Play-Based Interventions for Autism

Spectrum Disorder and Other

Developmental Disabilities

Play-Based Interventions for Autism Spectrum Disorder and Other

Developmental Disabilities contains a wide selection of play therapy
interventions for use with children and adolescents with autism spectrum
disorders, dysregulation issues, or other neurodevelopmental disorders. The
structured interventions focus on improvement in social skills, emotional
regulation, connection and relationship development, and anxiety reduction.
Special considerations for implementing structured interventions and an
intervention-tracking sheet are also presented. This valuable tool is a must-
have for both professionals and parents working on skill development with
these populations.

Robert Jason Grant, Ed.D, LPC, CAS, RPT-S, is a Licensed Professional

Counselor, National Board Certified Counselor, Registered Play Therapist
Supervisor, and a Certified Autism Specialist. Dr. Grant is a member of the
American Counseling Association, Association for Play Therapy, American
Mental Health Counselors Association, and the Autism Society of America.
He offers training to become a Certified AutPlay Therapy Provider through
his website RobertJasonGrant.com and owns a private practice in Missouri
where he works with children, adolescents, adults, couples, and families.
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Play-Based Interventions for
Autism Spectrum Disorder
and Other Developmental
Disabilities

Robert Jason Grant

First published 2017
by Routledge
711 Third Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2017 Taylor & Francis
The right of Robert Jason Grant to be identified as author of this work
has been asserted by him in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced
or utilized in any form or by any electronic, mechanical, or other means,
now known or hereafter invented, including photocopying and recording,
or in any information storage or retrieval system, without permission in
writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Names: Grant, Robert Jason, 1971– author.
Title: Play-based interventions for autism spectrum disorder and other
developmental disabilities / Robert Jason Grant.
Description: New York, NY : Routledge, 2016. | Includes bibliographical
references and index.
Identifiers: LCCN 2015048764 (print) | LCCN 2016006507 (ebook) |
ISBN 9781138100978 (hbk : alk. paper) | ISBN 9781138100985
(pbk : alk. paper) | ISBN 9781315657295 (ebk)
Subjects: LCSH: Play therapy. | Autism in children—Treatment. | Autism
spectrum disorders in children—Treatment.
Classification: LCC RJ505.P6 G735 2016 (print) | LCC RJ505.P6 (ebook) |
DDC 618.92/891653—dc23
LC record available at http://lccn.loc.gov/2015048764
ISBN: 978-1-138-10097-8 (hbk)
ISBN: 978-1-138-10098-5 (pbk)
ISBN: 978-1-315-65729-5 (ebk)

Typeset in Sabon
by Apex CoVantage, LLC
This book is dedicated to my son, Nolan.
“I am only one, but I am one. I cannot do everything, but I can do something.
And I will not let what I cannot do interfere with what I can do.”
—Edward Everett Hale
Contents

Foreword by Tracy Turner-Bumberry xi

Acknowledgments xiii
Introduction xv

1 Treatment Considerations 1
Autism Spectrum Disorder and Developmental Disabilities 1
Relationship Development and Rapport 3
Treatment Planning and Goal Setting 3
Creating Developmental Disorder Interventions 4

2 Implementing Directive Play-Based Interventions 7

The Power of Play 7
Practitioner Role and Level of Involvement 8
Psychoeducational Model 9
Parental Involvement 9

3 Primary Target Areas 11

Emotional Regulation 11
Social Skills and Functioning 12
Connection and Relationship Development 14
Additional Services and Support 15
Helpful Resources 16

4 Emotional Regulation Interventions 17

Emotional Regulation 17
Feelings Pick-Up Sticks 18
Feelings Beach Ball 20
LEGO Emotion House 22
Construction Feeling Faces 24
Bean Bag Toss 26
viii Contents
Feelings Spinner Game 28
Draw My Feelings Face 30
Heart Parts 32
Home and School 34
Feelings Don’t Break the Ice 36
Happy Me, Sad Me 38
Emotion Mane 40
Angry Yes, Calm Yes 42
Feelings Card Sort 44
Feelings Quiz 45
Write a Feelings Story 46
Feeling Fortune Tellers 48
Feelings Puzzle 50
Paint Swatch Degrees of Feelings 52
Paper Feeling Balloons 54
Feeling List Stop Game 56
Spon-Play-Ity 58
Anxiety Buster Toolbox 59
Anxiety Mometer 60
Calm Down Postcards 62
The Always Changing Picture 64

5 Social Skills Interventions 65

Social Skills 65
Friend Collage 66
Social Scales 68
Social Skills Puzzle 70
Let’s Practice Conversation 72
Candy Questions 73
Friend Mapping 74
What Am I? 76
Stepping Stones 78
Symbolic Play Time 80
Paper Friend 81
Instruction Puzzle 83
Bully in the Way 85
Social Media 87
I’m Going 88
Interview Me 90
That Does Not Sound the Way It Looks 92
Tweet, Tweet, Tweet 93
Role-Play 95
 Contents ix
Roll of the Dice 97
Social Media Friend, Foe, or Other 99
Social Skills Fortune Tellers 100
Take It to the Judge 102
Three Foam Dice 103
Prevention Role-Play 105
Quiet Loud 108
School Rules 110

6 Connection Interventions 113

Connection 113
Obstacle Course 114
Break Out 116
Iguana Walk 118
Feeling Card Find It 120
Ring around Me 122
Sand Games 124
Turn around and Make a Face 126
Fishy and Shark 128
Magnify Me 130
Crawling Crabs 132
Silly Glasses 134
Hands, Hands, Hands 136
Sculpture 138
Aluminum Wrap 140
Silhouette 142
Family Spin 144
Our Unique Greeting 146
Together Balloons 147
Hide and Find 149
Squiggle Drawing Gift 151
My Measurements 153
I Am a Tree, We Are a Family 155
Body Bubble Target 156
Bubble Tag 158
Flower, Rain, and Sun 160
Hello Friend 162

Appendix: Additional Resources 163

Feelings List 163
Social Skills Checklist 164
Toys and Materials List 165
x Contents
Play-Based Intervention-Tracking Sheet 166
Create-Your-Own-Technique Worksheet 167
Apps for Autism and Developmental Disabilities 169
Internet Resources 173

References and Suggested Readings 175

Index 179
Foreword

What an honor it is to know Dr. Robert Jason Grant! From our humble
beginnings as two therapists traveling the state to attend play therapy work-
shops, to now conducting workshops of our own, it has been quite a jour-
ney. Robert is just one of those people that once you meet you know you
have encountered the “real deal.” I am privileged to lend some words to
Robert’s latest book Play-Based Interventions for Autism Spectrum Disorder
and Other Developmental Disabilities.
As the saying goes, “If you know one person with autism, you know one
person with autism.” Autism spectrum disorder can be a difficult disability
to diagnose and then treat. The emotional toll felt by the child and the child’s
family can feel overwhelming and exhausting. The amount of community
resources can be scarce, and the family may feel pulled in many directions,
from the pediatrician and therapist, to the speech/language pathologist and
occupational therapist. For this reason, it is vital for all therapists working
with autism spectrum disorder to be invested and passionate at finding the
best treatment outcome for these children. Dr. Robert Jason Grant has done
just that, and his book Play-Based Interventions for Austin Spectrum Disor-
der and Other Developmental Disabilities will be a valued resource for all of
us in the field.
Robert’s books have been a lifeline to those professionals who work with
children on the autism spectrum, as well as other developmental disabili-
ties that cause emotional dysregulation, social skill deficits, and difficulties
connecting to others. He offers clear and concise explanations into the pri-
mary features of these diagnoses as well as detailed descriptors explaining the
symptoms seen in children. The greatest value I have personally gained from
Robert’s books is the research-based, meaningful interventions to help my cli-
ents better regulate emotionally, learn specific social skills, and connect more
genuinely with others. I have seen the progress made with each of my clients
and know this can be attributed to Robert’s theory of AutPlay Therapy and
the books he has authored on the subject.
I can say with certainty that any professional reading this book will be
pleased and excited to learn additional strategies to use with their clients who
xii Foreword
have autism or other developmental disabilities. I believe those of us who
work with this population have been called to do so, and we are all so very
lucky to have Robert on our team.
Tracy Turner-Bumberry, LPC, RPT-S, CAS
Author of Finding Meaning in Mandalas:
A Therapist’s Guide to Creating
Mandalas with Children
Acknowledgments

There are many great writers, speakers, and advocates for children and ado-
lescents with autism spectrum disorder and special needs. I want to thank
each of them for continually inspiring and encouraging me. To all the parents
who have participated with me in treatment and entrusted their children to
me, I want to give you a special thanks. I have learned more than I can convey
from you and your children, and I know your 24-hour-a-day, 7-day-a-week
job and the tireless advocacy and effort you put forth to make your child’s
life better.
Special thanks to Cherie L. Spehar, Audrey Gregan Modikoane, Tracy
Turner-Bumberry, Carrie Vaughan Boone, Shannon Anderson, Emma De La
Cruz, Tamara Newcomb, Ann Elliot, and John Laskowski for reviewing my
book and providing invaluable feedback. You all helped me create a more
thorough and thoughtful product. I am greatly appreciative of your time and
talents.
Thank you to Liana Lowenstein for all your support, words of wisdom,
and generosity and for being a great role model for my efforts. I could not
have created what I have without your example.
Thank you to the Association for Play Therapy, the Missouri Association
for Play Therapy, and all my play therapy friends and colleagues.
Thank you to Joann Lara: You are a great autism advocate, and you have
been a great friend and supporter; I am so happy that our lives connected.
You inspired me to move and be active in the change I want to see in the world.
Thanks you to the Amazing Autism Authors, what a great supportive
group, that I love being a part of. Thank you to the Southwest Missouri
Autism Network (SWAN); Dayna Busch and The Missouri Autism Report;
and all of the parents, support groups, and professionals in my community.
I learn from you all every day and have felt very blessed to know you all and
be a part of our wonderful autism community!
My most important acknowledgment and thanks go to my family and
friends for all their support and encouragement and to God for giving me
motivation and perseverance when I had none and for gifting me ever so
much to write this book. But Jesus looked at them and said, “With man this
is impossible, but with God all things are possible” (Matthew 19:26). I am
daily grateful and thankful for God and the possible!
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Introduction

This book is written for practitioners who work with children and adoles-
cents with autism spectrum disorder (ASD) and other developmental disor-
ders. The terms autism spectrum disorder, ASD, developmental disorder,
developmental disability, and neurodevelopmental disorder may be, at times,
used interchangeably where a difference in terminology is not necessary for
the information being presented. The play-based interventions listed in this
book are designed to improve social skill functioning, emotional regulation,
and connection and relationship development. The symptoms listed above
often occur at some level in most developmental disorders. The interventions
in this book are also designed to address specific learning styles and particu-
lars in skill acquisition that most children and adolescents with developmen-
tal disorders possess.
The play-based interventions in this book provide a wonderful treat-
ment approach that meets a child or adolescent at his or her functioning
level and assists him or her in gaining needed skills. Practitioners can easily
understand and implement the play-based interventions listed in this book
and become inspired to create even more play-based interventions of their
own. The interventions in this book have been implemented by profession-
als working in various disciplines, such as mental health therapy, occupation
therapy, and speech therapy. Further, interventions have been implemented
across various environments including play therapy clinics, schools, residen-
tial centers, hospitals, and various clinical and educational settings.
The play-based interventions in this book can be taught to parents, and
parents can implement the activities at home with their child and other fam-
ily members. Special emphasis has been placed on designing interventions in
such a way for parents to easily understand and implement the interventions.
The more practice a child or adolescent has in working toward improving his
or her skill deficits, the better opportunity for achieving gains, and parents
can play an important and beneficial role in the process.
This book begins with special considerations in working with children
and adolescents with ASD, other developmental disorders. Focus is placed
specifically on implementing play-based interventions for these popula-
tions, although several practitioners have reported using the interventions
in this book for other populations, such as children with ADHD, mood
xvi Introduction
disorders, and adjustment issues. Practitioners should pay special attention
to the first section of the book as several points are presented for reflection
and consideration before implementing any of the play-based interventions.
Fundamentally, this book serves as a tool in implementing a purposeful
treatment plan and approach to help children and adolescents gain needed
skill development.
1 Treatment Considerations

Autism Spectrum Disorder and

Developmental Disabilities
This book is not intended to provide a thorough or in-depth presentation of
autism and developmental disorders. The following brief is presented to help
practitioners have a better understanding of autism and other developmen-
tal disorders as it relates to implementing directive play-based interventions.
A suggested reading list is offered in the Appendix for those who desire to
increase their knowledge about autism and other developmental disorders.
Autism spectrum disorder (ASD) is a Diagnostic and Statistical Manual
diagnosis that is usually given after a thorough psychological evaluation
where the evaluator measures the child’s or adolescent’s behavior across a
myriad of tests, assessments, and observations. The disorder is considered a
spectrum disorder meaning that symptoms vary in intensity from severe to
very mild in individuals who have an ASD diagnosis. Common terms used
to describe the variance include high or low functioning and severe or mild
impairment. Children and adolescents with an ASD will likely have similar
problem areas, but the severity of their difficulties and the presence or absence
of other features (fine motor clumsiness, normal intelligence, increased or
decreased verbal output) will vary (Coplan, 2010).
Children and adolescents with ASD can and usually do exhibit multiple
symptoms. The most common symptoms that manifest for each child at
some level include impairments in social skills and functioning; impairments
in communication; impairments in the ability to self-regulate and modulate
emotions; difficulties establishing and creating meaningful relationships and
connections with others; restricted, repetitive, and stereotyped patterns of
behavior, interests, and activities; sensory processing issues; and difficulties
handling transitions and change (Exkorn, 2005).
In regard to play skills, children and adolescents with ASD usually struggle
in the areas of pretend or imaginary play and peer or group play. In regard
to peer or group play, children and adolescents with ASD typically do desire
to have friendships and interact with others peers but simply lack the social
ability and skills to interact successfully. Thus, most attempts at some type
of interaction usually are met with rejection and anxiety for the child with
2 Treatment Considerations
ASD. Repeated attempts to engage with peers only to be met with rejection
can lead to what others may perceive as a lack of interest in connecting with
peers. In reality, this may be a learned behavior to avoid further rejection.
Directive play interventions can help children and adolescents learn social
skills to interact more successfully with peers and participate more fully in
group and peer play.
Pretend and imaginary play skills may also be increased in children with
ASD but present a greater challenge. Due to the deficit in pretend and imagi-
nary play, practitioners should avoid play-based interventions that rely heav-
ily on abstract concepts, pretend play, and metaphor (unless specifically
working on improving this skill). Play-based interventions should be concrete
and clearly communicated to the child and should be literal in addressing the
child’s issues.
The following example highlights a play approach with a child with ASD.
A child with ASD is struggling with a bully at school. In neurotypical play, the
practitioner might conduct a puppet show with a frog and fox acting out a
bullying scene with the fox bullying the frog and the frog ultimately address-
ing the issue with an appropriate response and learning some coping skills.
For the child with ASD, this may be too much based on metaphor, and the
child may not apply the information to his or her situation. A better approach
with a child with ASD would be to choose two human puppets and label one
the child and the other the child’s bully. The practitioner can then act out a
bullying scene that actually happened to the child at school and include an
appropriate response to the bully. The practitioner can then follow up with
the child to make sure he or she understood the story is about him or her and
understood the response that he or she could give to the bully. Children and
adolescents with ASD are typically concrete and literal thinkers, and they
may not apply to themselves or connect with play interventions that rely on
metaphor or abstract presentation.
The fifth edition of the Diagnostic and Statistical Manual (2013) catego-
rizes ASD as a neurodevelopmental disorder. Other disorders in this category
include attention deficit hyperactivity disorder and Tourette’s syndrome. There
are several other developmental disorders/disabilities that exist as well. The
Centers for Disease Control (2014) states that developmental disabilities are
a group of conditions due to an impairment in physical, learning, language,
or behavior areas. These conditions begin during the developmental period,
may impact day-to-day functioning, and usually last throughout a person’s
lifetime. Common developmental disorders/disabilities include cerebral palsy,
fragile X, and Down syndrome. Whether categorized as neurodevelopmen-
tal disorders, developmental disorders, or developmental disabilities, these
various conditions often share similar symptoms in terms of social function
and emotional regulation struggles. Play-based interventions can be helpful
in addressing and improving symptom areas associated with these conditions.
Practitioners who work with children and adolescents with ASD or any
other developmental disorder should become thoroughly educated about
the many aspects related to these complex conditions before implementing
 Treatment Considerations 3
play-based interventions or any treatment. Practitioners are encouraged to
learn more about ASD and other developmental disorders from diagnosis,
to common symptoms, to treatment approaches, to how these conditions
affect a child or adolescent and his or her family in a myriad of ways. Proper
education about these disorders will enhance and elevate the implementa-
tion of play-based interventions for greater success. For editing purposes, this
book will often refer to ASD when discussing symptomology that tends to
apply to most developmental disorders. The play-based interventions in this
book address the commonly shared deficits and struggles that accompany
most developmental disorders. These struggle areas include social skills and
functioning, emotional regulation, and appropriate relationship connection.
Each developmental disorder contains specific and unique characteristics and
struggles. Practitioners are encouraged to increase their awareness of the spe-
cific developmental disorder that has been diagnosed in the child that he or
she is working with.

Relationship Development and Rapport

Regardless of the intervention being used, the practitioner-child relationship
is central to the child’s realization of treatment goals. The rapport that devel-
ops between the practitioner and child forms the foundation for therapeutic
success. In building a therapeutic alliance, the practitioner must create an
atmosphere of safety in which the child is made to feel accepted, understood,
and respected (Lowenstein, 1999). Play-based interventions lend themselves
to creating a very structured and directive session with a child or adoles-
cent. The directive element of play-based interventions should not displace
the importance for the practitioner and the child to develop good rapport
and relationship.
As with any therapeutic approach, it is essential that relationship build-
ing be a central focus. Practitioners should spend time in the beginning of
treatment and throughout treatment building relationship with children and
adolescents, and the parents they are working with. Implementing directive
instruction, no matter how great the instruction may be, will be much less
effective without proper relationship and rapport between the practitioner
and the child. Essentially, it is the relationship that gives the intervention
value. Engaging with interventions in the right frame of mind will yield better
results.

Treatment Planning and Goal Setting

It is important for practitioners to understand psychological theories and
have a theoretical framework from which to work (Cavett, 2010). Direc-
tive play-based interventions should always be grounded in a theoretical
approach. The interventions in this book align with the AutPlay Therapy
protocol for directive play-based interventions to address a child or adoles-
cent with a developmental disorder who is experiencing skill deficits. AutPlay
4 Treatment Considerations
is a treatment approach for children and adolescents with ASD and other
developmental disorders. The AutPlay approach is a blending of developmen-
tal and behavioral methodology. The foundations of the AutPlay approach
include cognitive behavioral therapy, behavioral therapy, and play therapy
approaches such as cognitive behavioral play therapy, filial therapy, and
Theraplay. Further, AutPlay Therapy incorporates elements from various
social skill enhancement programs.
Directive play-based interventions should be specifically chosen to address
issues or skill deficits with which an individual child or adolescent is strug-
gling. Interventions should be a component of the child’s treatment plan and
align with established treatment goals. Practitioners should be able to com-
municate why interventions are chosen for a specific child, how the interven-
tion will help address the child’s identified issues or skill deficits, and how the
intervention addresses the child’s treatment goals. Practitioners should also
implement evaluation procedures to assess that the chosen play-based inter-
ventions are actually helping the child improve targeted skill deficits and that
the child is making progress toward his or her established treatment goals.

Creating Developmental Disorder Interventions

The play-based interventions listed in this book for ASD and other devel-
opmental disorders are purposefully designed to be 1) simple in instruction,
2) low prop based, 3) easily implemented across various environments, and
4) targeted toward specific skill acquisition.

1. Simple in instruction: Children with ASD are less likely to focus on, or
engage in, an intervention if the instructions are too long or complicated
or involve too many steps to complete the intervention. For interventions
that may have multiple steps, it is sometimes helpful to present each step
one at time and allow the child to complete a step before presenting the
next step.
2. Low prop based: Children with ASD or other developmental disorders
may become distracted or over stimulated with too many toys, props,
and expressive art materials around them or available to them. Keeping
props simple and focused on the intervention being presented will aid in
helping the child maintain focus and engagement and ultimately aid in
successful completion of the intervention. Practitioners may even want to
present the intervention in an environment that is somewhat sterile and
low on possible distractions.
3. Easily implemented across various environments: Many different practi-
tioners in various settings work with children with ASD and other devel-
opmental disorders. The interventions in this book are designed to be
able to transfer across many environments such as a playroom, a school
counselor’s office, and even an in-home setting where a practitioner or
parent may be implementing the interventions.
 Treatment Considerations 5
4. Targeted toward specific skill acquisition: The interventions in this book
are grounded in a theoretical base and should be chosen for a child or
adolescent specifically to address skill deficits or issues that a particular
child or adolescent is struggling with. Interventions should align with and
be part of the greater treatment plan and goals for the individual child or
adolescent involved in therapy.

Practitioners wanting to create their own play-based interventions for chil-

dren with ASD or other developmental disorders are encouraged to follow
the guide listed above and utilize the worksheet located in the Appendix.
Some additional points to consider:

• Interventions should be structured, directive, and incorporate a playful

approach as much as possible.
• Ideally, interventions should be able to be taught to parents and imple-
mented in the home setting by the parents.
• Consider that interventions may be repeated several times and that the
same skill may be addressed with several different interventions.
• Interventions should be adjustable from simple to more complex, should
advance in complexity as the child advances, and be applicable to chil-
dren at different functioning levels.
• Interventions should be concrete and about the child or the child’s situa-
tion; metaphor and abstract interventions should be avoided.
• Ideally, interventions should incorporate more than one element (social,
emotional regulation, anxiety reduction, sensory processing, connection,
etc.).
• The practitioner should be flexible in regard to involvement in facilitating
the intervention and teaching of new skills; a psychoeducational model is
typically implemented.
This page intentionally left blank
2 Implementing Directive
Play-Based Interventions

The Power of Play

Play is considered the language of all children (Landreth, 1991). The benefits
of children engaging in play include cognitive development (learning, think-
ing, and planning, etc.); social skills (practicing social interaction, roles and
routines); language (understanding and talking to others, turn taking, etc.);
problem solving (negotiation, asking for help, solving difficulties, etc.); and
emotional development (managing feelings, understanding others, empathy,
etc.). Children with play skills are more likely to be included with their peers,
and play is a key learning tool through which children develop social skills,
flexibility, core learning skills, and language. Play also provides opportunities
for children to practice events, situations, and routines in a safe place, with
no pressure to “get it right” (Phillips and Beavan, 2010).
Sherratt and Peter (2002) suggest that play interventions and experiences
are extremely important to children with ASD. They state that simultane-
ously activating the areas of the brain associated with emotions and genera-
tive thought while explicitly teaching children with autism to play will lead
to success. Further, Thornton and Cox (2005) conducted individual play ses-
sions with children with ASD specifically to address their challenging behav-
iors. They incorporated techniques that included relationship development,
gaining attention, turn taking, enjoyment, and structure. Their research
found that play interventions did impact the child’s behavior with a reduction
in negative behavior following the structured play interventions.
Cross (2010) stated that no matter what type of play—constructive, out-
door, physical, or cooperative—play helps children learn and developmentally
thrive, and the health and productively of a child’s play greatly affects later
learning. Moor (2008) proposed that play with children with ASD is about
structure. In the play context, choice, freedom, and discovery are simply not
the things that motivate children with ASD to play in the way they motivate
neurotypical peers. Children with ASD need structure because, despite their
many differences, in general, they have impaired motivation to interact, learn,
and play. They have rigid and repetitive patterns of thinking, and therefore of
talking and playing, and are often motivated to preserve sameness.
8 Implementing Play-Based Interventions
Many play therapy and play-based treatments can be appropriate inter-
ventions in working with children with ASD especially when working with
children who have little in the way of social skills and poor communica-
tion (Parker and O’Brien, 2011). Play-based interventions are gaining more
and more valid research as effective treatment approaches for children and
adolescents with ASD and other developmental disorders. Play-based inter-
ventions of many types—outdoor, movement, art, music, games, and prop
based—provide the opportunity for practitioners to individualize treatment
and engage the child in both a playful and structured approach that other
ASD treatments may not offer.
This book presents a preferred guide in regard to the play-based interven-
tions listed, indicating what level is appropriate for each intervention. The
levels are listed as child, adolescent, or both child and adolescent. Most of
the interventions in this book could be used for children ages 3–18 as long
as content was adjusted adequately to reflect the child’s age. Also, the child’s
developmental level should be considered as most children with ASD or other
developmental disorders will likely present at a younger developmental age
than his or her chronological age.
Practitioners should not be hesitant about trying any of the interventions
listed in this book with any of the children and adolescents they work with.
It will be clear if an intervention is too advanced for the child’s chronological
or developmental age, and likewise, it will be clear if the intervention is too
basic. If a practitioner realizes the intervention is too advanced or too basic,
then adjustments can be made to fit the intervention to what is appropriate
for that child.

