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Handbook of Autism and Pervasive Developmental Disorders:
Assessment, Interventions, and Policy, Third Edition
Edited by Fred R. Volkmar, Rhea Paul, Ami Klin and Donald Cohen
Copyright © 2005 John Wiley & Sons, Inc.
CHAPTER 38
Addressing Social Communication Skills in
Individuals with High-Functioning Autism and
Asperger Syndrome: Critical Priorities in
Educational Programming
WENDY D. MARANS, EMILY RUBIN, AND AMY LAURENT
Social communication skills, or the lack
thereof, play a major role in our success or inability to form social relationships that enable
us to function happily and effectively in the
communities and cultures within which we
live. Our ability to engage reciprocally, to appreciate the communicative intent of others
and to convey our own, to establish and maintain joint attention, and to appreciate another’s
perspective or point of view is essential to
learning and to forming friendships. The capacity to appreciate nuances of mood, to empathize, and to understand the complexities of
pretense, imagination, humor, sarcasm, irony,
and other implicit messages contributes to the
richness of our lives and of those around us
with whom we have relationships.
For most of us, the underlying appreciation
of social communicative behavior and use of
skills permitting such complex interactions
were never taught directly. Rather, our innate
social interest in others and our ability to appreciate the complex verbal, nonverbal, and environmental cues that convey this social
information permit us to form hypotheses,
make inferences, adjust our impressions and actions accordingly, and reach a level of social sophistication that should not be underestimated
(Nelson, 1985). It is only when we are faced
with breakdowns in social behavior or with individuals for whom this social understanding
does not come naturally that the complexities of
social capacities and the difficulties of teaching them explicitly become apparent.
The pronounced social communication
disability in individuals with high-functioning
autism (HFA) and Asperger syndrome (AS)
is often masked by relatively sophisticated linguistic abilities (i.e., the ability to produce
novel and creative verbal utterances) and, in
some cases, the presence of exceptional cognitive abilities such as a mechanical talent or
a specialized knowledge about an academic
subject area (Koenig, Rubin, Klin, & Volkmar,
2000). These areas of relative strength, however, stand in stark contrast to the inability to
engage in mutually satisfying social interactions. Clearly, there is great heterogeneity
among typically developing children, adolescents, and even adults with respect to their level
of social competence in any given setting. For
individuals with HFA and AS, however, learning style differences and developmental vulnerabilities remain significant challenges across
all settings of their life and provide devastating
barriers to achieving social communicative
competence (Volkmar, Klin, Schultz, Rubin, &
Bronen, 2000).
It is now well documented that positive longterm outcomes for individuals with HFA and
AS are strongly correlated with the achievement of social communicative competence
977
978
Interventions
(Garfin & Lord, 1986; Koegel, Koegel,
Yoshen, & McNerney, 1999; National Research Council [NRC], 2001; Venter, Lord, &
Schopler, 1992). Specific knowledge of the
obstacles to achieving this long-term goal is
essential, as individuals with these social disabilities will clearly benefit from opportunities to acquire strategies to engage in positive
and successful experiences with a range of social partners and across a range of social settings. For example, we know that individuals
who display a greater capacity to establish
and follow the attentional and conversational
focus of their communicative partners are
more likely to initiate socially appropriate
bids for interaction, follow turns and topics in
conversation, use more sophisticated nonverbal gestures and symbolic language, and recognize and repair communicative breakdowns
(Carpenter & Tomasello, 2000; Wetherby,
Prizant, & Hutchinson, 1998). We also know
that, by their very nature, social communication disabilities are transactional, and, thus,
direct instruction with the individual does not
necessarily ensure success across all social
partners. Those who interact with the individual must learn to accommodate and modify
their interactive style to facilitate success.
As a result, to achieve positive long-term
outcomes, effective programs must include
learning supports and accommodations not
only for the individual with the disability but
also for all the social partners and settings
within an individual’s community (e.g., family members at home, peers and teachers
at school, colleagues at work, and individuals
within community settings; NRC, 2001;
Prizant, Wetherby, Rubin, Laurent, in press).
Last, we know that challenges in social
communication are part of a larger picture of
developmental strengths and vulnerabilities
(Prizant, Wetherby, & Rydell, 2000). In particular, we are concerned with an individual’s
ability to use language and information gained
through social interactions for the purposes of
self-monitoring his or her physiological arousal
and emotional state. This capacity, otherwise
referred to as emotional regulation, enables
an individual to be organized and focused, to
problem solve, to communicate, and to maintain social engagement (Bolick, 2001; Prizant,
Wetherby, Rubin, & Laurent, 2001). Because
individuals with HFA and AS are particularly
challenged with interpreting the emotional
states of others as well as appreciating and
expressing their own, these factors further
compromise their social communicative competence and can limit availability for learning
and social engagement across contexts. Thus,
this chapter provides an outline of: (1) our
current understanding of the core challenges
facing individuals with HFA and AS that
compromise their social communicative competence, (2) the unique learning style differences often associated with HFA and AS, (3)
implications for intervention and educational
programming, and (4) critical priorities for developing a comprehensive intervention program designed to foster social communicative
competence.
CORE CHALLENGES IN
SOCIAL COMMUNICATION
Social communication is broadly defined as
those competencies that contribute to an individual’s ability to effectively communicate in
social contexts. Although there is great heterogeneity in the social communicative profiles of
individuals with HFA and AS, there is also a
common pattern of impairments. Contemporary
research has, in fact, identified that developmental vulnerabilities tend to fall into two
primary areas: the capacity for joint attention
and the capacity for symbol use (NRC, 2001;
Prizant et al., 2000). The capacity for joint
attention is central to the qualitative impairments in reciprocal social interaction, the most
profound in its impact over time of the triad of
diagnostic features used to define pervasive developmental disorders (PDDs) in the DSM-IV
(American Psychiatric Association, 1994). Regardless of an individual’s level of functioning
or developmental stage, the capacity for joint attention allows an individual to orient and, likewise, attend to a social partner, to both read and
share affective states, and to establish and follow another’s attentional focus when sharing
experiences in reciprocal conversation (Carpenter & Tomasello, 2000). An individual not only
needs to acquire a range of grammatical forms,
syntax, and vocabulary, but he or she also needs
to develop a greater awareness of a social partner’s perspective. For example, a child may
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
have a great deal of language to communicate
about a preferred topic, such as the makes and
models of race cars, but may have difficulty determining whether the listener is paying attention to the conversation, interested in the topic,
and/or has enough information to follow his or
her ideas. These joint attention skills are essential for social problem solving and social judgment, which become areas of particular concern,
especially during the preteen and adolescent
years when the complexities of the social milieu
are compounded by hormonal changes associated with puberty (Tantum, 2000). Table 38.1
lists those abilities that are compromised by
having difficulties with joint attention (Prizant,
Schuler, Wetherby, & Rydell, 1997; Prizant
et al., in press; Volkmar et al., 2000).
The second diagnostic criterion in the
DSM-IV, qualitative impairments in communication (American Psychiatric Association,
1994), otherwise referred to as the capacity
for symbol use, also has a deleterious impact
on an individual’s drive toward social communicative competence. For individuals with
HFA and AS, the relatively intact structural
language skills and sometimes advanced vocabulary, reading decoding, or subject knowledge often masks the degree of difficulty
experienced in semantics and higher level,
nonliteral language use and connected discourse. Individuals with these social disabilities may fail to get “ the gist ” or “read between
TABLE 38.1
979
the lines.” Thus, assimilating and accommodating new information, making connections
to other knowledge, and integrating these in
ways that provide them with a coherent sense
of the world can be challenging (Landa, 2000).
Additionally, the capacity for symbol use
reflects an individual’s ability to understand
and adhere to the social “rules” of pragmatic
discourse, which vary depending on the social
context and the accepted standards of a social
group, that is, “rules” that are, in a sense,
symbolic expectations for conversational
form. Through social experience and symbolic
understanding, individuals typically learn to
adapt their strategies for initiating, maintaining, and terminating conversation depending
on the social setting (e.g., a friendly discussion at a picnic versus a formal debate in an
academic course), the status of their social
partner (e.g., a friend versus a teacher or a
coworker versus an employer), or the purpose
that they are trying to fulfill (e.g., persuade,
humor, or impress). At more sophisticated levels, changes are also made in response to the
cultural background of a social partner because conventions for conversational discourse
vary greatly from one culture to the next (Carpenter & Tomasello, 2000) and because of
other more subtle social parameters.
For individuals with HFA and AS, these variations in symbolic conventions across social
partners and settings can be incomprehensible.
Core Social Communication Challenges in HFA and AS
The Capacity for Joint Attention
Understanding the communicative intentions and emotional state of a social partner
Interpreting and using nonverbal communicative signals
(e.g., facial expressions, prosody, body orientation and
proximity, and gestures) as they relate to one’s attentional focus, affective state, and intentions
Considering appropriate topics of conversation,
maintaining information, sharing across turns, and
repairing communicative breakdowns based on the
social context and a listener’s perspective
Modifying interpretation of more ambiguous language
forms (e.g., sarcasm, humor, figurative expressions,
etc.) depending upon the intentions or perspective of
one’s social partner
The Capacity for Symbol Use
Acquiring higher-level linguistic rules, grammar and
syntax, that clarify one’s intent (e.g., subordinate
clauses and conjunctions) across social partners and
environments
Understanding and using verbal conventions for initiating, exchanging turns, and terminating interactions
across different social partners and social situations
(e.g., rules of politeness)
Interpreting and using language in a f lexible manner
by responding to language that may contain: multiple
meaning words, non-literal language, and irony
Using language as a tool for emotional regulation
(e.g., preparing for changes in routine, preparing for
the expectations of different social contexts, and using
appropriate means to request assistance and comfort
across social settings and social partners)
980
Interventions
This pattern is largely due to concurrent vulnerabilities in the capacity for joint attention,
as an individual needs to consider another’s
perspective to gauge the stigmatizing impact
of unconventional social communicative behavior. As a result, it is not uncommon for an
adherence to a more specific and unchanging
set of “rules” of social discourse to develop
over time (Klin & Volkmar, 1997). This extreme literalness or rigidity, as some would
call it, is a common profile resulting from
symbolic impairments in individuals with social learning disabilities. Table 32.1 presents
those abilities typically impacted by challenges in the capacity for symbol use in individuals with HFA and AS (Attwood, 1998;
Prizant et al., 1997, in press).
