Speech Therapy -> Pragmatics / Social Skills / Life Skills

Skilled interventions

  • Behavioral Support Services/Modifications

    A behavior is defined as ‘anything an individual does involving action and response to stimulation’. In individuals with communication delays/disorders, behaviors are often a meaningful form of communication. During behavioral support/modification, the SLP provides environmental structuring, modified activities, and semantic prompting to reduce negative behaviors and increase positive performance (MacDonald, et al, 1974).

  • Environmental Manipulation Strategies

    Environmental manipulation strategies are used by the SLP to target prelinguistic communication skills of attention so that communicative behaviors can be taught. This is highly researched for children with autism but can used with other specific language impairments that show deficits with joint attention.

    Techniques for environmental manipulation are placing objects close to the child or sabotage, such as placing a desired item in a tightly closed jar so that the child would have to request assistance to get the item. Addressing features of attention in categories such as orienting, sustaining, and shifting can lead to joint attention.

    1. Orienting attention is the initial physical adjustment toward a stimulus. This is an eye gaze shift or head turn toward a stimulus. Orienting deficits of children with autism directly affect intervention because if stimuli used in speech and language interventions fail to gain the attention of children with autism, they cannot have the desired teaching impact.
    2. Sustaining attention is the ability to maintain attention to a stimulus. Children with autism can remain fixated on a particular stimulus while ignoring others and can be “over focused”. This may be related to the child having difficulty with shifting attention.
    3. Shifting attention requires the child to disengage from one stimulus and then shift and reorient to a new stimulus. Children with autism seem to have more difficulty with disengaging then with reorientation. SLP may address this feature during activity transitions by hiding the toys that are no longer needed and quickly placing toys for a new activity in the child’s visual field. All of this information is important as it relates to joint attention, which refers to shared attention between two individuals and an object or another individual. Once joint attention is gained the SLP can target functional communication such as sign, gestures, AAC or words for the child to communicate their wants/needs (Patten & Watson, 2011; Yoder & Stone, 2006; Kasari et al., 2006).

  • Prelinguistic Milieu Teaching (PMT)

    This is an intervention for children with language delays who have a very limited or nonexistent lexical inventory and may be having significant difficulties in their production of nonlinguistic communicative acts. In PMT the SLP teaches other modalities for communication including specific gestures, vocalizations, and coordinated eye gaze behavior (Fey, et al., 2006).

  • Responsivity Education/Prelinguistic Milieu Teaching (RE/PMT)

    This is an intervention for children with language delays who have a very limited or nonexistent lexical inventory and may be having significant difficulties in their production of nonlinguistic communicative acts. In PMT steps are taken directly to teach specific gestures, vocalizations, and coordinated eye gaze behavior. The Responsivity education component of RE/PMT targets parents’ compliance to and recoding of children’s verbal and nonverbal acts (Fey, et al., 2006).

  • Script Therapy

    A language intervention procedure in which events and routines known to the child or made familiar by the clinician are used to teach advanced language skills including narrative and pragmatic skills. SLP uses mental schemes a child may have about common experiences such as eating in a restaurant, grocery shopping, or personal interactions/conversations.

  • Social Scripts Technique

    Social Scripts technique is a language intervention technique that improves patient’s linguistic and social cognitive skills using role play of social interactions and a checklist to elicit the patient’s statements about other’s perspectives and strategies for completing the social script. It is a way of rehearing new skills of social problem-solving (Timler, et al 2005).

