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Best Therapies for a Child With Autism

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Which Behavior Therapy Works Best for Children with Autism?

Autism Spectrum Disorders have kept behavioral scientists and researchers busy for decades. We have learned so much and yet there is so much that we still can’t figure out. Consider, for example, the increasing numbers of children diagnosed with autism every year. Going back to 1997, SARRC (Southwest Autism Research and Resource Center) roughly estimated 1 in 2,500 children born in the United States were diagnosed with autism spectrum disorders. By the year 2000, the CDC (Centers for Disease Control) began monitoring these numbers and reported that 1 in 68 children born in the United States were diagnosed with ASDs.

Diagnosed with Autism

Currently we know how to identify children with ASDs at an earlier developmental age and stage- some signs start as early as 6 to 12 months of age. Still, autism is increasing at an alarming rate- 1 in 54 children born in the United States were diagnosed with autism in 2020.  Yet, with all of the research and all of the advances that have been made on behalf of autism in the field of behavioral psychology there is currently no known cure.

Autism is treated by various therapies depending on the severity of the symptoms and the specific needs of the child with autism. The most common therapy used to treat autism is applied behavior analysis (ABA) therapy. ABA therapy is an evidence based behavioral therapy that focuses on improving communication skills, social skills and behavioral skills while reducing socially undesirable or inappropriate behaviors. ABA uses positive reinforcement to accomplish these goals.

ABA is the most common therapy because it has been the most effective autism therapy for the last fifty years. However, there are some other types of therapies that are worth mentioning because they are either good supplementary therapies to ABA therapy or they provide excellent stand alone benefits for specific symptoms of autism.

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What Therapies, Besides ABA Therapy, Also Help with Autism?

Speech Therapy is commonly recommended for children on the autism spectrum to help with communication and speech. A speech therapist can help children with compromised speech but they do much more than just help with pronunciation and teaching children how to speak. Speech therapy also addresses the misuse of language and helps those with autism to avoid misunderstanding language as they communicate with others. They teach their clients how to interpret body language and look for subtle physical signals. They also work with pragmatics in speech so that children know when, how and to whom they can say certain things to. Speech therapy teaches inflection or “prosody” which is the movement in a person’s voice as they speak. Children on the spectrum often need to learn this skill because many have a “flat” or monotone  pattern of speech that causes them to appear emotionless to others. Conversation skills, grammar, and social skills are also practiced with question and answer exercises as well as concept skills. Concepts can be difficult for some children with autism because concepts require abstract thought to make sense of some of the concepts. As you can see, there is much more to speech therapy than just learning how to speak clearly.

PECS is an acronym for Picture Exchange Communication System.

Picture Exchange Communication System.

Using single pictures, a child with autism can show someone what they would like to gain access to. This is part of the goal for Phase I of six phases. Phase II would work on generalizing the skills from Phase I, Phase III is picture discrimination whereby individuals learn to choose from a collection of pictures of their favorite things and ask (mand) for them. They can build a sentence to communicate by using sentence starters such as “I want” or “I need” and finishing the sentence with the rest of the pictures during Phase IV. Phase V moves on to responses so that the child will learn how to answer as well as ask. In the final phase (VI), children are taught to respond (comment) to questions such as “What do you see?” or “How do you feel?” They would use this opportunity to form sentences using starters such as “I feel” or “I see”.

Occupational Therapy is sometimes necessary for children with autism due to physical challenges that sometimes accompany autism. OT sessions can focus on:

*Gross motor skills to improve coordination

*Social skills to enhance physical activities with groups

*Fine motor skills to improve handwriting and activities that require small muscles and hand/eye coordination

*Play therapy to improve interaction and imaginary play skills with others

*Sensory skills to help children who have weak responses or extreme responses to sound, smell, touch, light or taste

The skills that are learned in occupational therapy improve daily living, the ability to perform academically and interact with others in social settings.

Nutrition Therapy- While there hasn’t been any substantial evidence that specific diets lesson the symptoms of autism, some parents believe that they see a difference in their child’s behavior when they add or subtract certain foods. Gluten and casein are hot topics with parents who report behavioral changes in their children when they are exposed to these proteins. Continued research is being conducted to examine the “leaky gut” theory which refers to the possibility of these proteins seeping through the intestinal tract, “fermenting” in the bloodstream and ultimately resulting in impaired behavior when the fermented blood reaches the brain. So far, this theory is unsubstantiated. However, nutritional therapy can be helpful for children with autism due to their limited preferences. Children with autism have a higher incidence of gastrointestinal problems and tend to have thinner bone density than children without autism. Working with a nutritional therapist can help to remedy potential health problems associated with limited food choices.

Art Based Therapy– This type of therapy refers to dance, music, drama and visual arts. The idea behind this type of therapy is that it provides an outlet for communication and expression that children with autism may or may not be able to express verbally or socially. Depending on what type of art form your child participates in, expressing themselves artistically can help with some of the skills that are being addressed in occupational therapy by exercising fine motor skills. Communication and social skills can also be improved by working with others in drama groups, or music and dance groups. Their senses can be engaged by color, art medium, and sound. It also provokes cognitive skills such as decision making, self awareness and perception and can also increase the chances of overcoming intolerance to certain stimuli like smells, sights and sounds that were previously unpleasant to them.