Specific deficits in the developmental capacities for joint attention and symbol use in
individuals with HFA and AS do not remain stable throughout development. Rather, challenges
in these capacities “may take different forms
as a function of ongoing development ” as well
as a function of the negative impact that a social disability may have within that individual’s
social network (Schuler, 1995, p. 21). Since social interaction always involves others to some
degree, secondary effects arise as a result of
the atypical social communicative profile of the
affected individuals. Potential social partners
often perceive the unusual and/or lack of social
overtures of individuals with HFA and AS as
deviant or odd. Partners may avoid opportunities for interaction and/or react in a negative
way (e.g., bullying and teasing). In some instances, these factors can hasten the development of social isolation (Schuler, 1995; Schuler
& Wolfberg, 2000). Other children, adolescents, or adults may interpret limited initiations, responsiveness, or persistence as signs of
a lack of interest or, worse, unfriendliness.
They may see unusual and idiosyncratic communication styles and social bids as off-putting
or “ uncool,” and they may react negatively to
maladaptive behavioral outbursts, failing to
appreciate their peers’ inability to cope and express intentions or feelings in more socially
appropriate ways. As a result, the very individuals who need the most practice with social interaction and communication often have fewer
opportunities to do so (Lord, 1984). Thus, it
is evident that individuals need to not only
demonstrate developmental capacities in joint
attention and symbol use to achieve social competence but also actively engage in social experiences across a range of social settings and
social partners if they are to develop these
skills. It is these social experiences as well as
developmental capacities that facilitate an ability to interpret another’s perspective and modify the individual’s use and interpretation of
language accordingly, taking into account the
social context, critical factors in the achievement of social communicative competence.
CORE CHALLENGES IN EMOTIONAL
REGULATION
Competencies in joint attention and symbol use
are not the only prerequisites for the achievement of social communicative competence.
Being able to attend to the most relevant information in a social setting, to problem solve,
and to process information ( both verbal and
nonverbal) also rely on an individual’s ability
to maintain a state of active engagement, that
is, an optimal state of arousal (Anzalone &
Williamson, 2000; Degangi, 2000; Williams &
Shellenberger, 1996). These abilities are reliant
on an individual’s capacity for emotional regulation, a developmental process that supports
the attainment and maintenance of a steady
internal state and facilitates adaptive functioning and active engagement across contexts
(Wetherby, Prizant, & Schuler, 2000). Emotional regulation is believed to be critical for
the development of socioemotional and communicative skills as well as for the development of
relationships (Prizant & Meyer, 1993; Stern,
1985). This is due, in part, to the fact that emotions “emerge from and provide the foundation
of human attachment and social communication” (NRC, 2000, p. 107). Emotional regulation is not synonymous with the suppression of
emotion. Rather, it involves experiencing and
utilizing all emotions effectively and fluidly in
transactions with social partners while playing,
while learning, and while in the pursuit of social goals with respect to situational demands
(NRC, 2000). If an individual is able to regulate
his or her emotions in an efficient manner, he
or she is better able to interact with a variety
of social partners in a variety of social contexts. In contrast, if individuals are not efficient
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
in managing their emotions, they are prone to
emotional overreaction, inattention, and avoidance of social interactions (Prizant et al., in
press). Difficulty in regulating emotions can
lead to an individual’s experiencing a heightened emotional state, which can undermine the
development and mastery of new skills as well
as the application of previously mastered skills
(Bolick, 2001; Prizant & Meyer, 1993). This is
particularly true for the development of social
communication because the capacity for joint
attention and the capacity for symbol use are
contingent on attention, memory, and executive
functioning, all of which are widely regarded as
products of efficient regulatory skills and the
resulting ability to maintain a state of optimal
arousal (Lyon, 1996; NRC, 2000).
Since individuals with HFA and AS find
identifying and interpreting emotional states
( both internal and external) particularly challenging, their ability to engage in emotional
regulation across contexts is often vulnerable.
These emotional regulatory challenges manifest themselves in a variety of ways, ranging
from difficulties maintaining social engagement and sustaining focused attention, to challenges with recognizing and interpreting their
own and others’ physiological and emotional
states (Attwood, 1998). The underlying factors contributing to these regulatory difficulties are varied and are the subject of ongoing
debate in the literature. However, factors that
are generally recognized include challenges
TABLE 38.2
981
in social communication (i.e., difficulties with
joint attention and understanding symbolic
conventions; Wetherby et al., 2000), neurophysiological factors (e.g., sensory sensitivities, difficulty differentiating relevant stimuli
in the environment from extraneous stimulation; Anzalone & Williamson, 2000; Asperger,
1944; Kientz & Dunn, 1997; Ornitz, 1989),
and differences in the acquisition of motor
skills (e.g., motor clumsiness and difficulties
with visual-spatial perception; Anzalone &
Williamson, 2000; Attwood, 1998).
Tronick (1989) differentiates emotional regulatory capacities into self-regulation skills and
mutual regulation skills. Self-regulatory skills
are regarded as strategies that are self-initiated
and self-directed for the purpose of managing
an individual’s own arousal, emotions, behavior,
and attention. Mutual regulatory skills are defined as strategies used to secure assistance
from another as well as the ability to respond to
assistance provided in an effort to maintain a
well-regulated state. Both of these capacities
are often significantly compromised in individuals with HFA and AS. Table 38.2 lists areas
that are compromised because of difficulties
with self- and mutual regulation.
As noted previously, these vulnerabilities
are related, in part, to core challenges in communicating with and relating to others. Compromised abilities in the areas of joint attention
(e.g., difficulty appreciating and sharing both
emotional states and intentions) and symbol
Core Emotional Regulation Challenges in HFA and AS
Mutual Regulation
Self Regulation
Understanding and interpreting the emotional state of
self and others
Recognizing and interpreting one’s own physiological
and emotional state
Interpreting affective cues (e.g., facial expressions
and gestures) as they relate to the intentions of social
partners
Emotional reactivity and variable arousal state due to
physiological factors (e.g., sensory sensitivity)
Expressing emotions in a socially conventional manner as a means to request assistance from others
Responding to assistance offered by others secondary
to difficulties processing the verbal and/or nonverbal
social cues of social partners
Maintaining social engagement and focused attention
due to variability in arousal states
Attending to relevant information in a social setting in
order to problem solve, focus, and process information
Grading reactions to coincide with the expectations of
the current social situation
Ability to use effective behavioral strategies (e.g.,
sensory-motor regulatory strategies) that are deemed
socially acceptable
Ability to use cognitive strategies, such as “inner language” to anticipate and cope with potentially dysregulating events
982
Interventions
use (e.g., difficulty understanding and expressing emotions in a socially conventional manner) impact the process of mutual regulation,
making it difficult for an individual to solicit
assistance from others and compromising
the ability to utilize and interpret nonverbal
communication (Volkmar et al., 2000). Often,
these social communicative challenges, in conjunction with variable arousal states, interfere
with the individual’s ability to attend to social
conventions and to benefit from inherent opportunities for learning within social interactions. In turn, these difficulties also negatively
impact the ability to develop appropriate expressions of emotional states (Prizant et al., in
press). Therefore, individuals with HFA and
AS often lack both range and refinement of expression and typically exhibit an all-or-nothing
reaction when displaying emotions (Attwood,
1998; McAfee, 2002).
Difficulties establishing shared attention
with a social partner and communicating in a
socially conventional manner further compromise the development of self-regulation and
self-control in individuals with HFA and AS.
These capacities are typically achieved through
a process of socialization, in combination with
biological predispositions. The emergence, and
later mastery, of these skills is closely tied to
adaptive functioning and social communicative
competence (Degangi, 2000; NRC, 2000). Selfregulatory abilities that are typically evident
in early development involve behavioral strategies (e.g., sensory-motor means) of regulating
arousal level and emotions (e.g., seeking out
comforting objects and modifying activity
level) and are often elicited in response to state
changes (e.g., hunger, fatigue, heightened emotions). As individuals continue to develop and
their executive functioning capacities emerge,
they begin to use their language and cognitive
skills to assist with regulation of emotional and
behavioral reactions, adding to those sensorymotor means previously acquired. Early capacities in this area include the ability to use “inner
language” for self-regulation (Vygotsky, 1978),
understanding of activity schedules, and the
employment of avoidance strategies. This internal linguistic shift occurs with the developmental transition to symbolic communication, as
inner language reflects an ability to represent
events in memory and to problem solve through
inner symbolic means. Inner language serves
to organize social experience and behaviors,
allowing the individual to think about and learn
from past social events and plan for future
social events. These abilities facilitate an
individual’s capacity to attend to social and environmental stimuli, plan a response, and anticipate social consequences. With limited ability
to use inner language for these cognitive functions, it is less possible to plan for dysregulating
events or to reflect on past experience in a manner that supports active engagement and emotional regulation across activities. These
difficulties play a significant role in the presence of unpredictable reactions to daily social
events often exhibited by individuals with HFA
and AS.
