IDEA_2_18 - IN*SOURCE



Hello, this is Wilner Cusic from INSOURCE and I’m talking to Lynn Sayre from the Sonya Ansari Center for Autism. Lynn is a licensed social worker with her master’s from IUSB. She is in charge of the Social Skills Program at the center. We are going to talk about the challenges to effective social interaction for individuals on the autism spectrum. We will also talk about supports and learning approaches that can help strengthen interaction skills. Lynn, let’s start out by sharing a common definition of the issues we are discussing today. When an individual with Autism Spectrum Disorder is described as lacking in social skills, what does this actually mean?

LYNN SAYRE:

Well, I’m going to start by sharing a definition of social skills that’s generally accepted in the field and that is that social skills are learned behaviors that enable a person to interact with others in ways that elicit positive responses and assist in avoiding negative responses. There’s quite a few words in that, but there are a few that are real important as we continue to talk today. The first of that is that these are learned behaviors. Most children begin at an early age to learn what is socially acceptable by trying behaviors, watching the responses and reactions and adults in their lives and then modifying their behaviors to get what they want. As they get a little older they continue to kind of pick up these skills by employing that same feedback loop with their peers. Individuals on the spectrum tend to be not as adept at using this kind of feedback approach. They often miss the signals from others and as a result, they miss the opportunity to refine their behaviors so that they’re effective in their interactions. Equally important in that definition is the idea that it’s important because of the response that they elicit from other people. If it’s the response that’s important, the person needs to be able to be aware of the feelings and the emotions and the reactions of the other people around them. So, when you say “a lack of social skills” or the medical community calls it a “qualitative impairment in social interaction” it means “failure to develop relationships as a result of ineffective use of socially accepted behaviors.” The impairment varies a lot among individuals since it’s a Spectrum Disorder. Sometimes they’re just seen or odd or eccentric and other times they might be seen as isolated or self-absorbed or antisocial.

WILNER CUSIC:

Ok, so what causes these problems in effectively using social skills?

LYNN SAYRE:

Well it does depend to what the degree the person is impacted and we can kind of talk about the kinds of things, difficulties, that people might experience first and then we’ll talk about the causes for them. So, some of the difficulties are problems with initiating or timing interactions with people. Whether it’s a conversation or playing or work activity, they might have trouble just getting started and even once they’re engaged, they might struggle with turn taking or balancing their contribution with others. They also could have poor sense of personal space. They might encroach on other people’s space, or they might not approach closely enough to signal that they’re intending to join in the activity. They might miss nonverbal cues and not figure out what to do if they do pick up those clues in the body language and facial expressions of the people they work with. Some difficulty with maintaining eye contact, sometimes it might be absent or too fleeting and others read that as maybe not interested and there’s also sometimes difficulties with perspective taking and that’s that whole idea of understanding that others might have different thoughts than you do and that might effect their behaviors. And it kind of wraps up with difficulty maybe recognizing or dealing with emotions, both their own and other people’s. That’s an important piece for monitoring our own behavior and challenges with language. They might have big vocabularies and fluent speech, but they’re not very effective in using that. So, those are some of the features that individuals have and then I believe the last you asked about what might be causes for some of these problems a few minute ago?

WILNER CUSIC:

Yes.

LYNN SAYRE:

Ok, ok, so if we go back for just a minute to our original definition, we talked about these being learned behaviors. We’ve observed that individuals on the spectrum seem not to be so adept at using this normal social feedback loop to refine behaviors. They’re not real good at kind of picking up on the signals that would clarify others’ expectations and tell them what to do. There’s several things that impact them and they vary among individuals, but there’s some common themes and I’m going to talk about three of them.

The first one that lots of people on the spectrum deal with is sensory integration issues. This isn’t something that’s really unique to Autism Spectrum Disorders, that it’s a frequent companion for individuals on the spectrum. Incoming signals from their senses don’t process real smoothly or predictably and that poorly regulated input overloads their neurological systems and can overwhelm them and when that happens they avoid interactions with others and they kind of escape all that noise of unorganized input. So, sensory is one. Another one is restricted interest or a hyper focus on their own interests. They get stuck on a topic or an activity to the point of shutting out others trying to move them on to something else and that will make their conversations maybe feel like monologues and their play might look unusual or their interaction is unusual or odd to their peers. The third one is probably the kind of most complex one and it has to do with a unique way of thinking. There’s kind of three areas of global functioning we can talk about to help us understand what’s unique about the way individuals on this spectrum think and then how those differences in thinking might effect how they behave. One is, one’s the idea of weak central coherence. What that basically is is a difficulty relating pieces to the whole. They don’t see big pictures often. They get focused on little pieces and have a hard time putting it all together and in context and what that skill allows us to do is process information, to analyze it, to make comparisons and to make good choices. Another issue that many may have problems is executive functioning. That’s really the ability to organize and create a structure to manage every day demands. That’s the skill that lets us prioritize and to be flexible when life throws us changes. And, the last one is the whole idea of theory of mind, that’s language that people who talk about autism talk about a lot. That’s the ability to read and track what others know and might be thinking while we’re interacting with them. That skill lets us monitor and adjust our behaviors and respond to those that we’re interacting with. It helps us know how others might ah respond to our behaviors too, so all of these things kind of come together and the sensory and restricted interests surface, the individual might come across unapproachable, disinterested or self-interested and the differences in thinking can drive some pretty unusual behaviors and all of these in combination are not really recipes for very successful social interactions.