Social Skills Therapy– This type of therapy is specific to the improvement of social skills and communication. The focus of social skills therapy is to improve communication by developing the child’s communication skills so that they can carry a conversation, understand jokes and sarcasm, answer questions, read non verbal cues and improve speech overall. Circle Care Services has a great group of therapists who oversee a social skills group within the practice. (link here)

Horseback Therapy– Also known as Equine Therapy, this form of occupational therapy focuses on teaching attention, self control and sensory management. Riding a horse can also be beneficial to how a child with autism carries their own posture. During a ride, they will inevitably have to adjust to different movements from the horse and the children may move in different ways than they are normally accustomed to and widen their range of movement without even thinking about it. This type of therapy is credited with improved adaptive behaviors like responding to new challenges, coping with everyday life, communicating, resilience and mental flexibility. While equine therapy may still be in the early stages of research, what is known now is showing positive benefits and improvements in regulating behavior, sociability, irritability, lethargy and hyperactivity.

Yoga Therapy– Anyone who practices yoga for an extended amount of time will most likely express the benefits of yoga such as improved strength, posture, cardiovascular fitness, coordination, body awareness, focus, concentration, stress reduction, balance and flexibility. For children with autism there are additional benefits that are helpful. Yoga can help children with autism to self regulate impulsive, obsessive, aggressive and self stimulatory behaviors. If they attend a class with peers or other people in the community you can also expect to see improvement in social and communication skills, awareness and expression of emotions, reduced frustration and a positive self body image.

Relationship Development Intervention (RDI)– RDI is a type of therapy that is focused on building social and emotional skills by developing “dynamic intelligence” (the ability to think flexibly). Parents are trained by certified behavioral consultants to be the primary “therapists” in this program. RDI has six main objectives:

  • “Emotional Referencing: the ability to learn from the emotional and subjective experiences of others
  • Social Coordination: the ability to observe and control behavior to successfully participate in social relationships.
  • Declarative Language: the ability to use language and non-verbal communication to express curiosity, invite others to interact, share perceptions and feelings and coordinate your actions with others.
  • Flexible thinking: the ability to adapt and alter plans as circumstances change.
  • Relational Information Processing: the ability to put things into context and solve problems that lack clear cut solutions and have no “right and wrong” solutions.
  • Foresight and Hindsight: the ability to think about past experiences and anticipate future possibilities based on past experiences”.
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How do I make sense of all the different treatments?

These are just some of the many additional and alternative therapies that are out there for families to explore.

Making sense of all of these choices is a matter of what is best for your family. ABA therapy has proven to be the most effective therapy for children with autism. It is still referred to as the “Gold Standard” by which all other forms of treatment should be measured.

“The Maine Department of Health and Human Services (HHS) and the Department of Education (DOE) reviewed 150 studies with 43 different treatment approaches for people with autism. The meta-analysis used the evaluative method for determining evidence-based practice in autism to assign each intervention a rating based on the amount of evidence involved in the treatment process. The report found that ABA therapy was one of the few that met standards as an established evidence-based therapy.”

the different treatments

Knowing this, there still might be an area of a child’s life that could be served well by additional therapies or perhaps alternative therapies. There is nothing wrong with trying new things. It certainly wouldn’t hurt to enroll your child in a Yoga class with other children who have autism. Most children certainly wouldn’t mind spending time with animals if Horseback Therapy sounds like something interesting that your family would like to try.

Most of the alternative therapies have some cross-over elements of social, occupational or behavioral therapy that complements ABA, speech therapy, social skills groups or occupational therapy. Any combination of these could be a wonderful way of reinforcing the learning that is taking place in ABA therapy.

What are the Costs for These Alternative Therapies?

Parents of children with autism are well aware of how costly it is for therapy services. Ideally, private insurance is the best option for autism treatment. However, some of the alternative therapies mentioned here, such as yoga or horseback, are most likely going to be out of pocket expenses. ABA, occupational therapy, and speech therapy are likely to be covered by private insurance. Social skills groups are also likely to be covered especially if it is part of the treatment program with your ABA provider.

Alternative Therapies

Here are some very rough estimates of annual costs for the therapies mentioned above- all of these are approximate costs and dependent on individual need:

  • ABA therapy can range anywhere from $20,000-$60,000 annually
  • Speech Therapy- Initial Assessments are approximately $250; half hour sessions are approximately $65 and one hour sessions- $130
  • Occupational Therapy- Initial Assessments $250; hourly $100- $200
  • Yoga Therapy is typically a private pay therapy; classes for children with autism range from a per class fee or a monthly membership at a yoga gym. Prices will vary with each facility or instructor
  • Horseback therapy is typically a private pay therapy ranging from $60- $250 per session
  • Art Therapy is a private pay therapy and will vary with each type of activity; private dance lessons, music lessons and drama lessons range from $60-$200 per month depending on whether your child receives group instruction or private lessons. Art therapy (paint, ceramics, and other various forms of media) are approximately the same cost.
  • RDI (Relationship Development Intervention)- may or may not be covered by private pay insurance. Initial assessments can cost approximately $250 and sessions can range $100-$200 per session.

It is roughly estimated that it takes $60,000 annually or more to support a child who has autism. It is a good idea to secure private insurance to keep out of pocket expenses to a minimum. Many of the therapies that are not covered by private insurance are the equivalent of what most families spend on extracurricular activities for their children who are involved in sports, drama, dance, theater or music. However, for the child that requires speech, occupational or behavioral therapy it is best to make sure that your insurance covers the cost. If it doesn’t, reach out to your local public health department, school district or state department and ask for assistance to find resources that are covered by government programs or the school district. There are plenty of resources out there.

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When Should I Consider Medications for My Child with Autism?

