Badger State Speechy: Pragmatics Therapy: Five Guiding Principles

Pragmatics. Social Skills. Social smarts. Social Language.

You can't put a value on helping children improve their interactions with others and I believe it's just as important, if not more so in many instances, as working on speech and language skills that build a child's academic performance. This post is dedicated to addressing five general principles that I have found to be effective when working on social skills/pragmatic skills.

Early in my career, I found working on social language skills to be a challenge. The wisdom of my years have helped me discover that my treatment strategies and tools were not always sufficient. Why? I would play board games with students and hope they would gain conversational skills through osmosis! I say that light-heartedly, but I, like many SLP's, used an indirect approach with my students hoping that a few comments here and there would be enough to obtain real growth in their social language skills.

Here's the thing, most typically-developing children acquire social skills by observing the world around them and experiential learning with guidance from parents and other adults in the child's life. If a child hasn't picked up on social skills by the time they are school-aged, then these skills may need to be taught directly to them! Simply playing a board game with a student and giving occasional cues about certain social skills is just not enough for many of our students. They need direct instruction in social skills just as students need instruction in math and reading. Acquiring social skills is a process so teaching social skills should be a process too! For me, that involves the following

Five guiding principles:

1. Introduce the skill and take time to build self-awareness.

Too often, we jump right into teaching the skill and neglect the step of improving the child's awareness of the skill prior to teaching it. Use you tube videos or clips, social stories and books that specifically target the skill you will be teaching to build awareness and generate overall discussion. Try not to bull-doze your students by jumping right into working on the skill. They need some background information....a little time to warm up to the idea!

2. Establish client"buy-in" in a non-punitive way!

Achieving "buy-in" from students is important, particularly for older students. Help them understand why the skill you are teaching them is important. Use clips from You tube, stories, books and if possible, feedback from a "gentle" peer worded in a positive way such as "I like it when you let me talk." Analyze a social script that reflects the lack of conversational skill that you are trying to teach. In my "interruption combustion" packet, (see links at end of this post) the student practices a social script where one person constantly interrupts. The student then uses a worksheet as a guide to analyze the interaction. During the reading of the social script, we role-play how a conversational partner reacts and looks when they are interrupted mid-sentence. Use a thought bubble to explore how the interrupted person felt or what they thought when they were interrupted. Avoid value judgements that invoke blame or shame. (I don't find directly pointing out a student's social inadequacies to be effective). Avoid "you" statements such as "you interrupted her." Instead, word your feedback in a positive way using "I" or "Friends like" statements. For example, "friends like" it when you ask them to play" versus "You never ask friends to play." It's easier to obtain buy-in for working on these skills is your student doesn't feel put down or inadequate.

**3. Do a task analysis and teach the steps to the skill:**

Our students don't always pick up on social nuances or the subtle steps involved in conducting a specific social interaction. Teach the skill you are working on in a sequential and specific fashion and provide specific feedback. For example, I hear many teachers tell students to "be nice" to their friends. That feedback might be sufficient for typically-developing students but students with autism, mental health issues or other developmental problems, often need a more specific explanation, such as "friends like it when you take turns," or "when Crystal talks to you, say words back." Try a task analysis and break the skill down into steps. For example, here are some steps to asking a group of children if you can join in their play:

a) Approach the group with a smile.
b) Look at your friend's face and say their name.
c) If they don't respond, gently touch their shoulder.
d) Say "that looks fun, can I play?"

By doing a task analysis and teaching the steps to a specific social interaction, you can see where the breakdown is occurring for the child too.

4. Teach the child what "TO DO" not just what "NOT" to do!

Determine WHY the student is making poor social choices in specific situations. The answer to that question should guide you in formulating a treatment plan.

What is your student trying to achieve when they exhibit a negative social interaction?

For example, I had a student who was flicking his hands in the faces of his peers. He had worked on personal space in his social skills group and all the adults in his life were telling him to "stop hitting" (he really wasn't hitting..be careful of the words you use to describe the actions of your students) or "keep your hands to yourself." These strategies had some minor impact in reducing the behavior. One day, we were walking down the hall and this student smiled and flicked his hand in the face of a girl from his classroom. SLP Light bulb moment!! He was not hitting and there was no intention of hurting this peer. He was smiling, he liked her, he wanted to have a social interaction with her but he didn't know how!! At one point in his young life, flicking his hand in a child's face had gotten a smile or a laugh so he assumed it would work in this situation too.

I love teachable moments. We did a thought bubble about what might be in some one's head when another person puts their hand in their face. "I'm afraid he's going to hurt me," "that's too close." Then, we role-played the skill of greeting a friend in the hallway and practiced it repeatedly. I videotaped his successful role-plays and we viewed them. Last, we practiced it with that specific girl the next day. Had I only worked on personal space issues, (or what NOT to do), I would have neglected the underlying skill (what TO do) that my student needed to replace the personal space invasion behaviors! Be sure to take advantage of incidental learning opportunities that pop up when you are with your student.

5. Make abstract skills concrete!

Social skills can be both subtle and abstract concepts for many of our students. Find a way to make the skills more visual and you'll have a better chance that your students will understand your expectations. For instance, I have one student who LOVES play dough. When we work on topic maintenance, we put small balls of play dough in the middle of the
table. We each receive one small ball of play dough for each on-topic statement we make in a practice conversation. If one of us makes an off-topic statement, a ball of play-dough is put back in the container. At the end of the session, he is given a short period to play with the play dough that he earned by making on-topic statements. Immediate visual feedback on their performance helps a child understand what he/she did right!! To help students generalize newly learned skills, catch them using the skill outside of therapy and specifically tell them what they did that worked! For example, if you are working on personal space, you might tell a student, "I noticed you kept your hands to yourself in line." Catch students exhibiting good social skills!

Use vocabulary that really gets at the heart of the skill and helps the student understand the skill or behavior that you are trying to improve. For example, in "Sometimes, we get stuck" I liken thought, language or behavioral perseveration to being "stuck" like when two things are stuck together with glue. Just as things can get stuck, so can people!!

I hope I have given you some specific ideas that might work for your students: Below, I have listed the links to six of the materials from my "Let's be social" series. These products are designed for the elementary school child.