Kwick/ July 30, 2013/ Sharing Stories

I first saw Janice Jeffries when she was twelve. A thin, shy, serious girl with long dark hair, she sat in my waiting room intently reading The Odyssey. She was a gifted child, precociously articulate, but she had some problems that made the social aspects of school a torment. She suffered from anxiety. Among her many fears—of being alone, of getting lost, of storms—was a fear of social interactions, particularly with children her own age.

Unlike her other fears, this one—although exaggerated—was not entirely groundless. Despite being intellectually advanced, Janice lagged when it came to social interactions. Her spatial processing skills, which include the ability to read faces and grasp the nuances of a social situation, were average at best. She was also very slow to process the information she was able to glean. She had trouble sensing people’s moods. She couldn’t really tell whether someone was bored or interested, sarcastic or kindly. She didn’t always know when she was being teased, or pick up on the “rejection cues” of those whose conversations she tried to enter; she also missed positive signals, when children tried to make an opening for her.

Anxious about her awkwardness, Janice refused to join clubs and activities, and wouldn’t hang out with other kids. This of course meant she was shunning the activities where social skills are developed, setting her back even further.

Fortunately there were several things we could do to help. Medication and behavioral therapy helped relieve Janice’s anxiety and with it, those moments of social panic that made any kind of interaction impossible. This laid the groundwork for developing better skills.

To help Janice we needed to know what her abilities actually were. When Janice observed a social interaction what did she notice? Could she read broad expressions? Fleeting glances? Did she pick up on subtle movements? Could she sense moods when a person stood stiffly or slumped or radiated confidence? Could she tell if a person was bursting with suppressed irritation? Could she tell when a person was trying to please someone else who was present?

To find out, we did a thorough neuro-psych evaluation including an assessment tool we are currently refining, called SELweb. SEL stands for Social Emotional Learning. The child observes a computer monitor showing video clips and is asked to assess faces, social interactions, and body postures. This allows us to determine how well the child reads these visual cues, and to what extent the child is able to recognize that other people may think in ways different from oneself. We also ask the child to explain the social interactions they observe and what a good outcome might be, allowing us to assess their social problem solving skills.

Most of us gather such knowledge without even noticing that we have done so. Seventy-five percent of the information available to us in a social situation is non-verbal. Janice’s responses to the SELweb images—along with other assessment tools and interviews—helped us to gauge how much of that information the child was taking in, and how well and how quickly she interpreted the information she managed to acquire.

Currently SELweb is only available at RNBC. But within a year or so, thanks to a grant from the Department of Education, we will have developed it into a tool that can be used remotely by schools and other professionals. Eventually we hope that it will help assess social-emotional learning deficits with the pinpoint accuracy that has developed in tests to assess and treat the myriad forms of dyslexia. There are many children who could benefit. Some have autism spectrum disorders. Some, like Janice, have difficulty reading faces, or suffer from an anxiety so acute that it shuts down the ability to process social information. Some are children with ADHD, whose impulsivity disrupts their ability to participate in conversations and form relationships.

At RNBC there are group sessions for these children to meet and develop their skills. Janice joined a group for middle school girls that runs the length of the school year. Although her anxiety persists (in a much milder form) social interactions have become easier for her. She is learning to relax and listen, to respond appropriately, and to keep a conversation going. These seem like small things, but mastering them is like unlocking the gate into a different world. Now when Janice gets to school she is no longer fearful. She instantly starts looking around for her friends.

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