Planning your intervention with Alex Kelly

Here are a few of my top tips for making your intervention work..

I like to put any intervention into the following four-step plan before I start my group or one-to-one sessions. This will help you to work out how best to work with someone on their social skills difficulties.

Step 1: The behaviour … what is it?

Make sure that you choose the right behaviour or skill to work on first. So, having assessed the person, you need to consider the hierarchy and the complexity of the skill you want to work on with them. Ask yourself: are you setting up the person to succeed? Is the behaviour too complex?

Now consider whether the behaviour has a function or a reason. Maybe the person is behaving in this way because of an underlying problem that has not been addressed, eg a sensory need. Or they may be getting something out of the behaviour: for example, people leave them alone and they like this.

Finally, try to really describe what the person is doing – the more detailed you can describe the behaviour, the more likely you are to be able to help the person understand what they are doing wrong. You may need to add how it might make other people feel or what they may think to give them insight, although I would do this jointly with the person.

Step 2: The rules … what are they?

We need to help people to understand what they should be doing instead – what are the rules?

What should be happening? So many adults I have worked with have asked me why they were never taught the rules as a child. Of course, before we can do that, we do need to know them ourselves, so that is where I hope the Talkabout resources will help you out!

Step 3: The motivation … what is it?

Every person you work with will need to be motivated at some level to come to your group, change their behaviour, and become more socially skilled. Often the key to success is to work out what the motivation is going to be for the person to want to change.

We cannot assume that all people are motivated by ‘being friendly’ or ‘friendly behaviour’ or ‘people will like me’ or ‘mum will be pleased’. It may be better to reward them with something: for example, an activity, a smiley-face chart or just saying ‘This is the polite thing to do’ or ‘This is the grown-up thing to do’. If we don’t consider the motivation, the intervention may fail.

Step 4: The strategy … which one is best?

There are many different ways of helping people to improve their social skills and usually the best intervention is the one that includes a number of them. There are eight main ways in which we can help someone.

1 The environment – in the school or at home. It is essential that the environment backs up what is being taught as much as possible. Think about getting all of the teaching staff on board with what you are working on. Making sure that everyone is encouraging and discouraging in the same way can go a long way to helping someone transfer those skills out of a group and into their everyday life. This doesn’t mean I wouldn’t work with someone if I can’t get the environment to back us up, but it may explain a slower progress. You may see people beginning to get the behaviour in certain situations but not all of them. This is OK. It shows you that the person has the ability to get it right when the environment is conducive.

2 Talk it through with them or use comic strip conversations. With many skills and behaviours, it is very helpful to talk it through with the person or to draw it using stick figures and speech bubbles. You will gain an insight into how they may describe what is happening and why it happens, which will help with your intervention.

3 Social storyTM. Carol Gray developed this approach in the early 1990s and I often use stories to help teach social skills. A social story gives someone insight into  their difficulties and helps them to know what they can do instead. It also contains perspective sentences about what other people may be feeling or thinking which can be very useful for people with ASD.

4 A visual cue or schedule. It is important to remember that many people are helped by working visually, so the worksheets and activities in this book will help, but people may also be helped by a prompt card or a poster displayed in the classroom. At our Day Service, ‘Speaking Space’, in the UK, we use a lot of ‘now and next’ symbolised strips which can work well to cue people in to what is expected of them in certain situations.

5 A reward system. Rewards can help if the motivation is very tangible: for example, stickers to get a financial reward or do an activity, or a certificate of achievement. Other rewards can include a special time with someone to talk about something specific – for example, 20 minutes at the end of the day to talk to their mum about dinosaurs. Any reward needs to work for the person, so you need to refer to their motivation.

6 Use of other media. Using DVDs and clips of cartoons or television programmes, or even video clips of you modelling behaviour, can really help to teach social skills. Many people find visual methods of learning much easier and showing a video will usually motivate most people. I often use this method in groups as well as in one-to-one sessions. The Talkabout DVD includes video clips of actors modelling inappropriate and appropriate behaviours for all of the key skills covered in Talkabout (Kelly, 2006).

7 Role play and modelling. In this book I often suggest using role play and modelling to help teach skills. Modelling is when the facilitators model a behaviour, both inappropriate and appropriate, and role play is when the group members practise the behaviour themselves.

Here are a few important points to remember when modelling:

• Keep it short and simple.

• Model one behaviour at a time.

• Start with bad behaviour and end with good.

• Never use the group members to help you model behaviours.

• Keep the situation as ‘real’ as possible – it is better to model a normal conversation between two group facilitators than to pretend that one is a child, shopkeeper or teacher.

• Ask the group what they thought was bad about the behaviour. What should have happened?

Here are a few important points to remember when role playing:

• The group members are asked to act a scenario or to practise a skill.

• It is a stressful experience for some people.

• Try a ‘getting into role’ exercise such as the magic carpet or twisting into a role like ‘Superman’.

• Remember to de-role, especially if the group members have played the part of someone else.

• Consider using puppets.

8 Social skills group. This is my favourite way to teach social skills and the Talkabout programme should give you all the resources you need to run a successful social skills group.

The advantages of group work over one-to-one work are as follows.

• It is a more natural and comfortable environment in which to learn.

• We learn from each other.

• It is easier to problem solve, play games and to set up role plays.

• It gives the opportunity to try out new skills in a safe environment.

• There is an opportunity to transfer skills to other staff, improving the chance of carry-over into the environment.

