Children with Autistic Spectrum Conditions experience great difficulty communicating and understanding the communication of others. Speech Therapy can help these children to gain skills to improve their functioning in every day life. This post explores the efficacy of conventional Social Skills Interventions and looks at promising new approaches to Speech Therapy for Children on the Autistic Spectrum.
The prominence of Social Skills Groups
Speech Therapists often target Social Skills. Around 70% of these Social Skills Interventions are taught in group format. Group Therapy is typically taught in a therapy office or the classroom, often using role play and work sheets to directly teach social skills such as Greetings and Starting a conversation. Around 14 percent of all Autistic Children are currently using a social skills group. This figure almost doubles when looking at children with Higher Functioning Autism or Aspergers syndrome.
Are they working?
Unfortunately, there has been a major lack of research into the efficacy of Social Skills Interventions. This is a major omission, considering the widespread use of social skills groups for children with Autistic Spectrum Conditions. The most major review, a meta analysis of 55 studies found that they are 'minimally effective'. Considering this is currently the main method of teaching social skills to children with Autistic Spectrum Conditions, this is a concerning finding.
What's the problem?
Research suggest that generalisation of skills from one area to another is poor. Children with Autism find it difficult to transfer skills they have learnt from one setting to another. Social skills are taught in artificial settings that do not come close to replicating real social experiences. Children are taught to apply social skills mechanically, for example, learning scripts such as 'What did you do this weekend' in a quiet, controlled environment. Although these are valuable skills, they do not tend to transfer easily to real life contexts.
Lack of engagement may also be a contributing factor. Research has failed to explore whether children are enjoying and engaging with social skills sessions. From our experience as therapists, social skills groups can be unpopular with children with Autism. Just as children who struggle with numeracy often dislike maths lessons, children with social skills deficits tend not to enjoy group work and forced social contact. If we are serious about supporting children to make progress with their social skills, we need to trial new approaches to delivery that make the experience a more positive and engaging one.
What are the alternatives?
Video modelling uses film to model appropriate social behaviour. It works with children with Autism's typical strengths in visual learning and a preferred leisure activity (watching visual media). Research has found it to be an effective direct teaching strategy when used to deliver a social skills programme to children with Autism. For more information on video modelling click here.
A recent study has found that training peers has led to greater gains in social inclusion than traditional 1:1 Social Skills Training with a Speech and Language Therapist. Peer Training involves teaching classmates of children with Autism how toengage and interact with children with social communication difficulties. Training sessions lasted for 20 minutes, twice a week for six weeks
Rock Climbing Therapy is a promising new approach to teaching Social Skills. Rock Climbing has traditionally been used by Occupational Therapists to improve motor skills and co-ordination. It is now beginning to be utilised for its social communication and psychological benefits. Through Climbing Therapy, children work on topics such as understanding emotions, turn taking skills and how to start a conversation in a naturalistic environment. Climbing Therapy is a particularly exciting approach for children with limited language who are unable to access conventional talking therapies. Climbing Therapy is delivered by Specialist Speech Therapists who also hold a climbing instructor qualification.
Looking to the future
Social skills deficits have wide ranging implications for children with Autistic Spectrum Conditions. Social demands increase as a child gets older, resulting in social isolation and commonly, associated mental health difficulties. Direct teaching of social skills through groups is likely to remain an important aspect of Speech Therapy for children with Autism. However, it is essential that we continue to investigate engaging methods of delivery that provide support and opportunities to apply newly learnt social skills to real life contexts.
This blog is created by Hannah Broughton and Caspian Jamie. Caspian is a Private Speech Therapist and Hannah is a Child development Specialist We have our own company, The Therapy Adventure Limited and live in Ramsbottom, Manchester with our daughter.