can anyone comment on these social skills ideas of mine please? (moondog are you about?)

[lingle]

My DS2 (resolved receptive language, possibly resolved sensory, anxiety) is now 6 and starting Year 1, doing very well. Social issues: likes to stick to one best friend and tends to go hang out with (mutually devoted) big brother on playground at breaktime. General social anxiety still there. So I've written to head asking for a plan for the year and I've said this:

"He also still seems to blank children other than his closest friends when they ask him questions or make remarks unexpectedly. I'm wondering if teaching him a set of "neutral" responses that will buy him time might help: even just learning to say things like "oh" in response to a remark, "umm....I don't know" in response to a question and "hello" in response to a greeting (rather than the current silence or "No") would buy a bit of time for him to process/relax, and count as a reasonably appropriate response- which might in turn reduce the anxiety of these encounters. We have been talking about saying "kind" things so I think he is ready for this."

My thinking is this. There's bound to be a big anxiety element to this "blanking" because DS2 doesn't blank DS1 or his best friend but he will blank people he likes like neighbours seen out of context in the school canteen. He obviously doesn't know what to say/do. So I reckoned if we simplied the responses right down, he might discover that the social demands of 6 year olds are not as great as he thought.

It's a kind of "learn by rote to get rid of the panic" idea, hence wondering what moondog thinks.

I'll appreciate any comments/context/more grownup names for similar things or even just more examples of "one size fits all" responses to questions from children. Or anyone who has tried out strategies for the same problem.

best wishes to all.

ds2 is 9 & most people do just get a blank look form him, but today was very typical of his conversation with me.

Me: Hi X, how was school
DS2: Why
Me: I'm interested X thats all
DS2: But why do you say those words

This was followed by ds2 staring out of the car window for the journey home & no longer acknowledging me at all, in fact no further conversation
until i asked him if he wanted blackcurrant or orange & he said "Dont know"

TBH I'm ok with his physio & OT stuff, i seem to "get it" but i'm crap at knowing how best to approach communication, beyond the basics of giving him time etc etc

I could help you so easily with that Anon but I don't want to put the stuff on here in case I compromise confidentiality issues but if you message me I can help.

really moondog, that is a very kind offer, thank you! I will message you.

Reading with interest. I have similar issues re:getting DS to tell me about his day at school. Occasionally he will happily tell me about something that has interested him re:learning/a friend, but the usual answer is "I can't remember". DS is quite the master of "I don't know/I'm not sure" etc. I think it's mostly that he doesn't want to make the effort of summing up his day rather than being unable to. I've tried re wording to make it less vague - "what did you learn at school", but that doesn't seem to help much!

Overall though I'ld say the big issue is a form of naievity - difficult reading others lack of interest etc.

I am going to apologise in advance, but this will be long!

I am also going to leap in and say not to over pathologise the lack of narrative recounts of the school day. I am a highly verbal NT female (which doesn't apply to a lot of your kids) and I hated this when I was a child and still sometimes feel irritated if I am asked about my day (although I comply with a "it was alright" or "nothing special" or "not much happened" as I know this is polite). It is developmentally normal for children to troubleshoot the bad bits and leave the good bits out, though of course it is a thornier issue when you are dealing with anxious children who really do need to talk about something but choose not to because of their anxiety so worth pursuing if there are issues...

It may not be relevant to all, but is also the case that as children get older they may not tell you as you are their parent. It was ever thus with all older children and teenagers.. I have a student (secondary of course) with ASD who apparently never verbalises thoughts or feelings at home. Today, he and two peers had a very lengthy conversation about the value of logic in understanding NT interactions and how frustrating it was that NT people were so unpredictable (Aside: there was a really great moment where one of the kids said: "oh you know, X, you are just like a falcon.". "Falcon? That comment makes no sense!!", "you know, a falcon, an alien being that loves logic.... VULCAN!!!). They all laughed hysterically and agreed how much they hated "our" illogical approach to behaviour!

In terms of intervention planning, verbal responsiveness and contingent responses are key social skills in terms of conversation for students with language and communication disorders (not necessarily just ASD).

There are all sorts of ways you can work on them..

