Trying to learn social skills. What to tell therapist?

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I've been thinking this over for weeks now. I have no idea what to tell her I need. So, when I go see her next week, what do I tell her?

I'm looking to improve socially, and I make mistakes often.
If I ever make a social mistake during our conversation, be sure to tell me right away, what I did wrong and why, so I can improve as a person.

If I speak too loudly for a second, or I'm not making eye contact, I'm fidgeting too much, or I sit down or get up too fast, If I'm too tense or I'm being too monotone, let me know, is what I tell her.

She always does

Can Social Pragmatic Skills Be Tested?

Contributed by Beverly Vicker

By definition individuals with an autism spectrum disorder have difficulty with what is called the pragmatic aspect of language. Parents and speech language pathologists often ask, “What test will demonstrate that my child (or student) has difficulties with pragmatics?” This question reflects the assumption that there is such an instrument. There isn’t one AND there may never be a singular effective standardized test of pragmatic ability. While this response may come as a shock, it may be more understandable if one knows more about the nature of pragmatics and knows how one can assess pragmatic function.
What is pragmatics and what does it involve?

If one has good pragmatic skills, he or she is able to communicate an appropriate message in an effective manner within a reasonable time frame in a real life situation. Pragmatics is like a cake. The cake is the whole or gestalt that represents the combination of many ingredients. No one ingredient is representative of the edible item, that we call a “cake.” In a somewhat related fashion, as one continues the cake analogy, no singular standardized test of ingredients can effectively capture the essence of the whole or gestalt called “pragmatics.” In order to communicate an appropriate message in a given situation, many ingredients have to mesh in an instantaneous fashion. Within a few seconds or less, the typical communicator must:


Note the current social situation in which the communication interaction is occurring, including the nonverbal cues.

Pay attention and receive the complete verbal message delivered by the speaker.

Analyze the meaning of the verbal and nonverbal messages within the context of the conversational situation.

Check the tentative interpretation of the messages against one’s bank of social knowledge.

Formulate a response inside one’s head based on the above, after considering several possible options.

Draw upon one’s knowledge of vocabulary and grammar.

Speak or generate the message in a manner that is understandable to others.

Be prepared to receive and analyze the new incoming message response, complete with its nonverbal and hidden messages.

Begin the cycle all over again.

This sounds like quite a task, but typical speakers do it all the time with little effort. For the person with an autism spectrum disorder, such situations often represent a serious challenge.

What can contribute to poor social pragmatic skills in a given situation?

The potential for difficulty or lack of effectiveness in any given situation is ample. A person may have difficulty because of one or more of the following reasons. He or she may have:


Limited awareness that a message is being directed to him or her.

Difficulty distilling the auditory message amid competing incoming sensory stimuli.

Difficulty processing the message of the communication partner because the communication partner:

Spoke rapidly;

Used vocabulary that was unfamiliar to the listener;

Spoke about events that were of no interest to the listener;

Spoke about unfamiliar events, ideas, or experiences;

Used grammar that was too complex for the listener;

Used figurative language that made interpretation difficult; or

Used gestures that were distracting and meaningless for the listener.

Limited knowledge about the social world, including understanding the mental state/perspective of the communication partner.

Difficulty sifting through all the confusing information and meshing it with stored knowledge/social skills training in a rapid fashion.

One may or may not have had the appropriate social skill knowledge. One may have misread the social setting or been oblivious to certain cues. The important issue, however, is whether one can access that social knowledge on the spot and use it in a real situation to guide a response, even though one might feel confused, anxious, over-stimulated, or rushed.

Difficulty planning the response in terms of message intent, vocabulary and syntax.

Some individuals may experience word-finding problems and have considerable difficulty using mature and complex language forms to express their ideas.

Individuals often have difficulty understanding that they must consider the other person’s background and perspective. Too often, the listener furnishes too little information to facilitate meaningful understanding.

Delivery of the message may be too rapid or too choppy to be intelligible or understandable.

