are social skills playgroups

[Anonymous]

Anonymous wrote:This started out as an interesting thread but turned convoluted and contentious - if anyone has any more on-point input I would really like to hear it because I'm considering a social skills group for my non-ASD almost 4 year old. I've talked to Parenting Playgroups about the one they have and am considering one other, but it is perplexing to figure out if it is right for my child. The especially tricky part is that you essentially have to sign up w/o knowing the issues the other children in the group will have.

My son is hesitant in social settings and doesn't seem to do well at really getting himself involved in the play - maybe anxiety, it's not entirely clear. He clearly wants to play with the other kids more than he does, but seems unclear about how to do it. We do playdates (and he goes to preschool), but my thought is that a small group - smaller than his preschool class, but bigger than a one on one playdate -- with some facilitation (unlike a group get together at the park or something with all the moms chatting on the side) might help him bridge the gap. But...I do wonder if I'm going to be doing more harm than good if there are kids in the group with behavioral issues, etc...(my son is not aggressive at all, well-behaved, shares, takes turns, etc...one of the things he needs to learn is how to deal with kids who are less well-behaved, aggressive and so forth, but I'm not sure this group is the right place for that).

Any thoughts??? I'm not sure what else other than a social skills group is the right kind of intervention. I've considered OT, which might be helpful in that I think he has some sensory defensiveness (doesn't like loud settings for example), but OT doesn't seem like it will directly address the situation.

You son sounds very similar to mine. Mine is in preschool and is more of a "watcher" than an interactor. He is 5 year old, though delayed in all areas including size about a year or a little more so is more like an almost four year old. He is shy, does have a bit of social anxiety (nail biting, etc) but is friendly and outgoing when comfortable. He is also gentle and sweet and loves other children once he feels comfortable with them. He is doing very well in preschool but if not actively engaged by the teacher in the activity, will watch from the outskirts. He has as speech delay, but most children can understand most of what he is saying. I worry that he will end up the receiving end of bullies because he is very gentle and "sweet" but not assertive - similar to how you described your son.

I too was looking into social skills playgroups but wonder if we might form our own? If you're in Bethesda or nearby, maybe we might get out guys together for a playdate? Let me know. You can email me at [e-mail]

[Anonymous]

good lord greenspan fanatic. . . you have enormous amounts of time to devote to these threads.

and the obsession with Dr. Greenspan is downright spooky.

[Anonymous]

To the woman who speaks in absolutes: Do you even read what you post? Even your own gospel says,

"The results of the chart analysis are impressive, but should be interpreted with caution. Due to sample limitations, the results only apply to the children used in the study. More research needs to be conducted with a larger and more diverse population, and by researchers other than the creators of Floor Time. In addition, a controlled scientific study would provide more definitive information on the efficacy of Floor Time intervention. However, the results of the chart review indicate that some children with autism are capable of symbolic thought, and they can make significant improvements in social relationships and affect...

...The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies."

I wish I could believe your promise not to post on the other social skills thread. You've 'mis-written' so many other times before.

[Anonymous]

Anonymous wrote:To the woman who speaks in absolutes: Do you even read what you post? Even your own gospel says,

"The results of the chart analysis are impressive, but should be interpreted with caution. Due to sample limitations, the results only apply to the children used in the study. More research needs to be conducted with a larger and more diverse population, and by researchers other than the creators of Floor Time. In addition, a controlled scientific study would provide more definitive information on the efficacy of Floor Time intervention. However, the results of the chart review indicate that some children with autism are capable of symbolic thought, and they can make significant improvements in social relationships and affect...

...The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies."

I wish I could believe your promise not to post on the other social skills thread. You've 'mis-written' so many other times before.

Another poster who read the article. I was struck by the piece in red. . .

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As Jeff suggested, I will continue to IGNORE the viciousness and keep this thread on track. The topic was about social skills playgroups and I'm keeping to this topic only. I don't care if you try to discredit me anymore so keep ranting away. I'm sticking to the purpose of this thread and supplying valuable information to parents of special nees kids.

Btw, I know Dr. Stanley Greenspan. He would be more blunt with you than I was.

how could you POSSIBLY supply more information than you already have? PLEASE give it a rest. Your behavior is bizarre, and I do mean that personally.

I'm the poster whose child you said has serious challenges, is a thread infector, nut job, thread hijacker: You are free to go to the OTHER social skills playgroup thread that was created if you wish to avoid me here. I will not post there.
And yes, there is more to publish. Here's another great writeup. Read the boldface part about Greenspan's Floortime model and it's astounding results (read in particular the part about social skills playgroups). Keep in mind this says it's about ASD children but it ALSO applies to children with social developmental challenges.

