour sessions addressing 6 themes: 1) whole body listening, 2) personal space, 3) turn-taking, 4) trading objects/toys, 4) listening/communicating personal ideas and 5) sportsmanship. Parents participated in 3 parent-only education sessions focusing on home strategies.
MEASURES: Visual analogue scales (VAS) of parent goals measured weekly change in social behaviors. Pre-post changes 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. Pre post changes were examined using Wilcoxon Signed Ranks Test.
RESULTS: Significant changes in mean level and slope were consistently noted for two VAS questions; ‘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 were ‘following rules in play’ and ‘having concern for other’s feelings’. There was significant improvement reported in the social skills subtest of the SSIS (p = .015, ES = .56) and there was a reduction of impairment on the FLIS (p = .059; ES = .44). No change was noted on the PSOC (p = .631; ES = .11).
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 approach.
CONCLUSION: Progressing children through dyad, triad and quartet group experiences, that combine child participation along with parent training, show potential for maximizing positive child and parent outcomes.
IMPACT STATEMENT: A graded approach to group intervention for the development of social skills in preschool children offers an alternative therapy program for children with autism or sensory integration/processing challenges that can address concerns in social participation.
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. https://doi.org/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.