Practitioner Role and Level of Involvement

Children and adolescents with ASD and other developmental disorders will
present on a wide continuum in regard to functioning level and ability to
understand and complete various directive play-based interventions. The
practitioner should be aware of this variance and be prepared to meet each
child or adolescent where he or she is in terms of functioning level. The prac-
titioner’s involvement in the facilitation, completion, and processing of any
intervention will depend on the functioning level of the child. Practitioners
should be prepared for their involvement to be anywhere from very directive
and involved, providing instruction and stopping to teach appropriate skills,
to being an observer and letting the child complete and process an interven-
tion fully on his or her own.
Practitioners should always let the child complete and process through
any intervention as much as the child is capable. Thus, if the practitioner is
unaware of the child’s capability, then he or she should first let the child try
before assuming the child is at a functioning level where the practitioner needs
to be involved in assisting the child. If a child is having difficulties completing
an intervention, the practitioner should become more involved and guide the
child through the intervention, breaking it down step by step if necessary.
 Implementing Play-Based Interventions 9
Practitioners should be prepared to adapt their style and level of involve-
ment at any time even during a session. Children and adolescents with ASD
may be able to complete an intervention entirely on their own, may not be
able to complete any of the intervention without assistance from the prac-
titioner, or may complete part of an intervention but then become stuck at
some point and need assistance from the practitioner. The willingness and
flexibility to adjust from observer to educator are key qualities for the prac-
titioner implementing directive play interventions with children with ASD.

Psychoeducational Model
The implementation of directive play-based interventions aligns heavily with
a psychoeducational model of treatment. The psychoeducational model is an
approach to changing the behavior patterns, values, interpretation of events,
and life outlook of children and adolescents who are not adjusting well to
their environment(s). Inappropriate behavior is viewed as a child’s or adoles-
cent’s maladaptive attempt to cope with the demands of that environment.
Appropriate behaviors are developed by helping the child or adolescent to
recognize the need for change and then helping the child or adolescent to dis-
play better behavior choices.
Positive behavioral change is more likely to occur when the practitioner
is able to develop and maintain a healthy rapport and relationship with the
child or adolescent. This approach involves a combination of both thera-
peutic approaches and education. According to psychoeducational models,
behavioral change comes, not just from the manipulation of environmental
variables, but also from the development of a better understanding of self and
others and the practice of new ways of reacting. The child or adolescent is
taught new ways of responding and the self-control to refrain from using the
former inappropriate actions or behaviors (adapted from Tom McIntyre of
www.behavioradvisor.com).
Practitioners working with children with ASD and developmental disabili-
ties who are implementing play-based interventions will most likely follow a
psychoeducational model. Relationship building and directive instruction are
both key elements when working with children with these conditions, and the
practitioner should not consider these elements as opposites but as combined
features that best serve the child with ASD.

Parental Involvement
Established autism treatments typically involve a parent-training component
where parents are taught to implement treatment approaches at home with
their child. Play-based interventions are designed to be taught to parents and
for parents to implement the interventions at home between sessions. Grant
(2012) proposed that parents are the people most knowledgeable about their
children and the most equipped with the opportunities to assist their children
in everyday situations. Parent training empowers parent to become co-change
10 Implementing Play-Based Interventions
agents and provides repetition of the intervention; thus, more practice is given
to increase skill development.
Booth and Jernberg (2010) stated that a secure attachment relationship
is both the outcome of healthy parent-child interaction and the key to long-
term mental health. Such a relationship is just as important in helping the
child with autism achieve his or her developmental potential as it is with
the typically developing child. Further, when parents are part of the treat-
ment, they carry on the successful interactions with the child at home. Home
interactions provide the added benefit that the child can generalize from the
treatment setting to the home.
Practitioners planning on implementing a parent-training component
should establish parent meetings or session times to fully and clearly teach
interventions to parents. Practitioners will also want to monitor home imple-
mentation carefully to make sure interventions are being implemented at
home accurately and successfully. Further, parents will likely have several
questions throughout the process, and sufficient time should be allowed to
thoroughly address any parent questions or concerns.
A typical structure for a 45–50 minute session may be broken down by
meeting with the parents to gain feedback on how things have been going
and teaching the parents a new intervention that will be taught to the child
and sent home to practice. This may last approximately 15–20 minutes. The
remainder of the session will involve meeting with the child and teaching the
child the new intervention. This is one example; there are multiple scenarios
for meeting with both parents and child. Another option would be to alter-
nate sessions, one week meeting with the parents and the next week meeting
with the child. It may also be appropriate to complete the whole session
working with both parents and child together, so both are learning the inter-
vention at the same time. The most important element is to make sure there is
parent-training time incorporated if interventions are going to be sent home
for parents to complete with their child between sessions.
3 Primary Target Areas

Emotional Regulation
When an individual is lacking emotional regulation ability, he or she has diffi-
culty handling emotions and emotional situations. An individual may become
overly emotional, may not display emotions, may lack appropriate emotional
expression, may not understand or be able to differentiate emotions, may not
recognize emotions in others, or may not have any manage or control over
his or her own emotions.
Children and adolescents with ASD often struggle with emotional regula-
tion. Managing and modulating both positive and negative emotions can be
a challenge, and often without proper ability or training to regulate, these
children and adolescents will produce negative, unwanted behaviors when
they become dysregulated. Some of the signs of emotional dysregulation
include mouthing or chewing on objects or fingers, holding or hording com-
forting objects, tip-toe walking and rocking back and forth, hand flapping,
humming and making random noises, becoming aggressive or noncompli-
ant, becoming withdrawn, removing self from a stressful situation, preoc-
cupation with specific topics/areas of interest, and rigidness in adherence to
rules or schedules.
In AutPlay Therapy (Grant, 2016), there are six categories of emotional
regulation that children and adolescents with ASD may be lacking: identi-
fying emotions, understanding and expression of emotions, recognizing
emotions and situations, recognizing emotions in others, sharing emotional
experiences, and managing emotions. Each category can be worked on con-
currently or progressively.
The six emotional regulation categories are defined below:

1. Identifying emotions refers to a child’s ability to identify emotions, accu-

rately label emotions, and reference several emotions as age appropriate.
2. Understanding and expression of emotions refers to a child’s ability to
understand the specific emotions he or she may be experiencing, such as
frustration versus anger, and being able to express the emotions that he
or she is feeling in an appropriate way, such as verbally communicating
his or her feelings to others.
12 Primary Target Areas
3. Recognizing emotions and situations refers to a child’s ability to recog-
nize that certain emotions would correspond to certain situations; for
example, attending a funeral would make a person feel sad.
4. Recognizing emotions in others refers to a child’s ability to recognize
emotions and emotional expression in other people, such as recognizing
when a parent is sad or angry or when another child at school is feeling
lonely.
5. Sharing emotional experiences refers to a child’s ability to mutually par-
ticipate in sharing emotions with another person, such as connecting
with another in excitement while participating in a mutual activity.
6. Managing emotions refers to a child’s overall ability to manage his or her
emotions, such as identifying feelings and being able to express them in
an appropriate way and understanding how to handle negative emotions
to self-regulate.

Kuypers (2011) proposed that self-regulation is something everyone continu-

ally works on, whether they are cognizant of it or not. All people encounter
trying circumstances that test their limits from time to time. If children are
able to recognize when they are becoming less regulated, they will be able to
do something about it to feel better and get themselves to a better place. This
comes naturally for some, but for children and adolescents with autism, it is
a skill that needs to be taught and practiced.
Play-based interventions that focus on emotional regulation can be indi-
vidualized to each child and adolescent to work on the regulation issues that
a particular child needs to improve. Play-based interventions are natural and
playful and, thus, more engaging to children. Many play-based interventions
can be implemented several times, both with the practitioner and at home
with parents and other family members. Play-based interventions can be
implemented until the child or adolescent successfully displays the emotional
regulation level or skill that is being sought.

Social Skills and Functioning

The term “social skill” actually functions as an umbrella term, covering a
wide range and variety of skills from simple to more complex. Social skills
can be anything from learning, to making eye contact, to knowing when a
situation is unsafe, to giving a speech in public.
Social skills are interpersonal, specific behaviors that permit an individual
to interact successfully with others in an environment. The extent to which an
individual is considered to have adequate social skills is determined by others.
This is especially true for children and adolescents with an autism disorder or
other developmental disability, as they may not be able to fully understand or
recognize a social skill even after they have obtained it (Grant, 2012).
Children and adolescents with ASD and other developmental disorders
have various levels of impairment in regard to social skills and social func-
tioning. Many fail to develop age-appropriate friendships and have great
 Primary Target Areas 13
difficulty understanding the rules of social life. Laushey and Heflin (2000)
suggest that impairments in social behavior are so fundamental to children
with autism spectrum disorder, that social deficits should be considered the
defining feature of autism spectrum disorder.
Dawson, McPartland, and Ozonoff (2002) stated that everyone diagnosed
with ASD has trouble with social interchange, specifically with reciprocity,
the back-and-forth interaction that make up all social encounters. Further,
children and adolescents with ASD tend to have a very limited concept of
friendship, tend to face peer rejection, and may struggle in initiating socially
encouraging body language. When children and adolescents with ASD are
placed in social situations where they do not have the proper social skills to
maneuver in the situation, it can create a great deal of anxiety for the child,
which typically leads to unwanted behaviors. Just the thought of being put
in a situation that is unfamiliar, or where there is a lack of skills to navigate
successfully, can also create a great deal of anxiety and lead to unwanted
behaviors.
Stillman (2007) suggested the following areas of social interaction and
functioning that children and adolescents with autism spectrum disorders
tend to have some level of impairment with:

1. Showing and giving affection to caregivers and other important people in

the child’s life.
2. What appears to be a lack of interest in making friends but actually is a
lack of knowing how to engage and make friends.
3. Presenting as very shy or withdrawn.
4. A lack of understanding and recognizing irony, sarcasm, and other forms
of humor.
5. A lack of being able to present and show emotions and recognize emo-
tions in others.
6. A tendency to talk too much and about one topic.
7. Randomly talking to him- or herself in public or around others.
8. Performing stimming behavior in social situations such as chewing on his
or her shirt or flapping his or her hands.
9. Seeming to be more interested in interacting with others through a com-
puter rather than in person and wanting to spend most of his or her time
playing with a computer or video game.
10. Seems to want to, and does better, talking to adults than to children his
or her own age.

Dienstmann (2008) proposed that social skills must be taught. The belief that
social skills magically appear in children without any development is a com-
mon misconception. Research supports social skills training as an evidence-
based treatment for learning social skills. It is important to remember that
social skills are skills; we all learned them at some point. No matter where a
child is at in terms of his or her current social functioning, he or she can learn
more social skills.
14 Primary Target Areas
Connection and Relationship Development
Children with ASD and other developmental disabilities do have a sense
of connection and would most likely do poorly if we suddenly took away
their caregivers and exchanged them for new ones. That being said, children
with ASD and other developmental disabilities do have difficulty showing and
expressing connection in meaningful ways and certainly have a difficult time
expressing connection in socially typical and acceptable ways (Grant, 2016).
Coplan (2010) stated that children with autism or other developmental
disorders have a lack of reciprocity that may be evident from birth, progress-
ing from poor eye contact as an infant or toddler, to difficulty in mastering
interactive play as a preschooler, and then to an inability to see things from
another person’s point of view as a school-aged child.
Lindaman and Booth (2010) described several difficulties that children
with ASD have in engagement and connection:

1. Difficulties related to sensory and motor coordination make it challeng-

ing to establish rhythm and synchrony with another.
2. Children are less able to imitate and anticipate another person’s actions.
3. Difficulty in verbal and nonverbal communication and engaging and
shifting attention create challenges in identifying feelings, thoughts, and
wants.
4. Children may receive or process information differently.
5. A child’s difficulties make it challenging for parents to attune, under-
stand, and respond appropriately, which can lead to more withdrawn
behavior by the child.

A lack of connection and of being able to feel a true sense of relationship may
be one of the most troubling concerns for parents of a child with an ASD or
other developmental disorder. What is happening between child and parent
cannot be undervalued. Parents need to feel connection between themselves
and their child, and some of that connection needs to be child initiated. Chil-
dren need to learn connection in healthy and appropriate ways. Ray (2011)
proposed that, when children establish closeness with others, they exhibit
warmth toward others, seek support from adults with whom they are com-
fortable, and show enjoyment in their close relationships.
The connection and relationship development interventions in this book
are designed to 1) increase connection between the child and caregiver and
increase relationship development between the child and other significant
relationships; 2) teach children and adolescents how to be more successful
in engaging others and increasing relationship connections in an appropriate
manner; and 3) provide a fun, natural, play-based atmosphere for children
and adolescents to master greater relationship and connection skills.
The connection and relationship development interventions in this book
range from simple to more complex by design. Practitioners should pay spe-
cial attention to the functioning level and age of the child they are working
 Primary Target Areas 15
with and choose interventions that match the child’s level. Children who have
a lower functioning level will likely struggle with the most basic connection-
based intervention and may start participating at a minimal level. It is impor-
tant and appropriate to work with the child’s level and progress forward with
the child. Forcing a child or adolescent to participate in a connection-based
intervention that he or she is uncomfortable with, or that is beyond his or her
functioning level, will likely result in the child having a behavior “meltdown”
and may result in the child being even more resistant to participating in future
connection-based interventions. Many interventions, especially those related
to connection and relationship development, involve physical touch. Before
implementing interventions that involve physical touch, practitioners are
encouraged to review the Association for Play Therapy’s “Paper on Touch”
that can be found on the APT website at www.a4pt.org.
Children and adolescents with ASD and other developmental disorders
seem universally to present a desire for greater connection with others and a
longing to have deeper relationship experiences, at least to a level that they
feel comfortable with. Consequently, almost universally, children dealing
with these issues are not experiencing the level of connection and relationship
that they desire and seem to lack the skill level or ability to attain the level of
connection they would like to have. Through the consistent and purposeful
introduction and practice of play-based interventions designed to increase a
child’s skill level and ability in making and keeping meaningful connection
and relationships, children and adolescents can reach the level of connec-
tion and relationship development that they desire. It is likely that each child
and adolescent will present with a different goal level in terms of how much
connection skill they develop and what level of relationship each child and
adolescent is seeking and comfortable with.
It is not necessary for every person, atypical or even neurotypical, to pos-
sess the same desire and skill level in relationship development. There is some
subjectivity that should be implemented in determining what level of connec-
tion ability each child and adolescent may need for general functioning pur-
poses and what level they may want to achieve in terms of greater connection
and relationship development.

Additional Services and Support

Many children and adolescents with ASD and other developmental disorders
will be involved in multiple treatments. It is common for a child or adolescent
to be participating in play therapy treatment as well as occupational therapy,
speech therapy, and an applied behavioral analysis (ABA)-based program,
and possibly several other types of treatment approaches. Practitioners may
also want to refer children and adolescents for additional treatments. It is
most helpful when practitioners can correspond with other service providers
and establish a comprehensive collaborative treatment approach.
The complexities of ASD and developmental disorders are vast, and men-
tal health professionals and play therapists occupy important roles in the
16 Primary Target Areas
treatment of children and adolescents with ASD and in working with families
affected by ASD and developmental disorders. Likewise, other profession-
als such as occupational therapists, speech therapists, and ABA professionals
facilitate important pieces of the treatment puzzle. When all the profession-
als working with the child can work collaboratively together and with the
child’s parents, the child is better served.
The play-based interventions in this book have been successfully imple-
mented by mental health practitioners, play therapists, school counselors,
occupational therapists, speech therapists, early interventions specialists,
and ABA professionals. Any professional reading this book is encouraged to
share this resource with other professionals who are working with children
and adolescents with ASD and further encouraged to institute a collaborative
community referral network in their own community.

Helpful Resources
The Appendix of this book contains helpful resources for the practitioner.
There is a feelings list that can be used with interventions that focus on chil-
dren and adolescents working on emotion identification and expression.
Likewise, there is a social skills checklist that can be used to help practitioners
identify social skills that children and adolescents need to improve. There is
also a toy and material list that can be used to help practitioners identify com-
mon toys and materials they will need to complete the directive play interven-
tions described in this book.
The Appendix also includes a play-based intervention-tracking sheet
designed to accompany the practitioner’s case notes and treatment plan and
help the practitioner quickly record and review which directive interven-
tions have been implemented and when the intervention was implemented. A
create-your-own-techniques worksheet is provided that gives the practitioner
a guide to follow when creating new interventions on their own to implement
with clients who have ASD. Several important considerations are presented in
the techniques worksheet to guide the practitioner in creating a technique that
would be effective with the identified populations that this book addresses.
A list of apps for children and adolescents with ASD and other special
needs is presented with a brief description of each. A list of relevant websites
and book resources are also listed, which practitioners can access for further
reading and knowledge enhancement as well as share with parents.
4 Emotional Regulation
Interventions

Emotional Regulation
18 Emotional Regulation Interventions
Feelings Pick-Up Sticks

Target Area Emotional Regulation

Level Child and Adolescent
Materials Pick-Up Sticks, Feeling/Color Sheet
Modality Individual, Family, Group

Introduction
This intervention utilizes the game pick-up sticks to help increase emotional
regulation in children and adolescents with ASD. Children and adolescents
with ASD and other developmental disorders may need to work on a variety
of emotional regulation skills, and this intervention provides the opportunity
to individualize the activity to target several different skills that the child or
adolescent needs to develop.

Instructions
Using the game pick-up sticks, the practitioner creates a sheet of paper with
each pick-up stick color listed and several feelings listed under each color
(included here). The practitioner and child play a game of pick-up sticks fol-
lowing the typical pick-up sticks rules. When the child or practitioner picks
up a stick of a certain color, he or she must look at the paper and pick one of
the feelings listed under that color to share a time that he or she felt that way,
act out the feeling, or define the feeling.

Rationale
This technique helps children and adolescents work on identifying, under-
standing, and expressing emotions. Children also work on fine motor skills
and verbal communication with this technique. The practitioner can develop
feeling/color sheets that address specific emotions that the practitioner
believes the child is struggling in identifying and expressing. It is important
to note that some children will have trouble picking up some of the sticks
without moving them. The practitioner should be lenient on this rule in the
pick-up sticks game, as the point is for the child to acquire a stick so he or
she can share a feeling.
Parents can be taught how to play Feelings Pick-Up Sticks, given a feel-
ings sheet, and encouraged to purchase a pick-up sticks game. (They come in
various sizes and are usually inexpensive.) The practitioner should encourage
parents to implement this intervention regularly a home with their child and,
if appropriate, involve the whole family. The game can be played several
times, and the feelings sheet can be changed as needed to work on new or
more complex emotions. Parents can create their own feelings sheets at home
as needed.
 Emotional Regulation Interventions 19
Feelings Pick-Up Sticks

RED
Happy • Confused • Scared • Proud

BLUE
Sad • Worried • Loved • Excited

GREEN
Angry • Calm • Nervous • Silly

YELLOW
Brave • Frustrated • Tired • Friendly

BLACK
Peaceful • Anxious
20 Emotional Regulation Interventions
Feelings Beach Ball

Target Area Emotional Regulation

Level Child and Adolescent
Materials Beach Ball, Black Sharpie Pen
Modality Individual, Family, Group

Introduction
Feelings Beach Ball provides an engaging and fun way for children and ado-
lescents to work on a variety of emotional regulation components. It is also
an easy intervention for children and adolescents to take home and play with
other family members. The practitioner can complete a beach ball prior to the
child attending his or her session and can individualize the ball with specific
feelings the child needs to address, or the practitioner and child can work
together to create a feelings beach ball.

Instructions
The practitioner blows up a beach ball and instructs the child that they are
going to write feeling words all over the ball. (The practitioner could also
create a beach ball and write feelings on it prior to the child’s session.) The
child should think of as many feelings as he or she can, and then the practi-
tioner can add feelings to fill up the beach ball. (The practitioner will want
to make sure that feelings are included that the child needs to address.) Once
the ball is complete, the practitioner and child toss the ball back and forth.
When someone catches the ball, whichever feeling is closest to the person’s
right thumb is the feeling that he or she has to select and share what makes
him or her feel that way or act out the feeling while the other person tries to
guess what it is. If someone’s thumb lands on a feeling that has already been
done, then he or she should choose the next feeling that is closest to his or her
thumb. An additional fun element would be to select different ways to toss
the beach ball as it is passed back and forth such as “This time, let’s hit it to
each other with our heads.”

Rationale
This technique helps children and adolescents work on identifying, under-
standing, and expressing emotions and recognizing emotions in others. The
child takes the beach ball home, and the practitioner can teach this interven-
tion to the parents to do periodically at home with their child. The child’s
feelings may change from day to day, and the level that the child is feeling will
also change from day to day. Completing this technique periodically at home
will help the child learn how feelings can change and how much a person feels
a particular feeling can change depending on the situation.
 Emotional Regulation Interventions 21
Feelings Beach Ball

List of Feelings
Anxious
Worried
Happy
Sad
Excited
Overwhelmed
Confused
Nervous
Proud
Scared
Frustrated
Loved
Lonely
Rejected
Accepted
Angry
Calm
Friendly
Confident
Peaceful
Tired
22 Emotional Regulation Interventions
LEGO Emotion House

Target Area Emotional Regulation

Level Child and Adolescent
Materials LEGO Pieces
Modality Individual, Group

Introduction
Several studies have supported the benefits of using LEGOs with children
and adolescents with ASD and other developmental disorders. This interven-
tion uses LEGOs to work on increasing emotional regulation, specifically the
identification of emotions. LEGOs are not only naturally inviting for a child
but also provide a positive sensory experience and typically are a toy that
children with ASD are familiar with.

Instructions
The child is given some LEGOs and instructed to build a house, a building
of some type, or a car. The child can also build an abstract object if he or she
would prefer. The child is instructed to use different colors, and each color
will represent a feeling. The child should choose feelings that he or she expe-
riences often. (The practitioner can also give the child a specific situation or
person to identify feelings about such as school or his or her parents.)
Once the child has constructed his or her object, the child goes through
the colors and talks about each feeling and what causes him or her to have
that feeling. The practitioner may also inquire if the placement of the LEGOs
has any significance for the child. The practitioner may also want to cre-
ate a LEGO Emotion House as well and role model identifying and sharing
feelings.

Rationale
LEGO Emotion House helps children and adolescents work on identifying,
understanding, and expressing emotions. Children also work on fine motor
skills and verbal communication with this technique. The practitioner can
teach this technique to parents to do periodically at home with their child.
A child’s feelings may change from day to day, and the level of emotion that
a child is feeling will also change from day to day.
Completing this technique periodically at home will help the child develop
better emotional regulation ability. Further, parents can gain a greater under-
stating of what their child is feeling and help their child to express his or her
feelings. Practitioners can also use this intervention in a group setting with
each child sharing the LEGO Emotion House that he or she has created with
the group.
 Emotional Regulation Interventions 23
LEGO Emotion House

(Red = Angry, Yellow = Upset, Blue = Sad, Green = Confused, White = Happy)
24 Emotional Regulation Interventions
Construction Feeling Faces

Target Area Emotional Regulation

Level Child
Materials Construction Paper, Glue, Scissors
Modality Individual, Group

Introduction
This intervention helps children recognize and connect with their emotions.
With this intervention, children are able to use expressive materials in a way that
allows them to create emotions and discuss the emotions they often experience.
Fine motor movements and skills are also involved in the construction of this
intervention. Construction Feeling Faces can be completed multiple times, cre-
ating several different feeling faces that the child can take home and reference.

Instructions
The practitioner explains to the child that they will be making faces display-
ing feelings and that the faces will be made completely out of construction
paper. The child chooses a piece of paper that he or she cuts into a large circle
to represent a head. The child then puts a face on the paper using construc-
tion paper only. The child will cut out eyes, eyebrows, ears, nose, mouth, hair,
etc. from construction paper. The child is instructed to make a face that dis-
plays an emotion. If the child cannot think of any feelings or is unsure how to
construct the feeling he or she is thinking of, the practitioner will want to help
the child with these processes. The child can cut out any pieces of construc-
tion paper and place them in any way that he or she likes on the head, but
the overall face must be displaying an emotion. Once the child has completed
making the face, he or she shows the face to the practitioner and shares what
emotion the face is showing. The practitioner and child discuss the feeling
face and when the child has experienced that emotion. The child can make
several construction feeling faces and process them with the practitioner.

