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Social skills include the ways in which we use both language and non-verbal communication such as eye contact, facial expressions and body language to communicate and interact. Expectations on what social skills are appropriate to a situation varies in each different social situation. This section includes relevant resources and advice to support the development of social skills.

Lots of children find it difficult to learn to talk and interact, for lots of different reasons. If your child can’t talk yet, communication can and will still happen. Supporting communication at the right level for your child can really help them to learn the skills they need to communicate more. This section contains ideas to try if your child is finding verbal communication or social interaction difficult.

If your child has a diagnosis of autism, read more information about Complex Communication and Autism.

Not all children find interacting with other people easy. There are lots of different reasons for this. All children can build on their interaction skills with support.

Being together and sharing space can be so valuable, without a plan to teach anything. Skills will build gradually and naturally.

The most helpful thing to try is joining in with what your child is interested in (whatever it is!).

Try not to imitate everything, like a mirror, but match your activities together, sharing your attention to the same things.

Don’t worry about eye contact if it is difficult at the moment. We can communicate well without eye contact and it’s okay if it’s difficult – focus on other parts of interaction to begin with.

Things to try

Great ideas for people-games are:

  • Peek a boo
  • Making funny faces
  • Tickling
  • Chasing
  • Physical fun like bouncing and swinging
  • Turn-taking games

Action songs are great for building interaction – repetition can become familiar and reassuring. Try pat-a-cake, row row your boat, if you’re happy and you know it.

Ideal objects are bubbles, balloons, balls, cause and effect toys (simple slides, lights and sounds), and first  musical instruments.

“Burst pause” sequences can help build anticipation of interaction, and engagement. These are when you do something that engages your child, then hold a pause for a prompt to do it again.

Ready, steady………. Go!!!!

Waiting for your child to prompt you to do something more is a great way of teaching them that communicating gets good things!

Good activities for this are hiding games, tickling games, ready steady go, making interesting sounds, or trying pausing in between a line of a favourite song – join in with what they enjoy.

Accept any form of response – a movement, a sound, a facial expression or a look – and treat it as a request to do it again. If you don’t get a prompt at all, carry on, it’ll come!

Repeat activities over and over again – it may feel boring, but familiar activities really help children to learn skills. Routines can be very reassuring.                  

Keep it fun!  If you show that you are enjoying an activity, this helps make the interaction more successful, keeps it going and demonstrates the skills you want to build.

Sometimes, a child doesn’t really need to communicate, as they get the things they need without having to ask.  Sometimes, it helps to stop helping!!

We can create more opportunities for children to communicate by:

  • not anticipating all of their needs. Even though you know what they want, give them a chance to tell you.
  • changing a familiar routine – try “sabotaging” by giving an empty cup, paper without crayons, putting their shoes on before their socks, stopping a favourite song in the middle and so on
  • making things a bit difficult – giving a tub with a tight lid, or putting things just out of reach, giving the wrong thing e.g. if you know they want a cookie, give them a crayon instead.
  • offering them a choice of two things instead of giving the thing you know that they want

Always try to wait for the child to initiate communication, and accept any form of communication – it doesn’t have to be a word.

If they don’t try to communicate, you can demonstrate, and offer the opportunity again next time.

If they become frustrated though, always offer the support they need – try again next time.

As adults, we make choices throughout the day: what we want to wear, if we want tea or coffee, where we want to go. Children need to learn how to make a choice so that they can tell us what they want, become more independent and less frustrated. Giving a choice also allows your child to listen to new words and begin to learn what they mean.

Children can sometimes find making a choice difficult and this leaflet contains steps to work towards being able to make an independent choice. The easiest way to do this is to start with an easy choice (imagine being asked if you want chocolate or fish on your ice cream!) and gradually make it more difficult.

Before you start

  • It is important that you know what your child likes and does not like (which can change all the time!)
  • Remember that communication is not just about ‘talking’. It may be signing, an attempt at a word, a noise, a gesture, or any other attempt to get your attention. All of these are ways that your child can tell you what they want.
  • Give your child time to think about the choice and answer you. This might take a while, but try to give this time when you can.

Choice with toys/items

  1. Choice of two toys: one should be a toy your child really enjoys playing with and one should be a toy your child isn’t interested in.
  2. Hold out the toys one in each hand and name them for example “ball or sock?”. Move the object slightly as you name them to allow your child to understand which one you are talking about.
  3. Wait for a response from your child before giving them the toy they want. A response may be your child looking, reaching out, making a sound or a change in body movement.
  4. No matter how your child chooses, acknowledge this by giving them the item they have shown interest in straight away, and repeat the word for them to hear e.g. “ball!”
  5. Make sure the favourite toy is not always in the same hand. This allows your child to look at both choices equally.  