Play Time: An Examination Of Play Intervention
Strategies for Children with Autism Spectrum DisordersContributed by Johanna Lantz

There is no question that play is an integral part of child development. Through play, children learn social skills such as sharing, cooperation and turn-taking. Social language is learned, self-esteem is built, and friendships are formed during recreational activities with peers. Play encourages cognitive enrichment, emotional growth, and influences personality development. It offers a means of exploring various societal roles and rules, and provides time to practice finding solutions to problems. Creativity and imagination are fostered through play. For typically developing children, engaging in pleasurable, imaginative and socially interactive activity is a natural part of life. In contrast, many children with autism spectrum disorders do not play in a manner that is beneficial to development. Skill deficits and interfering problem behaviors often inhibit productive play in children with autism spectrum disorders; consequently, this crucial aspect of development should be a target for early intervention. Pamela Wolfberg’s Integrated Play Groups (IPG) and Stanley Greenspan’s Floor Time are two intervention strategies that are intended to increase developmentally beneficial play in children with autism spectrum disorders. This article will discuss IPG and Floor Time, and will examine research that has investigated the efficacy of these models.

Play Characteristics of Children
with Autism Spectrum Disorders


Wolfberg (1995) defines play as an activity that is pleasurable, intrinsically motivated, flexible, non-literal, voluntary, and involves active engagement. In contrast, children with autism spectrum disorders often engage in inflexible, repetitive play patterns and may not exhibit symbolic or pretend behavior. Individuals with this disorder tend to view the world as concrete and literal; consequently, they may have difficulty with abstract concepts and imaginative behavior. Children with autism spectrum disorders may also display deficits in sequencing and motor planning. As a result of these deficits, they may not develop play scripts or understand the scripts of other children. Play in children with autism spectrum disorders is often solitary. Several factors contribute to the lack of social play. First, individuals with autism have communication deficits. They may not understand the language or social cues of peers, or have the ability to express their feelings effectively with others. Second, children with autism spectrum disorders may not understand that others have their own unique thoughts and feelings. This lack of understanding limits reciprocity in relationships. Third, it is common for individuals with this disability to have restricted and unusual interests, so they may be resistant to explore new play themes with others. Finally, peers may exclude children with autism spectrum disorders or may not understand how to effectively engage them in play. In summary, factors inhibiting social play in children with autism spectrum disorders include the following: communication deficits; difficulty understanding the feelings of others; restricted and unusual interests; and peer exclusion.

The Integrated Play Group Model

The Integrated Play Group Model, which is based on Vygotsky’s social constructivist theory, aims to improve the social and symbolic play skills of children with autism spectrum disorders ages 3 to 11. In addition to addressing skill deficits, the IPG model also emphasizes developing the intrinsic desire to play. According to Wolfberg and Schuler (1993), in the IPG model, “Play development is fostered by physically arranging the environment to bring about the most competent forms of play, and by guiding participation within these environments while capitalizing upon child initiations.” It is important to differentiate between social skills training which involves direct skill instruction, and IPG which provides a support system for a childs’ initiations.

Integrated play groups contain guides, expert players, and novice players. Guides are adults who have training in IPG and experience working with individuals with autism spectrum disorders. The play group guides use various methods of assessment to determine how to best coordinate play activities to maximize the social and cognitive development of the participants. The expert players are socially competent peers, and the novice players include children with autism spectrum disorders at any level of functioning. The groups are comprised of three to five children with a higher ratio of expert to novice players. The IPG model is based on the concept of guided participation. The guide adjusts the amount of support given during the play group sessions according to the needs of the children, and builds on the interests and abilities of the group members. Initially, the guide directs the play activity. As the children become more capable of creating play themes, initiating interactions and setting up play events, the guide fades support until no direct guidance is provided. Transitions are often challenging for children with autism. Consistency in schedule and routine are important components of the IPG model because they help participants anticipate future events. The same groups meet regularly in natural settings, two to three times a week for 30-60 minutes. Opening and closing rituals are utilized and visual cues provide additional support. Materials such as constructive and sociodramatic toys are selected to encourage interaction and imaginative play.

