Education and Counseling for Individuals Affected by Autism Spectrum Disorders

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What is the best treatment for teens with Aspergers?

The best treatment for Aspergers (high functioning autistic) children and teens is definitely “social skills training” (SST). Social skills training is a form of behavior therapy used by therapists to help Aspies who have difficulties relating to other people.

A major goal of social skills training is teaching Aspies (who may or may not have emotional problems) about the verbal - as well as nonverbal - behaviors involved in social interactions. There are many Aspergers teens and preteens who have never been taught such interpersonal skills as making "small talk" in social settings, the importance of good eye contact during a conversation, etc. In addition, many of these individuals have not learned to "read" the many subtle cues contained in social interactions (e.g., how to tell when someone wants to change the topic of conversation or shift to another activity).

Social skills training helps Aspies to learn to interpret these and other social signals so that they can determine how to act appropriately in the company of others in a variety of different situations. Social skills training assumes that when individuals improve their social skills or change selected behaviors, they will raise their self-esteem and increase the likelihood that others will respond favorably to them. The Aspergers child learns to change his social behavior patterns by practicing selected behaviors in individual or group therapy sessions.

Another goal of social skills training is improving the child’s ability to function in everyday social situations. Social skills training can help these children and teens to work on specific issues that interfere with their school or daily lives.

Techniques in social skills training—

Therapists who use social skills training begin by breaking down complex social behaviors into smaller portions.

Next, they arrange these smaller parts in order of difficulty, and gradually introduce them to the clients. For example, a therapist who is helping an Aspergers teen learn to feel more comfortable at parties might make a list of specific behaviors that belong to the complex behavior called "acting appropriately at a party" (e.g., introducing oneself to others, making conversation with several people at the party rather than just one other guest, keeping one's conversation pleasant and interesting, thanking the host or hostess before leaving, etc). The teenager would then work on one specific behavior at a time, rather than trying to learn them all at once.

Such specific techniques as instruction, modeling, role-playing, shaping, feedback, and reinforcement of positive interactions may be used in social skills training. For example, instruction may be used to convey the differences among assertive, passive, and aggressive styles of communication. The technique of monitoring may be used to ask clients to increase their eye contact during a conversation. In role-playing exercises, group members have the opportunity to offer feedback to one another about their performances in simulated situations. For example, two members of the group may role-play a situation in which a customer is trying to return a defective purchase to a store. The others can then give feedback about the "customer's" assertiveness or the "clerk's" responses.

Some of the goals for social skills group training are helping Aspergers kids and teens to:
  • read the body language of others
  • play and have fun
  • learn to cope with mistakes
  • learn strategies for developing peer relationships
  • learn peer group problem-solving
  • become aware of their emotions

Aspergers kids are pliable to treatment because they tend to be compliant. Although their ritualistic behavior and rigidity may create obstacles to treatment, most Aspergers kids are able to learn the nuances of feelings, body language and behavior to assist them in their everyday functioning.

Content of social skills training—

Social skills training may be used to teach Aspergers children and teens specific sets of social competencies. A common focus of social skills training programs is communication skills. A program designed to improve the teen’s skills in this area might include helping him with nonverbal and assertive communication and with making conversation. It might also include conversational skills that are needed in different specific situations, for example job interviews, informal parties, and dating. The skills might be divided further into such subjects as beginning, holding, and ending conversations, or expressing feelings in appropriate ways.

Another common focus of social skills training programs involves improving a client’s ability to perceive and act on social cues. Many Aspies have problems communicating with others because they fail to notice or do not understand other people's cues, whether verbal or nonverbal. For example, some Aspergers kids become unpopular with their peers because they force their way into small play groups, when a youngster who has learned to read social signals would know that the kids in the small group do not want someone else to join them, at least not at that moment. Learning to understand another person's spoken or unspoken messages is as important as learning conversational skills. A social skills program may include skills related to the perceptual processing of the conversation of others.


Social skills training may be given as an individual or as a group treatment once or twice a week or more often depending upon the severity of a client’s disorder and the level of his social skills. Generally speaking, Aspergers kids appear to gain more from social skills training in a peer group setting than in individual therapy. Social skill training groups usually consist of approximately 10 clients, a therapist, and a co-therapist.

