PALS Social Skills Group Helps Ellie Make New Friends

During the semester-long program, a class of eight participants of similar ages works together on learning things like creating and maintaining friendships, practicing conflict resolution and problem solving, and engaging in conversations.

Children in the PALS social skills group
Published in Johns Hopkins All Children's Hospital - Spring 2023

Ellie was struggling. Now 6 years old, her autism, ADHD and epilepsy interfered with her social skills and hampered her ability to develop friendships. 

When it became obvious to Ellie’s mom, Lauren, that she needed help learning social and coping skills, Lauren started looking for some kind of program that would help her daughter. While doing an internet search, she read about the Johns Hopkins All Children’s PALS Social Skills Group in St. Petersburg, Florida. PALS stands for pragmatic acquisition of language skills. An age-appropriate social skills group for children ages 5-17. Most have been diagnosed with autism or ADHD.

“These kids are really smart. They understand everything at age level, but they struggle to relate to their peers,” says Brianna Puentes, a speech-language pathologist who leads the PALS groups at the hospital. “These are the kids who are not being invited to birthday parties or may be getting bullied in school because of their difficulty with social skills. They also tend to get upset when they don’t get to be first in line or lose while playing group sports or games. Social difficulties really impact them from making and keeping friends.”

During the semester-long program, a class of eight participants of similar ages, works together to learn how to create and maintain friendships, interpret facial expressions and body language, practice conflict resolution and problem solving, working on teams and engaging in conversations. They also learn to understand empathy and how to apologize and accept criticism.

“I use a variety of tools to teach these skills,” Puentes says. “Things like role-playing, practicing with peers, naturally occurring events, video monitoring, reward systems and games, are just a few things we do in our group each week.”

The group setting works best for Ellie to practice these skills because she is around other kids, says Puentes. “Coaching her through difficult social interactions in real-time is key. This helps her learn how to interact and regulate herself in different situations, which will help her make and keep friends.”

Watching on a monitor in another room, Lauren can see the PALS group in action and Ellie’s progress. “I like that because I can see the skills that I need to help her with at home,” Lauren says.

“There are very few programs like PALS available to help kids like Ellie,” Puentes says. “We are always evaluating kids to see if they qualify to participate in the PALS program. If they do, we aim to ensure they can begin in a group within six months. The demand is high.”

Thanks to a donor-funded grant through the Johns Hopkins All Children’s Foundation, when spots are available, patient families don’t need to worry about the cost. If a family is unable to meet an insurance co-pay or to self-pay if PALS isn’t covered, the grant makes up the difference.

After just a few months in PALS, Lauren says the program has been a good fit for Ellie. “Oh my gosh, she loves it. It’s the highlight of her week,” Lauren says. “She loves coming to PALS. She calls it doctor therapy. Since it’s at the hospital and her group wears masks.”

“Ellie has finally started to make some friends, thanks to PALS,” Lauren says. “She’s learning to take turns and is playing better at home with her brother and sister.” Lauren says she found it interesting and a bit humorous that Ellie gained a new unexpected friend when she started talking to the family’s Amazon Alexa device. She will say, “Alexa, are you my friend?” To which Alexa replies, “Yes! I’m your friend.” In another exchange, Ellie tells Alexa, “You’re beautiful.” To which Alexa replies, “Thanks for making my day.” It was positive feedback she needed to hear. Before PALS, Lauren says Ellie would have never taken the initiative to start a conversation with anyone, including Alexa.

Programs like PALS are supported through funding from generous donors in the community. To learn more about ways you can help kids like Ellie, please reach out to our Foundation team.