Читать книгу Social Engagement & the Steps to Being Social - Kathleen Taylor ORL/L - Страница 6

Introduction

We began working together in 1987, providing occupational and speech-language therapy co-treatments for children who had sensory processing and communication struggles, including those with autism. As young therapists, we worked very hard to address the needs of the many amazing children we worked with and learned from week to week. Over time, however, we understood that there was something we had not studied in school or even thought much about that was an important link to success for so many. We realized that we needed to learn how to teach children not only motor and communication skills, but also how to use those skills in relationships with other people.

Over the past 25 years, we have been on a journey to discover, describe, and teach “social skills.” The model presented in this book has had many incarnations, from checklists to diagrams; we even conceived it as a picture frame one especially creative year! As we began conceptualizing the steps, we learned that each step should be broken down into still others, allowing for the opportunity to analyze “being social” and support those for whom it does not come naturally. As you will see, the “steps” are more of an escalator, ever moving and influenced by much that happens within the day-to-day interactions of a real person’s life.

Before we begin, we offer a few comments to help navigate the content. First, words associated with the model and used to communicate the specific definitions provided therein are in boldface, italicized, and capitalized. These include FOUNDATION, ENGAGEMENT, READY, LOWER 4, MIDDLE 4, and UPPER 4. The book is divided into four areas representing the skill sets of the model: FOUNDATION, LOWER, MIDDLE, and UPPER 4. Within each area is a description of the skills encompassed there, along with vignettes describing the social world of one individual with Autism Spectrum Disorder (ASD). At the end of each section, skills are broken down into smaller sub-steps. Evidence-based practices (EBPs) to support the skills in each area are then described, followed by a case study. After FOUNDATION, you will find a description of general strategies that support ENGAGEMENT. At the end of LOWER, MIDDLE, and UPPER 4, one sample intervention objective and activity to match each step is provided. Note that these are included as a framework for developing activities for intervention and meant to spark your own creativity as you support the development of social skills at each step across people and settings in a variety of ways.

It is our hope that people who have an interest in promoting social skills – family members, teachers, therapists, and the individuals they care about so deeply—will find Social Engagement & the Steps to Being Social to be a meaningful and practical guide. Our goal is to address both a growing understanding of the nature of what it means to be in social relationships with others and how to “step on” to the learning process on any given day and over time. Indeed, as we have learned from many extraordinary teachers, the process can be exhilarating!

Why Are Social Skills So Important?

Have you ever had time with a friend that you have not seen in years and been amazed by the experience of picking up just where you left off? Natural conversation highlights the magic of reciprocal social interaction that is both self-sustaining and mutually satisfying. The ease of these moments can mask the dynamic interplay of the subtle yet complex skills required.

Social skills are the skills we use to communicate our messages, thoughts, and feelings and to interact with each other (http://dictionary.reference.com/). These skills are the context for all learning, a prerequisite for positive adult outcomes and a deeply important part of being a person. Furthermore, impairments in social communication that are part of the diagnostic criteria for ASD include social-emotional reciprocity, nonverbal communication behaviors, and developing, maintaining, and understanding relationships (American Psychiatric Association, 2013). Those of us working with individuals with ASD must continue to develop our abilities to assess and teach these critical skills.

How did you learn the complex understanding we define as social skills? When you walk into a restaurant, office cubicle, movie theater, or public restroom, how do you know how close to be to another person, when you should or should not make eye contact, how much you can talk, or what is the appropriate tone of voice or topic of conversation? Indeed, it is a wonder that we ever know how to be! However, we act “intuitively,” based on years of observation and corrective feedback that might have been very direct, especially when we were children, or quite subtle as we note another person’s response to our own behavior. For individuals with ASD, and others who struggle to develop social skills, these skills need to be well assessed and taught directly. Think about something that is hard for you to do, maybe writing or spelling, packing the car, or reading a map. While others may find these tasks natural and proceed without thought, you have to understand your own area of weakness and develop strategies to compensate for a lack of skill. We all have areas in which we need to work harder than other people to succeed at something that is important to us. Remembering this can help us empathize with the incredibly hard work it is for many individuals with ASD to operate in a social world.

