Join Lindsey and GT’s very own Hannah Werner, MA CCC-SLP for an informative and engaging SPEDtalk. Hannah discusses the challenges and opportunities when it comes to providing online therapy, and ways therapists can run social skills groups through the virtual setting. Learn the process of how to preview, view, and review social skills with your students, so they can develop that process themselves and thrive in any social setting. Hannah also provides some great romantic and social interaction tips your students can use to ensure that they a happy and relaxed Valentine’s Day.

Lindsey:

All right, let’s talk about social skills that we’re struggling with our students, and seeing just the different things and ways that we can help them. I think it’s really hard just for just students in general to make friends, to navigate the social setting. I think technology has definitely changed how we communicate, and sometimes I feel like this has a negative impact on children. Do you find that same thing? Do you agree with that?

Hannah:

Yeah, I think so. I think that sometimes, sometimes with technology, I think students are looking inward more than they’re looking outward. And I think that that is something that has impacts across the board, where they’re not reflecting on others as much as they should be, probably, or perspective taking. And I also think it’s just a really difficult landscape to navigate. We’re getting a lot more information, a lot more information about other people, and it can be really challenging, and I think it promotes a lot of anxiety in our students, for sure.

Lindsey:

That’s so true, and anxiety, so people that struggle with anxiety, we hear about social anxiety, students on the spectrum as a key area for having social difficulties and working around social pragmatic situations. So what other students might struggle? Maybe those are the two that might come to mind, but there’s a lot of people that might struggle in this area. Any other students should we be watching out for? Any other disabilities that might come across as having trouble with social skills?

Hannah:

Well, in my field, we see that students that have difficulty with language disorders, expressive language disorders, receptive language disorders, pragmatic language disorders, they’re really going to struggle, because they are lacking that ability to understand that abstract language. When we’re talking about technology, they’re having a really hard time discerning the intent of their conversational partner, whenever it’s in this digital format. And they’re having trouble with that self-talk. So, we’re all used to, most people are used to, using language to navigate social situations in their head. And we are finding that a lot of students with language disabilities aren’t able to do that as fluidly, and so you can see them having issues when there’s a complex social interaction, which they’re all complex.

Lindsey:

Right. There’s so much [crosstalk 00:02:33].

Hannah:

In your field, I’m sure you see it, too, with ADHD and anxiety and so forth. Right?

Lindsey:

Absolutely. And just reading those social cues, preparing where the conversation is going, not having that awkward silence, but sometimes awkward silence is a good thing, and understanding, well, how long should we pause? And then [inaudible 00:02:51] take a turn, all those things. So how do we practice or how do we even teach those skills? We run into a couple of things.

Lindsey:

So here at Global, we are working with students in the virtual setting. We are doing virtual sessions with them through the computer, versus something in the school setting, where we can actually pull the students together in a group. Can we still run social skills group through the virtual setting? Are you finding that is a successful way to do it? And if so, what are you doing?

Hannah:

Yeah. So I’ve run social skills groups in the virtual setting, and I’ve run social skills groups in a brick and mortar setting. And I’m finding that it’s definitely possible, and it’s something that definitely supports the student in either setting. So in a virtual setting, there are some differences. Usually the groups are a little bit smaller, and sometimes it can be a little bit difficult to connect to their environment, but we still have those opportunities to engage in conversation. We have opportunities for the students to present their own content. We have opportunities to observe students, given recordings that were taken prior to our sessions together. So there’s a lot of opportunity for developing social skills. There’s opportunities for using self-assessment material. So a lot of those same opportunities exist in the virtual setting that exist in the brick and mortar setting for running groups.

Lindsey:

Okay. That’s really good information. So they’re practicing in these groups. We’re going to use a lot of tips and tricks and strategies and help them, and they might do really, really well, and then they go out into the classroom, on the playground, and you’re like, “What just happened? Why are we seeing that?” We’re like, “Oh my gosh, you totally met your goal of being able to do this in three out of four trials,” and then what happens? They go out into the classroom, and the teacher’s calling us, like, “We need help, emergency, emergency.” What is going on?

Hannah:

I think that sometimes, you know, there are a couple of reasons. Maybe the activities we are using aren’t super functional or specific enough. And then I also think that we need to be focusing a lot on using metacognitive strategies in order to help our students self-reflect, self-monitor, develop that situational awareness, so whenever unexpected things happen, they know what to do.

Hannah:

And that’s where the problem is. Whenever you enter an unstructured situation, anything can happen, and all of a sudden, someone says the wrong thing and they’re like, I don’t know how to react to that. Or they start feeling really weird, and they’re not able to really apply their skills fluidly, because their memory demands are being so taxed by all of that stress and anxiety, as well. So there’s a lot at play there, but there’s still things that we can do to support them whenever we do push them out into the real world.

