Autism Therapy: social interaction

definition of social interaction: not yet defined.

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Research in Autism Spectrum Disorder, by Jones, EA, published in 2009, summarized Nov 27, 2009

Behavioral therapy may help children with autism learn verbal and nonverbal ways to start a social interaction.

People with autism may have problems initiating (starting) a social interaction. The first step is called “initiating joint attention.” This article describes the way that 3 preschool children with autism were taught these skills. Therapists used behavioral therapy techniques based on Applied Behavior Analysis (ABA) theory. For one boy, the therapist used toys that could show a response (e.g., singing stuffed animal or piano with lights). When the boy did the right behavior, the therapist would make the toy react and the boy liked that. For another boy, the therapist used games as a way to teach the skills. The boys learned some of the skills, and eventually were able to use them with their.


Intellectual and Developmental Disabilities, by Causton-Theoharis, J., Ashby C., and Cosier M., published in 2009, summarized Nov 6, 2009

People with autism expressed loneliness and a desire for better social interactions when they wrote about themselves.

The authors of this article read seven books written by people with autism about themselves (autobiographies). The book authors had a range of social communication skills; three of them used facilitated communication. The people with autism said that they were aware of their own social difficulties. They wrote moving passages about feeling lonely. They described how they tried to reach out to people, and sometimes failed. The authors of this article think that people with autism may very much want to make social connections, even if it seems like they are not interested during therapy. The article authors feel that therapists and parents should be aware that people with autism may have a strong desire to connect with others.


Journal of Autism and Development Disorders, by Hilton, JC, and Seal BC, published in 2007, summarized Jun 26, 2009

Identical twin brothers with autism showed different improvements using Developmental, Individual Difference, Relationship-Based therapy (DIR) and Applied Behavioral Analysis (ABA) therapy.

Their mother wanted to see which therapy might work better for both of her sons. Each twin (2 years, 4 months old) began with separate therapy sessions (DIR and ABA) and separate therapists. They each attended 16 therapy sessions. The child who received ABA therapy showed more improvement responding to his name and using signs than his brother. He also had some tantrums and aggression. The twin who received DIR intervention showed improvement in social interaction and symbolic behaviors. The mother chose to put both boys in DIR therapy, even though more gains were seen in the ABA-treated twin. The authors said that parents may choose therapies based on several factors including individual and family needs.


Autism, by Stephens, CE, published in 2008, summarized Jun 22, 2009

Imitating musical play routines of children with autism may help increase their social interactions.

Imitation is an important way for infants and children to learn to interact socially with other people. Four children (5-8 years old) with autism were given musical instruments that matched ones the therapist had. They used tambourines, castanets, blocks, rhythm sticks, and maracas to imitate simple lively music. The music therapist gave either verbal praise or imitated the child's actions when the child played, danced, and/or sang. When the music therapist imitated the children's behavior, the children were more active and responded to the therapist.


The National Institute of Mental Health (NIMH) funded a recent study, led by Geraldine Dawson, chief science officer of the advocacy group Autism Speaks, that showed early intervention begun at 18 months of age and continuing for two years may help children with autism improve. The study included 48 children from the ages of 18 to 30 months. The children were randomly placed in groups that received either the Early Start Denver Model (ESDM) or referred for less comprehensive intervention. The ESDM promotes family involvement in the therapy plan as well as individualized treatment and systematic instruction. ESDM focuses on communication and social interaction and includes "four hours of therapist-led treatment five days a week, plus at least five hours weekly from parents." While none of the children were considered "cured," the children in the ESDM group had increased IQ, increased language skills, and in some cases the original diagnosis was re-assessed to a less severe form of autism.

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Paro, a robotic seal, has been found to be a good substitute for live animal therapy for children with autism and adults suffering from dementia. Paro was developed by Takanori Shibata to simulate movements of a small cuddly pet for animal therapy in areas that do not allow live animals. Currently the Opportunity House in Illinois is using Paro to help children relax and learn touching and stroking techniques and social interaction. Paro has diurnal rhythm, which means he can be more active during the day and quieter at night. Paro can also recognize his name and respond to simple greetings. Paro Robots, the U.S. distributors, plan to begin selling animal robots in the fall.