• script conversation as above, moving from immediate and familiar, highly preferred experiences to less preferred ones etc
• script conversation and demonstrate the turn taking nature of the conversation between 2 people with each having a different set of coloured cards, every time you say your "bit" you put down a card. This teaches a prompt for tracking turns/topic changes in more improvised and larger group conversations
• reduce the script once you have mastered several until you can give one word or topic prompt card, keep the coloured cues (script fading can be tailored to your child, some children need to fade out words, sentences or other prompts but this can be individual)
• Increase the number of conversational partners
• Decrease the familiarity of the situation (not at the same time as increasing other demands!)
• Get kids to focus on the good of each interaction where you can.. this is particularly crucial for students who are anxious. Sometimes, it is best to just look at successes and not focus or draw attention to things to improve in the early stages. Video modelling approaches often use this as a strategy - tape lots of scripted stuff and then edit out all the prompts so your child sees a smooth, successful interaction. You can reward them every time they watch it, as well as pairing this with verbal praise.
• Responsiveness diary/Set ups.. Create a special book, have your child decorate it with things that make it appealing to them e.g. Sponge Bob or whatever, and set up situations with familiar adults with a script then without one/less familiar adults with a script then without one/unfamiliar adults with a script then without them and then repeat hierarchy with peers, then repeat increasing number of conversational partners.. Build in rewards and levels e.g. give the child 2-3 compulsory things they must do in the situation e.g. say hello/respond to hello, ask for an item (e.g. shop) and say thanks when they get it. Have a clear reward for each to be collected after the interaction. As this is mastered, start to add optional extras e.g. say "the weather is awful today" and look at the lady, say something about the weather, ask the lady a question about a delivery etc (tailored to individual interests etc).

There is a huge amount of information on how to do lots more tricky social interaction things in the Social Thinking curriculum by Michelle Garcia Winner www.socialthinking.com e.g. building bridges between topics by working a conversation round to what you want to talk about. All our students who covered this material use this strategy spontaneously now.. There are lots of good ideas in this material which are practical and my students find them very motivating..

As I work with a group very verbally and cognitively able students with ASD, I would say that if your child meets this sort of profile it is important to build in cognitive rationales (e.g. WHY you are doing it, WHAT the purpose of it is etc) from early on. You want to match this to the language level and motivation of the child initially, but as they grow older it can be very abstract.

For much older and more able students, there is a protocol for really examining the nitty gritty of social interactions with a motivated teen (and we have lots of them in our settings who have diagnoses of both SLI and ASD) by Brinton and Fujiki.. the article is old now but the process it describes is one I have had success with, it's called "If you can have a conversation, you can have a relationship..".

Finally, the key to social and conversational success is to be successfully involved in as many social situations and conversations as possible. There are parts of these interactions that are pretty difficult for kids with ASD in terms of the underlying neurological issues that make e.g. facial expressions hard to read, multiple cues hard to process but there is huge progress to be made through learning the skills that we use to think about others and how they think about us.

aaargh... I was going to just not bother chasing up the social skills lessons at school for a while... now I'm probably going to not only chase the senco but have to get a book and volunteer to come in as a parent helper so I can make the sessions worthwhile. [would rather be lazy emoticon]

LOL Maria.

Thanks working. Really appreciate your lengthy and excellent posts.

Yes indeed.
A treasure trove of invaluable information there 9-5.

I make a scrapbook with my kids of significant outings or holidays. As we spend a lot of time abroad in different places, these are numerous. It doesn't however have to be contingent on going to fancy places. We are into castles at the moment and visiting a different one every week, so that will be the focus of our next scrapbook.

These are great conversational springboards and can be taken to school or shown to guests. I s very pleased the other night when someone came to see me on a work related matter and my dd got out our summer holiday scrapbook and brought it to show him.

A communication passport can function in the same way-as an ice-breaker, so that a conversation can start as a child shares pictures of their family, home, hobbies or whatever, developing mutual interest and trust with a conversational partner. As I have mentioned before on MN, the wonderful charity Cerebra will

www.cerebra.org.uk/English/gethelp/personalportfolios/Pages/default.aspx compile one for you for free

However these strategies aren't the only things that can be relied on. Someone, somewhere needs to be stting aims for nos. of interactions, counting them and measuring progress. That's where the world of s/lt can be a bit sloppy. Useful strategies are sugggested but noone does any measurement to assess progress.

So in short you need warm lively imaginative people running these sorts of things, who are also deeply data driven and highly organised. Not many of those about unfortunately.

Here's a useful little mantra to enable you to check whether what is being done with your child is useful.

