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My Social Communication Approach

Introduction

I've got loads of lesson ideas further down, but first I want to address a major unspoken problem:

 

Traditional "social skills" therapy is just plain bad.

 

If you're not familiar with it, it's generally centered around teaching kids how to have "expected behaviors" when interacting with others. When you look at them, you'll realize that "expected behaviors" translate to "neurotypical behaviors". And whether therapists are aware of it or not, teaching that way can promote shame, teach masking of neurodivergent traits (which can negatively impact mental health), center neurotypical behaviors as the "right" way to be, and more. It's so bad that some neurodivergent adults have spoken out against it and some neurodivergence affirming therapists have decided not to work on social communication at all. 

 

But social communication is an important skill for interpersonal safety, self advocacy, and just plain understanding and navigating the weirdness that is neurotypical culture. (And yes, it's weird. Fascinating, but weird.) So what's the solution?

Stop trying to change neurodivergent behavior and start trying to change the paradigm.

 

Neurodivergence affirming social communication teaches skills from the perspective of cultural differences, not disorders. Because although we think of cultures in terms of their connections to nationalities, the literal definition of culture is "a pattern of behavior shared by a society or by a group of people", a definition which perfectly encompasses neurotypical communication.

 

Culture is a very neutral thing. There is no "better" or "worse" culture, simply differences that can be learned about. If an American took a class about Japanese culture, for example, there would be no expectation that they would replace their own cultural practices with the ones they were learning about. The class would instead be aiming to provide information so that the American would better be able to understand Japanese people. If the American decided to, they could even use some of the facts about Japanese culture that they learned to better communicate with people they interacted with in Japan. But that would be fully the choice of the learner: a tool they could call on if they desired, no more, no less. When you teach neurotypical cultural communication norms, it needs to be from that exact same place of neutrality and simple exploration of another way of thinking.

 

The goal of all this learning should be empowerment through understanding, never changing behavior. In fact, my approach has three themes when I teach it.

1. Understand Yourself - explore your own neurodivergence!

2. Understand Others - decode some of the more confusing things neurotypical people do

3. Get Neurotypical People to Understand You - if desired, learn how to communicate in neurotypical culture

 

Understanding is the goal, not changing the person. Now, is it likely someone who learned all this would decide to change elements of how they interact with neurotypical people? Probably. I know that when I went to China I definitely changed how I behaved in light of what I learned in my Chinese culture classes. But I never approached it from a place of shame and I never felt I had to hide that I was from a different culture. I was empowered by knowledge to make my own informed choices, no more, no less. And that's how teaching neurotypical culture social communication needs to be, too.

Think of the following list of lessons through that lens. Use it as a "concept bank" to provide ideas to explore, not a list of lessons you must follow in order. I've certainly never taught it in a structured sequence, seeing as I'm actually a very flexible therapist who follows the learner's lead as to what we learn and how. That said, this is the mental data bank I'm pulling from as we learn. If you're a caregiver, educator, or therapist, please feel free to use this as inspiration for your own lessons!

Disclaimer: Note that"neurotypical culture" is shorthand for "the cultural practices of the majority of neurotypical people in a given region". Typing that each time is rather difficult, so I'm just saying "neurotypical culture". I know that other factors (race, religion, gender, sexuality, etc) influence cultural practices within a region, but for simplicity when I'm talking about neurotypical culture, just know it's from the perspective of my experiences of the dominant cultural practices in the US South. Some of these norms may be different in your region, so just edit to match whatever region/group of people you're teaching from the perspective of. Note also that this page is not an authoritative, perfect guide. It's just how I happen to do things, which is why I call it "My Approach". One last note - though this is all about neurotypical cultural practices, I recommend reading up on neurodivergent cultures too!

The Brain

This is essentially an introduction to neurodiversity. 

The brain and its parts

Learn how different parts of the brain have different jobs.

How the brain learns

Go over how the brain learns by making connections (show a video of a neuron connecting to another!) and how some brains learn differently from others.