Lindsey:

And that’s really good. And yes, things are so fast paced. You could be talking with one person, but then a third person interjects. And then you’re like, that’s not what we were talking about. Or when things are fast paced and they change subjects.

Hannah:

It’s my turn, it’s my turn. You know what I mean? Like, we’re not here to help them. We’re not here to coach them all the time.

Lindsey:

I know. I think sometimes it’s really good, therapists in sessions, what they do, they play that devil’s advocate and they throw those curve balls to see if they’re ready to handle those real life situations. But I know you’ve got some fantastic materials for us to take a look at, and just talk about different resources that are available. So I want to bring up one of the slides that you wanted to talk about, and just kind of go over. This is an overview, and I know you’ve got some other ones.

Lindsey:

And everybody that’s watching, don’t worry. These are going to be available for you in a PDF format after the show. So you’ll want to go on the hub and you’re going to want to go under our file section. And you’re going to be able to see not just this, but all of the files from all of our previous shows. We’ve got a lot of great resources, websites for you to check out. We always want to make sure you have something to take back with you, and you can utilize these in the traditional school or in the brick and mortar school, well, that is the traditional school, and the virtual school, for things. So Hannah, talk to us about some of this information.

Hannah:

Yeah, sure. So I created this handout to help us think about how we can make our interventions more applicable to the day-to-day, and to help push our students into those complex social situations with the tools that they need. So the big picture here is that we want our students to be able to preview the situation. We want to help them preview a situation, so we can free up those mental faculties to manage complex social interactions. So more practice is going to equal less demand on your memory and less anxiety, and so you’re really able to think about your strategies, if you’ve really thought a lot about what’s coming.

Hannah:

So we have scripted stories. I’m sure many of you are familiar with this. A lot of our students who are younger or who are a little lower functioning may benefit from this, but these scripted stories really target a specific situation or a specific challenge and guide the student through how they should react appropriately in a social situation. And then we have modeling and video.

Lindsey:

No, I just really like this idea of the scripted stories. I think that’s fantastic. And so we hear the term social stories. Is that the same thing as a scripted story?

Hannah:

Yep. Yeah. This is just another way of talking about it as just social stories. I was just being careful about what I was using, but yeah, social stories, scripted stories, they all mean the same thing, and it’s just a way of helping your students preview and giving them the words for what’s going to happen next. The words and the actions that are appropriate for what’s going to happen next.

Lindsey:

Awesome. Do you ever role play with them in some of these situations, or do you just have a flip chart and you go through it?

Hannah:

Normally, we run through it together and I try to make it really, really scripted and really, really routine, so we can sort of engrain certain reactions or phrases with these particular students, and then we’d role play, yeah.

Lindsey:

Awesome. And I see on there that you’ve got video modeling, and then one of our amazing resources that we just like to put a plug in for, Everyday Speech, and a few other ones. Are there any other ones that you absolutely love?

Hannah:

Well, so I’ve used Mike’s Crush before from Social Signals. It’s great for this time of year and great for those older students and helping them navigate having a big crush. So that’s one of my favorites for modeling and video modeling. And then just an idea for role playing down there, this is obviously a great way to preview, and it basically allows you to create a table of possible interactions. So who’s talking? What are they going to say when you order pizza, in my example here? What will you say? What will they probably say? So it’s helping you really think about how other people think and thinking about their intentions in an upcoming social interaction. So those are just a few ideas that I’ve used before, but there are tons out there.

Lindsey:

I love this whole Mike’s Crush thing, because that is definitely something we have to address. It is Valentine’s Day. There are so many of our students that do have a crush, or they don’t really know how to approach it, and so maybe they’re just staring at the person. And then like, how long is it that I gazed at [inaudible 00:10:44]? Oh my gosh, you’re such a creeper. And I don’t want our students who struggle with social skills to get this bad rap of not knowing what they’re doing and understanding how long they should look at somebody. I mean, that totally happens, or the person that gives not just one valentine, all the valentines, or even that doesn’t get any valentines, and how do we manage these things, or why this might happen? So we really want to try to front load them for potential things that could happen, role play those situations. So I think that’s a really good resource for them, as well.

Hannah:

For sure, for sure. And that helps lead us to our view activities.

Lindsey:

Absolutely.

Hannah:

Yeah, so these view activities, this is just a way for us to conceptualize helping them self-monitor and self-regulate and develop that awareness of themselves. Whenever they can view themselves clearly in a situation, they’re going to have more success. So whenever they are knowing that they’re staring and they’ve been staring for a long time, they can start to self-correct, because they’re like, well, that’s weird.

