March 27, 2020

Social distancing—or more accurately, physical distancing—is now our way of life. As difficult as it is, it's our new normal, at least for the short term. Even with physical distance, we find ways to connect socially. We call or use video chats to stay in touch with friends and family, email jokes or stories, and post on social media. Other community activities continue virtually: worship services, fitness classes, concerts, and more. We discover ways to maintain social distance without losing social connections.

Children with language disorders, however, find social interactions challenging in the best of times. So physical distancing can potentially aggravate their communication issues. They won't have as many chances to practice social communication skills with a range of communication partners in a variety of school and community settings. Physical distance, though, doesn't have to mean social distance—even for children with language disorders.

Speech-language pathologists build social communication skills—verbal and nonverbal—through a variety of strategies. Treatment sessions certainly aren't the same now. But SLPs can still help children and families through this difficult period using service-delivery models such as telepractice and home programs.

Try sharing some or all of these suggestions via telepractice with clients and families to help children with language disorders interact socially while maintaining safe physical distance:

  1. Social screen time. Most likely, screen time will increase when sheltering at home. Some research shows solitary screen time can lead to speech and language delays. But you can encourage families to watch shows together and discuss them with children of any age. Some questions to pass along to parents include: Who was your favorite character? What do you think will happen next? Why did the show end that way? Or you can even suggest apps that encourage language development.
  2. Conversation opportunities. Physical distancing might increase or decrease opportunities for social interaction. Families might be spending more time together at home, but parents might also focus more often on financial, medical, extended family, or work responsibilities. Try suggesting activities fostering rich conversations, such as cooking (following a sequence of steps), doing puzzles (finding pieces similar in color, shape, or size), playing language-rich board games (talking about rules, turn-taking, and strategies), walking outside (discussing what they see), and exploring the home (describing different rooms).
  3. Reading aloud. Relative isolation at home can mean more time for reading. But it doesn't have to be a solitary activity. Reading can be social and used to build language. Families can read to each other from new online library books or forgotten treasures hidden for years on the bookshelf. You can share information about the critical connection between spoken and written language, provide book suggestions, and suggest leading age-appropriate questions to develop narrative skills. For example: What happened at the beginning, middle, and end of the story? What was the main plot? What motivated each character?
  4. Staying connected. SLPs can't emphasize enough the importance of communicating with friends and extended family during this time. Fortunately, many families can access technology to stay connected virtually. Children with language disorders might find phone and video chat communication tricky. You can practice conversations in advance with suggested topics and responses: "What's the weather like there? It's sunny here. I like being home from school, but I miss my friends." Encourage siblings to help the child with the communication disorder.
  5. Understanding changes. We all struggle with major change in daily routines, but children with language comprehension and production issues especially so. In addition, they might pick up on tension from their parents or overhear alarming news. On top of that, they might find it difficult to express feelings, ask questions, or talk about this confusing time. During telepractice sessions, you can use and model clear, age-appropriate language to define new vocabulary words—coronavirus, COVID-19, social distancing, quarantine, sheltering at home—and explain changes in routine. Encourage families to establish new routines as much as possible and involve their child in the decision-making. For example: When would you like to call your grandma and pop-pop? Which friend should we talk to today? What food would you like?
  6. Encouraging creativity. The development of distance learning and online classes is an impressive and moving display of creativity and solidarity during an unprecedented situation. You can help families sort through offerings and find programs based on needs and interests of the children you serve. If your clients/students already enjoy using tech, guide them to apps for creating their own videos, digital art projects, or books and comics about experiences in their day. Then encourage them to share those creations with family and friends.
  7. Physical activity. Gyms, personal trainers, and community fitness programs like The November Project are finding ways to keep physical distance without losing the social interaction often associated with group fitness programs. Talk with children who have language disorders about these online fitness classes. Use them as topics of conversation (for example, different types of exercises, healthy eating, the connection between physical activity and wellness).
  8. Humor. Many of us are sharing or receiving amusing new coronavirus-related posts to ease tension and connect with others. Children with language disorders might not benefit from some of these humorous coping opportunities because they miss the nuances of humor. You can help children with language disorders better understand humorous anecdotes or jokes. Alternatively, find and recommend funny stories or visual humor that's easier to understand.
  9. Everyday language lessons. More time at home can mean time for decluttering and organizing. Try turning these tasks into language lessons: What items go together? Do you remember when you wore that outfit? Will you play with that toy anymore?
  10. Augmentative and alternative communication (AAC). You can remind clients/students and their families to use assistive communication devices and AAC at home. They should use them at all times. They are not just for school.

More resources on COVID-19 and social communication through telepractice:

Social Mediating: Using Telepractice for Clients With Autism

ASHA Telepractice Resources During COVID-19

COVID-19: Private Practitioners Report on Office Closures and Telepractice

SLPs are connecting with clients/students/patients in different ways, but they still connect when possible. You can provide specific suggestions tailored to the age, culture, and linguistic needs of each child. SLPs can also offer guidance for families to help their children with language disorders keep physical distance without losing social nearness.

Diane Paul, PhD, CCC-SLP, is ASHA director of clinical issues in speech-language pathology. [email protected]

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