The first few minutes of an autism group can be critical. How can you turn these few minutes into the most valuable social interaction time? Denise walks you through a simple activity that will supercharge your autism groups. 

— Links from the show
Sample Hello Time Goals

Client will draw something that represents a past experience and relate that experience to another person. 

In a group setting, client will remember details about other group members. 

In a group setting, client will remember details about other group members and make related comments or ask related questions.

Non-affiliate links

Pencil grips

Plastic Brian Jello Mold

Music: Simple Gifts performed by Ted Yoder, used with permission

Transcript

Dan: Welcome to the Mindful SLP, the podcast for SLPs, looking for simple tools and optimal outcomes. Your host is Denise, experienced speech therapist, specialized in all things, pediatric and Dan, business manager for her private clinic

Denise: Hi, thanks for coming back to our podcast. We appreciate you listening to us. And today we’re going to talk about how we can add another tool to your toolbox. We are going to talk about supercharging your hello time and autism groups.

Dan: So what do you mean by that?

Denise: Well, whenever you’re running any learning group, it’s going to be better if you go over the schedule. This is what we’re doing first. This is what we’re doing second. If you were to sit in on a preschool group, you’d see the teacher with a job chart and who’s going to do the weather and who’s going to be the line leader and it’s so-and-so’s birthday and it’s all visual. So the kids can see it.

Well then autism group, you want all of that and a little bit more.

Dan: What would it be a little bit more that you’d need for an autism group?

Denise: Literally, you want to encourage time for saying hello? So, you know, the chitchat that happens naturally when a group comes together before a class or an activity, and the teacher has to say, settle down, everyone, settle down.

Um, well, the ability to have a brief natural conversation where you exchange just a little bit about yourself as really, really important. So you want to have a little bit of that before you get down to going over your schedule in an autism group, but it doesn’t come naturally to kids with autism.

Dan: Tell me about this a little bit more. Let’s dig into the background. How did you develop this method?

Denise: Well, I want to back up here and describe how I stumbled upon supercharging my hello times, context is important because as someone had told me previous to me discovering this activity, that there is a way to teach kids with autism to begin to have natural back and forth chit chat.

So organically, I would have been, huh? I wouldn’t have believed it. I would’ve been so skeptical based on my past experiences. I think I might’ve rejected. It I’ve concluded that such a natural conversation could only come at the end of very many years of therapy.

Dan: You say you stumbled on upon how to do hello time. How did that happen?

Denise: It was pure serendipity. I was trying to solve a different problem and ended up not only solving that one, but also discovering a fantastic way to begin every autism group session.

Dan: I sense a story coming on.

Denise: Stories paint pictures, and I’m going to paint some interesting and I think very relatable pictures for you because if you’ve had an autism group go awry, you’re going to relate.

Dan: Yeah. So what was the original problem that you were trying to solve?

Denise: I was just trying to get the three kids in my autism group to all be attentive at the beginning of the session. I mean, that was it. We needed a semblance of order to go over the schedule or begin anything. And one child in particular that I’m going to call John was having a difficult time just sitting in his chair and he was acting silly and his behavior would get the other two going.

Dan: Oh boy.

Denise: Yeah. So all of these clients were well-behaved and attentive when I saw them one-on-one, but together it was chaotic. I mean, it was hell on wheels.

Dan: So that sounds like you really had your hands full.

Denise: I wouldn’t have wanted someone to walk in on me in those moments. So as a therapist, you want the time to be well-spent.

You want the clients to learn, you want parents to get their value. None of that was happening, as you can imagine, the beginning of the session sets the tone for the entire session. So it wasn’t an optimal situation.

Dan: No, that wouldn’t be good at all. So what did you try?

Denise: Well, first I tried to convey the idea of sitting and being attentive by making three Play-Doh balls, one to represent each child and putting them in the center of the group.

And I explained that our bodies needed to be in a group like the Play-Doh balls. And I showed how one ball rolled out and was away from the group. When a body left the group. I mean, that’s an idea I had heard before. And while it’s a good idea, it wasn’t the solution for this group.

Dan: So, how did that work?

Denise: The Play-Doh ball seemed to ramp up John’s silliness even more.

And there were Play-Doh balls going everywhere, along with bodies. So,

Dan: oh boy. So they weren’t ready to come into the group just because the Play-Doh balls were in a group.

Denise: No, no, that did not translate.

Dan: Where did you go from there? I do hope this has a positive ending.

Denise: Well, the key lay as it so often does in stepping back and observing John.

