Socialization deficits occur in enormous variety, running from extreme shyness and withdrawal to extreme intrusiveness. Children with socialization deficits may simply not care about the social implications of their behavior, may really not be aware of how their behavior affects others, or may be so self-focused that there are no “others” to affect as far as they are concerned. No matter where the social deficits lie, however, the treatment of every socialization deficit requires improvement in the child’s awareness of other people and their feelings. When a child does not have the ability to “put himself in another person’s shoes,” which affects many children with Autism spectrum disorders, the child is capable of learning “social skills” only by practicing them consistently so they become habits. Maintaining these habits will result in less self-stigmatizing social behavior and consequently greater access to socialization opportunities. Several intervention principles are noteworthy in addressing socialization deficits from a behavioral perspective:
Identification of cognitive or thought-process deficits that present a barrier to learning social skills is necessary. Children who have autism or significant cognitive (intelligence) deficits often have great difficulty “putting themselves in another person’s shoes” and will need to practice social skills conscientiously over relatively longer periods of time in order for these skills to become habits.
Abstract thinking (the ability to see a link between two objects or events) may be impaired in children who display socialization deficits. Accordingly, it may not be productive to use analogies, metaphors or other abstractions when teaching socialization skills.
Visual cues are often helpful to children who are learning social skills. Ongoing visual feed-back regarding behavior through the use of a device like the Behavior Barometer is more effective than verbal prompting alone for most children. Programs like “star charts” that provide just one feed-back point (usually at the end of the school day) are usually insufficient to teach new social skills.
For many children, the learning of social skills may create anxiety and requires practice in “safe” settings. Practicing a social interaction in a “dry run,” before the actual event is called “behavioral rehearsal” and is often very helpful. “Social Stories” give opportunities for the child to learn about a social behavior before it must be “demonstrated” it in a real-life situation.
A technique like “role playing” is inappropriate for children with deficits in the ability to “put themselves in another person’s shoes,” since role playing requires the child to switch roles with an adult (the adult “plays” the role of the child).