A parent recently came to us to ask whether it is important to include social skills goals as part of her son’s high school Individualized Education Plan (IEP). He is a bright young man who has one friend who shares similar interests. He would like to go to college, pursue a professional career, and have a relationship (“maybe someday”). Though he is friendly, keeping conversations going is challenging for him and he quickly becomes anxious and flustered, resorting to talking about his interest in solar systems. Our response to his parents, as it has been to all parents and educators who ask this question, was an emphatic “yes”: ongoing socials skills programming throughout late adolescence and young adulthood is essential for everyone with an autism spectrum disorder (ASD) diagnosis, even for conversationally verbal individuals. Most importantly though, the kinds of social skills goals and approaches to programming can and should look very different for older teens and adults than for elementary school-aged children.
Why is Social Skills Programming Essential in Young Adulthood?
Social skills development is a life-long process of learning and practice for everyone. Though it would be nice, we don’t turn twenty-one having fully mastered all the social interaction, communication, and problem-solving skills we will use throughout adulthood. If we did, there would be no need for the self-help sections at bookstores that shelve titles including Dealing with Difficult People, Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, and Crucial Conversations: Tools for Talking When the Stakes are High. Many individuals with ASDs, just like their typical peers, look forward with both excitement and trepidation to developing significant adult relationships and perhaps even getting married and having a family. Consider all the trials and tribulations that most individuals experience as they navigate the path to a satisfying adult relationship, then add the social difficulties and anxiety associated with ASDs. Young adulthood is a particularly critical time to emphasize the development and maintenance of social learning and skill development.
For individuals with ASDs, continued social skills development throughout the lifespan is essential for a number of reasons:
- The social world expands dramatically towards the end of high school: dating and relationships; interactions with college professors, teaching assistants and classmates; exchanges with co-workers and bosses; community interactions including store clerks, wait staff at restaurants
- An expanding social world introduces new skills and contexts (e.g. interviewing, landlords, reservations, dates)
- Skill development moves beyond mastery of the basics and emphasizes subtleties and nuances of interactions while at the same time facilitating fluency and feeling more natural and confident during interactions
- Continued learning of any skill requires repetition and practice. Once individuals are no longer in school, they can distance themselves from social contact, thus preventing achievement of goals that require continued social learning. In addition to purposefully distancing themselves, individuals no longer have the regular opportunity for interaction and social learning that a high school environment provides. Less structured college and occupational programs often require individuals to be proactive and independently seek out social contact, which can be very challenging for individuals with ASDs.
- Generalization of skills into a variety of settings and with a variety of people is essential for success in everyday tasks. There is a whole new “hidden curriculum” for adulthood that includes social norms that individuals with ASDs may not be familiar with. For example, a young adult who decides to live independently may not know what to do if there is a flood in his bathroom because this is not something he or she has been explicitly taught. While typical young adults may have learned how to handle such a situation by observing parents or others with a similar issue, individuals with ASDs are less likely to have benefitted from this form of social learning. We need to teach these individuals specific life skills such as how to call and interact with a plumber.
The Many Domains of Social Skills
There are many aspects of social skills and social communication that are important, and each individual may present with relative strengths and weaknesses across the various areas. For youth, there are many standardized assessments that professionals can use to evaluate an individual’s current social skills set and generate a “social profile” (e.g., Social Responsiveness Scale, Social Skills Improvement System) to determine what areas to target in social skills programming. However, there are limited resources for assessing social skills in adulthood. Some of the aspects of social skills that are important to evaluate include: social awareness (ability to pick up on social cues), social cognition (ability to interpret social cues once they are detected), social communication (expressive and receptive social communication including turn-taking, inference, perspective taking, conversation skills), social motivation (extent to which individual is motivated to engage in interpersonal behaviour), and social problem solving (individual’s ability to generate and carry out effective solutions to social situations that arise). Goals you may choose to work on would be very different for an individual who is socially aware and motivated than for an individual who is also socially aware, but is not at all interested in engaging with others. Related skills that are part of social functioning are also critical to evaluate including hygiene and grooming, coping skills, organization and time management, emotional understanding, and behavioral regulation. For bright conversationally verbal adults, many of these skills will need to be assessed informally as part of a session with a speech-language pathologist or a psychologist.
We Know it’s Important, So How Do We Make it Happen?