Neurotypes

Learn about the different neurotypes (neurotypical, neurodivergent and the many ways one can be neurodivergent), introducing the topic in a very "different not less" way. I've found it helps my kids if I talk here about other people they know who are neurodivergent (myself, family members if I have their permission, etc) to help normalize and even bring pride to the subject.

Executive Function

If executive function differences aren't involved in the client's neurotype go ahead and skip this section. However, as social communication and executive function are deeply intertwined, this section will usually be helpful. 

Awareness and Attention

Talk about how awareness is like a big broad floodlight, while attention is like a flashlight. (Tera Sumpter has a great resource on how to teach this. Another good source for your own learning that covers this metaphor is the book "Peak Mind".) Talk about how differences in the brain can cause differences in when our floodlights turn on, where our flashlights point, the conditions under which our flashlights focus best, etc. Feel free to get out actual lights to demonstrate!

Impulses and Inhibition

Cover what an impulse is and how our brains have a "stopping power" (inhibition). Talk about impulses in a very neutral way - they're not good or bad, they're just our brains having an idea or our body giving us some feedback and us reacting. (Refer to impulses as "starters" if that's easier.) Some people are great at acting on an impulse right away - but if their brain's stopper can't keep up, they can accidentally end up doing things they didn't actually want to do. Other people's "stoppers" are so good that they can sometimes make them get stuck analyzing something instead of responding to their impulse, even when they want to. No one way is better, just different.

Simulations

Talk about what a simulation is and how people use their brains and their memories (for your reference, it's nonverbal working memory) to simulate the world inside their own heads. 

Planning

Talk about how people use planning skills to come up with multiple plausible outcomes of a given action, check for outcomes they don’t want, and choose the plan that achieves their goal. Talk about tie in to social communication

Flexibility

Teach that by using our brains' abilities to hold multiple ideas or concepts in our minds at the same time, we can also recognize that two things that can be true at the same time even though they seem to be in opposition. For example, "she likes me" and "she doesn't want to play right now" might seem like they can't both be true, but when we hold them in our minds and look at them for a little while, we can see that they can both be true. (Another example is "I made a mistake" and "I'm proud of myself".)

Drawing Conclusions: Observations + Knowledge = Best Guess

There are so many executive function skills required to draw a conclusion, but here's a simplified take on it. First you have to be aware of/attending to the environment enough to gather the information you're drawing from. Then you have to hold that information in your head as you search inside your mind for memories ("background knowledge") that can help you make sense of that information. Then you have to hold both the information and the memories in your head at the same time and analyze them in different ways to come up with not just one conclusion, but all the likely conclusions. And this whole time you have to rein in your impulse to skip steps ("jump to conclusions") or just plain go do something else.

In short, it can be very difficult for learners with executive function struggles to do this well! So here is a framework I've been using to help learners with executive function struggles learn how to take in, analyze, and draw conclusions from their environments in an organized way. If you think about it, we essentially have a formula for how we do this. You take observations you have made, combine it with background knowledge you already have about the subject, and then come up with inferences ("best guesses") based on that information. 

This can literally be for anything you're learning. For example, pretend I'm looking at the sentence "The rocket won't take off until you activate it" and I don't know what "activate" means. It takes a whole lot of executive function skills to figure out a meaning from context! But I can take my observation-knowledge-guesses structure and observe the words themselves ("act" is inside "activate"), add in my background knowledge (I know "act" means "do"), and make a guess ("activating something might mean doing something to it"). 

You can also use it for making predictions for what will happen next in a story, figuring out what caused something to happen, guessing what others are thinking or feeling, making guesses about your own body (such as "is my stomach hurting because I'm hungry or I'm sick?"), the list goes on! It's helpful for providing structure to teach how to make an inference, that there can be more than one possible guess (working on flexible thinking), that the more information we have the better our guesses can be, that sometimes we don't have enough information to make a good guess yet, etc. 

Emotional Regulation

If your client has great awareness of, ability to communicate about, and ability to regulate their emotions you can skip this section. However, this is usually also an area of difficulty. The connection may not always be clear, but these particular skills are critical communication building blocks - especially for social communication, but with broader reaching implications as well. What sets the way I do this apart from counseling is that this is strictly understanding ideas and concepts - we aren't going into counseling about their own lives.