Dan: Uh, observation. I can see another story coming on. Tell me what did you observe?

Denise: Well, John usually arrived a few minutes before the other two clients and he always asks me the same two questions while he was still in the waiting room because he came on another day for individual therapy, he would ask me what day it was.

See he couldn’t remember if it was a group day or individual therapy day. He couldn’t remember the name of the day of the week even. And when he knew it was our group day, he would ask me who else was coming. He asked me this week after week in spite of the fact that my answers were always the same.

Dan: How did this help you?

Denise: They taught me something about John and also about many other autistic clients. I learned that he had a limited memory for when things happen, who they happen with and even for what things happen in his own life,

Dan: Did the other children in this group have this problem. I mean, John was the one who was misbehaving

Denise: That’s a great question. After I observed him, I was able to observe that to some extent, they all had issues with observing and remembering past experiences, or just being able to put them into words. John’s personality was such that he became more dysregulated by the experience, the excitement of being with kids his own age, but not having the tools to even remember their names and use them, or let alone hold a conversation with them. It overwhelmed him. He wasn’t even sure he would be seeing the other kids that day when he came to therapy, because he had to ask me, so there was no opportunity to prepare, you know, I don’t know if you do this, but I do this like this last weekend, we went to see my family and I’m thinking, I need to ask my stepfather.

He’s having health problems. You know, I care about him. I’m thinking about him. I need to ask him about that. I’m going to ask how that kid in college is doing. And I’m going to ask how this kid is doing. I kind of go that my mind, otherwise I just, I don’t remember. I seem oblivious. I seem inconsiderate. So think about John, who doesn’t even know who he’s going to see that day.

Dan: Yeah, he doesn’t have have that social acuity to even understand that.

Denise: The memory, it was really, really important, but to go on that kind of overwhelm causes some people to shut down, but fires other people up. So John was a very social kid and he was fired up with no direction to go. That’s this behavior now, by the way, it’s a misconception that kids with autism spectrum disorder or antisocial, some have an intense desire to be social and it can come across kind of weird and they try to socialize.

Dan: So it looks like you’re seeing this problem in a whole new light.

Denise: Exactly. It’s that moment when you have a paradigm shift, I realized all the kids in the group needed to build their memory skills. It gets a little weird. If you ask the same person, their name, every time you meet them. And if you get beyond that, then the person with autism will usually go one of two ways.

So they will ask you the same question about you. Every time they see you, they know they’re supposed to be interested in you, but they don’t remember much about you. They’ve got their stock question or they will tell you about what they are interested in, in great detail on and on and on. They’re labeled the bore, their label.

Dan: Hiding behind that so they don’t have to try and show that they don’t remember.

Denise: I know we usually think the latter happens because the person doesn’t realize that you aren’t as interested as they are in the topic. And that could be true. But what if they can’t even remember one thing about you to engage you in conversation about you?

So either way is a conversational, dead end and one must come before the other, I mean, the memory has to come first and then you could work on notice person isn’t as interested as you are.

Dan: Ahh, or what about the problem of getting them just to attend at the beginning of the session? Where does that fit in into your realization about memory?

Denise: I began to see how I could address both problems at once. Isn’t that fantastic when you come across something like that? Yes, I am so excited to share this with our listeners. This one thing has made more difference with my autism groups than any other activity I’ve done. I mean, I’m very strong when I say that it just has supercharging your hello time, addresses behavior, attention, tactile, and visual sensory needs and memory.

And it is so simple to do.

Dan: Wow. This sounds amazing. All right. Tell us more. How do you do it?

Denise: When the children come into the therapy room, I give them a large sticky note and a pencil. I ask them to draw something they did that day or that week. Uh, I provide pencil grips to clients who need them.

Dan: Okay, well, how do you use the pictures?

Denise: When everyone is finished drawing, they take turns holding up their little sticky note and talking about their experience.

So this builds a memory for their own experiences, which can be very poor. They also learn how to talk about their experiences, how to find that right words, how to formulate their sentences if that’s an issue for them.

Dan: Okay. So you’re really getting it to nail down first their own memories. And by using it with the tactile experience of actually drawing those down and gauging that different experience then, so what do you run into obstacles?

I would be in trouble cause I’m not the greatest artist.

Denise: Well, we only do stick figures here well. Somebody and artists go farther, but that is a great question. Nothing this good is going to be without obstacles. Right? So far I’ve had clients who could barely hold a pencil and a pencil grip helps, but initially a little help guiding their hand, that might be called for if they can draw a line, it can represent something.

