الفهرس Only 14 pages are availabe for public view
 |  | from | 147 |  |  |
| | | from | 147 | | |
Abstract
Although the concept of social competence is understood by the clinician and the lay public, the definitions for social competence are problematic. Embedded within this term one must consider culture, relationships, timing, perception (encoding), integration, and the behaviors involved in social relationships. Motivation, knowledge, and the ability to complete the skills are also important constructs for understanding social communication. In addition, emotional competence enters into our understanding of social functioning and the two abilities overlap.
In addition to defining social competence, it is also important to understand how to assess this ability. The use of observations, self-report rating scales, behavioral rating scales, and direct measures of social understanding are useful tools for first evaluating where the child/ adolescent functions. In addition to these measures, clinical interviews are very important to provide a window into the child or adolescent’s level of functioning as well as the parent’s ability to model and teach the child.
As indicated earlier, the parent–child relationship sets the foundation upon which social competence is built. To further understand this construct, it is important to briefly discuss the developmental issues that are present at each stage for the development of social competence.
When difficulties are present in social relatedness whether due to aggressive behavior, social withdrawal, or problems in social understanding, the child and adolescent will experience problems with adjustment that often play into difficulty with academic and vocational attainment.
As regard assessment, many techniques are now available; these measures can assist the clinician in evaluating the child’s skills. It is important to utilize multiple informants as the child’s behaviors likely vary depending on the environment and the people associated with that environment. Parents may have a limited view of their child’s social skills while teachers have a larger comparison group for the child’s development. Mothers have been found to be more realistic about their child’s social abilities than fathers. Thus, to have only one data point will restrict the understanding of the child’s abilities and likely provide an inaccurate measure of the child’s skills.
The age of the child also affects what measures may be possible. For example, Behavior self-rating scales are not generally helpful for preschool children. For the preschool child the use of observation is likely the best method for evaluation. The Berkeley Puppet Interview is a novel method that is promising for use with preschool children. The techniques, however, may be useful in assisting the clinician in developing an intervention that targets the child’s difficulties and there is research to support this type of use.
Research indicates that poor social functioning places all children at risk for the development of substance abuse and delinquency as well as for depression, anxiety, and conduct problems. ADHD has also been linked to comorbid problems in these areas and the expression of the disorder with these additional diagnoses is more severe, and hence more problematic for development. The child with ADHD progresses through many stages as he/she develops and at each point must master various developmental tasks. Many children with ADHD appear to be “immature” and behind their peers emotionally, and thus, stand out as problematic even at the early ages.
As the behaviors become more difficult to manage, peers and parents may seek escape from interacting with these children and this isolation even more fully restricts the child’s ability to learn corrective behaviors Skills involved in problem-solving (executive functions) and may also translate into difficulties socially. As the child attempts to interact, he/she may show more intensity and intrusiveness thus ensuring more rejection.
As the child becomes less accepted, self-esteem may also suffer. Parents and teachers are rightfully frustrated but so is the child, as nothing he/she does seem to work. Coercion training likely interferes with teaching the child the most appropriate manner for solving problems. Add to this mix the finding that many parents of children with ADHD also have a diagnosis of ADHD and the problems become more intimidating.
The literature on interventions is mixed as to the effect that social skills training alone is helpful. In addition, medication has been found to show the most promise for improving social skills, partly due to the fact that the child is more able to regulate his/her own behavior and pay attention to important cues. However, emerging evidence is present that combining social skills training and parent/teacher support may pay dividends.
The research studying methylphenidate utilized only systems that involved the child and not the parent or teacher. Comparing the child’s functioning when parent and teacher training is provided may show improvement in skills particularly when medication is utilized.
For children with pervasive developmental disorders, social competence is by definition a very difficult task to accomplish. of great concern is the toll that these disorders take on children as well as their families. These difficulties appear to be life-long with adults showing significant problems with unemployment or underemployment, social isolation, and problems with living independently.
While there is support for interventions utilizing behavioral reinforcement, the generalization of these interventions to more complex and novel social situations is by no means documented. More and more Interventions are showing promise but the one ingredient that appears to be consistent among these interventions is the necessity of intense intervention that begins when the child is quite young, providing support for children in elementary, middle, and high school levels is also important. These interventions were not generally present until the child was in middle school—that is way too late and many children begin to feel sad, anxious, and unmotivated to change. While children with PDD may never be social butterflies, it is important that they be provided with sufficient interventions to develop appropriate understanding of the social world around them and to participate in it as they chose.