Thoughts, Feelings, and Behaviors

Go over what a thought, feeling, and behavior is and how they connect. (They're a triangle. Thoughts -> feelings -> behaviors -> thoughts...and also behaviors -> feelings -> thoughts -> behaviors.) Help client understand "behavior" doesn't mean something bad, and that no thought or feeling is wrong, then talk about how we can communicate them.

Thoughts

Talk about how thinking can be helpful, but that thoughts are just thoughts. They don't have to have a meaning, they won't always be right, and they can even be misleading. (Think silly thoughts to demonstrate this. You can talk about thinking errors here.) Sometimes brains think things that surprise us, even thoughts that might be upsetting, and that happens to everyone. 

Also, talk about how your thoughts are your own. We can make guesses about what other people might be thinking about, but they're just guesses, we can't actually know what someone else is thinking, and they can't know what we're thinking either. (That's why we have to use words, gestures, etc to communicate!)

Types of Feelings

Before you start, make sure there's an understanding of the very most basic feelings vocabulary first - happy, sad, mad, scared, hurt, sick, and tired. If any of these aren't understood, learning this vocabulary needs to be priority. Talk about how some feelings are called emotions and some feelings are saying how our bodies feel (such as hurt, sick, tired - you can tie in interoception). 
Then move into how there are other types of feelings beyond those basic ones. Some are whole different types of feelings (such as stress, confusion, surprise, and shame), while others are words that express the intensity of an emotion (the category of happy actually has a whole spectrum within it, such as content, pleased, excited, or thrilled). This is a good place to incorporate the Zones of Regulation if that's something you're teaching (just make sure you only use the zones themselves, don't use the "social thinking" aspects of their curriculum).

Signs of Feelings

Explain how our bodies tell us our feelings (how we feel inside, what we're doing on the outside) and how we can also use some of these clues to figure out others’ feelings.

Emotional Regulation

Go over what emotional regulation is. Then present them with a list of written or picture choices of things they can do to regulate their emotions (I usually use the last two pages of the "How to Recognize Emotions and then Calm Down" freebie on this page as a source of picture choices for that) and let them choose the things that work for them. I like to make a collage so they have their own personalized list they can have at home or school for when things get stressful.

Mental and Physical Health

Talk about what mental and physical health are and how they're connected (the "mind body connection"). Explain how the state of our bodies (adequate sleep, food, drink, medications if any are taken, illness) can affect our emotions and how well we can regulate them.

Shame

Explain what shame is, what causes it, and how it's different from guilt. (Guilt is when you feel bad about something you did, shame is when you feel something about you is bad. For instance, if you break a window and think "I feel bad I broke the window" that's guilt. Shame is "I'm such a klutz, I'm always breaking things, now I've gone and broken this window!") Explain what they can do when feeling shame. Talk about how social interaction/neurology differences often lead people to feel shame but remind them that those don’t make people better or worse, just different.

Mistakes

Explain what perfectionism is and how it can make emotional regulation and trying to learn new things hard.

Perspective Taking

I teach this completely differently from traditional "social skills" curricula. In traditional curricula, perspective taking is taught in such a way as to make it a tool of shame, intentionally or not. Essentially they show the learner how them having "unexpected behaviors" (non-neurotypical behaviors) causes other people to have "uncomfortable feelings" and "expected behaviors" (which are all associated with being neurotypical) cause other people to have "comfortable feelings", all taught as learning to take someone else's perspective of you. It causes a lot of shame about differences.

The way I teach it is from a true "understanding how peoples' experiences of the world vary" point of view which addresses differences either through neutral observations or even celebrations of uniqueness. It's a bit hard to explain, but as you read I think it will make sense.

What makes a perspective?

Teach that a perspective is a unique way of perceiving the world. Using the learner and someone else (yourself or another learner) as examples, talk about how even though each is in the same place, at the same time, in the same class/session, their perspectives will still be different. This is complicated, so I'm going to do a deep dive into breaking this down. All perspectives of a situation have two basic elements to them - what we are currently experiencing from the world through our senses, and what our brains have learned from experiences that we already had. You can break it down further than that, though.

