How do Speech Pathologists work on social communication?

What is a social communication disorder?

A social communication disorder refers to any difficulty experienced with social communication and interaction.

This comprises of:

1. Non verbal communication skills, such as:

Body language

Gesture

Posture

Eye contact

Facial expression

2. Verbal communication skills, such as:

Starting conversations

Asking questions to maintain a conversation

Taking turns in a conversation

Making comments 

3. Social cognition, such as:

Theory of mind: The ability to put yourself in someone else’s shoes and realise that they may have beliefs, attitudes and feelings that contrast to your own.

Metalanguage: Understanding humour, jokes, sarcasm, metaphors and inferences.

Self-monitoring: The ability to recognise when you are behaving inappropriately, and knowing how to adjust your behaviour and communication accordingly.

Joint attention: The ability to focus on an object or event with another person, because you are both interested in it. 

Emotional regulation: The ability to control and manage your emotions, as opposed to behaving negatively such as having a tantrum or becoming upset. 

4. Social interaction, such as:

The ability to adjust your style and manner of communication depending on who you are talking to and where you are e.g. talking to a peer vs talking to a teacher. 

Using manners. 

The ability to resolve conflict when it arises in group play. 

The ability to participate and take turns in play with other children. 

What causes social communication disorder?

Social communication disorder can exist either:

1. On its own,

2. As a result of a diagnosis, such as:

Autism Spectrum Disorder

Specific Language Impairement 

How do I know if my child has social communication issues?

Attached is a helpful link from the American Speech and Hearing Association (ASHA). The link will take you to a table that details the expected social communication skills a child should be acquiring at each stage of development. http://www.asha.org/uploadedFiles/ASHA/Practice_Portal/Clinical_Topics/Social_Communication_Disorders_in_School-Age_Children/Social-Communication-Benchmarks.pdf

If your child is not meeting these expectations, or you are concerned about your child’s development, please seek the support of a speech pathologist in your local area. Alternatively, give ChildThink a call, we would love to help your child.

How does a speech pathologist manage social communication issues?

There are many ways to manage social communication issues. What a speech pathologist selects will depend on a number of factors including the client’s age, interests, strengths, weaknesses and needs. Below is a list of some commonly used treatments that help to:

Decrease unwanted behaviours (e.g. tantrums)

Increase alternate positive behaviours (e.g. sharing)

Give your child the opportunity to practise target social skills 

Behavioural Interventions:

Positive Behaviour Support

This intervention aims to decrease the frequency of unwanted behaviours by eliminating the triggers and reinforcers of those behaviours. It also involves shaping unhelpful behaviours into positive behaviours through praise and encouragement. As you can see, this intervention focuses on positive reinforcement, rather than punishing children when they perform unwanted behaviours.

Shaping

This intervention involves using items that your child is motivated by to support them in developing a skill. When your child attempts a certain skill, they are then praised and encouraged for their attempt, even if they did not execute the skill perfectly. This will encourage them to attempt the skill at another time.

Incidental teaching

This intervention involves creating opportunities for your child to practise a skill. For example, placing your child’s favourite toy/object just out of the reach (e.g. putting a teddy up on a high shelf, putting the lid back onto a container of playdough). You then wait for your child to ask for that object, or say the word you are targeting, and then give them the toy or object to reinforce their attempt.

Social communication treatments

Social stories

Commonly used for children with Autism Spectrum Disorder, this method involves identifying situations where the child has behaved inappropriately and creating a story surrounding the event. The story is used to teach the child about what the appropriate behaviour is in that situation and why.

Social skills groups

This intervention involves role playing and practising various social skills with others in a group e.g. introducing yourself, starting a conversation.

Intervention at school or preschool

This involves entering the learning environment of the child (preschool, primary school etc.) and conducting therapy in that setting. Intervention involves modelling friendship and conversational skills in the playground and having children practise these skills with their peers. Practising social skills in this context teaches children about the function of and reason behind learning these skills.

Puppets

This intervention involves using puppets to model social situations and appropriate social skills. Using puppets is a fun and engaging experience for children. Based on this, children are more likely to remember and attempt to use these skills in situations they come across.

Client profile: Josh (not the client's real name).

Dr Jenny identified social communication as one of Josh's areas of need based on completing a comprehensive assessment of his strengths and weaknesses. This included visiting Josh at his school and analysing how he communicated and interacted with his fellow peers. Dr Jenny is specifically working on Josh's ability to:

Give people eye contact

Greet people without having to be reminded

Make comments and ask questions when talking to others

Identify emotions (angry, sad, happy etc.) 

Dr Jenny is working on Josh’s social communication skills by using lots of fun and engaging activities. In one session, Josh practised his conversational skills by talking to one of Dr Jenny’s friends- Snailius the puppet! Dr Jenny helped Josh to ask Snalius questions and give him eye contact. This is a functional way of teaching social communication, because Josh is practising social skills in the context of a social interaction.

Dr Jenny also taught Josh about feelings using soft toys. Each toy had a distinct facial expression that represented a certain feeling or emotion. Dr Jenny prompted Josh to name each of the feelings and then feed them to Snalius the puppet. Feeding the toys to the puppet is a fun and engaging way to teach children about emotions. Learning about emotions is also highly beneficial for children. It can improve:

Their ability to recognise how others may be feeling (show empathy).

Their own behaviour, as they can name the emotion they are feeling, rather than becoming upset or displaying unwanted behaviours. 

Amelia Laurendet ChildThink Intern (Fourth year Student Speech Pathologist-Honours)

Reference List

http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934980§ion=

Overview Teach skills with puppets. (2013). ASHA Leader, 18(3), 9.

Bozkus-Genc, G., & Yucesoy-Ozkan, S. (2016). Meta-analysis of pivotal response training for children with autism spectrum disorder. Education and Training in Autism and Developmental Disabilities, 51(1), 13.

Horasan, M. M., & Birkan, B. (2015). The effects of incidental teaching on teaching children with autism spectrum disorders to demand their lost objects verbally. International Journal of Early Childhood Special Education, 7(2), 361. doi:10.20489/intjecse.65571

Jones, S. (2014). How positive behaviour support can reduce challenging behaviour. Learning Disability Practice (2014+), 17(10), 36. doi:10.7748/ldp.17.10.36.e1605

Karkhaneh, M., Clark, B., Ospina, M. B., Seida, J. C., Smith, V., & Hartling, L. (2010). Social stories™ to improve social skills in children with autism spectrum disorder: A systematic review. Autism, 14(6), 641-662. doi:10.1177/1362361310373057

Kasari, C., Dean, M., Kretzmann, M., Shih, W., Orlich, F., Whitney, R., . . . King, B. (2016). Children with autism spectrum disorder and social skills groups at school: A randomized trial comparing intervention approach and peer composition. Journal of Child Psychology and Psychiatry, 57(2), 171-179. doi:10.1111/jcpp.12460