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Social CommunicationMany speech-language
pathologists don't get enough training on how to objectively evaluate social
communications skills in order to get to the root of disorders in this area. The
focus needs to be on determining the level of language development. By Nicole Beckert Children
with conditions such as Asperger’s syndrome and nonverbal learning disorders
present with deficits in social communication skills, including making eye
contact, getting to the point in conversation, and staying on topic. Language
and processing problems often underlie these issues, according to Kathleen
Scaler Scott, MS, CCC-SLP, director of Training, Research and Fluency Programs
at the
Speech-language pathologists don’t get enough training on how to conduct an objective evaluation in order to get to the root of the problem, she said. The focus needs to be on determining the level of language development. “Otherwise, you’re just treating surface behaviors,” Scott said. “You’re not going to get to the root, and you’ll have much slower progress.” During the initial evaluation, she administers a social skills rating scale based on work by educational psychologists Stephen N. Elliott, PhD, and Frank M. Gresham, PhD. The scale considers problem-solving skills and the ability to understand nonverbal communication. “I like their definition of social skills because it focuses not just on the skills that individuals must have for interaction but the skills individuals must have in self-monitoring behaviors to help them avoid or escape negative situations,” Scott explained. Parents and teachers fill out forms that include objective and subjective information. Children who are old enough can offer comments and feedback as well. Scott combines these standardized forms with standardized tests of problem-solving and informal game-playing tasks to help determine where the problems lie. “If you can’t process the information, you can’t keep up with the flow of conversation,” she said. If children have a hard time organizing their language, “people are just going to move on without them.” The key is to provide children with the tools they need. There is limited research in speech-language pathology on social communication skills, Scott noted. While some information pertains to the effectiveness of training in this area, “a lot of the research is in the psychology literature. In our training we don’t get formal coursework on how to evaluate and treat those skills. It’s mentioned in the context of the other disorders, but it’s generally not in-depth information.” Drs. Gresham and Elliott define deficit areas in acquisition, performance and fluency. Acquisition deficits occur when children don’t understand the rules of social communication, Scott explained. “They don’t seem to be aware of some implied social rules, or they can’t take perspective.” Performance deficits cause a child to have underlying behavior and/or language issues that get in the way of effective interaction, such as when a child can’t stay on topic because of disorganized language, can’t follow a conversation because of processing problems, or is unable to problem-solve due to impulsivity. Probably the smallest percentage of what clinicians see is the third deficit area of fluency. Children with difficulties in this area may know what to do but not be comfortable in a situation because they haven’t practiced the skill enough to perform it consistently, such as initiating with peers. Incorporating work on skills in these three areas into what speech-language pathologists already are doing is possible, Scott said. “With clinicians going into the classroom, we have a great context in which to treat some of these social issues.” She works with children individually or in a small group for a short period and then helps them return to the larger group. She also works with full classes of students in a large group setting. Parents are involved in skill-building as well. Scott provides them with weekly feedback on what the group did and how their child performed. She suggests things parents can do at home with their child to carry over the skills learned in therapy. The emphasis is on functional activities that can be done over the course of a day. Finally, Scott uses games to reinforce social communication skills. In
addition to academic-based programs, she has developed her own programs and
adapted others to address specific skills, such as expanding upon conversational
responses. |
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