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Improving Social Skills of Language Impaired Children

social kids

Many children on our caseloads have social pragmatic language goals aimed at improving their social emotional functioning in a variety of settings.  In therapy we often target our clients ability to engage in interpersonal negotiations, interpret ambiguous facial expressions, as well as appropriately relate to peers.

However, oftentimes finding appropriate and relevant real-life photos is a challenge for busy clinicians. That is why I created the “Social Pragmatic Language Activity Pack“.

This 30 page social pragmatic photo/question set is intended for children ages 6 and older. It is organized in a hierarchy of complexity ranging from basic social scenarios to more abstract and socially ambiguous situations.  Some photos contain additional short stories with questions that focus on auditory memory, processing, and comprehension.

There are on average 10-20 questions per each photo, and each photo takes up one page.  While some scenarios may be suitable for younger children, most are suitable for children ages 8-9 and older. Select scenarios containing abstract concepts may be suitable only for upper elementary or middle school aged students.   These sets are suitable for both individual therapy sessions as well as group work. Depending on the student’s abilities and extent of deficits, one set (one page) may take up to 30 minutes to complete.

Areas covered by the questions:

  1. Recognizing Emotional Reactions
  2. Explaining Facial Expressions
  3. Making Predictions
  4. Making Inferences (re: people, locations, thoughts, feelings, and actions)
  5. Multiple Interpretations (of actions and settings)
  6. Interpersonal Negotiations
  7. Sympathy/Empathy
  8. Peer Relatedness (Support)
  9. Interpreting Ambiguous Situations
  10. Problem Solving
  11. Determining Solutions
  12. Determining Causes
  13. Determining Perspectives
  14. Social Judgment
  15. Safety Rules

So don’t delay and grab your set today. You can find it HERE in my online store.

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Introduction to Social Pragmatic Language Disorders

SPLDI have been making a lot of materials lately in order to disseminate information on a variety of helpful topics including insurance coverage for speech language services, improving feeding abilities in picky eaters, the importance of oro-facial observations during speech- language assessments  and so on. I’ve also created an “introduction” series, which offers handouts on popular topics of interest, most recently on the topic of Auditory Processing Disorders (APD), which can be currently found in my online store HEREContinue reading Introduction to Social Pragmatic Language Disorders

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Recognizing the Warning Signs of Social Emotional Difficulties in Language Impaired Toddlers and Preschoolers

emd toddlersToday I am exited to tell you about the new product I created in honor of Better Speech and Hearing Month. 

It is a 45 slide presentation created for speech language pathologists to explain the connection between late language development and the risk of social emotional disturbances in young children 18 months- 6 years of age.

Learning Objectives:

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In case you missed it: The importance of targeted assessments for school aged children

Last week I did a guest post for The Simply Speech Blog. In case you missed it,  below I offer an explanation why targeted speech language assessments are so important, as well as list helpful resources that will aid you in speech language assessment preparation.

In both my hospital based job and in private practice I do a lot of testing. During staff/caregiver interviews I used to get a laundry list of both specific and non-specific problems by the parents and teachers, which did not always accurately reflect the students true deficits.  Experience quickly taught me that administering general comprehensive language testing to every student simply did not work. Oftentimes the administration of such testing revealed one of two things: Continue reading In case you missed it: The importance of targeted assessments for school aged children

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App Review and Giveaway: Verbal Reasoning by Virtual Speech Center

Today I am reviewing a great app, which targets verbal reasoning skills in children and adults. Verbal Reasoning by Virtual Speech Center was created to target the following:

Adults with cognitive deficits caused by TBI, stroke, or other brain injuries as well as with Aphasia

Children with autism

Children with language disorders

It is intended for  individuals ages 12 and up and includes such activities as: Continue reading App Review and Giveaway: Verbal Reasoning by Virtual Speech Center

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New Webinar: Inattention, Hyperactivity and Impulsivity in At-Risk Children: Differential Diagnosis of ADHD in Speech Language Pathology

 Inattentiveness, hyperactivity, and impulsivity are the most common presenting behavioral problems in at-risk children. This workshop will describe select speech language causes of hyperactivity and inattentiveness in children beyond the ADHD diagnosis, including traumatic brain injury, auditory processing disorders, severe language disorders, as well as social pragmatic language deficits.It will review case examples to illustrate the importance of differential diagnosis. Implications for assessment as well as the need for relevant referrals will be discussed.

