Social Stories Help Reduce Anxiety in Children with Autism

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By Sarah Kassam-Hirji - Speech and Language Therapist

Social stories are exactly what their name suggests; very short and simple stories that illustrate a particular social scenario, often in picture format. They aim to help increase a child’s understanding of how to behave and what is expected of them in a given social situation. 

Visual strategies are highly effective tools to support language skills, and social stories can provide support to help children who struggle in social situations.  Examples may be using a social story to help a child line up, lose a game or stay in bed through the night.

It is important for a social story to be short and focused to keep the child’s attention. They are frequently used with children on the autistic spectrum to help them understand social cues and reduce anxiety, especially in unfamiliar settings.

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A social story should provide the basics of what will happen in that setting/situation, and how the child should ideally behave.  The idea is to write out exactly what happens and why, how it makes the child feel and the expected response.  Symbols are used to show these language concepts, but for some children it can be useful to have photos of themselves in the situation as well.  

As with all things in life, there will be unexpected variables that a parent/caregiver won’t be able to control for, but the story should provide a basic foundation of support and understanding.  

Key points to remember when writing social stories:

  • target one specific situation at a time

  • keep language simple

  • keep it positive

  • remain consistent

  • Children thrive on repetition and learning takes time

My experience has been that all children with language difficulties benefit and respond really well to the visual cues and prompts that are provided within each story.  We all struggle at times with how to behave in social situations and social stories can help give a child the ability to maintain emotional wellbeing as stress and anxiety are reduced when understanding increases.

A story that I have used time and time again with my children is ‘When I’m Frustrated’. Please note that the word ‘frustrated’ can also be substituted for ‘cross’, ‘upset’ or ‘mad’ – whichever the child will relate to best.   The story helps support understanding of the emotion of anger and has been useful across many social situations.  In general, emotions are difficult to understand and explain, and stories that help target emotions in relation to stressful scenarios can be very beneficial.

This story in particular illustrates the idea that sometimes situations will make us feel upset or angry, but there are different strategies that we can use, such as counting or breathing, that can help regulate our feelings once again. This then helps us return to the social situation and ask for what we need.  It also shows that these feelings pass and that we will feel better soon enough.

As  a wellbeing expert and speech and language therapist, this is a vital story for me to use with children that struggle with maintaining and regulating emotions when social situations become highly stressful for them. I believe stories that help children understand emotions can really impact how much a child continues to be motivated for peer engagement. This can then help develop other key skills such as turn taking and problem solving.

The wonderful world of Pablo!

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By Danielle Allen - Service Administrator

Autism Spectrum Disorder (ASD) is still a disorder that is vastly looked over. It is a complex disorder that has a variety of levels from mild escalating up to severe. Luckily today, although overlooked, people are becoming more aware of it and that it isn’t just a child misbehaving in the supermarket. As a mother I have found it hard trying to explain to my children why other people may act or look a little different to them and have found it such a relief that Cbeebies cover a wide range of disabilities and disorders in their TV shows or with their presenters. From previously working in an NHS setting providing paediatric training and now working in a Speech and Language Therapy setting for paediatrics, I have had some exposure to ASD children, but it wasn’t an area I was particularly knowledgeable in until doing my own research and then discovering the Cbeebies show Pablo which was released late 2017.

After work I often join my children on the sofa for a cuddle and to relax to the sound of the TV in the background whilst they tell me about their day at school. It has become routine now that once I get in we will put on Cbeebies for the 5.45pm show of Pablo. This is incredibly child friendly and explains in a simplistic way about the many troubles someone who has autism could be experiencing and why they react the way they do. Even with Pablo's autism being as mild as it is, the programme helps outline what autism is. Not only is it informative for the child watching but also for us as the parent or carer. In the show each character represents a different area of autism and although all those who have autism do not necessarily show all areas of it, it is a guide to and broad representation of autism.

  • Noa the dinosaur is great at problem solving but finds it hard to read others facial expressions

  • Llama loves to repeat things others say and has a keen eye for detail

  • Draff the giraffe loves to learn facts and is often heard saying “in point of fact”

  • Mouse doesn’t like loud noises or crowded places but is very organised and is also a perfectionist

  • Tang the orangutan is hyperactive but also isn’t good at reading social cues or other people’s feelings

  • Wren often is seen flapping her wings to calm down, she also lacks concentration and is easily distracted

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Many parents and others who have ASD have praised Cbeebies on social media since the premiere of the show in October 2017, leaving comments on Twitter such as:

 'My son Jaime is Autistic and I firmly believe that exposing children early to Autism and Autistic behaviour helps children become more accepting of their Autistic peers. Can't wait to watch the show with the little ones.'

 'I'm so happy you've done this there is hope for awareness :)'

‘I never thought I'd reach that point in my life where I started watching CBeebies again without kids. But, being like him, I am just compelled to watch #pablo. And after a few months, I just feel I have to say, @CBeebiesHQ, you done good. #ActuallyAutistic’

‘Pablo is the most moving, un-politically correct & realistic show 4 #Autism makes me cry!’

Another parent simply posted 'This is just so good I could cry’ with a variety of crying emojis.

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It is amazing that something as simple as a show can have such a positive impact on the ASD community and help spread awareness in such a creative way that is easy to understand and enjoyable to watch. What makes the show even more remarkable and relatable is that the young boy who plays Pablo is an ASD child himself! We have seen Cbeebies do this with many topics, Justin Fletcher’s shows for example, Something Special being a prime example for making children aware that everyone is different and special in their own way. Even though my children are still very young at the ages 3 and 5, I am glad they’re getting exposure to the disabilities and difficulties of others through the shows they see on Cbeebies, unlike my childhood growing up where there was very little exposure.

