Social cause and effect - non-ASD

[akafred]

I feel like a large part of DD's anxiety is caused in part by not understanding social cause and effect. For example, when she was around 4, I took her to a playground and while she played in the sandbox, I watched her throw sand. I was going over to get her but before I could, another kid hit her. It seemed like she couldn't connect the cause (her throwing sand) with the effects (other kid hitting her, me taking her out of the park). She seemed to think I was taking her home because the other child was "mean", not because she threw sand. Explanations fell to deaf ears. This is just one concrete example; it has been a thing her whole life. It is improving with age and anxiety meds, but it still seems to be an issue. I think it may contribute to her anxiety. It's like from her perspective, bad things just keep happening to her for "no reason." I can imagine how out of control that would make me feel.

Is this something an SLP can help with? Can she even qualify for speech therapy when she has no speech/language issues including (as I understand them) pragmatic (she "gets" tone, body language, sarcasm, etc)? Or another suggestion? When I look online I see suggestions for teaching cause and effect, but they are very remedial and not really focused on social things (more like you bump a trash can and it falls down).

[mamaturtle]

What about a social worker?

That is all I can come up with.

DS has a SLP and SW working together to provide him services at school on social skills. DS is still speech delayed so that is what is working for him. On top of that we have ABA at home.

[akafred]

We're actually seeing a social worker for therapy, but she didn't seem to have any practical suggestions for the cause and effect thing, just took a note of it. But we are still kind of going through intake.

[funchicken]

akafred, have you read any of MGW's social thinking books? I bought a copy of Thinking About You Thinking About Me when I was at the conference last year, and it's helped me understand DD so much.

Also, I know when DD does something wrong and she's mad at herself, she behaves as if whatever happened wasn't her fault, and she gets mad at me or her sisters or another kid. Maybe a therapist could help?

[auntie]

Sept 22, 2017 7:45:42 GMT -5 akafred said:

Is this something an SLP can help with? Can she even qualify for speech therapy when she has no speech/language issues including (as I understand them) pragmatic (she "gets" tone, body language, sarcasm, etc)? Or another suggestion? When I look online I see suggestions for teaching cause and effect, but they are very remedial and not really focused on social things (more like you bump a trash can and it falls down).

This is absolutely something a SLP could work on. About 55% of communication is strictly non-verbal (body language and facial expression). The bigger piece is that Char doesn't seem to appreciate her role in how things happen to her. That's the kind of information a well developing child doesn't need pointed out- the just intuit it by around age 5-6. 

Michelle Garcia Winner's Social Thinking addresses exactly this sort of disconnect and helps people take ownership of how others think about and act toward them based on their own behavior. This isn't like blaming the victim- it's about empowering someone to chose the reactions they want. DS's early SLP used to parse this into a kind of mind-control superpower. Thinking About You, Thinking About Me is the classic for this. 

[akafred]

In this case it isn't blaming the victim, it's blaming the obtuse perpetrator lol.

She has a speech eval where she gets OT a week from Monday. I'm just concerned that a private for-profit therapy center will find something wrong in a kid with 100% insurance coverage even if there isn't, so it is comforting to know this still falls within the realm of SLP services.

[auntie]

I meant that a lot of parents who initially look at the MGW materials feel like telling a child with ASD or ADHD that they are the reason other kids are unkind to them is blaming the victim. But it isn't quite presented like that. Most of the MGW site deals with kids on spectrum, but both DS's SLPs used it for some kids with ADHD who were struggling socially; DS was in the 6th grade ADHD group because his issue by then was accessing it in the moment rather than content and strategies. 

It is very difficult to teach cause and effect thinking to an ADHDer who isn't wired that way. They are too very much in the moment to contemplate that there even are consequences much less what those consequences may be. Living this with my mother lately.

[akafred]

Another question: Is the therapy likely to make DD tired or cause her to act up in the short term? If the eval comes back saying she needs ST, I have to figure out how/when to schedule this. Right now she goes to OT at 9am (first spot) on Wednesdays and goes to school at 10:05 (the center is just down the street from school, thankfully). This doesn't cause any problems at school because the sensory component of OT helps calm her down and get her focused. The teacher says she usually accomplishes 2-3 times what she normally would in that time. But ST won't have that sensory component probably, so if it makes her more anxious in the short term, that could be a problem. The last appt of the day is at 3pm. DH works 1-10pm so he can take her to morning appts, but afternoon spots are during work hours for both of us. But I don't want to do a morning appt if it will cause some behavior challenges. She recently got a promotion from second most challenging kid at school to THE most challenging kid, as there was an elopement followed by a subsequent elopement so that kiddo got pulled.