Much of what our senses tell us varies based on our brains (our neurotypes) and our bodies. Some people's brains are different in ways that make them extra sensitive or less sensitive to some information coming in through their certain senses. Or sometimes people's bodies might be shaped or move differently or the parts of their bodies that would usually send sensory information - like their ears, nose, tongue, skin, or eyes - might not send as much information to the brain, such as if a person is hard of hearing or has low vision. Or it might not send any information at all, such as if a person is completely deaf or blind. 

Even if your brain and body worked the exact same way as someone else's, your senses would still tell you something a tiny bit different than someone else's. If you're closer to a sound than someone else, you'll hear it just a little bit louder. If you're further away from something, it'll seem a little bit smaller. The world is the same, but you'll each experience it differently.

The next component that really changes our perspective of things is our experiences. Some experiences can change our brains - like if someone you knew got mad a lot and treated you badly for a long time, your brain might have learned to be extra quick to pick up on any warning signs that someone might be about to get mad, like a loud voice. Other experiences give us new information or teach us things, such as what you learn at school or knowing what it felt like to give a speech in front of a class. Our earlier experiences may also give us different opinions about things. What we've learned from our cultures change our perspectives, too.

Culture

Explain how different nationalities have different cultures and why it might change someone's perspective. (People's values, ideas of right and wrong, experiences, etc are often different between cultures.)

Everyone's thought bubble is different

Our perspectives change what's in our "thought bubbles". The only way to put what's in your "thought bubble" in someone else's is through communication. When we "take someone else's perspective", we imagine what it would be like to be them. That can help us figure out what we need to say in order to get what's in our thought bubble into theirs. For example, if you said "She hit her with her book" you might have the information in your brain to make that story make sense - but unless the person you're talking to also had the experience of watching that happen, they aren't going to have the same information in their brains and the sentence won't make sense from their perspective. (Who is she and who did she hit and did she use her own book or the other girl's?) Figuring out what the other person's perspective is will help you know what information you need to tell them to make what you're saying make sense. 

Different sensory perspectives

Go deeper into sensory perspectives. Imagine being different people or characters and what each of their senses would be telling them in a given situation. This is a great activity to practice while you read a book or watch a video.

What I say vs what you understand

Teach how different factors can make the words we say easier or harder to understand from another perspective. In order to understand another person's spoken speech...

1. Your ears need to hear enough of the sound to move your eardrums (needs to be loud enough).

2. Your brain needs to know it needs to tune into this sound to understand it. 

3. It needs to be slow enough to understand. 

4. The brain needs to be able to pick out the words it's trying to tune into without getting confused by other sounds that are going on. 

5. The words need to be clear, with all their sounds said in a way we understand.

6. We need to understand the words. (Both the vocabulary and the language.)

7. We need to understand the background.

Seeing more than one perspective

Using different perspectives can help you imagine different ways to do something, make guesses about what someone might do, or think about something in a different way. If I'm stuck on a problem and I know someone else is good at that problem, I might ask myself "What would they do if they had this problem?" and imagine it from their perspective to get ideas. Or if I think about the perspective of my friend who hasn't eaten all day, I can take a guess that they might want to go get some food before we play more. And if someone has a different opinion from me, I can take their perspective to see why they might think that way. That can help me understand them better or even know what to say to try to change their opinion. Like if I can figure out that my dad might not want to go to the restaurant I want to because he doesn't like pizza and that's the only thing he knows they make, I can tell him about the other things they have that he might like, like salad - even if it's something I don't like myself.

Then practice imagining solving problems from other perspectives, coming up with arguments for both sides of an opinion (like that their favorite movie is the best vs the idea that another movie they don't like is the best).

Neurotypical Culture Social Communication

This section is all about teaching neurotypical methods of social communication through the lens of cultural differences. It needs to be emphasized that even more than any other section, this section needs to really put the learner in the driver's seat. Let them decide if a topic is something they want to learn about receptively (just how to understand the way neurotypical people communicate) or want to try out expressively (act out how something would be communicated in neurotypical culture). There should be zero pressure to do any of this expressively, because that runs the greatest risk of unintentionally promoting masking of neurodivergent traits.

