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How to Help a Child with Autism Take Part and Make Friends

From Lisa Jo Rudy, About.com Guide   July 24, 2010

How do you teach a child with autism to socialize in a typical setting?  The answer is neither simple nor fool-proof.  One parent writes:

Our 3yo son has just been diagnosed with Asperger's and Social Integration Dysfunction. My frustrations lie in his inability to initiate any sort of play. Everything is SO literal. Do we force him to socialise? I see his enthusiasm at watching other children play but it seems as if he is watching them through a window. Rarely does he join in, nor does he seem to want to. We recently signed him up for a soccer camp where he spent 30mins of the 45mins screaming to go home. When we finally did leave he spent the rest of the day talking about it as if he had had the best day of his life and asked to go back?? Do I keep forcing him to social? Is this harming him? Is this more for me than him? Any thoughts?

To be honest, I've never heard of a diagnosis of "social integration dysfunction," and couldn't find it on the web.  I'm guessing that you may be dealing with SENSORY integration dysfunction (sometimes called sensory processing dysfunction), which is a disorder that often goes along with autism.  With sensory integration dysfunction, the individual may be over or under-sensitive to sensory inputs from light, sound, smell, taste and touch.

This can make ordinary experiences more challenging, since the child may find, for example, that the bright lights and loud noises of a gym are overstimulating.  Or, on the other extreme, he may deliberately smash into walls or other children during play just to experience the sensation.

Meanwhile, you're asking a three-year-old with social and sensory and communications challenges (and very likely to some motor challenges) to take part in a very complex game that is really too difficult for any typical child under the age of six or seven.  Yes, I know that lots of kids play peewee soccer - but it's really above most little ones' heads.  It's not too surprising that he's finding it tough to understand and follow the physical, social and communications rules in order to play the game appropriately.

So...  what to do?

First off, recognize that a child with Aspergers and sensory issues is different, and (1) needs some therapies to help him develop physical and social skills and (2) may thrive with activities that require a little less physical and social prowess and a little more of whatever your son loves and is good at.  It may also be that you, his parents, can provide some of the help he needs to develop play skills and learn to connect more successfully with others.

Some specific suggestions:

  • Look into sensory integration therapy.  It's usually offered by an Occupational Therapist, and may well be available either through your school/early intervention program or through a local or regional autism center.  You may also find individual therapists by googling.  Be sure to check out therapists' reputations through local autism support groups.
  • Consider Floortime, RDI, or Play Therapy to help your child with Aspergers build the kinds of interpersonal skills he'll need as he gets older and more socially involved.  Floortime in particular can be implemented at home by parents and other adults, and all three are great tools for bonding and building both relationships and joyful play skills.
  • Look into speech therapy.  Even if your child is talking, he may be using speech idiosyncratically or not understanding some of what is said to him.  Pragmatic speech skills will be important for him as he gets older.
  • Select camps and extracurricular activities with your son in mind - and not on the basis of what's popular with neighbors and friends.  Consider small group activities with very clear rules and direction, such as...  martial arts.  horseback riding.  swimming.  Boy Scouts.  There are many other options; soccer is probably not one of them.

Many readers of this blog have been through this or a similar situation with their child on the autism spectrum.  Do you have any further suggestions for this parent?

Comments
July 24, 2010 at 4:05 pm
(1) Suzanne says:

It looks like Lisa covered this pretty well but, honestly, since he’s still only 3 years old, you most likely have plenty of time and things may improve as he gets older. In the beginning, my son did not look at us, acknowledge us or have any desire to “be” with us – and we are a family of eight! For his 2nd birthday, we sat in a circle on the floor around him and played, had a great time…but he completely ignored all of us and focused on his new toys. He will be 5 soon and now has interaction with each of us in different ways and at different times. When it comes to interacting with others, this is usually initiated by someone else (older child or adult) but he ultimately responds and usually plays with that individual in some way. Recently he started “trying” to interact with kids at McDonald’s play place and the park…to us, the “trying” is huge…but he hasn’t figured out “how” to interact yet. Since he is older, we have started taking him out to more and more places. Tonight he will be going to the bowling alley for the first time. This is a hit-or-miss process and sometimes you don’t know how things will go until you get there, but it is important to just keep gently moving forward and learning how to help him every step of the way.

