Slide 1: Social Skills - VCU Autism Center



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This lecture was produced for the VCU-ACE Foundations of ASD Course. The transcript is intended for use by participants in the online course. Please do not disseminate this material without the permission of VCU-ACE staff.

Slide 1: Introduction

Hi, my name is Sue Palko. I am the training coordinator at the VCU Autism Center for Excellence. I will be presenting on social skills.

Slide 2: Social Skills

• Social skills are the behaviors we use when interacting with other people and our environment.

• Social skills help us to either have positive experiences or negative experiences.

• Social skills are a core component of development.

• Deficits in social functioning often create challenges for people with autism.

I want to take a minute to explain what I mean by social skills. In order to fully understand ASD and the impact the disorder has on the person, we must understand the word “social.” Many people, when they hear the term social skills, will think about one area: friendships or relationships. As you will learn in this presentation, social skills encompass so much more. Social skills are the behaviors we use when interacting with other people and our environment and help us to either have positive experiences or negative experiences For example, if Jack talks loudly on his cell phone in the middle of the library, this is an example of a social situation that will lead to a negative experience. If Jack opens the door for an elderly person, this is a social situation which can lead to a positive experience.

Social skills are always present. For example, if I meet a group of friends for dinner, attend a class, or even go to the bank by myself, I still need to demonstrate social skills. As mentioned, social skills are always present and are a core component of development. We need to develop socially in order to successfully interact with others. Deficits in social functioning can lead even the highest-functioning person on the autism spectrum to make blunders that may cause all kinds of problems in the home, school, and community.

Slide 3: Consider a wedding

Social skills are situation-specific and change depending on your age, gender, culture and even the setting or environment.

Let’s look at an example of a wedding reception. Take a minute to visualize a wedding reception in your head. Chances are there is some type of food at “your” reception. Your wedding reception might also share some commonalities with mine, such as the bride and the groom’s first dance and the tossing of the garter and the bouquet. But, depending upon different religions or cultural backgrounds or region of the country, all of these things might look different. I grew up in western Pennsylvania. Wedding receptions in western PA consist of a full meal with an open bar, followed by the best man making a toast to the couple. After dinner the couple has their first dance as husband and wife. Some of this might sound familiar to you. Toward the end of the evening there is a bridal dance. The bridal dance is when the guests pay to dance with the bride. A polka is usually played; people tie their paper money into a knot and wait in line to dance with the bride. When it is your turn, you give put your money into an apron that the maid of honor is wearing. You then get “one spin” with the bride. After your dance with the bride, you go over to where the best man is standing. If you are a woman, you get a piece of cake and if you are a man, you get a shot of liquor. As the bridal dance is coming to an end, everyone forms a tight circle around the bride. The groom then tries to make his way through the circle to get to his bride and carries her away.

My best friend is also from western Pennsylvania and was married in Virginia. She attempted to incorporate the western PA traditions into her VA wedding. She wanted to have a bridal dance. When it came to the point in evening to have the bridal dance, some of the guests knew what to do. The guests from western PA, like her family and some friends, were comfortable with the situation. Those who had never done it before had varied reactions. Some asked questions and tried to follow along. Others chose to watch, while some gave a strange look and went back to their table or engaged in conversation and ignored what was happening. In this situation everyone did the best they could with the information they had and everyone’s comfort level was different.

I just gave you an example of a social situation many of us have attended, a wedding reception. In this example you can see that the region of the country played a part in whether people knew the expectation for the different wedding reception activities. It demonstrates how social skills can change based upon the location.

Think for a minute about an example that applies to most of us. Think about answering your cell phone. Do your social skills change based upon who is calling? Do your skills change based upon where you are located when the phone rings? Most of us would answer yes to both of these questions.

Slide 4: Deficits in Social Skills

• Deficits in social functioning is the hallmark characteristic of ASD.

• List areas in which individuals with ASD might experience challenges with social skills.

• Examples include joint attention, play skills, turn taking, social rules, friendships and relationships, and emotional development.

