By Sarah Fowler
This week we are drawing inspiration from a webinar presented by Megan-Brett Hamilton, PhD, CCC-SLP titled: Social Communication Strategies for Adolescents: A Modern Approach
The scope of practice for SLPs is HUGE! While people tend to think of a speech therapist as someone who helps kids with lisps (articulation disorders), we treat so much more. SLPs also work in the areas of voice, language, literacy, executive functioning, swallowing, and what today’s blog is about: Social skills!
Typically social skills intervention involves peer-mediated intervention (social skills groups), video modeling, and/or social stories with goals focusing on identifying and discriminating social situations, conversation skills, interaction with peers and groups, developing and maintaining friendships, teasing/bullying, perspective taking, negotiation, initiating requests, and more. While these are all valuable lessons, some lessons might be more applicable to a student, but not others. In order to determine the most appropriate intervention strategies for each unique student, it’s important to consider what can influence the way they interact socially. 
For example, a person’s culture can greatly affect the norms of social communication. The best example being eye contact. While this is a common goal for students who identify as American, in other cultures, eye contact is considered rude. So as SLPs, we have to determine which goals mesh well with a child’s cultural identity. Worldwide Speech is well versed in this concept considering many of our clients are living internationally and belong to families with different cultural practices than our own. 
Another thing that can affect social interaction is identity. How we identify ourselves really begins to form during adolescence. Different life experiences are often key in determining one’s identity. What are some examples of how one might identify themselves? Race, ethnicity, religion, gender expression, sexual orientation, neurodiversity, SES differences, and future self are all things that shape our identity. Again, SLPs must use their clinical judgment to determine which goals are appropriate for the child’s individual identity. For example, if an adolescent identifies as transgender, we might work more on self-disclosure goals; whereas a cisgender adolescent with autism’s primary goal would focus on social reciprocity. 
While adolescence is already challenging, in today’s world, there are many things that have affected social development in adolescents. The COVID-19 pandemic brought about sickness, anxiety, stress, change in routines, and even with the use of vaccines, many of the adjustments we’ve made are here to stay. Additionally, many students are still participating in distance learning which exposes teens to even more challenges such as more time spent in stressful relationships with family members, depression, isolation, and loneliness. Social distancing has obviously affected social interactions. We are now engaging with people in a different way, primarily through platforms like Zoom which may be easy for some students but not others. We also have less salient features of nonverbal communication which forces us to rely more heavily on tone and articulation in the absence of being able to read someone’s face. While difficulty starting/maintaining friendships has been amplified due to the pandemic, our clients who are living internationally have had these difficulties long before COVID-19. 
So, we know that teens differ significantly from one another based on their life experiences, culture, and identity. The question remains, how do we develop an evidence-based practice when teens vary so greatly? Would you give the same evidence-based protocol to a white male teenager with autism as a young black female teenager? Hopefully, you said, “No way, Jose!” One of the most relevant examples of how treatment goals differ person-to-person is to think about how a police officer would respond to an autistic white male vs. an autistic black female. Which student do you think would more than likely require a social skills goal surrounding talking to police officers? The autistic black female has a greater risk of police brutality due to 1. the lack of understanding police officers have about people with autism, 2. the fact that she is black, and 3. the fact that she is female. All of her “intersections” make her more likely to have a negative experience with a police officer when compared to a white male teen. 
Seeing the necessity to individualize social skills goals may cause conflicting feelings. On one hand, you want to individualize therapy to meet functional goals for your student, but on the other hand, you want to use evidence-based practice to ensure success. 
Considerations for Practitioners and Parents
So what are some things we must do in order to make sure our treatment plan is effective for each individual? We must determine individual strengths/challenges, involve the student in treatment planning by discussing goals with your student, talk about their future, talk about behaviors they want to change, and ask what they want to accomplish during speech. You should also aim to use pictures that look like your student and use voices that sound like your student or their family members when using AAC devices when possible. 
One of my favorite notes from this Webinar was about considerations from a student’s perspective. People who have social communication challenges have noted the following as particularly difficult: masking, gender fluidity, race, homelessness, jobs, perception from women, getting along with parents, how to make/have friends, social media, and finding their own solutions. These are just some examples of the goals your student may want help with and it really shows why it’s so important to include adolescents in treatment planning. 
- Teach your student how to use technology safely and with consideration: Technology is ever present in our society and it isn’t going anywhere anytime soon! It’s important to address things like cyberbullying, writing emails, texts, or comments with consideration of audience, tone, and purpose, and how to connect both socially and academically in online spaces. You could also help your student a safe social media profile with permission from their parents and teach them how to detect unsafe profiles. 
- Assist with the identity piece: You can do this by showing videos of famous people who identify similarly to them, having conversations about neurodiversity, and allow them to choose how they want to identify by giving them the language to do so (e.g. autistic or person with autism). 
- Ask how your student feels about their goals/progress: Teach your student the language to describe how and why they feel a certain way. 
- Address consequences of charged conversations (e.g. race, politics, money, sexuality): Topics such as race, politics, money, and sexuality are treated differently depending on a student’s cultural upbringing. Having a conversation with parents is important to determine which topics are a no-go. Once you know which topics are considered “charged,” it’s important to talk to your student about when, where, and with whom these conversations are appropriate. 
A Parent’s role
These recommendations are not only for practitioners and educators, parents should feel comfortable exploring these topics with their teens too! It’s critical for parents to understand how their child identifies themselves, what their strengths/challenges are, and what their goals are in therapy. If you notice any specific challenges your teen encounters, present it to your child’s therapist. SLPs love to hear from parents about how students are using (or not using) social skills outside of the speech room. 
How can we help?
During the pandemic, Worldwide Speech saw a need for a social skills group via Zoom. We noticed that many students were struggling to maintain social skills via distance learning and created a Social Skills Group of students across 3 timezones to work on digital social skills. We address both academic and interpersonal social communication. A typical session of the Social Skills Group begins with the students engaging in small talk with one another (e.g. asking and answering questions about their weekend and the weather). After small talk, we have a brief lesson for a particular skill pertaining to social communication, with time to practice the skills after it’s taught. Lastly, the students engage in an online game that requires communication to meet a team goal. If you think your student would be a good fit for the group, send an email to email@example.com for more information!
5 Fantastic Parent Resources for Social Skills:
- 4 Social/Emotional Skills You Can Easily Practice with Teens
- 10 Important Social Skills You Need to Teach Your Teen Now
- 10 Ways Improve Social Skills in Children and Teens
- Social skills for autistic teenagers
- Evidence-based social skills activities for children and teens: A Parenting Science Guide
- Megan-Brett Hamilton, PhD, CCC-SLP, Social Communication Strategies for Adolscents: A Modern Approach. 2021.
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