There are certain circumstances that may require making the difficult decision to allow your doctor to prescribe medications for your child with autism. This is not an easy decision and it is always best to take time to carefully consider all of the variables and seek another doctor’s opinion if there are too many questions left unanswered while trying to decide.

Generally speaking, it is always best to consider the full impact of deciding against medication. Will the child suffer adverse effects if they are left untreated? Will the child have difficulty with behavioral therapy without medication? Will they have difficulty in school without medication? If a child needs medication at an early age to help with academics or to sleep and they don’t receive it, the long term effects could be devastating.

Medication is usually reserved for symptoms such as aggression, insomnia, self injurious behaviors due to anxiety or frustration, attention deficits, and obsessive compulsive behaviors. Without medication, these types of behaviors can limit friendships, academic achievement, cause aggression toward others, harm to self and insomnia can cause a long list of problems including depression, obesity, irritability and attention deficit problems.

When considering medication, the benefits should outweigh the risks for the child. Earlier is better than later because some of these symptoms are harder to reverse after too much time has gone by.

Take your time when making life changing decisions for your child and your family.

The team at Circle Care would love to answer any questions about ABA, alternative therapies, medications or any other questions you may have about your child with autism. Our staff is dedicated to helping you make good choices for your child as you consider a course of treatment for your child with autism.

We hope to hear from you as you start your journey with your child. Give us a call and let us help you with a plan for the future that will benefit your child and your entire family.

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The Do’s and Dont’s After Your Child is Diagnosed with Autism

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There are so many things to consider when you have a child that is diagnosed with autism. Most parents report that they are initially flooded with lots of emotion. It can be overwhelming to find out that your child will need additional resources for behavior, academics, speech, and motor skills. Being a parent of children who do not require any additional help in these areas is already a busy occupation. Depending on how much therapy is required, a parent of a child with atypical development, will often realize that they have involuntarily begun a part time job, sometimes a full time job, of navigating the symptoms and treatments of autism. This can be lonely, and draining physically and emotionally.

Read on for some tips about what you should do and what you should NOT do as you adjust to a brand new ASD diagnosis.

Take Care of Yourself

DO take some time for yourself to process all of the feelings that you have about the news that you’ve received about your child. It might take some time to really wrap your mind around the facts. There is no rush to find all of the right answers and all of the right people to work with your child. Helping your child with autism is a lifelong commitment. So, spend some time with your family and take whatever time that you need to figure out how you and your family would like to approach everything from therapy to school issues.

Diagnosed with Autism

DON’T try to make all of the arrangements immediately or all at once. It would be a good idea to sit and talk with your spouse or significant other to figure out what appointments will be needed in the upcoming months. Once you have an idea of how you would like to proceed, create a to do list in order of priority. Pace yourself, take one task at a time and you may find that some of the items on your list may drop off as you begin to  speak with various doctors, specialists, teachers or other parents.

DO make time for communication with your spouse or significant other. If you are a single parent, connect with someone who is a good listener; someone who is compassionate and understanding. If you reach out to a friend or a family member and the conversation consists of negative commentary, blaming or “horror stories” that someone has heard about someone else or something in the news- politely end that conversation and find someone else to talk to. There is nothing more frustrating than already feeling overwhelmed and then calling a relative that says something insensitive due to a lack of education or information. Comments like, “It was probably that vaccination you gave him….. I told you that stuff was bad!” or “Autism!? Where did THAT come from, your side or his side of the family?” These types of comments are not helpful and they will only serve to make a parent feel like they are to blame for something “happening” to their child. The truth is, autism has never been connected to a vaccine by any substantial evidence and what good will it do to figure out what side of the family a condition comes from? None at all. The child has a diagnosis and the focus should be on finding the right resources to help the child with autism.

DON’T fault your spouse or significant other. Blaming someone you love rather than coming together and supporting one another through this season will only add more stress to an already stressful situation. As research has shown, it is alarmingly evident that parenting a child with ASD seriously affects a person’s stress levels, and marriage, with divorce rates being 10% higher in families living with a child on the spectrum.

Keeping this in mind you will want to pay extra attention to your relationship and put in the work to stay connected. You will feel stressed at times because that is a very human response to an overwhelming and new situation. Worries about school, the future, friends, family, doctors, insurance, and money are inevitable. Exercising self control and avoiding finger pointing, or lashing out may be difficult in the moment, but it will pay off in the long run. Lock elbows, encourage each other, join together, and show respect to your partner, or spouse.  Everyone will be happier.

DO take care of your own health first. This is not a selfish suggestion. It is absolutely necessary. Remember the oxygen on an airplane metaphor: if oxygen masks drop down in front of you on a plane you MUST put yours on first or you will not be helpful to anyone around you who might need help. The same applies to your health and well being as a parent or caregiver. You cannot solely focus on your child with autism while you neglect your nutrition, your exercise or your hygiene. If you neglect your own care, you inevitably put your own health at risk and you will not have the mental faculties or the energy to accomplish all that needs to be done to care for your child with autism. The secondary benefit to keeping your health and appearance together is that you set a good example for your child with autism who will need to see modeling of appropriate behavior including self care.

DON’T take everything you hear from the internet, other parents, and unlicensed “advisors” as gospel truth. Parents who have a child with a new diagnosis of autism tend to read every article, every book, reach out to other parents, fall into conversations with “nutrition experts” and veteran parents with children who have autism. Once you start talking to others about your child, you will start to see a pattern of “experts” that will surface and offer unsolicited advice. As a new parent of a child with autism, you will feel like you need to listen to everyone and take notes. You do NOT have to listen to everyone else’s advice. What works for some families might not work for yours; in fact, what “works” for someone else might not really be working at all. For example, a certain diet that one parent swears by might seem “miraculous” to that parent yet everyone else that is in contact with the same child does not see any changes. Be careful who you take advice from. If something sounds crazy- it probably is. Politely excuse yourself from the conversation and continue to pursue the professional help that you need for your child with autism.

