Promoting Friendships for Preschool Children with Special Needs

What about kids with special needs?

Children with special needs³ (those with developmental, emotional, physical or learning difficulties) are often at risk for difficulties in social-emotional development. Many of these toddlers and preschoolers seem to lack the social and language skills needed to initiate or maintain age-mate relationships. Some have personal characteristics or personal styles that keep them isolated or contribute to rejection from peers, and have no idea that their own behavior is part of the problem. For example, children with an autistic disorder are impaired in their ability to interact with others, often preferring solitary, repetitive activities. They need support in order to participate in social games or activities. While children with a diagnosis of ADHD may be quite social and interested in peers, their low frustration tolerance, impulsivity, temper outbursts, and bossiness are qualities that often interfere with friendships. Unfortunately, children with special needs are the least preferred partners of children with more typical development, and are sometimes humiliated, harassed and deliberately excluded, or even the victims of bullies. Many of these children are clearly in need of specialized intervention if they are to have success with peer relationships.

The critical early years - Interventions make a difference

A number of studies provide evidence that an early emphasis on social competence through appropriate interventions can offset possible risks due to the child’s biology, environment, temperament, learning or emotional problems.^{1, 4} Since we know that early friendships for all children begin through play, providing frequent and appropriate play experiences with compatible age- mates could help youngsters with limited or poor social behaviors. With planning, early social behaviors and skills to enhance peer relationships can be promoted in all settings involving children, including:

• inclusive childcare or preschool settings
• center-based settings
• therapy sessions (e.g., speech, occupational therapy, physical therapy)
• home and community

Some questions about incorporating social-emotional goals in preschool

Unfortunately, the placement of children with special needs in self-contained or inclusionary settings, or individual therapies, is usually not designed to help children deal with the important developmental task of establishing peer relationships.

Given the importance of promoting social-emotional competence as early as possible, it is important to recognize when friendship difficulties are not only a part of growing up or a temperamental variable, but a sign that basic feelings and skills that are required to make friends are missing or not developing appropriately. The following questions should be considered in the planning successful interventions:

• What social goals can be expected of preschool programs offering services to children with special needs?
• When should difficulties with age-mates, disinterest, or fighting become a concern?
• When and how should concerns about social development and skills be identified and addressed?
• What is the best way to balance traditional assumptions about the priority of cognition or language?
• Should interventions to address important social-emotional competencies be delayed?
• Can social-emotional competence and a specific skill such as language be addressed simultaneously?
• Can the nature and quality of peer relationships be nurtured and strengthened?
• Do the staff, teachers, and related therapists understand the value of social-emotional attributes and have the skills to use their knowledge to accomplish multiple goals?
• How can the environment in the general school setting and the approach during therapy time be coordinated to include the goal of enhancing the child's social relationships?

Some possible answers

An integrated approach is ideal for promoting social-emotional development in children with special needs at the preschool level. Many established models of intervention in which "different team members perform largely independently is antithetical to recommended practices in EI/ECSE"[Early Intervention/Early Childhood Special Education].⁵In addition, it has been argued that efforts should be intensified to develop ways of "enhancing the peer competence of children with disabilities with special emphasis on unstructured situations in which exclusion occurs most frequently".⁶ Following are possible ways to pursue this goal:

Creating a Pro-Social Environment

Interventions in small group settings can be exceptionally potent. It is within a small group that teachers and related therapists can observe and provide experiences in which the child works out problems and feelings that interfere with relationships as they occur or immediately after the event. A group experience is often a child's main social experience in life, after home. The child's responses to this world - adults, peers, specific activities, and materials - provide significant data which enable teachers and related therapists to understand him/her better. The child's temperament, learning, coping style, as well as relationship patterns, are all demonstrated in the interactions with adults and age-mates.

Adult responses that are not verbalizations about past behavior or even anticipated behavior but are immediate on-the-spot interactions may result in alternative responses and solutions that are useful to the children involved. The selection of activities and curriculum, the use of materials and space, and most importantly, the adult's approach and reactions to behavior are major considerations. And, interventions that promote peer interaction are even more effective when coordinated and implemented across settings; in related services by therapists and at home by families.

