Nursing Center - Journal Article

The purpose of this issue is to examine two related topics: the role that enhancement of social communication skills will play in the ability of young children and youth to achieve an acceptable quality of life both at home and in academic contexts, and the part caregivers have in facilitating that social development. The term, social communication skills, refers to a set of nonverbal and verbal competencies learned across childhood and adolescence by typically developing children. These competencies span developments in communication, executive functioning, and social-emotional learning (Beauchamp & Anderson, 2010). Along with gaining expertise in basic communication abilities such as joint attention, the use and understanding of gestures and intonation, intentionality, and the area of language learning referred to as pragmatics, successful social and academic endeavors also require that children learn self-regulation and planning (i.e., executive functioning), as well as how to attribute intentions, empathize, take the perspectives of others, and finesse the additional social-emotional functions required to participate successfully in increasingly complex social contexts.

Not all children are able to meet necessary social communication skill milestones without specific intervention from speech-language pathologists (SLPs) and other specially trained professionals. Children on the caseloads of SLPs who are receiving treatment targeting social communication skills may carry a diagnosis of specific language impairment, pragmatic language impairment, pervasive developmental disorder-not otherwise specified, Asperger syndrome, language-learning disability, or autism spectrum disorder (ASD). Although it is clear that not all children with deficits in social communication skills are diagnosed with ASD, an increasing proportion of children are receiving this diagnosis (Autism and Developmental Disabilities Monitoring Network Surveillance Year 2006 Principal Investigators & Centers for Disease Control and Prevention, 2009).

Given enhanced public awareness of ASD and the close relationship between the diagnosis of ASD and social communication skill deficiencies, many more primary caregivers than ever before are actively searching for the best means to ameliorate the negative effects of social communication deficits on their children's social and academic success. At the same time, researchers are studying techniques for providing assistance to children with social communication skill deficits by investigating a variety of models to determine how best to include families as active participants in their children's intervention programs. Reasons for specifically including families in treatment programs to enhance social communication skills begin with the assumption that family-centered intervention represents best practice. In this issue, Weiss and Theadore expand and discuss the rationale for incorporating caregivers in therapy addressing social communication skills in young children. In our article, we emphasize that much of social communication learning occurs in the natural social learning situations to which caregivers have more consistent access, as well as greater cultural affinity.

An example of a multidisciplinary team approach to investigating parent-centered treatments is presented by Prelock, Calhoun, Morris, and Platt. They describe the results of two pilot studies targeting the development of age-appropriate social communication and joint attention abilities in young children diagnosed with ASD. The premise of their ongoing research is that, when children's parents are engaged as partners with professionals, children are more likely to make significant progress and the caregivers are more likely to become successful language interventionists for their children. In addition, professionals can gain a greater understanding of the individual nature of each family's strengths and needs, including the outcomes valued by each family. In a related article, Woods and Brown present a compilation of information substantiating what they refer to as a transactional relationship between social communication interventions that are administered by caregivers to their infants and toddlers with ASD and the family-centered services provided by SLPs. The gist of the contribution by Woods and Brown is that family-centered practice that involves individualization to fit the abilities of caregivers and their preferred activities/routines is likely to be most effective in enhancing the caregivers' skills to facilitate their children's social communication skills. One of the types of support for caregivers suggested by Woods and Brown is that of reflective practice. Reflective practice is the specific technique of the article in this issue by Theadore, Laurent, Kovarsky, and Weiss. In this article, the authors describe reflective practice as a way to give voice to parents' perspectives on their children's intervention programming and also to assist professionals in the refinement of a specific program developed to enhance the social communication skills of young school-age children.

Addressing the area of social communication skill development that includes emotion understanding and emotion regulation throughout childhood, Brinton and Fujiki suggest that caregivers can play a critical role in assisting their children by using what these authors refer to as emotion talk. That is, the language surrounding others' expressions of emotion can be subtle or inaccessible to children with social communication deficits or absent in their caregivers' interactions with them. By using explicit language to explain the emotions of others in context, caregivers can help this information become accessible to their children, thus reducing confusion and potential miscommunication and supporting emotional regulatory capacities.

It would be a mistake to assume that social skill development always normalizes by young adulthood. Many older students and young adults on and off the autism spectrum experience persistent deficits in complex information processing that significantly affect their ability to adapt to rapidly changing, novel environments. Hewitt's contribution to this issue outlines the support needs of students with ASD who are embarking on college experiences. Her suggestions focus on how families can increase the likelihood of their children's success in college through transition planning and implementation of preparatory skill set training. Hewitt also describes a university-based pilot program to provide supports for college students with problematic social communication and self-regulatory skills, with emphasis on the importance of providing intervention to enhance executive functioning, in particular.

Taken together, these articles provide the reader with a perspective on the types of programming currently in use involving caregivers in the treatment of their children with social communication skill difficulties across the span from infancy through adolescence. Issues impacting the development of successful family-centered programs also are delineated. By expanding opportunities for partnerships with caregivers, SLPs and other professionals are capitalizing on the primary role of parents and other caregivers, who provide constancy in their children's lives and accessibility to the most meaningful contexts for practicing new skills. The premise with which we conceptualized this issue was that involving caregivers is an essential element in fostering ongoing opportunities for children's social communication skill learning in natural contexts during and after direct intervention.

-Amy L. Weiss

-Geraldine Theadore

Issue Co-Editors

REFERENCES

Autism and Developmental Disabilities Monitoring Network Surveillance Year 2006 Principal Investigators; Centers for Disease Control and Prevention. (2009). Prevalence of Autism Spectrum Disorders-Autism and developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveillance Summary, 58(10), 1-20. [Context Link]

Beauchamp M., Anderson V. (2010). SOCIAL: An integrative framework for the development of social skills. Psychological Bulletin, 136, 39-64. [Context Link]

REFERENCES

Benefits of Membership