Culture and gender issues—

Social skills training programs may be modified somewhat to allow for cultural and gender differences. For example, eye contact is a frequently targeted behavior to be taught during social skills training. In some cultures, however, downcast eyes are a sign of respect rather than an indication of social anxiety or shyness. In addition, girls or women in some cultures may be considered immodest if they look at others, particularly adult males, too directly. These modifications can usually be made without changing the basic format of the social skills training program.

Generalization or transfer of skills—

Current trends in social skills training are aimed at developing training programs that meet the demands of specific roles or situations. This need developed from studies that found that social skills acquired in one setting or situation are not easily generalized or transferred to another setting or situation. To assist clients in using their new skills in real-life situations, therapists use role-playing, teaching, modeling, and practice.


Preparation for social skills training requires tact on the therapist's part, as Aspergers clients (especially older teens and young adults) may be discouraged or upset by being told that they need help with their social skills. One possible approach is through reading. The social skills therapist may recommend some self-help books on social skills in preparation for the treatment. Second, the therapist can ease the client’s self-consciousness or embarrassment by explaining that no one has perfect social skills. An additional consideration before starting treatment is the possibility of interference from medication side effects. The therapist will usually ask the client for a list of all medications that he takes regularly.

One of the most critical tasks in preparation for social skills training is the selection of suitable target behaviors. It is often more helpful for the therapist to ask the client to identify behaviors that he would like to change, rather than pointing to problem areas that the therapist has identified. The treatment should consider the client’s particular needs and interests. Whereas social skills training for some clients may include learning assertiveness on the job, training for others may include learning strategies for dating. Therapists can prepare clients for homework by explaining that the homework is the practice of new skills in other settings, and that it is as relevant as the therapy session itself.


Some studies strongly suggest the need for follow-up support after an initial course of social skills training. One study showed that follow-up support doubled the rate of employment for a group of older Aspergers adolescents, compared to a group that had no follow-up.

Normal results—

Outcome studies indicate that social skills training has moderate short-term effects, but limited long-term effects. Social skills training programs that include social perspective-taking may have greater long-term effects than traditional social skills training programs based on cognitive-behavioral models. In general, social skills training tends to generalize or transfer to similar contexts rather than to contexts that are not similar to the training. Social skills training programs for Aspergers children and teens should include programming for generalization, so that these clients can transfer their newly acquired skills more effectively to real-life settings. One approach to improving generalization is to situate the training exercises within the client’s school, work, living, or social environment.

The benefits of social skills training programs include flexibility. The treatment can take place either as individual or group therapy, and new trainers can learn the techniques of social skills training fairly quickly. An additional advantage of social skills training is that it focuses on teaching skills that can be learned rather than emphasizing the internal or biological determinants of social adequacy.

Future research should explore (a) the integration of social skills training with the needs of families from different cultural backgrounds, (b) the relationship between social skills training and different categories of mental disorders, (c) the transfer of skills from therapeutic contexts to daily life, and (d) improving the Aspergers client’s long-term gains from social skills training.


Steve-Prosper With Aspergers said...

Thanks for the very helpful breakdown of social skills training. One of the promising evidence based programs I've seen lately is the PEERS program based out of UCLA.

Anonymous said...

WV Grandmother trying to raise A Grandson, of 14 Aspie,ODD ,ADHD,..The Behavori is not good.Refuseale to change of any kind ,eating habits,not wanting to try any thing that may help. He has become demanding ,our lives as we knew it dose not exsit. The boy gose in total meltdown if I even mention what he don't want to hear.ex; Were planning to go fishing the weekend. NO'I can't b get him to budge without he becomes violent. out of control if i try makeing him...
STUCK IN place to place him. the Help I have seeked not helping. What is the best treatment for this kind of child.

Anonymous said...

I can see this site will help me out alot. Im a newbie to this syndrome but I ready to take it on... Love my girl and will help her with this all i can

Anonymous said...

Hello Mark,

We have a 14 y/o aspie son and am grateful for your newletters.