Social communicative challenges also compromise the ability of individuals with HFA
and AS to understand emotional concepts, particularly those that rely heavily on social
norms or conventions (e.g., guilt, embarrassment, pride). An individual’s ability to interact
in a reciprocal manner with others is critical
for developing the concept of emotional identification. It is through interactions with their
social partners that individuals learn to “map”
emotional words and concepts onto their own
visceral states and experiences and, therefore,
derive emotional meaning and affective concept development (NRC, 2000; Prizant &
Meyer, 1993). For individuals with HFA and
AS, difficulty attending to and deriving meaning from these interactions translates into difficulties understanding those emotions that
reflect aspects of social relationships and complex interpersonal experiences. To understand
“embarrassment,” for example, an individual
must develop a sense of self-consciousness by
obtaining and using feedback in social contexts. Because individuals with HFA and AS
have difficulty with these emotional concepts,
their ability to anticipate and interpret the
emotional reactions of others is compromised;
thus, their acquisition of skills essential for
the development of self-control and other sophisticated regulatory abilities is hindered
(NRC, 2000). An individual may, for example,
exhibit a limited ability to modify bids for
communication to match the emotional states
of communicative partners. When this concept
of emotional reciprocity and viewing others’
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
emotional states as different from, but related
to, the individual’s own is compromised, the
individual often has difficulty with social interactions and tends to dominate conversations
without regard for social partners’ feelings,
preferences, or opinions (Prizant et al., in
press). These affective difficulties contribute,
in part, to the ongoing challenges in forming
peer relationships experienced by individuals
with HFA and AS.
In addition to social communicative difficulties, neurophysiological factors complicate
the process of maintaining a well-regulated
state for individuals with HFA and AS. References to sensory sensitivity (e.g., hyperresponsivity to environmental stimulation) and
resulting fluctuations in arousal level and physiological state are prevalent in the literature
(Anzalone & Williamson, 2000; Attwood,
1998; Kientz & Dunn, 1997). Asperger (1944)
himself described the individuals profiled
in his initial works as having difficulty differentiating relevant from irrelevant stimuli in
their environments. Additionally, developmental studies illustrate that individuals who present with hyperresponsive reactions to stimuli
early on are at greater risk later in life for
being socially withdrawn and anxious (Kagan,
Reznick, & Snidman, 1987; Kagan & Snidman,
1991; Kagan, Snidman, & Arcus, 1998), characteristics often demonstrated in individuals
with HFA and AS (Tantum, 2000). Variable
physiological responses to environmental and
internal stimuli often cause strong emotional
reactions. If an individual is sensitive to tactile
information (e.g., a peer inadvertently bumping into him or her while making the transition
from one class to another), this stimulus may
elicit an increase in arousal level as well as a
strong fear response. In conjunction with the
previously mentioned difficulties in interpreting intent, individuals with HFA and AS may
have difficulties regulating their reaction and
response to this innocuous event. Many factors
contribute to arousal changes, including the social context, constitutional variables, repertoire of self- and mutual regulation strategies,
and communicative partner style (Prizant
et al., in press). Social interaction itself can
have a dysregulating effect on the arousal level
and emotions of an individual with HFA or AS.
Interaction styles that are primarily verbal in
983
nature pose challenges to individuals with HFA
because of their difficulties processing transient auditory information (Schuler, 1995).
Similarly, individuals with AS are particularly
challenged by nonverbal communication and
dynamic visual information (Klin & Volkmar,
1997) and, thus, may respond with a heightened state of arousal when touched by a social
partner, when a caregiver establishes close
proximity, and/or when gestures are used without verbal language as a means of communicating an intent (see discussion of unique learning
style differences later).
Challenges in maintaining an optimal state
of arousal experienced by many individuals
with HFA and ASDs often result in high levels
of anxiety. An individual’s attempt to cope
with an overwhelming inability to modulate
levels of arousal or anxiety may lead to a strong
preference for routines and frequently to restricted areas of interest, as represented within
the final diagnostic criteria identified in the
DSM-IV for the disorders (American Psychiatric Association, 1994). Individuals with HFA
and AS frequently engage in repetitive and
restricted patterns of behavior, such as a preoccupation with a particular topic of conversation, academic subject area, or the completion
of a manipulative task in a self-absorbed manner. These behaviors often reflect the individual’s attempt to cope with an overwhelming
inability to modulate levels of arousal or anxiety (Attwood, 1998). Attwood acknowledged
that the greater level of stress an individual
experiences, the greater is the likelihood that
the intensity of a restricted area of interest will
increase proportionately. Therefore, at times,
behaviors that are often viewed by peers and
caregivers as socially inappropriate and odd
may actually serve an adaptive function, facilitating order, consistency, and relaxation
(Attwood, 1998; Tantum, 2000).
THE IMPACT OF DIFFERENCES IN
LEARNING STYLE ON
INTERVENTION PLANNING
Notwithstanding the common pattern of impairments in social communication and emotional
regulation across the different subtypes of
PDD, there is increasing evidence to suggest
that there are “different pathways to social
984
Interventions
learning disabilities” (Volkmar & Klin, 2002;
Volkmar et al., 1994). Greater knowledge about
the neuropsychological profile of strengths and
needs in individuals with HFA and AS has led to
useful gains in our understanding of what
modalities, methods, and strategies are more
effective in accommodating these distinct
learning challenges within an individualized intervention program. The neuropsychological literature available provides suggestive evidence
of several significant differences in learning
style between individuals with HFA and individuals with AS (Volkmar & Klin, 2000, p. 52),
a finding that has critical implications for our
intervention planning. For example, results of
the DSM-IV Autism / Pervasive Developmental
Disorder Field Trial conducted by Volkmar
et al. suggested that in some aspects of learning,
individuals with AS performed better than individuals with HFA and, in other areas, the converse was the case. While individuals with AS
demonstrate relatively preserved, if not precocious, verbal abilities, they often demonstrate
significant vulnerabilities in nonverbal concept
formulation, visual-spatial perception, and visual memory (Volkmar & Klin, 2000). For individuals with AS, vulnerabilities in these
aspects of learning compromise their ability to
attribute meaning to nonverbal social cues,
process inflection and the emotional contours
of voice, and integrate sequences of visual information to create a social and affective context. It is interesting that the presence of strong
verbal skills in an individual with AS often
provides an ideal modality for intervention because the individual can incorporate the use of
verbal mediation throughout his or her day.
This refers to the use of explicit, verbal instruction to facilitate awareness of the subtleties of social and emotional behavior that
unaffected individuals typically learn incidentally through ongoing observations of nonverbal social cues in their environment during
meaningful interactions (Attwood, 1998; Jahr,
Eldevik, & Eikseth, 2000; Klin & Volkmar,
2000; Stewart, 2002). For individuals with AS,
verbal language, in fact, often becomes a lifeline for learning about themselves and about
the expectations of the social world.
Although developing an awareness of the
subtleties of social and emotional behavior
is also challenging for individuals with HFA,
differences in the contributing neuropsychological vulnerabilities are evident. Individuals
with HFA demonstrate relative strengths in
visual-spatial perception and visual memory
while their verbal abilities (i.e., expressive
language, comprehension, and verbal memory)
are likely to be more impaired (Ozonoff &
Griffith, 2000; Volkmar, Klin, & Cohen,
1997). Although difficulties with processing
nonverbal social cues clearly exist in individuals with HFA, these challenges are more likely
a result of a preference for static or nontransient visual information over fast-paced or
transient visual cues, rather than a limited
ability to process visual-spatial information
(Schuler, 1995). Additionally, individuals with
HFA, unlike individuals with AS, often present
with a gestalt, as opposed to an analytic learning style (Prizant, 1983), which further compromises their abilities to break down larger
units of information into smaller units of
meaning (e.g., individual words within a verbal utterance, subtle social cues such as a
change in facial expression, and variations in
intonation), particularly when that information is transient in nature (e.g., fast-paced social cues and verbal language). Therefore, the
provision of static visual cues is an appropriate
accommodation when supporting individuals
with HFA in their awareness of social conventions (Groden & LeVasseur, 1995; Hodgdon,
1995). Verbal mediation strategies, although
often helpful with individuals with AS, may
prove to be less effective for individuals with
HFA given that this modality is transient and
requires analytic processing, two identified
areas of relative weakness in HFA (Klin &
Volkmar, 2000; Prizant & Schuler, 1987).
Despite these significant differences in
learning style, the commonalities that individuals with HFA and AS demonstrate with respect
to impairments in social communication and
emotional regulation speak to their need for
similar accommodations within an educational
program. Difficulties understanding the communicative intentions and emotional states of a
social partner, compounded by difficulties recognizing social conventions across contexts,
contribute to a common preference for learning
within predictable routines, for very explicit
instruction, and for explanation about implicit
social messages (Schuler, 1995). It is these
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
common learning preferences in individuals
with both HFA and AS that require differentiation of the salient from nonsalient features of
social interactions and an increase in recognition that when a person is anxious or overwhelmed, as is often the case within more
novel or unstructured social contexts, learning
is unlikely to take place. Thus, individuals
with HFA and AS, as well as individuals with
other types of social learning disabilities, will
benefit from programs that incorporate: (1)
accommodations that foster an individual’s
ability to remain well regulated and, therefore,
less anxious as he or she traverses through the
constant flow of social interactions within
each day, (2) accommodations that support an
awareness of the intentions and affective
states of the individual’s social partners, and
(3) accommodations that facilitate an awareness of the predictable aspects of more novel
social events (e.g., the temporal flow, the social conventions, and communicative intentions of those involved).