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Parent educators from the Parents as Teachers program in Delaware are able to train fathers and mothers of children with autism and other high risk situations to parent. Many of the 2,000 parents who participate in Parents as Teachers are young, or single, or have a child with a disability. Parent educators visit them in their homes and teach them how to interact with their child from the start; early intervention techniques to encourage learning, speech, social interaction. Whitney Williams, supervisor of the New Castle County Parents as Teachers program, believes that, "A parent is a child's first teacher." One of the goals of Parents as Teachers is for children to succeed in school.

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Kim Fotter thought she wanted to be a vet, but early in her studies she discovered hippotherapy. Now Winkin Pony in New Hampshire provides Fotter's physical therapy office and her riding ring. Fotter, trained as a pediatric physical therapist, moved into hippotherapy, which uses the movement of a horse to help children with autism and other developmental disorders develop balance, social interaction, and taking responsibility for an animal.

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Social Skill Builder

Feb 16, 2010 by megan

Social Skill Builder, Inc. was founded by speech pathologists and sisters Jennifer Jacobs M.S. CCC-SLP andLaurie Jacobs M.A. CCC-SLP in 1999.  Social Skill Builder provides appropriate tools for teaching social skills to children affected by Autism Spectrum Disorder (ASD) and other language/learning difficulties. 

Because social interaction between people usually happens so quickly and naturally, it is hard to teach these skills to children with social competence difficulties. Social Skill Builder software programs allow children to dissect social situations in a safe and controlled environment, with the opportunity to replay scenarios for greater understanding. Such practice provides children with greater insight into social interactions and increases their confidence as they try out new skills in their real-world environments.

Social Skill Builder has created a series of learning tools, targeting preschool through young adults, which use real life video in computer assisted programs to teach social skills. The user is able to watch the video scenarios unfold and then make choices about what should be said or done next in a safe and controlled environment. These interactive features allow the child or adolescent to step inside familiar social situations to problem solve or predict outcomes. Motivating reinforcements and games make learning the social skills fun and entertaining. This unique training software provides a reference for language, behaviors and interactions that children can carry into the natural environment.

Social Skill Builder's products are designed for speech and occupational therapists, educators, counselors and psychologists, and parents who interact with children and adolescents ages 3-18 affected by ASDs and other learning/language deficits.


You can find more information regarding our software at www.socialskillbuilder.com


Social Thinking

Oct 29, 2008 by Anonymous

“Social thinking” is required prior to the development of social skills and successful social interaction. Michelle Garcia Winner coined the term to describe the treatment program she continues to develop that has helped thousands of students with their social learning. Individuals with autism, including high-functioning autism and Asperger Syndrome, ADHD and similar challenges have benefited greatly from this treatment approach.

 

www.socialthinking.com


Compassion

Feb 22, 2008 by Anonymous

            This past Tuesday’s meeting at school was disappointing.  Not because of what anybody said, but because I really didn’t need to be there.  The upshot was that there will be some additional testing and we’ll re-convene in May.  Uh…that’s pretty much what was said at the conference late last month, but whatever.  I’m glad I didn’t go to the trouble of finding someone to take care of Hayley while I went into school for this.  The form-letter that they sent home said “childcare won’t be provided,” and I should “make other arrangements for my children.”  If I had actually done that, I would have been steamed.  I brought Hayley with and she was fine.  She sat nicely in a little chair for the entire ten-minute duration of this thing.

            Okay, a few other things were mentioned during this meeting…the school nurse was there, the speech and occupational therapists and Thomas’ teacher.  The psychologist and assorted others who were supposed to attend didn’t show.  The nurse said that Thomas wouldn’t allow her to test his hearing or vision last year, but he did fine with it this year and passed both tests satisfactorily.  That saved me a difficult trip to the pediatric opthamologist and ear testing facility. 

