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What!?" 13 Reasons for Missing Social Cues
is this Kid?
Doesn’t understand what other
Anxious for no apparent reasons
Often speaks w/o inflection
Avoids spontaneous social
Trouble sustaining a
Suddenly hits or pushes w/o
Plays with toys over and over
Cries inconsolably over small
Frequent toileting accidents
Problems with transitions
Trouble making friends
Often clingy with adults
Takes disposed food from
garbage cans to eat
therapist, parents, and teacher developed this list of Jerry’s
behaviors. His parents
felt that Jerry would "grow out of it."
His behavior however was not strictly developmental and would
change with maturation. Teacher
and therapist concurred that Jerry’s behaviors were probably indicative
of other issues. Unfortunately
avoidance and denial may be parental responses when professionals bring up
potentially sensational issues. Schwartz-Watts (2005)
examined early attempts at intervention with a 5-year-old later diagnosed
with pervasive developmental disorder who eventually got into criminal
problems as a teenager. “Each
time the defendant attended a new school his teachers became
aware of his impaired functioning and sent him for evaluation.
His parents did not follow up with any treatments, although
they were recommended,” (p.390).
Jerry was showing behaviors and issues that predicted more serious
problems later. Nevertheless,
neither Aspergers Syndrome nor other key issues cause or is Jerry doomed
to dysfunction. Support, and
intervention, including therapy directed through identifying key
etiological factors can mitigate potential struggles and negative
Syndrome #1- Rote Learning
develop relationships primarily through the interactive process of play.
With greater verbal skills, conversation becomes critical to play.
Aspergers Syndrome (AS) fundamentally affects communication, play,
and relationships. Bauer
(1996) notes that “Pragmatic,
or conversational, language skills often are weak because of problems with
turn-taking, a tendency to revert to areas of special interest or
difficulty sustaining the ‘give and take’ of conversations… Some
children with AS tend to be hyperverbal, not understanding that this
interferes with their interactions with others and puts others off.”
By middle-school, individuals with AS often got into annoying verbal
sparring bouts trying “win.” Your
Little Professor, an online resource, discusses the targeting of children
with AS (referred to as “Aspies”) for bullying.
“The reason is that Aspies fit the profile of a typical victim: a
‘loner’ who appears different from other children. Like hungry wolves
that attack a limping sheep that can't keep up with the herd, the Aspie
with his clumsy body language and poor social skills appears vulnerable
and ripe for bullying…" (2008).
of AS, Jerry missed social cues- especially non-verbal social cues, that
are critical to interpersonal communication: facial cues including muscle
tension or relaxation around the eyes and mouth, tilting, leaning, or
nodding one’s head, and combinations of changes in breathing, expansive
to very slight movements of the hands, arms, body, and legs.
is quite possibly the most important part of the communicative process,
for researchers now know that our actual words carry far less meaning than
nonverbal cues. For example,
repeat many times the following sentence, emphasizing different words in
the sentence each time you do so: 'I beat my spouse last
night,'"(Long Beach City College Foundation,
The words themselves carry many meanings, depending upon
nonverbal cues- in the case, inflection.
Successful expressive and receptive communication
are keys to intimacy, trust, relationships, and to social, academic, and
vocational survival- issues that bring individuals of all ages to therapy.
In “Body Language in
Debating,” Mandic (2008)
promotes 10 compelling non-verbal forms of communication
applicable to day-to-day communications. Becoming non-verbally fluent,
centered, grounded and flexible not only develops self-esteem, fluency and
flexibility, but also enables better communication skills and
relationships in life. Gordon
and Fleisher (2002, p.84) described how an interviewee's truthfulness is
determined by observing a multitude of non-verbal cues that mirror
processes people intuitively use to determine honesty or deceptiveness in
others communication. Poor interpretation of social cues may include
inadequate presentation of social cues which intensifies problems.
Individuals Don't Get It!
issue, AS, is one of at least thirteen reasons for missing social cues.
Deficit Disorder (and
Attention Deficit Hyperactivity Disorder)
each issue and potential interaction directs responses or interventions to
help individuals better recognize social cues.
Disability #2– Compensation: “What?”
crept forward to read the words. Later with glasses… wow!
