Adults, teens and children who stutter may experience difficulty communicating in certain social situations. Challenging speaking tasks might include giving information, communicating in a group, or introducing a new discussion topic. Another social skill includes modifying information based on the listener's non-verbals. Activities to practice social interactive aspects of communication often improve a client's confidence in social interactions. Addressing social language communication in treatment could improve self-esteem, foster a better self-image and increase communication assertiveness.

Treatment activities addressing "social" communication skills should be introduced in activities that target the following: speaking for various purposes (i.e. informing, demanding, promising & requesting); changing language according to the needs of the listener (i.e. giving background information, using language appropriate to the listener/situation); and using conversational rules (i.e. turn taking, staying on topic, etc.). While working on social interactions, the students can also practice the transfer of fluency enhancing/stuttering modification techniques. A potential outcome for the client could be improved confidence in social situations and acceptance of stuttering.

Some of my favorite activities to practice social language with students who stutter include the following:

1. Topics on the Table (sports, school, etc): Approximately 25 topics are placed on the table. The student picks a topic and make two comments. Other students or the Speech-Language Pathologist (SLP) ask a question or make a comment. This activity continues with several verbal exchanges.
2. Functional Communication: Students also practice common sayings such as greetings, "slang" phrases, and other frequently utilized responses seen in conversational interactions both socially and in work setting.
3. Conversation Cards: Each student picks a conversational task. The cards include a. Compliments: making eye contact and giving a compliment; b. Transition Cards: commenting on a previous conversation & extending the topic; c. Speaker Change: getting another student to talk about the topic. Topics can be generated by the student or selected from a list.
4. Initiating a Topic of Interest: Each student writes down three topics of interest. The student selects one topic and explains it. Each group member must show interest by commenting and/or asking a question on the topic.
5. Requesting examples & information: The SLP provides a number of prompts -- pictures of current events or a list of topics. The student first asks a question. The listener must answer the question and include two examples or ideas and then continue the conversation by requesting information from another group member.
6. Keeping the Conversation Going: Each student lists three topics and speaks for a minute on a chosen topic. Individual goals are determined prior to the sample. All students share responsibility to maintain the conversation by commenting/questioning the speaker's topic or changing the topic in a positive way (i.e. "I saw that actor in another movie").
7. Expressing an Opinion: The SLP states three opinions about various topics -- for example, "all students should attend school year round". Each student in the group shares an opinion on the topic.
8. Restating/summarizing information: Each student picks a topic and talks about it. Another student then summarizes the information and extends the question by asking a question or making a comment about the main speaker's speech.
9. Communication Situations: The student(s) make(s) a list of "difficult" speaking situations such as: "answering quickly", "using feared or challenging words/sounds", "speaking to an authority figure", and managing "Speed Stress" by maintaining a slower rate despite communicating with a "fast talker". The student must a) describe why that situation is challenging ( i.e. I have trouble with _____because) and b) the student must problem solve the situation (i.e. say the first few words a little slower). The student also discusses "feelings" about speaking in the situation; explains why avoiding or changing words is a "short term fix"; suggests potential strategies for managing "stressful" situation and discusses "coping behaviors" used in these situations.
10. Dealing with "tough speaking experiences": If a student mentions a problem situation, it is important to immediately talk about the communication interaction. Drawing a picture or writing down "what happened" in the interaction often facilitates discussion and creates a problem solving dynamic. For example, a Junior High student experienced "teasing" from classmates. As he talked about the students involved, I drew a picture of each student and listed information about each student under the drawing. The following observations were made by "Ben" about his classmates: "Ryan"-good friend, strict parents, funny, wrestles, smart; "Alex"-gets in trouble, entertainer in class, family is rich/nice, not a good student, likes sports; "Chad"-does everything for homework, never gets serious, parents are goofy, plays soccer, basketball & baseball; &"Julie"- very smart, easy-going, plays a lot of sports- soccer, volleyball, basketball. I then asked him to complete his "profile" and Ben listed "smart, quiet in school, can get out of control, studies-does homework, sports-soccer, basketball, etc., is nice. Here is what Ben concluded from this activity: 1) everyone gets angry sometimes, 2) everyone has a special gift, and 3) everyone needs to work on things.
11. Tools: graphic organizers, drawing difficult situations; using webs, making a video etc.: Talking about difficult speaking situations or interactions is challenging for some students. The benefit of using graphic organizers/webs/PowerPoint is that the student can think about the situation, develop ideas and decide how to handle a similar situation in the future

In conclusion, social language activities are an important aspect of treating students who stutter. While group treatment is an ideal way to work on social communication, students' schedules may prohibit this type of interaction. However, it is beneficial to "share" information between students when possible. Students can record thoughts on various speaking situations that can be shared with other students using Power Point, Word documents or audio/video recording. Treatment activities that provide a problem solving or solution to difficult speaking situations can facilitate the development of positive social interactions.

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