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Early Intervention

DO start treatment as soon as you can. Educators and therapists know that the best outcomes are always connected to children with autism who received autism treatment at the earliest age possible. Autism research and medical advances have developed to the point that pediatricians can screen a child for autism as early as 6-12 months old and refer them for services at that young age. The advantages of starting behavioral therapy at the earliest age possible is that it can help to shorten or close the gap in speech, communication, social skills and behavior much sooner than it would be possible with an older child.

The same applies to academics with regard to early intervention. Students with ASDs or other learning disorders that are identified in preschool through first or second grade are more likely to learn how to conduct themselves in the classroom, overcome academic struggles and mainstream into the general education classrooms much sooner than students who are not identified in the early elementary school years.

Early Intervention

Don’t wait to bring developmental questions, suspicions or concerns up with your doctor.  If you notice any delays in academics, behavior, speech, or development in your child with autism, bring it to the attention of your pediatrician or school staff as soon as you notice a problem. Evaluations can be arranged to see if your child is in need of or eligible for special education services or medical intervention. Early intervention is always better for closing the gap between their deficits and their peer’s development and grade level performance.

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Parenting and Teaching a child with Autism?

Do consider the developmental deficits that your child or student is functioning with. There are times when you are raising or teaching a child with autism that the behaviors are so constant or difficult that it becomes easy to forget that the child is functioning with a deficit. It’s even more difficult if a child has high functioning autism and functions well in most ways yet has times when their behavior baffles you. Remind yourself as a parent or teacher of the child’s diagnosis of autism. When these behaviors occur, remember that this is exactly “why” the child is in special education or in behavioral treatment with therapists. Take a deep breath and communicate with the child from a different perspective- one that is filled with patience, understanding, and a willingness to use difficult moments as teachable moments. This doesn’t mean that the child should be excused or allowed to misbehave without consequence “because they have autism”. This leads us to the next point…

Parenting and Teaching a child with Autism

Don’t ignore and excuse your child or student’s behavior simply because they have autism. As much as we have to protect and guide children with autism, we also have to teach them. When your child or student displays an inappropriate behavior, correct them immediately. Never let something go just because the child is “special”. Teach them at whatever level they are at. It could be an explanation as to why something was wrong. Or perhaps they just need redirection away from something negative. Teach constantly and guide them in the right direction with positive affirmations when they do something right.

Do focus on achievements, progress and appropriate behavior. Parents and teachers can get in a bad habit of focusing on correcting behavior so much that they forget to say something when behaviors are good! It is exhausting when you are trying to teach a child with autism to respond appropriately to situations, focus attention on tasks or sit calmly with the rest of the class. After ten or fifteen corrections, you might feel like you need a break but stay vigilant! As soon as that child does something positive and appropriate make sure you do not miss the opportunity to praise them verbally, or reward them with a preferred activity or item. This is the whole idea behind positive reinforcement. Over time, if there is enough positive reinforcement for the appropriate behaviors, the child is likely to keep responding appropriately in the future.

Don’t label your child or student or add “he/she has autism” after you introduce them to new people. Parents do not owe anyone an explanation as to why their child seems a little different. Teachers are obligated to keep student information private. Adding an explanation after a child’s name is a bad idea for many reasons- but here’s two. When you introduce your child to other people and add “____ has autism”, you are giving the child with autism an excuse for their behaviors. Most therapists will tell you that children with autism are very intelligent. They will use that opportunity “_____has autism” to manipulate situations in their favor or do something they shouldn’t because they know that the adults around them (and even some children) will understand and allow the behavior. Secondly, when you introduce a child in this way you are defining this person by their deficit while ignoring any gifts, talents or interests they may have. Introduce your child or student with autism by their first name and leave it to the children to figure one another out.

Do take notice of your child or student’s preferred activities, food and favorite items. ABA therapists and BCBAs know the importance of finding out what motivates your child to comply with your requests or demands. Preference assessments are regularly conducted in ABA evaluations and during treatment sessions. If a child likes playing outside more than anything else, then it is very likely that the child will comply when asked to complete a task. Parents don’t have to do formal assessments. They usually know what their child prefers. Use those things that your child likes to motivate them to complete necessary tasks like homework or to listen the first time.

Don’t use physical force, restraint or punishment on your child or student. This never yields anything good. Physical force of any kind only serves to scare, frustrate or anger a child with autism. There is nothing about physical force that would be useful in teaching a child with autism about appropriate behavior. The use of physical force is inappropriate on its own. You cannot teach appropriate behavior with inappropriate behavior. It just doesn’t make sense.

Do introduce your child or student to new ideas, environments and people. Children with autism can be very inflexible when it comes to breaking routine or trying something new. This includes new friends, new places or new activities. It is good to introduce new things in small doses to see how your child responds. If they find something boring, aversive or difficult you can try something else. Children with autism tend to stick with the routine and they typically do not seek new opportunities on their own. Most children with autism need to be encouraged by others to venture out of their comfort zone.

