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Asperger’s Disorder & Social Skills

Asperger’s Disorder & Social Skills. Jom Choomchuay,M.D.,M.Sc .(Merit) Child and Adolescent Psychiatrist Samitivej Srinakarin Hospital. Asperger’s Disorder. AACAP,52 nd Annual meeting , Toronto, Canada, October 22 nd ,2005 Martin J. Lubetsky, M.D. John J. Mcgonigle, Ph.D.

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Asperger’s Disorder & Social Skills

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  1. Asperger’s Disorder & Social Skills Jom Choomchuay,M.D.,M.Sc.(Merit) Child and Adolescent Psychiatrist Samitivej Srinakarin Hospital

  2. Asperger’s Disorder • AACAP,52nd Annual meeting, Toronto, Canada, October 22nd ,2005 • Martin J. Lubetsky, M.D. John J. Mcgonigle, Ph.D. Melissa Smiley Jacobson, M.S.W.,L.C.S.W. • Center fo Autism and Developmental Disorders, Western Psychiatric Institute and Clinic (WPIC), University of Pittsburgh Medical Center

  3. What are Social Skills? • Definition: (Wagner, 1999) • Social skills are skill that: • Allow appropriate initiation of contact • Enable one to maintain positive relationships • Facilitate peer acceptance • Enable one to cope and adapt to social environment

  4. Basic Assumptions about Social Skills: • Learned skills • Made up of behaviors that can be explicitly taught • Can be systematically taughtwith considerations for generalization

  5. Why Social Skill development is difficult for those with Asperger’s • Lack of “Theory of Mind” • Central Coherence Deficits • Failure to develop “an Experiencing Self” • Executive Functioning Deficits

  6. Social Skill Development Techniques • Two Dominant Types • Instrumental Social Skills • Relationship Building Skills • Models • Individual Interventions • Group Work

  7. Instrumental Social Skills • Teaching social rules and behaviors that support ability to function • How to cope with day to day problems & situations • Eye contact • Waiting your turn • Smiling • Appropriate topics of conversation

  8. Instrumental Social Skill Teaching Techniques • Direct Instruction • Adult & Peer Mediated Strategies • Social Stories & Scripts • Comic Strip Conversations • Social Autopsies • SOCCSS • Thermometer • Role Play • Video Modeling

  9. Direct Instruction • First: identify social goal • Second: identify the steps the child needs to learn to reach the goal • Third: Teach these sequential steps through: • Modeling • Multiple opportunities to practice behaviours • Prompts ( verbal, visual) • Reinforcement

  10. Adult & Peer Mediated Strategies • AS child paired with typical peer in socially supportive setting • Typical peer is instructed to remain close to the AS child & participate in activities with AS child • Adult remains close to the children giving prompts when needed if interaction successful, adult provides reinforcement

  11. Social stories & scripts(Carol Gray) • Explicitly describes the process of social situation • Includes 3 types of sentences: • Descriptive: who what where why • Perspective: persons thoughts, feelings, mood • Descriptive: a desired positive response

  12. Example: Social Story“Learning to play fair” Descriptive • It is a good idea to play fair with my friends. • Sometimes my friend may win the game we are playing. Perspective • I will try to stay calm if my friend wins a game Directive & Perspective mix: • If my friend wins agame, I may ask them to play again. (D) • Asking to play again is a friendly thing to do. (P) • It is good to play fair when playing games. (D) • That way friends may want to play again. (P)

  13. Comic Strip Conversations(Carol Gray) • Visually illustrates aspects of conflict • Actions+ Feelings + thoughts +Intentions • Word Bubbles: what was actually said • Thought Bubbles: child perception of what others were thinking • Colors used to represent feelings • Helps to identify misunderstanding or misinterpretations

  14. Other Techniques • Social Autopsies • SOCCSS • Situation-Options-Consequences-Choices-strategies-Stimulation • Thermometer • Role Play • Video Modeling

  15. Instrumental Social Skills- Information for Coaches: • Treatment goals made collaboratively with AS child • Must explain theory behind rules/scripts • Must explain exceptions to “social rules” • Goal should parallel existing social opportunities • Parents should be involved to promote learning process

  16. Relationship Building Skills(Gutstein & Sheely) • Goal • To target deficits in Experience-Sharing in a systematic manner, resembling stages of development • To teach “ a new way to observe the social environment.” • Desired outcome • Creation and deepening of emotional connections • Shared excitement and joy • Collaboration in novel problem solving • Reaching shared goals • Cooperation in joint creative efforts

  17. Learning Process • Careful assessment of social skill level • Systematic layering of skills • Facilitated by Relationship coach • Address core deficits regarding: • Theory of mind • Sense of “experiencing Self” • Central Coherence • Focus on: • Skills more adaptable • Teaches importance of understanding and reacting to others perspectives

  18. Helpful Hints • Teaching Environment/setting • Balance Directive and Facilitative Interactive Style • Don’t rely solely on verbal communication • Keep your objective simple • Activities should be Motivating • Goals should be meaningful to child

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