Impairments in social communication are a key deficit of Autism, and can be seen across the varying range of the spectrum.

Social communication is a big word that can include many difficulties, such as making friends, maintaining friendships, being appropriate near peers, sharing or turntaking, empathy or perspective taking, initiating peer play, joining ongoing peer play, responding to peers, self-advocacy, conflict-resolution, getting AND keeping a job, etc.

 
When clinicians throw around the term "social skills", we are really talking about a lottttt of skills!

Some people have the mistaken belief that ABA therapy only focuses on 1:1 instruction, and therefore isn't appropriate to target peer social interaction. Nope, not true.
ABA therapy can absolutely include targeted social skills instruction. Depending on the age of the learner and their specific social deficits, that will impact how social goals are assessed and selected. 

Parents of very young children usually want to work on: sharing, playing with peers instead of isolating, playing with toys instead of hoarding toys, reducing aggression towards peers, etc.

Parents of teens or young adults usually want to work on: initiating conversation, increasing MLU (jargon translation= you want your child to use more than 1-2 words to make a statement or answer a question), buying items in the community, talking to community helpers (e.g. a police officer), going on job interviews, assertiveness, dating, etc.


There are also many ABA programs that offer formal social skill groups to families, where learners are grouped together based on interests, abilities, age, or other factors, to participate in games and activities as a group. But the games are far more than just "games", they are actually carefully designed to target specific social skill deficits. If you are already receiving ABA therapy services, ask if your child can participate in a social group with other clients.


Behavior Analysis has many empirically validated strategies to add to the social skills conversation, and also (depending on the funding source) the ABA provider can target social skills in a group format, at school, or out in the community, to ensure proper generalization. For example:

• Reinforcement for the win! Social skills training should include reinforcement individualized to the learner, and also should work to pair (transfer) reinforcement to peers, as pre-intervention the learner may not find interacting with peers to be all that fun ;-(
• Data collection. If no one is collecting data, reviewing that data, and evaluating that data to make treatment decisions then what is happening is not ABA.
• Generalization. Also known as, "real life". Learning social skills in the ABA clinic, or at school, or on the playground, will not necessarily generalize to other settings and other kids. Intentional generalization into real-world, real life scenarios is a must.
• Structure. This may sound weird, but it does NOT mean that the learner must do the same thing, in the same order, for each peer interaction. It means that the learner should be able to predict what will happen in social group today, they know the rules of social group, and they understand what rewards they contact during social group. These things should be somewhat predictable, from the perspective of the learner.
• Break down concepts visually or tangibly. Help learners understand abstract concepts through video modeling, games, visuals, or manipulatives, that they can touch, see, etc.
• Follow an evidence based curriculum.....just not too closely. While it is important to have a tool to create the lesson plan for social instruction, I'd also recommend individualizing the curriculum as much as possible across learners. Modifying the curriculum to make the content more relevant to the learner will go a long way to helping social instruction gains "stick", and be salient for the individual receiving intervention.
• Behavior management. So obviously, challenging or disruptive behaviors will interfere with learning during social interaction time. These behaviors can also frighten, intimidate, or confuse other peers present, which works against the goal of interacting with peers. This is why ABA providers are a qualified to implement these kinds of interventions, because we already have the tools to decrease inappropriate behaviors and increase appropriate behaviors, and keep the social interaction on track.

*Resources:

Mission Cognition

Crafting Connections (I love this book!)

Social Skills Training for Youth with Autism Spectrum Disorders, Otero, Tiffany L. et al. Child and Adolescent Psychiatric Clinics, Volume 24, Issue 1, 99 - 115

A Review of Peer-Mediated Social Interaction Interventions for Students with Autism in Inclusive Settings, Watkins, L., O’Reilly, M., Kuhn, M. et al. J Autism Dev Disord (2015) 45: 1070

Making & Keeping Friends

Baker, J.E. (2004). Social Skills Training: For Children and Adolescents with Asperger Syndrome and Social-Communication Problems. Shawnee Mission, KS: Autism Asperger Publishing Co.

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Tameika Meadows, BCBA, Blog Author

"Confidence is Key"

Guest Post written by: Emily Lauren Beard

Much of what I have learned over the last year working as a Registered Behavior Technician (RBT for short) has changed my life completely. I found my job as an RBT mostly by accident. I knew that I wanted to work with children, and I knew I wanted to make a difference. 