Rationale
Construction Feeling Faces help children work on identifying emotions and
recognizing emotions in others. Children also work on fine motor skills and
verbal communication with this technique. The practitioner and child should
try to make several Construction Feeling Faces, and all the faces created can
be sent home with the child for the child to refer back to and help him or her
identify and express feelings at home. The practitioner can teach this tech-
nique to the parents to do periodically at home with their child. Parents may
want to complete one a day with their child choosing the main feeling that he
or she experienced that day.
 Emotional Regulation Interventions 25
Construction Feeling Faces

(Happy face)

(Angry face)
26 Emotional Regulation Interventions
Bean Bag Toss

Target Area Emotional Regulation

Level Child and Adolescent
Materials Bean Bags, Bucket
Modality Individual, Family

Introduction
This is a simple yet engaging intervention that helps children and adolescents
work on a variety of emotional regulation skills. The physical movement and
challenge piece of Bean Bag Toss are also good for helping children and ado-
lescents learn to better regulate and accomplish a task. With Bean Bag Toss,
the practitioner has the ability to individualize the interventions to address
the specific emotional regulation needs that the child or adolescent needs to
improve upon.

Instructions
Using some type of small bean bag, the practitioner will write a different
feeling word on each bean bag. (Square, circle, or animal-shaped bean bags
can be purchased through most toy stores—practitioners should purchase a
type that can be written on with a Sharpie marker.) The child tries to throw
the bean bags into a bucket that is set up somewhere in the room. For each
bean bag the child gets in the bucket, the child has to share the definition
of the feeling or something that makes him or her feel that way. The prac-
titioner then takes a turn. The practitioner also defines the feeling or shares
something that makes him or her feel that way; this provides an educational
and role modeling opportunity. The practitioner and child go back and forth
trying to get all the bean bags into the bucket and ultimately discussing all the
feelings. The intervention can be played several times with new information
being shared about each feeling.

Rationale
Bean Bag Toss helps children and adolescents work on identifying, under-
standing, and expressing emotions. This technique also involves a movement
component, and after a couple of rounds, the practitioner should instruct
the child that they are now going to play the game using their nondominant
hand. Another option is trying to get the bean bags in the bucket by throwing
them backwards over the head.
The practitioner should teach this technique to parents to do periodically
at home with their child. Other family members may also play this interven-
tion with the child. Multiple people can be involved, creating a fun, social
activity that is working on emotional skill development.
 Emotional Regulation Interventions 27
Bean Bag Toss
28 Emotional Regulation Interventions
Feelings Spinner Game

Target Area Emotional Regulation

Level Child and Adolescent
Materials Color Spinner, Paper, Pencil
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
struggle on some level with emotional regulation ability. The Feelings Spinner
Game is a simple, low-prop intervention that can be manipulated to work on
any emotional regulation skill that a child or adolescent is lacking. Children
often enjoy using the spinner format and practitioners can involve children in
the planning and setup of the game.

Instructions
Using a color wheel spinner (typically purchased at an education supply store
and can be purchased in bulk), the practitioner and child decide what feeling
will go with each color on the wheel spinner and write the feelings down on a
piece of paper, such as yellow for happy, red for mad, blue for worried, green
for sad, etc.
The practitioner and child then take turns spinning the spinner; when
someone spins the spinner, whichever color the spinner lands on, the per-
son has to act out the feeling or tell about a time that he or she has felt that
way. The same feeling can be landed on several times with new information
shared about that feeling. Play continues until the practitioner and child want
to stop.

Rationale
The Feelings Spinner Game helps children and adolescents work on identi-
fying, understanding, and expressing emotions. Several different emotional
regulation components can be addressed with this intervention. The prac-
titioner can vary the spinner rules by having children, not only make a face
displaying or defining a feeling, but even change the rules to make the colors
different social skills or coping skills to practice instead of feelings. The spin-
ner should be sent home, and parents should be taught how to play the game
and encouraged to play the Feeling Spinner Game several times at home with
their child.
 Emotional Regulation Interventions 29
Feelings Spinner Game
30 Emotional Regulation Interventions
Draw My Feelings Face

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual, Family, Group

Introduction
Draw My Feelings Face works on several target areas that present struggles
for children and adolescents with ASD. This intervention targets improv-
ing emotional regulation (identifying and expressing feelings), social skills
(understanding body language), and relationship connection (attuning with
and noticing another person) in a format that is fun and keeps the child
engaged.

Instructions
The practitioner shares with the child that they will practice making and
understanding feelings using their faces. The child is given a piece of paper
and a pencil. The practitioner makes a feeling face for about 3 seconds. The
child has to draw the feeling face the practitioner made and then write on the
paper the feeling word that he or she believes goes with the face. The child
shows the practitioner, and the practitioner confirms if the child is correct.
If the answer is not correct, the practitioner should spend some time talking
about what the feeling looks like, what someone would be feeling if they
made that face, and practice with the child, possibly using a mirror. The prac-
titioner and child switch roles back and forth with each one making a feeling
face and the other drawing and labeling what he or she saw.

Rationale
This technique works on emotional regulation, connection and relationship
development, and understanding body language. It is likely that the child will
draw some incorrect faces, and when it is the child’s turn, he or she will likely
make faces that the practitioner cannot understand in terms of what feeling
is being shown. These incorrect examples provide opportunity for the practi-
tioner to discuss what a feeling should look like and practice with the child.
Some feelings will be difficult to display with a facial expression, or a facial
expression might be appropriate for several different feelings. This provides
a good opportunity for discussion on how to handle situations when it is dif-
ficult to read a person’s body language. This technique also provides a good
opportunity for parents and child to work on connection, eye contact, and
more accurate emotion expression at home. The intervention can be played
repeatedly going through several different emotions.
 Emotional Regulation Interventions 31
Draw My Feelings Face
32 Emotional Regulation Interventions
Heart Parts

Target Area Emotional Regulation

Level Child and Adolescent
Materials Foam Piece, Black Sharpie, Various Craft Decorations
Modality Individual

Introduction
Children and adolescents with ASD commonly struggle with anxiety and
worry. High levels of anxiety and worry most often lead to unwanted behav-
ior problems. Multiple sources can create high levels of anxiety in children
with ASD, such as a lack of social skills, change, new people or environments,
sensory issues, and inability to regulate emotions. This intervention focuses
on helping children identify worry and practice ways to self-calm.

Instructions
The child selects a foam piece and cuts the foam piece into 4 different parts.
(Practitioners can also have foam pieces available that are already cut into
a heart shape.) The 4 parts are labeled: worried, loved, mad, and calm. The
practitioner and child begin with the worried part of the heart. The practitio-
ner and child write on the front side of the part all the things they can think of
that make the child feel worried. On the back side, the child and practitioner
write strategies to help alleviate the negative emotion. The same process is
completed for the mad part of the heart.
The child takes the other 2 parts home, and together with his or her par-
ents, writes all the things they can think of that makes the child feel loved and
calm on the loved and calm parts of the heart. The child brings the completed
parts back to the next session, and the child and practitioner glue the heart
together and process through the 4 different feelings, discussing what creates
the feelings and helpful coping strategies when experiencing negative feelings.
The practitioner and child may want to role-play and practice the identified
coping strategies.

Rationale
The Heart Parts intervention works on emotional regulation improvement. The
focus is on helping children to identify the feelings they have, what causes those
feelings, and coping strategies to address negative feelings. It also helps the child
understand that he or she can have different feelings, both positive and nega-
tive. The 4 feelings identified can be different from the 4 listed above but should
always include worried and calm. Parents are taught to go through the 2 parts
that are taken home with their child and further process through identifying and
labeling feelings with their child.
 Emotional Regulation Interventions 33
Heart Parts

(Front: Four feelings with examples of what creates the feelings)

(Back: Four feelings with strategies to help regulate)

34 Emotional Regulation Interventions
Home and School

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Markers
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders are
often in two primary environments, home and school. Often, these two envi-
ronments hold the most potential for dysregulation and unwanted behaviors.
The Home and School intervention is designed to help children identify what
emotions he or she is feeling in both settings. Further, it helps children explore
what they can do to address the negative emotions in each environment.

Instructions
The practitioner instructs the child to draw a picture of his or her school on
one side of a piece of paper and a picture of his or her home on the other
side of the paper. The child should write the school’s name somewhere on the
school picture. The child is then instructed to write all the feelings that he or
she has at school somewhere on the school picture and the feelings he or she
has at home somewhere on the home picture. The child then shares with the
practitioner what makes him or her feel the feelings that he or she has written
down.
The practitioner then picks one negative feeling that the child has shared
from his or her school and home pictures and asks the child to write on the
school and home pictures what he or she thinks that he or she could do at
school and home to appropriately express that negative feeling. The practi-
tioner and child then role-play a scenario at school and home where the child
appropriately expresses the negative feeling. The practitioner and child can
continue until all the negative emotions have been addressed.

Rationale
The focus of this intervention is on helping children and adolescents identify
feelings (especially negative feelings) that they are experiencing at school and
at home and learn how to express those feelings in appropriate ways. The
practitioner and child should try to process through all the negative feel-
ings identified and role-play appropriate expressions for each. Parents can be
taught to do this intervention at home and encouraged to role-play through
negative feelings daily with their child to help them gain some mastery in
both their school and home settings.
 Emotional Regulation Interventions 35
Home and School Examples
36 Emotional Regulation Interventions
Feelings Don’t Break the Ice

Target Area Emotional Regulation

Level Child
Materials Don’t Break the Ice Board Game by Hasbro, Stickers
Modality Individual, Family

Introduction
Don’t Break the Ice is a common board game that is naturally engaging for children.
This intervention utilizes this popular game to help children differentiate between
positive and negative emotions and verbalize what creates certain emotions. The
typical game rules are followed with some additional skill development instruction.

Instructions
Using the Don’t Break the Ice board game by Hasbro, the practitioner takes
each of the “ice” pieces and, on the underside of each piece, puts a color sticker
such as a star or heart. There should be 4 different colors represented, and a
few of the “ice” pieces should be left blank with no sticker on them. (This is
done prior to playing the game with any child.) The practitioner instructs the
child that they are going to play Feelings Don’t Break the Ice. The practitioner
shows the child the stickers on the ice pieces, and the practitioner and child
decide together which 2 colors of stickers will represent positive feelings and
which 2 colors will represent negative feelings. For example, the practitioner
and child might decide that green and blue will be positive feelings and that red
and yellow will be negative feelings. The normal Don’t Break the Ice rules are
observed with an additional rule; once an ice piece is knocked out, if it has a
sticker on the underside, the person who knocked that piece out has to identify
a positive or negative feeling (depending on the color) and talk about some-
thing that has made him or her feel that way. For example, the child knocks out
a piece with a yellow sticker on the bottom; the child has to name a negative
feeling and then share a time or situation when he or she felt that feeling.

Rationale
This intervention helps children work on increasing emotional regulation
ability. The focus is on helping children identify positive and negative feelings
and learn how to talk about those feelings. Children with developmental dis-
orders also tend to like the action of hammering the pieces of ice out and put-
ting them back together to play a new game (which also works on fine motor
skills). Feelings Don’t Break the Ice can be played several times. Parents are
encouraged to purchase the game and are taught to do this intervention at
home and regularly play with their child. Practitioners should also consider
that the colored stickers can be used to represent other skill areas besides feel-
ings, such as social skills, coping skills, or motor movements.
 Emotional Regulation Interventions 37
Feelings Don’t Break the Ice
38 Emotional Regulation Interventions
Happy Me, Sad Me

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual, Group

Introduction
This intervention is simple yet engaging for children and adolescents and
presents a strong visual representation of the child’s emotions and connect-
ing emotions to situations. Happy and sad are the primary focus, but other
feelings can be incorporated such as mad, brave, scared, worried, or calm.
Practitioners can choose feelings that the child needs to address and repeat
this intervention using different feelings each time.

Instructions
The practitioner instructs the child to draw a line down the middle of a piece
of paper. On one side of the paper, the child will draw a happy self and, on the
other side, a sad self. Underneath the happy self, the child will write all the
things he or she can think of that makes him or her feel happy. Underneath
the sad self, the child will write all the things that he or she can think of that
make him or her feel sad.
If the child is struggling to identify things that make him or her feel happy
and sad, the practitioner can help the child by asking him or her questions,
such as “What is your favorite class in school?” “What feelings do you have
when you are in that class?” “What is something you don’t like to do?” and
“What feelings do you have when you have to do that thing?” Once the lists
are complete, the practitioner and child go through both lists, talking about
each thing the child has identified. At this point, the child could complete
another sheet with 2 different emotions.

Rationale
The Happy Me, Sad Me intervention helps children work on increasing emo-
tional regulation ability. The focus is on helping a child identify emotions that
he or she is experiencing and having a visual reminder that he or she can ref-
erence. Various emotions can be used to complete this intervention, but there
should always be a positive emotion that contrasts with a negative emotion.
Parents can be taught to complete this intervention at home and encouraged
to look for opportunities to play with their child, especially days or times
when it may seem their child is experiencing some negative emotions.
 Emotional Regulation Interventions 39
Happy Me, Sad Me
40 Emotional Regulation Interventions
Emotion Mane

Target Area Emotional Regulation

Level Child
Materials White Paper Plates, Markers, String, Hole Punch
Modality Individual, Family, Group

Introduction
Emotion Manes provide children with ASD the opportunity to better recog-
nize the emotions they may be feeling. This is an expressive art intervention
that incorporates a visual and tactile component, creating a more sensory
experience to aid in acquiring the emotional regulation skills being addressed.

Instructions
The practitioner communicates to the child that they will be creating a mane
(like a lion’s mane) that the child will be able to wear around his or her face.
The practitioner and child cut out the center of a white paper plate. The center
piece is thrown away, and the rest of the paper plate ring is colored with dif-
ferent colors. (Only the underside of the plate ring is colored.) Each color rep-
resents a different feeling that the child sometimes feels. The feeling word for
each color should be written on the inside of the paper plate ring correspond-
ing to the color that represents that feeling. Once the plate has been colored,
a hole is punched on each side, and string is used to tie in each hole and make
an open mask that can be tied on the child’s head. The finished product will
resemble a lion’s mane. Once the mane is on the child’s head, the child should
look in a mirror, go through each feeling, and talk about a time or something
that has made the child feel that way. The practitioner should discuss with the
child how the child has different feelings inside of him or her at different times
and how it is OK to feel different emotions and learn to identify them.

Rationale
This technique helps children work on identifying, understanding, and
expressing emotions. The child also works on fine motor skills and verbal
communication with this technique. Completing this technique periodically
will help the child learn how feelings can change from day to day and how
much a person feels a certain feeling can change depending on the situation
and on different days. If a child is at a more impaired level, then the practi-
tioner may do more of the construction work and assist the child in identify-
ing his or her emotions. Wearing the mane and discussing the feelings while
looking in a mirror better helps the child to connect with and take ownership
of his or her emotions. These elements also provide a strong visual element
to the intervention.
 Emotional Regulation Interventions 41
Emotion Mane
42 Emotional Regulation Interventions
Angry Yes, Calm Yes

Target Area Emotional Regulation

Level Adolescent
Materials White Paper, Construction Paper, Markers, Glue, Scissors
Modality Individual

Introduction
The Angry Yes, Calm Yes intervention helps adolescents identify situations
that make them feel angry or upset and identify calming strategies or inter-
ventions to use to help them calm and relax when something is bothering
them. Any dysregulating, negative emotion can be addressed besides anger,
such as worry, anxiety, frustration, disappointment, or sadness. The practi-
tioner should target the intervention to address specific emotional regulation
needs the adolescent is struggling with.

Instructions
The adolescent is instructed to draw an outline of 2 people on a piece of
white paper. One person is labeled “angry person,” and the other person is
labeled “calm person.” The practitioner informs the adolescent that both
people outlines represent the adolescent. The adolescent picks a colored piece
of construction paper for each person outline (one color for the angry person
and one color for the calm person). The adolescent cuts out pieces of the col-
ored paper and glues them on each person. On the cut-out pieces of paper for
the angry person, the adolescent is instructed to write things that make him
or her feel angry and, on the cut-out pieces of paper for the calm person, to
write things that make him or her feel calm.
The practitioner may have to help the adolescent identify things that make
him or her feel angry and calm. The adolescent then practices the things that
make him or her feel calm. The practitioner and adolescent should role-play
scenarios using situations or things that the adolescent identified as making
him or her angry and then practicing a calming activity.

Rationale
This technique helps adolescents work on identifying, understanding, express-
ing, and managing emotions. The adolescent should be encouraged to try and
apply the calming strategies the next time he or she is feeling angry. The
adolescent can take this technique home and practice the calming activities
at home. Parents can also be taught how to do this intervention and practice
with their child at home.
 Emotional Regulation Interventions 43
Angry Yes, Calm Yes Examples
44 Emotional Regulation Interventions
Feelings Card Sort

Target Area Emotional Regulation

Level Adolescent
Materials Several Index Cards, Pen or Pencil
Modality Individual

Introduction
Adolescents typically have a challenging time communicating their emotions,
especially in regard to the relationships in their lives. Feelings Card Sort
helps adolescents accurately identify and discriminate between emotions that
they may be feeling specifically related to various relationships with family
members.

Instructions
The practitioner explains that the adolescent will be using index cards to help
identify the various feelings that he or she may have in regard to different
relationships in his or her life. The adolescent writes as many feelings as he or
she can think of on index cards (one feeling per index card). The practitioner
can also add feelings/index cards so there are a variety of feelings represented
on the index cards. The adolescent then makes an index card for each family
member with the family member’s name written on the card. The practitioner
takes the family member cards and, one at a time, lays down a family member
card. Then, from the feeling index cards, the adolescent chooses the feelings
that he or she has for that family member and lays those feeling cards down
near the family member card. The practitioner and adolescent then discuss
why he or she has those feelings about that family member. The practitioner
and adolescent go through this process for each family member card.
An alternate version might be to have the practitioner lay down a family
member card and then have adolescent choose feeling index cards that rep-
resent the feelings that the adolescent thinks that family member feels. The
practitioner and adolescent then discuss why he or she believes that family
member would have those feelings. The alternate version is helpful in work-
ing on identifying and understating feelings in other people.

Rationale
The Feelings Card Sort intervention helps adolescents work on identifying,
understanding, and expressing emotions and identifying emotions in others.
The Feelings Card Sort game can be expanded beyond family member rela-
tionships and include other people in the adolescent’s life such as friends,
teachers, doctors, etc.
 Emotional Regulation Interventions 45
Feelings Quiz

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual

Introduction
The Feelings Quiz helps children and adolescents who are struggling with
simply identifying and connecting to feelings. The quiz format provides a fun
and engaging way for children to think about feelings and to try and name as
many feelings as they can. Practitioners should make the feelings quiz lively,
dramatic, and fun.

Instructions
The practitioner instructs the child or adolescent that he or she is going
to complete a Feelings Quiz. The practitioner should announce this in a
grandiose way and try to keep the process light, not serious like a true for-
mal quiz. The child has to name a certain number of feelings. The number
depends on the age and developmental level of the child. The practitioner
should try to pick a number that would be challenging yet attainable for
the child. It is important that the child be successful in identifying the feel-
ings. The child begins to name off feelings, and the practitioner writes them
down to keep track of what has been said and when the target number has
been reached.
The practitioner can give hints to help the child identify feelings. An
example hint would be to instruct the child to think about a specific place
or situation, like school or being on vacation, and what feelings he or she
had in that place or situation. Once the child has identified the number
required, the practitioner can provide a reward such as a piece of candy or
a small prize.

Rationale
This technique helps children and adolescents work on identifying emotions.
This technique can usually be done quickly and does not require the whole
session, so it can be paired with other techniques. This technique should be
done periodically throughout working with the child to see if he or she can
progressively identify more feelings. The practitioner can chart the child’s
increasing ability to identify more feelings without needing any hints. Feel-
ings Quizzes can serve as informal quantitative measures that evaluate the
child’s ability to increase feeling identification.
46 Emotional Regulation Interventions
Write a Feelings Story

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual, Group

Introduction
This intervention helps children more fully conceptualize emotions. The child
works on identifying feelings, understanding what may be creating a certain
feeling, and recognizing feelings in others. A story format is used so multiple
Feelings Stories can be created to present various emotions and situations.

Instructions
The practitioner has the child or adolescent complete a short story that has
pre-placed emotion words, for example:

happy

sad shy
loved
angry
excited worried

The child can write whatever story that he or she wants as long as it includes
and makes sense with the pre-placed emotion words that have to be used in
the spot they are located in the story. Once the child has completed the story,
he or she reads the story to the practitioner. The practitioner can process with
the child the story that he or she created. The practitioner may have to assist
younger or more impaired children with the writing of the story.

Rationale
This technique helps children and adolescents work on identifying, under-
standing, and expressing emotions. Fine motor skills and verbal communica-
tion are also addressed with this technique. Story templates are included here,
but practitioners can easily create their own. Practitioners should let children
know that the lines in the template are an approximation as some children
may need more room to write out their story between pre-placed feelings.
Practitioners can also allow children to create their own templates if desired.
 Emotional Regulation Interventions 47
Write a Feelings Story Templates

happy

sad shy
loved
angry
excited worried

happy

sad shy
loved
angry
excited worried

happy

sad shy
loved
angry
excited worried
48 Emotional Regulation Interventions
Feeling Fortune Tellers

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Marker
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD can struggle with multiple components
related to emotional regulation. The Feeling Fortune Tellers intervention pro-
vides the opportunity to practice several different areas related to emotional
regulation. The practitioner can make the instructions focus on any area of
emotional regulation they would like the child to practice, such as sharing
about a time you felt that way, showing the feeling on your face, acting out
the feeling, telling about a time you noticed someone else feeling this feel-
ing, defining the feeling, or identifying when someone else would feel this
emotion. Children typically enjoy the construction and the movement of the
fortune tellers and usually want to create multiple fortune tellers.

Instructions
The practitioner explains to the child that they will be creating a paper Feel-
ing Fortune Teller (instructions for completion included here). Fortune tellers
should have numbers on the outside, colors on the inside, and feeling words
placed on the tab on the other side of the colors. After the fortune teller has
been created, the practitioner and child can take turns playing the game.
The basic process of the game is as follows: The practitioner holds the
fortune teller in his or her fingers. The child chooses a number, and the prac-
titioner moves the fortune teller back and forth the number of times for the
number the child chose. The practitioner opens up the fortune teller, and
the child chooses a color. The practitioner lifts the flap for that color, which
reveals a feeling. The child has to share something that makes him or her feel
that way, act out the feeling, or provide a definition of the feeling.

Rationale
This technique works on emotion identification, expression of emotions,
and a variety of emotional regulation struggles. Feeling Fortune Tellers can
be made in different sizes and different colors using construction paper.
The practitioner and child can play the fortune teller game several times. The
child can take their fortune tellers home and play with other family members.
Parents can be encouraged to make additional feeling fortune tellers at home
with their child. The instructions for creating and playing fortune tellers can
be easily accessed online with picture and video examples.
 Emotional Regulation Interventions 49
Instructions for Playing the Feeling Fortune Teller Game
The outer layer shows numbers, the practitioner holds the fortune teller, and
the child picks a number. The practitioner moves the fortune teller back and
forth that many numbers and opens up the fortune teller. The inside shows
colors, the child picks a color, and the practitioner pulls up that color and
reads the emotion underneath that color. The practitioner and child complete
the instruction related to that emotion.

Instructions for Constructing Fortune Tellers

50 Emotional Regulation Interventions
Feelings Puzzle

Target Area Emotional Regulation

Level Child and Adolescent
Materials Blank Puzzle, Markers
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders are
often strong visual learners. This intervention provides a strong visual rep-
resentation of different feelings that children can remember and helps them
identify feelings that they may experience regularly. The tactile and puzzle
completion component also provides a sense of engagement, order, and cre-
ation for the child.

Instructions
The practitioner tells the child they will be using a blank puzzle to create a
puzzle focused on feelings. The practitioner instructs the child to write a dif-
ferent feeling word on the back side of each puzzle piece of a blank puzzle.
The practitioner may have to help the child think of different feelings and
should try to include negative feelings that the child may struggle with. On
the front side of the puzzle, the child can decorate the puzzle however he or
she wants. Once the puzzle has been completed, the puzzle is taken apart,
and the practitioner and child put the puzzle back together. Each time a piece
of the puzzle is connected, the child has to share when he or she has felt that
feeling or act out what the feeling would look like that is written on each
piece of the puzzle.

Rationale
Feelings Puzzles help children and adolescents work on identifying, under-
standing, and expressing emotions. Children also work on fine motor skills
and verbal communication with this technique. The puzzle pieces provide a
strong visual representation of feelings for the child, and the action of tak-
ing apart and putting the puzzle back together helps strengthen the child’s
familiarity with the targeted emotions. Children should take their puzzles
home and put them together with their parents and work with their parents
on sharing and identifying feelings. Parents and children can also make new
puzzles with different feeling words. Blank puzzles come in several sizes and
various numbers of pieces. A good basic size for children is a small puzzle
with 9 pieces. Puzzles with more pieces might be selected for adolescents.
A good website for purchasing blank puzzles is www.blank-puzzles.com.
 Emotional Regulation Interventions 51
Feelings Puzzle

(Back of puzzle: Each piece has a feeling written on it)

(Front of puzzle: Child can draw whatever he or

she wants)
52 Emotional Regulation Interventions
Paint Swatch Degrees of Feelings

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paint Swatches, Pen
Modality Individual, Group

Introduction
Children and adolescents with ASD often struggle with differentiating among
feelings. Basic feelings such as happy, sad, and mad may be identified, but more
specific variances of each may be challenging. This intervention helps children
identify and better understand a more wide range of emotional expression.

