The Importance of Social Skills Therapy for Autism

One of the most significant problems for people on the autism spectrum is difficulty in social interaction. The level of difficulty can be very severe (as it usually is for people with no spoken language) or relatively mild. Even mild difficulties with social communication, however, can lead to major problems with relationships, school, and employment.

Social Skills Affected by Autism

In some cases, people with autism lack very basic social skills. They may find it very difficult (or even impossible) to make eye contact, ask and answer questions, or respond appropriately with please and thank you. These basic skills, while they are not enough to support a meaningful relationship, are important tools for self-advocacy and for interacting with any member of the community.

In other cases, basic communication skills are intact, but there are gaps in understanding others' thoughts and feelings and responding appropriately. These issues, very often, are the result of not knowing what another person might be thinking. Most people can observe others and guess, through a combination of tone and body language, what's "really" going on. In general, without help and training, autistic people (even those with very high intelligence) can't.

This "mind blindness" can lead even the highest-functioning person on the autism spectrum to make social blunders that cause all kinds of problems. Without knowing why, a person on the autism spectrum can hurt feelings, ask inappropriate questions, act oddly or generally open themselves up to hostility, teasing, bullying, and isolation.

Social Skills Therapist

As autism spectrum disorders have become more and more common, a sort of industry has grown up around teaching social skills to both children and adults. There is no such thing as an association of social skills therapists, nor is there an official certification in the field. Thus, social skills practitioners come from a wide range of backgrounds and training.

In general, social skills therapists are social workers, psychologists, occupational therapists and speech/language therapists who specialize in working with autistic people. Over time, they have developed or learned techniques to build social interaction skills ranging from basic skills (such as making eye contact) to complex and subtle skills (like asking for a date).

In some cases, social skills therapists have received training and certification in a particular therapeutic method. Individual therapist/researchers, including Carol Gray, Brenda Myles, and Michelle Garcia Winner, have developed programs and materials that can be useful in teaching, practicing, and generalizing social skills.

In recent years, "do it yourself" social skills teaching tools for parents and adults on the autism spectrum have hit the market. These generally take the form of books and videos modeling different types of interactions, along with hints and tips for "doing it right." Drama therapists also work on social skills through literally scripting scenarios and/or improving and critiquing practice interactions.

How Social Skills Therapists Help People With Autism

Since there is no single official certification for social skills therapists, techniques vary. In a school setting, social skills therapy may consist of group activities (usually games and conversation) with autistic and typically developing peers. Groups may be overseen by school psychologists or social workers and may be held in the classroom, lunchroom or playground. Generally speaking, school social skills groups focus on game playing, sharing, and conversation.

Out-of-school social skills groups are similar in style but are paid for privately (medical insurance is unlikely to cover such programs). Children are grouped by age and ability and may make use of specific social skills curricula as developed by well-established practitioners of social skills therapy.

Drama therapy, a variation on social skills therapy, is somewhat unusual but where it's offered, it has the potential to be both fun and educational. Video modeling, video critiques of interactions, group therapy, and other approaches may also be available in your area and are especially appropriate for teens and adults. Typical cognitive therapy with a psychologist or psychiatrist may also be helpful.

Limits on the Effectiveness of Social Skills Therapy

In theory, social skills therapy will provide people on the autism spectrum with the ability to converse, share, play, and work with typical peers. In an ideal world, such therapy will allow people on the autism spectrum to become almost indistinguishable from their typical peers.

In fact, social skills therapy tends to be offered no more than an hour or two a week -- and while it may provide autistic learners with specific skills and techniques ("look at a person's face when you're conversing," for example) it's unlikely to make an autistic person appear typical. A program most likely to have such an impact would be very intensive, unlike the vast majority of existing social skills programs.

How to Find a Qualified Social Skills Therapist

Since there is no official certification for social skills therapists, it can be a challenge to find a qualified practitioner. Most of the best social skills therapists are not so much trained as born: they happen to be very talented therapists in their own field, with an innate understanding of how to help people with autism "get" how others think, feel, and act. Thus, the fact that someone has been trained in a particular social skills method does not necessarily make him or her an ideal therapist. Probably the best way to decide if a therapist is right for you or your child is to attend a few sessions.

Most school programs for children with autism do include social skills therapy. There is no guarantee that the person running those programs has specific training in or experience with running such programs, so it may be worth a parent's time to inquire into just who is offering such programs and why they were chosen to do so. It's not at all unusual for a school psychologist or social worker to run social skills programs with relatively little training or background.

If you are interested in finding private social skills therapy, a good idea is to start with your local Autism Society of America chapter or AutismLink, both of which offer information about local practitioners.