Wolfberg and Schuler (1993) examined the efficacy of the IPG model. The researchers were interested in determining if the model would increase the functional and symbolic use of objects and social play of individuals with autism. In addition, they investigated whether qualitative improvements in play skills would generalize to different settings. The researchers conducted three play groups in a public school setting for 30 minutes two times a week for four months. Each group contained two novice players and three expert players. Data were collected on three of the novice players with autism. The results indicated that all participants with autism engaged in a greater percentage of functional and symbolic toy use and social play after the IPG intervention. Parent and teacher interviews revealed that qualitative play improvements were evident in a variety of settings. This research is promising; however, the results are somewhat limited by the small sample size and lack of a control group. More research should be conducted on the IPG model.

The Floor Time Model

Greenspan’s Floor Time offers another play intervention for preschool age children with autism spectrum disorders. The Floor Time model focuses on developing relationships and affect. Interventions are designed according to the child’s developmental level and individual characteristics. Greenspan explains that although affective engagement such as showing pleasure, sharing emotions, and reciprocating interactions is secondary to the primary symptoms of autism (e.g., cognitive deficits), affect and relationships are more amenable to intervention. Greenspan believes that through affective interaction, children with autism will concurrently experience cognitive and emotional growth.

Floor Time is child directed and adult supported. It provides an opportunity to transform perseverative play into more meaningful and developmentally beneficial behavior, and works to expand the play themes of children with autism spectrum disorders. At the same time, it is designed to help the child develop relationships with others. Floor Time involves five steps:



The adult observes the child playing in order to determine how to approach him/her.


The adult approaches the child and joins the activity while trying to match the child’s emotional tone.


The child directs the action and the adult follows the child’s lead.


The adult expands on the child’s chosen play theme without being intrusive.


When a child builds on the adult’s input, the child “closes the circle of communication” and starts a new circle.

It is crucial that the adult does not use Floor Time as a time to teach a particular skill. It is also important to remember that the child is the leader of the activity.

Floor Time can be used to change perseverative behavior. For example, if a child is fixated on lining up blocks, the adult joins in and adds blocks to the child’s line. Then the adult may place a block perpendicular and start the line going in a different direction. When the child continues the new line, he/she has “closed the circle of communication.” Some suggestions for Floor Time include inserting obstacles into play and helping the child problem-solve. If a child has very limited play themes, it may be helpful to use sensory toys (e.g., sand tables, shaving cream, bubbles) or use popular characters that the child enjoys to gain attention.

Greenspan and Wieder reviewed the charts of 200 children diagnosed with autism spectrum disorders, and found that most children who received Floor Time intervention for at least two years made significant improvement in all areas of development. All children in the study received two to five hours of Floor Time interaction at home in addition to comprehensive services such as speech therapy, occupational therapy, and special or general education services. The researchers claimed that 58% of the participants made “good to outstanding” progress, which they defined as making significant improvements in affect, social behavior, cognitive skills, symbolic play, and creative behavior. In addition, the “good to outstanding” children no longer engaged in avoidant, self-stimulatory, or perseverative behavior. According to the authors, all of the children in the “good to outstanding” group were no longer considered autistic according to the Childhood Autism Rating Scale (CARS); however, these findings need to be replicated by other researchers not involved in the development of Floor Time. Twenty-five percent of the children were defined as having made “medium” progress. These children made affective improvements and gains in gestural communication, but they still evidenced significant delays in symbolic language and play. The “medium” group no longer engaged in self-stimulatory, avoidant, perseverative behavior. The researchers reported that 17% of the children were considered to have “ongoing difficulties.” These children made little or no improvement in affect, symbolic ability, attention, or avoidant behavior. The researchers added that most children in the “ongoing difficulty” group presented more extreme autistic symptomology when first evaluated.

The results of the chart analysis are impressive, but should be interpreted with caution. Due to sample limitations, the results only apply to the children used in the study. More research needs to be conducted with a larger and more diverse population, and by researchers other than the creators of Floor Time. In addition, a controlled scientific study would provide more definitive information on the efficacy of Floor Time intervention. However, the results of the chart review indicate that some children with autism are capable of symbolic thought, and they can make significant improvements in social relationships and affect.

Play is a voluntary activity and is differentiated from social skills training in which specific skills are systematically taught. In the IPG and Floor Time models, skills are learned indirectly through guidance and interactions with others. Both the IPG model and Floor Time are based on child initiations that are supported by adults.