Deficits in social functioning is the hallmark characteristic of ASD. Individuals with ASD, like us, may experience social misunderstanding and confusion which might lead to social mistakes. I would like for you to take a minute to pause the presentation and list areas in which individuals with ASD might experience challenges with social skills. I hope you took a minute to create your list. If you did, some of the areas you might have listed are: joint attention, play skills, turn taking, social rules, friendships and relationships, and emotional development. In the next few slides we will discuss each of these areas.

Slide 5: Joint Attention

• Joint attention is one of the earliest signs we see in individuals with ASD.

• Joint attention requires you to move your attention between you, another person and an object. It is one of the foundations of communication and social skills.

• In 1994, Osterling and Dawson did a classic study on joint attention.

• Four behaviors (pointing, showing objects, looking at others, and orienting to name) were not present in 10 of the 11 children with autism and were present in 10 of the 11 children who were classified as typically developing.

• Not only do individuals with ASD not initiate joint attention, they often do not engage in it when others initiate it.

Let’s start by talking about joint attention. Joint attention is one of the early signs we see in individuals with ASD. Joint attention requires you to move your attention between you, another person and an object. In other words, it is sharing attention with another person. For example, when you see something you want to share with someone else, you look at the person to get their attention and look at or point to the object, therefore directing the other person to look at the object. Young children do this with their parents or care takers when they see something they want to share. It is one of the foundations of communication and social skills.

Osterling and Dawson did a classic study on joint attention in 1994. They looked at videos of first birthday parties. Some of the participants in the study had autism and some were typically developing. The video showed four behaviors that were not present in 10 of the 11 children with autism and were present in 10 of the 11 children who were classified as typically developing. The behaviors were pointing, showing objects, looking at others, and orienting to name. The most well-known example from this study is that the children with autism did not look at their parents and then point to the candle on their birthday cake. In other words, they did not demonstrate joint attention even though it was a very novel and exciting event! Think about how a typically developing one year old would respond with a lit birthday cake, a clown entering the room or gifts being presented.

Not only do individuals with ASD not initiate joint attention, they often don’t engage in it when others initiate it. For example, when a parent points and says, “Look!” the child should attend and look in the direction of the point. Or when a parent says, “Look, a puppy, a puppy says ruff, ruff.” The child may hear the parent say, “Ruff, ruff” but not understand that it is the puppy that says, “Ruff, ruff.” They did not follow the parents lead to look at the puppy. The child misses the connection between seeing the puppy and hearing what the puppy says. This inability to make these connections can affect them throughout their life.

Slide 6: Importance of Joint Attention

• Why is joint attention important?

• Joint attention is a core component of how we learn.

• Joint attention is required to learn communication.

• Joint attention is the foundation of social competence.

So why is joint attention so important you ask? It is important for many reasons. First, joint attention is a core component of how we learn. We learn by watching and engaging with others. Think about how we teach. In math, for example, we direct the student’s attention to a word, operation, or a formula and then explain how to use the formula. Without joint attention, the student will miss key information. Think now about how we may learn skills that are not directly taught. Jasmine, a kindergartener, may hear a classmate on the playground say, “I love basketball.” This results in Jasmine trying her hand at basketball. Jared, a high school student, determines who he will ask to the prom based on the looks he receives from the girls in his history class.

Second, joint attention is required to learn communication. Think about a young child and his mother presents a stuffed animal to him and says “bear”. Through joint attention, the child learns that the brown fuzzy thing is a bear and he eventually begins to verbally label it.

Finally, joint attention is the foundation of social competence. It is a predictor of a child’s interest in sharing an experience with another person. If you don’t attend to others in a social situation, then you are missing much of what is happening in that situation. Think about how you change how you interact with someone based upon what is happening around you and the nonverbal communication that person sends you. For example, how you interact with a person at a party and how you interact with the same person when you see them at the grocery story is probably different.

Slide 7: Examples of Deficits in Joint Attention

On the next couple of slides you will see examples of a lack of joint attention. In the first video you will see a toddler playing with a toy. Notice the adults laughing and having conversations in the background. The little girl plays with the toy but does not engage in joint attention with any of the adults, even when one of the adults puts a ball down right in front of her.