Extract from Talkabout 2e - LOOK INSIDE

Alex Kelly 
Speechmark author of TALKABOUT

Get 20% off when you pre-order today! Hurry though this offer ends on the 30th April, enter code TA20

The Theory Behind TALKABOUT

TALKABOUT was first developed in the early 1990s when I was working as a speech and language therapist in London, UK. I was particularly interested in social skills but was frustrated by two aspects of my work as a therapist. First, there was nothing in the literature to guide me on where to start intervention following assessment; and second, my experience showed me that I was not always successful in what I was trying to teach and I could not always predict which children were going to improve and which were not. I set about to solve these two problems over a period of four years.

I started my investigations at a college of further education where I was working with 60 students who had a mild to moderate intellectual disability. We assessed all of the young people I was working with using an adapted social skills assessment from the Personal Communication Plan by Alex Hitchings and Robert Spence – now published in Kelly (2000). The students were involved in this assessment which gave us some insight into their own awareness of their difficulties. From these initial results, we grouped students into their main area of need: body language, conversational skills and assertiveness. We evaluated success through retesting on the original assessment and also compared students with poor and good awareness of their needs.

The results were fascinating. They showed that the students who had been working on their conversational skills progressed more if they had good existing non-verbal skills (ie body language), and students who had been working on their assertiveness progressed significantly more if they had good existing non-verbal and verbal skills.

In addition, we found that students who had poor self and other awareness struggled with all aspects of the work. From this, we established a hierarchy which forms the basis of the Talkabout resources.

Over the next four years, we piloted this programme using different client groups and a group of willing therapists from throughout the UK. We all found consistently that the success of intervention increased if non-verbal behaviours were taught before verbal behaviours, and if assertiveness was taught last (Kelly, 1996).

This original hierarchy then formed the basis of the first Talkabout book (Kelly, 1996) but it has been adapted over the years to include self-esteem and friendship skills. The hierarchy now looks as follows.

Using this hierarchical approach, teachers and therapists can start work with the person at a level that is appropriate to that person’s needs. They can then progress up the levels to enable the person to reach their full potential, ensuring that basic skills are taught before the more complex ones. So a student who needs work on all areas of his social skills would start work first on his body language skills and then would progress to working on his paralinguistic skills, then his conversational skills and, finally, his assertiveness skills.

If this student also had poor self-awareness and low self-esteem, he would need to work on this before working on his social skills. And if a student also had difficulties with his friendship skills, he would only work on developing these skills if he had good self-awareness and good nonverbal and verbal skills.

Of course, success is not just about what you teach first; it is also down to how you teach it.

Extract from Talkabout 2e - LOOK INSIDE

Alex Kelly 
Speechmark author of TALKABOUT

Get 20% off when you pre-order today! Hurry though this offer ends on the 30th April, enter code TA20.

What do you think about when you have toothache?

Please consider that question before we move on?

I was in Bradford recently. Facilitating a team of workers who are on the frontline
and facing difficult behaviour and aggression daily. Yet they love the young people they work with.

Those who had been excluded from school, little response, little change and little sign of hope. Still each of the group yearned to be of developmental assistance to them.

I asked them that question:

'When you have toothache, what do you think about?'
No pause.
An immediate answer from one worker
as we all stood in the circle -
"Toothache"
was the answer.

If we have toothache we struggle to concentrate on anything else.
Restless as a wolf - we feel like the cheese is falling off our cracker. Nothing else really matters.

We can see a person's behaviour but we cannot see their experience.
We can be so preoccupied by their behaviour that we don't see
beyond behaviour.

Difficult behaviour can get under our skin.
Feelings rise within us.
As emotionally intelligent as we may be the feelings we have stimulate us, sometimes, to make a regrettable response.

This is applicable in the staff room, the classroom, the team meeting, the prison, the street, the office, at home, and certainly not only when we are transacting with humans with special needs.

The way I work on awareness and skill development is by using Experiential Exercises including Blob Tree Tools.

The objectives are:

•          Become more aware of our own feelings.
•          Becoming more able to get into contact with them.
•          Develop emotional literacy by being able to give each a feeling name.

So there in Bradford we throw the Blob Feelings Ball around the circle.
'Motion changes emotion' I say.

An activity, doing, is the best way to learn - to practise.
So the ball is thrown around the circle, the miss-catching it is part of the-bouncing-around fun as the ball creates smiles as humans live in expectancy as to who will receive the ball next.

The Blob figure nearest your right thumb -
'what does that Blob feel like?' I ask.
I ban the use of 'happy or sad' as all feelings can be tossed in those headings.
So minds are stretched - everyone engaging in the struggle to articulate.
Even seasoned professionals struggle to find the appropriate word.

I often ask more questions as 'right thumbs' develop their literacy.
'Describe a young person you know who feels like that?'

'When one of your youngsters feels like that, what behaviour does it drive?'

When a group is ready - the questions may become deeper and more personal-
'When did you last feel like that?'

Awareness always precedes skill.
By becoming aware of our own emotional literacy, or lack of, we can then be more sensitive to the feelings of others. More importantly, we can begin to see beyond behaviour to be more in touch with a person's toothache.

Next time I will click about working with special needs groups. I want to share some methods of how I engage them with the crisp objective of making available more tools for their life toolbox.

- Pip Wilson
Beautiful Human Person
Speechmark author of Blobs