Autism Spectrum Disorder is a developmental disorder characterized by persistent deficits in social communication and social interaction across various contexts as well as restricted, repetitive patterns of behavior, interests or activities. Autism represents a large spectrum of functioning, with those on the lower end of functioning often also experiencing speech and language delays, cognitive impairment, and behavioral difficulties.
Many individuals with autism do not experience these types of significant impairments and still may present with difficulties across a number of areas of social communication including:
- Social greetings, such as saying hello or introducing oneself
- Sharing personal information and general knowledge
- Modifying communication based on characteristics of the listener; for example, understanding that one interacts differently with a young child versus an adult, and differently with a close friend versus an acquaintance
- Taking turns in conversation, which includes difficulty responding to others in conversation, staying on topic, or allowing the other person an opportunity to speak
- Changing communication to match the behavior of the listener or the context of the situation
- Using gestures in conversation, such as pointing or waving
- Understanding various forms of nonverbal communication
- Understanding aspects of verbal communication that are not explicitly stated; for example, difficulty understanding implied and indirect uses of language, such as metaphors and humor
These challenges lead to impairment across a number of areas. In addition to having challenges connecting and interacting with peers, these symptoms often cause challenges in educational and occupational functioning.
What treatments exist for autism?
There is no treatment that will “cure” autism; however there are many evidence-based approaches that help individuals with autism connect socially, advance academically and professionally, reduce any behavioral challenges, and address co-occurring symptoms of anxiety, depression, and ADHD. Many evidence-based approaches including Cognitive Behavioral Therapy (CBT) and Parent Child Interaction Therapy (PCIT) have also shown to be effective in individuals with autism.
In terms of addressing social interactions, children with autism can be explicitly taught the skills needed to engage in expected ways with others in their environments. Like other skills, these strategies need to be first taught and then reinforced through practice. Our social worlds are filled with nuanced and context dependent expectations. For example, the expectations for social greetings vary greatly based on a number of changing factors. These factors include the environment one is in, the nature of the relationship between the individuals, the length of time since the individuals last saw each other, and the apparent affect and behavior of the other individual. Therefore, a “one size fits all” scripted approach to teaching social greetings and other skills is rarely successful. Social skills are best introduced first through building social awareness and teaching the concept that social rules shift based on the situation. Social Thinking (Winner, 1999) is an example of a curriculum that addresses these lagging skills by focusing on these concepts.