When: Thursday, January 17, 2013, 4-5 p.m. ET

Where: Your computer*

Presenter: Tatyana Elleseff, MA, CCC-SLP

Cost: FREE

Who Should Attend: Anyone interested in discussing behavioral problems in at-risk children.

How: Register Here

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Understanding the risks of social pragmatic deficits in post institutionalized internationally adopted (IA) children.

Image may contain: 1 person, textThis article was originally published in December 24, 2012 issue of Advance for Speech Language Pathologists and Audiologists under the title: “Adoption & Pragmatic Problems” (pp 6-9) 

Photo credits: Leonid Khavin

Cover Model: Bella Critelli

According to U.S. State Department, 233,934 children were adopted internationally between 1999-2011, with a majority 76 percent (or approximately 177,316) of these children being under 3 years of age.

To date a number of studies have come out about various aspects of these children’s language development, including but not limited to, rate of new language acquisition, patterns of typical vs. atypical language acquisition, as well as long-term language outcomes post-institutionalization.

While significant variability was found with respect to language gains and outcomes of internationally adopted children, a number of researchers found a correlation between age of adoption and language outcomes, namely, children adopted at younger ages (under 3 years of age) seem to present with better language/academic outcomes in the long-term vs. children adopted at older ages.1,2,3,4

Indeed, it certainly stands to reason that the less time children spend in an institutional environment, the better off they are in all areas of functioning (cognitive, emotional, linguistic, social, etc.). The longer the child stays in an institutional environment, the greater is the risk of greater delays, including a speech and language delay.

However, children adopted at younger ages, may also present with significant delays in select areas of functioning, many years post-adoption. Continue reading Understanding the risks of social pragmatic deficits in post institutionalized internationally adopted (IA) children.

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“Appdapting” Flashcard Apps to Address Social Skills

I have to admit, I don’t really like flashcards. I especially don’t like it when parents or SLPs use flashcards to drill vocabulary in toddlers and preschoolers, much less school aged children. I feel that it produces very limited learnability and generalization. I am personally a proponent of thematic language learning, since it allows me to take a handful of words/concepts and reinforce them in a number of different ways. The clients still get the benefit of information repetition, much like one would get during a typical flashcard drill.  However, they are also getting much more.  Thematic language learning allows the client to increase word comprehension, make connections to real life scenarios,  develop abstract thinking skills, as well as to transfer and generalize knowledge (Morrow, Pressley, Smith, &  Smith, 1997; Ramey, 1995).

However, even though I dislike flashcards, I still don’t necessarily want to give up using them completely, especially because nowadays many different type of image based language flashcards can be found for free as both printables as well as Iphone/Ipad apps.  Consequently, I decided to pick a free flashcard app and adapt it or rather  “appdapt” it (coined by “The Speech Guy”, Jeremy Legaspi, the “Appdapt Guru”) in a meaningful and functional way for my students.

After looking over and rejecting a number of contenders, without a clear plan of action in mind,  I stumbled upon a free app, ABA Flash Cards – Actions by kindergarten.com, which is designed to target verb labeling in ASD children.   When I saw this app, I immediately knew how I wanted to appdapt it.  I especially liked the fact that the app is made for both Ipad and Iphone. Here’s why.

My primary setting is an out of district day school inside a partial psychiatric hospital.  So in my line of work I  frequently do therapy with students just coming out from  “chill out rooms” and “calm down areas”.  This is definitely not the time when I want to bring or use a lot of materials in the session, since in a moment’s notice the session’s atmosphere can change from calm and productive into volatile and complicated.  I also didn’t  want to use a bulky Ipad in sessions with relatively new children on the caseload, since it usually takes a few sessions of careful observations and interaction to learn what makes them “tick”. Consequently, I was looking for an app which could ideally be downloaded onto not just the Ipad but also the Iphone. I reasoned that in unexpected  situations I could simply put the phone into my pocket, unlike the Ipad, which in crisis situations can easily become a target or a missile.

