In my private practice, we are often asked by our funding sources when our children with ASD will no longer need social skills instruction. I often feel a sense of “indirect or subtle” pressure to discontinue our service and declare that a child is socially competent and basically cured of what is essentially the hallmark feature of ASD: impaired social interaction. However, given what I know and have observed with this population it is difficult both ethically and morally to do so.
As professionals we know that social skills are the foundation for getting along with others. We also know that there are social skills milestones which develop along a continuum. For example, one of the early skills focused on for our young children is “how” to make friends and join groups. Many are successful and with parental support during the preschool years engage in playdates and develop friendships with their typically developing peers. However, around 8 or 9 years of age the terrain shifts and children reportedly become more discriminating and scrutinizing as they select their friends. Labels such as nerd, cool and loser become important in the selection process. Our children with ASD often fall into the category of nerd.
As a result, many of them experience rejection and bullying and are left confused and hurt when their only friends abandon them. Social skills continue but our focus evolves to include discussions and skill steps to facilitate their understanding of “who” should be their friend and “how” our friends make us feel and accepting loss and changes in life. The need for social skills training into middle school and beyond can have a profound effect on the quality of life for these children.
High school brings yet another level of complex social interactions and negotiations especially when dealing with the opposite sex, changes in hormone levels, sexual maturation, and peer pressure.
The final phase is the transition process from high school to college and the world of work. The need for continued social skills training is essential and should address core clusters of skills critical for promoting independence and fulfilling lives: vocational, independent, and personal development. Social skills taught may include relationships and how to discriminate between a friend, a colleague, and an acquaintance, the importance of good hygiene, executive functioning, workplace conversation, nonverbal communication, unwritten social rules, and workplace idioms such as “hit the ground running” to name a few.
Based on decades of working with this population and the long-term relationships experienced with many of the children and families in my practice and more importantly the positive outcomes we have achieved, in response to the question, how long should children with ASD continue with social skills treatment, my short answer is, “Across the Lifespan.”
That having been said, based on the positive comments and requests from our colleagues following several ASHA presentations on social skills, my colleague and I have developed a series of social skills workbooks, Autism: Attacking Social Interaction Problems to cover the lifespan of children with ASD from 4 years to adulthood.
Our books contain clear and concise objectives and instructions on how to introduce and implement the lessons. Our approach is fun yet structured and each unit builds on previously learned skills to assist in the generalization of information across boundaries and contexts which include home, school, and the community while incorporating parent and teacher input.
Our newest additions are the teen and prevocational books which are fresh and relevant to today’s youth and include the use of social media and issues facing young people today such as sexting, texting, and TMI. The goal is to assist our students to develop a full range of interpersonal social competencies that can help them ultimately achieve acceptance in the workplace and develop a meaningful existence.