I would recommend “trying” nutritional supplements – we use over-the-counter gummy bears which are both daily vitamins and Omega-3 supplements. This helped our son’s mood a lot and “I believe” helped him socially. I am sure you will hear lots of different opinions about the subject of nutrition and supplements, etc., this is just one person’s experience…thought I’d throw it out there.

Also, we recently had a break through with exercise based upon the recommendations (and a prescribed regimin) from a physical therapist. Using light ankle weights, we do fun exercise with him about once a day and this also significantly improved his mood, his focus/eye contact, etc. It has made a world of difference. The PT said she based his routine on Books by Dr. Daniel G. Amen (Change Your Body Change Your Life, also Change Your Brain Change Your Life) and the benefit is supposed to reduce depression, anxiety, while improving mood and focus…all of which can encourage any of us to be more comfortable with socialization. I’m convinced it has helped!

I agree with Lisa about finding activities of interest and in small groups. We’re looking at Lego clubs for building social activity over time… You also may find other kids/families with Asperger’s in your community who may offer friendship or support.

July 24, 2010 at 5:13 pm
(2) Sandy-2000 says:

I agree, being 3 is a very young age. I have never heard of social integration dysfunction either being termed to itself. It generally is a symptom of an ASD. I myself never forced my child at that age. A bad experience can last a whole lot of years for a child with ASD. One also has to consider a young child’s comprehension skills, figure out just what prevents the child from interacting and then start teaching the tools to help that child. A child with ASD, for many these social interactions do not come natural nor will it without modeling.

I think the best thing is to help that person know they are not alone in that behavior of their child. My son was a follower and did better with kids who were much older than him than is own age. My son is also very literal and that follows him in social settings years later even if he interacts with others, thus making peer relationships difficult anyway.
I also believe for little kids soccer wont really always benefit the child in a typical setting unless there’s some one who really understands autism. I know a doc who runs soccer teams for those with ASD with the bases of RDI, with some knowledge of redirection of course. However when it comes to sports, one has to consider how that will then trickle to other social settings which would enable the child to initiate any sort of play, other than soccer. Soccer is more parallel play than it is actually interacting direcly with a peer/ friend. The idea of RDI is many, but not all with ASD cant focus well in a large group setting. There’s too many distractions, too much going on for a child to focus. You take a child in a 1:1 or 1:2 peer setting with same likeness, teach the child within that small setting social interaction and what studies have shown is the child with ASD can then take those skills to a larger setting. It’s an on-going thing for many with ASD, my son may always struggle with social interacting. I remember when he was 4 years old and the private SP started Dyads (part of the RDI concept) she started out in a large setting with about 7 kids and I happened to stay to watch. My son was completely lost. I almost bawled my eyes out, but we both sort of giggled at how obvious it was the play peer setting was too large, my son was so obvious there was no question the therapist needed to start smaller.

I had to laugh at the crying the whole time during soccer, then the little guy saying it was the best time ever and he wanted to go back. My son does this all the time and he speaks in opposites so it’s hard to know exactly what he really means all of the time; did he really like it or not? The fear my son has is so over whelming for him, he had little coping skills when younger so all there was, was crying. What I did in those situations is tell my son it didn’t at all look like he was having fun, so if we go next time, he wont be crying or throwing a fit and if he does, it means he’s not having fun and crying and screaming hurts ears. I gave him examples of what he could do when he was so afraid. But again, at age 3 coping skills were far less and it’s taken years of work to be able to enter situations and learn to use coping skills.

July 24, 2010 at 5:18 pm
(3) Bill says:

I am endowed with Asperger’s.

I recently watched the movie “The Imaginarium of Dr. Parnassus.” The film was 1/3 finished when Heath Ledger died, so they substituted three different actors for the filming of the dream sequences; Johnny Depp, Jude Law and Colin Farrell. This confused the heck out of my wife, but I didn’t even notice. Such is face blindness; I go off other cues, like hair and clothes to identify people.