Don’t force your child or student with autism to be somewhere or participate in an event or activity that is causing them stress. If most of us without autism can make choices based on our likes and dislikes, it stands to reason that those who do have autism should have the same opportunity. Forcing a child with autism to participate in something that they despise is punishment to them. Also, keep in mind that they might have a very good reason for not preferring something. Sights, sounds, smells, temperature, or the number of people in one place could cause a lot of anxiety for someone with autism.

Do advocate on your child or student’s behalf if their needs are not being met or if they are not being included in activities with peers. Don’t let your child sit on the sidelines. Ask coaches or teachers to allow them to participate if you see them sitting alone or ignored for too long. Being a strong advocate is important. Most of the programs for children with disabilities exist because someone decided to advocate for these things. You are the voice for children who have difficulty speaking up and asking for what they need.

Don’t restrict your child or student’s social activities to groups of children with autism or disabilities. Children with autism need variety in their lives just as the rest of us do. Expose your children to neurologically typical peers, younger and older children, elderly people, different cultures and environments. Take them to the zoo, the museum, the park, the hardware store or a musical. The more experiences a child with autism has the more likely they are to find their interests and this could be the key to communication or motivation to do well in school or at home.

Guiding Children with Autism Toward Cooperation

Do use positive reinforcement with everything that your child with autism does right. Use what they know and use what they love to encourage them to comply with requests at home and in school. ABA therapy focuses heavily on compliance. When the therapist leaves, make sure you continue to guide the child the same way that the therapist does when they are not there.

Don’t neglect to participate in parent training via your ABA provider. ABA sessions are not like dropping your car off at a mechanic to pick them up later all “fixed” and ready to go. Children with autism need continual guidance at home, at school and in all of the various settings that they are exposed to. The most successful outcomes are always those children who have a supportive network of family, friends, teachers, coaches, tutors and social groups. The more exposure your child has to various people and settings, the more these children will be required to communicate.

Helping Children with Autism with Communication

Do work cooperatively and communicate continuously with all of the professionals on your “team”. There will be positive reinforcement during ABA sessions, speech therapy and at school. It is best to have a team that works together on behalf of a child with autism. Teachers at school should be informed of what the child is working on at home with ABA therapists and parents. Grandparents, aunts, uncles, older siblings and friends can even be helpful if they are willing to play along with the way ABA works.

Don’t try to manage everything on your own. We advocate for children with autism and we are here to advocate for you and your family. You will access a network of team players for all encompassing supportive care at Circle Care Services. Call us and ask your questions. We have answers and support for you and your child. Keep these do’s and don’ts in mind as you progress through autism treatment with your child. Reach out for help with your child.

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The Importance of Social Skills Therapy for Autism

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Most new parents have experienced a time when their own child or someone else’s child was that “one” child that was causing major disruption among all of the other children at a park or at a playdate. It’s hard to forget those humbling moments when your child is grabbing toys away from other children or randomly hitting others. When grocery store excursions become a flip of the coin between mom and dad to see “who gets to chase him first” or “who gets to sit in the car when she melts down” any parent will feel lost.

Social Skills Therapy for Autism

Parenting is not for the faint of heart and all children need to learn a host of “do’s and dont’s” as they mature. They need to learn table manners, how to ask for things properly, how to share and play with others and how to behave in public. We could add to this list of course, but the point is that all children need to learn social skills as they develop.

When you have a child with autism, social skills training needs to become more deliberate. The reason for this is that children with autism struggle to understand and succeed at understanding social interaction. There are a number of factors that cause this to be so.

➔  Speech Delays.

Children with autism have delays in speech that can make it difficult to maintain a conversation. They may repeat words or phrases over and over (echolalia), or they may answer questions with completely unrelated responses. This often pushes other children away because they don’t understand them and ultimately this leaves the child with autism isolated.

➔  Non-Verbal (receptive) Language Delays

Another reason that children with autism struggle with communication is that they tend to have difficulty reading non verbal cues. Non verbal cues are facial expressions or body gestures. For example, the look of boredom on a person’s face (facial cue) when they are no longer interested in a conversation might be obvious to most of us but to a person with autism it may go completely unnoticed. A person checking their watch and tapping their foot (body gestures) would give many people the idea that this person is either impatient or in a hurry. A person on the autism spectrum might fail to take notice of these gestures.

Similarly, sarcasm is difficult for children on the autism spectrum to understand. People with autism spectrum disorders tend to see everything in a very literal sense. So, to say something in colloquial language like “oh my goodness….you look so cute I could just eat you up!” might be a very frightening thing to say to someone with ASD. Jokes and teasing are no different. Something that is meant to be playful and innocent might sound scary and threatening to a child with autism who has not been taught about figurative language,  joke telling or sarcasm.

This doesn’t mean that you should change the way you speak and avoid telling jokes or using figurative language. What this means is that these are the things that need to be taught deliberately in social skills training for children with autism.

➔  Low Emotional Intelligence

Another common struggle for children with autism is that they often fail to understand the feelings of others. This can lead to the misconception that children with autism are unfeeling or uncaring- but this is not the case. The difficulty for those with ASDs is that it is nearly impossible to think from another person’s perspective and consider how they might feel in various circumstances. The job of identifying and expressing their own emotions is one of the main interventions in social skills training for children with autism because it is such a common deficit with children on the autism spectrum. It is important to teach children with autism to identify and manage their own feelings and emotions first because until they can do that, it is nearly impossible to recognize how someone outside of them might be feeling.

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What is the goal of my child’s Social Skills Training?

The first goal of social skills training for children with autism should be to bring their social interaction with other children up to the level of their same age peers who are not on the autism spectrum (neurotypical). This is especially true for young learners as it will set the tone for how well they succeed in school, work, community and other social settings that they will encounter.