Learning outcomes must be expressed in measurable terms that can be assessed.

www.cerebra.org.uk/English/gethelp/personalportfolios/Pages/default.aspx Cerebra will make you a communication passport for free

Aaargh

Pretty much anything can be expressed in measurable terms that can be assessed, but it's important that the learning outcome has some sort of decent rationale too. Our service uses a system called EKOS to measure outcomes.. everything is measured and reported etc but it can be total and utter pants, a paper exercise. I am not a fan. Similarly, you could have a target to learn, say, 50 words a month and have been given all sorts of stipulations on how they are used e.g. in single words, in phrases, in sentences, in oral narrative, in spoken paragraphs etc and these could be very tightly written but if those words are meaningless and unlikely to be functional for you, the measurement won't make it more so.

I was at a study day today. We discussed what makes what you do with a child useful. Most speech and language therapists who have been working for a number of years feel that the profession has been sorely diluted as the people who give advice have not learned through hands on experience but simply repackage and generalise theory within a short time frame. How do you write a measurable target that is realistic and meaningful when you have never actually tried out what you are suggesting? Time and time again I hear on here that SLT's can't tell you how to do something. Well, that's hardly surprising is it? Personally, I fail to be convinced that seeing a child every 3 -6 months for an hour is really an effective service.. I don't care if what you demonstrate or write up in that hour is pure gold theoretically, it is not going to be a replacement for having a broad and thorough knowledge of a child's communication across a variety of domains and working through and troubleshooting all the many things that can go wrong with a strategy. This is what ABA does and does so well. The mistake that has been made in my profession is that while there are many many more speech therapists now than there were, say, thirty years ago, efforts have been directed more at the broad range of possible difficulty rather than the much smaller range of extreme difficulty. Everyone gets general advice and the majority of therapists don't learn to work with the most challenging cases with any degree of rigour and the skills we worked so hard to gain (linguistic analysis, fine tuned analysis of phonological disorder etc) are eroded.

Yes, we should all have much better data.. but generally speaking if you work with a small caseload of students e.g. several times a week, you will have this. Most of our students have up to ten targets a half term, all of which represent real change in functional skills, the majority of which they achieve. I don't think I could do it in one hour every six months, with all the best will in the world and with the fanciest recording systems known to man. Not with their degree of communication impairment and the huge array of targets that need to be gotten through.

My mantra for whether something is useful or not is "a report is not a service". Someone has to be doing something with your child or meaningfully training others in their environment to do something with your child. If they are not, it is not a service, it is a series of recommendations (at best).

Working. Is the solution to train people to do the doing then. I mean LSAs can do more than laminate, surely?

I am attempting to make a case for reduced SALT because it was so ineffective last year. SALT says she's sorted the speech, and the language is disordered but can only be fixed through either a)learning to read or b)improved communication, and she doesn't know how to teach either.

Fine says I. We'll do it. You keep track of what we are doing and advise on the next developmental step that we need to work on. And btw can we have some of your funding that you don't need now we are halving your time?

Funily enough, she's not completely against the idea but would never say so officially. But in any case we have moved areas so it is a different SALT who by reputation has poor ASD knowledge so we'll probably make the same case.

The doing thing.
Yes, so many of us have neither the time (nor, to be frank) the inclination to do.

That's what so blew me away about the 1st ABAers I met.
They had their sleeves rolled up literally and metaphorically.
In one analogy I comapred the presenting dsifficulty to a lake around which everyone else was strolling, occasionally dipping in a toe or ruffling the surface.
The ABAers just waded in, up to the neck and beyond.

This season, I am mostly saying
'Don't confuse activity with action'.

The solution is to train people to do the right job.

Speech and Language therapists receive a high level of training in speech development and disorders and language development and disorders. Speech and language therapists should work extensively with these at all levels of serious impairment. With all the best will in the world, an LSA can't listen to a sentence and immediately tell you what's wrong with it and explain why and this will alter their ability to repair disordered sentence structure and model it effectively. The linguistic knowledge needed for that is what we learned, but very few therapists utilise it and most lose what they don't use (the same is less true for speech, where there is still some good stuff going on at specialist level in clinics, but it will get there..). All that stuff that "goes wrong" in terms of remediating higher level language could be addressed if SALTS "did what it said on the tin". Any of you (who haven't studied linguistics!) ever heard of a gerund clause? A right-branching embedded clause? A catenative? Know what I mean by a verb indicating change of state and how it affects the syntax of serial verb constructions?

Most speech and language therapists don't either.. though they learned about them.