Even speakers without ASD “ flub up” in various situations because they are nervous or anxious. The message may be very clear inside the head of the speaker but getting the communication partner to understand the message intent can be a challenge. A smooth and effective delivery style is not always easy.

So much effort may have gone into formulating the first response that the person with ASD isn’t prepared to begin the process again without more of a break. Other individuals with ASD may be very used to one-turn conversations and not have any expectation that a second response will be expected.


How does one assess pragmatics?


When one considers the complexity of the process listed above, it is understandable why a singular formal test would not accurately identify something as complex and context based as pragmatic problems. Pragmatics represents the whole act of communication and is not simply a sum of the parts.

One might, however, initially identify that an individual has a problem with pragmatics (the whole) and particular situations that present problems by:

Observing the person with ASD.

Interviewing numerous people about what communication situations are challenging and identification of particular difficulties.

Completing inventories or checklists.

Using informal situations to sample the person’s ability to deal with specific communication challenges.


For an elementary school age student, this might translate into an observation in the classroom during group instruction and small group sessions, at recess, and in the lunchroom. Parents, teachers, aides and peers might contribute useful information during an interview or through a checklist. The student him or herself also might be able to identify situations that represent a challenge by completing a checklist. Challenging situations could be embedded within the daily routine so that the student might demonstrate how he manages situations such as being overlooked as papers are passed out, someone teasing him, or needing to ask for assistance with a difficult task. This type of data is called qualitative data. This data collection method is used to analyze complex behaviors such as social interaction. Qualitative data can be as legitimate as quantitative data (test scores) for decision-making about programming needs if it has been collected in an appropriate manner.

Does formal testing have a place in the assessment of pragmatic skills?


The Test of Pragmatic Language, for example, attempts to look at the application of social knowledge. The test involves pictured situations and requires responding to static, non-emotional, decontextualized situations. The examiner provides information about the situation and asks what the person might say in that situation. The test can provide some information about social knowledge but one has to understand the limitations. If one has been taught about certain social situations and has good associational recall, one might be able to pass the test.

This same person may have significant problems with natural pragmatic situations, however, when he or she is in a real life situation. He or she may have great difficulty coping with emotions and/or may be in sensory overload. He or she might be clueless about the subtleties of the situation. He or she may be unable to manage the demand for a rapid processing of information. And, he or she may be unable to deal with the rapid need for formulation and delivery of an appropriate response. In other words, the test produces false negative data for some children because it cannot capture enough of the holistic demands of real life situations. Emotional state, not measured by the test, can play an important role in how well one can use what he or she knows. The degree of challenge emanating from the demands will differ by individual and by specific situation.


Other types of formal testing might be used if the purpose is clearly defined and the results reviewed within the holistic context that pragmatics represent. For example, if it is suspected that the student has trouble with understanding complex grammar, this could be probed. Intervention focused on only this one underpinning element, however, may or may not improve pragmatic abilities unless coupled with increasing social knowledge. The reverse is also true. If one learns more about social knowledge, one may still be ineffective in real situations because other significant components collectively also impact performance. It may be very important to screen or evaluate selective contributing elements such as vocabulary, word retrieval, event representation skills, and so forth and consider these as one attempts to improve pragmatic skills for a specific individual.

Summary

By definition, individuals with an autism spectrum disorder will have difficulty with social pragmatic function. It does not take formal testing to identify that a social pragmatic problem exists. No singular test can evaluate the complexity of situational pragmatic skills. Passing a test such as the Test of Pragmatic Language can represent a false negative and exclude someone from needed support and intervention. Sometimes information from selective tests or subtests that probe specific elements that contribute to pragmatic competency, however, might be helpful for program design. Scoring within normal limits, however, on any of these tests does not mean that there is no pragmatic disorder but rather that one of the components, under specific conditions, does not seem to be a major problem.

Qualitative data is legitimate and can be gathered through various means. Individuals will differ in terms of how effective they are in specific situations, with specific partners, and as the mental and emotional demands of situations change. The complexity of pragmatics must be considered as intervention programs are designed.