Rethinking Social Skills

Over the years, my thoughts and opinions around social skills teaching have changed a great deal. Reading and listening to the viewpoints of autistic people has opened my eyes to the problems that social skills training can cause over time such as masking. When autistic thinking and neurology are not taken into account, social skills tend to be taught for the neurotyical brain. Judy Endow expresses this point well in her blog post Autistic Processing of Social Information:

When I was younger and deemed “in need of help” that “help” largely involved others trying to teach me to think and act as if I had a typically wired brain. I was never very good at it because no matter how many therapeutic social skills situations I availed myself of, because they were taught as if all participants had a neurotypical brain and my brain was not neurotypical, I mostly failed their learning agenda for me. My brain just plain works differently.

Sonny Jane, consultant and lived experience educator says:

“It’s not that being autistic affects our social skills. It’s that being autistic means we have a different way of socializing that needs to be understood and accommodated. Often, things we see as social skills are neurotypical expectations or rules like making eye contact or making small talk.”

Judy Endow has helped me to understand why social skills programs have not worked for my autistic children who are now 25 and 23. While my children have learned many skills and improved, they continue to struggle in new social situations. My son loves being around people and going out and about in the community, but he has communication difficulties and is echolalic. My daughter experiences high social anxiety when having to mix with people even though she wants to be engaged and involved. My attitude now is about trying to understand and learn more about supporting their unique communication styles, thinking, how they express themselves, and how I can help them and the people they interact with make social situations satisfying experiences for them.

What’s Missing from Social Skills Training 

Social skills encompass a number of areas such as play skills, conversing, emotions, problem solving and friendships/relationships. They can help a person know how to act in different social situations, make friends, learn from others, develop leisure interests, foster relationships, and support mental health and well-being. However, we have to think about how we are going to support and interact with an autistic person in social situations, respecting who they are and how their communication style which is comfortable and natural for them.

Ira Kraemer, an autistic self-advocate, created a list of 5 things that they feel are missing from most social skills training:

1. Interoception and Alexithymia – Do I feel uncomfortable? What am I feeling?
2. Sensory Recognition – Do I need sensory supports?
3. Taking Action Based on Feelings – Do I need to leave the situation because I’m uncomfortable?
4. Consent – Are the people around me listening to what I need and respecting my boundaries?
5. Acceptance – Am I allowed to be myself around these people? Do I feel safe?

Ira says, “And here’s the main reason why “social skills training” makes no sense to me: There is no neurotypical formula for social interaction.” They also stated, “We need to be told that there is space for us, a place we can feel safe, and people we can trust. It’s up to you to help us find that, and not give us “training” that will subliminally blame us for living in an unaccommodating world.” Ira’s perspective has given me a lot to think about because I never want to send the message that someone needs to change who they are to try and fit in.

The Double Empathy Problem

Dr. Damian Milton, autistic researcher and lecturer in the UK, brings up the important point of the double empathy problem in social interactions. He says, “Whilst it is true that autistic people can struggle to process and understand the intentions of others within social interactions, when one listens to the accounts of autistic people, one could say such problems are in both directions.” The issue of empathy problems between autistic and non-autistic people being mutual in character has led to the development of the ‘double empathy problem’ as a theory – and it makes sense.

According to the theory of the ‘double empathy problem’, these issues are not due to autistic cognition alone, but a breakdown in reciprocity and mutual understanding that can happen between people with very differing ways of experiencing the world. If one has ever experienced a conversation with someone who one does not share a first language with, or even an interest in the topic of a conversation, one may experience something similar (albeit probably briefly).

Communication is a two way street and non-autistics also need to understand different communication styles in the neurodiverse world. Dr. Milton states that attempts to reduce autistic ‘symptomology’ may not lead to increased well-being, and the lack of understanding and resultant stigma felt by autistic people in social environments can then impact upon mental health, employment, accessing education and services, and experiences of the criminal justice system. It is minorities that are socially marginalized in the double empathy problem.

How can we support and improve social outcomes?

I think we can start by deepening our own understanding of autistic neurology. Peter Vermeulen in Belgium has written about autism as context blindness. His work demonstrates that the autistic brain tends to predict and treat prediction errors in an absolute rather than relative way. This is not good or bad…just different, but it has an impact on how a person understands and processes social information.

We can learn about alexithymia which is a term that is used to describe when someone has difficulty identifying their feelings – or more specifically identifying and describing their emotions. Alexithymia doesn’t mean that a person lacks emotions, it just means that they have a hard time figuring out exactly what emotion they’re experiencing and sometimes even putting words to that experience. Not understanding one’s emotions has a huge impact on social interactions.

Teaching interoceptive awareness can help an autistic person identify the feelings they are having via their internal body signals. While this can take time to develop, the effort is worth it because the research shows that:

Within 8 – 10 weeks, there are:

· decreases in heart rate during interoception activity
· decreases in externalizing challenging behaviors
· increased engagement in learning
· increased prosocial behaviors—kindness, helpfulness, connections to others

Over 16+ weeks:

· decreases in stress
· helps with managing anxiety
· promotes caring and empathy

My daughter began to understand and interpret these internal body signals about 3 years ago, and her awareness continues to grow. She knows when she is anxious and has her calming strategies in place for herself, accessing what she needs independently before things escalate. She also said something so revealing – that during elementary school she only felt two things: happiness and ‘blank’. Feeling ‘blank’ was part of the reason she withdrew from social interaction throughout her elementary years.

I would also look at Kari Dunn Buron’s work that supports systematic thinking.  She is co-creator of The Incredible 5 Point Scale. She has a new updated book out for adolescents and young adults called Social Context and Self-Management: A System for Clarifying Social Information for Adolescents and Adults which uses scales as a way of explaining social and emotional concepts to someone who might struggle with such information, but have a relative strength in understanding systems.

If you want to learn more about using systems to teach social and emotional information, consider watching Kari Dunn Buron’s webinar on this topic.

What Has Worked for Our Family

In hindsight, now that my children are young adults I can see what really worked for their social engagement opportunities and skills which also supported their happiness and well-being. For my daughter, the most effective things were:

• Reading aloud to a dog every week at a public library program starting at age 9
• Volunteering at an organization that supports her interest in cats
• Becoming a puppeteer at age 18
• Writing stories on the WattPad website
• Participating in various community programs like adapted fitness, curling, yoga, and art classes.

For my son, the most effective things were:

• Volunteering at a Farmers’ Market which also had the added benefit of expanding his limited diet
• Horseback riding
• Tutoring class at the university
• Music classes
• Attending music concerts – you see the same people at most of those events and get to know them over time.
• Drum circles

I’ve always taken my children everywhere with me, which has provided many teachable moments over the years. I’ll continue to write more on social skills in future blogs as this is a vast and complex topic.