This year
I have been working with an increasing number of young people, who due to such
high levels of anxiety, are struggling to engage:
-
To engage in school expectations
-
To engage in home expectations
-
And to engage in ‘traditional’ speech therapy
sessions
So you do what you know is essential, spend time getting to
know the individual, rapport build, offering a reward..
But… what if the YP is still finding
it difficult to follow the ‘adult-led’ agenda because there is the underlying
demand to comply?
What do you do now?
Well most enthusiastic therapists know the importance of using
a child’s interests within therapy sessions to engage them…
But.. what if the YP has limited
interest in anything beyond sitting in their bedroom playing computer games all
day?
Well of course we could use this as a reward to try and entice
them into completing the therapy activities first
But… why would the YP ‘buy-in’ to
completing your activity just because you want them too, when they are already
happily enjoying their interest without needing to ‘earn it’ first?
I myself, don’t
have to adhere to persuasion of doing something I find difficult, like running
a marathon, just on the promise of a ‘glass of wine’ reward at the end, just
because someone said it would be in my best interest to do the exercise. I
would still find it anxiety provoking to conform to their wishes, however much
I liked the person and especially if I was already able to go to the fridge and
pour myself a glass without. No exercise necessary!
So… faced
with the dilemma of how to support my YP to ‘buy in’ to my sessions I had a serious
head scratching moment until I thought about the likelihood of me running a
marathon at the same time as drinking wine.
Now that is an interesting concept indeed!! Why does one
action necessarily need to precede the other?
Well… despite the complicated logistics of this, I have to
admit that the probability of me going for a run has significant increased.
‘Lightbulb moment’ – how
can I embed my speech and language targets into the actual activity the child
enjoys?
Despite my significant lack of gaming talent, one thing I
found I did have in common with the YP I was working with, is enjoying the
humour of memes.
So… where to start? Well after having fun sharing our
favourites and discussing what we found funny about them I soon realised the
previously highly anxious YP, who struggled to engage in any reciprocal social
conversation, was soon confidently and spontaneously talking me through the
steps of how to create my own Tumblr account.
Now, I must admit those sessions that are completely
unscripted, when the therapy plan has gone shooting way off the map, is the
most enjoyable part of my job and I’m happy to be a passenger to a student who
feels motivated enough to take the lead.
But…what actual speech and language
targets am I working on when using memes?
Well to be honest, we were actually working on a lot of
therapy goals simultaneously!
Social Thinking Goal 1: initiating communication that is
not routine
When she
is not anxious, Emily has no difficulties in engaging in conversations about
something she is interested in. However, where before she would just talk ‘at
me’, now during the sessions she can confidently initiate a narrative of talking
me through the Tumblr sign up process and displayed the best turn taking skills
so far; even pausing and allowing me the opportunity to ask for clarification.
Social Thinking Goal 2: Listening with your eyes and brain
When Emily was anxious, she would cover her face with her hair
and squeeze herself between the sofa cushions. But now she uses ‘whole body
listening’ with confident posture, joint attention and initiation of eye
contact when she is communicating.
Social
Thinking Goal 3: Understanding abstract language
Most of the language we use is peppered with idioms, metaphors, sarcasm and
inferences and each generation of teenagers and young adults leave a trail of
new slang for consumption - most of which is abstract. Through memes, I am able
to teach Emily how to make a ‘smart guess’ to interpret the abstract language
based on her previous knowledge, the context of the picture and the non-verbal
communication clues.
Social
Thinking Goal 4: Understanding perspective:
The
ability to interpret others’ perspectives, thoughts and feelings is critical to
social learning. Looking at memes with Emily created the opportunity to work on
her Theory of Mind skills by discussing the point’s of view of not only the
people in the memes but each other and our individual interpretation of the
jokes. Whilst Emily was narrating how to set up my Tumblr account, I reminded
her that I had no prior knowledge of the website. She was able to effectively
use her own analogies to link these new concepts to the social media knowledge
that my ‘inferior brain’ as she called it, already knew so that I could
understand her.
Social
Thinking Goal 5: Getting the Big Picture
If
a picture is worth a thousand words then a ‘meme’ must be worth a million and
the opportunity to share an imagination with other people is priceless. These
therapy activities focused on teaching Emily to infer how to link individual
pieces of information into an overall idea – to get the ‘bigger picture’.
Social
Thinking Goal 6: Humour and Human Relatedness
Establishing
human relatedness is essential before advancing in any therapy sessions; which
is why rapport building is essential, especially with our most anxious
students. Emily has a fantastic sense of humour and a very dry wit! But she
often feels too anxious to use her humour successfully with others. So starting
the therapy process with memes has helped to minimise some of her social
anxiety.
Last year, Emily was a very anxious young lady, isolated at
home and had little to no social interaction outside her immediate family. Now,
although her socialising is still largely from the safe space of her house, her
anxiety has decreased enough that she is interacting online with other YP with
similar interests and is beginning to leave the house to visit local
attractions. Everyday Emily is one brave step closer in gaining social
confidence to engage in reciprocal conversations with new people.
We’ve since extended our sessions from also decoding magazine
adverts and T.V. commercials to creating our own memes. It was surprisingly
easy to embed all of my therapy targets into these activities; the only
confusing thing was why I hadn’t tried this idea sooner!
So what I ‘meme’ is that therapists need to stop thinking
about what they think speech therapy ‘should’ look like and instead
about what is the most functional and meaningful skills for the YP to learn to
help them interpret social information and interact effectively with others. And
not a photocopied worksheet in sight!
