Social Skills

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

The ability to participate in "normal" social activities can be one of the greatest challenges for a child with an acquired brain injury. While able to demonstrate good verbal and intellectual knowledge of social situations, children with acquired brain injury may be unable to apply this knowledge in real situations. They may have difficulties with:

• Paying attention to all necessary information
• Considering another persons point of view (tendency to be egocentric and lack empathy)
• Anticipating the consequences of a given act
• Adjusting their use of language to suit the audience (friends/teachers/ parents)
• Self monitoring
• Ability to use subtle social cues such as: changes in tone of voice, facial expressions, body language, which can affect the meaning of a situation
• Success in social circumstances (especially in adolescence) which relies heavily on the ability to interpret abstract language such as metaphors, humour and sarcasm.

Strategies to assist children with social skills and interactions

• Limit the amount of information and point out the most important/relevant information which the child needs to consider.
• Make communications as clear and direct as possible to improve understanding
• Discuss others' point of view and interpretations of social situations
• Express feelings much more directly in order for the child to understand how you feel or how something affects you
• Point out the possible short and long term consequences of decisions
• Give a few specific choices instead of asking for an open ended decision
• Avoid the need to make decisions under stressful conditions or time pressures whenever possible
• Be clear and specific about:
1. the behaviour/language that is inappropriate b) why it is inappropriate
2. how it makes others feel or the message it gives. Eg: "You are not looking at me when you are speaking. If you don't look at me, I'm not sure if you are talking to me or to someone else. It makes me feel like you don't really mean what you are saying."
• Emphasise that it is the behaviour that is unexceptable and not the person
• Give examples of more appropriate or desirable behaviours in that particular situation
• Praise the things that are done well and reassure the child that they have the ability to succeed
• Try to use the same feedback each time so that the child hears the same message and can begin to monitor their own behaviour. Discuss this with parents, teachers and others who interact with the child to ensure consistency
• Be realistic about the child's abilities and the expectations placed on him/her
• Rehearse and "role play" the child's possible responses ahead of time

To assist children to understand abstract language, humour and sarcasm, focus on:

• Identification of incongruity eg: does the person's facial expression match what they are saying? Does what the person is saying make sense in that situation? Why? What else could they mean?
• Identify where the incongruity may be eg: is there a particular word that has a double meaning?(such as `The fans roared') Or does the way that the sentence is constructed lead to a double meaning (such as `The duck was ready to eat')
• Explore idioms and metaphors asking the child to suggest interpretations. Commonly used idioms and metaphors may need to be taught

Reference

Keith D. Cicerone PhD "Social Comprehension and Social Judgement" Family Articles about TBI

"Using Language for Social Interaction" Statewide Paediatric Rehabilitation Service, Royal Children's Hospital & Health Service District, Queensland Health (July 2000)

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/