For all of us, and especially school-age children, learning happens through social experiences that are defined by unwritten rules and an expectation that certain ways of being together are inherently understood (Endow, 2012; Winner, 2007). For example, even very young students in a classroom are expected to stay together and make transitions as a group. They need to understand that they are “one of many”; that is, when a direction is given to the group they are expected to follow it and, conversely, they cannot interact with the teacher as if there is no one else in the room (Gray, 2000). In addition, key areas of academic development require social understanding. Consider, for example, that the ability to comprehend a story necessitates discernment of character relationships and motivations as well as the ability to infer and predict social behavior. Clearly, social skills, which allow us to share space and experience with other people, are not just for making friends. We need our social skills to function well in everyday life (Winner, 2005).

Social skills are also paramount in considering outcomes for adults with ASD. Difficulties with social communication have been cited as roadblocks for adults with ASD in both higher education and places of employment (Barnhill, 2007; Thierfeld Brown, Wolf, Kind, & Bork, 2012; Tincani & Bondy, 2015; Endow, Mayfield, & Myles, 2012). Clearly, the development of academic skills, while obviously important, does not ensure success for individuals with ASD in post-secondary school settings or in the workplace. Rather, social skills (such as the ability to maintain calm, exchange important pieces of information, understand a common goal, be flexible and collaborative, understand hierarchy, and consistently follow the myriad of social rules that govern behavior) are essential (Myles, 2016). Undoubtedly, any director of human resources, working with people with or without disabilities, would say the same.

Equally important to the development of appropriate school and workplace skills is the ability to develop satisfying personal relationships that enrich each person’s quality of life. In the past, we have sometimes made the mistake of misinterpreting a lack of social skill as a lack of interest when trying to understand the lives of individuals with ASD. What we now understand is that everyone, including those who struggle to learn social skills, desires connection with other people and seeks comfort, safety, and a sense of belonging as part of a social community.

A strong premise for this model is that social skills and related strategies must be taught directly and with deep respect to individuals with ASD. Consequently, the development of these skills will not be supported by simply having the person who is struggling with “being social” spend time with others who have well-developed social skills. The analogy of teaching reading to a person with dyslexia is instructive; one would not seat a struggling reader with a group of strong readers and expect significant or meaningful improvement in the struggling reader’s skills. Rather, assessment must inform instruction, and each pre-requisite skill must be taught in a structured manner before that skill can be integrated for use. The same holds true for teaching social skills to individuals with ASD.

As we plan for direct teaching of these essential skills, we consider who will provide this instruction as a social communication partner. Initially, we learn to be engaged with a skilled partner (SP), often a family member or professional who has high motivation for interaction and proficiency with the skills being learned. We see that as we move up the steps to being social, trained peers (TPs), who are a similar age to the learner and are taught skills to facilitate specific aspects of “being social,” are key. Like the skilled partner, the trained peer is also motivated to be a part of the social interaction and has already mastered the skills he or she is helping to teach. In addition, while trained peers understand their role as teacher, they are also a true participant in age-appropriate activities and need frequent encouragement to understand their role in the success of the learner. Over time, learners increase their competence and confidence to use skills with the people they encounter in their day-to-day lives.

Finally, it is crucial to understand that all communication is social. While children may learn to talk or use alternative forms of communication, these have little value if social skills are not developed to provide opportunities to use communication for meaningful interaction (Frea & Vittimberga, 1999; W.D. Frea, personal communication, December 3, 2015). In fact, in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), social and communication impairments were combined into one domain reflecting that social skills are inextricably linked to the development of communication skills (American Psychiatric Association, 2013; Schreibman et al., 2015). As you will see in the next chapter, ENGAGEMENT, which we define as that remarkable ability to be self-regulated and share space, focus, and pleasure with another person, is where we begin our journey to “being social.”