Instructions
Using a paint swatch that has several shades of color (see example included
here), the child is instructed to write down all the forms of certain feelings
that he or she can think of. Common feeling categories include anger, sad-
ness, happiness, and anxiety. For example, the practitioner might label one
paint swatch “angry”; the child would then have to think of feelings that are
similar to angry. The child might write “irritated,” “enraged,” “annoyed,”
and “frustrated.” Typically, the child will create a paint swatch for happy,
sad, and mad. Once the child has written all the forms of these feelings that
he or she can think of, the practitioner can add to it if there are some that the
child has missed.
Once the feelings have been written down, the child is instructed to rank
them from the one he or she feels most often to the one he or she feels least
often. Once the ranking is complete, the practitioner and child process through
the highest-ranked feelings and discuss what makes the child feel that way.

Rationale
Paint Swatch Degrees of Feelings helps children and adolescents work on
identifying, understanding, and expressing emotions and understanding
degrees of feelings. The practitioner should use the different shades of color
to emphasize to the child the different feelings that may have similar compo-
nents. For example, lonely and rejected may feel similar to sad. This inter-
vention is helpful to increase a child’s awareness of the various nuances in
emotions. New paint swatches can be made for different feelings, and a gen-
eral feeling swatch can be made displaying the main feelings identified by
the child. Paint swatches can be acquired for free at various hardware and
paint stores. Paint swatches should be sent home with the child for the child
to reference and continue to work on accurately identifying what he or she
is feeling.
 Emotional Regulation Interventions 53
Paint Swatch Degrees of Feelings Examples
54 Emotional Regulation Interventions
Paper Feeling Balloons

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Markers, Pencil, Balloons
Modality Individual

Introduction
Paper Feeling Balloons is a fun and engaging way to help children think about
different situations and the feelings that they may experience in each situ-
ation. Children are often able to identify more feelings by thinking of spe-
cific situations, environments, or people and recognizing feelings they have in
regard to specific qualifiers.

Instructions
The child is instructed to draw 1 large balloon on a piece of paper. The child
is instructed to write as many feelings as he or she can think of inside the large
balloon. This is the master balloon the child will be referring back to. The
child is then instructed to draw 4 smaller balloons on the paper; each balloon
should be a different color. The practitioner takes the paper and labels one
of the smaller balloons a subject, such as “school.” In that balloon, the child
then writes all the feelings that he or she can think of that he or she feels
about school. The child can reference his or her master balloon. If he or she
thinks of a feeling that was not written in the master balloon, then he or she
writes that feeling in both the school balloon and the master balloon. When
the child is finished with the school balloon, he or she gets a real balloon that
he or she can keep and take home. This is repeated for the other 3 balloons
with the practitioner labeling each one a different subject and the child iden-
tifying feelings that he or she has in regard to that subject.
Some subject ideas might include school, home, mom, dad, siblings, music
class, Boy Scouts, the doctor’s office, playing video games, etc. The practitio-
ner should try to pick subjects that will produce a wide variety of feelings for
the child. When all the balloons have been completed, the practitioner and
child can discuss all the feelings that the child identified.

Rationale
This technique helps children and adolescents work on identifying, under-
standing, and expressing emotions. It also helps children understand that
they can have more than one feeling about a subject and that some of those
feelings might be a mix of both positive and negative feelings. Children are
typically able to identify more feelings by having them consider specific situ-
ations and the feelings they have in that situation. Children can take this
intervention home and complete more feelings balloons with their parents.
 Emotional Regulation Interventions 55
Paper Feeling Balloons Examples
56 Emotional Regulation Interventions
Feeling List Stop Game

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual

Introduction
The Feeling List Stop Game is a simple but effective way for children and
adolescents to think about feelings, to share what makes them feel certain
ways, and to communicate what they can do to help themselves feel more
regulated when they are experiencing a negative feeling.

Instructions
The child is instructed to make a list of 12 feelings. (The child can look at
a feelings chart or the feelings list provided in the Appendix of this book to
help them identify the feelings.) The child writes the feelings on a piece of
paper, down the side, numbered 1–12. (A worksheet is included here.) Once
the child has completed the list, the practitioner takes the list and instructs
the child that the practitioner is going to run his or her finger up and down the
list without looking at the list and when the child says stop, the practitioner
will stop. Whatever feeling the practitioner’s finger is on, the child has to
share when he or she felt that way, and if it is a negative feeling, the child has
to share what he or she could do to help him or her feel better.
The practitioner may have to help the child, depending on the child’s age
and developmental level. When discussing a negative feeling, the practitioner
and child can also role-play through any identified strategies for coping better
or regulating through the negative emotion. The practitioner and child can
also switch roles, and the practitioner can share his or her feelings and be a
role model for the child on how to discuss feelings and ideas for handling
negative feelings.

Rationale
The Feeling List Stop Game helps children and adolescents work on identify-
ing, understanding, and expressing emotions. This technique can be played
over and over again by creating new lists with new feelings. Variations can
also be added, like acting out the feeling or making a feeling face. Children
often enjoy switching roles with the practitioner and running his or her finger
up and down the list with the practitioner sharing emotions. Parents can be
taught this intervention to do at home and can be encouraged to play with
their child regularly. Practitioners and parents can use the pre-created sheet
included here or create their own lists.
 Emotional Regulation Interventions 57
Feeling List Stop Worksheet

1) _____________

2) _____________

3) _____________

4) _____________

5) _____________

6) _____________

7) _____________

8) _____________

9) _____________

10) ____________

11) ____________

12) ____________
58 Emotional Regulation Interventions
Spon-Play-Ity

Target Area Emotional Regulation

Level Child and Adolescent
Materials Various Playroom Toys/Games
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders often
struggle with changes in schedule or sudden or spontaneous happenings. This
intervention engages children in a playful way to practice regulating and cop-
ing when they experience sudden changes to the plan or when they experience
something happening spontaneously without any warning.

Instructions
The practitioner explains to the child that they will be working on how to better
handle changes to a plan or something happening without any warning. The
practitioner asks the child to identify several games that he or she likes to play.
The games can be traditional board games or any type of game. If the child
cannot think of anything, then the practitioner should make some suggestions
of games to play that the child is familiar with. The practitioner and child pick
one of the identified games to start playing. After about 5 minutes, the practi-
tioner says to the child that they are not going to play that game any longer and
chooses one of the other identified games to play. The practitioner and child play
the second game for about 5 minutes, and then the practitioner again stops the
game and chooses a different game to play. This continues throughout most of
the session. Toward the end of the session, the practitioner talks with the child
about the process and asks him or her how it felt to keep changing without
warning. The practitioner and child then discuss the concept of things changing
from the original plan and the concept of things happening spontaneously and
how the child can work on feeling OK about experiencing these changes.

Rationale
This technique helps children and adolescents work on general regulation and
developing the skill of handling sudden change of plans or things that may
happen without warning or preparation. The practitioner and child may want
to spend some time discussing ways to stay calm when things change and try
practicing those strategies during the intervention. The playful component of
this intervention provides the child the opportunity to practice regulating them-
selves through changes in a less anxiety-stimulating context. Repetitive prac-
tice is important to help children become more comfortable with spontaneous
events. The practitioner may want to implement this intervention across mul-
tiple sessions and teach parents how to implement this intervention at home.
 Emotional Regulation Interventions 59
Anxiety Buster Toolbox

Target Area Emotional Regulation

Level Child and Adolescent
Materials Small Box, Art Supplies
Modality Individual, Group

Introduction
This intervention provides a comprehensive tool for a child or adolescent to
have available when he or she is feeling anxiety or dysregulated. It is likely
that children with ASD will need many “tools” to choose from to help them
self-calm. The Anxiety Buster Toolbox puts all the child’s tools together in
one accessible location where the child can choose what he or she needs to
help self-calm and regulate.

Instructions
The practitioner explains to the child that they will be making a box and
placing in the box several ideas for helping the child calm and regulate when
he or she is feeling anxious, upset, or overwhelmed. The practitioner provides
a small cardboard box for the child to decorate any way that he or she would
like. The child should write his or her name somewhere on the box. Once the
child has finished decorating the box, the practitioner instructs the child to
cut several strips of paper. On each piece of paper, the practitioner and child
will write things the child can do to help him or her calm when he or she is
feeling anxiety or feeling dysregulated. The practitioner will gain feedback
from the child on what he or she feels helps him or her calm but should also
gain feedback, before this intervention is introduced, from the child’s parents,
teachers, or any other people in the child’s life who may be able to identify
techniques, strategies, or games that currently help the child self-calm when
he or she is upset. The practitioner may also have some ideas for what might
help the child and he or she can add those ideas to the box as well. Once the
box is complete, the practitioner and child should practice and role-play the
calming strategies.

Rationale
This technique helps children and adolescents work on decreasing anxiety,
regulating, and learning strategies to help them self-calm. Anything goes in
the Anxiety Buster Toolbox. Any activity, game, process, etc. that helps or
may help a child self-calm can be written on a piece of paper and placed in
the box. The box goes home with the child, and the child is encouraged to
go to their box and find something to do to help them self-calm with they are
feeling dysregulated.
60 Emotional Regulation Interventions
Anxiety Mometer

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Marker
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
have difficulty differentiating between levels of dysregulation or anxiety. This
intervention helps children and adolescents learn to identify different levels of
dysregulation and situations or triggers that create levels of anxiety.

Instructions
The practitioner and/or child draw a thermometer outline on a piece of paper.
(A thermometer template could also be used.) The practitioner and child
decide on different situations to place on the thermometer with situations
that create no anxiety for the child placed at the bottom of the thermometer
and progressively moving up the thermometer with different situations that
increasingly create more anxiety or dysregulation for the child. The practitio-
ner and child then review all the situations and talk about interventions that
the child can do at each level to help them self-calm.
The practitioner can refer to other interventions, such as the Anxiety Buster
Toolbox, and write on the paper beside the thermometer different interven-
tion ideas for the child to implement when he or she is at different levels on
the thermometer. The practitioner and child can then role-play through sev-
eral situations that create anxiety and practice implementing an intervention
to help decrease the anxiety and dysregulation.

Rationale
This technique helps children and adolescents work on decreasing anxiety
and dysregulation. This intervention provides the opportunity for children
and adolescents to learn to identify when they are beginning to feel dysregu-
lated and attend to the dysregulation before it amplifies. The practitioner
should have a clear understanding of different situations that create differ-
ent levels of anxiety. Practitioners may want to consult with the child’s par-
ents before completing this intervention. Children should keep the Anxiety
Mometer posted at home to reference. Parents can be taught this intervention
and encouraged to implement the intervention at home. Parents can also be
encouraged to direct their child to their Anxiety Mometer when they notice
their child becoming dysregulated and help their child implement a calming
strategy.
 Emotional Regulation Interventions 61
Anxiety Mometer Examples
62 Emotional Regulation Interventions
Calm Down Postcards

Target Area Emotional Regulation

Level Child and Adolescent
Materials Postcards, Pencil
Materials Individual, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
struggle with regulation when they are experiencing a great deal of emotion;
this emotion can be both positive and negative. Calm Down Postcards help
children identify situations that cause overstimulation and dysregulation and
provides a cognitive, visual reminder strategy to help the child self-calm.

Instructions
This intervention can be done using real postcards or postcards the practitio-
ner and child make out of paper. The practitioner and child write postcards to
the child reminding the child to stay calm when he or she is feeling dysregu-
lated. The postcards should address typical situations the child struggles with
and a cognitive affirmation or simple self-calming activity that the child could
do in the situation. The postcards can also include pictures that the child or
practitioner draws to represent the self-calming activity.
The child is instructed to take the postcards home and keep them acces-
sible so he or she will have the postcards to refer to when he or she is feeling
dysregulated. The practitioner may want to consult with parents about calm-
ing strategies that seem to be successful for the child. The practitioner can
also provide suggestions and practice the calming strategies with the child to
identify if the strategies are helpful to the child.

Rationale
Calm Down Postcards provide children and adolescents with a visual aid
that they can keep and refer to when they are feeling dysregulated. It also
addresses real situations that tend to cause dysregulation for the child, so he
or she can begin to conceptualize and remember strategies to help him- or
herself calm during those situations. Parents can be taught this intervention
and can be encouraged to make more postcards with their child. Parents can
work with their child to remind him or her to refer to their postcard when
they are feeling dysregulated and help their child implement the cognitive
affirmation or the calming strategy.
 Emotional Regulation Interventions 63
Calm Down Postcards
64 Emotional Regulation Interventions
The Always Changing Picture

Target Area Emotional Regulation

Level Child and Adolescent
Materials Paper, Markers, Pencil
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
need help in accepting transitions and managing when schedules and plans
change. This intervention helps children practice handling changes in a low-
stimulating environment and practice how to self-regulate when they are
experiencing change.

Instructions
The practitioner explains to the child that they are going to be working on
helping the child handle experiencing change. The practitioner explains that
the child is going to draw a picture, but there will be changes made to the
picture as the child is drawing it. The practitioner will begin by instructing
the child to draw something; after a short time, the practitioner will change the
instruction, giving a new instruction. The practitioner will continue to do this
several times before the final drawing is complete. An example might be that
the practitioner tells the child to draw a house and color the roof blue, and then
halfway through the child coloring the roof blue, the practitioner changes the
instruction to coloring the roof yellow. The practitioner might then instruct the
child to draw a tree with leaves; as the child is drawing the leaves, the practitio-
ner changes the instruction to no leaves. The practitioner will periodically give
a new instruction, changing what was previously instructed. This provides the
child with the ability to practice accepting changes without becoming dysregu-
lated. The practitioner can be processing with and talking to the child about
how he or she is feeling as changes are being presented.

Rationale
This intervention helps children and adolescents practice regulating through
situations and plans that change. The goal is to help children learn to “switch
gears” and stay calm in the process. By practicing in a lower-stimulating
“safe” environment, the child can better prepare for real-life situations.
The practitioner should provide several changes to the original instruction
so the child has several opportunities to practice regulating through change in
an atmosphere that is less dysregulating. The practitioner should process with
the child staying calm, regulating through changes, and applying examples to
the child’s real life.
5 Social Skills Interventions

Social Skills
66 Social Skills Interventions
Friend Collage

Target Area Social Skills

Level Child and Adolescent
Materials Magazines, Scissors, Glue, Paper
Modality Individual, Group

Introduction
Children and adolescents with ASD often struggle with peer-related social
skills. This intervention helps children identify what activities they could do
with other children. This intervention encourages application by having the
practitioner role-play scenarios with the child and establishes a “homework”
assignment by asking children and adolescents to participate in one or more
of the activities with another child before the next session.

Instructions
The child draws a person figure on a piece of paper. The child is then instructed
to cut out from magazines several pictures and/or words of things that he or
she could do or play with other children. The child glues all the cut-outs on
and around the person figure drawn on the piece of paper. The child creates
a collage of all the activities that he or she has identified that could be done
with other children.
The practitioner and child go through each of the activities and talk about
them together. The child identifies a real child who might be appropriate to
do each activity with and discusses how he or she can begin to initiate com-
pleting the activity with another child. If appropriate, the practitioner and
child decide on an activity that the child will try to do with a specific friend
before his or her next session, and the practitioner and child can role-play the
interaction.

Rationale
This technique helps children and adolescents work on social skills, specifi-
cally related to friendship skills and playing and interacting with other peers
in appropriate ways. This intervention also works on helping children initiate
social interactions with peers. The practitioner will need several magazines
for the child to look through. Magazines that have a child focus will likely be
more beneficial. If the child is struggling to identify things they can do with
other children, the practitioner should help the child think of ideas. Parents
can be taught to implement the intervention at home and make additional
collages at home with their child. Parents can also role-play with their child
and facilitate a play time for the child to practice initiating and playing one of
the identified activities before the next session.
 Social Skills Interventions 67
Friend Collage Examples
68 Social Skills Interventions
Social Scales

Target Area Social Skills

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual, Group

Introduction
The Social Scales intervention is designed to help practitioners create specific
scenarios in which a child or adolescent might need help in developing better
or more appropriate social responses. The sample scales included here can be
used or new scales can be individualized for each child. The scales provide
both an assessment tool to identify what the child perceives and a practice
tool to help develop social skills.

Instructions
The practitioner creates a scale sheet with several scales listed on it. The child
is given an example of a situation that relates to one of the scales and the child
puts an “X” on the scale where he or she believes is the correct response for
the situation. The practitioner should try to create scales and situations that
are relevant for skills that the child needs to develop. Once the child has given
a response, the child’s response should be processed with the practitioner. The
practitioner should especially discuss any response that is unhealthy, unsafe,
or not accurate. An example might be that the practitioner says, “A stranger
walks up to you while you are at the mall or playing at a park and says if you
come with me I can get you a free iPad. Mark on the scale where you think
this would fall on the truth-and-lie scale and the safe-and-unsafe scale.” Here
are the example scales:

Truth Lie

Safe Unsafe

Rationale
This technique helps children and adolescents work on a variety of social skills
and social situations. Scales can be directed toward identifying safety issues,
giving appropriate responses, understanding concepts, etc. Once the child
indicates what he or she believes, the practitioner and child should process the
response and discuss if the child has responded inappropriately or if it is a situ-
ation that might have multiple correct responses. Parents can be taught this
intervention at home and can be encouraged to play with their child regularly
between sessions and create new scales for new situations that arise.
 Social Skills Interventions 69
Social Scales Examples

You are sitting in class at school, and the boy beside you starts hitting
his desk.
Appropriate Not Appropriate

You are walking down the hallway at school, and another student
pushes you as you pass by.
Bullying Not Bullying

You meet a new student at school and talk for a few minutes
about her old school.
Friend Acquaintance

A student at school says your hair looks like an anime character.

Funny Not Funny

You are watching a YouTube video showing a dinosaur walking in

a backyard.
Fact Fake

A student at school says he will be your friend if you keep his

cigarettes for him.
Ok Not OK
Friend Not a Friend

Template
70 Social Skills Interventions
Social Skills Puzzle

Target Area Social Skills

Level Child and Adolescent
Materials Small Blank Puzzle, Markers, Pencil
Modality Individual, Family, Group

Introduction
This intervention helps teach social skills to children and adolescents with
ASD and other developmental disorders. The puzzle element provides a tac-
tile and engaging element to learning specific social skills. Each puzzle is cre-
ated by the practitioner and child so each puzzle is individualized to focus on
skills that a particular child needs to develop.

Instructions
The practitioner explains to the child that they will be creating a puzzle that
helps the child work on developing social skills. Using a small blank puzzle
(6 pieces for younger children, 9 pieces for adolescents), the child writes a dif-
ferent social skill that he or she needs to practice on the back of each puzzle
piece. On the front of the puzzle, the child can decorate the puzzle however
he or she wants. For more advanced children, the child can decorate each
puzzle piece to describe the social skill listed on the back side of the puzzle
piece. The practitioner and child then take the puzzle apart and put it back
together; each time a piece is connected, the practitioner and child practice
the social skill for that puzzle piece. Children will likely have a difficult time
identifying the social skills that they need to work on. The practitioner should
be prepared to identify several of the social skills that will be written on the
puzzle pieces.

Rationale
The Social Skills Puzzle helps children and adolescents work on a variety of
social skills. This intervention provides the opportunity for children to work
on specific social skills that he or she may be struggling with. The practitioner
should help the child think of social skills to write on the puzzle and make
sure that skills are included that the child needs to develop.
The practitioner and child can take the puzzle apart and put it back together,
practicing the social skills multiple times. Parents can be taught how to imple-
ment this intervention with their children and practice the social skills puz-
zle several times at home. Parents and children can also make new puzzles;
the puzzles can be put together, and social skills can be practiced with other
family members. Blank puzzles can be ordered several places online including
at Amazon.com.
 Social Skills Interventions 71
Social Skills Puzzle

(Back: Nine identified social skills to practice)

(Front: A picture representation of each identified social skill)

72 Social Skills Interventions
Let’s Practice Conversation

Target Area Social Skills

Level Child and Adolescent
Materials None
Modality Individual

Introduction
Children and adolescents with social skill deficits often have trouble entering
and maintaining a conversation. Individuals with ASD often report struggling
with “small talk” and knowing what to say and how to participate in a social
conversation. This intervention helps children practice the various compo-
nents of being in a reciprocal conversation.

Instructions
The practitioner gives instruction to the child that they are going to prac-
tice being in a reciprocal conversation. The practitioner gives the following
instruction for how the conversation is going to flow back and forth: The
practitioner is going to ask the child a question. The child is going to answer
the question in a succinct way, avoiding going off on a tangent, and at the
same time, avoiding giving a one-word answer. Once the child is done answer-
ing the question, the child will then ask the practitioner a question back. The
child will listen to the practitioner’s answer and when the practitioner is done,
the child has to repeat back to the practitioner what the practitioner said.
This process is repeated several times for practice.

Rationale
Let’s Practice Conversation helps children and adolescents work on social
skills, specifically conversation skills, which include asking questions, stay-
ing focused in conversations, avoiding talking too much, avoiding going
off on tangents, participating in “small talk,” and listening to others. This
intervention should be practiced many times; the more a child can partici-
pate in this intervention, the better he or she will become in participating in
conversations.
It is likely the child will not do well in the beginning and that the practitio-
ner will have to stop the intervention several times and give prompts to help
keep the child focused and participating correctly. Parents can be taught how
to do this intervention at home with the expectation of practicing several
times with their child. After several practices, parents can also arrange real-
life situations where the child can engage in reciprocal conversations.
 Social Skills Interventions 73
Candy Questions

Target Area Social Skills

Level Child and Adolescent
Materials Candy
Modality Individual, Group

Introduction
Children with ASD often struggle with simply asking and answering ques-
tions, especially in a public setting. This intervention helps children and ado-
lescents work on fully answering another person’s questions and asking other
people questions. The candy serves as a reinforcement to help keep the child
engaged.

Instructions
The practitioner chooses a candy that contains several pieces, such as a bag
of Skittles. The practitioner should try to choose a candy that the child likes
and also consider if the child has any special diet restrictions. If the child can-
not eat candy, the practitioner should use something like stickers or pennies
as a substitute. The practitioner tells the child they are going to play Candy
Questions. The practitioner is going to ask the child an open-ended question,
and the child has to fully answer the question, and if the child does this, he or
she will receive a piece of candy. The child then has to ask the practitioner a
question, the practitioner will answer, and the child receives a piece of candy
for asking a question. This exchange goes back and forth until the candy is
gone or the practitioner ends the intervention.

Rationale
This technique helps children and adolescents work on social skills, specifi-
cally conversation skills, which include asking and answering questions. It
would be beneficial for the practitioner to have a predetermined set of ques-
tions written out to ask the child. Questions should be designed to relate to
real issues or things happening in the child’s life. If candy is not acceptable for
the child, something like stickers or pennies would be alternatives.
The practitioner should try to practice with the child several times to gain
skill development. Parents can be taught this intervention and should practice
at home with their child several times between counseling sessions. Parents
should be strongly encouraged to practice as often as possible because the
more the child practices, the more improvement he or she will gain in conver-
sation skills, becoming more confident and comfortable asking and answer-
ing questions.
74 Social Skills Interventions
Friend Mapping

Target Area Social Skills

Level Child and Adolescent
Materials Friend Mapping Worksheet
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders typi-
cally have a hard time understanding friendships and differentiating friends
from acquaintances. This intervention helps children better identify what
friendship looks like and serves as an assessment tool to help the practitioner
gain a better understanding of what is happening in regard to the child’s peer
relationships.

Instructions
The practitioner tells the child that they are going to work on discussing and
identifying friendships. Using the Friend Mapping Worksheet (included here),
the child is instructed to complete each section. In the circles, the child will
write 3 current friends, 3 things he or she does with friends, 3 things the child
does with other children of the same age, and 3 people that he or she would
like to be friends with. In the 2 rectangles, the child will write 2 things that
are good friendship skills. The practitioner will then process through the map
with the child asking follow-up questions to gain a better understating of the
child’s current reality and perceptions of friendships. If the child is struggling
to identify any areas of the Friendship Map, the practitioner should provide
assistance to the child.

Rationale
Friend Mapping is an intervention that helps children and adolescents work
on social skills, specifically skills related to peer relationships and friendships.
Children with ASD often need help in differentiating among relationship lev-
els and help in creating and participating in friendships. This intervention
also serves as an assessment tool for practitioners to gain a more clear under-
standing of the child’s current friendship functioning and the child’s percep-
tion of what constitutes a friend.
Practitioners will likely begin and end this intervention with a discussion
of what friendship actually looks like. It is likely the practitioner will have to
help the child clearly understand and discriminate between the people he or
she is referring to as friends. Often children with ASD consider acquaintances
close friends and struggle to actually engage in deeper friendship relationships.
 Social Skills Interventions 75
Friend Mapping Worksheet

3 people I would like

to be friends with Friendship skill

3 friends

3 things I do with my friends

3 things I do with other kids my age

Friendship skill
76 Social Skills Interventions
What Am I?