My poor wife has the misfortune of having inherited some kind of pattern baldness; she recently finally gave up and bought a wig. This totally freaks out my mental processes; to my ability to identify people, the lady with cropped hair and no eyeglasses I see in my bedroom is different than the lady who leaves for work each morning.

One of my brothers recently mentioned to me that as a child he could not recognize my mother if she changed her hair style.

Now imagine trying to make and keep friends if you cannot identify faces. Imagine trying to comprehend the strategy of a soccer game, if everyone looks the same, even the uniforms are well, uniform.

Imagine the social terror of being an adult, and being approached by someone who calls you by your nickname, and you haven’t got a clue who they are.

I used to be uneasy when people talked about their first grade teacher or childhood friends, because I had no recollection of people from my youth at all. I used to fear that my memory was being suppressed. I now know that I never did recognize these people, at least in the sense of creating a memory of what they looked like.

Imagine taking two liter Coke bottles, and adding a small unique feature to each; a larger Coke script on one, a slightly different shade of red on another, different color caps. Imagine giving each bottle a unique name, and asking you to remember it the next time you saw the collection of bottles. Do you think you could identify them? It’s difficult, but not impossible, and I do eventually recognize some people with distinctive features, as long as the distinctive features don’t change.

Some aspects of my memory are nearly photographic; I can study a map of a city, and then navigate my way around without relying on a GPS navigator. I can study a photograph of a person and remember it, yet I can’t apply that two-dimensional image to the three dimensional, plastic, human face and if shown another photograph of the same person in different clothes with a different hairstyle taken from a different angle, I will not necessarily recognize the person.

I first realized I recognized people by their hair/scalp when I worked at an office where the cubicle walls were about five and a half feet high. As I would look out over the labyrinth, I would see the top of people’s heads bobbing around, nothing but the top, and never had any trouble identifying anyone (or at least no more trouble than I would have looking at them face-to-face). I had always wondered why newspapers and magazines put squares over people’s eyes, or movie stars wore sunglasses, when to me it made no difference, I could identify them just as well as before.

I can’t recognize voices either, not even my own children’s. I surmise neurotypicals recognize voices by the timbre; how else could they almost instantly recognize a voice? I have to hear enough speech to catch their unique accent and speech pattern before I recognize anyone’s voice, unless it is truly unique. Since all of my children have the same accent, their voices are indistinguishable to me.

Being unable to recognize faces or voices can get embarrassing at work. I once got a phone call from someone I had only met once before, in a conference room with all of a small department in it. I confessed that I am not good at remembering people, and tried to coach him to give me some distinguishing feature to jog my memory. We failed to connect. The next time we met in person I was shocked to see he was an African American. I struggle to distinguish and identify people, about the best I can do is narrow it down to race, so for someone to not mention he is black when I ask for some kind of identifying feature boggled my mind, since he was the only black present.

So it boggled my mind to read the excerpted letter. I wouldn’t be able to attend a soccer game, make sense of it, and make friends, and I am an adult professional engineer! When I think back on the times as a small child I was exposed to groups, all I recall is the details of the location like wall color or placement of windows, and flashy objects which caught my eye.

People talk about us autists not making eye contact. Obviously, to a neurotypical, eye contact is part of communication. To me, eye contact is a warning; if someone is looking at me then that person may intend to harm me; why else would they be looking at me? Ever stare at a dog? They will get nervous. Even a cat will look away and start grooming. At an instinctive level, eye contact is a threat; it says, “I am the leader of the pack”.
I once waited in customs in a Central Asian former Soviet Block country, following a group of Americans who all looked like MacGyver. It was the creepiest thing in the world to follow their eyes and know as the only other American present (I had not seen another American or even a single English speaking person in a week) that they had all mastered the art of looking at me without looking at me. (All CIA?)

So the three year old screamed for thirty minutes. Maybe that’s how long it took him to decide maybe everyone of those humanoid objects flinging and kicking ominous black and white objects around weren’t threats. The screaming is a Catch-22; the more he screams, the more eyes look at him. The more eyes that look at him, the more he screams.

