Social-Pragmatic Skills and Autism Spectrum Disorders

December 17, 2012

Social pragmatic skills help individuals engage in social interaction with others. Many of us grasped the unwritten rules that govern our behavior in the social environment early on in our lives. However, individuals with Autism Spectrum Disorder (ASD) have difficulties learning these rules. In fact, social-pragmatics is often considered a core challenge for these children. The “hidden” social expectations can make social interaction a confusing experience. Therefore, many professionals and parents may want to help children with ASD develop a variety of skills that fall within the social-pragmatic realm. Nonetheless, before we start, we need to first sort out important conversational skills and find ways to assess children’s performance.

Social pragmatic skills involve not only one’s ability to communicate intent, but also knowledge of discourse management, register variation, presupposition, and other social skills. Discourse Management involves managing the conversation to keep it flowing and effective. Conversation partners need to agree on turn allocation, which involves identifying turn-taking opportunities and limiting one’s talking to one’s turn. They stay on the topic unless there is a signal by a communication partner that he/she is going to change the topic. Knowledge of topic maintenance includes knowing how to smoothly switch to a new topic. When conversation breakdown occurs, one needs to recognize it and use subsequent repair strategies such as repeat, rephrase, or adding information to aid communication. Register variation includes politeness/social role recognition, as people change their word choices, sentence forms, vocal tone and gestures/body posture to adjust to social roles in various discourse patterns. Presupposition, or perspective-taking, involves making assumptions about what other people know. People learn to understand everyone has different thoughts, feelings, and experiences, and take this into account during the conversation. Paralinguistics refers to the use of prosody, gaze, gestures, and physical proximity to show interest in the interaction, convey different layers of meanings and monitor the nonverbal communication of the partner. Social behaviors involve use of facial expressions, conventional gestures, and social actions that are expected in one’s culture, such as dressing appropriately for an occasion, offering to share something, assisting someone who needs help, patiently waiting for a turn in a game, etc.

Children with ASD may be able to fluently express their intention, but they often face difficulties in their social interaction with lack of proficiency of more than one skill listed above.

Assessing pragmatic skills can be a challenge since conversations are dynamic, and there is no easy way to measure one’s performance via standard tests. Formal assessment which involves static, often pictured situations can be used to establish a starting point, but information collected through observation, interview, and check lists helps us to detect if the individual lacks the knowledge to manage such conversations or is merely experiencing a performance issue. If needed, specific situations can be created to probe particular skills. Information from more than one source is necessary to establish goals and priorities for intervention.

Several key components need to be considered as we develop an individualized treatment program for children with ASD. These include the child’s knowledge about social communication, his/her ability to apply social knowledge in various situations, the cognitive/emotional cost to the child, the need to find right strategies to specific challenges, the co-occurring elements in the planning/implementation stages of social interaction, plans to generalize learned skills, self-monitoring skills that promote independence and flexibility, etc. Interventionists should also consider what skills are easiest/most important to teach, which skills can be paired together, and which skills will make the biggest impact in terms of improving social interaction. Many tools and programs have been developed for improving social interaction in this population. For example, social groups and social stories help children with ASD to experience different social roles and social situations, expand their knowledge of social skills, give them examples of strategies they can use, and offer them opportunities to practice social-pragmatic skills in a low-stress environment. While the SLP may lead intervention, family members and school teachers can also provide additional learning opportunities throughout the day to help children monitor their newly learned skills.

Information taken from:

http://www.autismsupportnetwork.com/news/meeting-challenge-social-pragmatics-students-autism-spectrum-887512

– Chloe Chenjie Gu, MA., Speech-Language Pathology Intern

– Kristina Elliott, MA, CCC-SLP

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How can parents help their children to develop good social skills? The 4 P’s!

November 16, 2012

As children get older, they become part of a larger social world. They begin to form relationships with other children and adults in school as well as outside of school. Being sociable helps us with resilience (the ability to withstand hard times). Children who are constantly rejected by peers are lonely and have lower self-esteem. Parents can help their children learn social skills so they are not constantly rejected or begin to bully and reject others.

Parents can act as coaches for their children to develop these social skills. Children learn a lot from how parents treat them and when they observe how parents interact with others. The American Academy of Pediatrics recommends that parents use a 4-part strategy when helping their children develop social skills; Practice, Praise, Point out, and Prompt. These four steps can be used when parents notice that a child needs to work on a particular social skill. Before using them, however, the parent should point out the problem area sensitively and privately (not in front of others) to the child.

Practice: You can help your child substitute a specific appropriate response for a specific inappropriate one. This might mean brainstorming with the child about different alternative responses and then practicing one or more with the child. Practicing can involve mapping out actual words to say or behaviors to use, role-playing, and using the newly learned skills in real situations.

