The Goldilocks Principle

GoldilocksI had the rare opportunity last week to actually sit down and eat lunch with two of my favorite SLPs I work with, and we problem solved about different communication challenges that our students are struggling with (we SLPs know how to have a good time, don’t we?!).  One topic that seems to come up over and over again is helping students (and sometimes adults) find a balance in conversation between too much information and too little information.  You know, the kinds of conversation when you ask an innocent question and the person goes on and on for ten minutes telling you EVERYTHING they know about that topic?  Or how about the sound of crickets chirping when you ask another person the same question, and you get a one word response? How can we help them find the right amount of information to share-not too much, not too little, just right?

This is a pretty high level skill, so make sure you are addressing the foundational pieces first:

  • how to read non-verbal clues (facial expression, body language)
  • asking a question versus making a comment
  • turn taking in conversation
  • judging the right time to ask or respond to questions
  • tone of voice
  • context (does the other person know what I am talking about?  Do I need to give them some clues?)
  • asking for clarification if you don’t understand what the person is asking you
  • orienting my body towards the listener/speaker and looking at them to monitor their responses

I created this free visual on TeachersPayTeachers to help your students here: how much information is enough?  It’s in a PDF format, so you can print it without using Boardmaker.  It would make a fantastic poster for a classroom or to use as a visual to create a lesson for your students!  This is not just a special education or ASD issue by the way, conversational competency is critical for ALL of our students and strong oral communication is a life skill.

What have you tried when teaching students to gauge how much is enough?

How to be a tightrope walker.

tightrope

 

Have you ever watched someone walk a tightrope at a circus or on TV, like Nick Wallenda’s Grand Canyon adventure?   It is a tedious, breath holding process to behold!!  This image came to mind when watching a young lady with ASD navigate the treacherous waters of having a conversation with a new classmate.  She wants to have friends and has been working very,very hard at figuring out all the moving parts to a conversation, both verbal and non-verbal.  I imagine the practice and dissection of conversational skills in speech therapy is like working with a net when you first learn to walk on a tightrope.  You wobble and try to correct missteps, but have the comfort of knowing that if you fall, you are safe. Something (or someone) is there to catch you and help you try again.  But conversations with peers on your own?  That is like walking the Grand Canyon without a net.

For students who do not have social language impairments, they almost effortlessly glide across the conversational ropes, maintaining topics, eye contact, body proximity, tone of voice and humor without even thinking about it.  They learned these skills incidentally and don’t have to think about the moving parts of talking to people and making friends. That’s not to say that these students don’t make mistakes, we all do!  The difference is they can learn and apply these subtle social rules in the moment.  This particular young lady I mentioned has tried to make new friends before.  Her first attempt started with “I know you are new here, but I just want to tell you, you don’t want to make me mad.  I can get very, very mad.”   The new student just stared back at her, not really knowing what to say.

In talking with the young lady later, her thought process was preventative; if I tell a new friend that I can get mad, I am doing them a favor!  Then they will know how to act around me and we will get along great!  She did not recognize that she was being perceived as threatening and sending signals that she is probably not someone you would want to hang around with.  For younger students, I love the book You Will Be My Friend  by Peter Brown.  It offers a good conversation about how the main character wants friends, and the many wrong ways she tries to find one (spoiler:there’s a happy ending).  I have created a lesson to go along with the book here.  For older students, video clips are great examples of friendships.  I love Ned’s Declassified from Nickelodeon.  Here’s a link to an episode on what makes a good/bad friend.  It’s about 12 minutes long, so view it and mark different sections to use.  You can develop a whole month’s lesson plan from this one show!

It’s important to remember that friendship is a high level skill.  We have to focus on breaking down all the conversational pieces needed to succeed and teach them systematically, prior to attempting free range social interactions.  To use the tightrope analogy again, you walk a short rope, low to the ground when you start, not a mile long rope across two skyscrapers on a windy day!  I happened to run into the young lady this week that I mentioned earlier.  She and I had a short conversation in the hallway and she checked in visually with me, demonstrated some new turn taking skills,  and monitored her affect, tone of voice and volume beautifully!  She is still working on maintaining topic (she turned the conversation towards Minecraft, her favorite) but she didn’t fall off the rope, just wobbled a bit.  She is figuring out how to navigate the social world, one step at a time.

That’s not my job…or is it?

Tip of the Iceberg

 

Speech therapists have worn many hats over the years in a school setting.   It always amazes me when someone finds out the scope of our practice includes language, syntax, AT, phonological awareness, listening comprehension, oral expression, executive function, social communication AND articulation.  They usually respond, “I thought you just taught kids to say /s/ and play games.”  Ouch.  That being said, we need to do a better job integrating our services into the school environment beyond our speech closets classrooms.  Not to toot our own horn, but to demonstrate to our colleagues how we can partner with our teachers and support staff, ultimately benefiting our students.  I talked about this with connecting language and literacy in all academic settings here .

