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Video Transcript

Slide 1

Hello, and thank you for joining us today for the Social Competence Play and Friendship webinar.

Slide 2

My name is Wendy Szakacs and I am the Regional Coach for Autism and Low Incidence at OCALI in the northeast and eastern parts of Ohio. And I am Julie Babyak, an Ohio State University School Psychology Intern with OCALI. OCALI is the Ohio Center for Autism and Low Incidence. We serve families, educators and professionals working with students with low incidence disabilities including autism, multiple disabilities, orthopedic impairments, other health impairments and traumatic brain injury. Our mission is to build state- and system-wide capacity to improve outcomes through leadership, training and professional development, technical assistance, collaboration and technology.

Slide 3

Before we begin today's session, we would like to provide you with a few tips that will make your experience more enjoyable. First, we would like to let you know that your microphones have been muted. We find it best that you do not click outside of the Go-To-Meeting Webinar window during the presentation. If you have any questions about the content of today's presentation, please use the chat interaction tool located at the right portion of your Go-To-Meetings screen. We will have some question and answer time at the end of the webinar. For all locations that have more than one participant, we are asking that you take a moment right now to count the people watching this presentation. If you are not alone, please use the Chat tool to indicate how many additional people are in the room besides the person who registered. If you are watching alone, no need to chat us. Julie will now begin with the content for this webinar.

Slide 4

Thanks Wendy. This webinar will explain how autism affects early types of play. Then we will talk about supports that will help teach play skills to individuals with autism, and we will discuss friendship skills that will help those with autism develop and maintain friendships.

Slide 5

So, let's review the definition you learned in the first two webinars and remember what we mean by social competence. Social competence is the ability to interact successfully with peers and adults in a variety of situations and environments. An individual that possesses social competence is therefore able to participate in social situations. Social competence is more than simply learning or mastering discrete social skills, saying hello, how are you today or please and thank you. There are many things to know, remember, and react to. We all try to follow the social skills we have acquired; we are able to know that other people have thoughts and what those thoughts might be by listening to their language while watching their facial and body language; we can identify and understand our own emotions and the emotions of others, or we converse about them until we can gain understanding; we are able to enter different situations and know how to dress, talk, move, and behave.

Slide 6

Consider this quote from Michelle Winner, an author who writes about social thinking: "Social competence means one is able to adapt to an ever-changing landscape that takes into consideration the environment, the people in it, the thoughts, beliefs and needs of the individual and others who share the environment-whether or not they are in direct communication-as well as individual and collective history of knowledge and experience." Social interactions and behaviors are extremely complex, which is what makes social competence difficult to teach. Because social competence comes naturally to neurotypicals (which is a word used to describe those who do not have autism), it is not a natural process for neurotypicals to break down how to acquire social competency nor how to teach it. We use social abilities pretty much every waking moment-choosing what we will wear for the situation of the day; interpreting what is happening when watching TV or reading a book; and how we behave when we are with people. Those that are skilled in social competence keep mental records of people they know and how to interact with them, which is an intricate procedure to recall and react in appropriate ways.

Slide 7

So where does social competence begin? With parents, from that first moment with their baby! As babies mature, they learn to control their own bodies, their arms and legs, their heads and faces. They use this control of their bodies to interact with their world, their parents or caregivers, and the things in it--a baby rattle, a blanket, their hands and feet.

Slide 8

What is play? First, play is pleasurable. Children play in order to have fun. Children need to be actively engaged to play activities. In order for children to play successfully with objects, themselves, or their peers, they must be truly involved and entertained. Play is also spontaneous, voluntary and motivated from within. Children play for their own reasons and desires and therefore should not be forced or required to engage in play. Play involves enjoying the process more than getting to an expected result; the process is what drives play, not an end product. Play is flexible, changing, and not literal. Most children change their play activities several times during a play period and do not have rigid standards or expectations.

Slide 9

Think about this quote: "Play is the business of childhood and it would be fair to say that most children love their job." This thought is for all children, including those with autism. They may play the same as others, or differently, but they can enjoy themselves.

Slide 10

Why is play important? Good play skills have been connected to better cognitive, social, language and emotional development. Play helps build language skills, shows children how to communicate and get along, and gives a way for them to practice how to express, share, and control their feelings. Play and social competence are therefore directly connected. Playing helps children learn how to make friends and how to be a friend; without play, friendship could not develop as effectively or efficiently. Wendy is now going to talk about levels of play.