Intro to Neurotypical Culture

Review what a culture is - a pattern of the things people do and believe. There are two different types of cultures, which blend together with each other. The first is cultures that come from a place, whether big (like a country) or small (like your school). And the second is cultures that come from something about the people themselves. For example, people who are Deaf and consider Deafness to be part of their identity, have their own culture. Likewise, neurotypical people have their own cultural patterns.

Talk about how the “social skills” people use are really complicated ways cultures have developed to convey messages that indicate you care about someone, you can be trusted, you are safe to be around, and you respect them in a way that the culture you’re in understands. But talk about how there are ways to communicate these things even if you don’t use typical neurotypical social communication norms.

Neurotypical culture isn't a good or a bad culture - like any culture it's just another way of doing things. The assumption neurotypical culture makes, which isn't true, is that everyone's brains work about the same way as theirs. For neurotypical people it's easy to make eye contact, learn unspoken social rules just by seeing them, change the tone of their voice to indicate emotions, speak, and keep their bodies still when needed. So they often don't understand why neurodivergent people might not do those things. That's not fair, and later we'll talk about how if you want you can be a self-advocate and educate others about the unique way your brain works.

In the meanwhile, it can be really useful to understand the way neurotypical people in your country tend to communicate in their culture. 

1. It will help you understand what they're communicating when they do certain things.

2. It will let you take their perspective so if you want you can change what you're saying or the way you're saying it in order to get a message across, you can. Sometimes this can be important for safety, like if you're talking to a police officer or someone who is very angry, so it's an important tool to have even if you don't normally use it.

3. It will help you predict what neurotypical people are going to say or do. The world can be a really stressful place when people are constantly doing things you don't expect. Being able to predict how a neurotypical person might react to something or what they'll do next can be helpful.

Masking / Camouflaging

Explain what “masking” / "camouflaging" is (covering up neurodivergent traits so you seem more neurotypical) and how it can negatively affect mental health. Talk about the importance of only thinking of the neurotypical cultural social rules as something useful to understand others and tools you can use if you really want to to communicate with neurotypical people, not a way that is better or that you have to act like. Talk about how finding neurotypical people who are allies or other neurodivergent people to communicate with and know they'll understand you can be helpful.

What is a social rule?

Explain what a social rule is. Explain the difference between hidden and spoken rules. Talk about how social rules reflect culture.

Sending clues

List categories of clues neurotypical neurotypical people use to understand or change a message. (Tone of voice, body language, facial expressions, and other nonverbal cues.)

Why do they care about eye gaze?

Explain why neurotypical people use eye gaze to guess what people are thinking about (you can't see the ears working or the brain thinking, but you can see where someone is looking and people tend to look at things they're think about, so neurotypical people use where you're looking to make guesses about what you're thinking about) and how it isn’t necessarily accurate.

How they guess if you're listening

Explain the behaviors neurotypical neurotypical people in your culture use to determine if someone is listening. (Eye gaze, if your face is towards them, if your body is facing them, if you're moving around or doing something else, if you're talking while they're talking, if your reply is delayed or "off topic", etc.) Talk about why they think those things mean you're listening, even though it's not always right.

Body language

Explain the different areas of body language and the connection in neurotypical culture to what people are thinking or feeling, plus how it can help you guess what they'll do next.

Voice

Explain how changes in the voice (pitch, intonation, speed, stress, volume) can change the feeling or meaning of a message in neurotypical culture.

Words vs Meaning

Give examples of ways what a person says and what they mean don’t always match up.

Sarcasm/ Jokes

Explain what sarcasm is and how to identify it. Talk about jokes and times that neurotypical people think it is and isn't okay to joke. (Usually it's when the joke matches the mood of others - it gets a bit more complicated when you go deeper than that.) Talk about the types of jokes neurotypical people think it's okay to tell and when it's okay to tell them.