Target Area Social Skills

Level Child and Adolescent
Materials Index Cards, Tape, Pencil
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD can struggle with basic social skills such
as making eye contact and asking questions. This intervention helps chil-
dren and adolescents work on asking other people questions and maintaining
focus, attention, and eye contact. This intervention presents a fun and engag-
ing way to work on developing these social skills.

Instructions
The practitioner explains to the child that they will be playing a game that
works on increasing social skills. On index cards, the practitioner writes sev-
eral different things, such as types of food, animals, toys, material objects,
etc. There should be a variety of items, and one item is written on each index
card. (The cards should be created prior to the child coming in for a session.)
The index cards should be placed on the floor with the writing face down.
The child and practitioner each choose one card and put a small piece of
tape on the blank side and tape the card to their chests without looking at
what is written on it. The practitioner and child then take turns asking the
other questions to try and discover what is written on the index card taped
on their chest.
The child and practitioner have to maintain eye contact when asking and
answering questions and cannot look down at what is written on the index
card taped to their chest. When someone accurately guesses what is written
on his or her index card, then he or she can put tape on another card and con-
tinue with the process until all the cards have been guessed or the practitioner
ends the intervention.

Rationale
This technique helps children and adolescents work on social skills, specifi-
cally asking questions, answering questions, and making eye contact. The
practitioner should create at least 10 cards to go through in playing the inter-
vention. New cards can be created, and the game can be played multiple
times. Parents can be taught this intervention and encouraged to play regu-
larly at home with their child. Parents can also involve other family members
and the entire family can play together.
 Social Skills Interventions 77
What Am I?
78 Social Skills Interventions
Stepping Stones

Target Area Social Skills

Level Child and Adolescent
Materials Card Stock, Foam Pieces, Sharpie, Small Prize
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
have a difficult time understanding appropriate versus inappropriate behav-
iors in various social situations or contexts. This intervention creates a game
format that can be played repeatedly so children can practice appropriate
behaviors for a variety of settings.

Instructions
The child cuts out 6–8 pieces of foam in the shape of stepping stones. The
foam pieces are then glued on a piece of card stock to form a path with a
designated beginning and end. The practitioner and child then decide on vari-
ous situations the child is typically in and write a situation on each stepping
stone. The child can then decorate the rest of the card stock in any way he or
she wants, and on the last stepping stone, the child should write “PRIZE!”
The practitioner and child then play the Stepping Stones game. The child
starts at the first stone and reads the situation. The child then has to talk
about and act out an inappropriate behavior and an appropriate behavior
that could be done in that situation. The child then moves on to the second
stone and repeats the process until he or she gets to the end and receives a
small prize, such as a small toy, sticker, or piece of candy.

Rationale
The Stepping Stones game helps children and adolescents work on social
skills, specifically inappropriate and appropriate behaviors for various situ-
ations, such as sitting in a classroom, waiting in a doctor’s office, being in a
grocery store, eating at the dinner table, etc. Situations that tend to be struggle
situations for the child should be chosen for the game. Practitioners may want
to consult with parents and other individuals involved in the child’s life to
collect a variety of situations that the child typically struggles with or displays
inappropriate behavior in. The practitioner should ask the child to identify
situations and scenarios, but the practitioner should make sure that the game
includes several situations that are known problem areas for the child. The
game goes home with the child, and parents are taught to play the game with
their child and encouraged to play regularly between counseling sessions. Par-
ents and child can even create a new game with different situations.
 Social Skills Interventions 79
Stepping Stones
80 Social Skills Interventions
Symbolic Play Time

Target Area Social Skills

Level Child
Materials Various Toys
Modality Individual

Introduction
Children with ASD typically struggle with pretend and symbolic play skills.
Often children with ASD find themselves in peer situations where pretend
play is the most common form of play, and thus, children with ASD struggle
to engage with and participate in pretend play with their peers. This interven-
tion helps children practice and learn how to engage in symbolic and pretend
play.

Instructions
The practitioner instructs the child that they are going to have some pretend
play time. The practitioner explains the concept of pretend and symbolic play
and introduces the child to some toys that will be used in the pretend play
time. The practitioner should use nondescript toys such as blocks. The prac-
titioner tells the child they are going to pick a block and give it a name and
a character, such as making it a made-up person or an animal. The child gets
to choose the name and the character of the block he or she picks, and the
practitioner does the same. The practitioner then instructs that they are going
to make up a pretend story using their 2 block people/animals. The practitio-
ner begins by having the 2 blocks interacting in a short simple story. Then,
the practitioner begins incorporating the child into the decision making. The
practitioner will continue on with the play interaction, trying to involve the
child as much as possible. The practitioner can periodically switch to differ-
ent toys and create other symbolic play interactions.

Rationale
This technique helps children work on social and play skills, specifically sym-
bolic or pretend play skills, which are often a component of social interac-
tions with same-age peers. Practitioners can vary the symbolic play time using
different toys and creating different scenarios. The practitioner will likely
have to take the lead in directing the pretend play but should always be look-
ing for opportunities to have the child make decisions and engage in a leading
way in the pretend play. This intervention can be played several times and
will typically be implemented over the span of several sessions to try and help
the child better understand symbolic play.
 Social Skills Interventions 81
Paper Friend

Target Area Social Skills

Level Child and Adolescent
Materials White Paper, Construction Paper, Scissors, Glue
Modality Individual, Group

Introduction
Children and adolescents with ASD often desire to have friends but lack the
social skills to establish and maintain friendships. This intervention helps
children work on specific friendship-related skills, on targeting children to
engage with, and on strategies to develop friendships.

Instructions
The practitioner explains to the child that they will be working on increas-
ing friendship skills. The practitioner or child draws an outline of a person
on a white piece of paper. The child identifies someone in his or her life
that he or she would like to be friends with. The child designs the person
outline to look like the child he or she would like to be friends with (typi-
cally by drawing the identified child’s face on the paper outline person).
The child then writes things on the person outline that he or she could do
with that person, things they could talk about, ways that he or she could
be good friends to that person, ways that he or she could initiate with that
person, skills that help make friends, and what would make that person a
good friend. The practitioner and child process through what the child has
written, and the practitioner may add additional information. The practi-
tioner and child then practice the various friendship-related skills through
role-play. The practitioner will likely have to help the child identify friend-
ship skills.

Rationale
This technique helps children and adolescents work on social skills, specifi-
cally related to making and keeping friends. The child can make several Paper
Friends for several different children that the child knows and would like to
be friends with. The practitioner and child can also practice the child intro-
ducing himself or herself to the potential friend and the initial steps in getting
to know someone along with the ideas that have been written on the Paper
Friend. Parents can be taught this intervention, encouraged to practice the
skills at home, and encouraged to try to arrange opportunities for the child to
connect with the child he or she would like to become friends with or another
appropriate child.
82 Social Skills Interventions
Paper Friend Examples
 Social Skills Interventions 83
Instruction Puzzle

Target Area Social Skills

Level Child and Adolescent
Materials Small Blank Puzzle, Marker
Modality Individual, Group

Introduction
The Instruction Puzzle provides an engaging way to create a visual task
schedule for children and adolescents with ASD. The puzzle pieces serve as
steps to complete, and the puzzle can be completed as the child accomplished
each of the steps.

Instructions
The practitioner will give the child a small blank puzzle, probably no larger
than 6 pieces for a young child and 9 for an adolescent. On the front of each
puzzle piece, the practitioner and child will write instructions, broken down
in steps, toward completing something. The practitioner and child will decide
on something to instruct about, such as how to create a Facebook account,
steps to brushing your teeth, a morning routine, or how to check out a book
at the library. (A task or activity should be chosen that the child actually
struggles with or does not know how to do.) The child will try to write on the
front of each puzzle piece (going in order) steps to accomplish or complete
the task. The child can also add pictures to describe each step. The practitio-
ner should allow the child to complete as much of the instruction puzzle as he
or she can and the practitioner can assist the child as needed.
Once instructions/steps have been written on all the puzzle pieces and the
instructions are complete, the practitioner and child put the puzzle together
in the appropriate order for each step to complete the task. The practitioner
and child take turns picking a piece of the puzzle and explain or teach that
instruction to the other until the whole puzzle is complete. The practitioner
and child can practice completing the task several times.

Rationale
This technique helps children and adolescents work on social skills, specifi-
cally teaching and giving instructions to others and learning how to complete
different tasks that are relevant to the child. It also serves as a visual task-
completing schedule for the child. Several puzzles can be made to address sev-
eral different tasks. It is helpful if the tasks are actual things the child needs to
learn to complete. The puzzle should be sent home, and parents can be taught
how to use the puzzle with their child to complete the identified task.
84 Social Skills Interventions
Instruction Puzzle

(Child identifying steps in a morning routine)

(Adolescent giving instructions for getting a driver’s license)

 Social Skills Interventions 85
Bully in the Way

Target Area Social Skills

Level Child and Adolescent
Materials White Paper, Markers, Small Prize
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders are
typically more susceptible to being victims of bullying than neurotypical
peers. This intervention helps children role-play and practice what to do and
what to say if someone is trying to bully them.

Instructions
The practitioner explains to the child that they are going to discuss ways to
address bullying behavior. The practitioner and child draw and cut out sev-
eral people shapes. The child decorates each people shape to represent a real
person who has bullied the child. (If the child cannot think of real people then
generic bullies can be used.) Once the child is finished, each of the “bullies”
is placed on the floor scattered from one side of the room to the other side.
The practitioner discusses with the child how each person the child made has
bullied him or her. The child then starts at one side of the room, walks up to
each bully, confronts that bully, and practices a healthy response or action
that he or she could give to that bully. (The practitioner will have to teach the
child various responses or actions that the child could take, some examples
are included here.) The child confronts each bully one at a time until he or
she gets through all the bullies and is on the other side of the room. After the
last bully has been confronted, the child receives a small prize provided by
the practitioner.

Rationale
This technique helps children and adolescents work on social skills specifi-
cally related to addressing and handling bullying. The practitioner will likely
have to help the child learn healthy ways to confront bullies and teach the
child different options for responding to bullies. The practitioner may also
need to discuss bullying problems with parents who may need to contact the
school if bullying is happening at school and make the school administra-
tion aware of the bullying. Both parents and school officials may need to be
involved in eliminating the bullying and in knowing what approaches the
child is trying to implement when he or she is bullied. A list of web resources
for addressing bullying is included here.
86 Social Skills Interventions
Bully in the Way

Example Interventions to Teach Children

Tell the school counselor or teacher

Tell your parents
Teach comeback phrases
Teach positive cognition statements to say to self
Leave the situation
Teach self-worth concepts to improve self-esteem
Talk loudly back to the bully
Call the bully by their name and tell them to stop
Stand up straight and look the bully in the eye
Stay with friends
Ignore the bully
Make kind statements back
Make a joke about what the bully said
Keep a journal of the bullying
Act shocked and then give the bully a compliment
Teach “I” messages: I don’t like it when______, stop!
Work with the school to create a peer assignment program

(Bullying resources)

www.schoolviolencehotline.com
www.stopbullying.gov
www.bullyfree.com
www.pacer.org
www.nasponline.org
www.nea.org
www.safekids.com
www.violencepreventionworks.org
 Social Skills Interventions 87
Social Media

Target Area Social Skills

Level Adolescent
Materials Computer, Social Media Account
Modality Individual, Group

Introduction
Social media sites are very popular among adolescents and many adolescents with
ASD and developmental disorders lack the social skills to navigate social media
sites. This intervention teaches adolescents how to identify appropriate and inap-
propriate ways to use social media sites and how to stay safe with their interactions.

Instructions
The practitioner tells the adolescent that they will be discussing appropriate
ways to use social media. The practitioner and adolescent discuss the various
social media options including Facebook. (Practitioners should discuss with
parents if the child currently has any social media accounts and/or if they are
planning to allow the child to have one before implementing this interven-
tion.) The following acronym is written down on a piece of paper:

F = friends
A = angry
C = careful
E = embarrassing
B = bad
O = odd
O = oh no!
K = kind

The practitioner and child discuss what different Facebook posts would look
like for each of the above categories, for example, “Who is a friend?” “Why
is that person a friend?” “What is an angry post?” “Is it appropriate to post
angry things?” “What would be an embarrassing post?” “What would be an
odd or bad to post?” “What is a post that could get someone in trouble?”
and “What is a kind or appropriate post?” The practitioner and child try to
find examples of each one on the child’s or practitioner’s Facebook newsfeed.

Rationale
This technique helps adolescents work on social skills related to participat-
ing in and socializing through social media. This technique requires the child
to have a social media account or permission from parents to develop one.
Parents should monitor the child’s social media account and practice this
intervention periodically at home with their child.
88 Social Skills Interventions
I’m Going

Target Area Social Skills

Level Child and Adolescent
Materials Index Cards
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD typically need practice in regard to learn-
ing social skills and appropriate ways to respond or behave in certain situ-
ations. The I’m Going intervention helps children and adolescents identify
struggle situations and practice an appropriate behavior or response for that
situation.

Instructions
The practitioner explains to the child that they are going to play a game to
practice appropriate responses for certain situations. The practitioner writes
various I’m Going situations on index cards. Example situations could include
“I’m going to school,” “I’m going to an amusement park,” “I’m going to a
restaurant,” “I’m going to a friend’s house,” “I’m going to church,” and “I’m
going to the doctor.” (Sample cards are included here.) The index cards are
placed face down in a pile, and the child and practitioner take turns drawing
the cards. The child should go first. When a card is drawn, both the practi-
tioner and the child each say something that is an appropriate social skill that
he or she will do where he or she is going. For example, if the “I am going to
school” card is drawn, the child might say, “I am going to school, and I am
going to listen when the teacher is talking.” Then the practitioner might say,
“I am going to school, and I am going to wait in line when it is recess time.”
The practitioner should try to write 8–10 situations on index cards. The situ-
ations should be real situations that the child would participate in and may
be having struggles in displaying appropriate behavior.

Rationale
This technique helps children and adolescents work on social skills, specifi-
cally related to appropriate behaviors in certain situations. The practitioner
should make sure that the child provides an appropriate response. If the child
cannot think of a response or provides an inappropriate response, the practi-
tioner should explain an appropriate response to the child. The practitioner
can add an extra element to this intervention by role-playing the appropriate
behavior after the child and practitioner have given a response. Parents can
be taught this intervention and the entire family can play at home.
 Social Skills Interventions 89
I’m Going Card Set

I‛m going to school. I‛m going to a I‛m going to the

restaurant. doctor‛s office.

I‛m going to get my hair I‛m going to a friend‛s I‛m going to church.
cut. house.

I‛m going to the grocery I‛m going for a ride in I‛m going to a party.
store. the car.

I‛m going to the dentist I‛m going to the shoe I‛m going to a park.
office. store.

I‛m going to the mall. I‛m going for a walk. I‛m going to the post
office.
90 Social Skills Interventions
Interview Me

Target Area Social Skills

Level Child and Adolescent
Materials Paper, Pencil
Modality Individual, Family, Group

Introduction
This intervention helps children and adolescents work on social skills related
to talking to others, asking others questions, and learning about others. It
also helps children and adolescents stay focused and avoid talking excessively
about a particular fixation topic and going off topic during a conversation.

Instructions
The child is instructed that he or she is going to interview the practitioner. The
child is given a piece of paper and a pencil and asked to come up with 7 ques-
tions to ask the practitioner. The questions need to be open-ended questions,
avoiding yes-or-no response questions. The child should try to come up with
the questions, but if he or she is struggling, then the practitioner can offer
the example worksheet included here. Once the child has written his or her
questions, then he or she will ask them to the practitioner, listen to the prac-
titioner’s answers, and write the responses down. The guidelines for the child
are that he or she cannot wander into a tangent or talk about him- or herself
and he or she needs to try to listen to the practitioner’s answers. The practi-
tioner and child discuss the interview and if the child was able to follow the
guidelines. The practitioner and child can practice through several interviews
if there is time. The child is then instructed to go home and interview 3 people
in the same format, using the same guidelines, and bring the interviews to
the next session. The practitioner and child will then discuss how the home
interviews went.

Rationale
This technique helps children and adolescents work on social skills related to
asking others questions, listening, and staying focused in a conversation. The
child may struggle with coming up with appropriate interview questions and
may struggle with getting through the interview in an appropriate manner. At
any point, the practitioner can stop the intervention and help the child stay
focused and follow the guidelines. It will likely take practice for the child to
complete this intervention without help from the practitioner. Parents should
be made aware that the child is going to do 3 interviews at home and assist
their child in completing the assignment.
 Social Skills Interventions 91
Interview Me Worksheet

1. What is your name?

2. What is one of your favorite things to do?

3. Where would you like to go on vacation and why?

4. Why do you think school is important?

5. Tell me about a time you got angry.

6. Tell me about a good family memory.

7. What do you do to calm down when you feel anxious?

92 Social Skills Interventions
That Does Not Sound the Way It Looks

Target Area Social Skills

Level Child and Adolescent
Materials None
Modality Individual

Introduction
That Does Not Sound the Way It Looks intervention helps children and ado-
lescents work on recognizing body language and listening to what others are
saying. Further, it helps children and adolescents navigate to a more accurate
understanding and meaning when observing and listening to others.

Instructions
The practitioner tells the child that they are going to practice identifying situ-
ations when communicating with others and the interaction is not making
sense. The practitioner is going to say something like “I am happy” in an
angry voice with angry body language. The child has to say what does not
make sense about what the practitioner presented. For example, the child
would say, “Your face and the sound of your voice did not seem happy even
though you said you were happy.” Some other examples the practitioner
might give include saying “I am sad” with a happy face and upbeat body
language or saying “I really like going to the park” with a sad face and sad
tone of voice. The practitioner should have several examples prepared before
the session with the child. The practitioner can also ask the child if he or she
would like to create some examples and have the practitioner identify what
does not make sense.

Rationale
Children and adolescents with ASD often have struggles with understand-
ing and accurately identifying other people’s body language and understating
their intention by what they say. They also struggle with their own presenta-
tion and communicating with their words and body language what they are
thinking and feeling. This technique helps children and adolescents work on
social skills, specifically recognizing and accurately reading body language on
others, recognizing others emotions, and recognizing and identifying changes
in tone of voice. Parents can be taught how to implement this intervention
and encouraged to play at home with their child.
 Social Skills Interventions 93
Tweet, Tweet, Tweet

Target Area Social Skills

Level Adolescent
Materials Paper, Pencil, Example Tweets
Modality Individual, Group

Introduction
Adolescents with ASD are typically exposed to social media and often have
a difficult time navigating appropriateness in social situations especially
through a media format. This intervention helps adolescents practice what
appropriate and inappropriate social media responses look like on social
media sites.

Instructions
The practitioner explains to the adolescent that they will be discussing appro-
priate and inappropriate social media comments. The practitioner and child
then role-play sending appropriate and inappropriate messages back and
forth to each other. The child should be able to identify the appropriate from
the inappropriate and why the inappropriate messages are considered inap-
propriate. The practitioner then gives the adolescent several real tweets taken
from Twitter (several are included here), and the adolescent has to put them
in 2 piles: One pile is for appropriate tweets, and the other pile is for inap-
propriate tweets. The child has to talk about why they think each tweet is
either appropriate or inappropriate. If the adolescent is unsure if the tweet
is appropriate or inappropriate, then he or she can make a third pile of unsure
tweets, and the practitioner and adolescent can further discuss those tweets.
The practitioner should provide feedback and assist the child if he or she is
not correctly labeling tweets.

Rationale
This technique helps adolescents work on social skills, specifically skills related
to participating in and socializing through social media. This intervention
does not require the adolescent to have a Twitter or any other social media
account. It is a good intervention to practice before a child actually acquires
any social media account. The practitioner should discuss with parents the
relevance of social media access in the adolescent’s life before implementing
this intervention. If the adolescent is currently using any social media site or
is planning to, this would be an appropriate intervention to implement. This
intervention can be taught to parents at home, and parents can continue to
implement this intervention periodically with their adolescent.
94 Social Skills Interventions
Example Tweets

Real Tweets Posted on Twitter

Develop an attitude of #gratitude and give thanks for everything that

happens to you.
Lol no one likes you.
MERRY CHRISTMAS to the members and families of the Ozark
Drumline!
Friday afternoon will be warm and sunny; colder weekend.
so are you straight or gay I’m like really confused.
F#%k my mom she deletes my fb dat b#%*h can go die.
I hate you, Ted.
You and me. Lunch next week. I won’t be late this time.
that’s like saying Superman is better than Batman. You’re dead to me.
Just finished doing laundry  I hate Laundry!
Congratulations! Your new baby is so cute!!!!!
This is a great website for information on bully prevention.
She is a complete slut! I hate her!!! HATE!!!
I am seriously going to kill someone if all these a#%es don’t stop
messing with me.
The Hobbit is an awesome movie! Just saw it—Loved It!
Really frustrated with everything right now.
I love Justin Beiber, if you say anything bad about him I will kill you—
you stupid idiot!
Guess who is on TV acting like a total retard!?!
The #MSUBears defeated Alabama A&M, 68–47. Pickens posted a
15-rebound effort in the win.
Finals are over getting DRUNK tonight!
Home alone, so bored. Somebody hit me up!
 Social Skills Interventions 95
Role-Play

Target Area Social Skills

Level Child and Adolescent
Materials None
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders ben-
efit greatly from role-playing through situations. Practitioners have the ability
to identify several situations where a child or adolescent may need to improve
their social functioning or their behaviors. Role-playing should be about the
child and his or her situation and real situations the child struggles with.
Role-plays can be fun and engaging and can include props and other people.

Instructions
The practitioner explains to the child that they are going to role-play some
situations the child has been struggling with. The practitioner and child will
decide on various social situations to role-play and social skills to work on
during the role-plays. Some typical examples include recognizing when some-
one does something on purpose or accident, how to act when winning and
losing, when to talk and when to listen, how to ask a teacher a question,
saying hello and goodbye, how to respond to a bully, etc. Role-plays should
be practiced several times throughout a session. Repetition and practice are
essential for skill acquisition. The more the child can role-play situations and
behaviors, the more likely he or she will be able to implement the desired
behaviors during a real situation.

Rationale
This technique helps develop social skills through a role-play. The practitio-
ner and child can work on a whole variety of social skills. One of the best
ways to work on social skill development for children with ASD is through
role-play. The practitioner can pick any scenario; role-play through it with
the child; and cover how to act, respond, or handle the situation. When doing
a role-play, it is best to avoid working in metaphors or in an approximation
to the child’s situation; instead, focus should be on directly talking about the
child and what he or she should do in a situation. Role-plays can be taught
to parents, and parents can practice the role-plays at home with their child.
Parents can also role-play any situation that comes up that they feel needs
attention. Some more common examples that a child with ASD might need to
practice include how to act in a restaurant, using your manners, how to act
in the car, what to do when your sibling makes you mad, doing chores, etc.
96 Social Skills Interventions
Common Role-Play Scenarios

Recognizing when someone does something on purpose or by accident

How to respond when winning and losing
When to talk and when to listen
How to ask a teacher a question
Saying “hello” and “goodbye”
How to behave in a restaurant
How to order your own food in a restaurant
Saying “please” and “thank you”
How to behave in the car
What to do when your sibling makes you mad
How to behave when your parents ask you to do some chores
How to behave when standing in line and waiting for something
Different tones of voice for different situations
How to behave when you are getting your hair cut
How to behave when you are in the doctor’s office
Making eye contact when talking to someone
How to behave at the dinner table
How to take care of a pet
How to play with other children
Understanding appropriateness with humor
 Social Skills Interventions 97
Roll of the Dice

Target Area Social Skills

Level Child and Adolescent
Materials 6 Dice, Paper, Pencil
Modality Individual, Family, Group

Introduction
The Roll of the Dice intervention gives the practitioner the ability to practice
specific social skills that the child or adolescent is struggling with and needs
to improve upon. The dice provide a fun way for the child to engage and
participate in practicing social skills. The child can participate in thinking
about and deciding what skills he or she believes he or she needs to improve.

Instructions
The practitioner explains to the child that they are going to play a game
and practice some social skills that the child needs to improve. On a piece
of paper, the practitioner and child write down 6 social skills that the child
needs to practice and label them 1 through 6. The practitioner should let the
child try to think of some social skills that he or she feels need improvement.
If the child cannot think of any, the practitioner should write down social
skills that the practitioner knows the child needs to develop. The child will
then roll 6 small dice, pick one of the numbers rolled, and practice the match-
ing numbered social skill. After the child has practiced that social skill, one
of the dice will be removed, and the child will roll 5 dice and again pick one
of the numbers rolled and practice the matching numbered social skill. This
will continue until all 6 social skills have been chosen and practiced. The
practitioner role-plays and practices each social skill with the child. After
all 6 social skills have been practiced, the practitioner and child can play the
game again or create 6 new social skills and play the game again addressing
the new social skills. The practitioner should try to make the game fun and
engaging for the child. The practitioner can incorporate props such as hats,
masks, toys, etc., to try make the social skill practice more enjoyable.

