Tuesday, June 26, 2012

Reflections on Summer Travel: What do Social Thinking® and Executive Functioning have to do with Speech-Language Pathology?

In a word: everything!

I was thinking of all I have learned, and still need to learn, about executive function and social behavior as I prepared to head from the conference center where this year’s Social Thinking Providers’ Conference was held. It had occurred to me recently what an enormous task it really is to get even my (probably) neurotypical self to the airplane gate on time and without major self-imposed calamities. What must this task be like for people with diagnosed challenges in these cognitive areas? After a weekend of hearing discussions of context, self-regulation and planning, my self-talk was pretty conscious and quite loud. I thought I’d give you an earful of that to pull into focus the importance of our role as language experts in helping clients with deficits in these areas, not just to get to the airport on time but also to manage general life. 

On itineraries: “Hmmm I notice my TripIt itinerary never updated after I changed my flight from Monday to Sunday, so it’s not in the app, and I need to check (6 times) what time my flight is. Remember your temporal concepts problem (problem solving/referencing previous experiences). Ok, if (conditional language there) it’s not in TripIt, I can search and find it in the Mail app and oh, yeah, better text this info to Chris so I can get a ride home (prospective memory/forethought). 

On rental cars: “Remember I chose the self-refilling option as opposed to the Hertz “plans” after thinking about the minimal amount of driving I’d be doing (sequences, comparing). BUT (adversatives) this means I’ll need to get some gas maybe before the conference so I won’t have to do it later (prioritizing). While I am there I can get my trusty Trenta iced coffee (sensory planning) as well, at the sorta-fake gas station Starbucks. AND don’t forget this time to check which side of the car the annoying gas door is on, so I can position the car correctly and not P anyone off who is trying to navigate the gas station (perspective taking, visualizing).  

On departure time: “Ugggggh I would really like to stay and see more of Jessica Minahan’s talk but my flight is at 1 pm, which means I have to find my way to the airport which I don’t really know how to do (Maps app should help), return the rental car, take the skytrain to the terminal (What terminal is it? Oh, there was the sign on the train, I see it in my nonverbal memory), print my boarding pass from the kiosk, deal with the security line, and find my gate (sequencing/estimating time). It’s now 10:35, I better go. *5 minutes goes by* Why aren’t I initiating? *joke about this with friend* (referencing common experience/commenting). Gotta go.” 

On the Security Line: “This is really the Grand Daddy of executive function tasks, in which we (according to Sarah Ward’s paradigm of situational awareness) really have to be aware of reading the Space, Time, Objects and People involved (STOP)*
Space- hmmm where’s the entrance to the rope maze? That guy just ducked under a rope, should I do that? No, could get in trouble (evaluating expected behaviors and consequences). 
Time- Jeez, this line is long, how long will it take to get through? Probably about 15 minutes...s’ok.
Objects- “Oh, so many objects. Did I arrange my bag well? Pretty categorically, thinking of keeping the ziplock toiletry bag in a different compartment from the 2 iPads and MacBook Pro (avoiding problems). Gotta get my license out and WHOA- George Costanza wallet strikes again when I try to extract my license, like 10 cards fly out all over the ground scattering about the feet of the people in line! Better get ‘em quick, apologize and say thanks especially to that rather advanced-in-age man who stooped to pick up my AMEX (expected behaviors again).” 
People- “Better smile and think about the TSA person with my eyes so she doesn’t think I am terroristy. Does that person think he’s ahead of me? As the lines merge, he’s stepping ahead (“people tracking”/nonverbal awareness/inferencing). Whatever. You know, these TSA people work really hard (empathy) and I should give them an enthusiastic thanks for keeping me safe but...let’s not (awareness of my own aloof Bostonian communication style)."
*This is a concept created by Sarah Ward and Kristen Jacobsen- want to learn more? Go see them sometime!

This whole process leaves me so exhausted that sometimes I fall asleep at the gate and wake up with carry-on-face, which friends have gleefully photographed in the past.

So, luckily my self talk eventually shut up a bit, and you get the idea. Social and Executive Functioning skills are really all about language and (fun, actually) interventions (and a little bit of technology) that SLPs are in a unique position to implement, given our training on brain functioning and strategies. I hope this post may have peaked your interest in these areas, especially given that with the DSM-5 changes, SLPs could be seeing a spike in referrals due to the newly created Social Communication Disorder diagnosis. For more information, SocialThinking.com is a great place to start, and see more resources on the Cognitive Connections site from Sarah Ward and Kristen Jacobsen here.

I'm going to be heading on vacation for a few weeks, so see you sometime in July!


  1. This is an awesome post (as always) that is both humorous & informative!!

    1. I agree with Janelle... hilarious (and surprisingly how many of us think)! :)

  2. Fabulous post! I use Sarah Ward's STOP strategy with my middle schoolers...never realized how appropriate it was while in line waiting for TSA.