Slide 8: Video Example of Deficit in Joint Attention

Slide 9: Examples of Joint Attention

In the upcoming clip you will see a young man who has a deficit in joint attention. He is engage in a conversation about movies, which is an interest of his. But he appears to be uninterested in the movie the adult is talking about.

Slide 10: Video Example of Deficit in Joint Attention

Adult: Hey ya know, I just saw a movie the other day.

Boy: Really?

Adult: I did.

Boy: What it called?

Adult: Well I saw it on TV. I didn’t go to the theater. Do you ever watch movies on TV?

Boy: Yeah

Adult: Yeah? I saw a movie it was called “Million Dollar Baby”

Boy: Oh, well that’s from Warner Brothers Pictures

Adult: Have you seen that one before?

Boy: No, I don’t like that one.

Adult: I did go to the theater the other day and saw a movie.

Boy: Really?

Adult: Ah huh

Boy: That’s great.

Slide 11: Emotional development

• Emotional development is critical to successful interactions with others.

• Individuals with autism have a difficult time identifying emotions in themselves as well as identifying the emotions of others.

• Individuals with autism often have difficulty expressing their own emotions.

• Emotional regulation is a key component of socialization.

• Individuals with ASD lack the skills to read other people’s emotions.

Emotional development is critical to successful interactions with others. The ability to identify, express and regulate emotions, and to read and interpret social cues contributes to developing friendships, as well as to interacting with others and the environment. I will discuss each of one of these skills

I’ll start by talking about identifying emotions. If I asked you to identify five emotions you might list: happy, sad, scared, mad and excited or similar emotions. But there are many more emotions. There’s an ongoing list of emotional states we can feel at any given time. Let’s look at excited for a minute. Before you feel excited you probably feel anticipation and stimulated, and then excitement. Individuals with autism have a difficult time identifying emotions in themselves as well as identifying the emotions of others. Additionally, they often have difficulty expressing their own emotions. I once heard Ros Blackburn, a person with autism, speak and she described how she expresses emotions. She said, “When I see a trampoline, I jump up and down, scream and flap my hands. When I see a dog, I jump up and down, scream and flap my hands. I absolutely love trampolines and I am deathly afraid of dogs.” If we didn’t know her, we would never know that she is expressing completely different emotions. Challenges with expressing emotions may look different from person to person. Bradley often has the same, flat expression on his face, whether he is sad, happy, or excited. Amala frequently cries when she is sad, angry or even slightly frustrated. Jesse typically demonstrates appropriate behavior in response to his emotional state but is unable to verbally tell a person how he feels or why.

Emotional regulation is a key component of socialization. Have you ever been around someone who appears to go from low key and fine to upset in a matter of seconds? I supported a young man with Asperger’s syndrome who would enter the classroom and be fine. He would greet those around him, turn in his homework and get ready for class. If it was a day when he got a test or an assignment back and did not get a grade he thought he deserved, he would quickly go from being calm to yelling at the teacher and classmates around him. My point here is there are many different emotions between content and angry. This young man went from calm to very upset in a matter of seconds. This could easily impede him from making friends and interacting successfully. Each of us regulates our emotional state continuously throughout the day. If we receive an email that upsets us, hopefully, we become calm before responding. If we have someone cut us off in traffic, we refrain from aggressively chasing them down the road. Similarly, if we’re at work and hear that our colleague had her baby, we may get excited for a few minutes, then calm and return to work. Emotional regulation is a part of our day and a part of our social development.

So, if you have a hard time identifying emotions within yourself and have difficulty expressing emotions in a way that most people can interpret them, are you going to be able to read the emotional states of others? Probably not. Reading others’ emotional state can be tricky. You have to look at their eyes, their mouth and body language (e.g., Are their arms crossed? How are they standing?). All of these things give us clues to tell us how someone is feeling. Individuals with ASD lack the skills to read other people’s emotions. We have to teach them how to do this.

Slide 12: Social Rules

• We follow formal and informal social rules to fit in and to be accepted.

• Examples of formal rules include laws and regulations or rules.

• Individuals with autism may struggle learning formal rules or may be very rigid when using them.

• The other type of social rule is the informal rule or “hidden curriculum.”

