Hi, I'm Dr. Mary Barbera, autism mom and
board certified behavior analyst. In
today's video blog, I'm going to discuss
why I focus so little on teaching social
skills to very young children with
moderate to severe autism. As some of you
know, the diagnosis of autism is given if
the child has two main issues. The first
is a deficit in social communication and
social interaction. Basically, these
deficits for a young child include:
failure to share, or show, or point to
things of interest. And for older
children, it involves failure to take
turns and understand the social context
of things. In addition to the social
communication deficits, the second
component of getting an autism diagnosis
is restrictive and repetitive patterns
of behavior, interests, or activities. Kids
with autism are usually rigid. They
sometimes like to line things up. Many
engage in self stim behaviors such as
rocking, or hand slapping, and many older
kids with autism have specific interests
that are odd or unusual. Since social
communication and social interaction is
thought to be the central deficit in
children with autism, many people wonder
why I focus so much on increasing
language and reducing problem behaviors
and focus so little on social skill
intervention in young children,
especially those with moderate to severe
autism and major language delays. I do
want to give a disclaimer here that the
spectrum of autism is very wide and my
books, my online consulting work, and my
online courses, mostly address the needs
of children, teens, and adults who are
significantly impaired. I also want to be
clear that each child needs a thorough
assessment of his skills and deficits
and an individualized plan of
care and these video blogs are meant to
give just general information and my
ideas for how to improve things in
general for children with autism. So with
that in mind, why I focus so little on
teaching social skills to young children
with moderate severe autism. Let me tell
you about one of my former clients, I'll
call him Joe. When I first started with
Joe, he was just turning 2 years of age
and just diagnosed with autism. He used
to carry around straws all the time, that
was his big thing. He would carry around
straws, wave them in front of his face,
and he also liked to put them into clear
bottles if he had bottles too. The first
time I came to Joe's house he came to
the door with the straw in his hand.
Some kids carry around a blanket in a
similar way. Some kids like other things,
but Joe loved straws. Parents and
professionals often recommend and/or
choose classroom placements and group
instruction even for little kids like
Joe because they believe that every
child needs socialization
and exposure to typically developing
peers but putting Joe, and young children
like Joe, with little to no language into
a classroom full of typically developing
peers, or even with preschoolers with
special education needs, without 20 to 25
hours a week of one-to-one ABA
instruction is probably not the best
idea. For example, if Joe's mom would have
chosen to put him, who he was two
years old at the time, with a new
diagnosis of autism, if she would have
chose to put him into a daycare or
preschool situation without any
therapist to shadow him for
socialization instead of opting in for a
20 hour week one-to-one intensive ABA
program what Joe would have probably
done is played with straws or played
repetitively with any toys that were
available and he would have played over
and over again with the same toys. He may
not have caused a fuss as long as no
one tried to intervene and take the
straws and toys or other items away. But
if they would have tried to have Joe
participate in circle, or craft time, or
tried to take away the straws, or other
items, this would have most likely caused
Joe to have significant tantrums. Another
thing I see with some kids who were placed
in a preschool situation before they
have the needed prerequisite skills in
language and social abilities, especially
if the child goes alone without a
well-trained ABA therapists to shadow
him, is that these kids usually sit away
from the other students and they do not
engage in any meaningful
play or social activities anyway. They
tend to pick up toys that they can play
repetitively with, and in essence, they
engage in self stim behaviors while they
sit to the side of the room. Without some
language and imitation skills, exposure
to other children is usually just that,
exposure, with little to no impact. Kids
who have little to no language who are
placed in group settings for large
amounts of time, especially those without
support professionals who understand the
principles of applied behavior analysis,
tend not to do well. Some children with
major language deficits who exhibit
problem behaviors even get thrown out of
preschool because they hit or fight
other kids. The preschool teacher, no
matter how well-qualified and
well-meaning, usually doesn't have the
ABA training and support of a behavior
analyst needed, to know how to intervene
to reduce problem behaviors in children
with autism and probably can't
effectively teach our children important
language and learning skills, especially
in classrooms with ten or more children.
I do believe that a
few hours per week included in a
preschool or daycare setting with an ABA
therapist to shadow the child may be an
appropriate part of a complete ABA
program, even for young, early learners
who may not have all the prerequisite
skills in place. But sending a child,
without necessary skills, without a
well-trained one-to-one, even for a few
hours per week may not be the best use
of the child's time. I was speaking at a
conference many years ago, and they were
selling t-shirts that they had
designed and on the front the t-shirt
said "I have autism" and on the back it
read "don't waste my time." That really
struck me back then, and it still stays
in my mind now, because I think a lot of
times people ask well aren't you pro
inclusion? Of course I'm pro inclusion.
But many young children with moderate to
severe autism need at least 20 hours per
week a one-to-one intensive ABA
programming so that they can fully
participate, and eventually participate
even within a classroom setting, with
large group instruction. Our children and
clients with autism don't have time to
waste,
just like the t-shirt said. For more
information about proven ABA strategies
to increase language while reducing
problem behaviors, download my free ebook
and watch my free four-part video
workshop by clicking the link right
below this video and I'll see you next
week.