Additionally, it is appropriate to consider
the common modalities that appear to be effective methods of supporting social communicative competence in individuals with both HFA
and AS. Although visual-spatial perception
can be challenging for individuals with AS, we
know that reading, that is, the written word, is
often a relative strength secondary to their
strengths in word recognition and verbal language (Rourke & Tsatsanis, 2000). Individuals
with HFA also share this relative strength in
reading because the written word in contrast
TABLE 38.3
985
to oral language is nontransient and visual
by nature, and their ability to process the written modality often far exceeds their ability
to process oral language (Wetherby et al.,
2000). Regardless of the origins of this learning
strength, it has led to a number of universal
strategies for intervention including the provision of visual supports incorporating the written word for: (1) increasing an individual’s
preparedness for and independence when making transitions across activities, (2) progressing
through steps within tasks, (3) making choices,
and (4) accepting changes in routine (Dalrymple, 1995; Myles & Simpson, 1998). Written
cues have also been helpful, in some cases, for
supporting social conversational skills within
classroom settings (Freeman & Dake, 1997;
Krantz & McClannahan, 1998) as well as for
enhancing an awareness of social conventions
and perspective taking (Gray, 1995; Gray &
Garand, 1993; Hagiwara & Myles, 2001). Although the effectiveness of each of these individual strategies may vary from one individual
to the next, an understanding of an individual’s
learning strengths and preferences should
clearly form the basis of an appropriate intervention plan (NRC, 2001). Table 38.3 provides
a summary of the impact of distinct neuropsychological learning differences between
individuals with HFA and AS and our understanding of what modalities, methods, and
strategies are more effective within an individualized intervention program.
In addition to these unique neuropsychological patterns, the impact that challenges in
The Impact of Learning Style Dif ferences in HFA and AS on Modalities of Intervention
High Functioning Autism (HFA)
• Strengths in visual-spatial perception and visual
memory
• Preference for nontransient or static information
• Weaknesses in expressive and receptive language
and verbal memory
Implications
The provision of static visual cues is an appropriate
accommodation when supporting individuals with HFA
in their awareness of social conventions. Verbal mediation strategies, although often helpful with individuals
with AS, may prove to be less effective for individuals
with HFA secondary to the transient and languagebased nature of this modality of learning.
Asperger Syndrome (AS)
• Weaknesses in visual-spatial perception and visual
memory
• Strengths in expressive and receptive language and
verbal memory
Implications
The strong verbal abilities skills characteristic of AS
often provide an ideal modality for intervention, as the
use of verbal mediation can be incorporated throughout
his or her day. This refers to the use of explicit, verbal
instruction to facilitate awareness of the subtleties of
social and emotional behavior that unaffected individuals typically learn incidentally through ongoing observations of nonverbal social cues in their environment.
986
Interventions
emotional regulation may have on learning
style (e.g., attention, social engagement, problem solving, executive functioning) has critical
implications for developing an individualized
intervention plan. Therefore, when designing
an educational program designed to support
social communicative competence, it is essential to address the core emotional regulatory
challenges faced by individuals with HFA
and AS throughout their daily routines (Myles
& Simpson, 1998; Prizant et al., in press).
Addressing these problems will enhance the
efficacy of programming, promote social acceptability among a network of peers and,
thereby, increase the capacity to engage in
positive social experiences across settings and
partners. The development of both the capacity for self-regulation and the capacity for mutual regulation ensures that the individual with
a social disability and his or her social partners develop an ability to engage in reciprocal
interactions where both partners are actively
engaged, provide clear expressions of emotional state, and utilize effective and socially
appropriate coping mechanisms that reduce
anxiety and variations in arousal and emotional state.
Fostering emotional regulation may require
social partners to modify both their interaction
styles and the environment so that an individual
can remain actively engaged in a particular
social setting (see later discussion on transactional supports). However, the goal is for the
individual to manage independently in these
areas, thereby decreasing the need for environmental modifications. Appropriate goals to be
addressed may include, but are not limited to,
the following: (1) increasing the individual’s
ability to acquire and use socially acceptable
behavioral strategies to support engagement and
attention in daily activities and to cope with
unexpected schedule changes and transitions,
(2) increasing the individual’s ability to use
socially acceptable nonverbal and verbal expressions for social control and expressing
his or her emotional state, and (3) increasing
the individual’s ability to acquire and utilize
cognitive-linguistic strategies to support his or
her attention to activities and daily routines
(e.g., through the use of rehearsal and selfregulatory language, by reference to visual supports; Prizant et al., in press).
For individuals with HFA and AS, it is
also critical to foster abilities in the areas of
emotional identification and emotional understanding so that they are more able to grade
their emotional reactions to specific events or
incidents and to display their emotions in more
conventional ways. Therefore, the following
goals are viewed as critical for fostering increased social communicative and emotional
regulatory competence:
1. Increasing the individual’s acquisition of
conventional verbal and nonverbal communication forms for requesting assistance
and/or organizing supports.
2. Increasing the individual’s ability to use
specific vocabulary or conversational devices to express emotional state and arousal
level.
3. Increasing the ability to identify and express emotional state and arousal level as
well as using regulating strategies, with
and without the use of visual supports.
4. Increasing social understanding and social
expectations through language-based strategies (see later discussion on transactional
supports).
Because expression of emotional state and coping strategies are person and context specific,
these goals and supports should be implemented throughout an individual’s day across a
variety of social partners and social settings.
EDUCATIONAL PROGRAMMING
FOR INDIVIDUALS WITH
HIGH-FUNCTIONING AUTISM
AND ASPERGER SYNDROME
To make informed decisions about the curriculum and methodology of an educational program
designed to foster social communicative competence in individuals with HFA and AS, you must
maintain an awareness of the state of the science in the field, particularly in relation to empirical studies demonstrating the efficacy of
specific approaches, curricula, or methodologies. This is especially critical when working
with this population, as a number of specific,
programmatic approaches are available reflecting different philosophical views, and, in some
cases, proponents of these programs have made
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
claims that their approach is superior to other
approaches (Green, 1996; Smith, 1996). Although there remains great controversy in the
field as to which intervention approach is
the most appropriate, it is premature to claim
that “any one approach is more effective than
other approaches” (Prizant & Rubin, 1999,
p. 199). Empirical research has, in fact, demonstrated the effectiveness of a range of
approaches that vary in their curriculum and
methodology (Dawson & Osterling, 1997;
Rogers, 1996); and, perhaps more importantly,
a number of studies suggest that “no one approach is equally effective for all children”
(Prizant & Rubin, 1999, p. 199). Thus, it is critical to create an educational program that fosters success with a specific individual, his or
her family, and that individual’s social network.
The Committee on Educational Interventions
for Children with Autism was a panel formed by
the NRC (2001) to review empirical research
in the field, literature from model programs,
and literature from general education and child
development. Their charge allowed the committee to formulate specific recommendations
for educational programming, provide guidelines to direct public policy, and indicate the
need for more ecologically valid outcome measures (described further later). The findings
of the committee support the notion that “effective services will and should vary considerably
across individual children, depending on a
child’s age, cognitive and language levels, behavioral needs, and family priorities” (NRC,
2001, p. 220).
Educational Guidelines
When developing an appropriate educational
program for an individual with HFA or AS,
individualization of curriculum, learning accommodations, and settings are of paramount
importance. Social skills do not exist in a vacuum, and to teach them effectively, the individual must be considered as a whole from a
developmental perspective. His or her strengths
and needs, learning style, specific interests,
preferences, and regulatory capacities and vulnerabilities should be understood and planned
for when organizing the program. Likewise, the
Committee on Educational Interventions for
Children with Autism provided a number of
987
recommendations for programming and outcome measures to guide our work. These include, but are not limited to: (1) addressing
functional and spontaneous communication,
(2) implementing supports for social communicative competence across a range of social
settings, and (3) providing opportunities for
guided instruction within natural contexts (e.g.,
peer interactions, inclusion opportunities). Additionally, consideration of the range of factors
that may be contributing to problem behaviors
is considered critical as a means of supporting
each individual’s personal responsibility for
his or her social behavior (NRC, 2000, 2001,
p. 221). Last, the committee strongly recommended that meaningful outcome measures be
incorporated on an ongoing basis (i.e., 3-month
intervals; NRC, 2001, p. 220), as part of each
individual’s educational program, as a way of
assessing generalization of gains across social
partners, social settings, and activities (NRC,
2001, p. 228). Thus, social competence cannot
be measured without attention to an individual’s adaptation and success within day-to-day
activities in natural contexts.
Despite this recommendation and our clinical awareness of what we want to achieve,
it is not uncommon in programming for social
communication skills that different target
goals and objectives are treated as discrete entities and/or that provision of designated social opportunities at specific times of the day
(e.g., Circle of Friends, Lunch Bunch, or social
skills groups) is considered to encompass and
to address the social needs of an individual.