Designing curriculums with two goals

The traditional preschool programs for children with special needs usually recommend individual therapies; a one-to-one relationship with an adult and a specific focus on one domain of development, e.g., speech, motor, sensory. Such an approach misses an important opportunity to promote and reinforce social competencies, neglecting the fact that these children are less likely to have experiences which foster peer interaction. It is, however, possible to achieve both objectives - improved skill development and positive social development - if we re-visit the early intervention and preschool systems and their untapped potential to promote social-emotional competence and early friendships.⁷ Since social competence and language are closely related, curriculums that will achieve two goals may be designed so the children can interact, prompt, and motivate each other to participate in the activity and, at the same time, achieve their therapy goal. A comprehensive program that would utilize the best of individualized targeted intervention and interactive peer intervention would include the following aspects:

1. Initiation of individual language therapy to give the therapist time to assess the child and draw upon the discipline's specialized knowledge to set instructional objectives.

2. Observation of the child in the group setting provides an opportunity for the therapist to get to know the child and later conference with the teacher so that "match-making" with an appropriate peer can begin.

3. Creation of pairs and small groups in which activities are designed that will prompt reciprocity through the use of the children's spontaneous interests and responses to each other and their therapist.

4. Identification of learning objectives in order to plan strategies and anticipate behaviors that address both the relationship priority and the domain-specific developmental goal.

5. At the same time, the teacher in the classroom, through curriculum and play, offers "social skills lessons" designed to promote successful peer exchanges and reinforce relationships developed during therapies.

Increasing Social Inclusion: Case example

Following is the story of Joseph, which illustrates the way concepts of social inclusion were applied to help a classified child in an inclusionary program receiving Special Education Itinerant Teacher (SEIT)⁸ services and speech therapy. Joseph, diagnosed with a disorder on the spectrum of autism and pervasive developmental disorder, had no apparent interest in his classmates and a great deal of interest in small cars and trains which he chose to play with in a limited and repetitive pattern whenever he could. He also had strong visual skills but limited and delayed language skills. It was obvious that Joseph could not yet reach out to approach another child and would not be responsive to the usual approach by a classmate. On the other hand, Joseph was a compliant child with a readiness to accept the proximity of a classmate and a capacity to learn. A plan was developed by the two teachers (regular nursery and SEIT) and speech therapist to use his play interest to begin the friend-making process. Since Joseph was not the only boy who loved trains, his preoccupation attracted Anthony, who was not a child with special needs, and created an opportunity for peer interaction during free play. The teacher built upon the boys' shared interest in small trains by preparing a train station for them, adding dolls (conductors and passengers), and expanding on the materials and equipment. At first, Joseph simply tolerated Anthony's proximity. He became attentive to Anthony when he brought equipment that the staff knew (from mom) that Joseph had at home or that was new and selected to stir interest. A reading program using sight picture words of high interest, e.g., train, caboose, etc., and stories on the same theme supplemented the play. Fortunately, Anthony also shared Joseph's interest in pictures and words. Icons and pictures that were used to help Joseph were of value to Anthony, promoting his pre-emerging literacy skills. As a more related child, with more appropriate social behavior, he could be relied upon to respond to the teacher's introduction of new materials, suggestions for interactions, and a more stimulating use of the play environment. At the same time, the children's relationship was additionally supported by the staff's non-intrusive verbal or non-verbal assistance.

In order to prepare both children for the daily routines at school, speech therapy sessions together, and their play time, photos and then icons (picture symbols) were paired with words (which they recognized) to show the schedule; i.e., first, we arrive by bus, enter our class; then you will play with the trains and later see the speech therapist. Cards and pictures clarified the sequence of events and served to remind and prepare them for transitions. And, most importantly, both children were helped through the use of pictures (always with words underneath) to understand expectations. The team's use of photos, icons, and pictorial representations increased the children's understanding of the daily school schedule and helped them anticipate and respond to each other during interactive play periods which took place in class as well as in the speech therapy.

