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social pragmatics

To the mom I met last weekend

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Hi. I’m so glad that Charlie* is coming to our summer program this year. I’m so glad you brought him to the meet and greet a few days ago.

I know you were worried. When I sat down next to you, while Charlie was with his summer group and summer counselors, you gave me a tense smile and said, “I’m so embarrassed. He keeps saying bathroom words.” You went on to explain how awful he was behaving. That no other kids were saying poop or fart in response to questions. That during the year he had worked with his speech-language therapist who had provided him with social stories that were effective, and the bathroom talk had been extinguished. That you were petrified that it had returned.

When I gave you a smile and told you that this was SO common, that I had seen it a million times, I wasn’t trying to make light of your fears. I really was telling the truth. When I told you that potty talk doesn’t make any of us bat an eye, I was telling the truth. When I told you that it makes perfect sense that he’d resort to potty talk today, I was telling the truth. Charlie is 5 years old. Five year olds love potty talk. It’s silly and goofy and it’s a fun way for them to make each other laugh and connect. Charlie also happens to have an autism spectrum diagnosis. He has language, but anxiety and fear prevail over language. He was put into a new environment, with new kids, and new staff, for the first time all year. That would make ME nervous! So Charlie turned to the words that are easy for him, that he knows, that he could easily access. And those happened to be “poop” and “fart.” I promise you, this is the truth. I promise you, not a single one of us ever thought, or even will think, that he is “poorly behaved,” “trouble-causing,” or “disrespectful.”

When you left and told me, “Charlie said he loves this place!” I was thrilled. That was our goal for the meet-and-greet. To get each and every kiddo feeling like, yes, this is a place they will be safe and have fun this summer. You then followed it up with your disclaimer and fears, “But, he didn’t listen to a word anyone said.” My reply: “But he sat with the other kids. He kept his body in the group. He kept his body safe. He shared some laughs and some words. So from our point of view? It was a huge success.”

I was telling the truth.

We will work with Charlie all summer. We will help him find and access his language. We will teach him the “expected” and “unexpected” times to use potty talk. We will provide him with words and visuals to help him share his thoughts even if verbal expression isn’t accessible.

We are thrilled Charlie is here. We are thrilled you are here. You are in the right place.

I am telling you the truth.

 

 

*not his real name

In Declan’s head

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Ed note: The following is from the (imagined) perspective of Declan, an autistic 7th grader who I have seen for speech language therapy for several hours each week for two years. Some of this he was able to express in my words to me. Some of it I could figure out. And some is imagined based on what I know. I hope some day he will be able to tell me what I got right, and what I missed. Be kind, this is a weird kind of writing for me! I’ve never done anything remotely fictional before. All names have been changed.

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I walk down the hall, feeling the squirmy feeling in my stomach. It is excitement. Jen is outside her office, like she always is. She says,  “Hey Declan! It’s good to see you.” A few times earlier in the year she forgot that second part, so right before we began class I’d whisper to her,  “It’s good to see me.” I whispered because that way it would not bother the other friends. And then she would remember and say it to me.

I look at my friends in the room with us. When I was a little boy, Mommy and Daddy and teachers at the other school called everyone friends. But these two are my real friends. They like me and I like them! I grin and whisper to one of them,  “C for Carly!” and Carly smiles and says back like she always does,  “That’s right Declan!” She understands why I’m saying that, I think. It is because on the show that is Sesame Street that was on when I was a little boy, there was a girl named Carly and that’s what they said. And when I say that to Carly now it is to show her I like her like I liked Sesame Street. And she likes me too. Then I look at Maya, my other friend. I do our Friday routine. I say to her,  “What day is it, Maya?” and she exclaims,  “Friday!” We like our routines.

I am feeling so happy. Everything is right. Except then Carly and Maya start talking about who will be the teacher when they play school. This makes my belly squirmy but not the good kind.

“Ugh,” I tell Jen. “I really want to start our work. ”

Jen say, ” I know. But we can give them one minute to talk.”