While many of the specific goals or activities
are appropriate and beneficial components of
an educational program, fostering social communication must be understood as integral
across an individual’s day (e.g., each class at
school, lunch, recess, transition times), across
contexts (e.g., school, home, and community),
and across social partners (e.g., peers, teachers, siblings and parents, coworkers, and members of shared groups). Facilitating social
skill development does not rest solely with
the speech-language pathologist, occupational
therapist, social worker, psychologist, counselor or paraprofessional, nor does it rest only
with the parents. Rather it is shared among all
those coming into contact with the individual,
including peers, coworkers, and members of
988
Interventions
the community. Although certain team members will have more responsibility for developing and implementing aspects of the social
programming than others, a critical piece in
the program planning is to integrate and make
the connections among what is being taught;
why the skills are needed; how, when, and
where to use them; and, most importantly,
with whom. This cohesive and comprehensive
approach should be at the core of facilitating
social communicative competence, since the
ability to integrate and apply learned skills
and the capacity to generalize them forms the
essence of social understanding that is so challenging for individuals with HFA and AS.
Skills being taught should, therefore, not be
considered the end product but need to be
worked on with attention to: (1) the contexts in
which they occur naturally, (2) the reciprocal
adaptations demanded by social partners, and
(3) the ability to then generalize the skills to
other contexts and individuals. The complexity
of planning an educational program that integrates social skills across settings is not to be
underestimated. Nevertheless, the outcomes
are more likely to have ecological validity and
real life payoff. For any given individual, the
planning of a social skills educational program
must be individualized and take into account
the lifestyle and demands that will dictate priority needs, supports to be developed within
the community, choices of materials and activities, and individuals to be included.
The success of any educational program
should include measures of its relevance and
functional impact on an individual’s day-today life, that is, meaningful outcome measures.
Schwartz (2000) discusses the notion of using
“membership” as an important measure of
whether an educational program designed to
support social communicative competence has
been successful. Schwartz pointed out that social skills are not a goal in and of themselves;
rather, the objective is to support the learning
of social behaviors, including social communication, that permit and promote the development of meaningful relationships that are
culturally relevant. Based on a 5-year multisite project using natural settings to support
children’s social relationships conducted by
Meyer, Grenot-Scheyer, Schwartz, and Harry
(1998), the following guidelines for socially
and ecologically valid interventions were suggested. Interventions should be:
1. Consistent with the social expectations of
a given context;
2. Feasible with respect to available resources—personnel, expertise, and materials;
3. Sustainable over time;
4. Owned and operated by the constituency or
community within which they occur (teachers, parents, and students);
5. Culturally inclusive; and
6. Intuitively appealing.
Primary Dimensions of Intervention
In the case of social learning disabilities, we
must remember that the social impairment is
not solely due to the developmental vulnerabilities and learning style differences of the individual with HFA and AS; rather, the “social
impairment is shared” with all of those attempting to engage or, for that matter, disengage with the individual (Gray, 2001). As
noted earlier, social isolation can be hastened
by the negative perceptions that idiosyncratic
styles of communication often create among a
larger peer network (Lord, 1984; Schuler,
1995). Additionally, the success of any given
social exchange relies not only on an individual’s ability to adhere to social conventions,
remain actively engaged, and accurately consider another’s intents but also on the social
partner’s ability to adapt his or her interpersonal style and the environment to match the
needs of the individual with the social disability. As Gray indicated, we, as social partners,
“are part of the problem” and, thus, should be
“part of the solution” as well. An additional
factor is the impact of a social disability on
that individual’s family, with respect to not
only their interpersonal style and the home environment but also their emotional well-being
or adjustment. Recent studies have shown that
more positive outcomes are associated with
the provision of family support and mechanisms for coping with the stress of raising and
living with an individual with a social disability (NRC, 2001). The Social Communication
Emotional Regulation Transactional Supports
(SCERTS) model provides a comprehensive
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
framework to follow when designing an educational program to foster social communicative
competence in individuals with social communication disabilities (Prizant et al., in press).
This framework includes the following dimensions designed to foster social communicative
competence in individuals with HFA and
AS: (1) interpersonal supports across social
partners (e.g., communicative style adjustments with peers, teachers, family members,
and members of the community); (2) learning
and educational supports (e.g., visual /written
supports and environment arrangement /modifications); and (3) family supports (e.g., educational support as well as ongoing emotional
support).
TABLE 38.4
989
Specific accommodations and learning
strategies are discussed next as they relate to
these primary dimensions. Table 38.4 summarizes these accommodations.
Interpersonal Supports
To foster success within social interactions between the individual with HFA and AS and his
or her social partners, the emphasis should
not solely be on the individual with a social
learning disability. Rather, a critical emphasis
needs to be placed on supporting a partner’s
ability to make communicative style adjustments to support the interaction. Communicative style adjustments relate to the specific
Transactional Supports for Individuals with HFA and AS
I. Interpersonal supports
a. Identify the qualities of a social partner’s use of verbal and nonverbal forms of communication that are
either facilitative or provide barriers to an individual’s attempts to engage in reciprocal social communicative exchanges and maintain active engagement.
b. Implement communicative style adjustments to adapt to the unique learning style differences of an individual with HFA and AS. For example, the use of explicit and clear expressions of one’s intentions and emotional states, devoid of idioms and sarcasm, often supports the processing abilities of an individual with
HFA or AS. In contrast, the use of a high rate of nonverbal social cues (e.g., raising one’s eyebrows to indicate distaste) when interacting with individuals with AS or the use of verbal language in the absence of
static visual cues (e.g., concrete gestures) with an individual with HFA may actually provide barriers to
achieving successful communicative exchange. Consideration should also be given to factors such as vocal
volume, rate of speech, prosody, proximity, and physical contact.
c. Coordinate communicative style adjustments across all of the individual’s social partners (e.g., peers,
teachers and professionals, family members, and members of the community).
II. Learning and educational supports
a. Design visual and organizational supports to foster social communication and emotional regulation across
social partners and social contexts (e.g., understanding the communicative intentions and emotional state
of another, understanding of time and activity structure as a means of preparing for potentially dysregulating events, and identifying one’s emotional state and socially acceptable coping strategies).
b. Arrange and modify the physical environment to support social communication and emotional regulation.
For example, accommodations such as clear physical boundaries for activities, clear temporal structure,
reducing levels of auditory and visual stimulation, if appropriate, and providing opportunities to engage in
social interactions in small group contexts. Consideration should also be given to the demands of a given
environment, as expectations should be appropriately matched to an individual’s unique challenges and
learning style (e.g., curriculum modifications, reduced expectations for homework).
III. Family support
a. Specific accommodations should be developed across all family members who interact with the individual with HFA and AS. A particular emphasis should be placed on fostering an understanding of the
nature of the disability and the communicative style adjustments, learning supports, and environmental
arrangements that can be implemented in order to facilitate more positive social exchanges and development in the areas of social communication and emotional regulation.
b. Emotional support should also be provided in both one-to-one and group contexts by supporting each
family member’s ability to cope with the stress and challenges of raising or interacting with an individual with HFA or AS. A particular emphasis should be placed on supporting an ability to identify priorities and develop appropriate expectations and realistic, achievable goals for the family as a whole as well
as the individual’s ongoing development and drive toward social communicative competence.
990
Interventions
modifications that a social partner might make
with respect to interpersonal style, use of expressive language, and use of nonverbal forms
of communication (e.g., gestures, facial expressions, and intonation) to match the unique
needs of the individual with HFA or AS
(Prizant et al., in press; Quill, 1995). Identifying those aspects of interactions that either
support or interfere with an individual’s ability to engage in successful, self-initiated, and
reciprocal interactions allows for greater attunement when facilitating interactions across
social partners and settings. These interpersonal supports should be targeted across parents, peers, teachers, professionals, and other
members of the community, and may vary depending on the partner’s role in enabling the
development of each individual’s social competence throughout his or her daily routine.
Because the impact of a social disability on
family members is unique to that of other social partners, providing family support is discussed in greater detail.
Interpersonal Support for Peers
Individuals with HFA and AS often demonstrate an interest in peers, and, particularly as
they mature, they yearn for friendships and
social acceptance. The nature of their social
impairment, however, compromises their understanding of the social conventions necessary for entering into play-based interactions,
joining in social conversations, and/or engaging in the repartee that comes so naturally to
their peers (Schuler & Wolfberg, 2000). These
challenges reinforce a tendency that already
exists for those with HFA and AS to become
adult-directed and to turn toward their teachers, caregivers, or employers rather than their
peers as partners in interactions. Because children learn through observation, imitation, and
collaboration with peers, more typical learning
strategies are less common in HFA and AS.
Consequently, there is a dual risk of social
isolation, that is, limited opportunities for
learning within social interactions with peers
and learned helplessness—an overreliance on
adults for prompting or cueing of behaviors.
In a school setting, simply being alongside
peers in an integrated classroom will not allow
students with HFA and AS to develop social
skills and engage in interactions or form
friendships (Kohler, Strain, & Shearer, 1996).
The individualized educational plan with its
social goals and objectives should, therefore,
be designed to develop the individual’s capacity for joint attention and understanding of
symbolic conventions (see Table 32.1) to maximize the likelihood that the individual is
equipped to use opportunities, both created
and naturally occurring, for practicing and engaging in positive bids for social interaction.
The other essential part of the equation is
to provide the peer group with specific strategies and support. Peer training and support is
required to foster a level of understanding as
well as communicative style adjustments for
supporting and engaging the individual with a
social disability in ways that are sensitive,
pleasurable, and appropriate for the context.