Hannah:

And then we also want to teach them to view their conversational partners appropriately, as well. What are their intentions? What are they possibly thinking? And we’re using this mentalizing vocabulary, too, to help them think about thinking. That’s that metacognitive piece. We want them to be thinking about thinking, and thinking about feeling, and all of those things that are really not very tangible. So these are some ways to make it tangible.

Hannah:

So we’ve got the five point scale, which I think many people are familiar with. It helps with that self-regulation and understanding where you are, how appropriate you’re being, given a target behavior. We’ve got the zones of regulation, which really helps them understand how they’re feeling, that gives them some self-awareness and self-regulation. Are they in the blue zone? What can they do to get into the green zone? Are they in the red zone? What can they do to get back to the green zone? So those are great resources.

Hannah:

And then I love Stop and Read the Room by Sarah Ward. If you don’t know Sarah Ward, you should check her out. She’s really great for executive function resources. But when you stop and read the room, you’re really teaching the student how to examine their space. What’s happening in their room? How is their space associated with other people? You’re asking them to think about time. What needs to be happening right now? What is happening right now? And objects and organization, what is going on in my situation, what’s the organization of my situation, and what are other people doing? And then people, reading people, we want to teach them how to read other people’s cues so that they can react appropriately. So we really want them to practice these self-awareness, self-regulating strategies and get really, really good at it.

Lindsey:

When you’re talking about teaching them, so are these things that you teach during an individual session, and then who else, do you just teach a student? Do we help try to get care over, and maybe the special ed teacher or a parent? How do you utilize these once they’re taught to the student?

Hannah:

Yeah. So you’re definitely going to want to bring in their caregivers. You’re going to want to bring in their teachers. This is going to help them across contexts. So if they’re having an issue with their voicing in their classroom, where they’re whispering all the time, or they’re talking really loud all the time, this five point scale is going to help the teacher help them monitor themselves. With the parents, the parents are already bringing issues to the table in regards to social scenarios where their child is not blending very well. And you can talk about this stop and read the room, and they are so happy to have more resources to help their child and to reinforce some of these concepts. Again, you want it to be so, so, so, so routine, and so, so, so, so explicit, so that they’re not thinking about it when they are engaged in the social interaction.

Lindsey:

So what you’re saying is that these amazing resources can help facilitate, but a credentialed person doesn’t have to be the one to help implement them in the other areas. So this really can help. Something we take from our individual or our group [inaudible 00:15:08] to then transition to other people who are working with the students, so that way they can all talk the same language, essentially, and give those prompts. I love that it’s color coded, and there could be colored visuals on the student’s desk, or something like that. So it can be easily brought to their attention, but doesn’t have to single them out and make them be different in the classroom.

Hannah:

Yeah. And another thing that I love about telepractice versus in-person therapy is it sort of forces your hand to coach. So you have to bring in the people and their environment, and coaching should really be so integral to every part of therapy, no matter where you are. And when you’re in telepractice, you really are coaching and teaching on these explicitly, because you really have to.

Lindsey:

Yeah, no, I think that’s fantastic. I’m very curious, out in Facebook Land, all of our viewers, who uses some of these? I know zones of regulations, huge with mental health. Five-point scale, I was actually trained by one of my speechies at one of my schools, Denise. Hey girl, I know you watch this show, too. So when you check this out, shout out to you for you teaching me about that a few years ago at one of our traditional brick and mortar schools. She also works for GT now, as well, out in California. So yeah, we love to share resources with each other. And then this whole reading the room, actually, Hannah, this is a new concept that you shared with me, and I find it fantastic. I know that we can use those.

Lindsey:

So if you use any of these currently in your practice, put it in the comments. I want to know what you’re using. And if you haven’t used any of these and this is new, let me know that, too. We want to share resources with you, so you guys can actually feel like, “Oh no, I totally didn’t know this existed. This was very helpful.” We love to hear those comments, as well.

Lindsey:

So now that all these students, we’re teaching these skills, obviously they need probably some sort of review or some sort of practice, or how do you help tell them when to use it or that check-in basis, so that you know that you’re using it? I know you’ve got a slide for us to talk to us about this.

Hannah:

Yeah. So again, we’re talking preview, view, review, just to help us conceptualize how we’re going to implement our social skills activities. So we want to be constantly reviewing. This isn’t just like one time towards the end of therapy when they’re getting really good. This is all the time, we are reviewing and scaffolding that self-reflection. We’ve talked about how these students have difficulty with that self-talk and that self-reflection, seeing themselves, seeing others. We want to prompt them all the time, and we also want to be modeling it all the time.