• The hidden curriculum refers to the norms or social expectations associated with a particular setting or event.

• Understanding and following informal rules can be very challenging for individuals with ASD.

There are formal and informal social rules within our society. We follow these rules in order to fit in and to be accepted. We find that individuals with ASD have challenges following rules, especially if they are not directly or explicitly stated or written out. This is not due to noncompliance, but instead, is because they don’t always know or understand the rules!

Examples of formal rules include laws and regulations. The speed limit and laws against stealing or harming another are examples. Other examples include rules that are written or specified. In an elementary classroom, you may see rules posted regarding staying in your seat and asking the teacher to use the restroom. When it comes to learning the formal rules, some individuals with autism will struggle. For those who do learn the rules, they often can be very rigid when using them. For example, Alisha went to the movies with her mother. Her mother placed snacks and a soda in her purse. The sign at the theatre read, “No outside food or drink allowed.” Alisha would not enter the theatre until her mother had thrown away the snacks. Additionally, individuals with autism have to follow the rule the same way every time they do it, even if it needs to look a little different in different situations. The example that comes to mind for me is from the movie “Temple Grandin.” In the movie Temple’s mother taught her that when she meets someone she is to look at them, shake their hand and say, “Hi, my name is Temple Grandin.” This is an example of a proper greeting, right? However, this is not what you do when you are in a room of five or more people. In this instance, you introduce yourself to everyone at once. You don’t have to go around the room shaking each person’s hand and saying your name. This is an example of knowing the formal rule but not knowing how to deviate from that rule.

The other type of social rule is the informal rule. Some people in the field refer to this as the “hidden curriculum”. Brenda Smith Myles is credited for talking about the hidden curriculum as it associates to autism. The hidden curriculum refers to the norms or social expectations associated with a particular setting or surrounding a particular event. It can affect things such as social interactions, safety and how well a person does in school. Examples of unwritten rules include rules we abide by in the restroom. No one explicitly wrote them down, yet we instinctually know them. Other examples are rules when walking in a hall, appropriate behavior in a movie theatre, and entering a restaurant. When is the last time you went to a restaurant, pushed in front of the five people who entered before you, sat down at a table with strangers and started eating their food. We don’t do that. These are rules we just know!

The unwritten or informal rules can be different in different environments. For example, how to dress in one school might not be the same as in another. How you ask to use the restroom may vary from the classroom to the cafeteria. How you get to your next class in high school may depend on whether you are walking in the senior hall or freshman hall!

Difficulties with understanding the hidden curriculum are tremendous! Here’s an example of how it might impact school performance: a young man with Asperger’s syndrome is standing in the hall with friends before class. One of his friends walks up to the group and tells them that he got a “B” on his science test. He curses when he talks about the class and the teacher. Jake, the student with Asperger’s syndrome goes into his English class. He goes to turn in his homework and realizes that he forgot it in his locker. He asks the teacher if he can go get it and the teacher tells him “no.” Jake turns to walk back to his seat and curses at the teacher. The teacher sends him to the principal’s office. Jake does not understand that it is okay to swear in front of your friends but not in front of the teacher. Unless someone teaches Jake that it is okay to swear in front of his friends and not in front of adults, it is likely that the teacher’s perception of him will change. This incident has the potential to cause a problem for him socially as well as academically.

Slide 13: Friendships

• Having difficulty making friends is not the same as not wanting friends.

• A friend is someone who enhances a social situation. It is someone who you like, can trust, and enjoy at a more intimate level.

• Reciprocity refers to the back and forth nature of relationships.

• Reciprocity is a critical component of friendship.

• Some individuals with autism do not understand the social aspect of friends, reciprocity, or the meaning of friends.

Another area that individuals with autism can experience difficulty is making and keeping friends. Before I talk about why they can have difficulty making and keeping friends, I want to make the point that having difficulty making friends is not the same as not wanting friends. Many individuals with ASD express the desire to have friends and be involved in personal relationships.