I mean, I have a client who started in his representation of a face was a line that was a smile, barely curved, like a smile and two dots for eyes. That was it. That was as much as he could do. He’s way past that now.

Dan: So, you know, at least they get a place to start. It’s it’s the whole thing is encouraging them to use that and just build from wherever they are, to build up something more.

Denise: Cause that means something, that line means something to them. I mean, Usually they’ll tell me if they’re having this much trouble. Usually they’ll say something to me. Like, you know, I don’t know what to draw and we’ll brainstorm a little bit and they’ll say, oh, I could draw this. And I say, well, if you kicked a ball at recess, could you draw a ball?

You know, it’s someplace to start, the cue to start their memory.

And another thing, some clients may want to draw the same thing every week. And it’s often a TV show they like, I only let that go on for a couple of weeks. Then I ask them to draw something different. It’s great at first if they just draw anything

But they need to stretch themselves and not fall back on the familiar. And I, especially, especially encouraged them to think of something they did other than something they watched. One is active and the other is passive. And if you’ve ever been with that kid who is not quite skilled socially, and they just go on and on and on about their TV show.

Yeah. Yeah. You don’t want that.

Dan: Especially if you’ve already seen it.

Denise: Um, so yeah, something active that they did is what I really, really encourage. Um, yes.

Dan: Well, it’s getting back to their life and their actual memories, not just something else that just happened. Cause that’s totally outside of them, but you want them to start being able to vocalize and verbalize, you know, their actions.

Denise: Experiences where they were the actor and they had an effect on something. And sometimes you need to brainstorm a little bit with someone who was new to the activity about something they did all like, what did you have for lunch? Um, that’s a good way to start. I mean, that’s where I’ve started with some clients.

One other obstacle could be the child who takes a long time to talk about their picture and they don’t know how to self-edit so, this is what your own verbal model that shows how to condense an experience in a couple of sentences is really valuable. You need to be direct with these clients about using less words so everyone has time to talk.

They don’t know they’re being the conversation hog. They’re going to be socially punished unless you can show them, you know how. That’s one thing I’ve learned, you need to be direct. I model using way too many words. I’ll even cut up little strips of paper and say these, these are my words.

And I’ll demonstrate saying a whole bunch of words really fast at once. And I’ll throw the papers up in the air, just like mess confusion. Well, what happened to my words? Look, they’re all over the place. And then I’ll demonstrate I’m holding up my picture and just saying one or two sentences yeah, you’re you’re, you’re editing yourself this hello time is just to learn how to have that short little chit chat have conversations,

Dan: Because I can see that some people just, just spew, that they need to learn that sometimes it’s better just to have a couple sentences and move on.

Very cool. Okay. So, so far the kids have come in, sat down, you’d given a post-it note and a pencil and they have about drawing one of their memories of something they did this week. Is this a problem when some finished their drawing before others?

Denise: Time has been one of the most manageable factors in this activity, it really surprised me.

I encourage the budding Rembrandts to make a quick sketch, because we want to have time to hear you talk. Uh, and then I can quietly rehearse with the clients who finished earlier. What they’re going to say, how they’re going to say.

Dan: Oh, it gives you time to actually work with the ones who finish early.

Denise: It really works out very well.

Dan: Is it always the same person who finishes early or does it depend on the week and on their memory?

Denise: No, usually I have my Rembrandts and my I’m just learning how to draw kiddos. So some of them start to change into liking to draw more and drawing more detailed and shift over the line, but they usually don’t go back and forth.

Dan: You said that drawing their experiences builds their memories for themselves. How does this help them remember details about others?

Denise: Okay, this is so great. I love this was a brainwave. Um, I have a plastic brain. You can get them on Amazon. It’s a mold we could.

Oh, for like jello. Yeah. Oh, that’s not just for Halloween anymore.

It’s not just for Halloween anymore. So at the end of the hello time, I gathered up their sticky notes and I put them in the brain and I say, we put our memories in our brain. Our brain holds our memories. These are our friend memories, I’m going to ask you about them at the end. I’m going to ask you to remember what your friends did.

 And sometimes I’ll even review the memories as I’m putting them in the brain. John went to his cousin’s, Miranda got ice cream. And my own, I put my own, I always model always, always model. Then I set the brain aside and we do the rest of our activities, the rest of the schedule that we talk about.

Dan: Um, and then how do you bring these back later?

Denise: Well, I think snack time is a great time. If you have time to incorporate snack time into your autism group. It’s wonderful. Um, eating time is social time anyway, right? Although we’re working on conversation all the time, this is a little bit less structured. So while they’re having snack time, I’ll bring out the brain.