If this is an obvious question, I apologize for taking your time, but how do I go about finding a Social Skills Training group?

Thank you in advance,

Mark said...

Check with your nearest mental health facility.

Different, Not Diseased said...

Can I find more information on Social Skills Training? Is it actually a curriculum of sorts. I think our son's therapist would be interested in learning more. Thanks.

Anonymous said...

Lisa, this is a very good resource for parents. This particular article is one I found to be very accurate. My daughter is now in middle school and social skills training has made a very big difference in how she gets along with her peers, her academic performance and most importantly her self confidence. These are skills for life.

Anonymous said...

My husband is ashamed and embarrassed that our oldest son has aspergers and is not what he calls normal.
If my husband knew that I was typing this to you, he was become very irate and the yelling would start between the two of us as he does not like it when I try and seek help.
Will is 15 and in the years gone by He has called him a retard to his face, he even used to hit him across the back of the head. William does not seem to get along with our 13 year old and often hurts himself as well as our other son.. because of this, I try not to leave the two of them home alone. the other evening I went to visit my parents for two hours leaving them with their dad. Aparently the boys started into each other and instead of seperating them and talking with them, he told the oldest with the problem.... I wish you would just beat the shit out of him and teach him a lesson... When I found out about this I became very irate and tried to explain to richard that he just gave william permission to beat up his brother. He does not really understand right from wrong at times. So now I wait for the day they fight and he says.. dad said I could without realizing the damage he could cause or the consequences.
My husband refuses to seek help, says he reads up about what is going on but I find that hard to believe otherwise he would know better how to deal with issues...
is there anything you can suggest or anythign I can read??
I am starting to think that my feelings do not matter and I need to put my children first and remove him from my home so that our eldest will have a home that understands him.. even our 13 year old understands him better than his own dad..
ppls help..

Anonymous said...

Anonymous, I want to respond to your post. I don't know what exactly to say about your marriage, but I can understand what you are going through - someone I know is separated from her husband for that very reason. It is a long process for her to decide either way, and she is working hard. Sadly to say, he isn't. If your husband is willing to accept help, I have a few resources that may be good for him/you, but if he isn't, then I agree that something has to be done to protect your son while he is vulnerable. Blessings. I'll read this again...

Anonymous said...

I am a parent of a 13 year old son with Aspergers. School has always been difficult for both my son and me. Since he has entered middle school, things have gotten worse. Both his teachers and I are trying to help him but he is not interested in helping himself. He is about to get kicked off the bus because of his behavior, he won't do his work in the classroom or assigned homework, he has taken up swearing, and nothing seems to motivate him to do better.
I feel like I have tried everything I know, but things are starting to escalate and the school is losing patience with him and to be honest, so am I. This isn't the child I thought I was raising. I don't want to give up on him but nothing I say or do motivates him to do the right thing.
I feel like a failure as his parent. No one seems to understand. So many people around me give advice but the advice they give is what might work with a child who is "normal". Logan has never been "normal". He has always been my greatest love and my greatest challenge. I am lost and I am tired of crying and feeling like I am failing him.

Anonymous said...

Hi, I would like to ask anyone has recommendations of a good psychologist who really knows about Aspergers kids (you know, their strict way of thinking, poor social understanding etc) to come to school for doing FBA for my son. He is in 1st grade, struggling with a lot of frustrations in school. From what he told me, a lot seems to be frustration with the situations, but the school keeps saying it is overstimulation and has a plan to put him to a low functioning small autism class. They keep saying that will reduce his stimulation etc.

I live in North Jersey area.

In fact, I would expect he would have much more frustration in the self-contained class. As typical to many Aspergers kids, he is very smart academically, but very poor understanding of social behavior.

Anonymous said...

My 9 year old son, was diagnosed with Asperger's during Kindergarten. He has had wrap-around services in the home since the age of 6. His TSS would come out and work with him 10 hours a week. Every weekday afternoon, usually from 4 to 6 pm. And his behaviorist would come out once or twice a week also. And this was a good arrangement, that was showing positive results.

