Transcript Asperger’s Disorder & Social Skills Jom Choomchuay,M.D.,M.Sc .(Merit)

Asperger’s Disorder
& Social Skills
Jom Choomchuay,M.D.,M.Sc.(Merit)
Child and Adolescent Psychiatrist
Samitivej Srinakarin Hospital
Asperger’s Disorder
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AACAP,52nd Annual meeting,
Toronto, Canada, October 22nd ,2005
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Martin J. Lubetsky, M.D.
John J. Mcgonigle, Ph.D.
Melissa Smiley Jacobson, M.S.W.,L.C.S.W.
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Center fo Autism and Developmental Disorders,
Western Psychiatric Institute and Clinic (WPIC),
University of Pittsburgh Medical Center
What are Social Skills?
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Definition: (Wagner, 1999)
 Social skills are skill that:
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Allow appropriate initiation of contact
Enable one to maintain positive relationships
Facilitate peer acceptance
Enable one to cope and adapt to social
environment
Basic Assumptions about
Social Skills:
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Learned skills
Made up of behaviors that can be explicitly
taught
Can be systematically taught with
considerations for generalization
Why Social Skill development is
difficult for those with Asperger’s
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Lack of “Theory of Mind”
Central Coherence Deficits
Failure to develop “an Experiencing Self”
Executive Functioning Deficits
Social Skill Development
Techniques
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Two Dominant Types
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Instrumental Social Skills
Relationship Building Skills
Models
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Individual Interventions
Group Work
Instrumental Social Skills
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Teaching social rules and behaviors that
support ability to function
How to cope with day to day problems &
situations
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Eye contact
Waiting your turn
Smiling
Appropriate topics of conversation
Instrumental Social Skill
Teaching Techniques
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Direct Instruction
Adult & Peer Mediated Strategies
Social Stories & Scripts
Comic Strip Conversations
Social Autopsies
SOCCSS
Thermometer
Role Play
Video Modeling
Direct Instruction
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First: identify social goal
Second: identify the steps the child needs to
learn to reach the goal
Third: Teach these sequential steps through:
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Modeling
Multiple opportunities to practice behaviours
Prompts ( verbal, visual)
Reinforcement
Adult & Peer Mediated
Strategies
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AS child paired with typical peer in socially
supportive setting
Typical peer is instructed to remain close to
the AS child & participate in activities with AS
child
Adult remains close to the children giving
prompts when needed if interaction
successful, adult provides reinforcement
Social stories & scripts
(Carol Gray)
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Explicitly describes the process of social
situation
Includes 3 types of sentences:
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Descriptive: who what where why
Perspective: persons thoughts, feelings, mood
Descriptive: a desired positive response
Example: Social Story
“Learning to play fair”
Descriptive
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It is a good idea to play fair with my friends.
Sometimes my friend may win the game we are playing.
Perspective
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I will try to stay calm if my friend wins a game
Directive & Perspective mix:
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If my friend wins a game, I may ask them to play again. (D)
Asking to play again is a friendly thing to do. (P)
It is good to play fair when playing games. (D)
That way friends may want to play again. (P)
Comic Strip Conversations
(Carol Gray)
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Visually illustrates aspects of conflict
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Actions+ Feelings + thoughts +Intentions
Word Bubbles: what was actually said
Thought Bubbles: child perception of what
others were thinking
Colors used to represent feelings
Helps to identify misunderstanding or
misinterpretations
Other Techniques
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Social Autopsies
SOCCSS
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Situation-Options-Consequences-Choices-strategiesStimulation
Thermometer
Role Play
Video Modeling
Instrumental Social SkillsInformation for Coaches:
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Treatment goals made collaboratively with AS
child
Must explain theory behind rules/scripts
Must explain exceptions to “social rules”
Goal should parallel existing social
opportunities
Parents should be involved to promote
learning process
Relationship Building Skills
(Gutstein & Sheely)
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Goal
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To target deficits in Experience-Sharing in a systematic
manner, resembling stages of development
To teach “ a new way to observe the social environment.”
Desired outcome
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Creation and deepening of emotional connections
Shared excitement and joy
Collaboration in novel problem solving
Reaching shared goals
Cooperation in joint creative efforts
Learning Process
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Careful assessment of social skill level
Systematic layering of skills
Facilitated by Relationship coach
Address core deficits regarding:
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Theory of mind
Sense of “experiencing Self”
Central Coherence
Focus on:
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Skills more adaptable
Teaches importance of understanding and reacting to
others perspectives
Helpful Hints
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Teaching Environment/setting
Balance Directive and Facilitative Interactive
Style
Don’t rely solely on verbal communication
Keep your objective simple
Activities should be Motivating
Goals should be meaningful to child