Social Skills That Are Not Always Social and Problems That (PDF)

Research & Practice for Persons with Severe Disabilities 2007, Vol. 32, No. 2, 110-111 copyright 2007 by TASH Commentary Social Skills That Are Not Always Social and Problems That Are Not Always Problems Edward G. Carr State University of New York at Stony Brook DESCRIPTORS: autism, social skills, problem be- havior, social motivation, idiosyncratic interests The best research studies are more noteworthy for the issues they raise than for the questions they answer. Being informative is good; being heuristic is better. The two papers under consideration here are heuristic as well as informative. Thus, Wong, Kasari, Freeman, and Paparella (2007) provide an answer to the question of what might influence the successful teaching of certain key skills in children with autism. It appears that the nature of the skill (symbolic play versus joint attention), the teaching approach used (discrete trial training ver- sus incidental teaching), and the specific child charac- teristics (developmental quotient) all influence degree of success. Likewise, Klin, Danovitch, Merz, Dohrmann, and Volkmar (2007) provide an answer to the question, what is the nature and significance of circumscribed in- terests in children with autism? It appears that high- functioning individuals with autism are extremely likely to have an obsessive interest in verbal learning and memorization of facts that may interfere with other activities pursued by themselves or with others. The findings just summarized are informative, but more importantly they are heuristic. They raise two critical issues for the field: the centrality of social motivation and the possibility that not all "problems" need to be treated. The Centrality of Social Motivation There is a strong emphasis in the field on ameliorating the profound deficits in social skills that children with autism display (Rogers, 2000). There is much less em- phasis on ameliorating the profound deficits in social motivation that they also display (Magito McLaughlin & Carr, 2005). In illustration, children can be taught so- cial skiUs such as greeting others and caiTying on simple conversations. However, will the children use what they have been taught, in a spontaneous, functional, and sus- tainable way, if they lack social motivation? That is, why greet or converse with others if you are indifferent to Address all correspondence and reprint requests to Edward G. Carr, Department of Psychology, State University of New York, Stony Brook, NY 11794-2500. E-mail: Edward.Carr® sunysb.edu them? Building motivation has become a topic of interest in the field (Koegei & Koegei, 2006) because social skills will neither generalize nor maintain in a meaningful and a normative manner unless the person who has acquired them is also motivated to use them. The good news from the study of Wong et al. (2007) is that it is possible to build a social skill such as joint attention using a combination of discrete trial training and incidental teaching, a finding we have seen in our own research (Jones & Carr, 2004; Jones, Carr, & Feeley, 2007). However, it is also true that the less social skill (symbolic play) was easier to teach than the more social skill (joint attention). Could it be that differ- ing demands related to social motivation are the reason for the disparity? In illustration, pretending that a specific object (e.g., a banana) is a telephone (symbolic play), although cognitively advanced, does not require much in the way of social motivation. In contrast, seeking your mother's nurturance and comfort by sharing attention with her (joint attention) because you are upset at the sight of a wounded bird on your front lawn requires that you value her kindness, are concerned about the suffering of the bird, and are eager to alleviate your own pain as well as the bird's by marshalling attention from an indi- vidual to whom you are closely attached. Here, social motivation is of paramount importance. The study of Wong et al. (2007) raises the issue of how, ultimately, we might best judge what we have accom- plished after teaching children skills such as symbolic play and joint attention. Specifically, we may wish to use the postintervention content of these skills to determine just how well we have succeeded in addressing the issue of building social motivation. Thus, a young girl who uses her banana "telephone" to rotely recite the names of all the U.S. presidents (as per Klin et al., 2007) is qualitatively different, from a social motivation perspective, than a young girl who uses her banana "telephone" to call her friend to recount the detection, rescue, and heartwarming salvation of the wounded bird previously alluded to. Likewise, a young boy who, robotically and repetitively, draws his mother's attention to the numbers and locations of pay phones (again, Klin et al., 2007) is qualitatively different, from a social motivation perspective, than a young boy whose joint attention involves drawing his mother's attention to a cartoon character whose loneli- ness and sadness is the result of being rejected by others. 