Reference links

  • Nurturing Care For Early Childhood Development 1
    Author: World Health Organization - Your loving care as a parent is what a child needs to be healthy, wellnourished and safe. • Communicate early and often, starting even before your baby is born. It will help you build a warm and loving relationship. • Make time to play with your child and engage them in your daily chores. You will help your child to learn, be happy and thrive. • Remember that feeding times are periods of learning and love – talk to your child while feeding and make eye to eye contact. • If you feel sad and unable to respond joyfully to your child, seek help from your health care provider.
  • Leveling Up Regulatory Support Through Community Collaboration 1
    Author: Amy C. Laurenta and Jacquelyn Fede - While behavioral intervention methodologies and societal expectations for masking remain prevalent, in recent years, there has been a greater emphasis placed on understanding the underlying factors contributing to problematic and challenging behaviors. Furthermore, there has been greater recognition of the need to address those underlying factors as the primary areas to target for effective intervention that can actually help autistic individuals navigate their environments in school and as they transition out of school and into the real world (Prizant et al., 2006a). To provide this type of ethical, efficient, and sustainable support, it is imperative for clinicians to understand emotional or energy regulation as a developmental construct and then to understand its relationship to challenging behaviors.
  • Autism Spectrum Disorder and Other Development Disorder 1
    Author: World Health Organization - Psychosocial interventions that are effective in reducing core symptoms and improving adaptive skills and functioning are available, but they are very resource intensive. Increased evidence on affordable service delivery models and effective and scalable capacity-building approaches are required. Interventions mediated by parents and other non-specialist providers have the potential to significantly increase access to care.
  • Bilingual (English/Spanish) Therapy Materials By Bilinguistics 1
    Author: Bilinguistics - Downloads and resources for providing bilingual therapy (Spanish/English)
  • Red Flags For Speech-Language Impairment In Bilingual Children 1
    Author: Scott Prath On ASHA Wire - Red Flags for Speech-Language Impairment in Bilingual Children Differentiate disability from disorder by understanding common developmental milestones.
  • Learning Two Languages: Bilingualism 1
    Author: ASHA - Information and resources for SLPs and parents of bilingual children
  • Bilingual Language Development Video 1
    Author: Kathy Kohnert - YouTube Video on Bilingual Language Development by Kathy Kohnert
  • Bilingual (Spanish/English) Evaluation Resources 1
    Author: Bilinguistics - Dozens of speech, language, fluency, and other evaluation resources for bilingual evaluations
  • The Functional External Memory Aid Tool Version 2.0: A How-To Clinical Guide 0
    Author: Alyssa M Lanzi 1 2, Anna K Saylor 1, Robert F Dedrick 3, Michelle S Bourgeois 4, Matthew L Cohen 1 2 5 - This clinical-focus article describes new resources available to help clinicians administer and interpret Version 2.0 of the FEMAT when serving adults with cognitive-communication disorders.
  • Pathological Demand Avoidance: Symptoms but Not a Syndrome 0
    Author: Jonathan Green 1, Michael Absoud 2, Victoria Grahame 3, Osman Malik 4, Emily Simonoff 5, Ann Le Couteur 6, Gillian Baird 4 - In our Viewpoint, we reviewed the current literature and conclude that the evidence does not support the validity of pathological demand avoidance as an independent syndrome. Nevertheless, the use of the term highlights an important known range of co-occurring difficulties for many children with autism spectrum disorder that can substantially affect families. We explore how these difficulties can best be understood through an understanding social, sensory, and cognitive sensitivity in autism spectrum disorder, identification of frequently occurring comorbid conditions, and assessment of how these problems interact within the child's social environment. Pathological demand avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent.
  • Parents' Experiences of Professionals' Involvement For Children With Extreme Demand Avoidance 0
    Author: Emma Gore Langton 1, Norah Frederickson 1 - Parents felt positive about practitioners who had listened to their experiences, made efforts to understand the child, and provided or arranged for help. Parents found involvement most helpful when it resulted in comprehensive assessment, appropriate intervention, practical advice and management strategies, and a focus on the well-being of all family members. The overall ratings of helpfulness are encouraging, and the specific feedback about what is most helpful could be of value in shaping services.
  • Pathological Demand Avoidance: Exploring the Behavioral Profile 0
    Author: Elizabeth O'Nions 1, Essi Viding 2, Corina U Greven 3, Angelica Ronald 4, Francesca Happé 5 - This study is the first to use standardized measures to explore the behavioral profile of children receiving the increasingly used label PDA. It represents the first clear evidence that children fitting the PDA description display severe impairments across multiple domains. Comparisons between behavior in PDA and two putatively overlapping groups, ASD and CP/CU, revealed levels of peer problems and autistic-like traits in PDA comparable to ASD.
  • Scope of Occupational Therapy Services For Individuals With Autism Spectrum Disorder Across the Life Course 1
    Author: Copyright © 2015 By the American Occupational Therapy Association, Inc. The American Journal of Occupational Therapy, 2015, Vol. 69(Supplement_3), 6913410054p1–6913410054p12. - Occupational Therapy practitioners work collaboratively with individuals on the autism spectrum, their families, OTHER PROFESSIONALS, organizations, and community members in multiple contexts to advocate for and provide a range of needed resources and services that support individuals' ability to participate fully in life (Case-Smith & Ambersman, 2008; Kuhaneck, Madonna, Novak, & Pearson, 2015; Tanner Hand, O'Toole, & Lane, 2015; Watling & Hauer, 2015a; Weaver, 2015). According to a study conducted by the Interactive Autism Network (2011), occupational therapy ranks second to speech-language pathology as the most frequently provided service for individuals with autism throughout the United States.
  • Language In Brief 1
    Author: The American Speech-Language-Hearing Association - Language is a rule-governed behavior. It is defined as the comprehension and/or use of a spoken (i.e., listening and speaking), written (i.e., reading and writing), and/or other communication symbol system (e.g., American Sign Language).
  • Language Difference vs Language Disorder: Assessing English Learners 1
    Author: Carol Westby and Kimberly Murphy - Video available Language Difference vs Language Disorder: Assessing English Learners Carol Westby, Bilingual and Multicultural Services, Albuquerque, NM Kimberly Murphy (Host), Old Dominion UniversityFollow Document Type Presentation Publication Date 5-20-2020 Abstract To a large extent, determining whether an English learner has a language/learning disability is a process of elimination. There are no tests that can definitely tell us whether the student has a language/learning disability. Inappropriately identifying an EL student as having a language/learning disability can result in stigmatization or reduced access to academic content, but waiting too long to identify a student who truly has a language/learning disability can be the beginning or the extension of a cycle of communicative, academic, and/or social failure. Assessment of EL learners requires collaboration between classroom teachers and speech/language pathologists. This session will cover (1) factors that complicate the assessment of English learners; (2) multi-tiered systems of support (MTSS) and performance-based assessment; (3) process assessments, and (4) dynamic narrative assessment. Comments This professional development webinar was presented by Dr. Carol Westby for speech-language pathologists in Virginia. It was funded by the Virginia Department of Education and hosted by Dr. Kimberly Murphy, Old Dominion University.
  • Bilingual Service Delivery 1
    Author: ASHA - Information and resources regarding bilingual service delivery by SLPs (from ASHA)
  • Evaluation of Bilingual Children- Considerations 1
    Author: Alejandro E. Brice and Roanne G. Brice - An overview of considerations when evaluating bilingual (Spanish/English) children
  • Multilingual, Multicultural, Bilingual Resource Link For SLPs 1
    Author: ASHA - Link includes ASHA resources and information related to evaluation and treatment of clients from linguistically and culturally diverse backgrounds. Link includes ASHA resources to: Accent Modification Bilingual Service Delivery Collaborating With Interpreters, Transliterators, and Translators Cultural Competence Voice and Communication Services for Transgender and Gender Diverse Populations Dynamic Assessment Micro Course Cultural Competence Self Assessment Phonemic Inventories and Cultural and Linguistic Information Across Languages Collaboration With Interpreters: Securing Positive Outcomes Practical Assessment and Treatment Strategies for English Language Learners with Language Impairments Serving Clients From Diverse Backgrounds: Speech-Language Difference vs. Disorder Langu Continuing the Dialogue on Dialect: Positive Steps Toward Less Biased Assessments of Children Who Speak African American Englishage and Identity--Shifting Away from a Deficit Perspective on African American English Información en español