Children with mental retardation are social beings and flourish best when provided with interactions first with their parents and then with peers. Research as to the effect of differing care-giving strategies and challenges for parents of children with mental handicaps is incomplete at best and needs to be expanded. There is strong evidence that these parents face differing challenges and that a child with mental handicaps is often more difficult to parent and requires additional parenting skills compared to a typically developing child. These differences are important particularly for the development of appropriate intervention skills. Beginning to assist parents in helping children acquire appropriate adaptive behavior skills at an early age is a good first step in the child’s ability to learn appropriate social ability.
Cognitive and language handicaps have been found to have an impact on the child’s ability to share experiences and converse with peers. These difficulties are compounded for a child with mental retardation particularly as the child develops and language becomes more and more abstract. Some have suggested that difficulty in understanding and use of emotional language may be tied to social competence problems in children with mental retardation (Cicchetti, 1991). These problems indicate that intervention that specifically targets such understanding may be helpful.
Finally, the research indicates the support the family has from others and from organizations assists in how well the family can provide early interventions that have a better chance of improving the child’s performance. Family issues that include marital discord, financial stress, economic hardship, and social isolation certainly may contribute to difficulties the child later faces in developing appropriate social skills. These issues also are rarely addressed within the school setting where many of the interventions for children with mental retardation are provided. Family support and therapy appear to be issues that can be more readily addressed and which research supports as beneficial to the child’s overall functioning but also for his/her social and emotional development.
For children with depression, social competence is a major issue and encompasses concerns in psychological functioning as well as in adjustment and attributional style. These symptoms appear to be stable over time and change only when a drastic improvement in depressive symptoms is present. In addition, children who are depressed tend to be either ignored or rejected by their peers. Such rejection further isolates these children and research suggests they become less adept at coping and tend to focus on their emotional distress. As the child becomes more withdrawn and socially isolated, opportunities for positive social exchanges likely decrease, and thus the practice needed to become social adept is lacking. Empirical work has also found that these children often perceive negative intent where none is present. Such a tendency likely increases their reluctance to engage socially further limiting their social contacts.
This type of withdrawal is particularly important for our understanding as it appears to begin at an early age and to color the child’s perceptions of his/her world. If the child begins to see the world in a negative light and himself/herself as socially inept, the ability to change such attributions is quite resistant to change and appears to be particularly pervasive in terms of psychological and cognitive functioning. For girls in adolescence these difficulties are even more stable and may forestall attempts at therapeutic intervention. Findings have indicated that generally social skills are intact; what is problematic are the perceptions of self and others as well as a tendency to become very distressed over commonly experienced situations and to lack adequate coping skills. Thus, interventions appear to be best placed in the realm of individual therapy and to developing appropriate perceptions as well as coping skills possibly through the use of cognitive-behavioral therapy.
Family issues are also important in understanding social competence in children with depression. When mothers and/or fathers are depressed, the social competence of the child is significantly compromised. Maternal depression is most influential with adolescents while paternal depression appears to be more operative at younger ages. In addition, boys appear to be more vulnerable than girls when either parent is affected. Depression in the mother during gestation has also been linked to higher risks for the child in cognitive and social/emotional adjustment.
The social competence of children with bipolar disorder has not studied as often as that of children with depression. Findings indicate that, similar to depression, family style, genetics, and family environment may all contribute to the development of social difficulties in early childhood which are exacerbated in later life. Given the relatively strong inheritance of bipolar disorder, social problems may occur at younger ages given the disinhibition, liability, and irritability frequently seen early in the illness.
For children with anxiety disorder socialization is a challenge. Similar to children with depression, children with anxiety tend to withdraw from situations and to have difficulty developing appropriate skills. For children with depression problems are present in significant feelings of social isolation. They also tend to have negative perceptions of their own social ability. In contrast, children with anxiety disorder tend to become very hypervigilant of their surroundings and to read negative intent from their peers. In addition, children with anxiety tend to also have a parent with anxiety who may withdraw from social encounters and fail to develop a social network. Also, children with OCD have social challenges and tend to withdraw from new activities. In addition, they frequently feel “different” from their peers and attempt to hide their symptoms. Research indicates that parent–child interactions are characterized by poorer problem-solving and more conflict than children with externalizing disorders or with other types of anxiety disorder. Importantly, for both diagnoses, family treatment is strongly recommended particularly for younger children. In addition, when the diagnosis is shared between parent and child, interactions are fraught with more conflict and more difficulty. There is little research about families with dual diagnoses; that is, the father has one type of internalizing disorder and the mother another. This type of situation would be most intriguing but also significantly problematic. It would appear that family therapy by a knowledgeable clinician would be most appropriate particularly in assisting parents and children with social difficulties to expand their social network and support system. Given the lasting imprint of social competence difficulties for these children’s lives, it is particularly important to intervene at an early age.