Working with students who have social language impairments is a brave new world for many slps and teachers.   Often times we focus on the behavior issues and not the underlying reasons/deficits that may be causing them,  because the behavior is the what the teacher sees as the most pressing concern in the moment. However, the behavior is really only the tip of the iceberg.  The TEACCH model out of UNC gives a great example of this visual here:

 

What is often happening is once a team figures out what else might be going on with a student, or the family shares a medical diagnosis such as ADD or ASD, the next question is who is going to address these deficit areas?   Speech language therapists (SLPS) are often the first line of therapeutic intervention, and as a whole, we often take on more than we should.  We need to also consider that while the student may have a medical diagnosis, in the school setting we need to carefully and thoroughly evaluate the child as a team and determine if their diagnosis is impacting them socially and/or academically.  This is not always the case, so it shouldn’t be assumed that a diagnosis=eligibility for services. The medical/private model does not have the eligibility paradigms present in school. This is often a cause of frustration for parents and the team needs to be sensitive to them and have open dialogue with families to address these concerns.  Everyone needs to be working towards the best outcome for the student.

With social language impairments (and the behaviors that often are embedded), the SLP is a critical team member, but not the whole team. If a student does need support with social communication skills, they need to be taught, practiced and generalized beyond the walls of the speech room.  A one on one therapy session with an adult is not a natural social language environment.  For many kids who have been in therapy since they could walk, they figure out that adults will modify their own behaviors and language around the child’s deficits.  Peers don’t do this.

A good social language plan for most students (not all) with social language impairments is a combination of learning strategies, developing self monitoring tools and then having opportunities to practice these skills with their peers.  The team to support the student includes teachers, peers, SLPs, OTs, administration in the schools, counselors, and families.   It’s great if a student can talk about what they should do in a socially challenging moment within a speech therapy session, however, if they cannot try it and apply it in real-time with their classmates, it isn’t really that beneficial.  It’s only the tip of the iceberg.

How to be socially connected.

 

doritos goat commercial

Finding materials to work on social language skills can be a bit tricky.   I love looking through Pinterest posts, teachers’ amazing blogs and seeing other therapists creative techniques in action.  The school system I work for is really trying to get ahead of the social language curve this year, especially with the changes to the DSM 5 criteria for Autism Spectrum Disorder and the newly minted Social Communication Disorder.  The topic of discussion among many therapeutic and parent communities is that we now have SCD as a diagnosis which occurs in about 10% of the formerly diagnosed children with autism, and a bit higher in the population diagnosed with PDD-NOS.   However, there was not a lot of information regarding treatment guidelines for those meeting the SCD criteria.  While I am glad the medical community is considering the broader range of social communication impact (including add, tbi, non-verbal ld, and anxiety disorders), as a parent, I would be a bit frustrated to be handed this diagnostic information with no road map as to how to help my child develop their strengths and support their limitations!

Social language moves fast, and gets faster the older the child gets.  Learning how to read other people in real time is hard when you are trying to process personal space, spoken language (including sarcasm), non-verbal cues, intonation, eye contact, topic maintenance, joining a group, ending a conversation, asking connecting questions, using humor, mirroring body language of your peers and rules that change subtly across environments and without explicit rules (I can call my brother “dude” but not my teacher).  Did you even realize that we do all of that without really thinking about it, day in and day out?  No wonder our kids with ASD and SCD have a hard time navigating a social world.

A very bright high school student I worked with who was diagnosed with ASD (a former Aspergian), figured out if he could learn how the flow of a conversation went without the person actually being in front of him, that could work.  He started with online chat rooms (careful there) to understand the give and take of conversation.  When he felt comfortable with that, he practiced standing with people he felt safe with (family, teachers) and worked on his non-verbals, standing in a comfortable proximity, looking at the person he was talking to, and being aware of his anxiety levels in conversation before he became overwhelmed. He was a genius and it worked well for him.  Video modeling has also been helpful to show people how the social world works.  I am always cautious in showing negative examples as some of my students LOVE to model attention seeking behavior and/or don’t discern the difference between attention for positive and negative behaviors and the outcomes.