All of these things can be taught behaviourally. Language is hierarchical, it builds up from small building blocks to the narrative level that we are using right now to communicate. Look at that sentence I just wrote:

[itup][from [[small] [building blocks]][the [narrative] level[thatusing[right now][to communicate]].

I think there should be even more brackets in there, you know...

Bit more than four level word there, eh?

Can an assitant teach a child how to say "pushing][the trolley]", then [[Johnny][is pushing][the [big] trolley with training and a rigorous programme and recording etc? Yup, I have no issue with that (other than the DDA disgust I have that the education of our most vulnerable children is left to people with minimal education on £7K a year!!!).

What I do have an issue with is when people become jack of all trades and master of none, where people are left to flounder with serious language impairments because apparently language development stops with a why/because sentence..

ABA people would be and are much better at a lot of the mechanics of social skills e.g. initiating, requesting, maintaining, repairing etc, though it would be useful if a SALT could advise on appropriate structures and tweak language use.

The LSA's could do all the general language stimulation stuff that serves the masses well but is useless for children with the most severe impairments. Or even better, here's a radical idea, maybe the TEACHERS could? Being paid for it and all of that? Given that it's actually ON the curriculum, too?

And, while I rave on maniacally, how much it irritates me that publishers like Speechmark spend so much time publishing "soft skills" curricula about "anger management" and the like instead of actually producing language resources.

Language for Thinking, which moondog and I have both recommended, is a useful resource and I like it a lot but was normed on 3-5 year olds 33 years ago and a higher level resource has never been produced. Yet how many books are published annually with the same old crap about social skills which includes rubbish activities on eye contact with neither a cognitive nor a behavioural rationale???????

The amount of therapists nationally delivering "narrative" training that has nothing to do with oral narrative is staggering! When people are not research-active and are only trained at undergrad level for a short period of time, it does not lend itself to EBP etc. Notice how there are so few male SALTs relative to clinical psychology/ABA etc? It does not attract the people it should and that is a huge failing that has led to the dilute and ineffective rubbish out there passing off as SALT "service".

I don't mean that SALT needs more men, btw.. just that a lack of men in a profession often says something about status in our society, which is often reflected in how something is funded and received etc.. there were lots of male teachers once, as the status eroded so did the numbers of men choosing it as a profession. It is seen as a "soft" profession and "all about the kids" in a namby pamby, airy fairy way when really it should require a very analytical and creative mind. There is a chapter about this in a classic book on Aphasia, "The Man Who Lost His Language".

Sorry. Rant over!

LOL Working Absolutely. What you say makes perfect sense.

I was never for one second suggesting that LSA's or even ABA therapists could do the work of a SALT, but I do think that they can deliver the practising and drilling.

You see. I remember very clearly my ds' first SALT. I was SO eager to meet this specialist, who was going to explain to me what was going on with my ds, and help me understand his problems and what I can do to help him.

I sat there for 25 minutes whilst she blew bubbles at him which he ignored and told me she'd see me in 2 months time.

This was my very first interaction with any 'professional' wrt my ds. I left very confused at what SALT was. I had thought 'therapy' was what indulgent middle-class women did in the bath with mud. I had hoped SALT would be rather more than that but concluded it probably wasn't.

Then I wondered what on earth that person had learnt in their degree?

I went back 2 months later. Bubbles again. I wondered if under 5s SALTs only ever blew bubbles and I wondered, if all they ever do is blow bubbles, what was the POINT of their degree.

I learnt that time, at the end, that blowing bubbles was a way to get ds to request by using the word 'more' and that I was to try this at home. With bubbles. The therapist failed to realise that ds had NO interest in bubbles and couldn't care less whether there was more or not. Again I wondered what her training could have possibly been like.

She was sooo seemingly obsessed with bubbles, even I didn't make the leap I should have to figure out that I could do the same with a spinny flashy thing and get some sucess. I thought the bubbles were the 'therapy' as they were all floaty and that is what I thought therapy was.

I left thinking that the therapist believed that experiencing floaty bubbles was going to help him to speak, and whilst I thought it was a bit unlikely, so too is crystal healing etc.

Anyway. My point is. If she is blowing bubbles for 4 hours a day and just repeating the same 'more' exercise with under 5s, how is she ever going to apply the rest of her training and more to the point, what a waste of money it was funding it.

Very good 9-5.
I love it all.

Yes to teachers doing this stuff. In special schools so much precious time wasted in sensory rooms and utterly meaningless art activities and (my pet hate) printing out reams of photos of kids 'doing' things (that they actually can't do at all.)