There are a number of obstacles to creating and participating in effective social skills programming for young adults with ASDs. For example, we hear from many parents that their son or daughter often experiences group “burn out”; they participated in many groups when they were younger and are now feeling “done with groups.” These feelings are also often associated with a desire to be independent, to be seen as capable, and as such, teens and young adults may be left feeling reluctant to continue in formalized group programs that emphasize deficits rather than strengths. Young adults with ASDs may also be reluctant to engage in social skills programming as a result of years of unsuccessful and often emotionally painful social experiences.
In our experience, social skills for teens and adults must be taught within the context of appreciating and understanding the interests and goals of the individual with ASD. Related to this, emphasis on “why” social skills are critical, and not just presenting the “how to do them” or “what to do” is very important. For example, we saw an older adolescent in individual therapy who did not want to leave his house or socialize with anyone; he really wasn’t interested. However, he did want to go to college and he had professional career goals. Initial therapy sessions were aimed towards establishing “buy-in” – why is it important for me to learn social skills and interact with others? When he was able to make the connection between his career goals and the social experiences and skills he needed to meet those goals, he was able to recognize why working on social communication was going to be important. Bottom line though – being social to be social and have friends was not of interest to him. Your goals as a parent or a professional may not match your child’s or client/student’s goals. All people require an understanding of why a skill is important and how it is related to their aspirations before they will be willing to put forth effort in learning. Before specific skills are taught, programming needs to emphasize how influential adequate communication can be on the fulfilment of their life goals.
What Kinds of Opportunities for Social Skill Development are Available?
There are many kinds of opportunities for continuing to work on social skills in late adolescence and adulthood:
- Formal or informal social skills groups may still be appropriate depending on interest and ability
- Community-based group participation can assist with generalizing skills and learning in natural environments (e.g., bowling league, movie club, chess club)
- Peer-mediated support groups led by facilitators who have ASDs themselves
- Incidental learning – capitalizing on naturally occurring situations to teach skills. For example, a flood in your bathroom is a situation where an individual with ASD can learn directly what to do if this were to happen to him or her.
- Self-directed learning – reading books, watching films
- Individual therapy or counselling
Choosing a Social Skills Group
What can often make or break the success of a social skills group experience is the actual group itself. Though there are many social skills groups offered in the community, not all are created in a way that facilitates a positive learning experience for group participants. Relevant issues for adolescent and adult groups include:
- Compatibility of group members: how are group members selected? Is there a screening process?
- Appropriateness of group curriculum: what skills are being targeted and are they relevant for your child?
- Efforts to facilitate generalization of skills: home activities to complete, conveying information to parents and caregivers
- Gender mix of the group: for some individuals mixed gender will make sense and for others single gender groups will be most appropriate. Importantly, the nature of the topics discussed should guide the gender makeup of the group.
- Shared decision making between group facilitators and participants that demonstrates a desire for a respectful working partnership
- Formal and informal opportunities for building skills
- Balance between focusing on strengths and identifying areas of difficulty
- Monitoring of progress towards individualized and group goals
- Core foundations for teaching including problem-solving, critical thinking and self-awareness, understanding, and monitoring. As well, the types of strategies and techniques used to teach these foundations (e.g. role-playing, visual examples).
Unfortunately, there are no ideal groups that will meet everyone’s needs. Be thoughtful in your approach to deciding what social skills learning opportunities will be helpful. Will your son or daughter benefit most from attending a group or working one-on-one with a therapist? Should the group be formal or informal, community or center-based? And remember to include your child in the decision making. By listening, guiding, and coaching, you will make huge strides towards developing your child’s confidence, self-efficacy and self-determination. The journey from adolescence into adulthood may not be an easy one, but being part of a collaborative team can make the new experiences and challenges less daunting and more enjoyable!
- Autobiographies by adults with ASDs
- Asperger’s Guides (Social, Personal, Love) by Genevieve Edmonds, Lucky Duck Publishing
- Preparing for Life: The Complete Guide for Transitioning to Adulthood for Those with Autism and Asperger’s Syndrome, by Jed Baker, AAPC
Shana Nichols, PhD is Clinical Director and Researcher, Laurie Perlis, PsyD is Psychology Post-Doctoral Fellow, Stacey Kanin, CCC-SLP is Speech-Language Pathologist, and Samara Pulver Tetenbaum, MA is a Psychology Intern at the Fay J. Lindner Center for Autism and Developmental Disabilities.
For more information regarding individual and group teen, young adult, and adult social skills programming offered at the Fay J. Lindner Center for Autism and Developmental Disabilities, Advantage Care Diagnostic and Treatment Center, Affiliate of AHRC Nassau and NSLIJ Health System, please contact our intake coordinator, Georgia Reilly, at 516-686-4440.