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Good Buddies Group

by Sarah Lemke, MSOT, OTR/L


At Hope RISING Clinic, we serve children with prenatal substance exposure and their families. Children exposed to alcohol and other substances while in utero experience significant lifelong impacts on their daily lives. These impacts manifest in permanent brain-based, structural neurological differences which affect how they think, move their bodies, process sensory information, manage emotions, read social cues, and plan for the future. The physical impacts of prenatal substance exposure are often “invisible” and are unnoticed.

Children are labeled as “bad” or “defiant” when in reality, they cannot meet the demands of their world. Unfortunately, much of the greater community is unaware of the drastic impacts of this in-utero exposure due to limited research, media coverage, and global awareness. Our unique clinic prides itself on offering “all four CDC-recommended FASD interventions,” with Good Buddies being one of those evidence-based programs, but what is it?

Good Buddies is a group-based intervention focused on developing and maintaining friendships. Many children with prenatal substance exposure (PSE) struggle to interact appropriately with peers, make friends, and in turn, are challenged to maintain lasting relationships. Project Good Buddies (Primary Researcher: Mary J. O’Connor, PhD, ABPP. University of California, Los Angeles) was developed to support children with prenatal substance exposure and FASD (Fetal Alcohol Spectrum Disorders) in making and maintaining friendships. Its success has been examined and supported by many research studies. This summer, we were thrilled to pilot this program for the Hope RISING Clinic and offer a 12-week virtual group for children and their caregivers.

I was privileged to co-facilitate our Child Group with speech-language pathologist Callie Swayze and partner with Parent Group facilitators Alex Tarasar and Tiara Huffaker. We adapted the in-person group curriculum to the virtual environment while striving to maintain the program’s core values of teaching communication skills, peer entry techniques, and play strategies. At the same time, we wanted to create a space for caregivers to reflect on and find camaraderie in the challenges of raising a socially aware child with prenatal substance exposure.

If I asked our participants to recount the highlights of our weekly group sessions, I am sure that this fun, clever, and rambunctious group would choose One Night Ultimate Werewolf. While I hope that our participants gained foundational friendship skills throughout our time together, I was also pleasantly surprised by the unexpected lessons I learned along the way:

  • Our kids are good sports – I observed how unexpected circumstances created a window for teamwork. When trying to play our favorite game, one of our friends became frustrated, and their group members encouraged them to overcome their frustration, communicate their needs, and rejoin our activity.
  • Our kids are insightful – I was struck by our group’s growing awareness of themselves and others. Our kids are sensitive to gender differences and are passionate about LGBTQIA+ inclusion.
  • Our kids are empaths – I saw how the feelings of our friends can impact how we view and communicate the world around us.
  • Our kids are supported – I learned how families practiced skills, coached kids for social successes, and adapted expectations to accommodate playdates and sleepovers in their homes.
  • Our kids are vulnerable – Each week, our group members boldly shared themselves with their peers, trying new activities, challenging one another, and encouraging each other throughout our time together.
  • Our kids are assertive – I heard from parents about how group members are no longer afraid to speak up or confront their peers for their wrongdoings.
  • Our kids are friends – I was overjoyed to arrive at the Child Group to see the children who had arrived before the facilitators discussing their shared interests.

Over these few weeks, this group has empowered caregivers and children alike. I look forward to hearing how our group members continue to introduce themselves to peers, respond kindly when they lose, and stand up for someone teased at recess. As Good Buddies grows, I am excited to see how this program will continue creating a positive impact on families in our communities.

About the author: Sarah Lemke, MSOT, OTR/L, is an occupational therapist at Hope RISING Clinic for Prenatal Substance Exposure. Sarah earned her master’s degree in occupational therapy from Eastern Michigan University. She was drawn to occupational therapy by its creative opportunities to support children of all ages and their families. Sarah has most enjoyed her experiences in pediatric mental health, developing resources to educate and empower families. She also enjoys traveling, yoga, and caring for her plants and her rambunctious cat.


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