Activity List(s)

Visual Schedule Cards

Related Disorder(s)

  • Social communication disorders - Social communication disorder (SCD) is a condition that makes it hard to talk with other people. It's not a problem with speech or with the mechanics of language, like using grammar. But it does impact other areas of language. People with SCD have trouble communicating in ways that are socially appropriate.
  • Autism Spectrum Disorder - Autism Spectrum Disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person.
  • Post-traumatic stress disorder - Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.
  • Attention-Deficit/Hyperactivity Disorder (ADHD) - Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
  • Neurological Conditions - Types of neurological conditions may include: Alzheimer’s Disease, Dementias, Brain Cancer, Epilepsy and Other Seizure Disorders, Mental Disorders, Parkinson’s and Other Movement Disorders, and Stroke and Transient Ischemic Attack (TIA).
  • Selective mutism - Selective Mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed.


Goal Bank

  • Jacob will initiate greetings with familiar people over a 6 week therapy period. 0
  • Jennifer will respond to greetings of familiar people over a 6 week therapy period. 0
  • Jody will follow a daily sensory and movement diet with age-appropriate preferred regulatory activities 10 minutes per day, min 4 times per week, with visual and 50% verbal cues, to improve active participation at home and school, 80% of the time. 0


Therapists who selected this major focus area as their top area of expertise.

  • Jennifer Pierce

    Jennifer Pierce

    • Advanced Therapy Clinic LLC Advanced Therapy Clinic LLC
  • Emily Bultman

    Emily Bultman

    Full-time Therapist CF-SLP

    I am a Speech-Language Pathology Clinical Fellow and have the most experience providing treatment...

  • Leslie Edwards

    Leslie Edwards

    • MSU Denver Assessment Class MSU Denver Assessment Class