It is important for neurotypical therapists to understand that social interaction can be exhausting for autistic people and other people who are neurodivergent, especially if they are being pressured to imitate neurotypical mannerisms and mask their autistic behaviour and feelings. SLP Neurodiversity Collective therapists don’t “train” social skills. Historically, social skills therapy has been generally based upon neurotypical expectations which do not take into consideration the diversity of the populations we serve.

Examples of Pro-Neurodiversity Objectives:

  • Self-Advocacy
  • Perspective Taking: Self and Others
  • Interoception for: Self-Regulation, Self-Awareness, Flexibility of Thought, Intuition, Perspective Taking, Problem Solving, Social Understanding
  • Teaching how one’s body sensations  correlate to emotions
  • Figurative Language: Metaphors, Similes, Personification, Hyperbole, Symbolism
  • Building upon strengths

 
Note on Perspective Taking Therapy: 

Targeting perspective taking may include teaching children and teens to understand how and why neurotypical act the way they do in various settings and situations. We do not use rote social scripts or social stories that compel verbal or behavioral compliance as this takes away self-determination and leads to inauthentic communication.this takes away self-determination and leads to inauthentic communication. 

Targeting perspective taking may include teaching consenting Autistic people (old enough to determine their personal “social skills” goals, and old enough to understand potentially harmful aspects of masking) neurotypical socially expected norms in various social, educational and work environments. Clients will self-determine if, or when they choose to use this knowledge.

Examples of Ableist Objectives:

  • Treating Autism
  • Eye Contact with Communication Partner
  • Quiet Hands and Whole Body Listening
  • Extinguishing perceived neurodivergent social deficits
  • Teaching social scripting that encourages masking (feelings, emotions, stimming, sensory needs, quiet hands, compliance for rehearsed role-play, etc.) “Social Stories*” that are written and used in a manner that is meant to compel compliance
  • Social skills goals that focus on making the client appear indistinguishable from their neurotypical peers


Research:
Understanding, attitudes and dehumanisation towards autistic people
Cage, E., Di Monaco, J., & Newell, V. (2019). Understanding, attitudes and dehumanisation towards autistic people. Autism, 23(6), 1373–1383. https://doi.org/10.1177/1362361318811290

Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments
Sasson, N. J. et al. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci. Rep. 6, 40700; doi: 10.1038/srep40700 (2016).

Compensatory strategies below the behavioural surface in autism: a qualitative study
Lucy Anne Livingston, Punit Shah, Francesca Happé. Compensatory strategies below the behavioural surface in autism: a qualitative study. Lancet Psychiatry 2019; 6: 766–77  July 23, 2019 http://dx.doi.org/10.1016/ S2215-0366(19)30224-X

Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder
Lucy Anne Livingston, Francesca Happé. Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder. Neuroscience & Behavioural Reviews. September 2017. Volume 80, pages 729-742

Camouflaging and unmet support needs appear to be risk markers for suicidality unique to ASC 
Cassidy S, Bradley L, Shaw R, Baron-Cohen S. Risk markers for suicidality in autistic adults. Mol Autism. 2018;9:42. Published 2018 Jul 31. doi:10.1186/s13229-018-0226-4

“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions
Hull, L., Petrides, K.V., Allison, C. et al. J Autism Dev Disord (2017) 47: 2519. https://doi.org/10.1007/s10803-017-3166-5

Look me in the eyes: constraining gaze in the eye-region provokes abnormally high subcortical activation in autism
Hadjikhani, N., Åsberg Johnels, J., Zürcher, N.R. et al. Look me in the eyes: constraining gaze in the eye-region provokes abnormally high subcortical activation in autism. Sci Rep 7, 3163 (2017) doi:10.1038/s41598-017-03378-5

Why do those with autism avoid eye contact? Imaging studies reveal overactivation of subcortical brain structures in response to direct gaze
Massachusetts General Hospital. (2017, June 15). Why do those with autism avoid eye contact? Imaging studies reveal overactivation of subcortical brain structures in response to direct gaze. ScienceDaily. Retrieved January 13, 2020 from www.sciencedaily.com/releases/2017/06/170615213252.htm

Gaze fixation and the neural circuitry of face processing in autism
Dalton KM, Nacewicz BM, Johnstone T, Schaefer HS, Gernsbacher MA, Goldsmith HH, Alexander AL, Davidson RJ.  Nat Neurosci. 2005 Apr;8(4):519-26. Epub 2005 Mar 6. PMID: 15750588

Frontiers in Psychology – Body Influences on Social Cognition Through Interoception, September 10, 2019
Gao, Qiyang, Ping, Xianjie, Chen, Wei, 2019, M3 – 10.3389/fpsyg.2019.02066 , Body Influences on Social Cognition Through Interoception, Frontiers in Psychology, https://www.frontiersin.org/article/10.3389/fpsyg.2019.02066, VL – 10, SN – 1664-1078

For Further Reading:

“Training” Social Skills is Dehumanizing
How to address pragmatic language and social skills while respecting neurodivergent differences. Includes FREE Educational Tri-fold to download and share with clients!

How to teach pragmatic language without being ableist “Yet instead of recognizing autism as a different way of perceiving and interacting with the world, many practitioners of PLT train autistic folks to act neurotypical (also known as “masking” or “camouflaging”), even when their reasoning directly contradicts research.”

The costs of camouflaging autism

The Consequences of Compensation in Autism

Masking: I am not OK

For Those With Autism, Eye Contact Isn’t Just Weird, It’s Distressing

Eye Contact: Is It Important?

What’s The Problem With Whole Body Listening?

The Self-Advocacy Curriculum is a tool that is intended to help individuals with autism and other developmental disabilities learn more about the self-advocacy movement; celebrate neurodiversity; cultivate local self-advocacy groups; and ultimately, become and remain empowered through self-advocacy. – The National Autism Resource and Information Center and the Autistic Self Advocacy Network

THINKING PERSON’S GUIDE TO AUTISM – The Meaning of Self-Advocacy  “Self-advocacy has been and is still often labeled intransigence, non-compliance, treatment resistance, lack of motivation, behavior issues, violence, manipulation, game-playing, attention-seeking, bad attitude, bad influence, babbling nonsense, self-injurious behavior, inappropriate behavior, disrespect, disruption of the milieu, catatonic behavior, social withdrawal, delusions, septal rage syndrome, and even seizures or reflex activity.”

The ARC -POSITION STATEMENTS – Self-Advocacy  “People with intellectual and/or developmental disabilities (I/DD) must have the right to and be supported to act as self-advocates. Self-advocates exercise their rights as citizens by communicating for and representing themselves, with supports in doing so, as necessary. This means they have a say in decision-making in all areas of their daily lives and in public policy decisions that affect them.”

SO WHAT MAKES A GOOD THERAPIST? “Good therapists help children with finding ways to communicate, fostering independence without pushing too hard, understanding sensory issues, self-advocacy, learning to jump or ride a bike, understanding how to assess people and situations for danger, processing emotions in a way that is self-validating, and learning many new things the child desires to enhance their life.”

Autistic People. So, new Research. Different social skills, not broken ones 

Introception “The ability to tune into the activity of our internal organs is called interoception and there is emerging evidence that this ability is linked to how well a person is able to identify their own emotional state and to empathise with others.”

GETTING TO KNOW YOURSELF – INTEROCEPTION AND AUTISM

Activity Guide – Interoception 201

What is interoception? “Interoception is a pre‐requisite skill for self‐management and self‐regulation. It provides the tools to know when we are developing emotional reactions and the skills to be in control of those reactions.”