Choice with food

Please follow the same steps as above for choices with food:

  • Making choices with food should be away from meal times. Snack time could be a good time to do this
  • Break up food into smaller pieces so that you can practise offering a choice more times.
  • Offer choices in a bowl – you could also offer a choice of colour bowl

When your child is able to make a choice between something they like and something they don’t like, try to make the choice more difficult:

Making a choice with two items your child likes

  1. Hold out the two choices and name them - “cars or bubbles?”. Give your child time to make a choice and watch carefully for their response. As soon as they have made a choice, give them the item they have requested.
  2. What to do if too difficult - it might take time for your child to understand as they are both appealing options. To make this a little easier try choosing an item they always choose vs an item they may only sometimes choose.

To make choices with photos/symbols

  • Using photos or symbols can be more difficult as it is only an image of the object, so your child will not be able to touch, smell or experience it in the same way.
  • It is important that your child is able to understand what the photo or symbol means before you give them a choice using them, otherwise they will not know what they are being offered which may lead to frustration. If your child is new to photos/symbols, make the choice easier by showing the real life object alongside it.
  • Follow the same steps for photos/symbols as you would with the objects (see above). Start with an easy choice and then gradually make it more difficult.
  • Instead of showing the object, show your child the symbols or photos and say the words, e.g. “bubbles or balloon?”

Intensive Interaction is an approach to interacting with, and teaching early communication and interaction skills, to those who do not find it easy communicating or being social.

Intensive Interaction aims to develop the Fundamentals of Communication such as;

  • Enjoyment of being with another person.
  • Sharing personal space.
  • Understanding and use of eye contact.
  • Turn taking and shared enjoyment.
  • Using vocalisations with a purpose.
  • Developing attention and concentration.
  • Understanding and using physical contact.
  • Understanding and using facial expressions.
  • Understanding and using non-verbal communication.

Intensive Interaction should be used in a relaxed environment with the ‘teacher’ (parent/carer/key person etc) following the lead of the ‘learner’. By following their lead and being involved in what the learner is involved in (e.g. building a tower, using musical instruments), it is more likely that both the teacher and learner will have a more successful interaction. If brought away from an activity or area that they are particularly enjoying and engaging in, the learner may be reluctant to interact with the teacher or the new activity.

Examples of Intensive Interaction may include;

  • Copying vocalisations.
  • Copying actions.
  • Clapping hands together.
  • Taking turns to place bricks on a tower.
  • Copying or taking turns during active play e.g. jumping, running etc.
  • Rolling a ball back and forth.
  • Sitting close together.
  • Playing a game of peek-a-boo.
  • Physical touch such as hand or foot massage.

An Intensive Interaction may come to a natural end when the learner is no longer engaging in the session, or it may require the teacher to formally end the session.

It is helpful to practise the approach little and often. This helps the teacher to gain confidence and allows the learner to become used to the interactions without becoming over stimulated.

For further information, including video clips demonstrating the Intensive Interaction approach, please visit www.intensiveinteraction.org.

Using visuals such as objects, photos, symbols or gestures to support your spoken language can help your child to understand. Visuals can make situations more predictable and easier to cope with.

Visual supports and symbols can be used to support the development of communication skills where communicating is difficult. Using symbols can reduce frustration while communication skills are developing.

Whatever type of visuals you are using…

  • It is important to be consistent – use them repetitively, every day. This helps visuals to become familiar and reassuring, rather than something else to process.
  • Show how to use them. Just like a child learns to talk by hearing people talk around them, it’s important to use the visuals yourself to show how they can be used.
  • Not too many! It’s tempting to introduce every idea you come across, but it might be too difficult to understand and make life more confusing instead of easier. Try one at a time, and introduce it slowly.
  • Give it time – a new system may take weeks to become familiar enough to be helpful.
  • If it works, keep using it! It’s tempting to drop things once your child has learnt the skills, but it’s worth keeping it available. Communication can be harder sometimes, particularly when a child is anxious or upset, and reverting to a safe system can really help.

Objects of reference are objects which are used to represent a person, place, or activity, and provide a visual clue about what is going to happen. They “stand for something” in the same way that words or signs do.

We all naturally use objects to convey information e.g. every time you hand your child their coat, it is communicating that you are going outside. This is similar to using objects of reference, but it uses objects in a more structured way. Children have their own set of objects which can be used to represent different things.

Example

When taking your child to go swimming, before you go show them the object you have used to represent it, such as a towel.

