Ideas for creating successful therapy sessions

It was a great privilege to hear Gina Davies speak at the ASLTIP conference on March 21st 2015.  I attended her workshop on “Attention Autism” and there were some key aspects of her workshop that really made me think about how I approach my clients  who are on the Autistic Spectrum, and a few elements I am now incorporating into my therapy sessions.

  1. Do you offer an irresistible invitation to learn?

I am sure many of you will have done this: you are driving to work/walking through the supermarket/cooking dinner and suddenly, out of nowhere the dreaded theme song from Frozen pops into your head.  You don’t want to sing along. I mean, you really don’t want to, but the tune is just so catchy, before you know it, you are belting it out to the world (or silently wishing the mental tune would stop).  Whichever is the case, you have found it irresistible to join in.  I find myself quite jealous of the Disney group that they have been able to do this, as believe me it is not that easy to make someone join in when they really, really don’t want to.

So, we kind of need to recreate a Frozen theme tune for a therapy session, which is easier said than done! I have since tried to keep the following in mind, and found that it has altered my approach to therapy sessions as well as my expectations for interaction during a session.

  • Know what the average best communication effort of the child is on a daily basis.  Not the absolute best, but what is the average this individual can manage. I find classroom support assistants and teachers as well as parents often want to give us the best outlook, so it’s important to know whether what you are seeing is average.  I would also recommend staying a bit longer than you initially planned, thus making your observation window bigger.
  • Don’t take cooperation for granted – Be prepared but always have a backup plan, What you are envisaging while planning your session may not necessarily fit with your client’s plan for the day and it may just not tick enough boxes for them to engage.  My advice, always have more than one rabbit in the hat.
  • Observe and immerse yourself in the interaction and carefully read and interpret the social situation, only then can you hope to do the right thing at the right time.
  • Try and make your activities physical and practical where possible.

Most importantly, it has been found that children have an improved memory for things that interest them and experiences that have an emotional impact.  Also, fun activities are motivating and memorable.

2. Limit external rewards

I hadn’t really thought about it before, but by offering an external reward for something that we would like to occur naturally (i.e. communication) we are taking away the natural reward for participating in an interaction, which, if done right and follows the principle of being “irresistible” should be the enjoyment of taking part.  Granted, it’s an uphill struggle and I’m not suggesting we do away with all external rewards all together, just perhaps not offering them after each successful engagement, but at the end of a session instead.

3. Classroom or Therapy Room?

I always find it an amazing privilege to work inside a classroom with a teacher, and I always make a point of letting a teacher know how much I appreciate the opportunity to be a part of her classroom.  It’s not an easy task at the best of times to engage one child in an activity, let alone 30, so hats off to teachers everywhere.  So why do we want to be in the classroom?  Quite simply, that’s where the magic happens, that’s where the learning takes place and my task is to help a child, who would usually find it difficult to access a lesson, to get through the barrier and learn what the teacher is trying to convey to her students.  We are not spies.  We are not Ofsted inspectors.  We are not observing and criticizing the lesson.  We are there to support the child, to help them make sense in a world that does not make sense to them.  Outside the classroom it’s therapy.  Inside the classroom it’s identifying barriers to learning, exploring techniques and strategies to minimize these barriers and practically implementing strategies to optimize learning.

4. The four parts to engagement

As I mentioned before, don’t take engagement for granted!  Sometimes the smallest token of engagement is a success in itself.  According to the “Attention Autism” approach, there are four parts to engagement:

  • Focus – no interaction required, merely being able to focus on an object or activity for a finite amount of time, this can be fleeting.
  • Sustain – still not interacting, but deciding that something is worth watching, perhaps for a couple of minutes.
  • Shift – making that initial step into interacting with the object or person.
  • Transition – working independently with an object or person (without needing an external reward to do so).

I find going to workshops like these very handy as it gives me the chance to step back and reflect on how I approach my sessions, I hope you find these observations useful.