Formality

Explain how the way neurotypical people talk changes based on situation and person

Topics of conversation

Talk about the topics neurotypical people usually avoid in certain contexts (anything considered "gross", politics or religion with those that disagree, money, etc) and cultural reasons for that. Talk about the main neurotypical purposes of conversations. (Sharing information, getting to know someone, etc.)

How Neurotypical People "Drop Hints"

State ways in which people in neurotypical culture “drop hints”. (Tone of voice, body language, indirect requests, etc.) Come up with ways to explain to others that they have trouble understanding hints and need things to be explicitly stated.

How Interest is Shown

State ways in which neurotypical people in your culture show interest or boredom

Giving an "Honest Opinion"

When it comes to giving an opinion, unless something important is at stake (or they're trying to be hurtful) in many situations neurotypical people try to tell "nice truths". They imagine how the other person will likely feel after being told different truthful opinions, then pick one of the truths that isn't painful for the other person to hear, or find a way around the question.

 

The classic example is how to respond if someone asks "How do I look?" when they're trying on clothes that look pretty terrible. Since they know hearing the answer "Terrible" would make the other person feel bad, in neurotypical American culture they might sidestep the question (like "I think this other shirt would look better"), make a statement that doesn't actually answer the question (such as "It's very sparkly!"), or find a nice truth to say (such as "That's a beautiful color"...even if they think the actual style of the shirt looks terrible). 

How Neurotypical People Show They Care

Talk about ways in which neurotypical people in your nation show they care. Examples:

1. Responding to good or bad news from others, ie “I'm sorry to hear that” for bad news or "That's great!" for good news.

2. Showing interest in what others are doing /saying.

3. Doing things that show they remember details about others (sending a birthday greeting, letting them know when their favorite video game has gone on sale, etc).

4. Giving greetings, saying farewells, and asking how others are doing.

5. Looking like they're listening when the other person is talking.

6. In some contexts, some acts of physical affection (a hug, a pat on the shoulder, putting their hand on top of yours, etc) would show caring, but these are limited and the consequences for misreading when to use them can be high.

Showing Respect

Explain what respect is and list ways neurotypical people show it in this culture.

Rudeness

Explain what the word rude means and the connections to neurotypical cultural norms. (What's rude and what isn't depends on culture.)

Interpersonal Social Safety Skills

One of the dangers of not teaching social communication skills is that there are many contexts in which safety skills and social communication overlap. Here's an example question I'll ask my clients to check how high a need this area is. "You're in the kitchen and you see that a fire has started. You run to tell your mom but before you can say anything she holds up her finger and says 'I'm on the phone, don't talk to me until I'm done.' What do you do?"

Not one of the kids I've asked this question to has said that they would tell their mom about the fire anyways. Most say that they wait until she's off the phone to tell her. One seven year old told me he would just go put out the fire himself. Those are some terrifying answers which put into perspective why safety skills and social communication skills can overlap. Here are some ways in which I teach interpersonal safety skills.

What is a safety problem?

Talk about the difference between a regular problem and a safety problem. Talk also about how emergencies are a type of safety problem, but there are safety problems that aren't emergencies, too. Practice classifying problems as safety problems or not safety problems.

What is a safety rule?

Give examples of rules that are put in place for safety reasons. Sort rules into safety/non-safety rules. 

Rule Hierarchy

Explain how rules can conflict and that safety rules are always most important. When given two rules, say which is more important to follow.

Getting Help

Explain how to get help for a safety problem.

Strangers

Explain what makes someone a stranger and the difference between a “don’t know” stranger and a “kind of know” stranger. I like to use the "Safe Side Stranger Safety" YouTube video (which is very silly) with many younger kids. Have clients make a list of people (adults) that they can trust, "kind of know" people they see in their daily lives, and "don't know" people they see. (To give examples, the Amazon delivery driver would be a "don't know", a woman you see sometimes at church would be a "kind of know", and your caregiver would - hopefully - be someone you can trust.)

Intro to Boundaries

Explain what a boundary is and how there are different types of boundaries. (Types of boundaries include boundaries with touch, information, space, and words.) Talk about how everyone's personal boundaries will be different, but that some boundaries are safety boundaries that are never okay to cross. When I do this, I like to take a piece of paper and fold it so there are four boxes, then we put a type of boundary in each box. As we discuss each boundary category over our following sessions, we fill in our own personal boundaries for each. (For instance, "It's okay if my mom touches my hair but I don't want anyone else to touch it.")