I want to begin by defining the word “friend.” In its simplest form a friend is someone who enhances a social situation. I have some friends I enjoy going to museums with and others that I like to mountain bike with and still others that I attend concerts with. Why? Because each of my friends are different. I would never take my “museum” friend mountain biking with me, because she is not interested in it and won’t enjoy it. In other words, it would not be fun for either of us. However, I do choose to do these activities with certain people, because I enjoy their company and they enhance the situation for me.

A friend can also be defined as someone who you like, can trust, and enjoy at a more intimate level. In other words, there is a personal attachment. Individuals with autism often want friends; they just don’t know how to make friends. They have a difficult time understanding the finer points of a friendship. They have a difficult time understanding the social aspects of a friendship! You know the things we do in order to make a friend or keep a friend. We treat our friends nicely. For example we might call them to see how they are doing or how their week is going at work or school. We listen when they are having a bad day. We share good things that have happened in our lives. We also talk to them about common interests. All of this is to say, there is a benefit for me and a benefit for my friend. It’s called reciprocity.

Reciprocity refers to a situation being mutual or equal. It refers to the back and forth nature of relationships; what is commonly referred to as tit-for-tat! Reciprocity requires the person to be attentive and responsive and an equal partner in the relationship. Reciprocity is a critical component of friendship. While it is unrealistic to think all friendships are equal and completely mutual, there is still a level required of most any relationship.

Some individuals with autism do not understand the meaning of friends. I asked Bradley if he had friends and he stated, “Yes, I have 23!” and proceeded to name every student in his class. Others may have friends but not develop the friendships on an intimate level. Jesse has two friends from his neighborhood. When asked why they are friends, he will say, “Because they like to play the same video games I like.” Still, others with autism tend to treat people around them like objects without social regard. They may interact with others primarily by taking them by the hand and leading them to an item they want or need. This might have to do with some of the communication delays we discussed in the last presentation. On the next slide we are going to talk about Theory of Mind and the potential effects it can have on individual’s ability to make and keep friends or be in a relationship.

Slide 14: Theory of Mind

• Theory of Mind is when you know that another person has beliefs, feelings, intent or desires and these beliefs, feelings, intent, and desires may differ from yours.

• Individuals with ASD have deficits in Theory of Mind.

• Deficits in understanding nonverbal language and deficits in joint attention impact a person’s Theory of Mind.

• Theory of Mind helps us to respect others and to understand why people may have different thoughts, ideas and beliefs than we do.

Let’s talk about Theory of Mind and what it means. Theory of Mind is when you know that another person has beliefs, feelings, intent or desires and these beliefs, feelings, intent, and desires may differ from yours. An example of this is if I see a person at the grocery store in the organic food aisle. I can deduce the person eats healthy or is trying to lose weight. I love the Steeler football team. However, if I hear a person shout, “Go Chiefs!” I recognize there are other teams people may like. I may even wonder if the person is from Kansas City and conclude he wants the Chiefs to win the Super Bowl. I am able to use Theory of Mind to understand the person’s beliefs and desires. Let’s say that I show you a marker box and ask you what you think is inside the box. You would probably say (pause), “Markers.” I open the box and show you that it contains pipe cleaners. I then tell you that I am going to show Joe, your friend, the box. I then ask to you, “What do you think Joe is going to say is in the box?” You answer, “Markers.”

Individuals with ASD have deficits in Theory of Mind. If I were to go through this exact same example with a person with autism it would look and sound more like this: I show the person with autism a marker box and ask him what is in the box. He says, “Markers.” I open the box and show him that there are really pipe cleaners. I then tell him I am going to show Joe and ask, “What do you think Joe will say is in the box?” The boy answers (pause), “Pipe cleaners.” The individual with autism cannot separate what is in his mind and what he thinks his friend will say.