Social Skills Training

When social skills intervention occurs early on, a child can build confidence at a much earlier age by learning how to make friends and get along with others. Getting along with others is a springboard for learning other valuable skills like sharing, taking turns, imaginary play and sportsmanship.

Speaking of sportsmanship, it is important to provide opportunities for children with autism to play games where they may win or lose. Children with autism “feel” the happiness and victory of winning and the sadness or frustration of losing with added intensity. This is a great opportunity to teach good sportsmanship or frustration tolerance in social skills training. One way to teach this is to model good sportsmanship. Play a simple game that you may lose, (suggestions- tic, tac, toe, Candyland, Tag or Hide and Seek) and thank the child for a fun game. Congratulate the child for winning. Modeling social skills is teaching social skills.

What Social Skills Should My Child Be Learning?

Playing with others requires social skills training that is focused on a few pivotal skills. These pivotal skills are the skills that make or break the ability for play to continue.

Talking with others is a pivotal skill that facilitates meeting, getting to know one another and building friendships. A child with autism who has social skills training will learn that it is much easier to join a group of children at play by saying hello and asking to play than it is to stand and watch. The more times that a child successfully communicates and interacts with others, the more likely it is that they will continue to communicate to meet their needs.

Once a child with autism begins to talk with others more often, learning how to share or take turns  becomes easier to teach. Teaching children on the spectrum how to share requires an opportunity to play with other children or siblings. So, you can see how important it is to get children with ASDs to talk with others first. Sharing requires a little negotiation, “first you have the ball for five minutes and then I can have the ball.”

In the midst of communication, play and sharing there is bound to be conflict at some point. This is why managing emotions is considered another pivotal social skill for children with autism. When children with autism have difficulties managing their emotions it can be tied in with their inability to express themselves verbally or it can be a deficit in any combination of social, communication, sensory or executive functioning skills (memory, self control, flexibility).

When a child with autism has difficulty managing emotions, they might react to aversive or non-preferred stimuli in any of the following ways. 

  • Run away from the environment.  (This can be dangerous in certain settings).
  • Experience a  meltdown similar to a tantrum that would be seen in a toddler. (this is true for some adolescents, even those with high functioning autism)
  • Become aggressive or self harming
  • Resort to self stimulatory behavior like hand flapping, rocking or pacing.

The far reaching impact of social skills training

Beyond the pivotal skills of talking, taking turns, sharing, and managing emotions, is the ability to extend those skills into imaginary play and problem solving. These are life enhancing social skills that will develop over time and with exposure to peers and problems.

Pretend play

Pretend play happens best with a group of children who take on various roles and create scenarios and banter back and forth with one another developing a story as they go along.

Problem solving

Problem solving is a life skill that is best developed in a social setting and through interaction with peers. It’s a social skill that requires a little prompting and teaching, but the more a child with autism interacts with other children the more likely they are to encounter situations that will require some negotiation. It could be anything from a small disagreement between two peers or it could be a puzzle that a group of children is trying to solve.

All of these important social skills can be taught in ABA therapy sessions and by inclusion in a social skills group for children with social skill deficits. These social skills intervention groups work the same way an ABA session would by using positive reinforcement and a natural teaching environment. The biggest difference would be that the social skills groups are  focused on the group interaction and improving social skills with each child by providing opportunities to respond to situations and resolve potential conflicts as they arise by guiding the children step by step as they learn.

The end goal of social skills training and intervention is to bring children with autism up to the level of their neurotypical peers in order to behave appropriately in public and to make connections with other people at the earliest opportunity possible. These skills will follow them into school, community and workplace settings as they get older.

I want this for my child!

What Kinds of Strategies Are Used for Developing Social Skills?

Social skills intervention for autism should be fun while teaching necessary life skills. Luckily, social skills training is inherently fun because it’s all about getting groups of children together, playing and interacting.

Developing Social Skills

Some social skills training will be targeted for independent activities like going to the dentist or accompanying mom to the grocery store.

Whether your child is learning how to interact socially with peers in a group, one on one or independently in school or community these are some strategies that can be used for teaching social skills.

Role Play

Role Play is a useful strategy for practicing what will take place in a new situation that a child has never encountered before. If a child is going to the first day of school it can help ease any worries with a little first day of school role play. One child can pretend to be the teacher and another can be themselves. Practice introductions and finding a seat and starting the school day. Switch roles and allow the children to get creative and have fun with the role play. If imaginary play is difficult, a facilitator can step in and guide the role play.

Games

Games are always a great tool for teaching rules, turn taking and sportsmanship (as mentioned above). These social skills can be difficult for a child with autism and it may require time and patience to teach them. Some independent practice with a therapist or an adult at home is sometimes helpful to work through and talk through frustrations before getting into a large group setting. In the end, the social skills that are learned through game play are valuable.

Observation

Observation can remove fear of the unknown for children with autism. If a child on the spectrum is going to be exposed to a new setting (school, daycare, park) or a new situation (dentist, airplane, amusement park) it would be worth the time and effort to find ways to observe these new scenarios before the child experiences them.

If they are going to a new school, try stopping by to meet the new teacher, see the classroom, and watch the kids play on the playground.

If they will be visiting the dentist, try looking up some videos of other children during their visits to the dentist. Make sure (of course) that the videos are positive experiences and that there are simple explanations of what the dentist is doing in the video. The more the child knows before the visit, the less likely they are to fear the visit.

