Social communications therapy?

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I have a teen son recently diagnosed w/PDD-NOS and he has some real social communications issues -- initiating a social conversation, not knowing when to jump in to a conversation/both self reported by him and other things that my dh and I can see that he hasn't self identified such as understanding the value of asking questions of others to help build relationships and friendships. He does not have speech and language issues in general. He understands idioms, tests well on speech and language tests etc. We have him in an ongoing social skills group, but I was wondering of the value of doing social communications therapy for him as well. Not now, since he feels overwhelmed as is and I don't want to upset the psychological apple cart more than it already is, but I want to do anything and everything for him to give him as bright a future as possible. If you had your child do social communications therapy one on one, how much difference did it make? I wouldn't mind input from the AS people that have been through it as well. How long did it take to make a difference if it was a positive experience?

I can't really speak as a person with AS, because the therapies weren't available when I was a kid, but we have my son in pragmatic speech classes at school (social communication) AND a social skills class after school. That combo seems to be doing magic for us (my son is 11) The two things are slightly different, and I think the combination has been beneficial. If you're in the US public school system, this is a fairly standard therapy that's pretty easy for them to provide.

I didn't get "support" for this until college, where I was a theater major - we spent most of our time "analyzing scripts" for "subtext," which is essentially the same as pragmatics. I was a mess until I learned how to do this.

He's been tested by the school district. His testing showed he was slightly above his peers for Speech and Language so no help from the school district there. He was doing so well on the pragmatics test administered by the therapist that she declined to finish it due to the tedious nature of it. They tried him in their high functioning social skills group and he was above them as well as reported both by him and the social worker that runs the group. He gets no help at all in this area from the school as a result of this and they will not work with him one on one. They don't doubt that he has a PDD, but they will not help since he is really bright (no learning issues) and not a behavior problem. In addition, he sits w/some kids at lunch so they see him as having a friend's group, but ds does very little of the talking in that group by his own reporting and only rarely gets together with one boy from that group and it is usually with urging in the background by both moms. He doesn't qualify for services other than a 504. There is absolutely no doubt in my mind that he needs help/therapy in this area however and we will have to do it privately. He is in a drama class as an elective. I'm hoping that may help a bit, but he needs more than what this will do.

Acting classes might be a good way to get around this.

Keep in mind, the therapist needs to compare the value of the pragmatics to the values of the semantic scores: the deficit can be the differential between the two, not the score in either case (meaning that we expect better pragmatics from people with big vocabularies and good grammar.) DS didn't have an overall bad pragmatics score, but where he did badly, he couldn't even answer the question, and that was considered significant.

Here's another really good article on why a child may pass the test, but still not function well: http://www.autism-pdd.net/testdump/test15464.htm and the link within the article (which is broken) is here: http://www.iidc.indiana.edu/index.php?pageId=522

I think you are right, the specific social things you're saying he needs help with are something they would address in speech therapy. A really good pragmatics class happens in the school with neurotypical kids: we had that for a while, then the District changed the rules and put all the struggling kids together in a group (not so helpful.)

This may sounds "left field", but since your son is a good language skills and no learning disabilities, could having him read just a "manners" book help him? My DD (who is 9) is a voracious reader and when I struggled with how to explain particular social nuances, I found that magazines such as "Real Simple" and manners guidebooks actually had small lessons on navigating social situations ("How to Carry On A Conversation," "How to Politely Decline An Invitation", etc.).

I found that after DD understood the social niceties and how they were supposed to work, she was much better at trying her hand at getting involved in conversations. For her, just knowing what others expected was helpful in establishing a set of rules for her to go by.

Made me think of this :

http://www.cbsnews.com/video/watch/?id=7400882n

I did have him read a small three page section of Temple Grandin's book on unwritten social rules shortly after I tried to explain the idea of asking questions to other people to build relationships. I've explained to him the idea of asking about things even if it isn't your personal interest area to show the other person you care about them and what they are doing. I told him Temple Grandin explained it far better than I ever could. He said he understood it. Is he putting it into practice? Not really. We've put a challenge to him,to ask one person a question or pay a compliment when he goes to events including meals w/my family or with his social youth group. He is in a youth group with nice boys and he is accepted as far as I can tell. At this point I think the others only think he is really shy and quiet. He blends in and doesn't draw attention and has never been bullied. Sort of the perpetual wallflower and flying under the radar. I've suggested he ask the friends he sits with at lunch what they are doing in the summer or what classes they are taking the following year. They are the kinds of things they wouldn't think anything of if he asked. He hasn't done it. Granted it has only been a little over two months since he was diagnosed and about 6 weeks since he started a social skills group, but I really think he needs some one on one therapy so that he can be successful at these basic things.

He, for the most part, has basic manners down so the etiquette isn't much of an issue. He has never had an issue with violating anyone's personal space either.

I wonder if watching some video modeling would help? Maybe he doesn't have a good picture in his head of what a successful interaction looks like, or maybe he has a hard time seeing the conversation as a whole.

My other thought is maybe there is a buddy/mentoring programs near you that offers practice with these things?

I also wonder if role playing with family members might help. He might feel like it is silly, but role playing really helps cement ideas and get that extra practice that will make it easier when he is in a situation like that in the future.

Good food for thought. I'm not sure. He has an older quite talkative, NT sister and he has had successful conversations modeled around the dinner table every night. He does participate much more at home, but doesn't ask questions of us at home unless it is a need vs. something social, but will participate in social conversations that the rest of us initiate. The students he eats lunch with are all NT as far as I know and he sits at a full table for 8 five days a week so he sees and hears the modeling there. My dh is really good at creating conversations with almost anyone and has been trying to show him for the last few years how to chat up people. He still doesn't know when to jump into it to contribute or how to initiate.

I've never seen any video modeling. If anyone has any examples to share, I'd love to look and see if I think they could help him.

The only buddy type program I know of wouldn't work for him. Many of the kids he goes to school with volunteer there. He was actually a volunteer himself before we realized the extent of his problem. He is leary of coming out so to speak about this and I can't say I blame him. He would feel very awkward to go from volunteer to client. He is congizent of the difference between him and others, but doesn't want to be seen as different. He is about as high as you can go on the spectrum, yet definitely still be on it.

We've found that using regular TV shows that have more realistic positive social modeling has been helpful. DS uses TV as a form of social research, and we found that we had to be very careful about what media he chooses, but also by directing his choices, he's learned a lot.

Thank you SC2010. That makes a lot of sense. The video you posted m ay help him. He is overwhelmed by all the changes and testing he went through so I am going ot put it on the do in the future list.

Honestly, I don't know how much he wants to work on social skills. He says he wants more friends, but when I asked him why he couldn't answer it. Even a simple answer of someone to go to the movies with would have been fine, but he couldn't do it. He goes to social events and then hangs by himself for the vast majority of the time. He knows people there, but then doesn't talk to them as reported by my dd who has observed him. I've observed similar behavior at family events. By self report on a recent psychiatric evaluation he ranked loneliness fairly high, but then goes to things and says he didn't feel like talking to anyone. Kind of a paradox there.

As for us, I guess the push is feeling we are up against a wall or a deadline. He only has a few years until he will be going to college. We want to give him the best chance we can at success and we know that EQ is much more important than IQ in success at school. I want him to have people to eat with in the dorm -- he said he would rather eat with others when I mentioned someone else we know on the spectrum that eats all his meals alone at school. It is something little, but would be huge for him. I don't expect him to turn into a social butterfly, but having a few friends in college would be nice. He needs to improve the social communication skills in order to do that. I did explain to him in the last week or so why we were pushing so that he could learn some of these skills before he leaves home.