Let them hold it and give them time to feel the object.

This object will help your child to understand that they are going to go swimming. Over time as this is repeated, they will associate the towel with going swimming and will know it is going to happen.

Using objects consistently as objects of reference can have many benefits, including an impact on:

  • Behaviour - Knowing what is happening next can reduce anxiety, fear, and frustration.
  • Multisensory Skills - Objects of reference encourages children to explore the object using all senses (touch, smell, sound, sight).
  • Object Recognition - Children start to recognise and differentiate between objects using their senses.
  • Association - Children begin to develop the ability to associate objects with a specific activity, place, or person.
  • Understanding - Over time, children will begin to understand what the object stands for which will help them feel more secure and confident in understanding daily routines.
  • Expression - If children learn the meaning of the objects quickly, they can also use the objects to make requests and or choices. This can increase independence.

Choosing your objects

Think of what objects you can use to represent the different activities you typically do in your day. You can use objects around the house. Choose one object to represent one activity.

Objects can be an item that is used in the activity (e.g. spoon), a part of the actual object (e.g. piece of a towel), or a miniature object (e.g. toy car).

Objects should be safe, durable, portable, hygienic, replaceable, and inexpensive.

Here are some suggestions of the types of objects to use. However, objects should be unique to your child so don’t feel like you have to choose these specific objects. Find something that works for you and your child.

Activity 

Object

drink cup

bottle
mealtimes spoon, plate, bowl

bedtime

pyjamas, teddy

going in car

keys, seatbelt strap
swimming                 towel, armband
shopping                  bag, cooling rack (similar to shopping trolley)

Try to keep the objects in a specific location such as a box, a bag, or hang them on a wall when they are not in use. This makes them easily accessible.

You can attach a symbol or picture that represents the activity to the object, or you can just use the object.

Using the objects

The object must be used consistently and repeatedly every time you do that activity. Your child will not understand at first, but over time they will begin to associate the object with a certain activity. It will become meaningful for the child. They will start to form a strong link between what you are saying, what you’re showing them, and what they do next.

Before the activity

Before an activity, give your child the specific object to hold. Use a sign or speech e.g. “it’s dinner time”.

Allow them time to explore it and talk to them about what it means.

After the activity

After the activity is finished, put the object away. Try to draw your child’s attention to the fact that the object is gone and therefore the activity has finished e.g. “dinner finished”.

Objects should be accessible so that your child could use them to communicate as well.

Symbols, or sometimes photographs, can be used to represent words and ideas without words. Speech and language therapists sometimes suggest this as an option for teaching your child what communication is all about, if they are having difficulty using words or understanding how to use communication and interaction.

Sometimes we use an approach called PECS (Picture Exchange Communication System). PECS begins by teaching a child to give a single picture to a “communicative partner”, who then responds to the exchange by giving the desired item.  This teaches the skill of “two-way” communication, and skills can be built upon from there.

Click here to visit their web site for more information about this approach.

Now/next strips help your child begin to understand routines. Understanding that things have a start and end is an important skill for a child to learn to help them move through their day with flexibility.

Now/next strips can be used alongside or as an introduction to the use of a visual timetable.

You can use symbols, or photographs which can sometimes be easier to understand to begin with. It can be a good idea to make the strip on the front of a plastic wallet, and to keep the symbols inside. Having a clear place for “finished” symbols is also important.

Introduce now/next with two motivating activities – both should be fun!!

  1. Start with two motivating activities e.g. ball and bubbles and place the symbols on your strip.
  2. Tell your child what happening - “Now ball next bubbles” - pointing to the symbol as you say it.
  3. Show your child the first symbol and name it “now ball” then give your child the item to play with.
  4. Once finished name the item and say it’s finished with what’s coming next e.g. “Ball finished next bubbles”. Put the ball out of reach and place the symbol in your finished pouch.
  5. Show your child the second symbol and say “now bubbles”, and give those.

Once your child can understand this, the next step would be to add a symbol to the strip that the child wouldn’t usually play with or an activity you’d like them to complete like a jigsaw or book, followed by a motivating item like bubbles or a balloon.

Encouraged your child to complete the first activity and remove the symbol once finished, then give your child the motivating item, following the steps above.  Always give the “next”, even if they only briefly attempt the first activity – this helps to reinforce the idea that next always comes afterwards. Now and next should be used to teach sequences, not as a reward system for behaviour or co-operation.

Once your child is able to complete this you can start adding more activities to the strip along with a motivator, and move towards using a visual timetable.