Commercials and movie clips work so well for these teachable moments, especially commercials without a lot of spoken language for inferences.  Wing Clips is a website that has short movie clips dealing with many social concepts, and is more appropriate for older students and adults.  My favorite commercials include Super Bowl winners such as the Dorito’s screaming goat from a few years back.  Sonic restaurant has some wonderful, short commercials for common sayings, misinterpretations and non-verbal cues.  There is a new TV show coming this fall titled “Selfie” which deals with a young woman learning how to relate to other people appropriately- social language gold!  And not to be missed is my old standby, Sheldon Cooper and The Big Bang Theory,  which facilitates great conversations about what works and why.   One last thought, before you share any social media lessons, PREVIEW IT FIRST.   You do not want your first social language lesson to involve calling parents to explain what you inadvertently taught their child in school today…been there, done that!

SMARTER social goals

smarter goals

 

Social goals are a bit challenging to develop.  In working with new graduates in our field, it’s become very clear that our college curriculum is coming up a bit short in discussions of how to write social language goals that are SMARTER:  Specific, Measurable, Achievable, Realistic (!), Timely, Ethical, Reasonable.  The newly minted SLPs are well versed in writing goals related to articulation, language, voice and fluency but the social piece seems to have been a bit vague.   I don’t blame them, the field of social language is relatively new and it is a paradigm shift to think about social cognition,  My brain often spins thinking about the many nuances of social language skills!

The first thing I will do is share this amazing article about the Social Learning Tree .  We need to understand the foundations of social language before we can write good goals.  Next, it takes time and experience (duh) with people who have social communication impairments.  Social language goals extend to people with ASD, TBI, ADD, EBD and all along the bell curve of communication disorders. And if I may step on my soap box for a second, our electronic society is cultivating a socially language impaired culture of people who don’t look or talk to one another, but that is another post for another day!

Talk to the student’s teachers, interview the parents, utilize language and social checklists, observe the child in several settings (structured and unstructured) and interact with them to find the strengths and weaknesses.  There are lots of moving parts to the social communication puzzle!   You do NOT need twenty social goals in an IEP!   Since the IEP is a fluid document start small and focused with 3-5 goals at most and build from there.

I see a lot of IEPS from seasoned therapists as well that write goals for greetings and farewells as the first goal.  Yes, It’s important, but can you build that into each session without it being a goal?  Absolutely.  You need to consider where the student is on the social learning tree skill wise and then prioritize the deficits that impact them the most.  It’s not a one size/one goal fits all approach.  Don’t forget that a lot of social language is already built into the core, particularly in literature and language arts , including perspective taking, inferences, and cause/effect.

Utilizing materials that are researched based and are practical and brilliant at the same time such as Think Social and Superflex,  will help you develop goals and therapy plans. I know materials cost money, so consider applying for mini-grants to fund your social bank of materials. Talk to your fellow therapists, and ask lots of questions!  Look into Pinterest and other sites that can spark great ideas for you such as Jill Kuzma’s blog.  Don’t recreate the wheel, but also look at this learning curve as an opportunity to grow your own creativity!

What helped you in writing goals for social language?

 

It’s what’s inside that counts.

cereal boxes

I came across a great idea in  Games (& other stuff) for Teachers: Classroom Activities That Promote Pro-Social Learning that used empty boxes to touch on theory of mind perceptions.  Theory of Mind is the developmental concept summarized as “Do I know what you know is different from what I know?”   Many students with ASD have difficulty with this concept and it negatively  impacts their communication and social skills daily.  The gist of the game is to present students with a variety of boxes and ask them what they think is inside.  They will most likely predict the food or items that are represented on the box.  You, sneaky therapist that you are, will have switched the items inside before the students arrive.  The goal of the lesson is to start a discussion that you can’t judge a book by it’s cover (or a cereal by it’s leprechaun).

I think that’s a fabulous idea, and it gave me another idea when I was observing a therapy session with a student who has ASD and theory of mind (formerly known as an Aspergian).  He kept launching into discussions about basketball without giving a referent to his poor therapist.  He was going to talk about what he was going to talk about, therapy plan be darned!!  A lot of our students have this issue of speaking without context, leaving peers, parents and teachers confused.  This often translates into written expression as well.  So how can cereal boxes be used to teach context?

I think you start the lesson the same, with guessing what’s inside the box.   You can’t know what another person put in the box if you weren’t there or they didn’t tell you, right?  Our brains and thoughts are the same. I can make a smart guess about the topic of conversation based on your words and expressions (the cover of the box) but I can’t know what you are thinking inside your mind (the cereal box) or when you switch the topic (cereal) either unless you tell me. It would be great to include items such as toy cars or paper clips that aren’t at all what is shown on the box to illustrate the discussion.  We need to teach our students to give connecting thoughts to help others know what they are thinking about.  We also need to practice maintaining topics of conversation (even when it’s not what we are dying to talk about!) and asking connecting questions to show we are interested in other people’s thoughts and ideas.  Michelle Garcia Winner has a great activity for a visual conversation tree to illustrate these skills.

What other magically delicious ideas have worked for you to teach context?