Boundaries with Touch

Talk about boundaries with touch, including the difference between boundary crossing that is uncomfortable and that which is against the law.

 

The amount you can get into the details of this will unfortunately depend on your setting. Most parents I've talked to (some of whose children had already been sexually assaulted - our disabled kids are at such a high risk for this!) have wanted me to be very candid about boundaries with touch - with those kids I would explicitly talk about how when it comes to your penis, bottom, vagina, or breasts, it is not okay for someone else to touch them, ask you to touch them, ask you to touch theirs, or even show you theirs/ask to see yours. 

Unfortunately, in many settings this is an area that there would be push back for discussing openly. One safer way to discuss this is to say "anywhere that would be covered by a bathing suit is a private place" and to show some clipart pictures of a bikini and some short swim trunks.

Please, please talk about this. In the US the broad group of disabled people as a whole were reported as being over 3x more likely to be victims of sexual assault or rape. What's more, adults with intellectual disabilities specifically are 7x more likely to have been victims of sexual assault or rape.  The true number is almost certainly higher than that considering how many disabilities make it less likely the person will be able to report the assault. Not talking about this doesn't make it go away.

Boundaries with Words

Talk about boundaries with words, explaining that again some words are uncomfortable and some words cross a safety boundary and have to be reported. Explain what a threat is. Have clients write examples of their regular boundaries with words (hurtful words, teasing about their glasses, etc) as well as what would constitute a safety boundary break (a real threat to your own health/safety or even to someone else's).

Boundaries with Information

Talk about boundaries with information, such as secrets and private information. Talk about how some information is not safe to share with strangers. (For example, I wouldn't want to tell someone my address and that my parents don't get home until late.)

Boundaries with Space

Talk about boundaries with "personal space". Say how much it usually is for strangers and family in neurotypical culture where you live, but that it's different for everyone and what they want for themselves might be different. (Actual measurements can be tricky, so usually for my area I'll say neurotypical cultural norms are around arm's length for strangers and elbow's length for family.) Talk about how to ask for space if you need more, and how someone needing more space than you just means their brains and bodies need something different.

Secrets, Safety Lies, and Promises

Some things are okay to keep secret, such as what birthday present you're buying for someone. Secrets like that usually have an end time - maybe you won't tell them right now, but you'll tell them on their birthday, for example. Safety problems, touch, and anything that hurts you or someone else should never be secrets, though.

Sometimes you might have to tell a "safety lie" to get away from someone who is not safe. If someone is telling you that you have to promise not to tell about something, and you're worried they'll do something bad to you if you don't promise, it's okay to promise not to say anything. But what you need to do is get away from that person after and go tell an adult right away, even though you promised not to. Because some promises aren't safe promises.

Friends

Talk about how to tell the difference between someone who is and is not a friend. A true friend is someone who likes you and you like them. You can trust each other, care about each other, and spend time hanging out just for fun.

A person is not your friend just because your teacher called you friends, you promised to be their friend, or because they did something nice for you. If someone is emotionally hurtful to you a lot, or physically hurts you on purpose, that person is not a friend.  Strangers (don't knows) and acquaintances (kinda knows - you recognize them and know their name but not much more) aren't friends. 

Talk about why being able to tell who is a friend and who isn't is a safety skill.

Peer pressure

Talk about what peer pressure is, common ways it shows up, and ways to resist it.

Bullying

Explain what bullying is and the different types of bullying. There's an idea among kids that it's only bullying if it's physical, like hitting or kicking. Talk about how bullying is actually when one person is hurtful to another (physically, verbally, emotionally, etc) over and over and over. I found the book "Bully Beans" was great for exploring this topic with kids. Work to come up with possible ways to respond to bullying.

Abuse

Talk about the different types of abuse (abuse with words, sexual abuse, neglect, and physical abuse) and come up with a list of people they could tell about abuse.

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