1. Pragmatic Language Therapy Activities for Older Adolescents and Adults Margaret D. Miller TIPS 4 Kids University of Missouri-Columbia INTRODUCTION High functioning autism is primarily a social deficit marked by the following pragmatic deficits: Use of nonverbal behaviors to regulate social interaction (e.g., body language, eye contact) Difficulty establishing and maintaining peer relationships Lack of shared enjoyment of interests with others Difficulty with conversational skills Lack of social or emotional reciprocity Individuals with this diagnosis have difficulty developing peer relationships. Successful pragmatic language therapy can: Decrease these pragmatic differences Provide this population with skills to form lasting relationships Decrease their feelings of isolation and loneliness What is Pragmatic Language Therapy? Pragmatic language refers to: “Social Skills” Encompasses all verbal and nonverbal communication affecting social interaction Speech-Language Pathologists provide pragmatic language therapy to individuals with Autism Spectrum Disorders (ASD) The purpose of pragmatic language therapy: To improve individual’s social functioning Enable them to appropriately participate in conversations Interact with a variety of individuals Form friendships and relationships. Purpose of the Project Lack of pragmatic language therapy material for older adolescents and young adults with ASD Need for quantitative measurement system to objectify data and demonstrate progress Create an ‘Activities and Data Collection’ booklet specifically geared toward older adolescents and adults with ASD Enable beginning clinicians to choose targets, write measurable goals, and measure changes THERAPY TARGETS Areas of Deficit Eye Contact Initiating & Terminating Conversations Follow-Up Questions Topic Maintenance Turn-Taking Body Language Recognizing/Expressing Emotions Perspective Taking Humor Reducing Negative/Distracting Behaviors Writing Quantifiable Goals Important to write quantifiable, measurable goals in order to: determine the therapy’s effectiveness demonstrate improvement determine when a goal has been met Example of non-measurable goals: The client will maintain the topic of conversation during conversations with familiar and unfamiliar partners. The client will maintain appropriate eye contact. Example of measurable goals: The client will maintain the topic of conversation over 4 consecutive conversational turns when speaking with familiar and unfamiliar conversation partners. The client will maintain appropriate eye contact throughout a 50 minute session with less than 3 verbal cues from the clinician. DATA COLLECTION Qualitative vs. Quantitative Qualitative Data Observations Non-measurable Descriptions of what was observed May be helpful for noting small changes in performance from session-to-session Provides professionals a fuller picture of the client’s performance Ex. The client made poor eye contact throughout the session. Quantitative Data Measurements Numbers associated with session Measures therapy’s effectiveness and progress on goals Often necessary for insurance coverage Ex. The client required 6 verbal cues to maintain adequate eye contact throughout a 50 minute therapy session. Qualitative and Quantitative Data Combined Descriptions and measurable data from sessions Notes smaller changes in performance as well as larger, measurable changes Lengthier, but provides the most information Ex. The client made poor eye contact when asked questions by the clinician. He required 6 verbal cues to maintain adequate eye contact throughout a 50 minute therapy session. SUMMARY Older adolescents and adults with high functioning autism demonstrate a variety of pragmatic language impairments. The majority of pragmatic language therapy activities are geared toward younger children and adolescents. The ‘Activities and Data Collection’ booklet provides: Therapy materials for this population Specific examples of measurable goals Ways to collect quantitative data ADDITIONAL RESOURCES Autism Speaks (www.autismspeaks.org) The Gray Center (www.thegraycenter.org)