Visual timetables are created using photographs of symbols of events. They are used to help children understand what they are doing over a period of time. They give structure and can help to reduce anxiety levels.

They can be beneficial for all children (just as all adults use diaries and planners), and are particularly useful for children with language processing difficulties, attention difficulties, memory difficulties and for children who are learning English as an additional language, where the visual images can support understanding.

They can be created for a whole day or to help make clear the order of events for a certain activity e.g. getting ready for PE or going to the toilet.

Creating a visual timetable

You can use symbols or photographs.  Make sure that your child understands each symbol before expecting them to follow a timetable – associate the symbol with what it represents frequently.

It is useful to laminate the pictures and use Velcro/adhesive to attach them to a strip on the wall/ on the table. This will help by making it easy to move the pictures around and change activities.

Display the symbols either from top to bottom or left to right in the correct order.

Refer to the timetable as often as you can.

Usually, show the whole timetable at the start of the day, then point to the relevant picture before you start each activity and when moving to a new one. A way of identifying what you are doing now, such as a frame that moves along the pictures, can be very useful.

Social StoriesTM were originally created by Carol Gray in 1991 and are widely used to support social understanding in many different contexts. They are about specific events or situations, with information about what to expect and what to do. Stories should be tailored to the individual, taking into account their own needs, and their own interests.

Social stories can help in situations that are difficult because they are concrete, they increase structure and predictability and can reduce anxiety.

It should be noted that there are specific criteria for what is a Social StoryTM and the trademarks are owned by Carol Gray. Information can be found at www.carolgraysocialstories.com.

Social stories could be used in all sorts of different situations, for example, bedtime or school time, social interactions, or before a significant change to a routine.  Specific examples of social stories and support on how to use them can be found widely on the internet, or by asking your Speech and Language Therapist.

Writing a social story

A helpful story has a clear specific goal – identify the situation that is difficult, and the key features of the situation – where does it happen, when does it happen, who is involved, what happens?

It should be written from the child’s perspective, using positive language in the first person (i.e. “I”) and in the present tense.

There are several different types of sentences that can be used:

  • descriptive sentences: these describe the situation, e.g. “I love to play with the fire engine”.
  • directive sentences: these tell the child what they should do in this situation, e.g. “When someone is playing with the fire engine, I can say, ‘Can I have the fire engine please?’”.
  • perspective sentences: these describe how other people will feel e.g. “Other people want to play with the fire engine too”.
  • affirmative sentences: these express a shared social value or opinion, e.g. “It is okay to wait”.
  • control sentences: these identify strategies that the child can use to remind himself how to behave, e.g. “I can play with the fire engine when someone else puts it back in the box”.
  • cooperative sentences: these can explain who will provide help and how, e.g. “My teacher will help me stay calm while I wait for my turn”.

Social stories should be encouraging - there should be at least double the amount of describing sentences (descriptive, perspective, affirmative or cooperative) than there are coaching sentences (directive and control).

You can use words like “sometimes” or “usually” when outcomes are not always the same.

A story should be at the right level for the child to understand, and include pictures and visual support to help understanding.

It should take into account why the child might have difficulty in the specific situation.

Social stories don’t need to be professionally produced – they can be written at home, with your own drawings.

Recommendations for success when using social stories

Try a simple story about a non-challenging issue to begin with, rather than tackling a big battle.  This helps the idea of a social story to become reassuring and comforting.

Social stories should never be used as a punishment for misbehaviour, as this associates the stories with negative feelings.

Present the story to the individual at a time when everyone is feeling calm and relaxed. This will maximise the individuals learning and help the person to develop positive associations with the story.

Introduce the story using simple, clear language e.g. I have written this story for you. It is about thunderstorms. Let’s read it together now. Soon we will review it.

Review (read) the story as often as required - some social stories can be reviewed initially once a day, and others immediately before the situation for which they were written.

Be positive, reassuring and patient when reviewing the story and ensure the environment is quiet, comfortable and free of distractions.

Involve others in the story where appropriate. For example, a story that is focussed on a situation or activity at home might also be reviewed with the child’s teacher or learning support assistant.  You might use the same stories, or different stories in different settings, but it may help to keep the structure and presentation similar to maintain familiarity.

Introduce one story at a time to make sure the child does not become overwhelmed with information.

Fade out the story by either reading less often, or re-writing parts of it to include new skills (or leave gaps for the child to complete themselves). Remember that change can sometimes be distressing - some people keep a folder of stories to add to and keep the previous ones available.

Useful Links

Intensive Interaction

Contact Us

For more information or if you have any questions please contact andrea.arnold@nhs.net

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