Rationale
This technique helps children and adolescents work on social skills. The
social skills addressed can be anything that the child or adolescent needs to
improve. This intervention allows the practitioner the flexibility to target any
social skill that the child needs to develop. It is important to allow the child
to identify social skills that he or she believes need improvement, but the
practitioner should make sure that skills listed on the paper are skills the child
needs to practice and develop. Parents can be taught how to do this interven-
tion at home and can be encouraged to play with the entire family. The skills
can be changed each time the activity is played.
98 Social Skills Interventions
Roll of the Dice
 Social Skills Interventions 99
Social Media Friend, Foe, or Other

Target Area Social Skills

Level Adolescent
Materials Social Media Account, Index Cards, Pencil
Modality Individual, Group

Introduction
Adolescents with ASD and other developmental disorders are often attracted
to engaging with other people though social media as it provides a safe bound-
ary and usually presents less social anxiety. This intervention helps adoles-
cents understand different levels of knowing someone and what it means to
know someone in person versus through a social media site. It also opens up
the discussion of what it looks like to be safe and cautious when using social
media sites.

Instructions
The practitioner explains to the adolescent that they are going to discuss
being safe when interacting with others through social media. This interven-
tion requires that the adolescent have a social media account. The practitioner
should discuss this intervention with parents before implementing it with the
adolescent. The practitioner and adolescent go through the adolescent’s friend
or followers list on one of the adolescent’s social media accounts. The adolescent
identifies each person as a friend, a family member, an acquaintance, a stranger,
or an enemy and tells the practitioner if he or she knows the person in real life
or through social media. As the adolescent identifies, the practitioner writes the
name down on an index card, how the adolescent labels the person and if the
adolescent knows the person in real life or through social media. After each
person has been covered, all the index cards are placed in categories according
to how the adolescent identified the person. The practitioner and adolescent
then go through each category and talk about the number of “friends” in that
category and the number of people the adolescent knows only through social
media. The practitioner and adolescent then discuss different levels of knowing
people and the appropriateness of interacting through social media with people
that are only known online and how to be safe in those interactions.

Rationale
This technique helps adolescents work on social skills related to participat-
ing in and socializing through social media. This intervention also works
on understanding different levels of knowing people and what constitutes a
“friend.” Parents should monitor social media accounts and be taught this
technique to do at home with their child periodically.
100 Social Skills Interventions
Social Skills Fortune Tellers

Target Area Social Skills

Level Child and Adolescent
Materials Paper, Marker
Modality Individual, Family, Group

Introduction
The Social Skills Fortune Tellers intervention provides a fun and engaging game
for children to practice social skills. The social skills chosen should apply to the
child and be skills that the child and practitioner can practice together. The tac-
tile and movement piece of the fortune teller provides an engaging and regulating
component for the child. Fine motor skills are also practiced in this intervention.

Instructions
The practitioner explains to the child that they are going to be making paper
fortune tellers and using the fortune tellers to practice social skills. The prac-
titioner teaches the child how to make a fortune teller out of white paper or
colored construction paper (instructions for the creation of the fortune teller
are included here). Fortune tellers should have numbers on the outside, col-
ors on the inside, and social skills written on the tab on the other side of the
colors. After the fortune teller has been created, the practitioner and child can
take turns playing the game. The basic process of the game is as follows: The
practitioner holds the fortune teller in his or her fingers. The child chooses
a number, and the practitioner moves the fortune teller back and forth the
number of times for the number the child chose. The practitioner opens up
the fortune teller, and the child chooses a color. The practitioner lifts the tab
for that color, which reveals a social skill. The practitioner and child then
practice that social skill. The practitioner and child will decide on various
social skills to write on the inside of the fortune teller. The practitioner should
let the child try to come up with some social skills, but the practitioner will
likely have to help and should make sure social skills are chosen that the child
needs to develop. There will be 8 social skills written inside the fortune teller.

Rationale
This technique helps children and adolescents work on social skills. This interven-
tion provides the opportunity to work on several social skills. The practitioner
should direct the social skills toward skills that the child needs to develop. More
than one fortune teller can be made. The child and practitioner may make several,
all with different social skills to work on. The child can take their fortune tellers
home and play with other family members. Parents are taught how to make for-
tune tellers at home and taught how to play the game with their children.
 Social Skills Interventions 101
Instructions for playing the Fortune Teller game: The outer layer is num-
bers; the practitioner holds the fortune teller, and the child picks a number.
The practitioner moves the fortune teller back and forth that many numbers
and opens up the fortune teller. The inside is colors; the child picks a color, and
the practitioner pulls up that color and reads the social skill underneath that
color. The practitioner and child practice/role-play the social skill together.

Fortune Tellers Examples

102 Social Skills Interventions
Take It to the Judge

Target Area Social Skills

Level Adolescent
Materials None
Modality Individual

Introduction
Adolescents with ASD and other developmental disorders often have thoughts
and beliefs about themselves and the world around them that are not accu-
rate and tend to produce anxiety, worry, and avoidance behaviors for the
adolescent. Many of these beliefs are driven by poor social skills resulting in
negative or poor social experiences. Take It to the Judge is an intervention
that helps adolescents challenge their inaccurate thoughts and beliefs.

Instructions
This intervention is often implemented after the practitioner has developed
rapport with the adolescent and has an understanding about what irrational
or inaccurate beliefs the adolescent might be having. The practitioner makes a
list of some of the inaccurate thoughts and presents the list to the adolescent.
The adolescent chooses one to begin with. The practitioner explains they are
going to take this thought to the “Judge” who will be played by the practi-
tioner. The adolescent will be the attorney for both sides arguing to the judge
why the thought is accurate and arguing to the judge why the thought is not
accurate. The adolescent gets a few minutes to prepare what he or she wants
to say. The adolescent then presents both sides to the practitioner. The prac-
titioner addresses what is presented and makes a verdict. The practitioner
should talk with the adolescent about any irrational or inaccurate thoughts
or beliefs the adolescent is holding. The practitioner should try to present
evidence that the thought is inaccurate and try to move the adolescent away
from the inaccurate thought with a more accurate one.

Rationale
This intervention helps adolescents address any irrational or inaccurate
thought that might be driving negative emotions or withdrawn behavior. The
practitioner wants to use rational, concrete information to help the adoles-
cent see any inaccurate thought. The process is repeated for all the identi-
fied inaccurate thoughts until all have been addressed. This intervention is
cognitive based and provides a fun and engaging way to address inaccurate
thoughts and beliefs.
 Social Skills Interventions 103
Three Foam Dice

Target Area Social Skills

Level Child and Adolescent
Materials Foam Dice, Marker
Modality Individual, Family, Group

Introduction
Three Foam Dice is an intervention that focuses on preventative practice to
help children avoid getting into a dysregulated state. This intervention incor-
porates working on increasing social skills, on increasing emotional regula-
tion ability, and on improving relationship development.

Instructions
Using 3 foam dice (see picture included here), the practitioner designates one
of the die to be social skills, one to be emotions, and one to be connection
activities. The practitioner then writes a social skill to practice on each side of
the social skills die, a different emotion on each side of the emotions die, and
a connection activity on each side of the connection die. The information that
the practitioner writes should correspond to the individual child or adoles-
cent’s specific challenges. The practitioner will usually create the dice before
the child’s session. The child rolls all 3 dice, and whatever is displayed on the
upside of each dice is what the child has to do and the number of times that
he or she has to do it. For example, if the child rolls the emotions die and rolls
a number 3 and the emotion written on that side is sad, the child has to share
3 things that have made him or her feel sad. If he or she rolled a number 4 on
the social skills die, and give someone a compliment was written on that side,
then the child would have to give 4 compliments. If he or she rolled a 1 on the
connection die, and shake someone’s hand was written on that side, then the
child would shake someone’s hand once. The practitioner and child continue
to roll the dice and play the intervention until they have implemented every-
thing written on the dice or until the practitioner ends the game.

Rationale
The Three Foam Dice intervention works on multiple issues simultaneously.
Social skills, emotional regulation, and connection challenges can all be cov-
ered in this intervention. When creating the dice, practitioners should con-
sider the individual child they will be working with and what specific social
skills, connection issues, and emotional regulation challenges that child needs
to work on and represent those challenges on the dice. Foam dice come in
various sizes and can be found online and in most educational supply stores.
The foam dice can be given to the child to take home, and parents and other
family members can play this intervention with the child.
104 Social Skills Interventions
Three Foam Dice
 Social Skills Interventions 105
Prevention Role-Play

Target Area Social Skills

Level Child and Adolescent
Materials None
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders often
find themselves in specific situations or events that create a great deal of anxi-
ety and dysregulation for them. Parents often have a difficult time getting
their children to participate in dysregulating events, such as getting their hair
cut or going to the dentist. Prevention role-play can help children and ado-
lescents reduce anxiety levels, gain social skills, and desensitize to specific
scenarios and events that are typically troublesome for them.

Instructions
Practitioners should begin by identifying what specific situation or event a
child is struggling with. More than likely, this can be identified by the par-
ents. For example, the parents identify that going to the doctor is a struggle.
The child has had several meltdowns, and often the parents cannot get the
child to go into the doctor’s office. The practitioner would gather as much
information from the parents as possible about going to the doctor, such as
the doctor’s name, what the office is like, the usual procedures, and the child’s
specific reaction and behavior. The practitioner then meets with the child
and role-plays the situation with the child in a fun, engaging, and somewhat
exaggerated way. The practitioner may begin by using puppets or people fig-
ures or use him- or herself to play the roles of the child, the doctor, and
the parent. The practitioner should use props such as dress-up clothes and
masks to make the role-play fun, active, and playful, exaggerating all the
reactions. The practitioner will likely use a whole variety of props from the
playroom. The practitioner will ask the child to participate in the role-play
and let the child participate at the level he or she is comfortable with. The
practitioner will encourage the child to take on more and more of the roles
until the child is fully participating and playing him- or herself and going
through the role-play. When depicting the actual events through role-play
has been played several times, the practitioner will introduce playing the role-
play with a positive outcome where the child uses coping skills and goes to
the doctor without having a meltdown or getting upset. The practitioner and
child will then play through the new role-play several times until the end of
the session. The role-play may be repeated in the next session and several
sessions afterwards until the child can successfully participate in going to the
doctor. It is most helpful to begin this intervention a few sessions prior to the
event the child will be participating in.
106 Social Skills Interventions
Rationale
Prevention Role-Play is designed to help children practice positive social skills to
help them participate in challenging situations or events that create a great deal
of anxiety or dysregulation for the child. This intervention also helps children
become desensitized to the troubling situation or event. The role-play should be
played many times to help the child desensitize to the troubling event.
Practitioners should especially implement this intervention a couple of sessions
prior to the child participating in the troubling situation that will be role-played.
The practitioner will want to gain feedback from the parents on how the child
handled the situation after participating in the prevention role-play intervention.
Parents can also role-play with their child at home. Parents will especially want
to implement this intervention a few days prior to attending the targeted event.
 Social Skills Interventions 107
Prevention Role-Play Problem Situations

Going to the doctor

Going to the dentist
Getting a haircut
Going to a grocery or department store
Going through a car wash
Attending school assemblies
Participating in school field trips
Going to fairs and carnivals
Going to jump houses and arcades
Attending a family reunion
Attending a birthday party
Having relatives visit
Going on a vacation
Flying in an airplane
Going through airport security
Using a public restroom
Ordering food at a restaurant
Going to a theme park
Playing at a park
Going to a swimming pool
108 Social Skills Interventions
Quiet Loud

Target Area Social Skills

Level Child and Adolescent
Materials None
Modality Individual

Introduction
Children and adolescents with ASD often struggle with their tone of voice.
Some children with ASD may present with a flat tone of voice 100 percent of
the time while other children with ASD may speak at inappropriate volumes
(too quiet or too loud for the situation). The Quiet Loud intervention works
on helping children with ASD and other developmental disorders understand
tone of voice by recognizing how their voice can fluctuate and how they can
control the tone and fluctuation.

Instructions
The practitioner tells the child that they are going to complete an activity that
works on how the child speaks and how his or her voice can be quite, loud,
or in between. The practitioner demonstrates for the child by pressing his or
her hands together in front of him or her and begins by saying something in
a whisper. The practitioner moves his or her hands apart slowly and progres-
sively keeps moving his and her hands further apart. While the practitioner is
continually moving his or her hands further apart, the practitioner is increas-
ing the loudness of his or her voice. The practitioner then asks the child to do
the activity with the practitioner. The child can pick a word to say and that is
the word they will use to go from a quiet to loud voice.
The practitioner can follow up the activity with discussing places and situ-
ations where it would be appropriate to be quite, talk in a whisper, normal
voice, or loudly. The practitioner and child can also practice changing the
tone in the child’s voice to represent being sad, excited, scared, or any other
state by tone of voice.

Rationale
This intervention works on increasing social skills, especially related to speak-
ing in an appropriate volume for the situation and how to fluctuate tone of
voice to mirror various feelings and states that the child may be experiencing.
It is likely that this intervention will need to be played multiple times to help
the child gain mastery and increase their speaking and tone skills. Parents can
be taught to practice this intervention at home with their child.
 Social Skills Interventions 109
Quiet Loud
110 Social Skills Interventions
School Rules

Target Area Social Skills

Level Child and Adolescent
Materials Paper, Markers, Highlighters
Modality Individual, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
struggle with social skills and social interaction. Arguably, the school setting
is the largest social setting that the child participates in and is often the most
anxiety producing due to the myriad of social demands. School Rules help the
child identify various social situations and rules that the child may encoun-
ter and how to better understand social situations and practice developing
appropriate skills to navigate the situations that child is struggling with.

Instructions
The practitioner explains to the child that they will be working on improving
social skills to help the child follow rules and participate better in school. The
child draws a picture of his or her school on a piece of paper. The child writes
the rules of his or her school in the picture he or she has drawn. (The rules can
be whatever the child can remember about rules to follow at school.) The child
then draws an outline of a person beside the school. Inside the outline person, the
child writes any social rules that he or she can think of that exist at school. The
practitioner may have to explain to the child what is meant by social rules. After
the child has completed the drawings and written the rules, he or she goes through
each of the rules and colors a dot next to each rule using the following guide:

Green = Rules that he or she does not understand

Pink = Rules that he or she does not like
Yellow = Rules that he or she breaks
Blue = Rules that he or she likes

The practitioner then processes through the rules with the child and specifi-
cally addresses the rules that the child does not understand and does not like.
The practitioner should also discuss ways to help the child follow the rules
that he or she is breaking.

Rationale
This intervention works on increasing social skills to help the child or ado-
lescent navigate school rules and social rules that the child may be struggling
with. Parents can be taught this intervention, and a copy of what the child
created can be sent home so parents can continue to practice improving the
school-related social skill deficits.
 Social Skills Interventions 111
School Rules Examples
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6 Connection Interventions

Connection
114 Connection Interventions
Obstacle Course

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Several Pieces of Paper
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
struggle in meaningful connection with others. This intervention helps chil-
dren work on connection, trust, being present with another person, and gen-
eral relationship development.

Instructions
The practitioner explains to the child that they will be playing a game to work
on trusting and becoming more comfortable with other people. The practitio-
ner wads up several pieces of paper and places them around the playroom. The
practitioner then explains to the child that they are going to take turns leading
each other from one side of the playroom to the other without stepping on any
of the pieces of paper and that the person being led will be wearing a blind-
fold. The practitioner goes first and blindfolds the child. The practitioner stands
behind the child with his or her hands on the child’s shoulders. The practitioner
guides the child with words and physical prompts across the playroom having
the child avoid stepping on any of the pieces of paper. Once successfully across
the playroom, the practitioner and child switch roles, and the child leads the
practitioner back across the playroom avoiding all the pieces of paper. The game
can be played multiple times with the papers being rearranged each time. The
practitioner should regularly check in with child to make sure he or she is feeling
comfortable with being blindfolded and being physically led by another person.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development. Children and adolescents can work on becoming more
comfortable with engaging other people and work on reducing any anxiety
that might accompany interacting with others. The practitioner and child
can play the intervention several times. Each time they play, they can mix
up the pieces of paper on the floor so there is a new obstacle field to guide
through. Parents can be taught this intervention to implement at home and
encouraged to play regularly with their child and include the entire family.
This intervention, along with several of the connection interventions, requires
a level of physical touch. This should always be explained to the child before
implementation, and the practitioner should confirm with the child that he
or she is OK with the level of touch and close proximity of the practitioner.
 Connection Interventions 115
Obstacle Course
116 Connection Interventions
Break Out

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Toilet Paper or Crepe Paper
Modality Individual, Family, Group

Introduction
The Break Out intervention helps children and adolescents attune to another
person, recognize their own physical self, and become comfortable with the
physical presence of others. Further, it promotes a sensory-based experience
that children with ASD typically respond positively to.

Instructions
The practitioner explains to the child that the practitioner is going to wrap
the child’s legs and arms in crepe paper (toilet paper can also be used), and
the child is going to bust out of the wrapping. The practitioner begins by
wrapping one part of the child’s body such as the child’s legs in toilet paper
or crepe paper. The child is instructed to remain still until the practitioner
has finished wrapping the child’s legs. Once the practitioner has finished, the
practitioner says, “Go,” and the child breaks out of the wrapping. The practi-
tioner then wraps another part of the child’s body such as his or her arms and
repeats the process. The practitioner can also wrap the child’s hands and the
child’s entire body. If the child wants, the practitioner and child can switch
roles, and the child can wrap the practitioner.

Rationale
Break Out helps children and adolescents work on connection and relation-
ship development. It also works on attuning to another person and body con-
trol issues. This intervention can be repeated several times. When wrapping
the child, the practitioner should wrap the child several times around but not
too much. It is important that the child be able to break out of the wrapping
easily.
This intervention should be taught to parents to do at home with their
child. Parents should be encouraged to make the intervention fun and ani-
mated and switch roles with the child, letting the child wrap the parent. Par-
ents can even include the entire family in the intervention.
 Connection Interventions 117
Break Out
118 Connection Interventions
Iguana Walk

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Individual

Introduction
Iguana Walk is a simple yet effective intervention that helps children develop
relationship and connection with others. It is presented in a fun and playful
manner that engages children to participate. Further, it helps children under-
stand and become comfortable with positive touch and closely interacting
with another person.

Instructions
The practitioner tells the child that the practitioner is going to do an iguana
walk up and down the child’s arms and legs. The practitioner should demon-
strate on a stuffed animal or the practitioner’s own arm first to show the child
what will be happening. The child sits on the floor or a chair and holds out
one arm. The practitioner makes his or her hands into the formation of talk-
ing puppet hands, and one hand at a time, the practitioner clamps onto the
child’s hand (starting with the child’s fingers) and moves up the child’s arms
clamping onto the child as an iguana might clamp on and walk up the child’s
arm. The practitioner then repeats the same action for the child’s other arm
and then the child’s legs.
The practitioner can then ask the child if he or she wants to do the Iguana
Walk on the practitioner. The practitioner should be cautious to explain to
the child that there will be touch involved and gain permission from the child
for each level of touch. The practitioner and child can play the Iguana Walk
back and forth several times.

Rationale
This technique helps children work on connection and relationship develop-
ment especially in attuning to others, becoming comfortable with physical
touch, and participating in a reciprocal activity with another person. This
intervention can be repeated several times. The practitioner should encourage
the child to complete the Iguana Walk on the practitioner, but if the child is
not comfortable with this, it should not be forced. This intervention should
be taught to parents to do regularly at home with their child. This connection
intervention can be paired with other connection interventions for parents to
do with their child at home and involve the entire family.
 Connection Interventions 119
Iguana Walk
120 Connection Interventions
Feeling Card Find It

Target Area Connection (Relationship Development)

Level Child
Materials Index Cards, Pencil
Modality Individual, Family

Introduction
Children with ASD and other developmental disorders often struggle in con-
necting with others, even their own family members. Connection skills often
include both social skill and emotional regulation components. This interven-
tion helps children develop relationship connection, social skills, and emo-
tional regulation. The practitioner can design this intervention to address
specific feelings that the child needs help expressing and regulating.

Instructions
The practitioner and child write feeling words on several index cards (usu-
ally 8–10 to begin with). The practitioner and child then take turns picking
an index card and hiding it somewhere on their body while the other person
is not watching. The other person then has to find the card on the person’s
body by physically searching for it. When the card is found, the person who
found it has to read the feeling word on the card and talk about something
that makes him or her feel that emotion. This process is repeated until all the
index cards have been completed. The practitioner should hide the cards in
fairly obvious places on his or her body. If the child is uncomfortable with
being touched or touching the practitioner, then feeling words can be used,
and each person can point at different areas on the body.

Rationale
This technique helps children work on social skills, connection and rela-
tionship development, and emotional regulation. This intervention can be
repeated several times with the practitioner and child creating different index
feeling cards. The placement of index cards on the body should be somewhat
obvious such as coming out of a sleeve, on top of head, coming out of shoe,
etc. This intervention helps children learn to notice and attune to another
person, recognize and express emotions, and develop connection. The prac-
titioner can also change the feeling share time to another instruction such as
“Make the feeling on your face.” This intervention should be taught to par-
ents to do at home with their child. Parents are encouraged to attune to what
their child may be feeling and represent those feelings in the index feeling
cards. Parents are also encouraged to involve the entire family.
 Connection Interventions 121
Feeling Card Find It
122 Connection Interventions
Ring around Me

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Individual

Introduction
Ring around Me is a fun and engaging connection intervention especially for
young children. Physical contact is maintained throughout the activity, and
social skills such as eye contact are also practiced in this intervention.

Instructions
The practitioner explains to the child that they will be playing a game that
requires them to hold hands the entire time. The practitioner stands in one
spot, and the child stands beside the practitioner. The practitioner takes the
child’s right hand, and the child starts to walk around the practitioner. As
the child gets to the back of the practitioner, the practitioner switches to his
or her left hand and takes the child’s right hand as the child continues around
the practitioner. The child keeps walking around the practitioner with the
practitioner switching hands but always keeping contact with the child as he
or she walks around the practitioner.
After several times of walking around, the practitioner can have the child
switch directions and walk around the practitioner the opposite direction.
The practitioner can also have the child walk around him or her in a specific
style such as in slow motion, fast, hopping, skipping, or walking backward.

Rationale
The Ring around Me intervention helps children work on connection and
relationship development, especially in attuning to another person, making
physical connection, and following another person’s instructions. This inter-
vention can be repeated several times, and the practitioner and child can
switch roles if the child desires.
This intervention should be taught to parents to do regularly at home
with their child. This intervention can be easily paired with other connection
interventions for parent and child to play together at home. Parents can also
involve siblings or other family members. Involving other family members to
play with the child will likely help generalize relationship connection skills.
 Connection Interventions 123
Ring around Me
124 Connection Interventions
Sand Games

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Sand Tray, Sand, Various Sand Toys
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders often
need help in learning how to connect with others. Further, they often respond
well to sensory-based instruction and experiences. Sand Games are sensory-
based activities that help develop relationship connection.

Instructions
The practitioner explains to the child that they are going to be doing some
activities in a sand tray. The practitioner and child proceed in playing several
sand games together.

1. The practitioner and child take turns burying each other’s hands and
arms in the sand.
2. The practitioner and child create a hand sand sifter, pouring sand from
the practitioner’s hand to the child’s hand back to the practitioner’s hand.
3. One person makes a hand cup and the other person fills it with sand.
4. The practitioner and child each bury one hand in the sand and move their
hand under the sand trying to grab the other person’s hand.
5. The practitioner and child hold hands and place their held hands on
top of the sand. With their free hands, the practitioner and child work
together to bury the held hands in the sand.

Rationale
The Sand Games intervention helps children work on connection and rela-
tionship development. Children can work on becoming more comfortable
interacting with another person and working with another person to complete
a task. This intervention can be repeated several times, and the practitioner or
child can create new sand games to play. Sand Games should actively involve
both the child and practitioner doing something together and/or utilizing the
other person’s hands/arms, etc. This intervention can be taught to parents to
do at home with their child if the family has a sand tray. If not, the interven-
tion will be done only in the practitioner’s office.
 Connection Interventions 125
Sand Games
126 Connection Interventions
Turn around and Make a Face

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials None
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD can struggle in basic interactions with
another person such as simply looking at another person. This intervention
helps children and adolescents work on noticing and connecting with another
person. Further, it works on helping children develop social skills such as
looking at others and participating in a joint activity with another person.