            Something interesting that Thomas’ teacher does with him to get him to sit still during circle time (still his biggest challenge at school) is give him a bit of lotion to rub into his hands.  His teacher has “magic lotion” (that’s what she called it until one of the other kids in class recognized it as the same lotion his mother keeps at home and pronounced that it is indeed “not magic” – the emperor that is their teacher has no clothes, so to speak) that smells like lavender which, for normal kids, is supposed to be a soothing scent.  Nothing soothes Thomas much, except for the Clonidine.  But this lotion seems to keep him occupied enough to sit still.  The occupational therapist doesn’t even need to use the weighted vest that she had me sign a consent form for a couple weeks ago.  Lotion is cool…much more socially acceptable.  I’m excited about that.

            I don’t want to seem like I’m reading too much into this meeting (which, as it turns out, included much more than I originally stated above), but the way that the school nurse was talking about the need for additional testing, it almost seemed like the school staff might be experiencing a bit of disagreement with the autism diagnosis.  She asked several questions that led me to think about that.  She wanted to know who diagnosed him, when he was diagnosed, if his current neurologist was actually the doctor who originally diagnosed him, if she could get a report from this doctor (good luck!), etc.  The need for “new” testing came up, too.  They want him to be re-tested by the psychologist in particular.  Despite my amazing ability to jump to the best-case scenario, I didn’t make statements like, “Gee, by the way you’re talking, it almost seems like you don’t think Thomas is autistic!  He’s healed!  Halellujah!  Thank you so much, and of course we’ll be suing the school district for emotional distress if you’re wrong!”  I didn’t ask questions, either.  I know they can’t answer anything about medical diagnoses.  I’m just going to play it cool and see what happens.  Even if they don’t think he’s “autistic,” he’s still definitely got issues. 

            Everyone at school has been telling us how much Thomas has improved with social interaction.  He still has to work on using language appropriately, but he is definitely communicative and shows compassion toward others.  When Thomas’ cousin was here two weeks ago, he brushed against her and accidentally knocked her on her little bottom.  She was fine, but Thomas was very upset about it.  He was sad and cried for a few minutes.  When he was with the occupational therapist a couple weeks ago, he broke something in her office (which was very small and not important, she assured me) and cried about it.  His ability to show compassion for others and regret for his actions – especially those that were accidental – is a very encouraging thing.

            Of course, due to our frequent use of the word “accident” at home, we’ve had to help the kids understand the difference between that and “on purpose.”  Unfortunately, both Thomas and Hayley have realized that if anybody says that something was an accident, that means that nobody gets mad and a disinterested and apathetic apology will make everything okay.  Hmpf.  I have a hard time not laughing when I see Thomas willfully whack Hayley on her arm or yank a toy away from her and then tell me that it was an “accident.”

            An amusing anecdote before I close:  Last week, Thomas was riding his tricycle around the living room at break-neck speed and crashing into the ottoman.  I had spoken to him about this a moment before so I was getting frustrated.  I said, “Thomas, if you can’t ride your tricycle nicely, I’m going to put it in the garage and only let you ride it outside.”  His reply:  “Don’t say that to me, old lady!”  I had to hide in the pantry so he wouldn’t see me laughing.  It took me several minutes to re-gain my composure and by then, Thomas had moved on to destroying something else.  I decided to let it go for the time being.  I was in no state to dispense discipline.  Thomas, 1; Mom, 0.  I guess I’ve really got to watch what I say in the car to less-astute drivers when the kids are with me.  It must be divine retribution.


Close-talker

Feb 4, 2008 by Anonymous

            I called the neurologist last Monday and upon hearing that Thomas is waking up earlier than ever, she decided to increase the Clonidine to two pills at night.  Now, he can barely get through his shower with his eyes open.  We’re giving it to him a little later than 7 p.m. so that he doesn’t fall asleep too early.  This medication seems to work quickly but not long-term.  I have heard that there is an extended-release Clonidine and I think I’ll have to call the doctor to ask her about it.