Social Stories

Social Stories are stories that help children with autism learn what to do and what not to do in social situations. Social stories are written in a specific format:

*They are constructed teach perspective

*They present opportunities for responses.

*They reinforce and support what they learn from the stories

*They teach the important role played by other people in situations and how they are handled

*They are reviewed by using partial sentences (fill in the blank) to encourage a child with autism to determine the ideal response to social situations.

Social stories are available in book and video formats and they are increasingly popular in social skills training.

ABA Therapy is the most frequently recommended course of treatment for autism spectrum disorders because it has shown the highest evidence based outcomes. Social skills intervention can be taught using Applied Behavior Analysis. ABA therapy uses positive reinforcement to reduce undesired or inappropriate behaviors while increasing socially appropriate behaviors. ABA focuses on improving specific behaviors such as communication, adaptive learning skills, academics and social skills.

Social Skills Groups

Social skills training can happen in just about any setting and there are opportunities throughout the day that can be utilized as teachable moments for children with autism. But, one of the best places to start is a social skills group that is specifically set up as a safe and accepting environment for children on the autism spectrum.

Kids Club is an after school social skills intervention group that is run by Circle Care Services’s ABA therapists.

At kids Club, children learn how to better

  • Talk to others
  • Take turns
  • Share
  • Manage emotions
  • Solve problems

This enables them to

  • Build confidence
  • Behave more appropriately
  • Make new friends

 All these skills are practiced and eventually mastered in a setting that is fun and free from any conflict or tension with peers. Parents need not  worry that their child is being bullied or isolated. Compassionate Circle Care therapists play with the children using activities and situations that ultimately teach them how to better navigate social situations in their everyday lives.

As your child breaks through barriers that previously kept him from joining in with activities that might be messy or loud or include a lot of friends, he will gain newfound joy.

Learn more form a new group in your New Jersey location or enroll now.

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What Is A Developmental-Behavioral Pediatrician?

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As a child grows from birth to adolescence, there are important developmental milestones that each child is expected to reach physically, cognitively and emotionally. When there is a delay in a child’s cognitive or emotional development that affects academics, social or family dynamics it might be time to become acquainted with a Developmental Pediatrician.

Developmental-Behavioral Pediatrician

A family Pediatrician is trained to monitor your child’s physical growth milestones and watch for any signs that your child might need to be referred to an outside specialist for issues outside of their immediate scope of practice. A Developmental Pediatrician is a subspecialty in pediatrics that addresses more specific issues that are related to delays in areas that affect development such as speech disorders, motor skills delays, sleep or eating disorders, attention deficit disorders, learning deficits, autism spectrum disorders, Down syndrome, cerebral palsy, Tourette’s and many others.

Developmental Pediatricians are trained to understand the effects of the medical and psychosocial aspects of the developmental and behavioral issues that their children are struggling with and how it affects the family as a whole. Developmental Pediatricians are trained to work with the entire family to evaluate, provide counseling and treatment.

In addition to working with families, Developmental Pediatricians work closely with school personnel and other organizations that are involved in the care and education of the child.

Where Can I Find a Developmental Pediatrician?

If you are in need of a Developmental Pediatrician, you can find them at private practices, hospitals, clinics, rehabilitation centers, health departments, and community outreach programs. Children’s hospitals often have an entire department dedicated to developmental pediatrics.

Developmental Pediatrician

Due to the wide range of developmental and behavioral disorders that Developmental Pediatricians address, it is commonplace to find these specialists work with a team of professionals that specialize in various areas. These specialists might include a child psychologist, speech pathologist, physical therapist, occupational therapist, child psychiatrist, pediatrician, social worker, neurologist and even educational consultants or diagnosticians.

Send me a referral for a developmental paediatrician that can diagnose my child.

What Do Developmental Pediatricians Diagnose?

Developmental Pediatricians are highly trained to be more specific when it comes to diagnosing behavioral and developmental disorders. General Pediatricians are somewhat limited in their training when it comes to learning disabilities, autism spectrum disorders and developmental disorders. There is a wide range of behavioral and developmental difficulties. Developmental Pediatricians can identify, recommend specific treatment options and provide options for the entire family.

Developmental Pediatricians Diagnose

Additionally, if there is a need for any medication a Developmental Pediatrician can also provide a prescription and monitor the child.

Over the long term, a Developmental Pediatrician is part of your child’s team of advocates that will support your entire family through the early years of childhood and throughout the years in school when the most help will be needed.

Our staff at Circle Care Services, New Jersey, joins up with that team of advocates to support you and your family through this time of growth for your child. Collaboration between our Behavior Analysts and the Developmental Pediatrician while working in cooperation with family, school and other outside agencies over the long term gives your child the best opportunity for learning and growing through the challenges they face.

Bring us into your inner circles, and get the supportive team collaboration you need anywhere in New Jersey.

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How Does Autism Affect Social Skills?

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People on the autism spectrum have developmental deficits in communication and display some of their most obvious struggles during social interactions with other people. One common struggle is often a lack of interest in social interactions with others. This is a big problem because social skills are primarily learned through regular interactions with others. If a child with autism is continually avoiding interaction with peers, inevitably the child’s social skills will be delayed over time.

Autism Affect Social Skills

Autism comes with its own inherent list of difficulties. In addition to the lack of interest in peers, autism is also well known for causing difficulties with initiating and responding to social interactions. It takes great encouragement to get a child with autism to walk up and introduce themselves to another child and ask them to play. Even if they do, it may be a scripted delivery that was prompted by a supervising adult and they might quickly walk away even if their gesture is accepted by the other child.

