One of the most recommended therapies for youth with Autism Spectrum Disorder (ASD) is social skills therapy. After all, deficits in social interaction define the autism spectrum – meaning, all children with autism/Asperger’s/PDD have impairments in this area. But, is it possible to effectively teach social skills and, more importantly, can that teaching translate into meaningful social relationships for children with ASD? We think so, but there are some things parents can do to ensure that their children are getting the most benefit from social skills treatment.
First, let’s discuss what we mean by “social skills therapy.” Therapy targeting social skills can take many forms. For example, it can occur in small groups of same-age children, with two children at a time, or individually with an adult therapist (although the latter type often has limited utility). It can occur in the school setting or through a community provider and can be facilitated by speech-language pathologists, psychologists, educators, or mental health therapists (among others).
Further, social skills therapy can target many different skills. In very young children, these may include seeking proximity (tolerating playing close to peers), developing pretend play skills, increasing eye contact, and practicing and improving listening skills. Building on these skills, targets may include increasing joint attention skills (showing things to others, telling someone about a vacation or other event), playing structured games with a peer and learning how to take turns. Sharing (being flexible), imitating and learning how to join a group or start an interaction with another child are all skills that can be specifically taught. Higher level skills include negotiating conflict, perspective taking, conversation skills, and friendship skills. Each one of these skill areas can be broken down into sub-skills or steps, each one specifically taught and modeled for children.
A skills-based approach is one of the most common approaches to teaching social skills. This approach follows the steps outlined below:
- 1) Generate concrete RULES that specify what happens when the skill is used (e.g., When you look at me, I know who you are talking to)
- 2) TEACH skills through scripts, cartoons, role play, videos, observing other kids, etc.
- 3) Set-up SITUATIONS that encourage the skill
- 4) REINFORCE effort (not just 100% success), highlight natural contingencies (e.g., when you share your toys you get to play with Jimmy’s toys too) and work on generalization (practice skills in many different settings)
Now that we understand what is meant by “social skills therapy,” let’s highlight why social skills are so important. It’s true that not everyone needs to be a social superstar, but here are some compelling reasons why social skills should be a primary target for intervention:
- -Being competent in the social arena has been shown to predict success in other areas. Language skills, for instance, primarily develop within the context of social interactions. When a child looks at something another person is looking at (what we call “joint attention”) children learn to associate words with objects and events. At older ages, by participating in social interactions (often through conversations with others) children learn to understand more abstract and subtle language
- -Academics are also impacted, as specific skills such as listening and asking questions enhance classroom performance
- -Social acceptance by peers, greater social support and the ability to deal with difficult and intense emotions have been associated with fewer behavior problems in youth
- -Being successful with peers also helps children to build self-esteem, feel good about themselves and protect them from developing depression and/or anxiety
- -Another very important reason why children with ASD need a foundation of social skills is to enhance “adaptive functioning,” or the ability to live and work independently
So if social skills are so important and there are therapies that help children develop these skills, why are many families disappointed with the lack of social progress their child makes? First, because this type of therapy targets the core symptom domain in ASD, that means it is often the toughest area to tackle. Also, social skills continue to get more and more complex as we grow older because social interactions become more complex. At age 5 we simply need to share toys in the sandbox, but by age 15 we need to rapidly move from conversation topic to conversation topic.
Given that progress in the social skills arena will be steady, but slow, here are some tips to help kids and families get the most out of social skills therapy:
- -First things first. Address other difficult or primary behaviors first, such as intense anxiety, oppositional behavior and ADHD behaviors. These other behaviors can get in the way of your child’s ability to pay attention to and then practice what is being taught. Children with these behaviors will still benefit from social skills therapy, but progress is often enhanced when these behaviors are better managed at the outset.
- -Slow and steady wins the race. Children with autism benefit most from social skills therapy when it is ongoing across development. Be creative. If social skills groups are too expensive, get some ready-made materials yourself (such as materials from Social Thinking as well as the Social Skills Picture Book series by Jed Baker, PhD) and work on these skills with your child at home and in your everyday lives (i.e., when doing errands, participating in group activities, at the grocery store, etc.).
- -Adopt a “24/7” Mentality. Social skills are skills that we use all the time, even when we don’t realize it. Your child needs to practice new skills all the time too, not just one hour a week during therapy. Be sure that your child’s teachers and other community providers know what skills your child is working on at any point in time. Ask that they help by prompting and reinforcing use of new skills. Remember it is effort that counts not just 100% success!
- -Parents can play too! We know that when parents are involved in the therapy, it works better. Find out what lessons are targeted each week in therapy and specifically how you can support your child’s learning and practicing new skills. Come back next week and talk to the therapist about what worked well and what didn’t so you can troubleshoot problems right away.
In sum, social skills therapies come in many forms and target the core symptom domain in autism. Social skills take time to develop, but there are many benefits that come from intervening in this area. For example, language skills improve, adaptive functioning increases, and self-esteem is boosted. Most importantly, social skills therapy can teach children that being social can be fun and rewarding.