Each semester, our clinic hosts a social opportunity and rehearsal group for adolescents on the autism spectrum. This group was previously conducted in-person, but COVID-19 pandemic social distancing requirements resulted in a format change to virtual. Our group underwent several adaptations to accommodate the needs of the participants and to make the group educational and reinforcing.
When we began our first virtual group, it featured a HIPAA compliant telehealth platform with limited capacity for varying internet connections/speeds. This forced a cap on group size and quality connection and only permitted spoken language communication. We originally designed hour long lessons and limited activities without preference assessment for group members. We didn’t know what we were doing!
Based on observations and feedback from our group members, we made modifications resulting in improved group policies. We switched to a more expensive and much better functioning platform— well worth the cost! We made our social lessons much shorter and included more activity-based learning and we made the activities reinforcing in themselves.
We allowed use of the typewritten chat feature for participants who were less comfortable speaking in front of the group. “Chatting” greatly increased behavioral participation in group activities and allowed for complimentary social interaction that paralleled the group activities. The chat feature also assisted individuals with slower response speeds, as they were able to contribute to the discussion without perceived social pressure to respond quickly. This reduced the aversiveness of task demands for many of the teens.
We began to provide participants with the opportunity to choose social activities, and to create/contribute their own versions of games/activities. They responded with joy and interest to these responsibilities. We made it a point to assess for preferences during intakes and using these interests to reinforce and teach social skills concepts in a fun and meaningful way.
People on the autism spectrum often have intense special interests that are powerful reinforcers and that help make activities meaningful and reinforcing. As social facilitators, we increased our flexibility and willingness to adapt to technology and individual participant needs. We assigned facilitators as needed for redirecting participants that occasionally need additional support and created a plan for using a virtual breakout room if a participant needed more individualized support. This helped everyone feel more emotionally safe. We limited our use of generic open-ended questions, instead implementing special interest specific questions that exemplified social teaching topics. We implemented “ice-breaker” activities to encourage participation and social behavioral rehearsal. We requested participant and facilitator feedback after group sessions. We incorporated topics relevant to group skill needs and preferences (friendship, relationships/dating, and accepting change).
One group member said: “The weeks are hard for me and I can look forward to being together with all of you on Friday.” Ah! With a little flexibility and adaptability, we have the beauty of zoom friendship!
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By: Myra Bundy, Ph.D., BCBA; Tara Bord, M.S.; Tyler McQueen, M.S.; and Molly King, M.S.