“Because why?” I ask. If there is a reason, it makes my belly calm down. Jen knows that. She always tells me the reason.

“Because it is okay to let people have a minute to talk. It is good practice for them to talk to each other. And it is good practice for you too. Like, is this a 5 problem?” Jen asks.

I grin because not only did Jen give me a good reason, she is launching into one of my most favorite scripts that always makes me make happy noises.

“No it is not a 5 problem. We don’t have to say….” I wait for Jen to do her part.

“We don’t have to say,  ‘AH!  STOP TALKING WE HAVE TO WORK RIGHT NOW!!” I love when Jen fake screams. I make some happy noises.

“We could just say…. ” and together we say, “Oh well, I can be flexible.”

Now I’m feeling much better. I watch the videos in my brain from when I could not be okay with that, from when it would make my belly feel so awful that I might scream. It is different now! I’m a bigger boy and I can use my scripts to help me feel soft and squealy instead of hard and breakable!

We get started with our activity. We are talking about problems and solutions. We talk about what’s a wacky solution and what’s a smart solution. We are practicing calling 911 because Carly wants to act out one of the situations. She is in theater club. My brain knows that in the file of Carly that is in that folder in the brain.

Carly pretends to dial 911 and Jen pretends to be the operator. This is pretend. I know that now because there is not a real phone. I play pretend too sometimes, like when I feel heavy because a friend is absent so I pretend call and talk to them so I feel better. Jen is telling Carly that the pretend officers will be there right away. It is sillyscarystrangefunnybumpyhardwhirly so my mouth laughs. Jen says,  “I know! It’s a little funny pretending.”  I am glad she doesn’t tell me to stop laughing. I am not laughing. I think other friends and teachers hear laughing but that is not what my body is trying to do. I don’t know how to explain that. But my friends and Jen get it.

I start thinking about going over a bridge because I love bridges. And then I imagine putting the bridge on my head. Jen used to teach me that we could script about that, but in real life, it isn’t possible to do things like that. I know. But in my brain real life isn’t going on. Anything can happen which is why I am making a bridge go on my head. I start laughing and then remember, OOPS! Out loud I remind myself,  “Pause that thought! You can save it for later.” Jen gives me a thumbs up. I pick up my pencil and on the paper next to me, I write,  “Putting a bridge on my head.” This is a paper where I can write anything I want so that the words are still there, just not in my mouth, and my brain will remember because my eyes will look there later so I can tell Jen and Carly and Maya about it.

I give one last squeal, because I am excited to tell them about the bridge, and then I make my ears listen to the group.

“What do I tell him?”

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The mom of a 7-year-old kiddo who I just started seeing in a social pragmatics group, approached me before group this week.

Glancing at her son, she whispered, “He’s asking why he has to come to this group. What do I tell him?”

Such a common question. The parents I work with want what’s best for their children. Especially when they are in the early stages of an autism-related diagnosis, they are anxious and worried. They don’t want to say the wrong thing or do the wrong thing. They want to protect their child, yet empower him.

Ultimately, it comes down to the fact that while yes, I am a professional, nobody knows their child better than a parent does. So it’s a parents’ decision as to what to say or do. However, I do have my opinions. And I shared them with this mom.

I told her that we will get to talking about it in group, in a few weeks, once we’ve established some sort of cohesion and a sense of safety between the boys and me. I told her that when we do talk about it, we talk about how everyone has things that are easier for them and harder for them. I told her how I always, right off the bat, use the example that I’m really good at reading, but drawing is hard for me. Inevitably, one of the kids always replies, “I’m so good at drawing!!!” and I use that to say, “That’s great! It’s harder for me, but that’s okay.” And that opens up a discussion of everyone sharing what is easy and hard for them.

I explained that our kids are smart. And that even if they don’t know, diagnostically, that they have social-cognitive difficulties, they know it on an intuitive level. They’re aware that it doesn’t come as easy to them. They’ve felt frustration and sadness and confusion. And I firmly believe that it’s validating to know that others recognize it, that it’s okay, and that there are groups and ways to help make it easier.