Slide 11

Thanks Julie. We are going to talk about the different levels of play for typical children and for those on the spectrum. Manipulation play, which appears in infants as young as 8 months old, may also be referred to as exploratory or sensorimotor play. Manipulation play includes numerous movements such as gazing, mouthing, patting, swiping, grasping, shaking, banging, turning and dropping. Think of a young baby picking up a rattle. They look at it, rub it on their cheeks, lick it, might even put the whole thing in their mouth if they can, and they're feeling it with both their hands. Then the baby probably shakes the rattle and bangs it on something hard, sometimes even making themselves jump. This is manipulation play.

Slide 12

For children with autism, manipulation play is present at higher rates than functional or symbolic play, possibly due to the fact that children with autism are often attracted to play activities that involve sensory experiences. Manipulation play in children with autism is slightly differently. It often includes running, jumping, spinning, and bouncing. During manipulation play, some children with autism may begin playing with toys in a stereotyped way, such as lining up toys or spinning the same part over and over. Their need for sameness and routine can move play in the direction of repetition rather than exploration.

Slide 13

Functional play is the next stage of play in young children. We usually see functional play by the end of the first year. It consists of one step or multi-step actions with constructive materials. These could include simple actions like stacking blocks, putting a doll in a bed, or trying on hats. Complex actions include brushing a doll's hair or wrapping a stuffed animal in a blanket. Think of a one-year-old child you have observed recently, and remember how their play looked. Were they pushing a toy car or fitting different shaped blocks into matching openings? We need to be aware of typical development and understand the skills so we can teach them to our children with autism.

Slide 14

For children on the spectrum, functional play ranges from simple to complex actions. Because children with ASD possess such a wide range of abilities, functional play differs between children and can include activities that are directed to objects, self and peers. Some children with ASD may only play with activities that are directed to objects, such as rolling cars on a track or even lining up vehicles, while other children may play with activities that are directed towards their friends, like playing with dress up clothes and they may even put some of those items on their friend. Because every child with ASD has different strengths and challenges, functional play will present differently and at different levels for each child.

Slide 15

The last level of early play is symbolic-pretend play. It may also be referred to as imaginary or fantasy play and appears between two and three years of age. There are three fundamental forms of symbolic-pretend play. They are object substitution, attribution of absent or false properties, and imaginary objects as present objects. Big words to describe FUN for 2 to 3 year olds! Object substitution is when you use one object to represent another. So a banana is a telephone or a bowl becomes a hat. An example of attribution of absent or false properties is pretending a dry table is wet or that it is snowing inside. An example of imaginary objects as present objects is pretending that an empty cup is full of tea or that you are throwing and catching a ball that isn't there; think of adults who play air guitar.

Slide 16

Symbolic-pretend play is the least likely form of play to appear spontaneously in children with ASD. When children with autism do engage in pretend play it often consists of fewer different, flexible and new acts than children of a similar developmental level. Pretend play in children with ASD is often seen as play rituals that only vary slightly and are often scripted and repetitive. For instance, a child with autism may want to play Ninja warriors with some of his neighbors. The children may be told by the child on the spectrum what characters they will be, what they will do, what to say, where to stand or walk. He is acting out a script that he knows and it makes him comfortable, while the other kids may want to make it up a little bit more. Now that we've talked about what play is and how it is affected by autism, we are now going to share how you can support teaching play to those on the spectrum.

Slide 17

Consider this quote: "If play is the beginning of measuring the world and finding one's place in it, it shouldn't be hard and one should feel successful." Playing according to other people's rules can initially prove difficult for the child with autism, but we can help them find enjoyment and feel successful. Let's look at some ideas for teaching play.

Slide 18

This slide lists some tips to assist in enhancing play skills and increasing children's interests in various activities in order to improve their ability to imitate adult play, increase the variety of toys they will play with, and to increase the spontaneity with play materials. So here is one scenario: I have a student who loves Dora the Explorer and plays with a Dora talking toy in the play area all the time. So I find a Dora playhouse with Dora figures and set it up in the play area. When the student makes the Dora talking toy say something, I act it out with the characters in the playhouse. I encourage the student to explore the figures as he is playing with the Dora talking toy. This way, I have used a familiar toy and favored characters to expand play.

