Social Skills Difficulties in ASD.

Michelle Garcia Winner describes the development of social skills from birth to adulthood, how social skills typically develop through experiential and incidental learning experiences. 

She uses the analogy of the Social Learning Tree and outlines the developmental trajectory of social skills acquisition.  The following components are necessary for basic and advanced social interactions:

• Joint attention, which includes reading intentions of others and paying attention to others and the environment (Jones and Carr, 2004)
• Emotional sharing and reciprocity (Prizant, Wetherby, Rubin, Laurent, & Rydell, 2006)
• Central coherence – getting the gist of a message, determining relevance (Plaisted, 2001; Happe & Frith, 2006; van Lang, Bouma, Sytema, Kraijer, & Minderaa, 2006)
• Theory of mind, which involves interpreting that you know something different from me (Baron-Cohen, Leslie, & Frith, 1985; Flavell, 2004; Hale & Tager-Flusberg, 2005; Frith & Frith, 2010)
• Executive functioning, the ability to process and respond to many stimuli simultaneously (Hill, 2004; Happe, Booth, Charlton & Hughes, 2006)
• Sensory integration, the ability to integrate the signals coming into our sensory systems, which keeps us aware and active at a level where we can comfortably participate, as needed, in the environment
• Cognition
• Language

For children with Autism, deficits in one or many of these areas may occur, making it difficult to interact with peers and engage in appropriate social skills.

The criteria outlined in the DSM-5 specifies certain difficulties in the area of social communication:

Deficits in Social Communication and Social Interaction

• Deficits in conversational skills.
• Poor non-verbal communication – eye contact & body language, use gestures.
• Deficits in developing and maintaining relationships.
• Poor imaginative play and difficulty making friends.

Restricted, repetitive patterns of behaviors

• Repetitive speech, motor movements or use of objects.
• Excessive adherence to routines, excessive resistance to change.
• Highly restricted or fixated interests.
• Under or over reactive to sensory input.

Children with Autism often have difficulty using a variety of language acts for different social situations.  These difficulties can be broken down as follows:

Difficulty using pre-linguistic communication skills

• Developing appropriate eye gaze.
• Using gesture to communicate.
• Joint attention skills.
• Using vocalisations to signal wants and needs.

Changing language according to the needs of a listener/situation

• Talking to people of all ages in same way.
• Will omit background information to a story.
• Difficulty discriminating between classroom and playground conversation.

Following rules for conversation and storytelling

• Poor turn taking in conversations.
• Difficulty introducing topics of conversation.
• Difficulty staying on topic.
• Rephrasing when misunderstood.
• Difficulty recognising facial expressions & non-verbal body language.

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Barriers to Social Communication:

Within social situations, there contains an array of variables that act as barriers to successful social communication. 

As educational providers for children with ASD, it can be difficult to control and remove all these barriers to make it easier for the child.

However, we can identify what is preventing a child from interacting with their peers and teach the core skills required to be successful in a variety of social situations. 

The following list outlines some of the most common barriers to social interactions/inclusion:

• Poor expressive language skills.
• Deficits in language comprehension.
• May not be understood by others.
• Rules are complex, vague or arbitrary.
• Interactions with peers may not be reinforcing/may not see other children as valuable.
• Preference to be alone.
• Difficulty generalising skills.
• Confusion with social rules – easier to play alone.
• Social demands cause anxiety.
• May cause offence or be insensitive without being aware.
• Repetitive interests/conversation patterns not reinforcing for peers.
• Previous experiences with peers were negative.
• May not know how to react to other’s feelings.
• May demonstrate poor social thinking skills.

Weitzman and Greenberg (2002) outline 4 different conversational styles when describing pre-school children with ASD and/or social communication difficulties.  They are as follows:

• The Sociable Child: This profile iniates interactions spontaneously and is very respsonive to other peoples initiations. They interact freely with both adults and peers.
• The Reluctant Child: These children seldom initiate interactions and prefer to be on the periphary of the group.  They may observe what is happening but are reluctant to join in.  This may be a result of poor language comprehension or an expressive language disorder, or may be a result of increased social anxiety or a preference to play on their own.  Given time and reducing pressure to interacte will often lead to some interaction eventually.
• The Child with His/Her Own Agenda: This child could spend a lot of time playing on their own, engaging with toys in a particular way, sometimes getting ‘stuck’ on a particular social routine or way of playing with an item.
• The Passive Child: This profile is often very difficult to engage in play or interactions, might have limited reinforcers or interests and may not respond to interactions.

We can also add the following profiles to this list:

• Active But Odd Child: Will approach other children spontaneously but this may be odd or inappropriate.  He will often pay little attention to the responses of his peers.
• Over Formal, Stilted Group: Will use overly formal language and behaviour and are excessively polite. Also, very rule bound in conversation and social situations.

Following an assessment of a child’s current communication and social skills repertoire, there are a number of interventions that can be implemented in order to increase participation in social interactions, increase functional communication skills, increase co-operative play skills and increase peer-interaction.

Intervention Strategies. 

An example of some of the intervention strategies include:

• Incidental teaching
• Contriving motivation to request and learn functional communication (either verbally, through PECS or AAC)
• Social Thinking Curriculums.
• The Hanen Programme.
• LEAP – social skills programme.
• JASPER – Joint Attention Symbolic Play Engagement Regulation.
• Social Narratives
• Apps – The Social Express (for older children)
• The SCERTS Model – Social Communication Emotional Regulation Transactional Support.
• Early Start Denver Model

Peer Mediated Intervention & Instruction.

There is a large amount of research to demonstrate that peer mediated interventions can be used to increase a range of skills including meaningful interactions between children with autism and their peers.

Skills which have been increased through peer-mediated instruction and intervention with children as young as 3 include:

• Social skills
• Communication
• Play
• School readiness
• Joint attention

There are various elements and considerations when designing and implementing PMII. Some of these include:

The National Centre for Professional Development in Autism offer various resources including a peer training script and activity