When thoughtful approaches to peer-mediated
intervention are implemented, as in the use of
peer-implemented pivotal response training,
integrated play groups, play organizers, and
buddy skills training programs (discussed in
greater detail later), research shows that the
interactions between individuals with HFA
and AS and their typical peers tend to increase
across contexts and that, on occasion, those
interactions extend to other students as well
(English, Goldstein, Shafer, & Kaczmarek,
1997; Goldstein & Wickstrom, 1986; Oke &
Schreibman, 1990; Pierce & Schreibman,
1995; Strain, Kohler, Storey, & Danko, 1994;
Wolfberg, 1988). This results in an enlarged
social network and expands the frequency with
which the affected individual will have the opportunity to practice and experience social
success through his or her day and over time.
Failure to include the individual’s peer
network in a support program may contribute
to peers’ misinterpretation or anxiety about
unexpected behaviors and responses or, for
those affected individuals whose style is more
passive, to peers’ decreased expectations and
attempts to engage them socially, thereby reducing the very opportunities for interaction
that they need. Likewise, you must observe and
seek the input of typical peers to ensure that
the social conventions being fostered are relevant and age appropriate because acceptance
into a given network or community of social
partners requires expertise in the particular
interpersonal styles used within a given context
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
and peer group. Particularly during the adolescent years, these conventions (e.g., the language used, the style of dress, and preferred
topics of conversation) may vary from group to
group or time to time. Failure to attend to these
important nonverbal and verbal features may
jeopardize successful attempts to engage. It
is important to deemphasize the role of teacher
as instructor and increase the peers’ responsibility for the successful social interaction
(Brown & Conroy, 2002). In many instances, it
appears that not only can peer-mediated interventions be as effective as teacher-based instruction but also, more importantly, there may
be some generalization of spontaneous social
bids across peers and settings, as the students
begin to recognize each other as potential partners independent of the adults around them
(Oke & Schreibman, 1990; Pierce & Schreibman, 1995; Strain et al., 1994). It is important
to keep in mind that while peers become more
active as facilitators, they continue to require
support and supervision from the adults who
develop the students’ skills and understanding
of how best to promote interactions. In addition, staff must try to ensure that the individuals with HFA or AS do not become passive or
reliant on their peer supports and that they are
seen as partners with responsibilities within
the interactions.
The involvement of a peer network depends,
in part, on the developmental level and the
settings in which the students are engaged.
Younger peers, for example, may simply need
reassurance regarding the reasons for a given
individual’s difficulties with emotional regulation, how to reinforce more positive and
adaptive responses, and how to simply redirect
to desirable or regulating activities. Likewise,
these peers would benefit from explicit training and support in how to modify their use
and interpretation of language and nonverbal
forms of communication when engaged in
communicative exchanges with the individual
with HFA or AS. Social skills programs and
play-based groups that incorporate simple cues
for peers, such as the integrated play group
model presented by Wolfberg (2003), play organizers offered by Odom et al. (1999), the
buddy skills training program presented by
English et al. (1997), and pivotal response
training presented by Pierce and Schreibman
991
(1995, 1997), foster social partners’ ability to
modify their communicative style by acting
more responsively; providing social overtures
such as prompting, choices, and praise; and
using natural reinforcement appropriate to the
given social context.
Older peers may receive more explicit information about the nature of HFA and AS within
a broader context of appreciating differences
and increasing tolerance for these within the
school community as a whole. Approaches such
as the Circle of Friends and peer networks capitalize on the sensitivity of typical peers, as
their curricula are designed to foster awareness
of learning style differences across individuals
and to teach the critical communicative style
adjustments that can allow for more positive social exchanges both within social group settings
and outside the school environment (Haring &
Breen, 1992; Kamps, Potucek, Lopez, Kravits,
& Kemmerer, 1997; Whitaker, Barratt, Joy,
Potter, & Thomas, 1998).
Some peer group programs targeting academic, as opposed to social skills and play,
have led to secondary gains in social interaction between participating students. In studies using classwide peer tutoring (Kamps,
Barbetta, Leonard, & Delquadri, 1994) and
cooperative learning groups (Kamps, Leonard,
Potucek, & Garrison, 1995), students with
HFA and their typical classroom peers worked
cooperatively to improve reading skills
(fluency and comprehension), understanding
of vocabulary, and question comprehension by
participating in academic-based games for
practice of skills. An important part of the
process was role reversal—each student took
the role of trainer and trainee at different
points, providing an opportunity for equal status and for perspective taking. Outcomes included gains in the targeted academic areas,
but perhaps more importantly, greater engagement in the academic process, more peer interaction and integration, and greater duration of
engagement in social interaction. Results indicated that use of peers proved as effective an
outcome as teacher-delivered intervention, and
it was felt that the inherent structure of the
tasks promoted the communicative style adjustments that were needed to foster successful engagement across the individuals with
HFA and their peers.
992
Interventions
Last, a number of peer support programs
and curricula have been developed to foster
success within groups of children working on
common social learning objectives and goals,
strategies which are also applicable within
integrated settings. The I LAUGH model presented by Winner (2002) and Navigating the
Social World presented by McAfee (2002), for
example, provide a framework for addressing
vulnerabilities in social communication by incorporating learning style accommodations and
communicative style adjustments across the
day as well as within group learning contexts
with peers with difficulties with social cognition. Relationship development intervention
(RDI; Gutstein, 2000) is another curricular
model that approaches the building of capacities for social relationships from a developmental perspective by placing an emphasis on
fostering genuine pleasure from social interactions with others, replicating the progression in
affective-emotional development of typical infants and children. In the RDI approach, children are often paired with other children with
similar social communication challenges, at
least initially. The rationale for this accommodation is due, in part, to the notion that typical
peers are so adept at social interactions that
they simply take too much responsibility, potentially increasing learned helplessness within
the children with HFA and AS. Within the
structure of the sessions, “experience-sharing”
activities and games are designed to promote
awareness of and attunement to the other children, in contexts where they are actively enjoying themselves, while also developing their
sense of self- and mutual regulation. This approach aims to promote the underpinnings for
social relationship building that will increase
the individual’s desire to initiate, maintain, and
extend interactions with others. Key elements
of these curricula and intervention models are
their appreciation of the transactional nature of
social communication, as support is provided
both to the individual with the disability as well
as his or her peers, partners, and larger social
network.
Interpersonal Supports for
Teachers and Professionals
Within a comprehensive educational program designed to foster social communicative competence, it would be appropriate for
interpersonal supports to be developed across
all teachers, professionals, and paraprofessionals who will be working directly with the individual with HFA or AS as well as those who
come into regular, albeit less frequent, contact.
In a manner similar to peer-mediated interventions, a critical first step will be to identify
the qualities of a specific teacher’s or professional’s use of verbal and nonverbal forms of
communication that are either facilitative
or provide barriers to attempts to engage in reciprocal social communicative exchanges and
maintain active engagement. Communicative
style adjustments should then be developed to
adapt to the unique learning style differences
of an individual with HFA and AS. For example, the use of explicit and clear expressions
of an individual’s intentions and emotional
states, devoid of idioms and sarcasm, often
supports the processing abilities of an individual with HFA or AS. In contrast, the use of a
high rate of nonverbal social cues (e.g., raising
the eyebrows to indicate distaste) when interacting with individuals with AS or the use of
verbal language in the absence of static visual
cues (e.g., concrete gestures or written language) with an individual with HFA may
impede the achievement of successful communicative exchanges. Consideration should also
be given to factors such as vocal volume, rate
of speech, pause time for processing and formulation of a response, prosodic variations,
proximity, and physical contact.
In middle school and high school settings,
this assessment process can be complicated because the number of teachers and professionals
that a student will likely come in regular contact with increases significantly from elementary school settings. Consequently, careful
consideration should be given to the composition of a student’s educational team because
the unique learning style differences of individuals with HFA and individuals with AS require a significant commitment on the part of
the educational staff to provide accommodations such as modifying the use of nonverbal
versus verbal discourse for a particular individual. As with any other job or occupation,
there are individuals whose natural temperaments and interests make them the ideal candidates for working with individuals with HFA
and AS, and there are others who, through
no fault of their own, may be less suited to
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
this work. It is important for both staff and recipients of training to be honest about their
strengths and what they find more challenging
in the task of teaching this population. Characteristics that may increase the likelihood
of becoming a positive facilitator for an individual with HFA or AS include, but are not
limited to, curiosity about learning style differences, a capacity for organization and temporal structure, and flexibility with respect
to the interactive style adopted with individual
students. Additionally, those teachers and
professionals who present with more than usually well-developed social skills, affective attunement, and unlimited patience when faced
with unconventional social behavior are often
the most adept at reflecting, analyzing, and
putting into place effective interventions.
These interventions can help in preventing
a high frequency of social communicative
breakdowns and social and environmental antecedents that lead to states of emotional dysregulation for individuals with HFA and AS. It
is also important to be able to share some of
the responsibilities, to have a capacity to supervise, and to appreciate the experience of
parents, welcoming them as part of the team.
Training of educators should be paramount
and should include all members of the school
community. The degree of training may vary,
however, depending on the level of responsibility for the implementation of the individualized educational programming. Those with
direct responsibility such as special education
teachers and therapeutic personnel (e.g.,
school psychologists, speech-language pathologists, occupational therapists), for example,
should have specific expertise in HFA and AS
and would benefit from knowledge of the core
challenges that compromise the development
of social communicative competence in these
social disabilities (e.g., core challenges in
social communication and emotional regulation). These staff members should also be familiar with the specific modalities, methods,
and strategies that are the most effective in
accommodating the distinct learning challenges associated with these social disabilities
within an individualized educational program.