110  Social Skills That Are Not Always Social and Problems That Are Not Always Problems 111 In each example given, both for symbolic play and for joint attention, the first vignette is much closer to the classic asocial autism profile whereas the second vignette is much closer to the "recovered from autism" profile that is the most cherished goal of all our efforts. In sum, it is not simply the acquisition of multiple skills that we seek, but rather the harder to obtain social motivation that transforms skills into human attachment. The concept of social motivation, inchoate at present and difficult to operationalize, cuts to the core of what it means to have autism. Therefore, the research question for the future concems how we can elevate critical skills such as sym- bolic play and joint attention to a level that reflects mean- ingful growth in attachment, bonding, sensitivity, and all the other aspects of human functioning inherent in the construct of social motivation. Not All Problems Need to be Treated The finding, in the study of Klin et al. (2007), that chil- dren with autism have a marked preference for focusing on things and facts rather than thoughts and feelings is quite consistent with the issue of social motivation just discussed. The bad news is that these children have mark- edly idiosyncratic interests. The good news is that they have interests. The bad news is that their narrow interests may impede interaction with family and peers. The good news is that we may be able to marshal their interests so that a lack of social interaction per se does not necessarily translate into an empty and failed life. Let me illustrate with an example. Recently, an undergraduate student ap- proached me with an urgent request to speak with me. He had been told that because he had Asperger's syn- drome, he would likely have a bad life although he was a straight "A" student in his senior year, had a girlfriend (with Asperger's syndrome!), and was being approached by prospective employers. I told him that many "typical" students without Asperger's syndrome would be elated if they had so many good things happening to them. Half jokingly, I remarked that, in my opinion, most of the successful, happy faculty and students in our Computer Science department seemed to have Asperger's syn- drome. The student expressed amazement and relief. Puzzled, I asked him why he had such a strong reaction and he revealed to me that he was, in fact, a computer science major. My point is that I am in complete agree- ment with Klin et al. when they assert that it may well be possible to channel idiosyncratic interests into vocational opportunities. The answer to the "how to do it" question, I believe, is related to positive behavior support (Carr, 2007). That is, consistent with the suggestion of Klin et al., the provision of systematic, organized, and functional supports is key to ensuring that people with autism can manage daily living demands that often require social judgment and the ability to "read" others' emotions. As the example of my computer science major makes clear, it can be done. The larger heuristic point is that not all "problems" may need to be treated. In a deep sense, not all problems may be problems. The fact that the computer science major whom I spoke to lived, breathed, and ate facts about software design and programming theory did not prevent him from having a good life. It was the insensitivity of others who suggested that his "disability" would be ruinous in the future that made him unhappy. In fact, his intense idiosyncratic interests did not require any treatment. What then is the alternative to treatment? The answer is niche picking. There is a profound principle operating here. Specifically, any one of us, with or without autism, when forced into a niche that does not blend well with our personal strengths and interests, is likely to develop "problems" to which we respond by selecting a different niche. That is the likely reason why so many of us change our jobs, spouses, and where we live. With support, people with autism can also be helped to transition to new niches that are more compatible with their strengths, and those strengths can sometimes involve "idiosyncratic" interests. Consider this observation: If you do not have autism but are intensely focused on a narrow set of interests, people may well describe you as passionate, dedicated, and self-disciplined. They may not want to marry you but they respect you. In light of this fact, our job (and a worthy research goal) is to find the right niche for people with autism and to support them so that they can pursue their interests in a constructive way that brings happiness to themselves and generates feelings of pride, respect, and hope from their loved ones. References Carr, E. G. (2007). The expanding vision of positive behavior support: Research perspectives on happiness, helpfulness, hopefulness. Journal of Positive Behavior Interventions, 9, 3-14. Jones, E. A., & Carr, E. G. (2004). Joint attention in children with autism: Theory and intervention. Focus on Autism and Other Developmental Disabilities, 19, 13-26. Jones, E. A., Carr, E. G., & Feeley, K. M. (2007). Multiple ef- fects of joint attention intervention for children with autism. Behavior Modification, 30, 782-834. Klin, A., Danovitch, J. H., Merz, A. B., & Volkmar, F. R. (2007). Circumscribed interests in higher functioning individuals with autism spectrum disorders: An exploratory study. Research and Practice for Persons with Severe Disabilities, 32, 89-100. Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treat- ments for autism. Baltimore: Paul H. Brookes. Magito McLaughlin, D., & Carr, E. G. (2005). Quality of rapport as a setting event for problem behavior: Assessment and inter- vention. Journal of Positive Behavior Interventions, 7, 68-91. Rogers, S. J. (2000). Interventions that facilitate socialization in children with autism. Journal of Autism and Developmental Disorders, 30, 399-409. Wong, C. S., Kasari, C, Freeman, S., & Paparella, T. (2007). The acquisition and generalization of joint attention and symbolic play skills in young children with autism. Research and Prac- tice for Persons with Severe Disabilities, 32, 101-109. Received: May 30, 2007 Final Acceptance: June 14, 2007 Editor in Charge: Lynn Koegel