This blog post has been playing around in my head for a long time now. I wanted to get it out to you way before this, but i needed to get this right. There are so many of us in the situation where our child’s speech and language skills are assessed and deemed appropriate for their age minus a few issues. Some of your children much like Lola can speak clearly, have a wide vocabulary and therefore only basic - or none in some circumstances - of speech and language therapy is provided. For Lola i always knew there was more to understand, yet without a competent professional who completely understood Lola and was able to think outside the box, using non-traditional methods of assessment we were stuck. Her profile was spiky, she had difficulties in some areas and was average in others. Her demand avoidance played a part in this also. Lola was diagnosed with Atypical Autism in 2014. In 2017 she was assessed by Dr Judy Eaton and subsequently diagnosed Autistic with a demand avoidant profile. (Pathological Demand Avoidance)

Lola had limited speech when she was two and half, making a few sounds, but her speech was mainly growling, screaming and grunting. She quickly caught up though, almost overnight she went from growling at people to singing Katy Perry’s ‘Roar’ - ironic right? - without the tiniest hint of difficulty.

It seemed that professionals thought as soon as she could speak it meant she understood too and so we found ourselves in a position where she was given basic Speech and Language Therapy delivered by a teaching Assistant. Is it any wonder that her skills in this area haven’t progressed over the last few years?

I truly believed that we were missing something from the bigger picture and that it was down to her understanding, but i had no idea what it was or how we could help her. That all changed last month when i attended the PDA Conference organised by The PDA Society who I will be eternally grateful to for continuing to raise awareness and acceptance and understanding of PDA.

There were a few workshops that the delegates could choose from and I chose the SALT workshop by Libby Hill - Speech and Language Therapist and all round legend of a woman who completely smashed her presentation like a boss, with humour in abundance and the ability to keep the attention of god knows how many people for a whole hour, hanging onto her every word and enthralled by the new information that was being presented before them. She’s the type of woman you want to immediately make your best friend. (I think I just about managed to not actually ask her out loud) Although I did stalk her a bit on social media afterwards and was delighted when she accepted my friend request.

Anyway, her presentation wasn’t what you’d expect. It didn’t tell us how to teach our children and young people to socialise appropriately. Remember when you had that “light bulb moment” when reading the text on Pathological Demand Avoidance? You know, the one where you quite literally thought they were describing your child? Well I had my second one during Libby’s talk which made me so excited. Finally I had been given the last tool that I needed in my toolkit and everything finally made sense to me.

“Social thinking is a user-friendly term for social cognition. Social thinking is required prior to the development of social skills”

Michelle Garcia-Winner

Social thinking is crucial to the development of Social skills and therefore we have been teaching our children step two before they’ve had the opportunity to learn Step One, much like the phrase “running before you can walk”

Social Thinking or Social Cognition is having the ability to consider your own thoughts, emotions and intentions as well as those of others so that you have the ability to interpret that information in your mind - which could then be transferred to Step Two and your social skills. Your interactions with people can be developed once you have the ability to predict another persons intentions.

Its quite a mouthful isn’t it? Libby used a fantastic explanation with some useful visuals and a description of some people in a train station with natural social cognitive abilities and others who were impaired in that area and the ways in which they responded to different situations.

Libby said...

“when walking through a train station and you see someone coming towards you with a buggy, you’ll automatically glide to the left to allow the person with more difficult manoeuvring skills to pass you by, and then along comes an elderly person using a walking stick and you automatically glide to the right to allow the elderly person to walk on by”

It is a response from your brain that sends the correct messages to your body that gives you social cognition.

However if a person has difficulty in the areas listed below then they are likely to experience SOCIAL COGNITIVE CHALLENGES

Executive Functioning

Cognitive Flexibility

Language Skills

Emotion Regulation

Social Skills

Sensory/Motor Difficulties

Before we start to implement strategies for Social Interaction we need to work on these difficulties. So if it seems like your child has not made nay progress during their periods of Speech and Language Therapy then it may be worth you exploring these ideas first because if you’re anything like me, this is most definitely the key that we have been looking for to unlock Lola’s potential for improving her Social skills.

Libby then went on to describe a techniques used to enhance these skills that was completely new to me. It wasn’t a technique i was familiar with at all and yet it made so much sense.

THE I-LAUGH MODEL - MICHELLE GARCIA WINNER.

I = INITIATION OF COMMUNICATION

L = LISTENING WITH EYES AND BRAIN

A = ABSTRACT AND INFERENTIAL LANGUAGE

U = UNDERSTANDING PERSPECTIVE

G = GESTALT PROCESSING: THE BIG PICTURE

H = HUMOR AND HUMAN RELATEDNESS

I IS FOR = INITIATING

The initiation of communication is the ability to use language skills to get your message across. It is a difficulty to start or (initiate) something that is not routine. Being able to ask for help, or seeking clarification on something and executing a new task. The individual with Social Thinking difficulties can have very little difficulties when speaking to someone about his or her own topics of interests however, when asking for help, or asking for clarification on something they are confused about can be extremely challenging because their initiation of communication is impaired. These two skills (asking for help and understanding how to join a group for functional or personal reasons) when combined together can enhance a persons ability to succeed in the workplace, in education and in relationships. Being able to initiate communication is paramount to ones future success. Asking for help is a really difficult thing for children to do and when you add on this difficulty in social thinking it opens them up to more vulnerability with their peers, their own self esteem and their teachers.

