Interventions For Autism: Social Skills, Academics, And Communication
Updated October 03, 2019
Reviewer Lauren Guilbeault
Interventions for autism run the gamut. Most children will, upon receiving an Autism Spectrum Disorder diagnosis, be immediately referred to at least 2-3 types of therapy, usually including speech and occupational therapy. The ways these therapies are delivered can also vary greatly and may come from a clinic, an at-home therapist, a school, or a mixture of all of these. Although speech, occupational, ABA, and physical therapies can all be immensely important for a child with ASD, many of them do not target an aspect of children with ASD that is most in need: social skills.
Working With Autism: Social Skills And Their Importance
While people often focus on the delays within autism, there is an overarching difficulty within autism: socialization. Most of autism's symptoms are derived from difficulties with socialization and what that encompasses; language difficulties are often related to not understanding or misunderstanding cues and communication attempts. Stimulatory behavior is engaged without understanding or recognizing that certain behaviors and noises are not considered socially acceptable. Many of the hallmark tendencies of individuals with autism are directly related to social difficulties and delays, such as repetitive movements, outbursts, and lack of eye contact.
Despite this, most therapy modalities focus more on working with a child's delays or limitations, rather than placing a heavy emphasis on socialization. Although children receive socializing time in school, it is often unstructured and unmonitored. Many therapy sessions, too, are one-on-one and do not encompass how to make and keep friends, communicate with peers, and understand your needs.
Many schools challenge students with autism to achieve good grades and academic accomplishments. What many schools do not focus on, however, is encouraging a greater number of peer interactions, and teaching children with ASD how to navigate the complexities of friendship.
Teaching Social Skills To Children With ASD
Many schools and therapy modalities can incorporate social skills into existing models. Speech therapy, for instance, can focus not only on developing words, but on developing conversation skills, and going back and forth between the child and therapist. Speech can also use a child's interests to further improve speech and encourage children to carry on more complex conversations. Therapy with two children and a single therapist may also be a helpful intervention, as therapists can not only encourage peer interaction but can also identify any particular areas of need in a child's vocabulary or interactive habits.
Occupational therapy can work on identifying appropriate social awareness to help children with ASD learn how to find an appropriate stance in which to speak to and interact with peers, rather than standing at too great a distance or getting too close to peers' faces. Occupational therapy can also work on removing some of the sensory difficulties that can factor into social communication and behavior, and may be able to help reduce the incidence of stimming, so children can focus more attentively on interactions with peers and friends.
ABA therapy, in particular, can be helpful in teaching social skills, as therapists can encourage children with the ABC model of ABA therapy to initiate peer interactions, engage with peers in play, and initiate a conversation with parents, therapists, and educators. Teaching children to associate peer interaction, greeting others, and eye contact with positive consequences can go a long way in encouraging social development.
Encouraging Social Interaction: Group Therapy
Perhaps one of the best ways to teach social skills is through holding group therapy. Group therapy can be used in a variety of settings, including speech, occupational, ABA, physical, and even music therapy. These types of therapy are delivered in numerous settings. If a clinical setting is not an option for families and home therapy is the only availability, siblings and parents can be used to simulate a sort of group therapy setting.
Schools can also be helpful in applying group therapy, as many schools prefer to enlist the help of therapists in larger groups in order to maximize time and efficiency. School itself might function as something of therapeutic intervention, as children are, at the very least, placed in a setting with many other children, and given opportunities to interact with peers.
Inclusion classrooms in schools are also useful in teaching social interactions, as children with ASD are placed in learning settings with typical peers. ASD children may learn social interactions from typical peers, or may simply benefit from peers more willing to and confident in initiating friendships and interactions.
Social Therapy Interventions
Teaching Social Skills To Students With Autism to increase peer interactions is typically on the docket for teachers in special education and inclusion classrooms. Although these settings can be incredibly useful, there are some limitations, such as school districts with large student-to-teacher ratios, and limited options available for students with special needs. While all public schools are required to offer special education to students, parents have found that this is not always the case, and some schools may offer inclusion classrooms without having a dedicated special education department.
Social therapy interventions can also be engaged at home. Because most forms of therapy require parents to continue therapy techniques in the home to maximize efficacy, parents can use siblings, family members, and friends to increase a child with Autism Spectrum Disorder's exposure to social interactions.
Pitfalls Of Social Interventions At Home
Some well-intentioned parents might encourage social interactions with their ASD children the same way they encourage social interaction with their typical children, and unfortunately, this approach will likely be confusing and disorienting for both children on the spectrum, and typical peers. Many parents encourage children to work out their own issues with friends, for instance, which might result in a typical child trying to engage a child with ASD, and a child with ASD being unable to respond.
To teach children with ASD social interaction, some amount of intervention will be necessary. Simply "working it out" is unlikely to go anywhere, as children on the spectrum do not usually understand the mechanisms involved in negotiating and resolving disputes. While parents do not need to monitor every single moment of peer or sibling interaction, arguments, disagreements, and misunderstandings may escalate more frequently than with typical children and will likely require more parental involvement.
Social Stories And Scripts
Social stories and scripts can help children with autism learn to navigate the complexities involved in social interactions. Social stories are usually delivered in a format, not unlike a comic book. Social stories can teach small things, such as how to wash your hands, and larger, more complex concepts, such as how to speak to peers while playing. These stories allow children with ASD to see a concrete breakdown of steps in order to more fully understand the process involved in a skill.
Scripts can also be helpful in encouraging social interaction with children on the spectrum. Although the goal for many families is to eventually help children learn how to speak freely, scripts can help children with ASD build social confidence. A script usually gives children a framework with which to speak to peers, such as, "Hi, how are you?" Although a typical child might not ask this of every single friend, a child with autism can feel safe and secure with scripts, knowing they have something to say in each new interaction.
Exercise As A Social Intervention
While more research is needed to fully understand movement as an intervention for ASD, a few studies have determined that children who engage in movement-based therapy are better able to engage in social interactions. One study found that children who had ABA therapy and children who engaged in a music-and-movement therapy had similar symptom relief, but the music-and-movement group was more comfortable engaging with peers following the conclusion of the study.
These findings suggest that some amount of social difficulty may come as a result of lack of body awareness and comfort and that placing emphasis on body awareness can help children feel safer and more comfortable in social situations. Because many children with ASD seem averse to physical exercise or may experience difficulty with coordination, this intervention might have more initial pushback than some other therapy options. Because it is an emerging field of study, however, parents may be able to apply the principles of the studies at home by playing songs and dances with children-both typical and on the spectrum-practicing yoga together, or engaging in small physical interactions, such as playing catch together.
Teaching Social Skills And ASD
Although there is no single social skill-focused therapy, social skill instruction can be applied to most types of therapy in both group and individual sessions. Because social interactions are complex, teaching social skills on their own can prove challenging. Teaching them in conjunction with other skills seems to be the most effective approach, at home and in school and clinical settings. The most effective forms of social intervention at present appear to be Applied Behavior Analysis and movement therapies, wherein children are encouraged to move and better understand their bodies.