Given the fact that many children with psychiatric disorders present with significant social pragmatic language deficits (Hyter, 2003; Hyter et al 2001; Cohen et al., 1998; Bryan, 1991; Goldman, 1987 ), which is certainly the case for the children on my caseload, I planned on adapting this app to target my students’ pragmatic language development, social problem solving skills as well as perspective taking abilities.

So here are just a few examples of how I appdapted the cards.  First, I turned off the sound, since the visual images were what I was going after.  Then I separated the cards into several categories and formulated some sample questions and scenarios that I was going to ask/pose to the students:

Making Inferences (re: People, Locations and Actions)

iPhone Screenshot 2

What do you think the girl is thinking about?

How do you know what she is thinking?

How do you think she is feeling?

How can you tell?

Where do you think she is?

How do you know?

 

Multiple Interpretations of Actions and Settings: 

iPhone Screenshot 3

 

What do you think the girl is doing?

What else could she be doing?

 

 

 

 

 

boyflowerHow does the boy feel about the flower?

Give me a different explanation of how else can he possibly feel?

 

 

 

 

Who are the boys in the picture? (relationship)

Who else could they be?

What do you think the boy in a blue shirt is whispering to the boy in a red shirt?

What else could he be saying?

How do you know?

 

Supporting Empathy/Sympathy and Developing Peer Relatedness:

How does this child feel?

Why do you think he is crying?

What can you ask him/tell him to make things better?

 

 

 

 

The girl is laughing because someone did something nice for her?

What do you think they did?

 

 

 

 

 

Interpreting Ambiguous Situations:

girlrunning

 

What is the girl doing?

Who do you think is the woman in the picture?

How do you know?

How does she feel about what the girl is doing?

How do you know?

My goal was to help the students how to correctly interpret facial features, body language, and context clues in order to teach them how to appropriately justify their responses. I also wanted to demonstrate to them that many times the situations in which we find ourselves in or the scenes that we are confronted with on daily basis  could be interpreted in multiple ways. Moreover, I wanted to teach how appropriately speak to, console, praise, or compliment others in order to improve their ability to relate to peers. Finally, I wanted to provide them with an opportunity to improve their perspective taking abilities so they could comprehend and verbally demonstrate  that other people could have feelings, beliefs and desires different from theirs.

Since I knew that many of my students had significant difficulties with even such simple tasks as labeling and identifying feelings, I also wanted to make sure that the students got multiple opportunities to describe a variety of emotions that they saw in the images, beyond offering the rudimentary labels of “happy”, “mad”, “sad”, so I took pictures of Emotions Word Bank as well as Emotion Color Wheel courtesy of the Do2Learn website, to store in my phone, in order to provide them with extra support.

                

The above allowed me not only to provide them with visual and written illustrations but also to teach them synonyms and antonyms of relevant words.  Finally, per my psychotherapist colleagues request,  I also compiled a list of vocabulary terms reflecting additional internal states besides emotions (happy, mad) and emotional behaviors (laughing, crying, frowning). These included words related to:  Cognition (know, think, remember, guess), Perception (see, hear, watch, feel), and Desire (want, need, wish), (Dodd, 2012) so my students could optimally benefit not just from language related therapy services but also their individual psychotherapy sessions as well.

I’ve only just began trialing the usage of this app with the students but I have to admit, even though its still the early days, so far things have been working pretty well. Looks like there’s hope for flashcards after all!

References:

———Bryan, T. (1991). Social problems and learning disabilities. In B. Y. L. Wong (Ed.), Learning about learning disabilities (pp. 195-229). San Diego, CA: Academic Press.

—Cohen, N. & Barwick, M. (1996) Comorbidity of Language and Social-Emotional Disorders: Comparison of Psychiatric Outpatients and Their Siblings. Journal of Clinical Child Psychology, 25(2), 192-200.

Goldman, L. G. (1987). Social implications of learning disorders. Reading, Writing and Learning Disabilities, 3, 119-130.

—Hyter, Y. D., et al (2001). Pragmatic language intervention for children with language and emotional/behavioral disorders. Communication Disorders Quarterly, 23(1), 4–16.