Both Joseph's and Anthony's mothers supported their efforts. At home, they:

• used pictures to identify feelings and moods
• read and discussed appropriate friendship stories
• helped find suitable playmates (choosing others, with or without disabilities, who seem compatible)
• encouraged twosomes and play dates (noticing common interests and potential matches)

Conclusions

The approach to building friendship skills in preschoolers with special needs proposed in this article emphasizes three inter-related ideas. One, the classroom as the main therapeutic milieu, and, consequently, the teacher or teachers are responsible for creating a beneficial environment. Two, the related services therapist (in this instance, the speech therapist) has dual tasks. The therapist should use his/her specialized knowledge and skill to assess, establish goals and interventions to help the child achieve domain-specific speech IEP objectives. Additionally, therapists can promote the transfer of this learning into more effective classroom performance in two areas: language and social competence. Integrating both aspects is the challenge. Three, this beneficial classroom ecology requires that the teacher(s), the related therapist(s), and parent(s) continuously inform each other and collaborate, e.g., the teacher incorporating strategies and promoting dyads developed through observations and team planning, the related therapist incorporating peer relationships and inter-personal work into her specialty as she observes the teacher carrying out classroom activities, and the parent incorporating ideas and interventions at home and in the community whenever possible.

Facilities that serve preschool children with disabilities, either in inclusionary or self- contained settings, have an obligation to provide experiences that promote the social- emotional competencies needed for children to have successful peer relationships and to facilitate the children's inclusion in as many settings as possible. An approach that provides frequent and appropriate play experiences in settings that include children with disabilities increases the likelihood that they will learn, generalize new behaviors, maintain skills, and hopefully, make new and lasting friends.

About the Author

Judith S. Bloch, ACSW, is the Founder and CEO of Variety Child Learning Center (VCLC), in Syosset, NY, which provides training, evaluations, early intervention and special education for infants and children to age 7.

References

1. Shonkoff, J. P., & Phillips, D. A. (Eds.) (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academy Press.

2. Bullock, J. R. (1998). Loneliness in young children. Champaign, IL: University of Illinois. ERIC, Clearinghouse on Elementary and Early Childhood Education. (ERIC Digest. EDO-PS-98-1).

3. "The term 'child with a disability' for a child aged 3 through 9 may, at the discretion of the State and the local educational agency, include a child - experiencing developmental delays, as defined by the State and as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas: physical development, cognitive development, communication development, social or emotional development, or adaptive development" (Individuals with Disabilities Education Act [IDEA] Amendments of 1997, Section 602 (3) (B) (i)).

4. Turnbull, A. P., Pereira, L., & Blue-Banning, M. J. (2000). Teachers as friendship facilitators. Teaching Exceptional Children, 32(5), 66-70.

5. McWilliam, R. A. (2000). Recommended practices in interdisciplinary models (p. 48). In S. Sandall, M. E. McLean, & B. J. Smith (Eds.), DEC recommended practices in early intervention/early childhood special education (pp. 47-54). Longmont, CO: Sopris West.

6. Guralnick, M. J. (2000). An agenda for change in early childhood inclusion (p.221). Journal of Early Intervention, 23(4), 213-222.

7. Odom, S. L. (2000). Preschool inclusion: What we know and where we go from here. Topics in Early Childhood Special Education, 20(1), 20-27.

8. SEIT means "an approved program provided by a certified special education teacher on an itinerant basis in accordance with the regulations of the [State Education Department] commissioner, at a site determined by the board, including but not limited to an approved licensed pre-kindergarten or Head Start program; the child's home; a hospital; a state facility; or a child care location..." (New York State Consolidated Laws-Education, Article 89, Students with Disabilities, September 2000, Policy 00-11, p. 36.)

About the NYU Child Study Center

The New York University Child Study Center is dedicated to increasing the awareness of child and adolescent psychiatric disorders and improving the research necessary to advance the prevention, identification, and treatment of these disorders on a national scale. The Center offers expert psychiatric services for children, adolescents, young adults, and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training utilizing the resources of the New York University School of Medicine. The Child Study Center was founded in 1997 and established as the Department of Child and Adolescent Psychiatry within the NYU School of Medicine in 2006. For more information, please call us at (212) 263-6622 or visit us at http://www.aboutourkids.org/.