The IPG and Floor Time models have strengths and weaknesses. The primary advantage of both models is that they allow children with autism spectrum disorders the opportunity to explore relationships with others on their own terms without the imposition of adult demands. One disadvantage of the IPG model is that it requires regular participation from at least two typically developing peers, an appropriate setting, and trained guides to facilitate the group. This may be difficult to organize without the cooperation of a school or community group. Some disadvantages of the Floor Time model are that it does not address social interaction with peers, and there is little information on generalization of skills to other situations and settings. More research on the efficacy of IPG and Floor Time needs to be conducted by individuals who have not been involved in the development of the models. Although a few limitations exist, both intervention strategies have merit and deserve further investigation. As with any intervention, individual differences and desired outcomes need to be considered when deciding what method to use and progress needs to be regularly evaluated.

Summary

Through play, children learn a variety of skills that are fundamental to development. Many children with autism spectrum disorders have skill deficits and interfering problem behaviors that hinder developmentally beneficial play. Integrated Play Groups and Floor Time are two early intervention strategies that aim to improve qualitative play skills in young children with autism spectrum disorders. In both models, direct instruction is not provided; rather, adults provide support to child initiated interactions. The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies. Early intervention efforts typically focus on the development of communication skills, social skills training, and the reduction of problem behaviors through direct instruction. Often a child with an autism spectrum disorder has a day filled with constant demands from adults, which when compared to the expectations placed on typically developing children, seems unnatural and developmentally inappropriate. It is proposed that skill deficits addressed through child directed and adult supported play become a standard component of early intervention practice.

Suggested Readings and Websites

Greenspan, S. I., & Weider, S. (1998). The Child with Special Needs: Encouraging Intellectual and Emotional Growth. Reading, MA: Addison-Wesley.

Greenspan, S. I., & Wieder, S. Developmental patterns and outcomes in infants and children with disorders in relating and communicating: A Chart Review of 200 Cases of Children with Autistic Spectrum

Diagnoses. World Wide Web: www.icdl.com/greenspa.html

Integrated Play Groups: www.wolfberg.com.

Wolfberg, P. J. (1999). Play and Imagination in Children with Autism. New York, NY: Teachers College Press - Columbia University.

Wolfberg, P. J. (1995). Enhancing children’s play. In K. A. Quill (Ed.), Teaching Children with Autism: Strategies to Enhance Communication and Socialization (pp. 193-218). Albany, NY: Delmar Publishers.

Wolfberg, P. J., & Schuler, A. L. (1993). Integrated play groups: A model for promoting the social and cognitive dimensions of play in children with autism. Journal of Autism and Developmental Disorders, 23, 467-489.

I hope I never get stuck sitting next to you on an airplane.

[Anonymous]

that was funny.

[Anonymous]

It's bad enough being subject to her on DCUMs, I can only imagine how horrid it would be to be stuck on an airplane with her! I guess I should be careful what I post. I'll probably get accused of trying to limit her ability to travel!

[Anonymous]

WWSIA (woman who speaks in absolutes) has totally twisted what Dr. Greenspan promotes. His approach in no way contradicts or negates what others have said they've done. His philosophy is that you have to master foundational skills prior to moving to the next and if a child hasn't mastered those, there's no point in moving on no matter what the child's age. Our more mildly afflicted children don't need the same intensive interventions as others who might use Floortime. My child certainly has those foundational skills, he just needs some assistance and an environment to practice - all of which Dr. Greenspan supports and would consider as part of a "transitional" experience or education. Doing Floortime with him would be like getting a backhoe when a garden trowel would be sufficient.

As with many fantatics, she has twisted and misinterepreted a philosophy.

[Anonymous]

Anonymous wrote:WWSIA (woman who speaks in absolutes) has totally twisted what Dr. Greenspan promotes. His approach in no way contradicts or negates what others have said they've done. His philosophy is that you have to master foundational skills prior to moving to the next and if a child hasn't mastered those, there's no point in moving on no matter what the child's age. Our more mildly afflicted children don't need the same intensive interventions as others who might use Floortime. My child certainly has those foundational skills, he just needs some assistance and an environment to practice - all of which Dr. Greenspan supports and would consider as part of a "transitional" experience or education. Doing Floortime with him would be like getting a backhoe when a garden trowel would be sufficient.

As with many fantatics, she has twisted and misinterepreted a philosophy.

This post was helpful and provided some necessary context to other posts. Much appreciated and thank you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:WWSIA (woman who speaks in absolutes) has totally twisted what Dr. Greenspan promotes. His approach in no way contradicts or negates what others have said they've done. His philosophy is that you have to master foundational skills prior to moving to the next and if a child hasn't mastered those, there's no point in moving on no matter what the child's age. Our more mildly afflicted children don't need the same intensive interventions as others who might use Floortime. My child certainly has those foundational skills, he just needs some assistance and an environment to practice - all of which Dr. Greenspan supports and would consider as part of a "transitional" experience or education. Doing Floortime with him would be like getting a backhoe when a garden trowel would be sufficient.

