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Autism: Are Social Skills Groups and Social Communication Therapy Worthwhile?
vortex2.71 (802986) writes I imagine that enough of us on Slashdot are on the Autism Spectrum or were once diagnosed as having Aspergers that this might be the right venue for this question. My son is on the spectrum, but is in a mainstream classroom at a private school. We have spent thousands of dollars on a bunch of different social skills groups, speech communication therapy, occupational therapy, and physical therapy. We've found that the specific skills and intuition that the therapists possess is much more important than their credentials and are frequently disappointed by the overwhelming mediocrity of special education teachers, speech therapists, and OT/PT therapists. We are at the point where we wonder if our time is better spent with playdates with peers that are facilitated by us than continuing with the groups. I'm curious if there are adult Slashdoters who are on the spectrum who participated in these therapies as children who can weigh in on this? What was your experience with social skills groups and social communication therapy? Did they help?
or were once diagnosed as having Aspergers
Yes, there are plenty of self-diagnosed Aspergers people on Slashdot. Unfortunately for them, the real problem is that they are simply assholes.
I'm not autistic or have any syndrome.
I'm just a nerd.
If as you suggest the quality of therapists is all over the map, getting a "statistically significant representative sample" may require many more data points than you could get by asking /.
Not to mention that people who reply here will be self-selected and unlikely to be "representative" even if you were able to get enough data points.
Unfortunately, there are many things in this world that you have to decide whether to "buy in" to them or not long before you know if it's likely to be "worth the money" or not.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
Quit making excuses for your lack of social skills, and quit expecting the world to adapt to you.
I never asked the world to adapt to me, it can just keep out of my way.
As someone who remembers childhood. (And I am not Diagnosed being on the autism spectrum) kids (even little ones) can be very cliquey. If your child has social problems, the other kids may try to push him out of their games, as games in general about playing by social rules of play, kids with autism may not get the differences in the rules that the version the kids play and make it no fun for them. For a child with special needs play time needs to be monitored, otherwise the other kids will just end up doing their thing and he will be playing by himself, with kids around him.
If something is so important that you feel the need to post it on the internet... It probably isn't that important.
You're an idiot. No matter what your mother told you Asperger's is not the next step in human evolution. A dash of it is probably useful, but people don't usually have a dash of it, I'm not sure it would even be diagnosable at that stage. I've worked with folks that had this and it's debilitating.
Psycho-social education is probably the only thing that's likely to help. The question though is which program and which professionals. There's an array of possibilities, some might work and some won't. And to an extent it depends upon the individual, this isn't a one-size fits all treatment situation.
They are not robots, they are people capable of learning social skills, just as they can learn math, art, and other human knowledge.
The question is do we know how to teach them?
I don't know a lot, but I am willing to bet that autistic people are as different from each other as they differ from us. The whole thing is a spectrum, what works with one won't necessary work with others.
I think you original idea is correct. No particular accreditation will satisfy you. You need to talk to the specific teacher/aid and hear what they have to say, what they know, and what is their guiding principle. If they impress you go with them. If not, ignore them.
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I don't know why every other special group like gays and transexuals expects society at large to adapt to them, but I have to adapt to society?
I've never been diagnosed, a few online tests put me solidly Aspergers but that doesn't mean a whole lot. With that being said, for myself I've never been able to intuitively understand social interaction. Over time I've been able to think through social interaction and get a better handle on them.
My parents tried putting me in a learning disability freshmen orientation in college but I went to the normal orientation instead. I've found the best teacher is just time being around people. The more I observe, the more it seems to make sense.
And ultimately I've just come to the realization that we are all weird in our own way, anyone who can't handle that can stick to their own clan.
I've been diagnosed with borderline Asperberger, i.e., it wasn't specifically tested for, but 70% of other people who scored the way I did on certain tests also were diagnosed with Aspberger. I also have a son who's mildly affected, and is positively diagnosed.
This is a little off-topic relative to your questions, but here are some of the things we've found:
First, I'll say that there's no one solution here. Autism is a tough thing to put into a single box and find a prescribed set of steps for. People with autism are still people, and we're all different in our approaches to the world around us.