The ability to “read” others is a skill that needs to be taught purposefully to a child with autism. Social-emotional curriculum that teaches these skills is equally important as the rest of the academics in school for children with developmental delays such as these. Children on the autism spectrum literally need to be taught with repetition to recognize the difference in facial features between happy, sad, angry, jealous, curious, tired, distracted, bored or whatever the mood might be.

Social stories are used to describe various scenarios and outcomes as teaching tools for how to respond to social situations as appropriate behaviors are taught. These can also be used to display what it looks like to have an appropriate back and forth conversation or understand social cues. Check out these amazing books and activities recommended by our New Jersey autism specialists to improve these areas of difficulty:

  1. Key Education Photo Conversation Cards
  2. SkillEase Story Cues Skilled Sequence Cards
  3. The New Social Story Book
  4. Social Skills Activities for Kids: 50 Fun Exercises

There are many other areas that can make social interactions awkward such as sensory sensitivities, inflexibilities with activities or schedules or a refusal to participate in collaborative or imaginary play while in school or some other social setting.

The goal in social skills training while in treatment is to teach socially appropriate skills that will help communication skills and social interaction. At Circle Care, we desire to see that your child with autism is able to regulate his/her emotions, play with peers and communicate back and forth in a positive way that builds social confidence.

Explore our autism social groups

Can an autistic child have good social skills?

There is such a broad spectrum of the ways that autism will present itself in each child, and so the definition of “good” will differ from one child to the next. The best way to put this is to say that all children on the autism spectrum are capable of learning and improving their social skills. This is true because social skills are something that can be taught and positively reinforced at home, at school and during ABA treatment sessions.

autistic child have good social skills

When children with autism are properly taught and positively reinforced for appropriate social skills, they will make improvements. Over time they will continue to repeat those appropriate social behaviors as they interact with others.

There are some fairly simple suggestions for teaching social skills that you can integrate throughout your daily routine. These suggestions can be done by any parent or teacher. All that is needed is a learning opportunity to share with your child.

1)   Model and Explain

The first is simply to model and explain social interactions. Children are observant and they learn by watching what is going on around them. At each opportunity, explain social situations that you experience. Explain the communication, facial expressions, tone of voice, gestures, body language and any questions. You may find out rather quickly that your child does not understand sarcasm, manipulation or nuances in the conversation without explaining more than once or explaining in another way if the first explanation fails.

2)   Present Social Scenarios

Another way to teach social skills is to present social scenarios. You can either make up your own scenarios or use movies, books, comic strips or social skills curriculum that is specifically created for teaching these skills.

Role playing is a way to act out certain situations and practice skills in a non judgmental environment. This might be difficult for a child on the spectrum who is not fond of imaginary play, but it can also afford an opportunity to practice engaging in more imaginary play while working on social skills.

3) Participate in Social Skills Groups

Lastly, support groups are great sources of information and encouragement for frustrated parents and good social skills practice for children on the spectrum. Social skills groups usually combine the two groups simultaneously- while the child is in social skills training with peers, the parents are usually chatting in their own support circle in another room. This is a benefit for everyone. No matter where on the spectrum your child is diagnosed, there is hope for improved social skills. Social skills are learned by modeling and teaching your child, using positive reinforcement and exposing your child to peers and social settings over time to practice those skills. As they grow and learn, their social skills will improve to the extent that they have been taught, positively reinforced and exposed to social settings.

Who are the therapists at Circle Care?

Social Skills Groups vs. Social Skills Training

Trying to decide between a social skills group or social skills training? Here are some general concepts that are taught in each setting:

Social Skills Groups vs. Social Skills Training

Social Skills Training with ABA Therapist (all of these skills are worked on independently with therapist)Social Skills Group (all of these skills are worked on with peers in a group setting)
Accepting the likes and dislikes of others
Asking for help
Communicating clearly
Complimenting others
Being encouraging to others
Following directions Being a good listener
Being an active participant
Conflict resolution
Sharing
Staying on task
Taking turns
Using a quiet voice
Waiting patiently		Sharing details about yourself
Expected and unexpected behaviors
Tattling versus reporting
Personal space
Thinking with your eyes
Complimenting others
Body language
Joining a group
Conversing without interruption
Telling jokes
Whole body listening
Self control
Taking turns
sharing

There are benefits to both types of social skills instruction. The individualized instruction with an ABA therapist provides valuable one to one instruction for your child and the social skills group provides exposure to peer group settings. Peer group settings are wonderful places to practice social skills that your child has learned about during 1:1 instruction. This will better prepare him for the social challenges he faces at school, a restaurant, a library, a store or standing at a bus stop. An added benefit of a peer group setting is that everyone is working toward the same goal of learning socially appropriate behavior in a safe and non judgmental environment.

Social skills require practice in social settings. Your child might feel uncomfortable at first, but with your encouragement and help and with the staff at Circle Care we can come together to support your child through any fear or apprehension they might have about interacting with other people in a social group.

We at Circle Care Services New Jersey, incorporate social skills training as part of our ABA treatment plans.

Also, we offer social skills groups for our children so that they can

  • Get to know one another
  • Get encouragement and guidance as they practice their newfound skills.
  • Get social interaction prompts and facilitation by trained specialists.

Let us help you and your child to improve the quality of life with greater communication skills and improved social skills. These are skills that will carry on into your child’s adult lives to serve him/her well. We can’t wait to hear from you and we can’t wait to introduce you to some of our other families here in New Jersey.

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