As with many fantatics, she has twisted and misinterepreted a philosophy.

This post was helpful and provided some necessary context to other posts. Much appreciated and thank you.

IF I understood your point correctly, what you wrote is actually not true. DC is a perfect case in point. He was dx by Greenspan as being mildly affected. He's not on the autism spectrum. Yet he did require several floortime sessions a day and four OT sessions a day. I have met two other parents who saw Greenspan for their own kids. They, too, were dx with mild non-spectrum disorder but their parents were still asked to do 4 floortime sessions and 6 mini OT sessions per day. So unless you have seen Greenspan for your child or perhaps at least have read his books, you would not know Greenspan's protocol to make your claim.

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the woman who speaks in absolutes: Do you even read what you post? Even your own gospel says,

"The results of the chart analysis are impressive, but should be interpreted with caution. Due to sample limitations, the results only apply to the children used in the study. More research needs to be conducted with a larger and more diverse population, and by researchers other than the creators of Floor Time. In addition, a controlled scientific study would provide more definitive information on the efficacy of Floor Time intervention. However, the results of the chart review indicate that some children with autism are capable of symbolic thought, and they can make significant improvements in social relationships and affect...

...The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies."

I wish I could believe your promise not to post on the other social skills thread. You've 'mis-written' so many other times before.

Another poster who read the article. I was struck by the piece in red. . .

Parenting Playgroups owner teaches and talks about Floortime in her own parenting lectures. Kennedy Krieger, the Johns Hopkins autism clinic, also uses Floortime. Many places throughout the country do use floortime. Remember that this writeup says it has not been tested by other than floortime researchers. It does not say Floortime is ineffective. In fact, it says floortime is extremely effective; it just hasn't been rigorously tested. Many treatment modalities for developmental problems have not been tested though. As far as I know, RDI does not have double-blind tests to back up their treatment strategies. Does ABA? Who knows, really. How do you do double-blind studies for psychiatric treatments of developmental problems anyway. I published this not to show that floortime is the ONLY way to treat a child with challenges. I published this to show Floortime is one profoundly effective way for most of them. I have, in fact, used RDI with my own DC and it was wonderful. It was limiting when he got older, but very effective when he was a toddler. I also published this to show that it talks a bit about social skills training and how social skills training focuses on discrete behavior training as opposed to development. Just a reinforcement of Greenspan's own position.

[Anonymous]

You don't need to reinforce Greenspan's protocol or approach anymore. We get it. BELIEVE ME, we get it.

[Anonymous]

If you read widely, you will find that Greenspan's approach is not generally seen as a gift from the gods. He makes some good points, he makes some iffy points, he has limited research to back up his ideas. Some patients are very satisfied, some are quite unsatisfied. Quoting Greenspan is just that, quoting the opinion of one expert among many - it may hold true for your child, or it may not.

[Anonymous]

I've never heard or read anything from Dr. Greenspan that contradicts the approach we're taking. We've not only consulted with Dr. Greenspan, we have also read his books and several of our therapists have attended his workshops and incorporate the Floortime philosophy in therapy and in their social skills group. We also see a large and diverse number of other specialists. None of their approaches have been contradictory, just the opposite, they've been reinforcing. I can't speak to approaches used for ASD kids and their effectiveness but Floortime is just one more tool in our toolbox - not the only tool. You also need to make sure you have the right tools for the job and there is no universal tool. Given the number of professionals we've seen, I know our situation is not unusual.

Parents may not realize it but, Floortime is widely studied and therapists incorporate many of those theories into their own sessions. Subsequently, what parents observe in sessions and they reinforce at home. They may not call what they do at home Floortime but once caregivers are made aware of what to focus on, therapy is easily incorporated into daily routines, much like the sessions you're talking about.

Your logic is flawed if you're dismissing all other approaches other than Floortime because you consider your DC mildly affected. Compared to other children, your DC may be considered mildly affected but he clearly hadn't mastered some essential skills needed to reach his full developmental potential. You were instructed to engage him in certain ways a certain number of times per day. This isn't any different than the homework we get from our OT. Progress is very dependent upon how often it's done and Dr. Greenspan certainly requests a certain level of interaction. I can guarantee you that not every parent follows the plan diligently. But, that doesn't mean other approaches don't work. Unless you're going to be seeing him soon, I suggest you re-read some of his publications. Children who have empathy, understanding and engage in reciprocal relationships can benefit greatly from transitional activities such as social skills group, gymnastics, karate and any other activity that allows them to build on the strengths and skills they have. You don't always need Floortime.