Instructions
The practitioner tells the child they are going to play a game where they will
be looking at each other. The practitioner and child stand with their backs to
each other; on the practitioner’s count of 3, the practitioner and child both
turn around and make a face at each other. Each person has to say what kind
of face the other person was making.
This activity is repeated several times, each time the practitioner and child
have to make a different face at each other. The practitioner can also instruct
that specific faces have to be made each time, such as turn around and make
a silly face, angry face, happy face, confused face, scared face, mean face,
friendly face, etc.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development as well as social skills and emotional regulation. With
specific instructions from the practitioner, the child can practice making vari-
ous faces that are displaying emotions and practice making faces that display
social awareness such as a friendly face or mean face.
Turn Around and Make a Face helps the child not only work connection
but also increases emotional expression and helps the child learn to recognize
body language. This intervention should be taught to parents to do regularly
at home with their child. The practitioner should give parents several ideas
of faces to make and practice when completing this intervention with their
child at home.
 Connection Interventions 127
Turn Around and Make a Face
128 Connection Interventions
Fishy and Shark

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Individual

Introduction
Playing with another person, paying attention to others, and engaging in
physical contact with another person are typical struggle areas for children
with ASD and developmental disorders. This intervention helps children
work on developing these skills in a playful and engaging process.

Instructions
Fishy and Shark is a hand game that is done between the practitioner and the
child. The practitioner and child sit on the floor across from each other but
close enough to touch. The child could also sit on a chair with the practitio-
ner on the floor. The practitioner puts his or her hands together and moves
them across the floor wiggling them like a fish swimming. The practitioner
wiggles his or her hands toward the child saying, “Fishy, fishy.” When the
practitioner gets close to the child, the child says, “Shark,” and takes his
or her hands and clamps down on the practitioner’s hands that are making
the fish. This intervention should be repeated several times, and if the child
desires, the roles can be switched, and the child can be the fishy and the prac-
titioner can be the shark.

Rationale
Fishy and Shark helps children work on connection and relationship develop-
ment, especially in attuning to and paying attention to another person. This
intervention also incorporates increasing concentration, eye contact, and
joint attention skills.
Fishy and Shark should be taught to parents, and parents should be encour-
aged to play this intervention with their children regularly at home. This
intervention can be included with other connection interventions so parents
can play several connection interventions during one play time. Parents can
also try to incorporate other family members to play this intervention with
the child.
 Connection Interventions 129
Fishy and Shark
130 Connection Interventions
Magnify Me

Target Area Connection (Relationship Development)

Level Child
Materials Magnifying Glass
Modality Individual

Introduction
Magnify Me is a fun and engaging way for children to work on relationship
connection. This intervention helps children interact positively with others,
notice others, be comfortable being noticed by others, and develop a better
sense of the child’s physical self.

Instructions
The practitioner explains to the child that the practitioner will be using a
magnifying glass to closely examine different parts of the child. The practi-
tioner uses a toy magnifying glass and looks through the glass moving over
different parts of the child, such as the child’s ear, nose, eyes, hair, fingers etc.
As the practitioner moves over a part of the child, he or she should make
positive comments such as “Wow, you have such a cool nose!” or “This is
some really brown hair.”
It is important that the practitioner make comments about the child and
that the comments be positive and/or descriptive. The practitioner should
then try to get the child to switch roles and have the child look through the
magnifying glass at the practitioner. This intervention can be played several
times with the practitioner making new comments as he or she examines the
child.

Rationale
This technique helps children work on connection and relationship develop-
ment. Magnify Me helps children become more comfortable and aware of
their own self and more comfortable with and aware of others. Further, the
magnifying glass creates a fun component that also provides a safe distance
for the child as he or she works on these skills. This intervention can be taught
to parents to play at home and can be combined with other connection tech-
niques that parents can play with their children regularly between counseling
sessions.
 Connection Interventions 131
Magnify Me
132 Connection Interventions
Crawling Crabs

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Individual

Introduction
Children with ASD often need to work on various connection skills in a way
that is less anxiety producing and more playful and engaging. Crawling Crabs
is a simple yet effective connection and touch intervention that helps children
(especially young children) develop relationship with others. Further, it helps
children understand and become comfortable with positive touch, attuning
to another person, and engaging in a mutual process with another person.

Instructions
The child sits on the floor with his or her legs stretched forward and his or her
hands on his or her legs. The practitioner sits across from the child and starts
moving his or her hands with fingers down on the floor in a walking move-
ment toward the child. When the practitioner reaches the child, the practi-
tioner continues with his or her hands walking up the child’s legs and then
up the child’s arms until the practitioner reaches the top of the child’s arms.
At the top of the child’s arms, the practitioner gently squeezes the child’s
shoulders.
The practitioner should explain the game to the child before beginning and
complete a demonstration of the movement on a stuffed animal or on the
practitioner’s own legs and hands. Crawling Crabs should be repeated several
times. The practitioner and child can also switch roles if the child desires.

Rationale
Crawling Crabs helps children work on connection and relationship devel-
opment as well as concentration and eye contact. This intervention should
be taught to parents to do regularly at home with their child. Parents may
also combine this intervention with other connection interventions and try to
incorporate other family members to play with the child.
As with any touch intervention, practitioners and parents should try to be
aware of and understand the child’s limits in terms of being comfortable with
or having a sensory sensitivity to physical touch. Before beginning any inter-
vention that involves touch, practitioners should reference the Association of
Play Therapy’s “Paper on Touch” available at www.a4pt.org.
 Connection Interventions 133
Crawling Crabs
134 Connection Interventions
Silly Glasses

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Several Eye/Sunglasses, Mirror
Modality Individual, Family, Group

Introduction
Silly Glasses is a fun technique to help children notice and pay attention to
themselves and others. There is an interactive component for a child that
promotes participating and connecting with others. Joint attention skills are
also developed in this intervention.

Instructions
The practitioner explains to the child that they will be playing a game using
several different glasses. The practitioner displays several different eyeglasses
or sunglasses for the child to choose from. The more sunglasses and the more
variety of sunglasses that are available will keep the intervention going and
make the intervention more interesting to the child.
The practitioner explains to the child that they are going to take turns
picking out a pair of sunglasses and putting the sunglasses on the other per-
son. (It is important that each person chooses the sunglasses and places the
sunglasses on the other person; the sunglasses should not simply be handed to
the other person.) Once the sunglasses are in place, the practitioner and child
look in a mirror to see themselves in their sunglasses. This process is repeated
several times with the practitioner and child going through several sunglasses.

Rationale
This technique helps children work on connection and relationship develop-
ment, especially in regard to noticing another person and reciprocally inter-
acting with another person. Children also work on improving eye contact
with this intervention. Practitioners are encouraged to assemble several dif-
ferent styles and types of eyeglasses, sunglasses, and silly play glasses.
This intervention should be taught to parents to do regularly at home with
their child. Parents should try to incorporate other family members to play
this intervention with the child. Parents will need to collect and have avail-
able several types of glasses. Some suggested options for collecting sunglasses
would be yard sales and flea markets where the cost would typically be less.
 Connection Interventions 135
Silly Glasses
136 Connection Interventions
Hands, Hands, Hands

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Piece of Paper, Pencil
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD often feel uncomfortable or are unsure
with physical touch. This intervention provides a simple and fun way to
engage a child with ASD with a variety of physical touch activities that are
presented in play form. The practitioner can engage the child in one, two,
or several hand activities. The intervention can easily be modified to fit the
child’s comfort level.

Instructions
The practitioner explains to the child that they are going to play several games
connecting with their hands. The practitioner instructs the child to trace
around his or her hand on a piece of paper. The practitioner then instructs
the child to write on the traced hand all the positive things he or she can think
of to do with his or her hands that involves another person.
Once the child is finished, the practitioner can add to the list if the prac-
titioner can think of other positive things. (Several ideas are included here.)
The practitioner and child then do or pretend to do all the things on the
list. The practitioner also discusses with the child how connecting with
others can be positive and can feel good.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development. Children learn several positive ways (that are playful
and feel good to the child) that he or she can connect with others through
physical touch games. During the intervention, the practitioner should dis-
cuss with the child how interacting with others can feel good and be a posi-
tive experience and that playing with other children can be enjoyable.
This intervention can be taught to parents to do regularly at home with
their child. Parents may need help in coming up with several positive things
to do with hands so the practitioner should provide a list of examples for the
parents.
 Connection Interventions 137
Hands, Hands, Hands

Example Activities
Thumb wrestling
High five
Pat on the back
Hand massage
Head massage
Ear massage
Shoulder massage
Patty cake
Holding hands
Creating a special hand shake
Hand stack game
Intertwining fingers
Lotion hands
Pretend palm reading
Drawing on person’s
back with your finger
Tickling
Arm wrestle
Painting fingernails
Washing hands
Hug
Palm press
Interlocking fingers
Dancing
Finger face painting
Finger press
Hand slap (grab) game
Fist pump
Handshake
Pinky swear
Ring around the Rosy game
London Bridge game
138 Connection Interventions
Sculpture

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials None
Modality Individual, Family, Group

Introduction
Sculpture connects the child and practitioner together in a way that the child
has to pay attention to and notice the practitioner. It also incorporates a
physical component that helps with connection between child and practitio-
ner. Children are able to work on becoming more comfortable with physical
touch and interacting with others while engaging in a playful activity.

Instructions
The practitioner instructs the child that they are going to take turns making
each other into sculptures. The practitioner goes first and moves the child
into whatever position he or she needs the child to be in for making the
child into a sculpture of something. The practitioner should physically move
the child into position by touching the child’s arms, legs, etc. and moving
them into position, not simply using verbal commands. Once the child has
been made into a sculpture, the child has to guess what he or she has been
made into.
The practitioner and child then switch roles, and the child gets to make the
practitioner into a sculpture of something. This intervention can be repeated
several times with the practitioner and child making each other into several
different sculptures.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development, especially interaction with another person and partici-
pating in physical touch. The intervention should be repeated several times,
and the practitioner and child should take turns creating each other into a
sculpture. It is important that physical touch be included by having the per-
son creating the sculpture physically move the other person into the posi-
tions, not just giving verbal instructions.
The practitioner will want to make sure that the child is comfortable with
the level of physical touch involved. The intervention can be taught to par-
ents to do at home regularly with their child, and the entire family can play
together.
 Connection Interventions 139
Sculpture
140 Connection Interventions
Aluminum Wrap

Target Area Connection (Relationship Development)

Level Child
Materials Aluminum Foil
Modality Individual

Introduction
Children with ASD can have challenges with sensory issues when trying to
connecting with other people. This intervention works on both sensory pro-
cessing and being present with and connecting to another person. It also pro-
vides a reciprocal component that is beneficial for relationship development.

Instructions
The practitioner explains to the child that they are going to use aluminum foil
to wrap different parts of their bodies. The practitioner begins by wrapping
one of the child’s hands in aluminum foil and pressing in lightly on the alu-
minum foil so it molds around the child’s hand. The practitioner then takes
the aluminum foil off the child’s hand and wraps the child’s other hand. The
practitioner can wrap the child’s feet, ears, fingers, anything that would be
appropriate but only one body part at a time. The practitioner should notice
the child’s reaction and be sensitive to the child as each body part is wrapped.
The practitioner should ask the child how it feels when one of his or her
body parts is wrapped in aluminum foil. The practitioner should try to engage
the child in switching roles and having the child wrap the practitioner’s hands
and feet in aluminum foil. Once the practitioner and child are finished wrap-
ping each other with aluminum foil, the aluminum foil should be used to
make something for each other that the other person can wear on themselves,
such as a hat or bracelet.

Rationale
This technique helps children work on connection and relationship develop-
ment. It also works on sensory tactile and touch issues and physical pressure.
This intervention can be repeated session to session. It can also be taught to
parents to do at home with their child periodically. It is important to have
the child switch roles and be in both positions: being wrapped and wrapping.
The child may prefer one role over the other, and it may take time to get the
child to switch roles.
 Connection Interventions 141
Aluminum Wrap
142 Connection Interventions
Silhouette

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials White Paper, Pencil
Modality Individual

Introduction
This intervention provides the opportunity for the practitioner to connect
with the child and for the child to pay attention to and reciprocate back to
the practitioner and create a visual representation of that connection. Silhou-
ettes can be simplified or made more complex depending on the comfort and
functioning level of the child.

Instructions
The practitioner explains to the child that they will be using paper and pencils
to trace different body parts. The practitioner has the child lay his or her head
down sideways on a white piece of paper. The practitioner traces around the
child’s head. The child then draws his or her features on the tracing. The child
then traces the practitioner’s head while the practitioner lays his or her head
down on a white piece of paper.
The practitioner and child then trace each other’s hands and lastly feet (if
appropriate and the practitioner and child are both comfortable with tracing
feet). The traced hands and feet can be colored and decorated by the child.
If the practitioner has a large enough piece of paper, the child can lie on the
paper and have their whole body traced. The practitioner should try to get
the child to reciprocate and trace the practitioner. If the child is not willing
to do this, the practitioner should just trace the child. For adolescents, the
practitioner should talk with them about what parts of their body they are
comfortable tracing before the intervention is started.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development. The practitioner should introduce the intervention
to the child so the child understands they will be tracing each other’s head,
hands, and feet on a white piece of paper. The practitioner will want to ensure
that both children and adolescents are comfortable with the intervention
before beginning. This intervention can be taught to parents to do at home
with their child on a regular basis.
 Connection Interventions 143
Silhouette
144 Connection Interventions
Family Spin

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials None
Modality Individual, Family, Group

Introduction
This intervention is typically completed as a family play activity. It can be
completed with just the practitioner and child but tends to work better with
a family or in a group setting. It provides an opportunity for family members
to connect and engage with the identified child or adolescent with ASD in a
playful game that works on connection and relationship development.

Instructions
The practitioner instructs the family to make a circle and each family member
to put both of their hands in the circle (out in front of them) and everyone
grab someone else’s hands. Each family member should be holding another
family members hand so the whole family is connected. The practitioner then
instructs the family that they will start spinning around to the right slowly.
After a period of time, the practitioner will interject various instructions for
the family to do, such as speed up, walk in slow motion, start spinning to the
left, stop, jump, hop to the right, etc. The practitioner can also play this game
with a child one on one, and the practitioner and child can take turns being
the person who gives the instructions. If the family plays this game at home,
one person can be designated as the person who will give the family instruc-
tions on how to spin. Each family member can have a turn in this position.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development, especially in making eye contact, attuning to others,
and physical touch. This intervention is a family intervention and can be done
with one parent and one child or multiple family members. It can also be
implemented in a group format. The size does not matter as long as there are
at least 2 people. When the family does the intervention at home, it is helpful
if there is one person who stays on the outside of the circle calling out the
instructions. If there is no one to do this, then the parent should interject the
instructions as he or she plays with the child.
 Connection Interventions 145
Family Spin
146 Connection Interventions
Our Unique Greeting

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials None
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
have challenges in greeting others. This intervention creates the opportunity
for the practitioner to create a unique greeting with the child or adolescent
that can involve many elements but should involve some physical touch. This
intervention helps improve social skills as well as connection ability.

Instructions
The practitioner explains to the child that they will be creating a unique
greeting that they can give each other each time they see each other. Hands,
gestures, and words can all be used in creating the greeting. The practitioner
and child can use their unique greeting each time the child comes in for a ses-
sion. The practitioner and child can also create a unique way to say goodbye
at the end of each session.
The greeting and goodbye should involve some form of physical touch.
The practitioner should allow the child to try and come up with the greeting
and goodbye on their own. The practitioner should assist the child as needed.
Once the practitioner and child have created their unique greeting and good-
bye, the practitioner and child should practice the greeting and goodbye sev-
eral times.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development in the areas of physical touch, acknowledging and
attuning to another person, and creating special meaning in a relationship.
Once the special greeting and goodbye have been created and practiced, the
practitioner will want to make sure that he or she remembers them so the
next time he or she sees the child, the special greeting and goodbye can be
implemented.
This intervention can be taught to parents to do at home with their child.
Each parent and other family members if appropriate can all create a unique
greeting and goodbye rituals with the child. The greeting and goodbye rituals
should always contain a physical touch component.
 Connection Interventions 147
Together Balloons

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Balloon
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD and other developmental disorders often
need practice in connecting with others and working with and cooperating
with others. Together Balloons provides a fun and engaging way for the prac-
titioner and child to work on connection. This intervention also incorporates
social skill development in the areas of working together to complete a task
and making eye contact.

Instructions
The practitioner explains to the child that they will be playing a game together
that involves a balloon. The practitioner blows up a balloon and explains to
the child that they are going to work together in a special way to keep the
balloon in the air.
The practitioner and child stand facing each other and grab each other’s
hands and hold both hands. The practitioner hits the balloon in the air, and
the practitioner and child have to keep the balloon from touching the ground.
The practitioner and child maintain holding hands the whole time and move
around together to keep the balloon in the air. If the balloon hits the ground,
it should be picked up and the game started again. The game can be repeated
several times.

Rationale
This intervention helps children and adolescents work on connection and
relationship development through physical touch, working cooperatively,
and attuning to and being aware of others. Together Balloons can be taught
to parents to do at home regularly with their child. Other family members
can also get involved and play with the child. This intervention works well as
a family play activity and a group activity. In a family or group setting, the
participants can pair up or function as one large group holding each other’s
hands.
148 Connection Interventions
Together Balloons
 Connection Interventions 149
Hide and Find

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials Index Cards, Pencil
Modality Individual

Introduction
Children and adolescents with ASD and other developmental disorders often
have challenges in establishing relationships and meaningful connection with
others. This intervention provides several opportunities for the child or ado-
lescent to practice relationship and connection skills. A variety of other skills
can be easily incorporated in this intervention such as social skills and emo-
tional regulation improvement.

Instructions
The practitioner tells the child they are going to play a game where the child
is going to find some things the practitioner hides in the room. The practitio-
ner writes various connection activities on index cards and hides the index
cards around the playroom. (The child should be waiting outside the play-
room door or standing in a corner and not watching.) Once the practitioner
is finished hiding the cards, the child then enters the playroom and has to find
all the index cards.
When the child finds an index card, he or she has to do the activity with the
practitioner that is written on the index card. The practitioner should create
around 5–7 index cards. Connection activities should be short and simple.
Some examples include shaking hands, making eye contact, giving a hug, giv-
ing a double high five, giving a pat on the back, thumb wrestling, etc.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development through a variety of methods (some examples are
included here). The practitioner can write any connection-related activity
on an index card. The practitioner can also include activities that work on
improving social skills and emotional regulation. The intervention should be
taught to parents to do at home. Parents will likely need to be given several
ideas for connection activities that can be written on index cards. Parents will
need to prepare several index cards and play the intervention using around 7
cards; they can play the intervention several times, creating a new set of index
cards/connection activities each time they play.
150 Connection Interventions
Hide and Find

Example Activities

Shake hands
Make eye contact for 10 seconds
Give a hug
Give a double high five
Give a pat on the back
Thumb wrestle
Have a staring contest
Play patty cake
Play the hand stack game
Lotion each other’s hands
Draw a picture together
Give a fist pump
Feed each other candy
Hold hands and walk around the room
Give a hand or back massage
Look at each other and make a face
Do a face painting
Do a dance together
Bury each other’s hands in the sand
 Connection Interventions 151
Squiggle Drawing Gift

Target Area Connection (Relationship Development)

Level Child and Adolescent
Materials White Paper, Pencil
Modality Individual, Family, Group

Introduction
Children and adolescents with ASD do tend to feel connection to impor-
tant people in their lives but often lack ability to show that connection. This
intervention provides the opportunity to work on connection with another
person, and it creates a strong visual element to help reinforce learning and
remembering the connection. It also presents the opportunity for children to
show another person they are thinking about them and acknowledge them
in a meaningful way. This intervention is adapted from Donald Winnicott’s
Squiggle Technique (Berger, 1980).

Instructions
The practitioner explains to the child they will be doing a drawing activ-
ity. The practitioner and child each take a piece of white paper and a pencil.
When the practitioner says, “Go,” they both start squiggling all over the
paper. This lasts about 10 seconds, and then the practitioner says, “Stop.”
The practitioner and child exchange papers, and each one has to make a
drawing out of the other person’s squiggle to present back to the other person
as a gift.
After the practitioner and child have finished their drawing, they share
with each other what they created for each other and then give the drawings
to each other as a gift. The practitioner and child should both sign each draw-
ing, showing that they completed it together. The practitioner and child can
then complete another Squiggle Drawing Gift; there is no limit on the number
of times the activity can be played.

Rationale
This technique helps children and adolescents work on connection and rela-
tionship development by thinking about and creating something for another
person. It also provides the opportunity for the child to create something
collaboratively and practice giving another person a gift. The practitioner
and child can repeat the squiggle drawing intervention several times. Parents
should be taught how to do this intervention at home and instructed to play
it with their child regularly. This intervention also works well in a group set-
ting with each participant pairing up and rotating through the group, creat-
ing several drawings.
152 Connection Interventions
Squiggle Drawing Gift

(Child turned squiggle into a dragon to give to practitioner)

(Child turned squiggle into sailing trip to give to practitioner)

 Connection Interventions 153
My Measurements

Target Area Connection (Relationship Development)

Level Child
Materials Measuring Tape
Modality Individual

Introduction
Children with ASD often need to engage in connecting activities to become
more comfortable and confident in relationship skills. This intervention is a
fun way to promote relationship connection. The practitioner can adjust this
intervention to be simple, with 1–2 measurements conducted, or be more
complex by conducting several measurements. The adjustment should match
the child’s functioning level, comfort level, and developmental level.

Instructions
The practitioner explains to the child that the practitioner is going to conduct
several measurements of the child. Before beginning, the practitioner should
give the child an example, such as “I am going to measure the length of your
arm.” The practitioner should then demonstrate the measuring on the prac-
titioner’s own arm.
The practitioner conducts various measurements on the child and writes
down the child’s measurements on a piece of paper. The practitioner should
try to get the child to engage in a reciprocal process having the child conduct
some measurements on the practitioner. Some of the types of measurements
can include measuring the child’s legs, arms, head, feet, hands, height, ears,
smile, nose, hair length, fingers, etc.

Rationale
This intervention helps children work on connection and relationship devel-
opment especially in the areas of physical touch, receiving positive attention
from another person, and engaging in reciprocal and joint attention processes.
A cloth or flexible measuring tape works best for this intervention. The prac-
titioner should try to incorporate fun measurements such as the length of the
child’s smile and the length of the child’s fingers. Making the intervention
silly and fun will make the intervention more engaging and comfortable for
the child. Parents should be taught how to do this intervention at home and
encouraged to play the intervention regularly with their child at home. Par-
ents can keep track of the measurements and show the child each time the
measurements change.
154 Connection Interventions
My Measurements
 Connection Interventions 155
I Am a Tree, We Are a Family

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Family, Group

Introduction
This intervention is implemented in a family or group setting. This interven-
tion promotes connecting with other people and working together to accom-
plish a task. Both relationship development and social skill development are
incorporated in this intervention.

Instructions
The practitioner explains to the family that they will be working together to
create a short and fun skit that they will perform for the practitioner. The
practitioner should designate a stage area in the room where the skit will be
performed. The family has to choose one person who will lead out the skit
and be the tree. The tree goes first and moves to the stage area, makes a tree
shape, and says, “I am a tree.” The family has to decide who will go second,
third, and so on. Each person will be something different that naturally con-
nects to a tree. Some examples might be grass, leaves, roots, a bird, a squir-
rel, a piece of fruit, an acorn, moss, etc. For example, the second person to
go might be a leaf: That person would go next and move to the stage area,
physically connect (however they choose) to the “tree” person, and say, “I am
a leaf.” Then the third person would go and so on. Once the last person has
gone, then the family says in unison, “We are a family.”
The family should be given as much time as they need to create the skit
(although it will likely not take long). They will need to decide the order that
each person will go in and what each person will be. Once the family has
finalized the skit, they will perform the skit in front of the practitioner. If the
family would like, they can perform a second skit with each family member
choosing different parts to perform.

Rationale
This intervention helps children work on connection and relationship devel-
opment and social skills, especially in the areas of physical touch, attuning
to other people, and working as a group to accomplish a task. The practitio-
ner should give the full instruction to the family before they begin and then
allow them time to put together their skit. Once the skit has been performed,
the practitioner should applaud and congratulate the family. The practitioner
might suggest creating another skit with the identified child as the tree if he
or she was not the tree the first time.
156 Connection Interventions
Body Bubble Target

Target Area Connection (Relationship Development)

Level Child
Materials Bubbles
Modality Individual, Family, Group

Introduction
Children with ASD tend to respond positively to bubbles. This intervention
uses bubbles in a fun and engaging way that promotes connection and rela-
tionship development skills. Body Bubble Target also incorporates social skill
development in the areas of noticing others and spatial awareness in regard
to personal body space.

Instructions
The practitioner explains to the child that they will be playing a game that
involves bubble blowing. The practitioner and child decide who will blow the
bubbles first. The other person will stand somewhere in the room and make a
circle target with his or her arms and hands. The bubble blower has to stand
a certain distance from the target. (The practitioner can decide the appropri-
ate distance.) The bubble blower tries to blow as many bubbles as he or she
can through the bubble target that the other person is making with his arms
and hands. After he or she has successfully blown several bubbles through the
target, the practitioner and child can switch roles.
The practitioner and child can keep switching roles and playing the inter-
vention throughout the whole session. Whoever is the target, can change the
target position to vary the game. Some examples might be making a circle in
front of the person, making a circle above the head, making a circle beside the
body, making the circle larger or smaller, etc.