Praise: Reward your child with praise when the new skills are practiced as a way of helping the skills become habits. This might be a specific verbal statement (“You did an awesome job of X instead of Y when you got angry at the store”), a nonverbal sign such as a thumbs up, or even a treat (10 minutes extra play time before bed).

Point Out: Parents can use opportunities to point out when others are using the desired skill. It might be a specific behavior of the parent, another adult, a child, or even a character in a book or on TV. The idea is to give children examples and role models of people engaging in the appropriate social skill.

Prompt:  Without nagging, parents can gently remind their child to use a new skill when the opportunity arises. This might be verbal (“Now might be a good time to count to ten in your head”) or nonverbal (a nonverbal cue such as zipping the lips when a child is about to interrupt).

Good coaches know that patience is important because learning new skills takes time and practice. It is important to remember that the ability to have good social relationships is not simply about personality or in-born traits. People who get along with others have learned skills to do so, and they practice these regularly.

 

Information gathered from Angela Wiley, Ph.D., “Importance of Teaching Social Skills to Children” and AmericanAcademy of Pediatrics

Sarah Peters, M.A., CCC-SLP


Social-Pragmatic Skills and Autism Spectrum Disorders

November 10, 2012

Social-Pragmatic skills help individuals engage in social interaction with others. Many of us grasped the unwritten rules that govern our behavior in the social environment early on in our lives. However, individuals with Autism Spectrum Disorder (ASD) have difficulties learning these rules. In fact, social-pragmatics is often considered a core challenge for these children. The “hidden” social expectations can make social interaction a confusing experience. Therefore, many professionals and parents may want to help children with ASD develop a variety of skills that fall within the social-pragmatic realm. Nonetheless, before we start, we need to first sort out important conversational skills and find ways to assess children’s performance.

Social-Pragmatic skills involve not only one’s ability to communicate intent, but also knowledge of discourse management, register variation, presupposition, and other social skills. Discourse Management involves managing the conversation to keep it flowing and effective. Conversation partners need to agree on turn allocation, which involves identifying turn-taking opportunities and limiting one’s talking to one’s turn. They stay on the topic unless there is a signal by a communication partner that he/she is going to change the topic. Knowledge of topic maintenance includes knowing how to smoothly switch to a new topic. When conversation breakdown occurs, one needs to recognize it and use subsequent repair strategies such as repeat, rephrase, or adding information to aid communication. Register variation includes politeness/social role recognition, as people change their word choices, sentence forms, vocal tone and gestures/body posture to adjust to social roles in various discourse patterns. Presupposition, or perspective-taking,involves making assumptions about what other people know. People learn to understand everyone has different thoughts, feelings, and experiences, and take this into account during the conversation. Paralinguistics refers to the use of prosody, gaze, gestures, and physical proximity to show interest in the interaction, convey different layers of meanings and monitor the nonverbal communication of the partner. Social behaviors involve use of facial expressions, conventional gestures, and social actions that are expected in one’s culture, such as dressing appropriately for an occasion, offering to share something, assisting someone who needs help, patiently waiting for a turn in a game, etc.

Children with ASD may be able to fluently express their intention, but they often face difficulties in their social interaction with lack of proficiency of more than one skill listed above.

Assessing pragmatic skills can be a challenge since conversations are dynamic, and there is no easy way to measure one’s performance via standard tests. Formal assessment which involves static, often pictured situations can be used to establish a starting point, but information collected through observation, interview, and check lists helps us to detect if the individual lacks the knowledge to manage such conversations or is merely experiencing a performance issue. If needed, specific situations can be created to probe particular skills. Information from more than one source is necessary to establish goals and priorities for intervention.

Several key components need to be considered as we develop an individualized treatment program for children with ASD. These include the child’s knowledge about social communication, his/her ability to apply social knowledge in various situations, the cognitive/emotional cost to the child, the need to find right strategies to specific challenges, the co-occurring elements in the planning/implementation stages of social interaction, plans to generalize learned skills, self-monitoring skills that promote independence and flexibility, etc. Interventionists should also consider what skills are easiest/most important to teach, which skills can be paired together, and which skills will make the biggest impact in terms of improving social interaction. Many tools and programs have been developed for improving social interaction in this population. For example, social groups and social stories help children with ASD to experience different social roles and social situations, expand their knowledge of social skills, give them examples of strategies they can use, and offer them opportunities to practice social-pragmatic skills in a low-stress environment. While the SLP may lead intervention, family members and school teachers can also provide additional learning opportunities throughout the day to help children monitor their newly learned skills.

