School-based speech-language pathologists who work with high school students face the ever-present question, "How do I help my students with autism spectrum disorders learn to be high school students?"
The answer to this question varies depending on students’ individual needs. Individualized education program goals may focus on conversation skills, perspective taking, and understanding and interpreting humor, to name a few, but all center on helping students with ASDs engage with other students and adults, develop naturalistic peer relationships and adapt to ever-changing social situations.
In addition to IEP goals that target academic skills, students with ASDs can benefit from instruction in the subtleties and nuances of social interaction and communication—areas that should be addressed in an IEP. Given SLPs’ knowledge and expertise in pragmatic language development, we should address these skills as they arise in high school. As Michelle Garcia-Winner notes, "As communication specialists, SLPs can continue to explore ways to add to this theory-driven practice simply by becoming better observers of the social world and by using that knowledge to make the abstract social world more concrete for students."
A good starting point for developing appropriate goals and objectives is reviewing ASHA’s online resources on social language development and speech-language intervention. These include a Web page on pragmatic language disorders, which provides definitions, ASHA policy documents, articles, presentations, professional development, and information for consumers; and a page on social language use (pragmatics), which is useful in understanding the components of pragmatics and some problems that clients may encounter.
Next, it’s important to identify the most appropriate treatment approach to use with each client. An evidence-based practices comparison chart [PDF] developed by the Centers for Medicare and Medicaid Services, the National Autism Center and the National Professional Development Center provides brief descriptions of evidence-based interventions and strategies for use with students who have ASDs.
A few interventions that may be appropriate include social skills groups, SCERTS (SC: Social Communication; ER: Emotional Regulation; and TS: Transitional Supports) and Score Skills Strategy.
- Social skills groups teach ways of interacting appropriately with or without typically developing peers through instruction, role-play and feedback. Groups typically consist of two to eight participants with social communication disorders and teacher(s) or adult facilitator(s).
- SCERTS is a model of service provision, rather than a specific program, that focuses on how to regulate emotions and communicate with others.
- Score Skills Strategy is a social skills program that takes place in a cooperative small group and focuses on five social skills: sharing ideas, complimenting others, offering help or encouragement, recommending changes nicely, and exercising self-control.
Armed with this background knowledge and expertise in communication, school-based clinicians may consider specific skills to target, such as conversation initiation and maintenance, nonverbal communication and problem solving. Sample goals drafted by ASHA members include:
- The student will increase his or her ability to maintain a topic during conversation, including his or her use of appropriate comments and questions, from 40 percent to 60 percent of opportunities given verbal and visual cues to 80 percent of opportunities (four out of five opportunities) over three consecutive sessions. (Brittany Walker, Wash.)
- Given instruction, the student will understand and use context clues, sarcasm and irony, and the implied meanings of language to understand and react to various social language situations that he/she confronts daily and to react in socially appropriate manners during conversations with adults and peers, with 80 percent accuracy in four out of five trials, as measured by clinician data. (Sandra Perrino, Fla.)
- Given a contrived situation, the student will determine the problem and the "size of problem" ("glitch, medium or big problem"), describe emotional reactions related to the problem, and adjust response to fit the problem through verbal and nonverbal communication in four out of five given situations. (Megan Grossman, Md.)
- The student will be able to note people’s facial expressions, body language and tone of voice within specific contexts to determine how that person is feeling and if the person is interested and/or listening to what the student is saying, in four out of five opportunities. (Esther Goetz, Md.)
Ultimately, school-based clinicians should work closely with the IEP team, including the student, parents and guardians, educational staff, and transition staff to ensure that each student’s goals and objectives focus on the social communication needs and desires of that student, align with the educational program, and foster naturalistic and relevant communication.
For more information on school-related topics, visit the schools section of ASHA's website. Also visit the ASHA Community to post questions and discussion topics with colleagues on clinical professional issues.