Ask the Expert – September 2016


Q. My son has difficulty making and keeping friends. He sometimes says and does things that aren’t tics, making other kids uncomfortable and he gets in trouble because teachers think he’s being rude. This is causing him a great deal of anxiety. The school is providing social stories but they don’t seem to be working. What can I do?

A. While some students may respond well to social stories, these aren’t always successful for students with TS. Students with Autism/Aspergers tend to do well with social stories because having a script to memorize and follow, can help to decrease stress for them. Although social stories may be a useful tool for students with TS who have social skills difficulties, they may not respond in the same way as the student with Aspergers. For example, your son might be painfully aware of his behaviors and deficits, so reading a social story may just increase the stress he already has about the situation thereby making it more difficult for him. If he struggles with obsessive thoughts, then he might get stuck on the behavior he is trying to change and it may actually get worse after reading the social story, rather than improve. Or, your son may have working memory deficits and the social story may be too much for him to remember and follow; this may create more stress for him and cause an increase in undesirable behaviors. For some students with TS, social skill difficulties are more a by-product of another deficit and if that deficit isn’t addressed, the problem won’t go away. You have to get to the root of the problem. It’s possible that instead of being seen as having Social Skills Deficits, your son may need to be evaluated for Social Communication Disorder. Students with Social Communication Disorder may have difficulties with the following (this is not an all-inclusive list):

  • understanding the behavior rules of the classroom, such as raising your hand or waiting to be called on.
  • understanding non-literal language, such as humor, sarcasm, multiple meaning words, and metaphors.
  • inhibiting their responses; they may blurt out answers or get angry when not called on, which can disrupt the class.
  • regulating their emotions or may not be able to inhibit emotional responses. They may say things that sound hurtful or mean to another student and not understand why the student’s feelings are hurt.
  • playing well with others during recess or unstructured time and need guidance on how to interact in these situations.
  • understanding that what is in their head is not in your head, so they won’t tell you all the background information in order for you to follow and understand their story. They assume you know what they do so they don’t provide enough supporting details.

It is critically important to address social skills for several reasons. Your child can become withdrawn and unwilling to participate because he may know that he doesn’t know what to do but he doesn’t know how to fix it. Difficulties with social skills can also affect his ability to make and keep friends. Both of these situations can have a negative impact on self-esteem. Therefore, early intervention is key and getting help from a trained professional who can identify your child’s unique skills and deficits is important. Often social skills difficulties are due to related issues and therefore, social skills sometimes need to be addressed by a collaborative team of professionals and not just one. So, finding knowledgeable professionals to develop a supportive, comprehensive plan is essential. As they say, it takes a village…and in this case, it really can!

Pamela Malley, MA, CCC-SLP, Speech-Language Pathologist, Member TAA Education Advisory Board