I began a Master’s program for Mental Health Counseling, but I knew that ultimately, I wanted to work in a field that provided therapy for children with disabilities. After a semester of graduate school, unhappy and confused, I decided to go a different direction and look for a different career path.  After months of research, I found ABA therapy and immediately knew that was where I needed to be. I connected with a local behavior therapy clinic outside of my hometown near Jackson, MS, received a job offer, and began training to become a Registered Behavior Technician. As I approach my 1-year anniversary working at Blue Sky Behavior Therapy in Ridgeland, MS, I have begun to think about all the ways I have grown as a therapist.

I want to tell you a story about a few of the most important lessons I have learned about myself, my life, and my job as a helping professional:

This job is about the children, not you.  

 Ouch, that hurt. At least it did the first time I heard it.

My supervisor had just finished taking notes about the session I had just run with a particularly challenging client. This kiddo was sweet, no doubt, but I learned very quickly that if you didn’t have it together – your emotions, a plan for task presentation, control over the situation – the session could take a nosedive quickly.

What I realized during this session in my first few months of training is that being prepared is a must. Adaptability – the quality of being able to adjust to new conditions (Lexico.com, 2019) is a skill that is most definitely learned on the job. One minute we were at the table working hard at sorting pictures by their category and the next, my sweet kiddo was hurling a giant spit wad at my face from across the room. Chairs were knocked over, cards and toys were scattered all over the room, and my client was standing on top of the table.

All the sudden, my heart rate increased, my palms began sweating profusely, I couldn’t breathe and the whole room became blurry and it was as if time had stopped. I began asking myself, “What is my boss going to think of me?”, “Am I going to get fired?”, and “How could I possibly let this happen? I am so stupid!”

Yep. You read that right.

Not once in that moment did I even think about the client and how I could deescalate the entire situation. I was not thinking about the child’s safety or what he could have needed. I was thinking about me.

Luckily my supervisor was there and was all too familiar with the disruptive and problematic behaviors this child engaged in. She quickly deescalated the situation and had him sitting back at the table, working on identifying common objects, compliant and calm as could be, in under 10 minutes.

Looking back on this and discussing with my supervisor, I realized that this job is a selfless one. Walking into a session means leaving yourself – your fears, anxieties, stress – at the door. This job is not about you. It is about the client and what he/she might need to be successful at the skills that we are teaching.

This job requires confidence – a trait that unfortunately, you do not possess.

Over the next few months as I trained with a variety of clients with very specific skill deficiencies and behaviors, I learned that confidence means having the ability to go into a session believing in the work that has prepared you for this moment. Confidence means knowing you’ve got the skills, you are good at what you do, and that you are prepared for the unexpected....and believe me when I say this – kids can smell fear from a mile away. 

If you go into a session afraid of looking silly or not being quick enough, the child will know. They may possibly use it to their advantage. If you look like you don’t know what you are doing or can’t be quick on your feet, your session could go poorly. The session could end in tears, a torn-up room, and sometimes worse, a broken relationship with your client.

You can reach your goals.

Luckily, my boss saw my potential and believed that I could become a successful and confident RBT. Eventually I began to believe it, too. The more sessions I sat in on, the more trials I ran, the more confident I became.

Now don’t get me wrong, this was a long and grueling process. Some days it felt as if I was just tossed to the wolves. I learned to think on my feet and adjust as I went along. I learned that the work that I do is not about me. Sure, I earn a paycheck and have financial stability and that’s great. However, when I walk into my office, the client lobby, the therapy rooms, my goal is to help my client be successful and learn life skills that will make them happier and healthier. The joy that I feel when I see my client finally master a goal that has taken them weeks to understand outweighs any fear or anxiety that I might carry with me deep inside.

I am here to tell you that being an RBT is not an easy job. It is not for the faint of heart or the ones just in it to make money. This job is for the compassionate, hard-working, selfless individuals who wish to see others achieve their goals.

If you are one of these compassionate go-getters, believe me when I say: You can do this!

You can gain confidence in your skills. 

You can be successful. 

You CAN see lasting change in your own life, and the life of your clients.

*References:

Adaptability. 2019. In lexico.com

Retrieved November 29, 2019, from https://www.lexico.com/en/definition/adaptability

Guest Post Author:

Emily Beard is an Registered Behavior Technician at Blue Sky Behavior Therapy, a clinic with locations in Ridgeland, MS and Winona, MS.

Find out more at www.blueskybx.com or email Emily directly at emilybeard.proofreader@gmail.com

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Tameika Meadows, BCBA, Blog Author