Rationale
This intervention helps children work on connection and relationship devel-
opment, especially in the area of attuning to another person. This interven-
tion also works on spatial and body awareness and joint attention skills.
Parents can be taught how to implement this intervention at home and can be
encouraged to play with their child and involve other family members.
 Connection Interventions 157
Body Bubble Target
158 Connection Interventions
Bubble Tag

Target Area Connection (Relationship Development)

Level Child
Materials Bubbles
Modality Individual, Family, Group

Introduction
Bubble Tag incorporates two fun and engaging games for children—bubble
blowing and tag. Connection and relationship development skills as well as
social peer play skills are addressed in this intervention. Bubble tag works
well as in individual intervention but can also be played in a family or group
setting.

Instructions
The practitioner explains to the child that they are going to play a game of
tag using bubbles. The practitioner and child decide who will blow bubbles
first. That person will blow bubbles and try to tag (hit) the other person
with a bubble. The other person should move around the room and try to
avoid getting hit by any bubbles. Once the person is hit by a bubble, the two
switch roles. The game moves back and forth with each person tying to tag
the other person with bubbles until the practitioner ends the game. The game
can be lengthened by requiring a person to be tagged by a certain number of
bubbles; for example, decide that 10 bubbles have to hit he person before the
two switch roles.
This intervention should be played in a playroom or other room setting
where the space is somewhat restricted. It should not be played outside. Play-
ing outside or in a large space would make it very challenging for the bubble
blower to ever catch someone with the bubbles.

Rationale
This intervention helps children work on connection and relationship devel-
opment skills as well as social peer and group play. The child may prefer
to stay in one role such as the bubble blower, but the practitioner should
encourage the child to switch roles as each role addresses different skill areas.
Parents can be taught to implement this intervention at home and can be
encouraged to play with their child. The whole family can participate and
play with one bubble blower or assign multiple family members as bubble
blowers working together to tag the rest of the family.
 Connection Interventions 159
Bubble Tag
160 Connection Interventions
Flower, Rain, and Sun

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Individual

Introduction
Children with ASD often have challenges in attuning to and playing with another
person. This intervention promotes connection and relationship development as
well as joint attention and play skills with another person. Flower, Rain, and
Sun also promotes increasing comfort with physical touch and sensory process-
ing. It is a quick, easy, and fun intervention to implement with children.

Instructions
The practitioner explains to the child that they will be playing a game that
involves some physical touch. The practitioner may want to complete a dem-
onstration on a stuffed animal before implementing the intervention with the
child so the child is prepared for what will be happening. The practitioner
begins by making a fist and telling the child that the fist is a flower that wants to
grow. The flower needs sun and needs to be watered. The child should pretend
to give the flower water and sun. The practitioner then slowly opens his or her
fist and spreads his or her fingers out representing the flower blooming. The
practitioner tells the child that he or she can smell the flower, touch or feel the
flower, or pretend to pick a petal from the flower. The practitioner then pre-
tends to be a snapping flower and when the child touches or smells the flower,
the practitioner will gently close up his or her hand on the child’s finger or nose.
The practitioner and child can play the intervention several times growing
several new flowers. The practitioner and child can also switch roles, and the
child can pretend to make a flower. The practitioner will want to make sure
that he or she explains the game to the child before they begin so the child
is not startled by the practitioner implementing the snapping flower compo-
nent. If the child is uncomfortable with this element, it can be left out of the
intervention.

Rationale
This intervention helps children work on connection and relationship devel-
opment, especially in regard to attuning to another person, participating in a
reciprocal activity, and being comfortable with physical proximity and touch.
Parents can be taught to play this intervention with their child. This interven-
tion can be implemented with several other connection interventions, as most
connection interventions will not require much time to complete.
 Connection Interventions 161
Flower, Rain, and Sun
162 Connection Interventions
Hello Friend

Target Area Connection (Relationship Development)

Level Child
Materials None
Modality Family, Group

Introduction
This intervention is implemented in a family or group setting. Hello Friend is
a variation of the “Namaste” greeting in yoga for children with autism and
special needs. This intervention promotes connection and relationship devel-
opment as well as making eye contact, following instructions, and participat-
ing in a group. This intervention is adapted from Louise Goldberg’s Creative
Relaxation (Goldberg, 2013).

Instructions
The practitioner explains to the family or group that they will be implement-
ing a special greeting to each other that will be done in a unique format. The
family or group will form 2 circles, an inside circle and an outside circle.
The outside circle will be facing the people in the inside circle, and conversely
the inside circle will be facing the people in the outside circle. Each person
will begin by holding the hands of the person in front of them, so a person
in the inside circle will reach forward and hold hands with a person in the
outside circle.
Once everyone is holding someone else’s hands, each person will great the
other by saying “Hello friend” 3 times to the tune of “Three Blind Mice.”
Once Hello Friend has been said 3 times, the outside circle shifts to the right,
and now each person is facing a new person. They again hold hands and say,
“Hello friend” 3 times to the tune of “Three Blind Mice.” This continues
until the outside circle has shifted back to their original people.

Rationale
This intervention helps children work on connection and relationship devel-
opment as well as social skills, especially in the areas of physical touch, attun-
ing to other people, working as a group to accomplish a task, greeting another
person, and group peer play skills. This intervention works best with a larger
number of people, typically recommended for a family or group with at least
5 members. Practitioners can learn more about Louise Goldberg’s work at
www.yogaforspecialneeds.com.
Appendix
Additional Resources

Author’s Note: This chapter contains various assessment materials, forms, and
other useful worksheets that can be downloaded in a larger, printable format
from www.autplaytherapy.com/resources.

Feelings List
Accepted Afraid Affectionate Loyal
Angry Miserable Anxious Misunderstood
Peaceful Beautiful Playful Ashamed
Brave Awkward Calm Proud
Capable Quiet Bored Overwhelmed
Caring Relaxed Confused Cheerful
Relieved Defeated Comfortable Safe
Competent Satisfied Concerned Mad
Depressed Pressured Confident Provoked
Content Desperate Regretful Courageous
Silly Lonely Rejected Curious
Special Disappointed Remorseful Strong
Discouraged Disgusted Sad Sympathetic
Excited Embarrassed Shy Forgiving
Thankful Sorry Friendly Thrilled
Fearful Stubborn Nervous Stupid
Glad Understood Frustrated Good
Unique Furious Tired Grateful
Valuable Guilty Touchy Great
Hateful Happy Helpless Hopeful
Wonderful Hopeless Humorous Worthwhile
Unattractive Joyful Uncertain Lovable
Humiliated Uncomfortable Loved Hurt
Ignored Impatient Indecisive Inferior
Insecure Irritated Jealous Worried
164 Appendix: Additional Resources
Social Skills Checklist

NAME_______________________________DATE_____________

 Listening  Asking Questions

 Starting a Conversation  Smiling
 Ending a Conversation  Saying “Thank You”
 Introducing Self  Making Eye Contact
 Introducing Other People  Basic Boundaries
 Asking for Help  Following Instructions
 Apologizing  Asking Permission
 Sharing  Joining in a Group
 Helping Others  Taking Turns
 Appropriate Body Language  Appropriate Tone of Voice
 Understanding Personal Space  Two-Way Conversation
 Making and Maintaining Friends  Public Boundaries
 Handling Losing  Handling Winning
 Giving Instructions  Convincing Others
 Negotiating  Using Self-Control
 Handling Bullying  Giving Compliments
 Accepting Consequences  Managing Disagreements
 Recognizing Trouble Situations  Understanding Humor
 Completing Tasks without Assistance  Initiating Tasks
 Well-Rounded Play Skills  Problem Solving
 Flexibility  Advanced Boundaries
 Expressing Emotions Appropriately  Knowing Emotions
 Recognizing Emotions in Others  Expressing Affection
 Expressing Concern for Others  Handling Anxiety
 Emotion/Situation Appropriateness  Showing Compassion
 Handling Anger-Related Feelings  Avoiding Fights
 Dealing with Accusation  Standing Up for Others
 Self-Relaxation Techniques  Accepting “No”
 Other________________________________________________________
 Appendix: Additional Resources 165
Toys and Materials List

Functional Toys
Kitchen • Food • Dishes • Baby Dolls • Doll House • Miniature People
• Miniature Animals • Cars, Trucks, Boats • Bowling Set • Basketball Goal
• Cash Register • Doctor’s Kit • Tool Kit Blocks • Toy Phone • Toy Camera

Expressive Materials
Paper • Markers and Crayons • Paints • Play Doh Clay • Dry Erase Board and
Markers • Stickers • Beads • Ribbon • Pipe Cleaners • Confetti • Pom Poms
• Puppets • Dress Up Clothes and Hats • Mr. Potato Head • LEGOs

Sensory Toys
Sand Tray • Water Tray • Moon Sand • Kinetic Sand Rice or Bean Tray • Snow
Mobility • Sensory Balls • Theraputty • Tangle Toys • Sidewalk Chalk • Fidget
Toys • Musical Instruments • Slinky • Whirly Wheel • Koosh Ball • Magnets

Brain-Based Toys
Punching Bag • Hula Hoops • Bean Bags • Brain Puzzles • Balloons • Bubbles
• Ring Toss • Rubik’s Cube • Origami Kit • Mini Trampoline • Word Search
• Word Scramble • Seek and Find Games

Board Games
Find It • Bop It • Jenga • Chairs • Pick-Up Sticks • Jacks • Barrel of Monkeys
• Animal Logic • Blokus • Rush Hour • Twister • Spot It • Stare I Spy • Story
Cubes • Memory • Chicky Boom • Hed Banz
166 Appendix: Additional Resources
Play-Based Intervention-Tracking Sheet

Play-Based Target Area Date Child/Adolescent

Intervention Addressed Administered Response
(Emotional, Social,
Connection)
 Appendix: Additional Resources 167
Create-Your-Own-Technique Worksheet

Name of Technique:

Area(s) Addressed (circle all that apply): Emotional Regulation, Social Skills,
Connection Other:

Level (circle one): Child, Adolescent, Both

Modality (circle all that apply): Individual, Family, Group

Materials Needed:

Practitioners should be able to answer the following questions with a “yes”

response:

Is the technique directive?

Is the technique concrete and not a metaphor?

Does the technique address real situations/issues that the child is strug-
gling with?

Does the technique refer back to the child’s treatment goals?

Can the technique be adjusted from simple to more complex?

Does the technique take into account different developmental levels?

Is the technique low prop based?

Can the practitioner participate with and assist the child if needed?

Is the technique simple to explain and complete (not too many steps)?

Can the technique be taught to parents to implement at home?

168 Appendix: Additional Resources
Description of Technique:

Goals of Technique:

Additional Information:
 Appendix: Additional Resources 169
Apps for Autism and Developmental Disabilities

Meebie
This app assists children and adolescents in identifying emotions and vari-
ous degrees of expression using the Meebie doll and several accessory pieces.
Meebie provides a strong, engaging visual element to help with emotional
regulation ability.

Touch and Say by Interbots

This app helps children learn various skills, such as colors, numbers, and let-
ters, but also has an eye contact and feelings component. There is also a talk
component where the app will mimic what the child says. This app is visually
appealing and interactive.

Face-Cards
This app presents several different feelings that can be chosen, and an accom-
panying face is displayed showing the emotion. There is also an iGaze video
that helps work on making and maintaining eye contact. The emotions faces
are all female and provide good expressions.

Emotions Flash Cards for Kidz

This app presents several emotions categorized into three categories: positive,
neutral, and negative. When a feeling is selected, a flash card showing an ani-
mated face displaying the emotion appears. This app offers a thorough index
of emotion flash cards.

Autism Aide: Teach Emotions

This app focuses on the emotions of happy, sad, hurt, ashamed, anger, bored,
and scared. When a feeling is chosen, several different animated faces show-
ing the emotions are displayed. There is an option to record someone saying
the emotion word and an option to select background music.

Emotions (Teaching Tool for Speech and Language Development)

This app has five categories for helping with emotional regulation: 1) iden-
tifying pictures with emotions, 2) identifying emotions with a picture, 3)
identifying picture-based scenarios with an emotion, 4) identifying pictures
with labels based on scenarios, and 5) identifying pictures based on scenarios.
Children are given options to choose from, and the pictures are of real people
displaying emotions. This app is full of strong visuals and multiple ways to
learn emotional regulation.
170 Appendix: Additional Resources
ABA Flash Cards
This app goes through several flash cards displaying real people showing
emotions. When each flash card is presented, there is an auditory voice saying
what the feeling is. The pictures are very good, and there are several feelings
presented.

FeelingOmeter
This app uses a temperature gauge design to represent and help children learn
about various feelings and levels of feelings. Children can choose from several
feelings and choose colors to go with their feelings. Pictures can also be used
to help display feelings. This app provides several elements that all combine
together well to help children increase their emotional regulation ability.

Self-Regulation Training Board by Brad Chapin

This app helps children identify warning signs that correspond with a certain
feeling, the feeling itself, and a strategy that the child can do when he or she
is feeling the emotion. This app has a strong visual and seems appealing and
engaging.

Zones of Regulation
This app is a thoroughly developed app that has several levels (reminiscent
of popular video game design) and helps children learn about and develop
emotional regulation ability. There are several components, and each one has
strong visual elements and engaging levels for the child.

Stories2Learn
This app focuses on creating social stories. Several predesigned stories are
available for viewing. The predesigned stories can be edited, and there is the
option for creating your own social stories. This app is well designed and easy
to use for making and viewing social stories.

Language Lab Spin & Speak

This app displays a board game that works on social skills. Up to 5 players
can play at one time. This app addresses several social skills and is visually
engaging and fun.

Choiceworks
This app includes working on emotional regulation, a waiting timer display,
and a visual schedule. The components are all well represented and easy to
 Appendix: Additional Resources 171
follow with auditory prompts. There is a short accompanying book with each
component.

FindMe
This app is designed to help children improve their social and attention/con-
centration skills. Several scenes are presented that become increasing more
challenging in identifying the target person in the picture while several dis-
tractions are happening.

Kimochis Feeling Frenzy

This is a fun, playful, and engaging app that helps children distinguish
between positive and negative emotions and helps children identify various
emotions. There are four different levels so children can begin on an easy
level and progress to more challenging levels.

iTouchiLearn Feelings
This app presents several options for helping children learn about and identify
emotions. There is a feelings section where children can watch a feeling being
performed and identify what feeling is being displayed. There is a games sec-
tion with various interactive games that work on feeling identification, and
there is a music section that presents feelings through music.

Puppet Pals
This app presents several stages (scenes) to choose from and several differ-
ent characters to choose from to create your own puppet show. Children can
record the story using their own voice and then watch the story back. Prac-
titioners can also record stories made specifically for children and have the
children watch the stories. There is also a Puppet Pals II.

Story Maker
This app allows children to create their own stories with audio and pictures.
Several pictures are provided, and personal pictures can be used. This app is
easy to use with lots of options. Practitioners can also create stories designed
specifically for the children they work with.

CBT4Kids
This app was developed by two clinical psychologists and provides a fun,
engaging, and informative approach based on cognitive behavioral therapy.
Practitioners can enter in actual children and track their progress. There are
several interactive tools such as a relaxation and breathing game.
172 Appendix: Additional Resources
Time Timer
This is a simple but effective app. A timer is displayed that represents 1 hour.
Users can select how much time they want put on the timer, and the time
counts down with a red visual. This is a very useful app for parents and prac-
titioners who want to use a strong visual aid to help children stay on task and
understand amounts of time.

ZoLo
This app presents various shapes and sounds that children can manipulate
to create fun and whimsical designs and play sculptures. There is a strong
creative and sensory component that is very engaging.
 Appendix: Additional Resources 173
Internet Resources

Play-Based Treatments
AutPlay Therapy, www.autplaytherapy.com
Autism Movement Therapy, www.autismmovementtherapy.com
The Theraplay Institute, www.theraplay.org
Filial Therapy, www.play-therapy.com
RePlays, www.drkarenlevine.com
Floortime, www.stanleygreenspan.com
The Play Project, www.playproject.org
Creative Relaxation, www.yogaforspecialneeds.com
Social Stories, www.thegraycenter.org
Do 2 Learn, www.do2learn.com
Model Me Kids, www.modelmekids.com
The Social Express, www.thesocialexpress.com
Liana Lowenstein, www.lianalowenstein.com

Toys/Games/Supplies
The Self Esteem Shop, www.selfesteemshop.com
Child’s Work Child’s Play, www.childswork.com
Child Therapy Toys, www.childtherapytoys.com
Play Therapy Supply, www.playtherapysupply.com
Therapy Shoppe, www.therapyshoppe.com
Therapro, www.therapro.com
Fun and Function, www.funandfunction.com
Fat Brain Toys, www.fatbraintoys.com

Organizations and Resources

One Place for Special Needs, www.oneplaceforspecialneeds.com
The Missouri Autism Report, www.moautismreport.com
Children with Special Needs, www.childrenwithspecialneeds.com
Autism Society of America, www.autism-society.org
National Autism Association, www.nationalautismassociation.org
HollyRod Foundation, www.hollyrod.org
Association for Science in Autism Treatment, www.asatonline.org
Families for Early Autism Treatment, www.feat.org
Autism Consortium, www.autismconsortium.org
CHADD, www.chadd.org
ADDitude, www.additudemag.com
National Fragile X Foundation, www.fragilex.org
FRAXA, www.fraxa.org
National Tourette Syndrome Association, www.tsa-usa.org
National Down Syndrome Society, www.ndss.org
174 Appendix: Additional Resources
Down Syndrome Research Foundation, www.dsrf.org
Apraxia-KIDS, www.apraxia-kids.org
NADD, www.thenadd.org
American Assoc. on Intellectual and Developmental Disabilities, www.aaidd.org
The ARC, www.thearc.org
Association for Play Therapy, www.a4pt.org
Play Therapy International, www.playtherapy.org
British Association of Play Therapists, www.bapt.info
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Index

ABA see applied behavioral analysis Construction Feeling Faces 24–5

Aluminum Wrap 140–1 Coplan, J. 14
The Always Changing Picture 64 Cox, E. 7
Angry Yes, Calm Yes 42–3 Crawling Crabs 132–3
Anxiety Buster Toolbox 59 Cross, A. 7
Anxiety Mometer 60–1
applied behavioral analysis (ABA) Dawson, G. 13
14, 16 developmental disorder interventions
Association for Play Therapy: “Paper 4–5; easily implemented across
on Touch” 15 environments 4; low prop based
attachment relationship 10 4; simple in instruction 4; targeted
atypical 15 toward specific skill acquisition 5
AutPlay Therapy 3–4, 11 Dienstmann, R. 13
Draw My Feelings Face 30–1
Bean Bag Toss 26–7
Body Bubble Target 156–7 emotional regulation 11–2, 17; see also
Booth, P. B. 10, 14 The Always Changing Picture; Angry
Break Out 116–17 Yes, Calm Yes; Anxiety Mometer;
Bubble Tag 158–9 Bean Bag Toss; Calm Down Postcards;
bullying 2; see also Bully in the Way Construction Feeling Faces; Draw My
Bully in the Way 85–6 Feelings Face; Emotion Mane; Feeling
Fortune Tellers; Feeling List Stop
Calm Down Postcards 62–3 Game; Feelings Beach Ball; Feelings
Candy Questions 73 Card Sort; Feelings Don’t Break the
Centers for Disease Control 2 Ice; Feelings Pick-Up Sticks; Feelings
connection interventions 14–15, 30, Puzzle; Feelings Quiz; Feelings Spinner
113; see also Aluminum Wrap; Body Game; Happy Me, Sad Me; Heart
Bubble Target; Break Out; Bubble Parts; Home and School; LEGO
Tag; Crawling Crabs; Family Spin; Emotion House; Paint Swatch Degrees
Feeling Card Find It; Fishy and Shark; of Feelings; Paper Feeling Balloons;
Flower, Rain, and Sun; Hand and Spon-Play-Ity; Write a Feelings Story
Find; Hands, Hands, Hands; Hello Emotion Mane 40–1
Friend; I Am a Tree, We Are a Family;
Iguana Walk; Magnify Me; My Family Spin 144–5
Measurements; Obstacle Course; Our Feelings Beach Ball 20–1
Unique Greeting; Ring around Me; Feeling Card Find It 120–1
Sand Games; Sculpture; Silhouette; Feeling Fortune Tellers 48–9
Silly Glasses; Squiggle Drawing Gift; Feeling List Stop Game 56–7
Together Balloons; Turn Around and Feelings Card Sort 44
Make a Face Feelings Don’t Break the Ice 36–7
180 Index
Feelings Pick-Up Sticks 18–19 of 7–8; practitioner role and level of
Feelings Puzzle 50–1 involvement 8–9; psychoeducational
Feelings Quiz 45 model 9; tracking sheet 16
Feelings Spinner Game 28–9 power of play 7–8
Fishy and Shark 128–9 practitioner role: level of involvement
Flower, Rain, and Sun 160–1 8–9; -play 66, 97
Friend Collage 66–7 Prevention Role-Play 105–7
Friend Mapping 74–5 psychoeducational model 5, 9

Grant, R. J. 9 Quiet Loud 108–9

Hands, Hands, Hands 136–7 relationship development: Aluminum

Happy Me, Sad Me 38–9 Wrap 140; attachment 10; Body
Heart Parts 32–3 Bubble Target 156; Break Out 116;
Heflin, L. J. 13 Bubble Tag 158; connection 14–15,
Hello Friend 162 30, 114, 116, 118, 120, 122, 124,
Hide and Find 149–50 126, 128, 130, 132, 134, 136,
Home and School 34–5 138, 140, 142, 144, 146, 147, 149,
141, 153, 155, 156, 158, 160, 162;
I Am a Tree, We Are a Family 155 Crawling Crabs 132; Family Spin 144;
Iguana Walk 118–19 Feeling Card Find It 120; Feelings
I’m Going 88–9 Card Sort 44; Fishy and Shark 128;
Instruction Puzzle 83–4 Flower, Rain, and Sun 160; Friend
Interview Me 90–1 Mapping 74; Hands, Hands, Hands
136; Hello Friend 162; Hide and Find
Jernberg, A. M. 10 149; I Am a Tree, We Are a Family
155; Iguana Walk 118; Magnify Me
Kuypers, L. 12 130; My Measurements 153; Obstacle
Course 114; Our Unique Greeting
Laushey, K. 13 146; rapport 3, 7, 9; Ring around
LEGO Emotion House 22–3 Me 122; Sand Games 124; Sculpture
Let’s Practice Conversation 72 138; Silhouette 142; Silly Glasses 134;
Lindaman, S. 14 Squiggle Drawing Gift 151; Three
Foam Dice 103; Together Balloons
Magnify Me 130–1 147; Turn Around and Make a Face
McPartland, J. 13 126
Moor, J. 7 Ring around Me 122–3
My Measurements 153–4 role-play 32, 34, 42, 56, 59, 60, 66, 81,
85, 88, 93, 95–6, 97, 101, 105–7; see
neurotypical 15; peers 7, 85; play 2 also Prevention Role-Play; Role-Play
Role-Play 95–6
Obstacle Course 114–15 Roll of the Dice 97–8
Our Unique Greeting 146
Ozonoff, S. 13 Sand Games 124–5
School Rules 110–1
Paint Swatch Degrees of Feelings 52–3 Sculpture 138–9
Paper Feeling Balloons 54–5 Sherratt, D. 7
Paper Friend 81–2 Silhouette 142–3
parental involvement 3, 4, 5, 9–10, 14 Silly Glasses 134–5
patterns: behavior 1, 9; thinking 7 Social Media 87
Peter, M. 7 Social Media Friend, Foe, or Other 99
play-based interventions 2–4, 5, Social Scales 68–9
15; emotional regulation 12; social skills and functioning 12–13,
implementing directive 7–10; 65; see also Bully in the Way; Candy
parental involvement 9–10; power Questions; Friend Collage; Friend
 Index 181
Mapping; I’m Going; Instruction structure 3, 7, 8, 10
Puzzle; Let’s Practice Conversation; Symbolic Play Time 80
Paper Friend; Prevention Role-Play; symptoms 1–3
Quiet Loud; Role of the Dice; Role-
Play; School Rules; Social Media; Take It to the Jude 102
Social Media Friend, Foe, or Other; That Does Not sound the Way It Looks
Social Scales; Social Skills Fortune 92
Tellers; Social Skills Puzzle; Stepping Theraplay 4
Stone; Symbolic Play Time; Take It Thornton, K. 7
to the Judge; That Does Not Sound Three Foam Dice 103–4
the Way It Looks; Three Foam Dice; Together Balloons 147–8
Tweet, Tweet, Tweet; What Am I? treatment planning and goal setting
Social Skills Fortune Tellers 100–1 3–4
Social Skills Puzzle 70–1 Turn around and Make a Face 126–7
Spon-Play-Ity 58 Tweet, Tweet, Tweet 93–4
Squiggle Drawing Gift 151–2
Stepping Stones 78–9 What Am I? 76–7
Stillman, W. 13 Write a Feelings Story 46–7