Hold up a picture, does anyone remember what Miranda said she did? Who remembers what John said he did? That’s how I bring it back in for them remembering about other people. That really cool thing that happened is one of my kids who was kind of new to this and really struggling to remember anything other people said, okay, We were having apples for snack time.

One of the other kids said that he only liked crunchy apples and he looks up all of a sudden and he’s like, he likes crunchy apples. I mean, he heard what someone else said in the conversation picked up on it, repeated back. I mean, that may sound like a little thing to you, but as actually huge

Dan: It’s a stepping stone,

Denise: it’s what these kids don’t do.

They don’t, they’re not attuned to what other people are saying. Or remembering, it just kind of goes in one ear and out the other and he caught it. And after that, he started remembering the friend memories. Now it’s not consistent. I mean, they’ll remember one week and then remember the next thing I remember the next week consistently.

They might remember when we forget one week, but over time they do become really solid and they will remember every single week what the other kids shared.

Dan: Well, give me some ideas on how you’ve extended these skills, they’re learning into other areas.

Denise: Okay. You can have them draw each other’s memories when they are good enough at this.

And they don’t necessarily need to have something in their hands. They can describe to their friends. So their friend is standing at the whiteboard, say John is sitting down here and he tells Miranda, this is what I did. And she draws it for him.

Dan: Okay. So they’re going from being able to, I mean, before they even, couldn’t verbalize their own actions and their own memories, but once they get used to that, then the next step is to verbalize it and then have someone else draw it.

Denise: Yeah, so the other person is taking on the perspective of their friend when they’re drawing their memory. Right. So perspective taking is a huge issue for autism. They’re kind of taking on the perspective because they’re drawing it for them.

Dan: It really improved. I mean, there’s a lot of skills going on in that, from listening to interpreting, and then, then they got to draw it. Wow.

Denise: I know. And to think that you could get there. I have got there in less than a year. Well, with some of my autism kids, but I have a super funny story here. This is so funny. I had two kids had John and I had Enoch.

John was kind of new at drawing and a hesitant about it, but he was getting into it and Enoch was the Rembrandt. Right. So. he drew very carefully. Um, so they were drawing. John was drawing Enoch’s memory for him and he happened to give him three hands or what looked like three hands. Cause he was a little bit new at this drawing, well Enoch is across the table from him.

And he looks over and he’s like, he’s having a little meltdown. He could not get over it. Oh, that was. So funny. Okay. Yeah. Okay. It looks to you, at least he was drawing body parts. So anyway, another thing is you can begin to segue into future plans and I’ll model this like tonight, I’m going to the movie. Hi, I’m going to get ice cream and I’ll draw a picture of what I expect to happen.

So that’s building a future memory, memory for expectation. Cause that’s also a problem. They can’t anticipate what is going to happen. You can start to build that in and then journaling, this really is pre journaling. Right? Right.

Dan: So it’s just a visual journal.

Denise: Yeah. It’s a visual journal and you’re verbalizing it and I’ve moved kids from that into giving them a piece of paper where the top half is empty.

The bottom of it has the lines. They draw the picture at the top and they write, or sometimes I write for them their memory and bam, they have a journal page. They can take it home. They can build a journal book. They can start to build memories for more than just the past week. If you’ve got a date on it,

Dan: This sounds like something that their families can do as well. Then, you know, you can extend this out beyond the group and into the family.

Denise: Absolutely. Everyone wants a chance to talk about themselves. You remember our kids growing up, but sometimes it’s a bit of a competitive, so conversation, there’s actually been studies done, conversation is a competition,

Dan: Right? And I remember because we had one child who was extremely expressive and vocal and he would dominate the conversation in our quiet when we’d never get to say anything. And I always felt bad because I felt like I was suppressing the child who was verbally explosive, just to hear from the other child and get them included and that the verbal child was feeling resentful.

Denise: You can feel bad about the family dynamics, right? Um, these can be tricky, these to figure out how to work with, but this is a great way to work with it because everyone. gets their chance, you can be working on your picture, thinking about planning about what you’re going to talk about. Um, and by the way, I don’t have them continue drawing when other people are talking.

No, because you’re paying attention now to this other person, but families know the context of what the child is talking about that can really help with the memory building. They can help with everyone getting their turn. You know, the next time I have an autism group, I’m going to direct the parents to this podcast because I want them to do it.

Um, sometimes it’s hard to take this much time to explain to parents, you could do this, but here, now it’s in a podcast.

