Social Communication Therapy For Adults

Social (or pragmatic) communication is the verbal and non-verbal behaviour we use to communicate effectively with other people. Effective social communication is comprised of three main types of skills:

1. how we use language to communicate in various ways (e.g., greetings, making requests, looking for information)
2. how we make changes to the use of language based on the social setting (e.g., how we speak differently to a stranger versus a family member or close friend); and
3. how we learn the social rules and etiquette of a conversation (e.g., turn-taking and reading social cues).

People who have a very good grasp of the English language may still find it difficult to apply their language effectively in a social way. Conversely, people who struggle with the English language may still find it effortless to connect with the people around them in other ways. This is because using core language is very different to using social language, and social communication is a tricky skill that can take years and years to refine.

Why is it important to have social communication skills?

Social communication is important for making and keeping relationships with others and enhancing social connectedness. In other words, social communication skills are important for:

• Improving overall wellbeing. Increasing social supports and maintaining close relationships is linked to better overall mental health and emotional wellbeing.
• Accessing the community. Establishing social networks can help to facilitate community access such as: gaining employment, volunteering or engaging in social community groups.

Who may benefit from social communication intervention?

Intervention to improve social skills will benefit anyone who has difficulties communicating in social contexts. A social communication disorder can be diagnosed by a Speech Pathologist based on primary difficulties in social interaction, social understanding and use of language in social situations. An adult with a social communication disorder may have specific difficulties with:

• Communicating for social purposes or in an appropriate way for the social situation
• Changing their communication to match the context or the needs of the listener
• Following rules for conversation and storytelling
• Understanding non-literate and ambiguous language
• Understanding what is not explicitly stated

Social communication disorder can be a distinct diagnosis or may co-occur with other diagnoses, such as:

• Autism Spectrum Disorder
• Intellectual Disability
• Learning Disability
• Developmental Language Disorder
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Traumatic Brain Injury
• Aphasia
• Dementia
• Right-Hemisphere Brain Injury

What evidence is there to support social communication intervention?

There is no ‘one size fits all’ approach for social skills therapy. One-to-one clinician directed intervention is useful for teaching new skills. Group intervention is often used in conjunction with one-to-one services to help to promote generalisation to everyday life. Some common examples of evidence-based social skills intervention are listed below:

Social Stories and Scripts

Social stories are used to help provide direction or appropriate ways to respond in a specific social situation. Social stories have been shown to be significantly effective when used to target behaviour reduction (Kokina & Kern, 2010).

Video Modelling

Video modelling is one of the most effective social skills teaching methods. Video modelling is effective to teach social communication, functional skills and perspective taking (Delano, 2007).

PEERS

PEERS is an evidence-based social skills program for motivated adults who are interested in making and keeping friends and/or developing romantic relationships. Young adults and their social coaches attend 16 weekly sessions for 90 minutes each week. Attendees are taught social skills through role-play, social activities, and homework. Meanwhile, their allocated social coach (usually a parent, caregiver, or family member) attends a separate 90-minute session each week to learn additional strategies for assisting their loved one in making friends and/or with their dating journey. The PEERS program can be facilitated either face-to-face or via Telehealth.

Social Groups

Social skills groups are used to help generalise skills that have been taught in a one-to-one setting. Social skills groups are typically made up of other people that are a similar age and include 1-2 adult facilitators (generally a Speech Pathologist or Occupational Therapist). Social skills groups are effective for generalising social skills that have been taught in one-to-one sessions (Spain & Blainey, 2015).

How can I help to facilitate my loved one’s social communication skills outside of therapy?

The chances are you are already supporting your loved one with social communication skills all the time without even realising you are doing it. For people with well-developed social communication skills, it is often automatic to ‘repair’ or ‘guide’ social interactions on behalf of those who find them difficult. So, the likelihood is your loved one is already learning from you every day – but here are some more specific things you can do to maximise the support you are giving them at home and in the community:

1. Discuss ways that you can practise skills that are taught in one-to-one Speech Pathology sessions with your Speech Pathologist. Practice outside of these sessions is critical in helping your loved one to generalise these skills into everyday life.
2. Play boardgames that require communication skills and collaboration with others such as Charades, Taboo, Articulate or even card games that require conversation.
3. Encourage your loved one to join a local community group. This could be a sport, a hobby, or any other kind of social group in the community.
4. Encourage your loved one to initiate communication in public. Whether it be with a cashier, waiter, or a bus driver, these are all great opportunities to practise communication that is socially appropriate in that context and with that person.
5. Look into local or Telehealth social skills groups. It may be helpful to discuss options that are most suitable for your loved one with a Speech Pathologist. They will be able to guide you to what content may be most appropriate for them at that point in time.

If you would like to book an initial consultation with a Speech Pathologist from our team, please contact us on 1300 086 280 or at [email protected].

References

Delano, M. E. (2007). Video Modelling Intervention for Individuals with Autism. Remedial and Special Education, 28 (1), 33-42.

Kokina, A. & Kern, L. (2010). Social Story Interventions for Students with Autism Spectrum Disorders: A Meta Analysis. Journal of Autism and Developmental Disorders, 40 (7), 812-826.

Spain, D. & Blainey, S.H. (2015). Group Social Skill Interventions for Adults with High-Functioning Autism Spectrum Disorders: A Systematic Review. Autism, 19(7), 874-886.