Learning to kick a soccer ball at three; learning the science of ballistics when even a neurotypical child will still be struggling with visual concepts like what a shadow is, depth perception and how to step off a curb without falling flat on your face. (And recent research suggests autistic children do not process shadow information properly in identifying objects.)

I would not force him to be social; I would teach him manners as best you can.
Are you harming him? Not any more than any other parent who makes their child do something they don’t want to do. A rather think that prepares them for school and employment, since they’ll spend most of their life doing things they don’t want to do.
Is it more for you than him? I am the last person on earth to figure out the enigmatic neurotypical mind which makes decisions based on emotions and social cues instead of logic and goals, so I can’t answer that question.

July 24, 2010 at 11:41 pm
(4) C. S. Wyatt says:

There was a time in the 1990s when the “Journal of Affective Disorders” and similar publications published articles addressing “social dysfunction, social integration, and social awareness disorders.” These were approached via something called “social-information-processing theory” which evolved from “child psychopathology” and is now called the “theory of mindblindness” by some scholars. Depending on the age and background of a clinician or researcher, these terms can get a bit mangled in write-ups and discussions.

Like many individuals diagnosed with autism, I was often the recipient of “does not play well with others” notes on my report cards and progress reports. I still don’t “play well” with others — which is why I prefer to work alone as much as possible. Most people annoy me after the shortest of times, for a variety of reasons. Those that don’t annoy me still manage to overload my mind within minutes.

I have to consciously interpret every motion, every word, every little aspect of a social interaction. I don’t “instinctively” know anything — so I must analyze like a computer running though a flowchart. My wife can look at someone at tell me about the person in a split second, from age to possible likes and dislikes. I have to study and analyze the same person for minutes, deliberately taking mental notes.

I would concur with Bill that I can memorize a city from a map — I did that recently in Dallas and drove all about the area even after forgetting the map at the hotel. Yet, I can’t recall people from mere days ago. I have to be reminded of a lot of things and even then the person is defined by what he or she does / knows, not the personality traits others notice.

I’ve written that I want social skills for the practical benefits, namely the ability to interact with some people I know could teach me certain skills, data, or knowledge. It is not because I friendships, but that I know social skills lead to situations in which I might hear or see new data.

Social skills would be valuable to me, because those connections produce intellectual and vocational results. I have endured years of assistance and still lack most social skills without a great deal of effort to mimic something close to “normalcy” — and I doubt I do that well.

Merely introducing myself to the moderator of this blog was no small task earlier this month. As it was, she was the only person I managed to meet at ASA. She has knowledge I admire and believe could help me understand other data points I have accumulated.

I dread dealing with people. It is so exhausting to process interactions that I choose carefully, knowing I will need hours to recover after most social interactions. It’s simply too much data to filter, so I end up focusing on the content of words and their literal meanings, leaving no “bandwidth” for information about the individuals I meet.

My wife has told me I notice more than she does about other people, but am terrible and knowing what I notice means. Example: I can tell you a person I met had a bracelet with cat, Eiffel Tower, and music note charms. My wife tells me these mean the person likes cats, has been to or might like to go to Paris, and probably plays an instrument or sings. My conclusion was that this person liked the charms.

July 25, 2010 at 8:51 am
(5) autism says:

Hi, CS, and thanks so much for your comment. I have to say it’s very helpful; gives me (and others) a window into a somewhat different way of processing information and interacting.

On a related note: I think there is a bit of a misperception that people without ASD diagnoses are by definition socially competent and able to manage complex social situations gracefully. Perhaps one reason you and I connect is that my social skills are nowhere near the high level that (apparently!) are typical of people withOUT ASD. When I read books about the hidden curriculum and related topics, I realize that the expectations for “social IQ” are very, very high indeed – higher, in fact, than many of us can manage!

I would also note that, apart from romantic triangles and other socially fraught situations, adult interactions are usually a LOT simpler than school interactions. As adults, we’re allowed a lot more leeway, and we can choose settings in which our differences are acceptable (which may be why so many folks on the spectrum gravitate to academics, research, technology and the arts!). In school, we’re forced to manage people and situations that make little or no sense to us. Perhaps there are better ways to set up our school situations???

Anyway, just a few thoughts!

Lisa

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