Neurodiversity Approach to Autism & Social 'Skills' Therapy

Parent:           “My kid needs social skills therapy..."

Me:                 “Do they..? Really?”

We get enquiries about social ‘skills’ therapy every day here at Sum of Us Kids, so I know what I’m about to write might be controversial... BUT, I am on a bit of learning journey and I want to bring as many autism parents & speech pathologists along with me for the ride as I can. So, here we go!

What is the Neurodiversity Approach to Autism?

The term ‘neurodiversity’ was first coined by sociologist, Judy Singer, in the 1990s. It describes the idea that, throughout the human population, different brain developments and structures exist. Neuro-differences, such as autism, should therefore not be seen as disorders or deficits that need a cure, but rather that neuro-diverse people should be included and embraced by society.

What are traditional approaches to social ‘skills’?

Most traditional therapy approaches for autistic kids’ social abilities are very much based on the idea that these kids have social ‘problems’ that need to be ‘fixed’. I refer to these approaches as ‘old school’, but unfortunately they’re still the status quo for a lot of speech pathologists.

Traditional approaches include:

‘Social Thinking’ - we get LOADS of parents requesting the Social Thinking approach for their kids. I have to admit that up until relatively recently, this was a go-to therapy for me and I have many Social Thinking resources. However, after listening and learning from the autistic community, these books have started to grow dust on my bookshelf. Among other things, the Social Thinking approach teaches autistic kids that their body needs to be still (Whole Body Listening), that their neuro-differences are “Unthinkable” and that their emotional responses are inappropriate (Big Problem, Small Problem),

Focussing on verbal communication above all other means of communication (e.g. AAC or signing),

Forcing eye-contact,

A focus on ‘stimming’ reduction.

What’s the problem with traditional approaches to social ‘skills’ therapy?

All of the above mentioned approaches focus on the Medical Model of Disability. That is to say, they focus on the autistic child’s perceived deficits. Traditional approaches can encourage masking, curtail ‘stimming’, and demand eye-contact. We have now learned from autistic adults and recent research studies, that such approaches can lead to significant life-long mental health issues.

Masking - Many traditional therapy approaches directly, or indirectly, encourage ‘masking’. Masking refers to when autistic people learn to hide their autism by acting like (non-autistic) people around them, in order to fit in. Recent research indicates that masking can lead to increased anxiety, depression and suicidal thoughts in autistic people.

Stimming - Stimming refers to ‘self-stimulatory behaviours’ (such as hand flapping) that is characteristic to many autistic people. Parents and therapists often have goals around reducing stims, mainly due to concerns about social acceptance. However, autistic people report that stimming can help with self-regulation and anxiety reduction. It can also just feel lovely! 

Eye contact - I suspect that there are still many parents (and speech pathologists?!) out there who don’t realise how uncomfortable eye-contact can be for autistic kids. Research and reports from autistic adults indicate that eye contact can be over-stimulating and that it can actually make it more difficult for autistic kids to listen to what the other person is saying. 

We could argue that demanding that autistic kids make eye-contact is solely to make the non-autistic person they’re communicating with feel more comfortable. This leads me to the ‘double empathy problem’…

Double Empathy Problem - Most early literature about autistic kids describes them as unaffected by other people and as being unable to achieve empathy. (This is what I was taught at Uni). More recent research evidence indicates that, rather than autistic people lacking empathy, BOTH autistic and non-autistic people can lack empathy about the other person’s perspectives, thus leading to the ‘double empathy problem’.

So, what can we do differently?

I am the first to admit that I am still learning (and unlearning) about how best to support the autistic community.

• I believe the number one thing we can do is to listen and learn from the real experts - autistic kids and adults. Google #actuallyautistic and you will find a plethora of amazing autistic humans willing to help you learn,
• Educate non-autistic people about changes they can make to respect and embrace autistic communication styles and,
• Help autistic kids develop self-advocacy and problem solving skills with a strengths-based approach to therapy.

What changes have you been making in your thinking about social 'skills' therapy and autism? Let me know your thoughts in the comments :)