Other personnel such as paraprofessionals,
regular education teachers, and administrators
should receive in-service training on the
unique learning styles and developmental
993
profiles of students with social learning disabilities in order to foster greater awareness of
how to teach to their strengths, how to understand and read their reactions, and how to support their academic and social growth in the
mainstream or nonacademic arenas in which
they will be placed. Those personnel who may
be less visible, but are frequently in charge
during the more challenging parts of the day
(e.g., bus drivers, crossing guards, cafeteria
workers, and recess monitors), also need to be
familiar with the specific communicative style
adjustments that facilitate positive social communicative interactions and those that may result in communicative breakdowns and
frustration on the part of students with HFA
and AS. These staff members are, in fact, critical because students with HFA and AS are
vulnerable during times of transition (e.g., riding a bus or walking to school), when their
time is unstructured as it often is during recess, and when the social demands are particularly high such as in a cafeteria setting. For
this group of staff, there will likely be very
specific routines/demands that occur during
their time with the student (e.g., lunch routines, traveling on the bus). An analysis of
what happens and how a student manages
these routines will allow for planning and staff
support so that action plans, visual supports,
environmental modifications, and practice of
the events can occur. Should difficulties arise,
an understanding of the elements that may be
interfering can lead to changes and modifications that allow for greater success. For example, where a student sits on a bus, who sits next
to him or her, having the student meet the driver, and ensuring that he or she knows the routine for getting to and from the bus will likely
alleviate anxiety and promote a smooth transition. Some students may benefit from having
something that they can do on the bus—listening to music, looking at a favorite book, or
having a preferred toy to play with—allowing
them to cope with the trip more comfortably.
Interpersonal Supports for
Members of the Community
Although the family and those close to the individual with HFA and AS form their community at an early age, the range of opportunities that are age appropriate and culturally
typical greatly expand as an individual
994
Interventions
matures. These unique social experiences coupled with developmental capacities in social
communication and emotional regulation set
the stage for social awareness and growth.
Such opportunities can facilitate an ability to
interpret another’s perspective as well as an
ability to modify the use and interpretation of
language based on the perspectives of those
involved and/or the social context. These opportunities for active engagement across a
range of social partners and social settings are,
indeed, a critical factor in the achievement of
social communicative competence and may
form the basis for important leisure time activities and group membership. Selection of
community-based activities, however, should
be based on the preferences and unique learning style strengths of an individual with HFA
and AS, as well as a consideration of the social
demands related to the activity. Since communicative style adjustments should be embedded
within these community settings and across
the social partners within them, it is essential
to predetermine who will be running, teaching,
or organizing programs and whether they will
be open and willing to adjust their use of nonverbal and verbal forms of communication
when interacting with the individual with HFA
or AS to facilitate successful social exchanges
and maintain emotional regulation. Parents
may find that their role as assistant coach, volunteer parent, or administrative assistant allows for the additional interpersonal support
necessary for successful inclusion in clubs,
sports, and/or extracurricular activities.
For many, though not all individuals with
HFA and AS, team sports are particularly
challenging because they require both motor
skills and social awareness for team playing.
In particular, team experiences at the schoolage, middle school, and high school levels
are clearly challenging because the player
needs to cooperate, integrate temporal motor
movements with visual tracking, and simultaneously attend to verbal and nonverbal cues
during fast-paced (i.e., transient) social interactions. The competitive nature of these
events also diminishes the likelihood that
peers will be tolerant of “someone learning on
the job.” Interpersonal supports such as having
a social partner modify his or her use of
nonverbal or verbal discourse are not likely
to occur in these fast-paced and competitive
contexts. Sports such as swimming, martial
arts, skiing, and horseback riding are more individualized, yet occur within social group
settings. Since interactions with peers are
less fast-paced in these contexts, they may
allow for communicative style adjustments and
time to foster positive social communicative
exchanges. These activities may, as a result,
build self-esteem and confidence and can be
lifelong pastimes that allow for shared experiences. Likewise, Special Olympics, bowling
leagues, chess clubs, and music/drama groups
provide many teens and young adults with typical social and physical opportunities that are
structured and offer genuine pleasure and a
sense of achievement. The experience of being
competent and adept provides a more balanced
base from which to interact and may, therefore, allow for somewhat different and more
“ typical” social opportunities. Social coaching for both partners in the interaction may
facilitate further development of social relationships that are mutually satisfying.
The need for interpersonal supports will
continue to be essential as the individual with
HFA and AS matures and transitions from high
school into postsecondary educational settings,
supported living arrangements, and/or group
homes (if appropriate). Once again, knowing
what the social and communicative demands
are in a given situation can allow for tailoring
of specific skills to help the individuals to fit
in and feel capable of meeting the expectations
of the new situation. Additionally, educational
opportunities for the broader community (e.g.,
law enforcement agencies, religious institutions, and vocational settings) can be beneficial when ensuring the long-term goal of
providing interpersonal supports that foster social communicative competence for an individual with HFA and AS. For example, education
programs designed to foster awareness among
law enforcement agencies provide a critical aspect of community teaching, since individuals
with ASDs are not immune from situations
in which they may be involved with the legal
system. The stress involved in situations such
as minor car accidents, misunderstandings, or
having been led unwittingly into a situation involving some illegal activity places tremendous
burdens on self-regulatory capacities, interper-
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
sonal skills, and the ability to communicate
and advocate effectively for oneself. Having a
police department with staff who are informed
about social disabilities and psychiatric disorders is essential if the situation is to be understood and resolved in an informed, accurate,
and fair manner. It is also critical to have advocates and lawyers who can be available to ensure that individuals are aware of their rights,
to provide an accurate account of their role,
and to ensure that their intents as well as their
actions are both assessed and understood.
As adults, individuals with these social disabilities will still greatly benefit from the support of professionals and mentors with specific
training who can ensure that communicative
style adjustments are implemented across all
social partners and across daily routines and
settings (e.g., academic settings, living arrangements, and places of employment).
Learning and Educational Supports
As discussed previously, there are significant
differences as well as commonalities in learning styles between individuals with HFA and
AS. Designing appropriate learning and educational supports to facilitate social communicative competence requires a careful
consideration of the individual’s unique profile of strengths and needs, the expectations
of a given social context, as well as the priorities of the family (NRC, 2001). With respect
to the commonalities in core challenges in social communication and emotional regulation
among individuals with HFA and AS, they
will need a similar range of learning accommodations. These supports tend to fall within
two primary categories: visual and organizational supports and environmental modifications (Prizant et al., in press).
Visual and Organizational Supports
Visual and organizational supports should
be designed to foster an individual’s capacities for social communication and emotional
regulation across social partners and social
contexts based on core challenges in these
domains (e.g., understanding the communicative intentions and emotional state of another,
understanding of time and activity structure
as a means of preparing for potentially dys-
995
regulating events, and identifying an individual’s emotional state and socially acceptable
coping strategies). Although individuals with
HFA and AS can be different with respect
to their abilities to process verbal language
and visual-spatial information (as discussed
previously), they share a common area of relative strength in processing the written word
(Rourke & Tsatsanis, 2000; Wetherby et al.,
2000). This common modality has led to the
development of a number of effective visual
and organizational supports for individuals
with HFA and AS.
The implementation of visual and organizational supports will depend, in part, on the
current goals of the educational plan for an
individual with HFA and AS. When fostering
the understanding and use of verbal conventions for initiating, exchanging turns, and terminating interactions across different social
settings, supports such as dialogue scripts
(Krantz & McClannahan, 1998) capitalize on
the common modality of the written word as
a learning strength and foster an individual’s
ability to engage in basic social conversations
as well as conversational discourse within
unique social contexts (e.g., dating and attending family celebrations). Modifications
to these dialogue scripts, however, are often
appropriate to ensure that an individual attends not only to his or her verbal discourse
but also to the verbal discourse of his or her
social partner. Thus, learning supports that
involve a review of the content exchanged
within these social conversations clearly
serve to augment these social communicative
exchanges. These include, but are not limited
to, the use of comic strip conversations (Gray,
1994), video replay (i.e., videotaping and reviewing actual social exchanges with peers
and social partners),and video modeling (i.e.,
the use of videos to model appropriate
conversational skills and social conventions).
Research has, in fact, documented the effectiveness of the use of video within educational programs designed to foster social
communication skills (Charlop & Milstein,
1989). This support fostered an improved rate
of skill acquisition, generalization of skills,
and maintenance of skills for as long as 15
months. Thus, both dialogue scripts and
video-based instruction provide appropriate
996
Interventions
visual and organizational supports for enhancing conversational conventions.
When fostering an individual’s ability to
acquire and use cognitive-linguistic strategies
to support attention and active engagement
throughout daily routines, visual and organizational supports can be implemented to develop
an awareness of the temporal structure and social communicative expectations of specific
events. As noted earlier, the use of the written
modality allows otherwise transient auditory
information to be presented in a way that is static and present long enough to be understood. It
also allows for the salient and most necessary
information to be presented, while decreasing
extraneous stimuli that may distract or confuse.
The use of a written schedule, for example, provides a clear sequence that can map the actual
unfolding of an event that is far easier to appreciate than the rapidly fading, temporal equivalent of nonverbal social cues and the verbal
modality. It, thereby, reduces the load on shortterm working memory and allows for reflection
on cause and effect. In addition, with this
more permanent way of representing event sequences, it is possible to reduce unpredictability and accompanying anxiety, fostering better
emotional regulation, which increases availability for social engagement and reduces maladaptive social behavior (Dalrymple, 1995;
Myles & Simpson, 1998).