 

Information taken from:

http://www.autismsupportnetwork.com/news/meeting-challenge-social-pragmatics-students-autism-spectrum-887512

 

Chloe Chenjie Gu, MA., Speech-Language Pathology Intern

Kristina Elliott, MA, CCC-SLP


Use of Social Stories for Children with Autism

November 2, 2012

Many children with autism have difficulty knowing what to do in various social situations.  Carol Gray, Director of the Gray Center for Social Learning and Understanding, created social stories.  Social stories are short stories used as a teaching tool for children with autism that describe a potentially challenging situation, skill, or concept in terms of relevant social cues, perspectives, and common responses.  They are written or tailored to an autistic individual to help them understand and behave appropriately in social situations. The stories have a specifically defined style and format.

They describe a situation in terms of relevant social cues, the perspective of others, and often suggest an appropriate response. They may also be used to applaud accomplishments.  It breaks down a challenging social situation into understandable steps by omitting irrelevant information and by being highly descriptive to help an individual with an ASD understand the entirety of a situation. It includes answers to questions such as who, what, when, where, and why in social situations through the use of visuals and written text. Social Stories are used to teach particular social skills, such as identifying important cues in a given situation; taking another’s point of view; understanding rules, routines, situations, upcoming events or abstract concepts; and understanding expectations.  Social Stories can provide information in an accurate but supportive manner, describe an unfamiliar or uncomfortable situation, prepare an individual for an upcoming event, or help an individual understand what is going on around them and the expectations of the situation.

The goal of a social story is to reveal accurate social information in a clear and reassuring manner that is easily understood by the individual with an ASD. The improved understanding of the events and expectations may lead to a change in behavior, although it is suggested that the goal of a social story should not be to change individual behavior.

Examples of situations when a social story would be appropriate are: “Going to the grocery store,”  “Going to school,” “Going to the doctor,” or “Riding the bus.”

Prewritten social story examples can be found on: http://www.child-behavior-guide.com/free-social-stories.html.

It is also beneficial to create your own stories with real pictures to help the child relate better.

Information taken from:

http://en.wikipedia.org/wiki/Social_Stories

http://www.autism-community.com/social-stories/

Michelle Morgado, M.S., CCC-SLP


What is Early Literacy Development and How Does it Tie to Language Acquisition?

May 22, 2012

Children start to learn language from the day they are born. As they grow and develop so do their speech and language skills. They learn to understand and use language to express their thoughts, ideas, and feelings to communicate with others. During this stage of early speech and language development, children also learn skills that are important to the development of literacy skills (reading and writing). This is known as Emergent Literacy or Early Literacy. This begins at birth and continues through the preschool years.

Children are exposed to print (e.g. books, writings on the grocery list) in everyday situations (e.g. home, daycare) well before they enter elementary school. Parents can see their child’s appreciation for print grow as they begin to recognize words that rhyme, scribble with crayons, name some letters in the alphabet, and eventually combine what they know about speaking and listening with what they know about print indicating their readiness to read and write.

The Development of Print Knowledge

Children start by making guesses:

  1. Understanding what symbols mean
  2. Making inferences based on the size and length of the print
  3. Making inferences based on their unique design
  4. Directionality
  5. Oral/Written Language Correspondence
  6. Understanding how letters relate to sound

Warning Signs

The experiences with talking and listening learned during the preschool years prepare children to learn to read and write during early elementary school years. This means that children who enter school with weaker verbal abilities are much more likely to experience difficulties in learning literacy skills than those who don’t. Children who are at risk may exhibit these warning signs:

  • Persistent “baby” talk
  • Absence or lack of interest for nursery rhymes
  • Absence or lack of interest in joint book readings
  • Difficulty understanding simple directions
  • Difficulty learning or remembering names of letters
  • Failure to recognize or identify own name

What can you do?

Children need to engage in learning about learning literacy through meaningful experiences. You, as a parent, can help your child develop literacy skills during regular activities without adding extra time to your day. Show them reading and writing is part of everyday life and can be fun and enjoyable. Activities for children include:

  • Talk to your child and name objects, people, and events in their everyday environment
  • Repeat what your child is saying, including babbling (e.g. “dadada, bababa”) and add to them
  • Talk to your child during routine activities (e.g. bathtime) and respond to their questions
  • Draw your child’s attention to print in everyday settings such as traffic signs, store logos, and food containers
  • Introduce new vocabulary word during holidays and special activities such as outings to the zoo, park, etc.
  • Engage with your child in singing, rhyming games, and nursery rhymes
  • Read picture and story books that focus on sounds, rhymes, and alliteration (words that start with the same sound, as found in Dr. Seuss books).
  • Reread your child’s favorite book(s).
  • Focus your child’s attention on books by pointing to words and pictures as you read.
  • Provide a variety of materials to encourage drawing and scribbling (e.g., crayons, paper, markers, finger paints).
  • Encourage your child to describe or tell a story about his/her drawing and write down the words.