Hyter, Y. D. (2003). Language intervention  for children with emotional or behavioral disorders. Behavioral  Disorders, 29, 65–76.

Morrow, L. M., Pressley, M., Smith, J.K., & Smith, M. (1997). The effect of a literature-based program integrated into literacy and science instruction with children from diverse background. Reading Research Quarterly, 32(1), 54-76.

Petersen, D. B., Dodd, J & Finestack, L. H (2012, Oct 9) Narrative Assessment and Intervention: Live Chat. Sponsored by SIG 1: Language Learning and Education. http://www.asha.org/events/live/10-09-2012-narrative-assessment-and-intervention/

Ramey, E. K. (1995). An integrated approach to language arts instruction. The Reading Teacher, 48(5), 418-419.

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Improving Social Skills in Children With Psychiatric Disturbances Speechpathology.com Webinar

Will be presenting a webinar via speechpathology.com on July 2nd 2012 at 12pm EDT entitled

Improving Social Skills in Children with Psychiatric Disturbances

Course Abstract

This course is aimed at increasing the participants’ knowledge regarding the role of SLPs in the treatment of social pragmatic language disorders of school-age children with psychiatric impairments. It will review social pragmatic treatment approaches which can be used for children with psychiatric impairments, explain the functions of common challenging behaviors, as well as list a number of proactive behavioral intervention approaches professionals can implement to decrease challenging behaviors and increase compliance and cooperation in therapy sessions.

Course Objectives

  • After this course, participants will be able to identify social pragmatic deficit areas of children with psychiatric impairments.
  • After this course, participants will be able to describe components and targets of successful social skills treatments.
  • After this course, participants will be able to list common challenging behavior types and explain proactive behavior strategies used to prevent inappropriate behaviors from occurring.
  • After this course, participants will be able to describe social pragmatic treatment approaches that can be used for children with psychiatric impairments.
  • After this course, participants will be able to identify materials that can be used to address relevant social pragmatic treatment goals.
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Upcoming New Jersey Speech Language and Hearing Convention 2012 Presentations

Tatyana Elleseff MA CCC-SLP will be giving 2 presentations at the NJSHA 2012 Convention on April 19-20, 2012

1. Presentation Title:     Behavior Management Strategies for School Based Speech Language Pathologists

Time:                         Thursday, April 19                8:15 AM – 10:15 AM

Summary: In recent years more and more school based speech-language pathologists have to work with children who present with behavioral deficits in conjunction to speech-language delays/impairments. A significant portion of work with these children in therapy sessions involves successful management of inappropriate behaviors such as excessive inattention, hyperactivity, aggression, opposition/non-compliance and/or apathy, which interferes with successful objective completion and goal attainment. This workshop will explain what type of common challenging behaviors can manifest in children with select communication, psychiatric, and neurological disorders.  It will outline behavior management strategy hierarchy from most to least intrusive methods for students with differing levels of cognitive functioning (high-average IQ to varying levels of MR). It will list positive proactive behavior management strategies to: prevent inappropriate behaviors from occurring, increase students’ session participation as well as improve compliance and cooperation during therapy sessions.

2. Presentation Title:     Social Pragmatic Assessment of Children Diagnosed with Emotional/Psychiatric Disturbances in the Schools

Time:                         Thursday, April 19              10:45 AM – 12:45 PM

Summary:  The number of children who present with non-spectrum emotional, behavioral, and psychiatric disturbances (oppositional defiant disorder, reactive attachment disorder, mood disorder, etc) has been steadily increasing in recent years. Many of these children attend district schools and due to high incidence of communication issues associated with these conditions, speech language pathologists are frequently included on the team of professionals who treat them.   This workshop is aimed at increasing the participants knowledge regarding aspects of social pragmatic language.  —By the end of the workshop participants will be able to list common pediatric psychiatric diagnoses, explain the impact of psychiatric disturbances on language development of children, summarize the role of SLP in assessment of pragmatic language and social cognitive abilities of school-age children, as well as utilize formal and informal assessment instruments to assess pragmatic language and social cognitive abilities of school age children.