Tuesday, May 8, 2012

Social-Pragmatic Skills and Autism Spectrum Disorders (ASD)

 As a group, higher functioning students with ASD tend to demonstrate strength in formal language, but a weakness is pragmatic and social skills.  As a result, they often fail to qualify for speech-language services because they present strong verbal skills and large vocabularies, and score well on formal language assessments. Particular attention should be given to the pragmatic, social communicative functions of language (e.g., turn taking, understanding of inferences and figurative expressions) as well as to the nonverbal skills needed to communicate and regulate interaction (e.g., eye contact, gesture, facial expression, and body language).  Significant and severe deficits in the ability to communicate and interact with others can limit their participation in mainstream academic settings and community activities. Moreover, pragmatic deficits tend to become even more obvious and problematic as social and educational demands increase with age.
There are many unwritten rules in society that govern our behavior. While most of us intuitively understand these rules, individuals with ASD have not automatically learned the conventions and nuances that make up their social environment. These unspoken or “hidden” social standards can make the world a confusing place and result in life-long challenges. For example, social expectations such as “it is not polite to interrupt others while they are talking,” “take turns in conversation” and “discuss other topics besides only those you are interested in” are not taught and are assumed to be known and understood. We seem to have an “unconscious” navigator that allows us to make intuitive sense of the unspoken rules in society and adjust to the social demands of our everyday lives.
The unspoken rules of social engagement involve the use of the pragmatic, social communicative functions of language (e.g., turn taking, understanding of inferences and figurative expressions) as well as nonverbal skills needed to communicate and regulate interaction (e.g., eye contact, gesture, facial expression). This includes body language and idioms, metaphors, or slang – phrases and meanings that we intuitively assimilate or learn through observation or subtle cues. Individuals with ASD tend to interpret language literally and may be puzzled by the common everyday expressions used by a typical peer or adult. Consider how idioms or figurative speech such as “how the cookie crumbles,” “curiosity killed the cat,” and “when it rains, it pours” might have a totally different meaning and result in confusion if taken literally. In order to understand language, we must understand what the idioms in that language mean. If you try to figure out the meaning of an idiom literally (word by word), you will be bewildered. While the typical individual might understand that the phrase “that’s the way the cookie crumbles,” and accompanying body language (e.g., voice, body) communicates to the listener that something unfortunate has happened, to someone with a pragmatic social-communication problem, this idiom will have a completely different meaning and be confusing. The following are but a few of well over 3,000 idioms in the English language. 
  • Bite off More than you can chew 
  • Cross that bridge when you come it
  • Everything but the kitchen sink
  • Get up on the wrong side of the bed
  • Have a bone to pick with you
  • Have your cake and eat it too
  • In hot water
  • Kill two birds with one stone 
  • Out of the clear blue sky
  • Piece of cake
  • Put all your eggs in one basket
  • Raining cats and dogs
  • Read between the lines
  • Rub the wrong way
  • Run circles around someone
  • Sick as a dog
  • Throw in the towel
  • Till the cows come home
  • If the shoe fits, wear it
Additional examples can be found on http://www.usingenglish.com/reference/idioms/
It is important to not assume that your message is being interpreted correctly. You should always check for understanding and “say what you mean.”  Jennifer Twachtman-Reilly (2010) offers some tips for improving pragmatic inference ability in children with ASD.  For example, teach the child to comprehend the figurative meaning of idioms by focusing on the context to determine the speaker’s intent (e.g., When the teacher says, “Don’t bite off more than you can chew” when you start this project. What does this really mean?). Providing visual supports can also be helpful in conveying the hidden meaning of the message. The following resources should be helpful in navigating the confusing world of idioms.

Myles, B. S., Trautman, M. L., & Schelvan, R. L. (2004). The hidden curriculum: Practical solutions for understanding unstated rules in social situations. Shawnee Mission,  KS: Asperger Publishing Company.
Snodgrass, C. S. (2004). Super Silly Sayings That Are over Your Head: A Children's Illustrated Book of Idioms. Higganum, CT: Starfish Specialty Press.

Terban, M. (1996). Scholastic Dictionary of Idioms: More than 600 phrases, sayings, and expressions. New York: Scholastic, Inc.

Twachtman-Reilly, J. (Spring, 2010). Tips for improving pragmatic inference ability in children with ASD. Autism Spectrum Quarterly.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.

© Lee A. Wilkinson, PhD


Jonathan S. Corchnoy, Esquire said...

I wish more school districts conveyed this message to their professional staffs and gave such students greater instruction in pragmatic communication and social skills. If they did so, many of my clients, their dhildren, and the educators themselves would be happier and see me less.

Janis Maltos, M. Ed., ECSE said...

I have two sons with high functioning autism, one in fifth grade and the other in 7th. This delay in pragmatic and social language is obvious, yet our school district does not work on these skill deficits. They measure receptive/expressive language and speech articulation. What formal assessments measure pragmatic skills/social language?

charlotte scheel said...

Arnold Goldstein have written a book called "the prepare Curriculum", it is not written for this specific group, but it contains a near step by step instruction on a many social skills. Understanding abstracts are not a part of it, but i think that maybe a strict instruction could be a help for those who are trying to learn and those who are trying to give instructions on social skills.

Lee A. Wilkinson said...

The following instruments can be used to assess social pragmatic language skills in children with ASD.

Children’s Communication Checklist (CCC-2)
Comprehensive Assessment of Spoken Language (CASL)
Pragmatic Language Skills Inventory (PLSI)
Test of Pragmatic Language (TOPL)

Please refer to A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools for a complete description of a comprehensive assessment battery for school-age children and adolescents.

Lee A. Wilkinson, PhD, NCSP

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