Home Academia & Research Finding the Right Fit: Social Pragmatics Groups in Middle School

Finding the Right Fit: Social Pragmatics Groups in Middle School

by Lisa Lucas

The recent explosion of social pragmatics curricula and materials for students with social challenges like autism spectrum disorder is both a blessing and a curse to those of us SLPs who work in private practice or outpatient settings. On the one hand, I am grateful for the selection of topics and target goals. On the other hand, how can we best weed through it all and offer a group curriculum that is the most functional and change-inspiring for this tricky but very deserving population of pre-adolescents?

There are many benefits of conducting groups outside the school environment in an outpatient setting, including more time spent on concepts, practice in a “safe” and diverse environment (participants may not have to see each other again), making new friends (participants may like to see each other again), parent/caregiver education and training, and parent/caregiver networking opportunities.

Along with the benefits, there are challenges that are unique for private practice and outpatient SLPs as we try to help these children and their families. These challenges can be grouped into two categories: logistical and content-related.

Logistics are tricky, but are definitely the easiest barriers to overcome. A typical group series for outpatient settings lasts 8 weeks. Group sessions range from 1-2 hours, depending on the number of participants. Costs to families for each session can be substantial, despite the Health Care Affordability Act, whether it be insurance co-pays or out-of-pocket. And there are also transportation costs and challenges for families who live in rural areas. These barriers mostly belong to the families of our group participants, but SLPs can help reduce their impact by strategies such as offering the group at “family-friendly” times (evenings or Saturdays), as well as choosing a central location for the meetings.

Once logistics are met, the real work begins. This brings me to the content of this post: content-related challenges. As a former instructional designer and journalist, my foremost consideration is “know my audience.” It may be a funny way to initially think about a therapy group, but it’s a basic tenant that I find critical.

Unlike the school setting where therapists can get to know the child in their “natural environment,” outpatient SLPs must somehow determine which kids can best go together in groups. Finding the right fit may sound like a logistical challenge, but is actually content-based.

From experience, placing the right kids together can make or break the success of the group, particularly at the tween/middle school age. Knowing this however, is only the beginning of the solution. My colleagues and I have whittled out three main areas of need for this age group:

  • Basic Social Rules—skills associated with being with another or group, such as eye contact, body language, expected behaviors, thinking about others.
  • Conversation Rules—skills associated with communication with another or group, such as establishing a topic, asking and answering questions, staying on or switching topics, social wondering.
  • Higher-level Social Skills—skills associated with making others comfortable and making/keeping friends, such as social problem-solving and perspective-taking.

Regardless of diagnosis or age, these three areas seem to be a good way to group kids so that behaviors can be managed equally and everyone learns. I have tried pragmatic assessments such as the CELF-5 Pragmatics subtest. I have given self-made parent/caregiver surveys of functional skills that coincide with the teaching concepts of the group. I have given their referring SLPs surveys of functional skills. Sometimes I have used all three methods. So far, I have not found a combination that can qualify everyone accurately. In every group, there always seems to be at least one kid whose skills are significantly more advanced or significantly more impaired than the rest.

The question is this: How can we most effectively figure out where each child fits? How do we qualify a child for the right group when the reality is that most of our candidates demonstrate a constellation of challenges across two or all of these areas?

That is the question I am posing to this ASHAsphere community. Thank you in advance for your responses as we problem-solve together.

Lisa Lucas, MA, CCC-SLP, is a speech-language pathologist in Cincinnati, Ohio. She practices as an outpatient SLP for Cincinnati Children’s Hospital and as a telepractice SLP for Presence Learning. She is an affiliate of ASHA Special Interest Group 18, Telepractice.

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6 comments

Arlene September 11, 2014 - 3:14 pm

The extensive work by Michelle Garcia Winner and Pamela Crooke should provide you with many answers to your question. I suggest reading her book, Thinking about you Thinking About Me as well as reading the wealth of information on her website at http://www.socialthinking.com

Jennifer O'Connor September 12, 2014 - 7:54 am

I love this question and look forward to responses! Thanks for posing, Lisa! And, what about he little guys (3-5 year olds) on pragmatic assessment.

Martine McGroarty, M.S., CCC-SLP September 12, 2014 - 11:18 am

Hi, I am a speech therapist in the Nashville area. I perform individual and group therapy sessions for adults with autism, helping to prepare them for the workplace. I have worked to combine different curricula into one, but I find myself constantly making revisions based on the individual needs of each social training group. I like to have my groups made up of individuals who are fairly similar in their communication needs. As far as assigning clients to a specific group, I usually have the luxury of meeting with the client before placing him or her in a group. Once in a social training group, if the group is not a good fit, I will try to move the client to a different group that is more suitable to his or her individual needs. Like you, I have tried basing placement off of parental/client/teachers surveys/pragmatic checklists, but meeting the individual ahead of time has been the most beneficial resource for me. People always present much differently than they do on paper! However, if anyone has a set method to assigning clients to social groups that works well for you, please pass it on. Great questions raised in this article – thank you!

Sean Sweeney September 15, 2014 - 9:48 am

HI Lisa- good post. We also find the concepts behind the Social Thinking® Social Communication Profile helpful in grouping students who have more significant needs (“emerging”) vs. those with issues in the moment of interaction vs. students with a notable component of anxiety- see the materials at
http://www.socialthinking.com/what-is-social-thinking/social-thinking-social-communication-profile

Full Spectrum Mama September 15, 2014 - 12:48 pm

I think third key might be extrapolation – actual USE of these skills in real-world settings. My son does fabulously in his “group” but often has a much, much rougher time in school…THanks!

Lisa Lucas September 21, 2014 - 8:42 pm

Thanks to everyone who posted a reply to my blog. I value your responses and have looked into all your suggestions. I was not aware that Michelle Garcia-Winner had a Social Thinking Social Communication Profile, although I use her Social Detective and Superflex curriculum materials. That was super helpful!

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