Ghinwa Salem Speech Therapy
Speech & Language Conditions

Social Communication Therapy for Children & Teens in Beirut

Grammar is perfect, vocabulary is wide, and yet conversations go wrong. Your child interrupts, monologues about one topic, takes jokes literally, or stands at the edge of the playground not knowing how to join. Social communication — pragmatics — is the part of language nobody teaches explicitly, and for some children it has to be.

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What it looks like at school and at home

  • Talks at people rather than with them; doesn't notice when the listener has lost interest
  • Struggles to start, join or end a conversation
  • Takes idioms, sarcasm and jokes literally
  • Gives too much detail, or too little — the story has no beginning or the point never arrives
  • Doesn't adjust how they speak for a teacher versus a friend versus a toddler
  • Misreads facial expressions and tone; misses that someone is upset or joking
  • Wants friends but keeps losing them; often the last chosen for group work
  • Teachers describe them as "rude" or "odd" when they are neither — just not reading the room

When to book

Social skills develop late and unevenly, and a shy six-year-old is not a case. Book when the difficulty is consistent across settings — home, school, sports — and when it is costing the child something: friendships, participation in class, or their own view of themselves. The teen years raise the stakes, because peer conversation gets more indirect and more sarcastic just as it gets more important. Social communication difficulties can exist on their own or as part of autism or ADHD; the assessment tells you which, and the therapy is useful either way.

What therapy looks like

The unwritten rules are made written. Sessions teach the skills explicitly — how to open a conversation, how to tell you've said enough, what a face means, how to disagree without ending a friendship — then practise them through role play, video of real interactions, and structured tasks with a clear rationale. Teenagers respond best when they set the goals themselves ("I want to be able to join the group at break"), and therapy is built around those. Parents and teachers are given the same language so the skills are cued everywhere.

Social rules change with the language

A Lebanese child moves between social codes several times a day: the directness that is warm in Arabic reads as blunt in French; the English humour of an international school does not translate at a family lunch. Children with social communication difficulties find this particularly hard, because they are learning rules that shift under them. Therapy at the clinic works in the language and setting where the difficulty actually bites — usually school — and is explicit about which rules belong to which room.

Questions parents ask

Not necessarily. Social (pragmatic) communication disorder is its own diagnosis, given when a child has these difficulties without the restricted interests and sensory features of autism. It also appears alongside ADHD and language disorder. The assessment looks at the whole picture, and if an autism evaluation seems warranted Ghinwa will say so plainly.

Shyness is about anxiety: the child knows what to do and finds it hard to do it. Social communication difficulty is about knowledge: the child doesn't know what to do, and may be confidently doing the wrong thing. A shy child watches from the edge and joins when comfortable; a child with pragmatic difficulty barges in mid-game or delivers a monologue about trains. The two are treated very differently, which is why the distinction matters.

Teenagers accept it when it is about what they want. Sessions with adolescents start from their own goals and treat them as the expert on their social world; the therapist's job is to make the rules visible, not to lecture. Many teens find it a relief to have things explained that everyone else seemed to know.

Often a mix. Skills are learned one-to-one, where they can be broken down and practised safely; they are consolidated in real interaction. Where a suitable peer is available, paired sessions are arranged, and the home programme deliberately uses siblings and cousins — of whom Lebanese children have no shortage.
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Other conditions

Speech & language delayStutteringSpeech sound disordersAutism & communicationAll services

Not sure if this is your child?

Send a WhatsApp message with your child's age and what you have noticed. You will get a straight answer about whether an assessment makes sense — and if it doesn't, you will be told that too.

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