That said, I totally get where you're coming from. My daughter is autstic, and we've spent an enormous amount of time and money on various therapies to help her interact more easily with the world around her. Notice that I didn't say, "change her," or, "cure her," or, "make her fit in." She's a wonderful person who just has a really hard time communicating with others and dealing with the sensory load that people live with all the time. I just want to help her develop the ability to compensate for that so she can have the opportunities to interact with others that she deserves.
But as you've found, it doesn't take long before you're a much better SLP, OT, PT, etc. than the people you're paying for that expertise and help. We've gone through countless therapists of various disciplines because while they had the credentials they had absolutely no practical experience or approach to dealing with autstic people. It's incredibly frustrating for me as a parent, and for my daughter, who really needs to build some long-term relationships with people but can't count on ever seeing the same providers because they either suck, are far too heavily booked because they don't suck, or burn out and go find something easier that pays better.
There are still further questions about whether any of the therapies are effective, since we've only got the one kid and there's no control group to measure against. She's smart and makes progress on her own, and we know how to effectively help her develop because we spend so much time with her. But is she getting any value out of a 45-minute OT session with somebody who's used to helping people learn to eat after a car accident? I have no idea.
But the one thing I do believe is important is to provide opportunities for social interaction. My daughter tends to ave more successful interactions with adults because they're patient and polite and understand that they're not dealing with a standard-issue kid. But it really breaks my heart to take her to a playground. She's cute and happy and wants to meet other kids, so she goes up to them and says, "Hi!" Then the other kid says hi. And then it all falls apart. She doesn't know how to get past that, and the other kids figure out that something weird is going on. They might say one or two more things, but then they give up and wander off. It's too big a barrier to overcome in a casual encounter, and they have better things to do.
Opportunities for mediated playdates are probably the best thing, and we're trying to do more of that. But at least for my girl, equipping her with a basic set of social skills to get past the introduction and on to some further interaction is the thing we struggle with most, and the one thing she needs more than anything else right now. Some of that is communication, but most of it is ritual and nonverbal queues. I think it can be taught - scripted at first, then more natural over time - and should be a priority.
In the end, as a parent, I want my daughter to be happy in life. She's destined to be weird/quirky/odd, and I think that's OK. Like many people here, I work in a field that has a large portion of people who fit that description and I appreciate that. If she chooses to be alone, that's one thing. But I'm going to do everything I can to help her get to the point where she can choose how and when to socialize and to find the people who make her happy and comfortable. Like the OP, I'm interested in hearing from those on the spectrum who are now adults, and their path to where they are now. But please remember that not all autistic people have that choice or capability. There's a selection bias that can't be avoided in soliciting that information, so interpret the responses accordingly.
Perhaps a key part of the problem is that neurotypicals are the ones that are 'pieces of shit' that don't develop the skills to work with people who think in a manner different than their own. If they bothered to work on their ability to empathize and make themselves understood better, the lives of autistics could probably be a great deal better, in addition to society being able to benefit from more productive citizens and less citizens who are a burden.
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The appropriate way of dealing with homosexuals is to let them be themselves and to treat them equally. If your suggestion to homosexuals over the difficulties they have in society is to act like a heterosexual, then you are (correctly) seen as a bigoted asshole for doing so. However, the manner in which autism is often dealt with is to train them to resemble neurotypicals to the extent that they are not ostracized as much. What it looks like this AC is suggesting is that society actually allow autistic people to be autistic people instead of trying to shoehorn them into being like neurotypicals.
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I have twins with an Autistic Spectrum Disorder (it's hard to narrow it down because it doesn't really fit any of the DSM4 categories.) I've not found that /formal/ social skills work is very helpful. What seems to work better is finding situations where they can have positive social engagement with people who "get it". As you observed, I've found that the particular training is much less relevant than whether the person "gets" people on the spectrum. A lot of people just don't understand how kids on the spectrum think, and they never will.
For us, our church was a great resource for an understanding, friendly group of people who knew us well enough to know that the twins needed special gentleness in social situations. But I don't think that would be true of every church.
"He who would learn astronomy, and other recondite arts, let him go elsewhere. " -- John Calvin, commenting on Genesis 1
Scheduling playdates for your son is a recipe for bitterness and disappointment. Without feedback or direction for what the proper behaviour is, the end result will be ridicule and ostracism. Over and over. And this will continue into his adult life.
Since your son has no "feel" for interaction, the best you can get is an "intellectual appreciation" for correct behaviour. He has to learn the skill that everyone else will pick up naturally.