However, sometimes the progress was slow in coming, and was frustrating. But overall, it was working. Well, recently I had a meeting to continue his services, and they want my son out of the program. And they have implemented a fading of services until the end of November. After the services in the home are discontinued at the end of November, they recommend outpatient services for him.

I am fighting this decision, and requested a appeal. There is another meeting on the 24th of this month. This is the first step in the appeals process. I was informed that these meeting are generally done, over the phone. But I requested it be done in person. My thinking on that decision is that they may be less likely to look me in the eye and deny my son these services, than they would over the phone.

In the meantime, Alex's behaviorist has left the company. And Alex's TSS just stopped showing up, or returning phone calls or text messages. And we know that she is not sick, because she teaches 4th grade at my my son's elementary school and Alex sees her everyday.

They had replaced my son's behaviorist with another one. But they removed him from Alex's case before any of us had even met him. They removed him from Alex because he is new with the company. And they did not feel that he would be right for Alex, because of the appeal process, and his lack of experience. So, they gave him a behaviorist that has a great deal of experience that will guide us through the appeal process.

And Alex's new TSS will actually be his old one. So, that is one positive thing. At least he already knows her. And she did a very good job in the past. So, I don't see any problems with her coming back. In fact I asked if she was available. And it worked out.

Any advice? As far as the County is concerned, these wrap-around services are supposed to be temporary services that provide support to the parents, by instructing them how to deal with certain behaviors. And they feel that after three years of services, the parents should be able to address whatever issues might arise.

But, in my opinion these services are needed to give the parent the additional support that are needed through out. After all we are not always dealing with the same problems, time after time. As time goes on and he matures old problems go away and new ones arise. And Aspergers is not something he will outgrow.

Looking for any advice that might help.

Anonymous said...

My 18 yr son, has wrap around services that come to house six hours a week, a Master level behavioral therapist, a Doctor in Psychology he sees once a week, a school life skills program, a MH/MR caseworker, a person at OVR to help him with job skills and employment, a caseworker from AHEADD also to help with employment and skills, and a very supportive and involved family.

For 12 years of this child's life I have brought him to one doctor, clinic, after another to seek the help I know he needs. I have spent my life devoted to helping him and at times my other children have suffered because they just do not get the attention my oldest receives. I thank God that my other children can seem to find their way more independently.

I was away in Florida two weeks ago and received a call from my daughter that my oldest was caught stealing game cards from Walmart. They were kind enough to let him go into his younger sisters care. They don't press charges for under 20 dollars.

He was grounded, faced consequences, and I am far from easy on him. He has stolen in the past and has had to pay fines. Which I always made him responsible for.

We discussed this with his therapist and they again put another diagnosis on him. Impulsive Control Disorder. His impulsiveness gets in the way of daily life. Too much risk taking etc....

I thought my son learned a lesson since he was caught and embarrassed. Yesterday I get a call that while he is supposed to be in school he was at a convenience store across the street and stole a stupid box of Mike and Ikes. He was caught and they arrested him. Being over 18 he now has a record.

Then after telling his wrap around services (behavioral) they have sat me down and said that they can't help my son. His problems are beyond their scope. They recommend going to a family based service which they said has more programs, resources etc. Their company does not do family based so I would have to start the process all over again with new therapists.

I am so frustrated because I do not see how family services will help him more than individual services. I kind of feel that they are giving up on him and they have only been here a couple of months. I feel they don't have the experience needed or the answers to provide true behavioral modification. When they come we are playing therapeutic is this to help my son? The therapist stated that he felt he was providing family based services and not doing what his job is supposed to be. Is this my fault? They are supposed to be the experts and put things into place. They are supposed to know how to work with my son to change his behaviors. I look at them for guidance and knowledge in this area and yet they are telling me they don't know what to do.

Could anyone please explain to me why we should go family based vs wrap around?

I am ready at this point to place my son in a group home. I feel that though he is extremely bright, he refuses to do anything for himself as long as I am here with him.

We are so back and forth because without an MR title we do not know what our expectations should be. We feel there are things my son could and should be doing but he seems to never be able to attain any goals. Are our expectations too high? He's not a little boy anymore and he has point blank told us he doesn't want to grow up because growing up is not fun.

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