In the presentation on communication we discussed deficits in understanding nonverbal language. Earlier, we talked about deficits in joint attention. Both of these impact a person’s Theory of Mind. For example, Bradley has Asperger’s syndrome and asked his mother for a drink. His mother told him to wait. Bradley became upset. His sister was lying on the ground, had a sad look on her face, and was holding her knee. Bradley’s mother pointed to his sister and said, “Tanya’s hurt, I need to help her right now.” Bradley did not show sympathy but instead became upset because he was unable to get his drink. Bradley was not able to demonstrate Theory of Mind and understand his sister was sad. Additionally, he had a difficult time understanding her facial expressions and body language and did not demonstrate joint attention. As you can see, deficits in joint attention and Theory of Mind can have a tremendous impact on the person with autism. It can result in rigid thinking. The person with ASD may think everyone should believe what they believe, regardless of the topic. Further, he may think everyone knows the same information he does. Bradley, who loves birds, will frequently ask me whether I like the Cerulean Warbler or the Green-tailed Towhee better, not realizing I do not know many of the birds that are native to Virginia nor do I have a strong preference or opinion about them!

Theory of Mind is critical for a variety of reasons. Theory of Mind helps us to respect others and to understand why people may have different thoughts, ideas and beliefs than we do. Through our Theory of Mind, we are able to make sense of people’s actions. Bradley was unable to make sense of his mom’s actions in the example I shared. Theory of Mind helps us to negotiate with others. It helps us to collaborate with others. By listening to the thoughts of others, we are able to expand on our own way of thinking. Boy is in middle school and has AS. He has challenges working on a group book report because he is unable to realize that the other students have different opinions and answers. Because of his limitations in Theory of Mind, he is unable to collaborate effectively and does not benefit from the knowledge of his classmates.

Limitations in Theory of Mind show up in other ways as well. I worked with Mary, a student with Asperger’s syndrome, who, when I would lean down to talk to her in the morning, would yell, “Your breath always stinks like coffee!” She did not think about how I would feel. Limitations in Theory of Mind can frequently lead to lack of sympathy or empathy and affect the way people interact with the person. On the next slide we will discuss how deficits in social skills can affect the person with ASD with respect to play and leisure skills.

Slide 15: Play and leisure skills

• Individuals with autism frequently do not have appropriate play and leisure skill

• Play and leisure skills may be very limited.

• Play may be very repetitive

• For the child with autism, creative play may not develop or may develop but may be centered on an area of interest.

• Interactive play with peers is also impacted.

Individuals with autism frequently don’t have appropriate play and leisure skills. Skills in this area often do not become more sophisticated over time. We use the term play in reference to young children and leisure for adolescents and adults. We have play and leisure skills that we do in isolation and some we do with others through interaction. For the person with autism, both are often impacted.

Play and leisure skills may be very limited. For example, Jasmine only plays with one doll and ignores her other toys. Jesse only plays video games. Additionally, play may be very repetitive. When Jasmine plays with the doll, she pushes it around the house over and over in the stroller. Bradley likes Legos and builds the same structure repetitively. He also removes the cushions from the couch and builds a fort every night. A young child might be overly engaged with one particular part of a toy rather than playing with the toy as it is intended to be played with. A common example of this is a child spinning the wheels on a truck or a car rather than pushing the car and engaging in pretend play such as pretending he is driving somewhere.

As children age, play should become more creative involving pretend and imaginative activities. For the child with autism, creative play may not develop. For others, creative play may develop but may be centered on an area of interest. For example, Jesse loves dragons, so each time he plays the theme always involves medieval heroes slaying dragons.

Interactive play with peers is also impacted. If the child has interactive play, it might be centered on his interest. As noted earlier, Jesse only plays the video games he likes with his friends. Individuals with ASD may direct those who are playing with them instead of engaging in “give and take.” I taught a young man who was very interested in “The Wizard of Oz.” When the class was at recess he wanted the other kids in his class to act out different scenes from the movie. He did not pick up on the fact that fifth graders are not interested in acting out the “Wizard of Oz”. Without intervention this young man might have been socially rejected by his peers. He had other interests that his peers had. He simply needed to know the social rules.

In the video example on the next slide you will see a child with ASD who lacks interactive play skills. Then you will see a video interview with the child’s teacher explaining this deficit and the impact it has on the child with ASD.

Slide 16: Video

Slide 17: Video

Slide 18: Summary

Now that we have talked about both the communication and social challenges individuals with ASD have, I hope you can see how the two are connected and are evident during the early childhood years. In the next presentation we will discuss how autism affects behavior.

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