The first half is to get him to want to learn. You do this by rewards and other incentives, as outlined by any of a number of teaching methods. Sit down with him at regular scheduled intervals, be sure to show appreciation when he does things correctly, and show disappointment when he screws up. When he screws up, do the disappointment thing *quickly* and move on. Promise him a big reward at the end of a semester of these if he does well, and follow up on it (take him to an arcade, get him a specific toy, take him snorkeling in Hanauma bay, whatever.) Little rewards at intervals is good too (take him out for ice cream, his special time with his dad &c).
Make him want to change.
The second half is being able to recognize his behaviour *yourself* and communicate to him instantly. I cannot describe how incredibly difficult this is, you have to be alert for specific patterns and people are just not wired to do this. People go through their daily lives on autopilot, and don't normally evaluate what they're hearing/seeing/doing on a continual basis. It's s a difficult skill that needs to be developed through discovery and practice.
The problem with therapists is that the feedback isn't immediate. The therapist might be able to analyze and correct and connect with your son, but your son will tend to forget outside the session. Like I said, most people are on autopilot and changing the autopilot programming is hard.
When you get the ability to recognize his behaviour, simply say "ding!" when you see it.
It's immediate feedback, and when he hears it he should stop to consider what he's doing and change his behaviour. That's all it takes.
Be very clear that saying "ding!" doesn't mean you're angry with him or that he should stop or that he's being punished. It's simply a signal, and it's not meant to get him to stop, it's meant to get him to *think*. Also be very clear that he can ask you why you said it, and that there's no penalty for doing this.
Start with small, obvious behaviours such as repetitive habits or sentence construction, then slowly work into tactical advice (always look someone in the eye, always ask how they are doing, always remember their name), then into strategic advice ("never lie to a friend", "never tell something told to you in confidence"), then into planning advice (see what other people do and imitate them, dress like them, try to act like them).
Get a copy of "How to Make Friends and Influence People" (Dale Carnegie) and use it as a syllabus for what to teach. Also check out "Influence, the science of persuasion" as a guide for what to watch out for (so that others don't take advantage of him).
Best of luck to you.
I was diagnosed with Asperger's syndrome (now high functioning autism) at the age of 19. I went through 2 or 3 years of therapy (though not the therapy you described, mine was just one on one with a therapist), but what helped me the most (in my experience) is that I read an ungodly amount of fiction between then and now (I'm 30 years old now). Books really describe how people think, and I've found that if I interpret what people do based on what authors say people think in books I'm usually not far off. That is, I'm close enough that interpreting people based on what I've read in books is close enough to the truth that it doesn't lead to major social fuck ups. When I was in high-school (ie., before I was diagnosed), teachers would sometimes get mad at me for what I thought then was 'no reason', but I now understand that it was caused by my behavior.
For example, I remember one time when my 9th grade German teacher asked the class about our 8th grade German teacher, and I said that he was a huge asshole. This caused the teacher to flip his shit, but I had no idea why, because he and the 8th grade German teacher were clearly different people, so why would my opinion of the one affect the other? I now understand that my use of language was inappropriate, as well as that they were probably friends, or that it is inappropriate to shit on one teacher in front of another one in a classroom setting.
I'm basing my interpretation of my memory of what happened then on what I've read in the (among others) Harry Potter series. Interactions with teachers and classmates are explained very well there. I may not be able to intuitively feel what is the right way to behave, but because I have a good memory and because I read so much I'm usually able to determine what's going on now. So, in my experience, reading has been more fruitful than therapy.
My son is diagnosed on the spectrum (Asperger's). He's 11 (6th grade, middle school). Intellectually, he's probably about 13. Socially/emotionally, though, he's about 6. Without proper supports*, he quickly winds up socially isolating himself with his actions. The ways of making and keeping friends that come naturally to everyone else don't come naturally to him. He *wants* friends, but just doesn't know how to make them. Worse, he will interpret any sign of kindness as friendship and follow this person. This can either annoy the person whom he is now "best friends" with or cause harm to him if the wrong person uses this against him. This goes way beyond "he doesn't belong to the popular kids group and has to sit with the outcasts."
