In today’s video blog, I’m going to discuss why I focus so little on teaching social skills to very young children with moderate to severe autism.
In addition to social communication deficits, the second component of getting an autism spectrum diagnosis is restricted and repetitive patterns of behavior, interests or activities. Kids with autism are usually rigid. They sometimes like to line up things, many engage in self-stim behavior such as rocking and hand flapping and many older kids with autism have specific interests that are odd or unusual.
Since social communication and interaction is thought to be the central deficit in children with autism, many people wonder why I focus so much on increasing language and reducing problem behaviors and why I focus so little on social skill intervention in young children with moderate to severe autism with major language delays. I do want to give a disclaimer here that the spectrum of autism is very wide and my books, my consulting work and my online courses mostly address the needs of children, teens, and adults who are significantly impaired. I also want to be clear that each child needs a thorough assessment of his skills and deficits and an individualized plan of care.
So with that in mind, why so little focus on teaching social skills to young children with moderate to severe autism.
Let me tell you about one of my former clients, I’ll call him Joe. When I first started with Joe, he was just turning 2 years of age and just diagnosed with autism. He used to carry around straws all the time.
That was his big thing. He’s would carry around straws, wave them in front of his face, and liked to put them into clear bottles. The first time I came to Joe’s house, he came to the door with a straw in his hand. Some kids carry around a blanket in a similar way. Some kids like other things, but Joe liked straws.
Parents and professionals often recommend and/or choose classroom placements and group instruction even for little kids like Joe because they believe the child needs socialization and exposure to typically peers. But putting Joe and young children like Joe with little to no language into a classroom full of typically developing or even in with preschoolers with special education needs without 20-25 hours a week of 1:1 ABA instruction is not recommended.
For example, If Joe’s mom would have chosen to put Joe who was 2 with a new diagnosis of autism within a daycare or preschool situation without any therapist to shadow him for socialization instead of opting for a 20 hour per week 1:1 intensive ABA program, what Joe would have probably done is played with straws or played repetitively with available toys over and over again. He may not have caused a fuss as long as no one tried to intervene and take those items away, but if they would have made Joe participate in circle or craft time and taken away straws and other items, they would have more than likely caused Joe to tantrum.
Another thing I see with some kids who are placed in a preschool situation before they have the needed pre-requisite skills in language and social abilities, especially if the child goes alone without a well trained ABA therapist to shadow him, is that these kids usually they sit away from the other students and do not engage in any meaningful play or language activities. They tend to pick toys that they can play with repetitively and in essence, they engage in self stim behaviors while they sit to the side of the room. Without some language and imitation skills, exposure to other children is usually just that — exposure with no impact.
Kids who have little to no language who are placed in group settings for large amounts of time, especially those without support professionals who understand the principles of Applied Behavior Analysis, tend not to do well. Some children with major language deficits who exhibit problem behaviors even get “thrown out of preschool” because they hit or bite other kids. The preschool teacher, no matter how well-qualified and well-meaning usually doesn’t have the ABA training and support of a Behavior Analyst needed to know how to intervene to reduce problem behaviors in children with autism and probably can’t effectively teach our children important language and learning skills, especially in classrooms with 10 or more children.
I do believe that a few hours per week included in a pre-school or daycare setting with an ABA therapist to shadow the child may be an appropriate part of a complete ABA program, even for young, early learners who may not have all the pre-requisite skills in place but sending a child without necessary skills without a well-trained 1:1, even for a few hours per week may not be the best use of the child’s time.
I was speaking at a conference once and they were selling t-shirts that they had designed. On the front of the shirt it said, “I have autism,” and on the back it read, “Don’t waste my time.” That really struck me then and it still stays in my mind now because I think a lot of times ask me, “Are you pro-inclusion?” Of course, I’m pro-inclusion, but many young children with moderate to severe autism need at least 20 hours per week of 1:1 intensive ABA programming before they can fully participate and benefit from a classroom setting with large group instruction. Our children and clients with autism don’t have time to waste just like the T-shirt said.
For more information about proven ABA strategies to increase language while reducing problem behaviors, download my free e-book and watch my free 4-part video workshop.
I’ll see you next week!