            Last Friday I had a conference with Thomas’ teacher.  It’s lucky that I came early because the principal cancelled conferences due to the big snowstorm we had here beginning Friday afternoon.  We had a great little talk about Thomas, who is doing so many new and interesting things.  He can trace his name all by himself!  He actually draws the letters – I saw a sample and she took pictures of him doing it!  I was very excited to hear that.  They have all the kids do it at the beginning of school every day, so I suppose that eventually they’ll just remove the letters that they trace and have the kids write their names.

            Also, and this is very cute, there’s a little girl in Thomas’ class who has a crush on him!  He has a little girlfriend!  She started right after winter break, so she is new to the class just like Thomas was in November.  The first day back from break, the kids were doing the “Freeze Dance” and Thomas asked this little girl if she wanted to dance with him – just like a couple of teenagers, but without the angst and fear of rejection.  Now she hangs around with Thomas and follows him around during the school day.  The teacher felt that Thomas actively seeking social interaction is a huge step in the right direction and so do we.

            One thing that we both agreed Thomas needs help with is that he’s a close-talker (remember Judge Reinhold on “Seinfeld?”).  He doesn’t acknowledge or understand other people’s need for personal space.  He gets about four inches away from someone’s nose and asks questions or starts talking.  I’ve been trying to model for him the appropriate distance there should be between two faces when a conversation is taking place.  As is typical, he doesn’t understand social nuances.  We continue to be grateful that he notices others and talks to them.  In the meantime, he’s our little close-talker.

            We talked a little bit about next year’s placement for kindergarten.  Thomas’ teacher thinks that at this point, Thomas would be best-suited to spending part of the day in a MLP (that’s multiple learning placement) class and part of the day in a typical kindergarten class.  Apparently, there are around thirty children in a regular class and the teacher feels that lots of kids would over-stimulate Thomas and he’d have a hard time with it.  The MLP class is much smaller but very similar to the kindergarten class in terms of what they learn.  There’s also the possibility of Thomas having an aide with him in the regular class.  Those are our options at this point, but we’re very excited at the idea of Thomas being able to spend part of his day in a regular class with typically developing kids.

            I’ve started taking Thomas with me when Hayley has dance class on Tuesday nights.  He’s been asking to come with me for a while now.  I explained that all we do is sit in a room and wait for Hayley to be done, but he was eager.  Luckily, there’s another little girl in there to play with and last week there was a six year-old boy he played with.  This boy was a little confused by Thomas’ lack of respect for the personal space, but he was actually very nice to Thomas and played with him during the entire hour.  Unfortunately, the Leapster that Thomas got for his birthday already crapped out, and that thing kept him quiet and entertained for quite a while.  I think we’ll have to get him another one and tether it to his wrist so that he can’t drop it anywhere…like the toilet.

            We’re having our car fixed so my mom was gracious enough to lend us hers while we wait for the necessary repairs to be completed.  Thomas has been very interested in the fact that Grandma’s car is sitting in the driveway, but luckily he’s not as crazy about the Camry as he is about Grandpa’s Highlander.  My dad specifically lent us the sedan knowing that Thomas is completely and utterly obsessed with my Grandpa’s car.  I explained that the Suburban was going to the “car doctor” to hopefully be fixed.  I told them that if the “mechanic” (vocabulary!) couldn’t fix the car, we’d have to get a different one.  Thomas was all for that idea.  He doesn’t really understand about commerce and the exchange of money for good and services, though.  Typical for his age group, but we’re still trying.  Luckily, we can get the family truckster repaired.  I told Thomas that the mechanic can give our car the right medicine and we’ll get it back tomorrow.  He said, “Wait, wait, wait.  You mean our truck is coming back?  What about a new one?”  I explained that we don’t have to get a new car after all and isn’t that great?  He was crestfallen, apparently really hoping to get rid of that old jalopy leaking oil in the driveway.  It’s so offensive to him.



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