Yes to all that bilge churned out by these companies. I was at a professional do last week and did the rounds of the stalls, stopping to look at some interesting new materials on inferencing. I asked the rep. how the child's progress was measured and she looked at me as if I was mad.
'Oh no, you don't measure' she said 'You just do it'.
Then I saw a book called 'Yoga for Autisitc children' and almost lost the will to live. Talk about Rome burning while Nero fiddled.

And, at the very same do I had a long conversation with a male s/lt about all of this 'nice ladies' and 'caring sector' stuff. He began to rant about what his lot were up to for 'Giving Voice ' (don't start me on that) and talked about how much time he had spent at garden fetes eating scones.

It would make you laugh if it didn't make you weep first.

You rant away. We need more people willing it stand up and really tell it how it is.

Yes, Star. What we did in our degrees.. We don't use it so we lose it. Here is a tutorial article about identifying complex sentence structures via a flowchart that also gives the sequence of development. It contains useful references as to why this stuff needs to be done (and why language is more than verbs, tenses, vocabulary and who, what doing, where, when, why and how....).

Blimey working that's facinating.

And also Working I'm sorry that I missed an essential aspect of the model that we are suggesting INSTEAD of SALT time.

One of our tutors is a SALT

I don't put a lot of the details of our 'case' on here. For obvious reasons. But perhaps it's only fair to put this less people think I'm suggesting SALT work is entirely replaceable.

Hi, OMG ds is about the same Lingle, he says he only needs one friend, so does. When people come up to say hi, he has one of three responses, blanks, turns around so cannot see them or runs off. Which i decided was his panic as did not know what to do. I've been trying to teach him all he has to do is reply hello and how are you. It works in limited cases, if not to much going on, or we prepared immediately but hoping it will become easier.

Oh love the mini conversations starlight, will use them if ok. I also only just clicked about making a nice comment when seeing the mums, am mainly observing at the moment to make note of changes as - once i noticed someone had there hair done (she was pleased i noticed and commented it was for a wedding, i went lovely and then stalled - clearly i have more homework to do).

Looking like teaching ds social stuff will help me!

moondog, working - I'm curious about SALT & actual therapy. As a parent who isnt as well read as starlight (or as perhaps i should be) i struggle to understand SALT after DS2 being in the system for 9 years.

I dont have the same lack of understanding with his OT, PHYSIO or Psychology input. With all of these other professions he has had numerous assessments but also & more importantly actual structured therapy given by the therapists in conjunction with us at home and his school/lsa.
All of these therapies have been very specific to ds2 with real measurable targets set, reviewed and adjusted. He currently is under the care of the Autism spectrum team & ahs specialist Sensory OT, a different motor OT and a different physio.
The SALT from the same team has assessed him twice - but no therapy?

There is the same lack of Specialist OT's and length of waiting list etc as there is for the SALTS.

Is it so much harder to develop a SALT programme, I honestly believe my lack of understanding of ds2's SALT need, comes from a lack of involvement in any actual therpay. Like a child, us parents learn from doing too.
I knew nothing about psychology, OT or physio when I gave birth to ds2 BUT i do now. I'm not claiming to be an expert. but i know enough to at least feel like i'm doing something constructive to help ds2.
I just can't help thinking that the SALT service is missing a trick in not offering actaul therpay & involving the parents at an early stage.

I hope you get what i mean by my rambling post!,

Did not see second page when writing post.

People seems to have lost the ability to challenge, rather make life easy.

My concern is that ds is suppose to be seeing SALT soon, as parents should be told what he will be doing. Or should I ignore and get on we our own stuff. Wth my own limited abilities in this area (i think my dx was oral dyslexia well badly dyslexia) makes for a challenge with no suppport for ensuring it's right. Or would the book recommended - Language for Thinking teach us both.
I feel very removed from the imput ds gets.

OT is only interested in his handwriting and given school ideas like writing between the lines. Which was not want i wanted to see her about (propitiation, hypermobility, stimming). I get this impression everything is geared to measureable targets, across the board in terms of acheiving school targets, then the individual need for support.

our ASD team is Health Authority funded & headed by a paed & psych rather than LEA so the targets are not so much purely school/academic focused.

In reality if you help his propriaception (sp) & all the other stuff his handwritting atc should improve as a result.
We have already seen improvements at school following ds2's intensive SIT.