WILNER CUSIC:

I see so that leads to my next question then so why is it important to teach more effective social skills?

LYNN SAYRE:

Well it’s really success in many aspects of our daily lives relies on us being pretty effective in our social interactions. When you think about education, recreation, employment, even living in the community or developing personal relationships, they’re all linked to our ability to effectively connect to the people that are around us. We even see the social skills deficits impact academic performance too and when that performance falters, it impacts self-esteem in return. In addition we see problem behaviors are linked to social skills issues because they may have frustration that they’re really not very effective and they’re unsuccessful so the high frustration builds into behavior problems. And social skills also help us with transitions and reducing anxiety and keeping flexibility and just overall an individual on th spectrum’s unexpected behaviors give them lots of negative responses and those responses throw up barriers and limit opportunities and that is a loss for the person and also a loss for society because they can’t really fully contribute. So the reason why we teach them is to help reduce the barriers so that they can meet their fullest potential.

WILNER CUSIC:

Now that we’ve identified the barriers as such, what approaches have been found to be helpful in building social interaction skills?

LYNN SAYRE:

Well the most effective work on social skills works at the two pieces we talked about earlier, both skill building and taking a look at this different way of thinking and understanding that better and helping the individual understand they really do think about the world a little differently. So the skill building part starts with identifying what skills the person needs to work on. We do observations and do questionnaires and profiles to help get a picture for the skills that need to be worked on and then we ask is the skill something they need to learn or is it something they need to learn to apply. So they might know the steps, but they don’t know how to call that up and spontaneously use it in real life, so then we would teach generalization. They might not even know the steps, so we would teach basic skills, so it kind of depends on what the need is. The next question is now that we’ve identified the skill and what level we need to teach it. We say, “What approaches are we going to use?” and the approach depends on what is the skill, who is the person, what is the setting, so we need a large toolbox of approaches to try and then we monitor and modify and we try again till we find the one that works for the particular person. So one of the very fist steps is this idea of teaching specific skills so we take an activity like initiating a conversation that a person might have trouble with and we break it down into small discrete skills, even to the point of deciding who to talk to and how to approach them, what kind of expression to have on your face. So really pretty fine steps. At first we would teach these I a small group. We teach the steps, then we do role-playing with the individual and with their peers. Then we might move to promoting reinforcing this in larger groups so they would able in a larger group with preplanned activities where they’re all set up to be successful with some prompting and monitoring and coaching throughout so that they can use these skills in kind of a protective environment before they have to generalize it in the public. And then there’s a couple of real useful specific tools. One is video self-modeling and basically what that is is videoing an individual successfully using some new social interaction skills, capturing it on tape so they can watch it and they can picture themselves as visual learners, being successful with a kind of “I can do that” and “I can be successful” and it’s a pretty powerful tool. And another one of those tools is social stories which are another visual way to kind of communicate expectations and to show how other people might respond. So, there’s lots of different mechanical ways or approaches to teach skills and then the second thing we do is addressing the difference in thinking and that starts with helping them even realize that other people are thinking about them and the importance of that realization. So, there’s some language that Michelle Garcia Winter uses. She calls it “interactive perspective taking” and what that is is we teach them the steps that other kids have in their more instinctive feedback loop that we talked about earlier where they act and monitor and then modify behaviors. We actually teach all those pieces of that feedback loop so those individuals can do that as well. So that’s a great approach that’s pretty effective too.

WILNER CUSIC:

Well, you’ve definitely given us a lot of ideas and strategies and I mean, as many as they were, if listeners wanted to get more information, where could they go to look for this on this particular topic?

LYNN SAYRE:

Sure, there’s a couple of web pages that are are great resources. One is the Indiana Resource Center for Autism’s web page, that’s at iidcindian.edu and through that page you can see a book that is written by Scott Balini that’s Building Social Relationships that’s a those are nice resources and then when it comes to some of the work on investigating and understanding the difference in thinking, is the web page of Michelle Garcia Winter and her book __ Social is referenced on there too. So there’s a couple good places for methods and techniques and better understanding about social skills and autism.

WILNER CUSIC:

Ok, well, Lynn, with all the information that you’ve already given us, is there anything else you would like to add before we close.

LYNN SAYRE:

I just wanted to take a minute to acknowledge that today’s discussion was focused on really a subset of individuals with autism. This is a broad spectrum and individuals can be very differently impacted. For some on the spectrum there’s an earlier more basic challenge. That’s the whole idea of even establishing joint attention and social engagement. Those are all early stepping stones and kind of basic interactions that are the foundation for the skills we talked about today. There are some different approaches that help with these early skills that are based on the one-on-one and interactive play. Generally you meet the child where they are and use their natural interest and their attention to help engage them to get these basic skills. There’s a couple models and some approaches, the DIR model of Dr. Greenspan and the RDI model of Dr. Goodstein are two models that are great if you’re working with individuals that are at this basic interaction level. That is probably discussion for some other podcast one day.

WILNER CUSIC:

Great, Lynn, with all of the information that you’ve provided us with and after parents have listened to this podcast, is okay that if they want further information they could contact you there at Logan Center?

LYNN SAYRE:

Certainly, that would be fine.

WILNER CUSIC:

Ok, at 574-289-4831, correct?

LYNN SAYRE

Correct and just ask for Lynn Sayre.

WILNER CUSIC:

Ok, thank you so much for your time.

Thank you for listening to the INSOURCE podcast. The views expressed on this podcast are the views of the person being interviewed and not necessarily the views of INSOURCE.

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