Individuals often develop intuitive compensations, whether or not
they recognize a challenge. Intuitive
compensations for a physical disability may include turning one’s ears
towards sounds for example. Intuitive
strategies may work relatively well or be stressful and risk
misinterpretation. A Florida
Today article (Best, 2007) described a young girl perceived negativity by
teachers, peers, and herself. Finally,
an eye examination discovered she had strabismus (cross-eyed).
Vision therapy taught her to use different parts of her brain for
focus and mental concentration. Her
headaches and nausea went away. She
got “smarter!” Unidentified
physical disabilities or difficulties, specifically vision or hearing, can
cause missing or misinterpreting cues.
However, adults should be aware that receiving extra help in school
is predictive of a child being bullied (Carter and Spencer, 2006, p.14).
Issues #3- Cross Cultural Education: “So, that’s what you mean!”
said, “I wanted that last piece of pie.
I thought Ronald was going to offer it to me again.”
His girlfriend laughed, “You had your chance!”
Don anticipated an exchange of polite refusal, polite insistence by
the host, and more polite refusal and insistence.
Whereupon, the guest graciously accepts! Propriety around courtesy
cues occurs in many cultures. Japanese-American
Don mistakenly assumed such a ritual culminating in his accepting the last
piece. However, my question
was literal. He said no, so I
literally ate it! Cross-cultural
education regarding social cues, courtesies, and rituals clarifies
communication. The next time I
offered Don the last piece, he immediately responded, “Yes!”
Successful cross-cultural education!
Purposeful cross-cultural education teaches how behavior or
expectations serve the contextual demands of a community.
Shared experience tend to lead to shared norms.
Shared challenges may result in distinctive cultures, such as deaf
culture- a term “developed in the 1970s to give utterance to the belief
that Deaf communities contained their own ways of life mediated through
their sign languages,” (Ladd, 2003, p.xvii).
Therapists should look for other behaviors mediated by other shared
#4- De-Stress: “I don’ wanna have fun!”
to recognize accumulation or releasing stress creates overwhelmed or
over-stimulated children. Over-stimulation
interferes with ability to recognize non-verbal social cues.
Therapy directs reducing stimulation through cutting back on
activities, facilitating stress release, and so on.
Additional therapeutic targets include family strife and chronic
illness. Relatively minor
stimulation such as fluorescent lights, tastes, smells, sounds, and dust
floating in sunlight can become overwhelming to some children. For
example, Attwood (2006) says that people with AS often describe feeling a
sensation of sensory overload not readily apparent to others (page 272).
Overwhelmed individuals lose focus, becoming more likely to be
surprised by circumstances and situations that others notice.
Therapists should address over-stimulation or over-whelm that
causes acting out.
– Alleviate Fear (#5 of 11), “No
closed…“No no NO!” Children sometimes block out the intolerable.
Individuals may find ugly or challenging experiences, emotionally
or psychologically devastating… too much… too intense.
Denial is a primary defense mechanisms.
“When people are confronted with circumstances they find to be a
threat, they often deny association or involvement with any aspect of the
situation. Young children are
often caught in the act of lying (denial) when they are accused of eating
cookies right before dinner or making a mess in the bathroom.
Examples in adulthood include denying a drinking or gambling
problem. Any stimulus
perceived to be a threat to the integrity of one’s identity can push the
button to deny involvement or knowledge.
At a conscious level, the person truly believes he or she is
innocent and sees nothing wrong with the behavior” (Seaward, 2006,
#6- Stabilize/Secure: “What? Where?
Watch out? Where? Now?!”
develops without something specific to fear and thus without specific
remedy for the amorphous fear. Normal
fears are managed through frequent positive experiences. Reassurance,
support, and positive experiences and outcomes do not relieve habitually
anxious people. Anticipating
foreseeable issues, normal anxiety prompts scanning for social cues to
mood and intent. Hypersensitivity
and hypervigilance cause unnecessary scanning in benign situations and
interpreting neutral social cues as threatening, leading to becoming
over-cautious and overly negative. This
re-ignites anxiety that exacerbates the anxiety-failure-anxiety-failure
cycle. Resultant behavior
destabilize the environment, heightening everyone's anxiety.
Intervention targets breaking cycles of anxiety and failure by
establishing predictable, stable, concrete, secure, and consistent
interactions, relationships and environments.