Dan: Oh, I can see all sorts of things that you could do with as a family to, to bring this in to help with all sorts of dynamics in the family,

Denise: Autism not required for this activity.

Dan: Yeah, this could really be used in lots of different places. Well, this also makes it easy to measure, right?

Denise: Yes. Social skills can be this amorphous goal that you’re like, how do I even write something to measure this? Well, you can measure whether they can independently share their own memory this number of times. Whether they can independently remember a friend memory with visual cues.

That means with the sticky note or without visual cues. Cause eventually I don’t show them the sticky note and I send to remember lots and lots of different goals. And now we’ll include some of those in the show notes. I’ve already got lots of written cause I’ve been doing this for a while.

Dan: Have you seen an effect beyond the group session that this has had?

Denise: Yes. I’ve been able to see one and I believe it has extended more than what I’ve seen, but the one example, um, so I had two kids who liked the same cartoon show. In fact, they liked the same little song that went with the cartoon show and they would sing it together. And so one time, just the beginning of the session, one of the kids came into the waiting room with his lunchbox, which had the cartoon character on.

And I said, I brought this because I want to show it to John. Uh, and he didn’t say, because we both liked this cartoon, you know, but it was obvious. So he remembered outside of therapy, what this other child liked, you know, put it together. This is what he liked, that they shared something, something they could talk as a shared experience.

I mean, that’s what you’re trying to get with a social goal, a shared experience that both people can talk about.

Dan: That’s really good. So what do I need?

Denise: Okay. So simple. You need sticky notes. Pencils, maybe a pencil grips, the best ones that I have found I’ll link to in the show notes and something to represent a brain.

It can be a bowl even with a picture of a brain on it. Right.

Dan: Okay. And then how do I do it again? Re refresh my memory.

Denise: So occupy them as soon as they come in, if they don’t all come into your therapy room at the same time, this is great. Sometimes some kids are a few minutes late, but you need to start on time.

So this is a great time management tool that way. Occupy them as soon as they come in with the sticky note and the pencil, gently encourage the detailed drawers to do a quick sketch, give help when needed for beginning drawers. Yeah. Don’t over help though. Cause I have seen them really start to take off on their own and fly.

If you hold back a little bit, try to only give them just as much help as they need. Model by drawing your own memory and sharing it. Okay. So you do the share you review it, put the sticky notes in the brain, then do your other things come back and do their friend memory at the end of the session.

Dan: That sounds really simple.

Denise: It is simple and it works so well. And then elaborate it elaborate as you can, you know, like elaborations I talked about, you can build those when you see that the group is ready.

Dan: What do we want people to try?

Denise: Try it. If you have a group, try it. Um, and come and tell me about your experience at SLP pro-advisor dot com. What is so fantastic about this approach is I don’t have to teach them how to converse that amorphous kind of out there, skill how you teach conversation. They’re learning it as they remember memories about each other. And as a model talking about each other, I’ve seen the conversation happen where before I tried to teach conversation more direct way, and it was just really hard going.

Dan: Right. I mean, that’s a tough skill to teach directly, but I think you’re right, this, this kind of approaches it from a sideways angle by gaining them to just talk about things that’s familiar to them. And then eventually just builds right in naturally. And that’s what you really want to do, it’s how the rest of us all learned how to do it too.

It’s just giving them a pathway that is very easy, very familiar and is manageable. Yeah, it can be a lot of fun in the meantime.

Denise: Go on. I’ve seen them start to talk at snack time and during other parts of the session too, I see them start. I mean, it’s very gradual, but it’s a beginning. It’s a beginning that I never thought I could see so soon.

So the sooner you do this, the more time they have to practice these conversation skills, which by the way are so, so needed when they reach adolescence it’s conversation, it becomes such a subtle skill. When you’re an adolescent building that as soon as you can, is super, super helpful for these autistic clients.

Dan: There, you have it, there’s another tool for your toolbox. Dive in with these autistic groups and try this. Let us know what you think. SLP pro-advisor dot com is where the conversation’s happening. Thanks. And we’ll talk to you next week. Thank you for listening to The Mindful SLP. We hope you found some simple tools that we we’ll have optimal outcomes in your practice.

This podcast is sponsored by SLP pro-advisor. Visit SLP pro-advisor dot com for more tools, including impossible are made possible. Denise’s highly effective course for treating those troublesome R’s. A link is in the show notes. If you enjoyed this podcast, please give us a five-star rating and tell your fellow SLPs.

And please let us know what you think. Join the conversation at SLP pro-advisor dot com.