[Anonymous]

Anonymous wrote:I've never heard or read anything from Dr. Greenspan that contradicts the approach we're taking. We've not only consulted with Dr. Greenspan, we have also read his books and several of our therapists have attended his workshops and incorporate the Floortime philosophy in therapy and in their social skills group. We also see a large and diverse number of other specialists. None of their approaches have been contradictory, just the opposite, they've been reinforcing. I can't speak to approaches used for ASD kids and their effectiveness but Floortime is just one more tool in our toolbox - not the only tool. You also need to make sure you have the right tools for the job and there is no universal tool. Given the number of professionals we've seen, I know our situation is not unusual.

Parents may not realize it but, Floortime is widely studied and therapists incorporate many of those theories into their own sessions. Subsequently, what parents observe in sessions and they reinforce at home. They may not call what they do at home Floortime but once caregivers are made aware of what to focus on, therapy is easily incorporated into daily routines, much like the sessions you're talking about.

Your logic is flawed if you're dismissing all other approaches other than Floortime because you consider your DC mildly affected. Compared to other children, your DC may be considered mildly affected but he clearly hadn't mastered some essential skills needed to reach his full developmental potential. You were instructed to engage him in certain ways a certain number of times per day. This isn't any different than the homework we get from our OT. Progress is very dependent upon how often it's done and Dr. Greenspan certainly requests a certain level of interaction. I can guarantee you that not every parent follows the plan diligently. But, that doesn't mean other approaches don't work. Unless you're going to be seeing him soon, I suggest you re-read some of his publications. Children who have empathy, understanding and engage in reciprocal relationships can benefit greatly from transitional activities such as social skills group, gymnastics, karate and any other activity that allows them to build on the strengths and skills they have. You don't always need Floortime.

Please read what I wrote above. I specifically said that I'm not saying Floortime is the only treatment that may work. What I am saying is that it is one profoundly effective treatment. I mention above that I also used RDI with some success. And I think I did also mention above that Floortime is used throughout the country in many, many programs. Though Greenspan created Floortime, lots of people have incorporated it into their treatment. Greenspan's floortime is a bit different from other floortimes, though any floortime is better than none. But seeing as how you are already a patient of Greenspan you already know what those differences are.

You said 'children who have empathy, understanding and engage in reciprocal relationships can benefit greatly from transitional activities such as social skills group...' I'm going to focus on social skills groups only and not address the gymnastics, karate part because that is the subject of this particular thread. If a child is developmentally already quite healthy in terms of his empathy, ability to relate in reciprocal relationships, then why does he need the social skills groups to begin with? Children whose parents seek out social skills groups often do so because their kids are lacking in some foundation skills that is necessary for good social interactions and necessary for friendships. There are some holes in that foundation Greenspan talks about. Mildly affected kids have circles of communication to engage in social reciprocity, but just not enough, or sometimes it is hard for them to have greater circles of communication if it's a subject not of their own choosing. There could be all kinds of reasons why they just are not able to form friendships on their own, but the fact that they can not usually means something is missing in the foundation and those are holes that need to be filled.

I didn't quite understand you when you wrote, "unless you're going to see him soon, I suggest you re-read his publications." Please state specifically what part of his program or teaching you think I misunderstood. Is it that some effort, even if not full effort, will result in improvement? That I already knew but the best results are seen if the patient follows Greenspan's treatment as much as is humanly possible. Is it that I think other treatments do not work? Never said that. In fact, Greenspan himself says ABA may be called for but only in some cases. And again, I mention above that I used RDI which is not a Greenspan approach.

Did you read the ICDL article Greenspan published that talks about social skills groups relying on rote memorization? He explains their disadvantages. Can you please show me the quote where Greenspan actually suggests social skills programs relying on rote memorization are beneficial? Jake Greenspan runs DIR Support Services where they do in fact have social skills playgroups. DIR is affiliated with Greenspan's office (Jake is his son). It is where they do OT also. Greenspan would not permit social skills groups to take place at any office he's in control of if he thought they were all worthless. It's the rote memorization part that he doesn't think works. It's the learning of discrete behaviors part that he says is not effective in promoting healthy development. So please share with me the quote from Greenspan where he recommends social skills groups that do this.