#7- Reality Filter/Check: “That was then, and this is then.”
puppy.” A stranger reaches
to pet the dog. The dog
reflexively snaps. All cues
indicated no danger. But the
dog’s master had smacked its head… many times.
The dog misinterpreted cues as “another smack coming!"
Instincts and intuition from prior experiences alter interpretation
and distort cues to fit expectations.
Neurosis assume previous bad outcomes will repeat. Children need
abundant positive reparative experiences to countermand such prior
experiences. Frequent reality
checks regarding cues counter neurotic filters. Identified patterns can be
overtly challenged to discover partial influence, power, and control.
Doom is predicted with declarative terminology such as:
must be going to…”
terminology acknowledges potential problems but allow for other outcomes:
might be going to…”
be or not!”
is allowed! It implies the
possibility of increasing positive while decreasing negative frequency.
Adults can challenge individual's neurotic self-definition as
Disassociation #8- Trauma
Work: “Click… This station is no longer broadcasting…or
occurs when experiences cannot be endured. Unconsciously, memory and
feelings disconnect or are blocked. Devastating
incidents or experiences such as chronic abuse, push one beyond conscious
tolerance. Cues similar to
original trauma may become triggers. Traumatized
individuals may freeze or cause dysfunctional responses to triggers that
others handle readily. The
therapist can anticipate conflict situations, picking teams, tests, and so
forth may be potential triggers based on individual's history, and
mitigate triggers, for example by announcing, “I’m going to say
something that sounds scary, but you'll be ok.”
Adding touch- a hug to maintain emotional connection may reduce
Disabilities #9- Compensation:
“Trying hard, and harder…”
pick a partner. Second, get
the blocks from the tub. Third,
go to page 3. Then, copy the
structure there. After that,
make up your own structure. Then
draw a picture of it.”
pick a partner. Second, tick
tick (from the clock). Tick,
go to… (rustling pages). Then,
tick tick… it.”
neuroses, disassociation, and other issues that complicate reading social
cues can arise with LD. Adult
auditory teaching styles frustrate children with auditory processing
issues, who may be strong visual learners.
Auditory or visual instruction may not reach motor-kinesthetic
strengths characteristic of LD and/or ADHD.
Teacher-directed instruction versus child-centered orientations
differentially serves managing impulsive energy. Adult structure might
stabilize or stifle different children.
instructions lead to mistakes and acting out to hide ignorance.
Even when trying hard, many non-verbal facial, tonal, or body
language cues get missed. Instructions
may be heard but inefficiently processed into short-term memory creating
cognitive retrieval of information, taking more time and concentration
makes one oblivious to continuing cues from others.
Classmates frustrated by a child’s poor responses label him or
her "rude," "mean," and/or "weird.
Whitney (2002) says, “Children
with NLD (non-verbal learning disabilities) are frequently the target of
bullies. Because they take
things literally, because they are so trusting, and because they rarely
tattle, they are the perfect victims.
Often they can't tell the difference between bullying and friendly
banter or dangerous intentions... A
child with NLD won't be able to read the subtle cues that tell the bully
the teacher isn't paying attention, so he is likely to assume the teacher
sees the bully's behavior and condones it.
Frequently the teacher hasn't seen the bully's
behavior and the teacher only sees when the child with NLD
reacts to the bully's taunts.
A child with NLD will react whether the adult is around or not.”
may intuitively try harder, but with ineffective and/or inefficient
tactics. Adults need to teach
specific compensations for LD: auditory challenges with visual
compensations; visual difficulties through auditory strengths; and so
ADHD (and ADD) #10- Focus:
Marc gets involved with his guitar,” complains Debra.
Marc watches her. Gradually,
his gaze wanders to a branch swaying in the window.
“It’s just hard,” Debra says tearfully, head bowed, and hands
clasped. Marc watches the
branch. “And, he doesn’t
care!” Debra snaps. “Huh?
What?” Busted! But he
does care. His attention
wanes despite good intentions as it did in school.
ADD share the common issue of high distractibility.
With wandering attention, someone like Marc misses subtleties of
cues: tears, bowed head, clasping hands, and especially, the quavering
voice. When Debra accepted
that despite loving her, Marc’s ADHD made paying attention difficult,
she accepted helping Marc focus. Marc
took responsibility that attention was critical to their relationship.
He improved recognition of her non-verbal cues.