Hannah:

So I’ve gotten really good with this with my kids, where I’m constantly talking, speaking my thoughts all the time. This is what I’m thinking. This is what I’m feeling. And we want to be doing that with these students. So I have performance tracking is one area that you can do all the time. So say we have a target behavior, or a personal goal that the student has. And we want to give them the opportunity to discuss how well they are doing in working towards their goal, and when did they use it? You can use this at the end of a session. You can use this at the end of a week. You can use this at the end of a special event. It just prompts a really good discussion for self-reflection.

Hannah:

You can do a video analysis. So you’re recording that special event, or you’re recording a session, and then you’re going to review it and you’re going to discuss, and maybe you use that performance tracking during your video analysis. And then scaffolding self-reflection. This is what I was touching on at the start of this page. You want to be asking questions all the time, routinely, after sessions or maybe monthly. You want to be making sure that the student is reflecting on how they’re doing. So what did we work on today? Was it helpful? What was helpful? What did you notice about when so-and-so did this? How did you react? Are you showing this skill when this happened, and how do you think you did on your goal, and what did you like or dislike about whatever? So these are just examples of questions you can ask, but you should be asking them to self-reflect all the time, because they need a lot of practice in that area.

Lindsey:

Yeah. I love, one, that you said that you model, and I love that you model this just in your everyday life. This isn’t just techniques that just people that have disabilities need to use. These are just life skills, and they’re not just used in school setting, or just randomly. You really do live by this. We do this. This is what makes us socially inept or capable in these situations. So that way people understand what is going through. So I do like that you’re modeling this and that you’re talking the language out loud so that people hear what that internal dialogue is.

Lindsey:

And I do ask you this question. When you run this, like the first time in a group with a student, are they really able to answer these questions and self-reflect, or is it almost a train wreck, and that this takes practice, just like any skill?

Hannah:

It takes practice, just like any skill. So I think, I didn’t really touch on it from an earlier page, but whenever you’re teaching a new skill, you really need to follow that you do, or sorry, I do, we do, you do model of teaching, and we need to be doing it all the time in therapy, especially with these complex concepts, too. We need to be modeling it. Now we’re trying it together, and now you’re doing it. And you can do that with these questions, too. You can help to frame their answers with what we call carrier phrases. So, okay, well, I liked this, or you can ask a yes and no question to help them answer this more open-ended question, or just any sort of scaffolding techniques to help them come up with a response is how you’re probably going to start with these students who’ve never done it before.

Lindsey:

That makes sense.

Hannah:

And then you’re constantly modeling, constantly modeling.

Lindsey:

Right. Because these students, yeah, like you said, we have to scaffold, we have to start. This is a skill that they did not develop, and they need to be actually taught these skills. But once they learn them, they should be able to do them more independently. So it’s a great idea to start with those yes or no, and then work your way up to those open-ended questions. So those are fantastic resources, and I love how these materials were used in just great handouts.

Lindsey:

Again, all of our viewers, these are going to be available for you after the show. Just look in our file section on The Therapist Hub. You’ll be able to find them there. Hannah created them, so they are hers, and she is sharing them graciously with us. So thank you so much. And thank you so much for being our guest. If anybody has questions, you can put those in the comments. We will respond back to them. Any other closing thoughts, or Hannah, anything that we didn’t discuss that maybe you’re like, oh, just one more nugget of information for our viewers?

Hannah:

Not necessarily. I just want to reiterate to preview, view, and review all of these social skills with your students, so they can develop that process themselves. They need to be anticipating what’s going to happen. They need to be thinking about themselves while it’s happening, thinking about others while it’s happening. And then at the end, they should really be self-evaluating. And that’s the big goal, that they’re able to do that whole process when they’re done with therapy.

Lindsey:

How long do you think that takes to learn and master? Is this something they’re going to get in one of those 21 day fixes, or in 90 days change your different habits, or is this something that takes a year?

Hannah:

You’re taking this skill by skill by skill. So, I mean, I guess it depends on the level of the student, but I would argue that many of us could benefit from this. I know that the more I learn about executive function, the more I know that I need to be practicing strategies.

Lindsey:

Practice, practice, practice, this is not some quick fix. This is not some fad that’s just going to go through. This is something that does take practice, like any skill. And so your goals on your IEP may take a year, may take two years, may take just a year to learn one of these skills and that you have to build up on it. So I want to make sure that our therapists don’t think that they can just, oh, we’re going to magically fix this or something. This is a skill, and any skill does take time.

Lindsey:

So Hannah, thank you so much for sharing these resources. I think it’s really going to benefit not only our therapists, but our students and the families that we work with. So thank you so much for being our guest today.

Hannah:

Yeah, I so enjoyed it. Thanks for having me.