As paediatric therapists, we often see children diagnosed with Autism Spectrum Disorder who require support for their social skills. Being on a spectrum, these children are all remarkably different to each other with their own individual strengths and there is definitely no ‘one size fits all’ approach to their therapy plan.
As Dr Stephen Shore famously said – “If you’ve met one child with Autism, you’ve met one child with Autism”!
Despite this, there are some typical patterns in the social communication profiles of children with Autism that therapists and caregivers can help to support. Some examples are:
- Seem to be on their own agenda
- Repetitive language
- Difficulty maintaining eye contact
- Difficulty sharing a common focus with another person about the same object or event (known as joint attention)
- Difficulty playing with others
- Difficulty interpreting feelings/the perspective of others
- Difficulty making inferences or understanding non-literal language
“The long held notion that children with autism spectrum disorders lack an interest in social interactions is often inaccurate. Many children with ASD do indeed desire social involvement, however, these children typically lack the necessary skills to interact effectively.”(Scott Bellini, Indiana University)
How can therapists and caregivers help?
1.Teaching children to look for clues in their environment
Whereas, many children learn basic social skills by exposure to social situations, children with Autism often need to be taught these skills explicitly. Therapists, teachers and caregivers can spend time directly teaching these children to look out for social clues and reference those around them.
Michelle Garcia Winner’s ‘Social Thinking’ framework encourages social observation through being a “social detective”. Observing their peers in social settings can help these children figure out the “hidden rules” and determine what is expected and unexpected behaviour in that situation.
“if everybody is sitting down, I should sit down too”
2. Paired/group therapy
Finding an appropriate pair or group of children with similar social abilities can be extremely beneficial. A group provides the opportunity to practice social skills in a safe environment and because no child with Autism is exactly the same, the children can learn from one another’s strengths to overcome their challenges. Role-playing activities can be an engaging and beneficial way to involve all group members and work together on interaction skills.
In the classroom, it can also be useful to pair a child who has strong social skills with the peer who needs support in this area (while being careful not to turn the peer into a teacher).
3. Social stories
A social story is a simple story that builds social understanding by providing a positive perspective and appropriate response towards a social activity. The story is written from the child’s point of view, in the present tense.
These stories act as a framework for the child’s social interaction and may also help the child to understand social cues and reduce anxiety around the given situation. The stories can also be used to teach social boundaries, for example, personal space.
4. Thoughts and feelings activities
Children with Autism often have difficulty understanding the non-verbal cues of what someone is thinking or feeling. Activities involving discussion about feelings and perspectives using visuals can step up to activities using short videos. Mr Bean and Wallace & Grommet videos are motivating examples. These videos use minimal language and therefore require the child to infer based on facial expression, gesture and what they know about social rules.
Videos are also a useful way to talk about inappropriate social behaviours without making the child feel negatively towards themselves. We never tell a chid we’re having a weird thought about them, rather, we teach them to notice their weird thoughts about others!
For children with who have difficulty interpreting their social environment, the world really is your oyster! In everyday life, look for opportunities to interpret feelings, perspectives and solve problems that don’t have an immediate answer in the context. For example if a group of people look like they are celebrating, or a baby is crying, ask the child to think about what is happening, and why they think this might be the case.
If you are concerned about your child’s social skills, we recommend that you consult a speech and language therapist.
One of the main indicators of being on the Autism Spectrum is difficulty with social interactions, however please note that not all children who have social difficulties, have a diagnosis of Autism, and that the above-mentioned strategies are useful for children with and without a diagnosis of Autism Spectrum Disorder.