[funchicken]

Sept 24, 2017 5:59:29 GMT -5 auntie said:

It is very difficult to teach cause and effect thinking to an ADHDer who isn't wired that way. They are too very much in the moment to contemplate that there even are consequences much less what those consequences may be. Living this with my mother lately.

I definitely see this. DD1 will often feel bad or apologize later, but in the moment, she's very defensive and won't acknowledge how her behavior impacts the situation.

Thinking About You, Thinking About Me does such a good job of describing where people with social-cognitive challenges are coming from. The section on kids who have difficulty understanding group dynamics really gave me a lot of insight into DD's behavior. I wish I could go to the conference on nuance-challenged social learners this fall, but I'm too broke They've added a bunch of webinars to the site, I think. I haven't had a chance to check them out yet.  

[auntie]

funchicken, I've never attended on IRL. By the time I catch on, there's only room in the overflow area so I'd be watching on a screen anyway.

[akafred]

The speech eval came back without a need for services anyway. In all tested areas but one, she was 50%+ (one she was 95%). In the remainder she was 35% which was considered in the average range, and it was the last one tested so she was probably tired at that point and may not even be representative.

So...that's good...mostly. It is just a little sad because it effectively closes one more door for possible help.

[macchiatto]

I'm sorry you weren't able to get help for this. :/ I'm not sure if MGW's stuff is something a parent could use with the child or designed more for a therapist to use.
Leo's SLP has been using MGW's stuff (I believe Social Thinking and Superflex) with him a good bit and was all excited she just got to go to one of her conferences in VA. (She knew I was excited about this and texted me a pic in the room with MGW. ) Can't wait to hear what she learned!

[funchicken]

akafred, I would highly recommend either buying or borrowing a copy of Thinking About You, Thinking About Me. Social Thinking doesn't focus on diagnoses. MGW addresses the fact that a lot of kids with social-cognitive challenges don't qualify for interventions, and people with a wide range of diagnoses can have social-cognitive difficulties.

My oldest DD (ADHD, SPD) doesn't qualify for any services, and when the school SLP screened her, she was within the normal range for social stuff as far as the SLP was concerned, but I have three girls, and I see a marked difference in the way my 6 year old (and even my three year old) intuitively grasps social situations. DD1 isn't like that. Interpreting social nuance, body language, and perspective-taking are more challenging for her. Thinking About You, Thinking About Me breaks down components of social interaction and allows you to see what your child's strengths and weaknesses are.

Does the SLP practice who tested your DD have experience with Social Thinking?

[akafred]

funchicken, yes, they do MGW in their pragmatics.

DD actually has an excellent grasp of things like body language, facial expression, tone of voice. Way better than mine and I am in my 40's. Her issue is more of the social anxiety side where she is sure everyone is staring at her, but by extension (or in contrast?) she can't see how her actions/reactions cause others to feel that way about her. Or maybe she knows but acts oblivious (perfectionist thinking maybe). But my gut says she doesn't get it. Stuff like she still thinks or acts like I control the universe and expects me to literally move heaven and earth. Very immature innthose ways.

[funchicken]

akafred, so I still think you should check the book out. I'm not doing a good job of explaining it. Like I said, my DD doesn't qualify for accommodations or an IEP, and she's "within the range of normal." The book helped me identify what might be driving some of her behaviors. The best example I can think of is that when she's in a group (like say driving in a car with a group of girl scouts), sometimes she acts out when the group gets quiet not because she's trying to be disruptive, but because she feels invisible because she has trouble imagining what's in other people's heads. I know she needs help understanding and processing social stuff. I work with her at home, and our school counselor is awesome so she helps, but we don't do formal therapy. I would still consider this as an avenue to help your DD even if the SLP said she didn't need/qualify for therapy.

[akafred]

funchicken, thanks. I will def check it out!

[auntie]

Oct 21, 2017 11:43:41 GMT -5 akafred said:

funchicken , yes, they do MGW in their pragmatics.

DD actually has an excellent grasp of things like body language, facial expression, tone of voice. Way better than mine and I am in my 40's.

Eh, but does she really? It's one thing to look at a picture or even a movie one-on-one with an adult during an assessment (formal or informal) and say someone is mad, scared or happy. DS could out guess typically developing kids if he was working 1:1 with his SLP who commented on how unusual this splinter skill was for him.

Her issue is more of the social anxiety side where she is sure everyone is staring at her, but by extension (or in contrast?) she can't see how her actions/reactions cause others to feel that way about her.