Visual and organizational supports can also
be used to foster an awareness of another’s intentions, emotional states, and perspectives.
This developmental goal leads to improved social communicative reciprocity as well as increased emotional regulatory capacities, as
the individual’s ability to accurately read another’s intents contributes to sustaining a
more reciprocal interaction (Prizant et al., in
press). Gray and Garand (1993) discussed the
use of social stories as a visual modality for
enhancing an individual’s awareness of a social partner’s perspective and the impact of
this social information on his or her own perspective and social communicative behaviors.
This learning support involves consideration of
the following critical elements:
1. The perspective of the affected individual,
a frequently overlooked variable, although
often central to correctly understanding the
2.
3.
4.
5.
6.
7.
8.
potential causes of social difficulties as
well as effective interventions;
The use of simple visual cues (e.g., simple
pictures, cartoons, written text, and rulebased color coding);
Careful attention to the social context to
determine what social conventions are appropriate;
Extraction of those salient features in a social situation that are the most relevant;
Explicit directions as to what behaviors/responses might be appropriate;
Inclusion of possible emotional reactions,
that is, the social partner’s perspective;
Explanation as to why a particular choice
of positive behaviors will provide a positive
consequence with respect to the perspectives of self as well as others; and
An attempt to unravel the complexities of
later social relationships and to make positive social choices and decisions.
By implementing tools such as social stories
prior to an anticipated social event, you can
provide an individual with HFA and AS with a
cognitive-linguistic strategy to prepare and rehearse socially appropriate conversational
discourse and emotional regulatory strategies
(Hagiwara & Myles, 2001). As an instructional strategy, social stories were designed
with a specific directive to be implemented
in a positive rather than a negative manner so
that the individual is encouraged to develop
more adaptive behaviors, rather than being reminded of those to be extinguished. Perhaps
most importantly, these supports should be designed with respect to the specific contexts in
which social events are occurring so that the
final intervention is personalized and functional for the individual with HFA and AS.
Additional strategies using visual /written
means to facilitate social problem solving have
been developed as part of the I LAUGH model
(Winner, 2002), the Teach Me Language program (Freeman & Dake, 1997), and by Roosa
(1997), whose Situations Options Choices
Strategies and Stimulation (SOCCSS) program
provides a sequence to facilitate an individual’s
understanding of a social problem, an appreciation of having more than one option for a response, and an awareness that each choice will
also have its own consequence. Again, these
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
approaches foster more flexible thinking, provide more than one perspective, and encourage
active participation on the part of the individual so that he or she is empowered to develop
social decision making and social cognition.
Environmental Modifications
A preference for learning within predictable
routines and for very explicit instruction of implicit social messages is a common pattern
noted across individuals with HFA and AS
(Schuler, 1995). This preference is secondary,
in part, to persistent difficulties with understanding the communicative intentions and
emotional states of social partners and difficulties with maintaining a steady emotional and
physiological state of arousal, that is, active engagement in a given social environment. These
patterns speak to the need to modify each of the
social settings that an individual engages in
within daily routines. Special events (e.g., family celebrations or vacations) that fall outside the usual routine will require even more
careful consideration. Environments should be
arranged or modified to support an individual’s
capacities for social communication and emotional regulation. For example, accommodations might include clear physical boundaries
for activities, clear temporal structure, reducing levels of auditory and visual stimulation, if
appropriate, and offering opportunities to engage in social interactions in small group contexts (Dalrymple, 1995). Consideration should
also be given to the demands of a given environment, as expectations should be appropriately
matched to an individual’s unique challenges
and learning style (e.g., curriculum modifications, reduced expectations for homework). For
some children, haircuts, dental appointments,
and other necessary life events cause dysregulation because the unusual setting, need for intrusion on the part of novel adults, and, at
times, unpleasant physiological response all
contribute to high levels of tension and behavioral disruption. Families can be helped by finding professionals in the community who have
dealt with children on the spectrum before and
whose reputations for patience and understanding precede them. Children can accompany
other family members when they have appointments so that the setting, required seating,
noises, and smells become somewhat familiar.
997
During these “practice” visits, it might be helpful to have the child sit in the chair, press a button, or turn on the water as real-life
opportunities for experiencing cause and effect, experiencing control over some aspect of
the environment, which may help to decrease
anxiety and give a sense of mastery. Using a social story or simple photo series that explains
the sequence of events for the appointment may
then allow for a successful first time of the
child’s own, one which he or she can then share
with extended family and friends.
Family Supports
An individual initially develops his or her selfconfidence as a social communicative partner
through positive social interactions and successful communicative exchanges within the
context of interactions with family members
(e.g., parents, siblings, and grandparents) and
eventually during social experiences across
settings and partners. The family and home
contexts, in fact, follow an individual throughout his or her life, while specific educational
contexts and professionals “come and go”
(Domingue, Cutler, & McTarnaghan, 2000,
p. 380). Likewise, the experiences of a family
unit contribute greatly to an individual’s
social communicative competence, as daily
family routines (e.g., shopping and going to
dinner) and family celebrations (e.g., weddings, birthday parties) provide the context for
social and cultural learning (i.e., understanding symbolic conventions). Thus, the individual’s home and family settings are clearly
critical contexts for addressing his or her drive
toward achieving social communicative competence. Interpersonal supports (e.g., communicative style adjustments) and learning
supports (e.g., visual tools and environmental
arrangement) for use within the home and
family contexts must be part of a comprehensive educational program (Prizant et al., in
press). This accommodation, which has been
supported by the NRC, requires the provision
of therapeutic and educational support to
family members with a particular focus on: (1)
supporting an understanding of the nature of
the social disability consistent with HFA
or AS, as appropriate to the individual family
and (2) developing specific modifications that
998
Interventions
can be embedded across the day to foster social communication and emotional regulation
(NRC, 2001, p. 219).
All too often, a pattern of interactive
breakdown develops, whereby an individual is
not able to effectively communicate his or her
intent to a family member and/or a family
member is ineffective at reciprocating the
exchange. This pattern often leads to the perception and often the real experience that interactions with the individual with HFA and
AS are stressful and, in some cases, the interactions produce anxiety and frustration for
both the individual and his or her family members. When appropriate supports are established, family members will be more likely to
experience a sense of competence as effective
communicative and social partners with respect to their children or siblings with HFA or
AS (Dawson & Osterling, 1997).
The role of family support when implementing strategies designed to enhance social
communicative competence for an individual
with HFA and AS, however, is not limited to
the provision of specific training and educational input. Rather, long-term positive outcomes for individuals with social disabilities
require sustained efforts to reduce the emotional stress associated with raising or living
with an individual with a disability by providing individualized and family-centered emotional support (Dawson & Osterling, 1997;
NRC, 2001). “Adaptation to having a child
with a disability is a lifelong process that occurs in a vastly different manner from family
to family and even among family members
within the same family” (Domingue et al.,
2000, p. 373). Therefore, the provision of contexts for one-on-one emotional support and
counseling to foster appropriate expectations
and achievable goals for family life is another
critical component of an educational program
for an individual with HFA and AS.
CONCLUSION
Although there is great heterogeneity across
individuals with HFA and AS with respect to
personal circumstances (e.g., social settings,
family life, and culture) and learning style,
there is a common pattern of impairments in
social communication (i.e., the capacity for
joint attention and understanding of symbolic
conventions) and emotional regulation (i.e.,
the ability to maintain a state of active engagement across social contexts) that compromises
the ability to achieve social communicative
competence. These learning style differences
and developmental vulnerabilities remain a significant challenge across all settings throughout an individual’s life and provide potential
barriers to achieving social communicative
competence that can be, in many cases, devastating to the individual (Volkmar et al., 2000).
While the social impairment is attributable
largely to the developmental vulnerabilities
and learning style differences of the individual
with HFA and AS, the “social impairment is
shared” across all of those who have social
contact, positive or negative, with the individual (Gray, 2001). Therefore, the success of any
given social exchange relies not only on an individual’s ability to adhere to social conventions, remain actively engaged, and accurately
consider another’s intents, but also on a social
partner’s ability to adapt his or her interpersonal style and the environment to match the
needs of the individual with the social disability. Thus, comprehensive programming designed to foster social communicative competence must be understood as integral across an
individual’s day (e.g., each class at school),
across contexts (e.g., school, home, and community), and across social partners. Additionally, it is critical to consider the following
sources of information when designing an individualized educational program: (1) our current understanding of the core challenges that
compromise social communicative competence
that are faced by individuals with HFA and AS,
(2) the unique learning style differences often
associated with HFA and AS, and (3) our
awareness of the critical priorities for developing a comprehensive intervention program
designed to foster social communicative competence (e.g., establishing interpersonal supports, learning and educational supports, and
the provision of family-centered supports). To
develop social communicative competence
within functional and natural settings, you
must keep in mind the importance of supporting an individual’s capacity for emotional regulation. The latter fosters active engagement
across a range of social contexts, the capacity
Communication Skills in Individuals with High-Functioning Autism and Asperger Syndrome
to appreciate the various social conventions of
these contexts, and the capacity to consider the
emotional state, intents, and needs of various
social partners.
Cross-References
For information on communication development, see Chapters 11 and 12; for additional
information on communication intervention,
see Chapters 36 and 37; for information on
other aspects of development, see Chapters 13,
14, and 15. For information on intervention for
other aspects of development, see Chapters 33,
34, and 35.
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