So as a mum of two, I applaud Cbeebies, they have a household of Pablo super fans! I’d also like to applaud them with their wide range of shows exposing children and families to the different cultures and disabilities that are in world around them, I’m sure I’m not alone with that thought!

Brick by Brick

By Natasha

Those familiar little bricks are being put to extraordinary use.

Originally developed by Daniel B. LeGoff (a neuropsychologist), who saw the mighty potential of this humble brick, Lego® Therapy has grown into a motivational practice used by speech and language therapists, teaching staff and parents alike.

It is believed that the name Lego® was adapted from the Danish phrase for ‘play well’. Certainly for many children, the ability to play and interact within social settings seems perfectly natural: it is a skill we often take for granted.  Although, there are also children who find the strategies needed for peer interaction less accessible. Intimidating, even.

Magic Words Therapy - a boy playing with Lego

How can a child learn to socialize in a safe and supportive environment?

Our method: Lego® Therapy!

At Magic Words, we use this play-based approach to facilitate children toward ''communicative competence'' (Ralph and Rochester, 2016), depending on their individualised targets. Whilst some might need to work on maintaining eye contact and attention, others might attend the group to aid understanding of prepositions, problem-solving or sequencing.  

The aim of the game is, of course, to build a Lego model. This can be a simplistic or as complicated as you need it to be, according to ability and attention span of the group. The roles that we use are:

  • Builder: constructs the model, listens to the architect

  • Supplier: selects the bricks at each stage, listens to the architect

  • Architect: holds the instructions, describes the bricks to the supplier, instructs the builder where to put them

  • Facilitator: identifies problems and supports the group with solution

If you have limited numbers you do not have to include every role. Pick them according to the child's targets. For example, if the child struggles with listening you may wish to encourage them by letting them be the builder; they have the motivational reward of receiving a brick and putting it in place. Alternatively, if you have a child who needs to practice describing and ordering key words, the architect role would be an option.

Magic Words Therapy - an infographic describing a brick analogy

In addition to the jobs, we establish a set of lego-rules to encourage 'model' behaviour. Depending on the age of the group, this could be a clear-cut as good sitting, good looking, good listening, and good talking. Lego® points can be rewarded to acknowledge their participation.  

Once the adult has explained each rule and role, they must aim to 'gradually step back and allow the participants to work out social solutions more independently as the intervention progresses' (Ralph and Rochester, 2016). It is hoped that at some point each child will become their own facilitator and navigate social interactions with the same skill they require to build a collaborative model.

One parent, whose child attended Lego® Therapy sessions at Magic Words, explained how her child began to generalise his new awareness:

“He has understood what good listening is for the first time. He now understands why we need to listen and what we need to do to listen well. This has really helped him access small group activities and to concentrate. His eye contact which was a major problem area for him has also improved as a result of understanding that looking is important as it helps people know you are talking to them. He has thoroughly enjoyed the activities and it has also increased his interest in Lego which he is playing with much more outside the group. I think it has also improved his social skills generally...” 

With the motivation of Lego® and the naturalistic setting of a play-based task, this child was able to access a level of social interaction, that he had previously not understood the benefits of.

It has certainly become apparent that this therapy is versatile and accessible approach for those with social, communication and language difficulties. Carolyn Green and Elen Wales, two of our very own therapists, remarked in their article 'Building Lego, building language': 'Several parents expressed that Lego Therapy offered intervention where the alternative would have been to not access sessions at all' (Bulletin, November 2016). 

Consequently, what does Lego® mean to the therapists at Magic Words? 

Lego® Therapy is a impressively straightforward and structured approach that allows for a great variety of skills to be modelled, practiced and repeated. It allows a therapist, teacher, teaching assistant or parent to incorporate a diverse range of targets under the guise of play. It allows the children who participate to have fun, to collaborate, to build their skill set brick by brick.

To learn more about Lego® Therapy, please contact us.

Lego® Therapy: Teaching Teachers to Play

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Over two very successful sessions, Magic Words provided training for Learning Support and Teaching Staff who were eager to understand how Lego® groups could be utilised in a way to support their pupils' needs. The group came together from various school settings based in Milton Keynes and the surrounding areas.

Amongst some enjoyable practicals and video examples of therapy sessions, we covered: 

  • History and research on the development of Lego®-based practices

  • The communication pyramid 

  • Language and Social Skills

  • Job-roles: Builder, Supplier, Architect, Facilitator, Examiner

  • Who should do each role?

  • Lego® rules

  • Discussion of how to facilitate a group

  • What a typical session looks like

  • Visual timetable

  • Evaluation of progress

  • Question-time with a qualified speech and language therapist

Magic Words Therapy - ladies discussing around a table with Lego on it

We received some encouraging feedback from several of the staff to the effect that they would be running their own Lego® groups as soon as possible. It would appear that Lego®Therapy is not only extremely accessible for our children, but is an inviting scheme for the adults facilitating social growth and communicative needs.

This particular continuous professional development training was arranged in association with PEP:MK, Primary Enrichment Partnership. For further dates, please visit their website here.  

Alternatively, we can provide direct training adapted to your needs. Please contact us to learn more.