There are many factors that can affect a child's social skills, interactions, and social-emotional behaviors, such as:   

• Sensory modulation disorders such as tactile defensiveness, gravitational insecurity, auditory defensiveness, sensory seeking, etc. Sensory modulation problems can affect a child's ability to interpret messages in the environment, and children with sensory defensiveness are usually more sensitive, more easily stressed and anxious, and therefore appear more withdrawn or agitated in social situations.
• Poorly regulated arousal level: Children with a high arousal level often become over-excited or over-stressed in response to changes in their environment, resulting in a lack of control over their behavior in social situations, or too nervous and withdrawn. Children with a low arousal level are often in a trance, or too absorbed in their own world to participate well in social situations. Whether the arousal level is high, low or fluctuating, the child will not be able to socialize appropriately.
• Poor emotional regulation, e.g. gets angry easily when playing games with peers, argues with others, etc.
• Poor impulse control, e.g. snatching toys, not waiting in line, interrupting, etc.
• Low frustration tolerance, e.g. cannot lose in games, refuses to play with others if they lose, etc.
• High level of persistence, stubbornness, inflexible thinking, e.g. unable to discuss game rules with peers, insists on own opinions.
• Poor problem-solving skills, e.g. not knowing what to do when you disagree with your peers, or communicating in inappropriate ways (e.g. shouting, a bad attitude).
• Lack of empathy, e.g. ridiculing the loser when they win a game, calling others stupid, etc.
• Lack of (positive) interaction with peers, e.g., an only child who has no regular playmates.
• Lags behind peers in comprehension or expression skills, which may result in conflicts with peers when playing games or when peers do not want to play together because they do not understand the rules of the game or cannot express their ideas properly.
• Lack of social thinking skills, e.g. not thinking about others, not seeing things from other people's perspectives, not knowing enough about the unspoken rules of society.

The occupational therapist will first assess and deal with the child's individual situation during individual sessions. After the child's situation has gradually improved and stabilized, For children who need social skills training, the therapist will discuss with other therapists if there are children who are suitable for group classes and form small groups of 2-6 people to  practice interpersonal skills, interaction and problem solving skills, as well as build up children's self-confidence, empathy, frustration tolerance and emotional regulation, so that children can gradually be equipped with the ability to cultivate good interpersonal relationships.