-Michelle Smith, M.S. CCC-SLP & Chary Liz Macasero, B.S. – Student Intern


References

Roth, F., Paul, D., & Pierotti, A., (2006). Emergent Literacy: Early Reading and Writing  Development. American Speech-Language-Hearing Association (ASHA).  Retrieved May 14, 2012, from http://www.asha.org/public/speech/emergent-          literacy.htm.

Dobbels, D. (2003). Using what we know to enhance early literacy programming: An  SLP’s guide to early literacy development & practices [PowerPoint Slides].  Retrieved May 14, 2012, from  http://www.asha.org/Events/convention/handouts/2007/1500_Dobbels_Deidre/


What is Joint Attention and Why is it Important for Children with Autism Spectrum Disorders?

April 10, 2012

Joint attention is the shared focus of two individuals on an object or each other . Joint attention on  an object is achieved when one individual alerts another to an object by means of eye-gazing, pointing or other verbal or non-verbal indication. An individual gazes at another individual, points to an object and then returns their gaze to the individual (3 point gaze). Each individual must understand that the other individual is looking at the same object and realize that there is an element of shared attention.  The individual must display awareness that focus is shared between himself and another individual. If two individuals are simply looking at the same object, but not referencing each other, it is referred to as shared gaze. Shared gaze is the lowest level of joint attention.  Joint attention between people is a conversation-like behavior that individuals engage in. Adults and infants engage in this behavior starting at two months of age. Adults and infants take turns exchanging facial expressions and sounds.  The sole purpose of joint attention is to share an interesting object or experience with another person.

Joint attention is a necessary precursor skill for language and social-cognitive development.  It is important for the development social referencing, language acquisition and learning through modeling behaviors of others around you and other, later-emerging, skills, such as more complex expressive language, symbolic play, and theory of mind.

Children with Autism Spectrum disorders have a particular difficulty in their social relationships. Children with Autism often demonstrate a lack of or delays in joint attention skills.  Children with Autism are often more interested in and engaged by their own thoughts and sensations than by other people or even the outside world.  Social connections are more difficult to build and understand for children with Autism.  A lack of or a delay in joint attention skills can limit children’s ability to learn through imitation, develop play and social skills, and attend in a learning situation such as a classroom.  Children with Autism who display more intact joint attention skills exhibit better outcomes with respect to the development of cognitive, language, and symbolic play skills. Joint attention skills have a vital role in the development of children with autism spectrum disorders. Joint attention skills can be taught and addressed in a number of therapy models and approaches.

-Brandi Quinsay, MA, CCC-SLP


You Will Not “Zone-out” With This Great Self Regulation Program

April 4, 2012

The Zones of Regulation Curriculum was designed to help children become more successful in school, at home, and in the community by independently controlling maladaptive behaviors through the process of self regulation and emotional control. Self regulation is the ability to be in the best state to successfully engage in a particular activity. When exposed to a frustrating activity, an individual with self regulation difficulties may find coping challenging and will likely demonstrate maladaptive behaviors such as physically escaping the situation or lashing out.

Through the Zones of Regulation program, students will learn how to categorize their emotions and states of alertness into four  color categorized zones.

  1. The Blue Zone: A low state of alertness. For example, when one feels sick, tired, or bored.
  2. The Green Zone: A regulated state of alertness. Characterized when one is focused, calm and content.
  3. The Yellow Zone: A heightened state of alertness. For example, when one experiences feeling of frustration, silliness, or confusion.
  4. The Red Zone: An extremely heightened state of alertness. When one feels intense emotions such as rage, panic, or terror.

The Zones of Regulation curriculum teaches children which zones are expected for given circumstances. For example, right before a championship sports event, it is okay for one’s body to be in the Yellow Zone as a heightened state of alertness may boost athletic performance. In contrast, a heightened state of alertness is not appropriate when one is sitting in math class. If a child is in a zone that does not match the demands of the environment, the Zones curriculum teaches children tools that help them move between zones; this helps a child get their body in a “just right” place to do what is expected of them. A child’s toolbox of self regulation strategies consists of a variety of calming techniques, cognitive strategies, and sensory supports.

The Zones of Regulation curriculum is appropriate for any child, even as young as preschool years, that struggles with self regulation. However, some children with the following conditions frequently have difficulty self regulating: Autism Spectrum Disorder, Attention Deficit Hyperactive Disorder, Oppositional Defiant Disorder, or Anxiety Disorders.

For more information about the Zones of Regulation program, please ask your CSLOT occupational therapist.

-Rosie Commons M.S. OTR/L

References:

Kuypers, L.M. (2011). The Zones of Regulation: A Curriculum Deisgned to Foster Self-Regulation and Emotional Control. San Jose, CA: Think Social Publishing, Inc.