It sounds like she hasn't globalized the lesson for some reason. Either it is an emerging skill she can't reliably access in the moment or she doesn't understand fully. Anxiety could be a piece of this, but mental and behavioral health conditions can also impact this. It's sometimes seen in ADHD where the executive function piece fails them- learning through experience- if I do this, that happens.

For DS, who didn't self-identify as a child- buy-in to the rules of his peers was difficult to get because while he understood them, he didn't feel they applied. FTR, this isn't unusual in otherwise typical kids who are the oldest or an only. Or it could be she doesn't feel the rules apply to her for some other reason. 


Or maybe she knows but acts oblivious (perfectionist thinking maybe).

How so? Do you think maybe she acts out because it's easier than admitting she doesn't grasp this concept that you obviously value highly? 

But my gut says she doesn't get it. Stuff like she still thinks or acts like I control the universe and expects me to literally move heaven and earth. Very immature innthose ways.

You are probably correct. Most kids this age want to make the choices that reflect well on them and to please their teachers and parents. 

I've known a few parents who did TAYTAM with their kids because they couldn't find a SLP who was familiar or because their district used some other social skills curriculum. 

[akafred]

Oct 23, 2017 9:26:14 GMT -5 auntie said:

Oct 21, 2017 11:43:41 GMT -5 akafred said:

funchicken , yes, they do MGW in their pragmatics.

DD actually has an excellent grasp of things like body language, facial expression, tone of voice. Way better than mine and I am in my 40's.

Eh, but does she really? It's one thing to look at a picture or even a movie one-on-one with an adult during an assessment (formal or informal) and say someone is mad, scared or happy. DS could out guess typically developing kids if he was working 1:1 with his SLP who commented on how unusual this splinter skill was for him.

Honestly, yes, I think she really does. Now I grant you this is a particular deficit of mine (I am very spectrumy in this area) so I am probably not the most objective observer, but this is I would say an actual strength of hers vs simply not being a deficit. At any rate she didn't qualify for services.


Her issue is more of the social anxiety side where she is sure everyone is staring at her, but by extension (or in contrast?) she can't see how her actions/reactions cause others to feel that way about her.

It sounds like she hasn't globalized the lesson for some reason. Either it is an emerging skill she can't reliably access in the moment or she doesn't understand fully. Anxiety could be a piece of this, but mental and behavioral health conditions can also impact this. It's sometimes seen in ADHD where the executive function piece fails them- learning through experience- if I do this, that happens.

For DS, who didn't self-identify as a child- buy-in to the rules of his peers was difficult to get because while he understood them, he didn't feel they applied. FTR, this isn't unusual in otherwise typical kids who are the oldest or an only. Or it could be she doesn't feel the rules apply to her for some other reason. 

Yes this is definitely true for her. She will vehemently call a child out for breaking a rule that she has a particularly hard time following. She does seem to think herself above the rules. She also has a superhero complex. She's not just an adult who doesn't need the rules; she's a savior who breaks them for Justice.

Or maybe she knows but acts oblivious (perfectionist thinking maybe).

How so? Do you think maybe she acts out because it's easier than admitting she doesn't grasp this concept that you obviously value highly? 

Yes. This is definitely a part of it. I have lost some of the context in the quoting box so not sure what concept I value highly that you mean, but in general she does not want to admit to making mistakes of any kind, whether it be social or academic or any kind of task she doesn't think she can succeed at. She becomes very dysregulated, her behavior becomes chaotic, and if challenged to do whatever it is, the most you will get is "No, I just don't want to."



But my gut says she doesn't get it. Stuff like she still thinks or acts like I control the universe and expects me to literally move heaven and earth. Very immature innthose ways.

You are probably correct. Most kids this age want to make the choices that reflect well on them and to please their teachers and parents. 

I've known a few parents who did TAYTAM with their kids because they couldn't find a SLP who was familiar or because their district used some other social skills curriculum. 

She definitely wants to please me. She just doesn't always know how. Some of that is improving, but very slowly. I am going to try to get my hands on TAMTAY. It is quite expensive apparently and hard to find.

[auntie]

Yeah, for a while about 10 years ago TAYTAM was selling for upwards of $400 for a used copy.

It's down to a mere $49 now.

www.socialthinking.com/Products/Thinking%20About%20YOU%20Thinking%20About%20ME%20%202nd%20Edition

[funchicken]

akafred, if you haven't ordered the book yet, I think there's a coupon code (Social10) you can try for 10% off. ST just posted that it will work for most of their products.