Classmates hurt by inattention they interpret as dismissive may
feel entitled to vengeful retribution.
Unaware of their transgressions, distracted children experience
such treatment as unjustified. This
may prompt retaliatory behaviors, which prompts further retaliation-
negative cycles that may be broken with education about cues, boundaries,
Abuse #11: Sobriety: “Common adverse effects…”
abuse might seem most relevant to teenagers or adults.
However, children might be on sedative or stimulant medication
affecting alertness and focus. Cough
medicine may include chemicals such as Dextromethorphan with possible side
effects of dizziness, lightheadedness, drowsiness, nervousness, and
restlessness (MedlinePlus, 2008).
Albuterol (brand name-Ventolin HFA), an asthma medication may have
a stimulant effect. Giedd
(2003) surveyed research and found the diagnoses of ADHD and substance
abuse occur together more frequently than expected by chance alone. The
National Center on Addiction and Substance Abuse at Columbia University
(2000) examined the link between LD and substance abuse finding,
“…adolescents with low self-esteem may use drugs for self-medication
purposes--to counter negative feelings associated with social rejection
and school failure… Some specialists believe that people with ADHD
medicate themselves with drugs such as alcohol, marijuana, heroin, pain
medication, caffeine, nicotine and cocaine to counter feelings of
restlessness” (p.9). Ritalin,
a common ADHD medication easy to obtain, has been used as a recreational
or self-medicating drug (addictionsearch.com, 2013).
Self-mutilation or self-injury might be considered self-medication
since they trigger physiological responses that include whole canopies of
chemical responses that numb not just physical pain but also painful
emotions. Timofeyev, et al
(2002) suggests that in addition to dopamine, “endogenous opioids have
also been linked to self-mutilation. The biological reinforcement theory
suggests that the pain from self-mutilation may cause the production of
endorphins (endogenous opioids) that reduce dysphoria. A cycle is formed
in which the habitual self-mutilator will hurt themselves in order to feel
gambling, and other behavioral compulsivity can also activate biological
processes for self-medication. Behavioral
compulsions or acting out may be the first and only observable indications
of individuals’ depression or anxiety and should activate appropriate
referrals or support.
Personality Disorder #12- Behavior Training
with schizoid personality disorder (APA, 1994, p.638) recognize social
cues correctly, but are indifferent to most common social processes.
Schizoid individuals don’t seem to enjoy, miss, or desire
relationships or intimacy, and are generally unavailable to motivation
other than perhaps behavior training directed at dealing with specific
problems in daily functioning. Long-term
change is difficult given individuals’ apparent disinterest.
This category was included to be comprehensive rather than a
likelihood of applicability to children.
nervous breakdown used to be called vapors, melancholia, neurasthenia,
neuralgic disease, or nervous prostration. Clinical descriptions found in
DSM-IV or DSM-V (APA, 1994, 2013) include psychotic break, psychosis,
schizophrenic episode, catatonia, manic break, post-traumatic stress
disorder, panic attack and major depressive episode. When psychotic,
individuals respond to internal cues causing gross misinterpretation of
non-verbal cues or anything else. Extreme
stress, depression, anxiety, fear, mania, or trauma can cause temporary
psychosis. Individuals often
re-stabilize back to normal functioning.
Some breakdowns precipitate deeper and permanent mental and
psychological disabilities. Psychopharmacological
intervention is the dominant treatment for long-term or ongoing psychosis.
teens, and adults may have depression, anxiety, or personal and
relationship issues with multiple interactive roots.
Therapy may orient towards dealing with symptoms and/or with
etiological factors. An
important diagnostic consideration is the potential influence on
inter-relational functioning and subsequent self-esteem of ones accuracy
interpreting non-verbal social cues. And,
of how inaccurate interpretation can lead to problematic acting out
behavior that become the target of discipline, and hence of therapy.
Effective therapy and interventions would derive from not only
addressing behavior adjustments but also to the underlying roots and
factors precipitating the chain of processes for the child or teen (or
adult). Children and adults
frequently behave in inappropriate or mysterious ways possibly due missing
social cues from one or more of the thirteen reasons.
Identification of how and why social cues are missed may itself be
highly normalizing to distressed children.
Often, several of these reasons co-exist to compromise a person’s
conceptualizations may guide purposeful intervention and more effective
therapy for a Jerry and his family.
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