* By the way, "proper supports" also includes educating the other students so they know why my son does what he does. We all think of kids as mean individuals ready to take advantage of anyone they can, but they can also be helpful and supportive. We've had peers of his come up to talk to us when they spotted a problem that my son was having. They were concerned about him and wanted to make sure he was ok.
My sci-fi novel, Ghost Thief, is now available from Amazon.com.
The ways of making and keeping friends that come naturally to everyone else don't come naturally to him. He *wants* friends, but just doesn't know how to make them.
They don't come naturally. Those are skills you have to learn. Most end up being naturally taught, but some people miss it.
Without proper supports*, he quickly winds up socially isolating himself with his actions
Which he will always do until you teach him better social skills. Don't look at it as some medical disorder, look at it as a skill gap. I have the same problems and I'm 28. There's no one to help me now and no one ever tried. The older you get with poor social skills the worse it gets. People don't fault kids for social awkwardness, but you're a creepy crazy guy if you're socially awkward after being a teenager. People don't give you any benefit of doubt. You exist to kidnap or harass people as any mistake you made was on purpose and for some specific reason. 'Why does this person not have any friends? He must be dangerous, lets stay away from him.' Social awkwardness is a self perpetuating problem that can quickly spiral out of control into deep depression and suicide.
You won't help him by teaching others how to behave around him. You can't teach everyone he'll meet in his life. You have to teach him how to interact with others.
Worse, he will interpret any sign of kindness as friendship and follow this person.
Because everyone else ignores (or hates) him or at least that's how he sees it. When no one talks to you, that one person who does must be really interested in you. Why else would they talk to you? No one else does.
Please don't let him end up like me. Teach him social skills like you might teach someone math. Read about some specific type of communication or behavior and then practice and practice and practice it. You might have to deal with anxiety issues as well.
I'm sorry, but YOU are the idiot. Autism is not a disease. The problem is not autism, it's neurotypical people who need to have things their way. Don't be a part of a neurotypical person pointless social rituals and the little asshole will do whatever he can to hurt you. So your solution is to make sure autistic people learn a way which is not and will never be natural for them because YOU can't tolerate someone else not playing your social games? Fuck you. The best thing that could help autistic people is if YOU went to therapy to cure your social obsession.
Every fucking day of my life I have to act. I can never be myself or I will be hated. Of course I'm now quite good at acting and playing your stupid social games, but having to constantly play a role is extremely tiresome. After a simple two hours meeting with a client, which I have to do frequently because neurotypicals need to have social contacts even when working, it seems they can't think if their social instinct is not satisfied, I'm so tired I need to alone with my cats at least for a full day. Yes, it's debilitating, but it's not autism per se which is debilitating, it's me having to play your idiotic social games.
You should try to play by my rules. I'm pretty sure you wouldn't last more than a few days before saying being "neurotypical" is debilitating and need to be treated.
That isn't the only reason they do that.There are lots of reasons. People like that often like consistency. It isn't even the practice. They know that sandwich. They know what it tastes like. That isn't just people. That's everything.
If you left someone like that in an abandoned city with shopping malls full of clothing, they'd probably stock up on the same clothing rather then wearing any old random thing. Keep in mind... the city would be abandoned. No one would see them. They wouldn't care.
Anything different can be stressful. Suggesting that autism begins and ends at social interactions is wrong. And beyond that, it is important to keep in mind that autism spectrum is such a broad category that there is really nearly infinite variation within it.
For one thing, neurologically there is no autism brain pattern. To the contrary, people with such disorders have an almost random brain pattern where as people without have a much more consistent and predictable pattern. And that randomness means how things line up and actually work is basically unpredictable. People with autism spectrum have practically random wiring. And sometimes that means good things happen and more often it means either bad things or nothing at all.
My wiring... ME... My wiring is pretty random. I function just fine, thanks. But then maybe I got lucky with having wiring that wasn't terrible. I can tell you that I do have trouble with interactions but personally it is not in the way you think I'd have trouble.
See. I do understand people. I understand because I have studied them. And at will I can pass for normal. No trouble at all. It gets a little tiring if I have to keep it up for hours and hours. But you'd never know. Why is my issue? I don't feel what you feel. I have feelings. They're just not human normal. I don't respond instinctively the way that other people respond. And that means if I want to interact with the monkeys that I have to listen to their hoots and chest thumps to understand what they're trying to say. And then with great skill and practice I return the chest thumps and hoots to the monkeys and all is well.