Mom said, “Yes! That’s what I told him! I said that he’s so smart at things like math and science, but the social stuff can be harder for him sometimes. Is that okay? I don’t want him to feel like I’m pointing out his faults.”

I told her that in my opinion, yes, it’s absolutely okay. There’s a difference between accusing, and pointing out failures, and factually acknowledging strengths and weaknesses. I told her that when we keep it a secret, when we lie to our kids or tell them fakely, with a big smile on our face, “There is nothing wrong with you!! You have so many friends, all the kids like you,” that they know that something is off. It’s validating to hear, “I know this is hard for you. It’s hard for other kids too. It’s not a big deal.”

I always tell my kids and students that even for people who “social stuff” comes easier for, have difficulty here and there. I explain that what’s tricky for me is to sit back and let others talk sometimes.  And that’s okay. And I then ask, “Does that ever happen to anyone else?” And I validate anything they say. And if they say, “Sometimes I get frustrated with friends” or “Sometimes I don’t know what to say in a conversation,” I let them know that I get it. That I feel that way too, sometimes, and that probably other kids do, too.

It’s a big deal in that we want to help our kids get to a level of succeeding, we don’t want to ignore their challenges. But it’s not a big deal in that it’s not a huge secret. Everyone has strengths and weaknesses. Validate them for our kids. Let them know that we get it, that it’s not a “bad” thing. That we all struggle sometimes. That we’re going to help them as best we can.

But what do you DO?

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Because I have been invested in the field of speech-language pathology for many years now (truly since my junior year of high school), I sometimes forget that not everyone totally gets what the field is.

Friends and family know that I work intensely with autistic kids, and kids with social pragmatic difficulties. They know that I work in a school. That I see all ages. That I work with language-disordered kids, among other things (fluency, articulation, etc). But, I do realize that that’s still not clear — why does a speech-language pathologist do all of those things? What do I do?

Here is the quick cheat-sheet overview.

Language has three components: form, content, and use.
1. Form has three components. Phonology (the sound system of a language, how sounds are combined), Morphology (the structure of words), and Syntax (the order and combination of words in sentences). Essentially, we’re talking about grammar, noun/verb agreement, prefixes, suffixes, etc. Phonology is the basis for reading — knowing which sounds go together in which ways, etc.
2. Content: here we’re talking about words (aka “semantics”). What words mean, how words are defined, how to put words into sentences, paragraphs, how to cohesively use the definitions of words to express points, how to sequence sentences in the correct order, which words are antonyms and which are synonyms, and so on and so forth. Goes on forever.
3. Use: how form and content combine in daily life. AKA pragmatics. AKA, “how do we use language to be social?”

And….I work on all of these. All of these components develop naturally along a trajectory for neurotypical kids. But for most of my kids, they aren’t developing naturally. They have to be taught, often explicitly. That’s where I come in.
Examples of things that my kids might struggle with:
–Grammar, noun/verb agreements, prounoun uses
–Adding detail to sentences (e.g., adjectives)
–Using words to succinctly express what they are trying to say (e.g., “This weekend, she was there, I mean, my aunt, and um we went to that store you know? And……..”)
–Extracting the main idea, main points
–Higher-level language: idioms, multiple meaning words, metaphors (e.g., does “It’s raining cats and dogs” mean that animals are falling from the sky?)
–Predicting
–Comparing and contrasting (e.g., a 6th grader who can’t explain what’s the same/different about a lemon and an orange)

And again, the list goes on and on. It all comes back to these fundamentals of language. They are the building blocks of everything. If a kiddo has a language disorder, and struggles with the above, it’s only logical that they may have trouble in content classes — Science, Social Studies, etc. Because then, not only are they missing the building blocks, but they’re expected to understand the concepts too.

This is a very, very, very, summarized, abbreviated, and quick explanation. But maybe it’s what someone needs to see. Does it make sense? Should I give more information? I could geek out post after post with basic, or detailed, information….say the word and it’s a go. (Or, I may just do it anyway, because after all, I can!)