L IS FOR = LISTENING WITH EYES AND BRAIN

Did you know that listening is more than just receiving auditory information. Using your eyes to listen means that your brain is receiving visual stimuli and messages and interpreting them into messages that can be heard, or as Libby Hill more accurately describes - “Listening is not all about processing but also about how we synchronise non-verbal communication skills to process and respond more succinctly to a message.

So imagine you are speaking to someone and that person looks away seemingly distracted by something that they’ve seen and then looks back at you with disgust on their face, or amusement. Individuals without difficulties in Social Thinking are able to successfully interpret those non - verbal cues into a message that the the other person is relaying. A person without those difficulties will follow the other persons gaze, see the thing that is causing amusement or disgust and then react appropriately to the information that they’ve listened to with their eyes and brain.

A IS FOR = ABSTRACT & INFERENTIAL LANGUAGE / COMMUNICATION

There are lots of different types of abstract and inferential Language and communication that even i struggle sometimes when I can’t quite make sense of tone of voice and body language together with what someone is saying. When there is an impairment in understanding different types of communication then messages can get lost and/or misinterpreted causing confusion and frustration for the individual that needs to work really hard with these different types of language and communication.

Types of communication and Language that can cause these difficulties are:

Metaphor

Sarcasm

Inference

Idiom

’Slang’

So just going back slightly to the individual that struggles to initiate conversation or ask for help with meanings, and has difficulty listening with their eyes and brain, these types of language and communication are going to be extremely difficult for people to understand which can then be exacerbated by the difficulty to start a conversation explaining that they don’t understand = (INITIATION) Children with social and communication difficulties are often confused by ‘sarcasm’ and many Autistic adults are often describing their frustration of sarcasm and left wondering ‘what is the point’ ‘why don’t people just say what they mean?’

Are we being purposefully difficult by using idioms or sarcasm? Why do we seem to make communication so difficult that other people need to constantly interpret meanings by use of listening with eyes and brain to work out the actual message that is being sent.

“It’s raining cats and dogs” is a relatively over used term for ‘Lots of rain’

Why don’t we just say what we mean? - “Its raining quite a lot today isn’t it?”

Being able to understand this is incredibly complicated, yet many of us can understand the underlying meaning of abstract language but those with social thinking challenges battle daily with our complicated use of language. If you think about it, it is everywhere, and many are left wondering ‘What does it actually mean’ The slang today is different from yesterday. When i was growing up we used the ‘BAD” For awesome or (Good) and then 10 years later slang changed from ‘Bad’ to ‘Phat” I must admit i didn’t get this one! However another ten years later, i have a son who uses the word ’Sick’ How does one even try and understand the meaning of slang when it changes so randomly and frequently. I can completely understand why people would be confused. And it isn’t just in the spoken word that we use slang either, its prevalence on advertisements is astounding, which then creates the frustration of not understanding the meaning of adverts or wether something is a good deal or not.

The six steps to the I - LAUGH Model is quite complicated in itself to understand, The brain - for many people who do not have impairments will naturally jump from step 1 to step 6 very quickly. However not everyone is born with that natural ability and will need to be taught those skills in order to develop a good understanding of social skills and how to practice those for their future.

U IS FOR = UNDERSTANDING PERSPECTIVE

Understanding Perspective isn’t just one thing, its considering your own and others thoughts, Emotions, and personalities amongst other things which helps create the definition of perspective taking. Considering things like other peoples thoughts, emotions using prior knowledge and experiences and language based and physically coded intentions with regards to the specific situation. Confused? its a bit of a mouthful but simply put, To be able to UNDERSTAND someone else’s PERSPECTIVE you need to consider the thoughts, emotions and intentions of that person while also considering the specific situation simultaneously.

Which leads us to:

G IS FOR = GESTALT (GETTING THE BIGGER PICTURE)

Now i struggle with this one, conveying this in my own words, remembering the talk and explaining this in a way that can help others understand is difficult, but overall this basically means putting everything together, gathering all those tiny pieces of information and collating them so that they mean something, so that you can respond, understand, take it all in, it helps you stay on track in conversations and intuitively understand the underlying concept. When reading something you need to be able to follow the concept instead of just gathering those tiny bits of information and collating them together. Conceptual processing and organisational skills often go hand in hand and weakness in one area is normally accompanied by a weakness in another area. You may find that people with those difficulties are more likely to struggle with completing homework projects where they need to relate one piece of written work with another piece of art work or numeracy.and it can greatly impact on the persons ability to formulate written expressions. I always described Stanley as so intelligent in mind, he was so clever and advanced but when he started school those skills didn’t come through, he was described as :behind” and he needed A LOT of help. He couldn’t get it out of his head and onto paper, and thats where his difficulties lay.

H IS FOR = HUMOR AND HUMOUR RELATEDNESS

Humour for these beautiful minded people can be tricky, they can have a great sense of humour but will often miss the cues that enable them to participate successfully with others in social situations. Often some can have inappropriate sense of humour, timings, anxiety and being unable to judge another response can all impact on ones ability to convey their humour effectively.