Core Features of Autism -
Social Skills
by Dr Avril Brereton
One of the key features of autism is a
range of problems with interpersonal relationships, such as reduced
responsiveness to or disinterest in people, an appearance of
aloofness and a limited or impaired ability to relate to others.
The DSM–IV criteria for social
skill impairment in autism are:
Qualitative impairment in social
interaction, as manifested by at least two of the following:
- Marked impairment in the use of
multiple non-verbal behaviours such as eye- to-eye gaze, facial
expression, body postures, and gestures to regulate social
interaction;
- Failure to develop peer
relationships appropriate to developmental level;
- A lack of spontaneous seeking to
share enjoyment, interests or achievements with other people;
- Lack of social and emotional
reciprocity.
(American Psychiatric Association:
Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition, Text Revision. Washington, DC, American Psychiatric
Association, 2000)
Autism affects the development of
social skills in children from a young age and may be apparent in
infants with autism.
INFANTS WITH AUTISM:
-
often do not assume a normal
anticipatory posture or put up their arms to be picked up.
-
are usually not cuddly babies. They
often do not snuggle in when being held. Some infants may resist
being held by wriggling or becoming stiff. Others prefer to be
held facing outwards with their back to the person holding them.
-
may not respond to their name, may
respond inconsistently to their name or may be late to develop
this skill.
-
will often avoid eye-contact or only
make eye-contact quickly and then look away. Other children may
look you in the eye but stare for too long or be looking at
their own reflection in another person’s eyes. Some mothers
notice problems with their baby’s eye contact at a very early
age.
-
may have difficulty sharing their
interest in things and may not point out interesting objects to
others. Some infants with autism may point but the point will be
vague rather than a protodeclarative (direct) point.
-
tend not
to engage in social imitation, such as waving bye-bye and
pat-a-cake games.
PRE-SCHOOLERS WITH AUTISM:
-
may
show very little variation in facial expression in response to
others. For example, if smiled at they may not smile back.
Preschoolers with autism generally do not make eye-contact with
their peers or their eye-contact may have a staring quality to
it.
-
usually have impairments in the ability to make friends. They
may latch on to another child at preschool and want to be with
them all the time regardless of the child’s reaction to them. A
child with autism may have a preference for some peers based on
their appearance. For example, hair colour rather than their
personality or temperament. Some children may be rejected for a
particular reason. For example, a 4 year old who would not go
near a certain boy because of the shape of his ears.
-
find
playing with other children difficult, particularly
understanding the rules governing social behaviour. Taking turns
and sharing can be difficult concepts to understand and these
skills usually need to be taught in a concrete way. Preschoolers
with autism usually find group activities, such as mat time at
kindergarten difficult and often do better in small, structured
groups. Others may avoid the other children altogether
preferring to play alone.
-
rarely
develop an age-appropriate empathy (the ability to feel for
others) or the ability to understand that other people have
feelings. They may not share other people’s happiness or
sadness. At preschool the child with autism may not respond to
another child who is upset and crying or offer comfort. Some
children with autism may be distressed at the noise a crying
child makes and react to the noise rather than the emotionality
of the situation.
-
are
unlikely to spontaneously share with others things they have
done. To ‘show and share’ is difficult. For example, children
with autism will rarely take work out of their bags to show
their parents or bring a drawing to show them. They are also
unlikely to show what they have done to other children at
preschool.
-
usually have difficulties with joint attention. Joint attention
is the sharing of attention on one task. For example, a child
and parent looking at a toy together. Usually joint attention is
maintained by making eye-contact with the other person and then
looking back at the object of interest. Children with autism
also tend not to use pointing to direct other people’s attention
to things they are interested in.
-
often
do not respond to their name being called and seem to become
absorbed in whatever they are doing or whatever they are looking
at.
-
have
difficulty interpreting the feelings of others. They find it
difficult to read facial expressions such as detecting when
others are sad or angry. Even if they are able to determine that
a person is unhappy, the child with autism will usually not
attempt to offer comfort. They may also not seek comfort
themselves when upset or hurt or if they do so it is on their
own terms. For example, a child with autism may want mum to kiss
a hurt better, but if she tries to comfort him with a cuddle
this may be rejected.
All children with autism have impaired social skills, however, the
nature of these impairments can vary and may modify as the child
grows older. For example, there may be an increase in interest in
other people and the development of some social skills often learned
as rules in a mechanical or inflexible manner. In the past it was
thought that children with autism were not attached to their
caregivers, however, it has now been demonstrated that most children
with autism do show selective attachments to their primary
caregivers.
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