That is how I am different. Just me. I can't speak for any of my neurological cousins. But that is what it is like to be me. Now would a class that teaches human interaction be helpful for me? Nope. Because the people teaching the class are just going to be another set of fucking monkeys and they don't know how to tell someone how to be a monkey anymore then a fish can tell you how to be a fish. People just are what they are. They don't know why they do what they do are very rarely aware of why they're doing the things they're doing. The thousand unconscious signals they send each other go entirely unnoticed by their conscious minds.
I notice however. I notice and interpret them all in real time and then give the counter signals fluently.
Do you know what it is like? Imagine being stranded on a planet with people that aren't quite human. I don't mean sub human... I just mean a different breed of ape if you will. Different smell... different body language... different sexual habits... Just different. Imagine being a chimpanzee in a world full of baboons. If you've lived with them all your life then you know how they are and what they mean when they do that thing. But you'll never feel the way they do about things. All that excitement about the bright blue asses... you'll never quite get it and more importantly you'll never care.
I don't believe the classes help. I think people with these conditions need to help themselves because they are by definition too different to be fit into some cookie cutter class that just assumes they're all on some sliding linear scale. People on the "spectrum" are not on a spectrum at all. It is only a spectrum from the perspective of normals that evaluate such people from the selfish perspective of how well such people interact with normals. Yes, it helps if you can interact with normal people. But it is vastly more complicated then that... basically infinitely more complicated.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
After being suggested by two unrelated acquaintances to look into it, I've gone to many Aspergers meetups only to find out that everything horrible that happened to me from early childhood to early 20s matched 1:1 the lives of people with Aspergers. I've come to understand these people deeply and they feel to me closer like family. The reason things changed after my mid-20s was because of Aikido. Now I can actually withstand crowds to a certain extent, and have realtime spontaneous reactions to people. It also changed how I walk - my walking actually looks human now, and so do other physical movements. This is how it happened:
One of the key factors in an Aspergers' person's life is patterns. They usually attach to patterns and become greatly disfressed during major life changes.
This happens because normal people have a main-purpose CPU for processing everyday information, and a specialized GPU for adaptive realtime behavior, such as mingling in crowds fluidly, partnered dancing, just spontaneity in general. The main CPU's emulation mode of this GPU is very very slow - it's no substitute. This truth I've ran into not only with myself, but with many Aspergers people I met in person.
And so, a person with Aspergers will spend 2 weeks pre-caching their possible reactions for a social occasion with their CPU, because their GPU is inaccessible. They cannot generate them in realtime, so they pre-cache as many possibilities as they can. If-then, if-then, if-then... And after it ends, they will spend a ton of time analyzing gathered information because it could not be done in realtime. Going over every potential mistake, and adding it to the if-then pile, for the FUTURE...
There is a way, however, to regain access to the GPU. Maybe not for all Aspergers people, but for many. There's a lever by which it can be operated, and that lever is adaptive physical movement.
Aikido is ideally suited for this, because it is a structured Japanese art which limits social interaction (a plus), is usually non-confrontational (another plus), very friendly to newcomers, and, most importantly, Aikido techniques don't work at all until you activate the GPU, and sense what's happening in your training partner's structure NOW. It FORCES your brain to restructure and reach out where you previously didn't know you could, into that unseen area where decisions are made without conscious processing. Eventually you learn to trust your GPU, just like a neurotypical human does.
Considering that Aspergers frequently comes with co-morbid conditions like PTSD from bullying, and depression, Aikido also addresses those. It has been used to treat PTSD in war veterans, because its movements retrain how we perceive conflict on a deeper level. It certainly eliminated PTSD flashbacks I had from high school after walking into every single social faux pas known to man and becoming the laughingstock of the class, that weird dude on whom you'd test your reflexes...
#Aikido4lyfe
There were four boys in my youngest sons class in elementary school on some type of ADD or ADHD medication out of about twenty five boys. I only know this because I spoke with their parents and they told me about it I have no idea what the actual percentage for the class was, I probably only ever met ten of them. He also had a couple friends a grade ahead of him that were on ADD medication.
When I was a kid it was almost unheard of for an elementary kid to be medicated like this. Now it's common place and their parents and teachers are popping Prozac and Wellbutrin like M&Ms.