Slide 19

As parents and teachers, we tend to approach play as an experience of the "whole", but we may need to rethink that approach. New activities, games, and toys may produce anxiety in individuals with ASD when we would be expecting excitement. So how can we expand play opportunities for those on the spectrum with the least anxiety possible? Go slowly; break multi-step games into small parts and teach one at a time and then chain those parts together; and make play sessions short and spread them out through each day, knowing when enough is enough by reading the child's level of comfort rather than the amount of time we plan to play. Take the case of Toshi, a young boy with autism, who was interested in shows on television about buying houses. He would watch them over and over, talk about real estate and home improvements. His mom decided to teach him how to play Monopoly (TM). At first, she just got the board out and they looked at it together, reading the names. Another time she got out the money and houses so they could pretend to count out how much this house was or that hotel was going to cost. The next time mom and Toshi sorted and read the cards for the properties. Toshi realized these were the same as the board they had looked at and mom had her hook. She wrote out a simple set of directions and they started learning how to play Monopoly(TM).

Slide 20

What are some steps to consider as you teach play? You want to set up the environment in a natural way, like you would for any same age peer, while having toys and activities appropriate for differing ability levels. Help the area or activity make sense visually using pictures, containers, shelving, or other visual supports. Use items that will attract the individual with autism. Set up limits to the area using shelving, furniture, rugs, or tape. There is an Autism Internet Module at www.autisminternetmodules.org that explains more about Visual Supports.

Most importantly, have a way for the individual to communicate and know the best way to communicate with the individual so interactions can occur. When you're looking for possible interests, watch for subtle clues from the individual-it could be fleeting eye contact, or a slight movement towards a person, toy, or activity. Talk and verbally describe your play while near those with autism and also watch what the person with ASD is doing and join in, SLOWLY expanding the action. Use visual scripts, picture directions, and video models as a way to show how to play.

Slide 21

Using a child's special interest in play is one strategy to improve motivation and add reinforcement. This slide illustrates how using a special interest such as Star Wars can be used to teach several different play skills. Some possible play skills that can be taught through the use of special interests include building, fine motor, pretend skills, peer play, figurine pretend play, sharing, turn taking, and winning and losing. Don't worry about making a child's special interest "worse" or that you are helping to create an "obsession". We all have special interests and we participate in them because of the enjoyment they bring. Use the special interest to expand other areas, just as this Star Wars example illustrates.

Slide 22

When teaching play, there will be a point when we want to involve peers. Provide opportunities for individuals with ASD to play with peers in different environments. You could invite the friends to a play date at home, go to the playground or park, try a neighborhood kickball game, or maybe even an organized sport. This can be challenging for someone with autism, so start by including things that are interesting and motivating and move into things that the same age peer group are involved in. This will take some help to teach peers and other adults how to assist the individual with ASD to be successful. Take time to show the friends how to communicate, how to help when needed, how not to help too much, how to calm when necessary, and how to use visual supports that may be helpful to the individual. This will make the play experience more comfortable for the peer and the individual with autism. You can see how knowing how to play is important in helping individuals with autism form friendships, which is what Julie will discuss now.

Slide 23

Great Wendy. We have discussed how to develop play skills as part of building social competence and now we are going to talk about what it takes to make and keep friends, including some special ideas for those on the spectrum.

Slide 24

Let's start with levels of friendship. Level one occurs between the ages of 3 to 6 years old. At this level, friendship is very basic and is often defined by who is near the child. Children believe that a friend is someone who asks you to play or hands you a ball or a book. Level two occurs between the ages of 6 to 9 years old. At this level, children do less pretend play and are more likely to start sharing and doing some of what each child enjoys. Children are also more likely to understand why they want to play certain things and how they think and feel about it. Therefore, friendship at level two is deeper than level one. Children in this level believe someone is their friend because they share their toys or time with them.

Let's think about how ASD might affect friendship at these levels. Friendship at these levels is going to depend on play abilities, communication differences, social differences, and interests. Also, sensory issues can affect a child's ability to play and make friends. Supports will need to be in place to help those with autism progress in making friends. We'll be sharing some supports shortly.

Slide 25

Friendship Level three occurs between the ages of 9 and 13. At this level, friendship is defined using activities that kids like to do together because they both or all like it. Children at this level start to realize that other people have feelings and thoughts and opinions that might be the same or different from their own. There is also less playing together and more helping each other. Children in level three are also more likely to focus on games with rules such as sports, board games, card games and video games. At this level, children would say someone is their friend because they help them with their homework or they play video games together or they simply both like basketball and football. Level four appears in adolescence and lasts through adulthood. At this level, being part of a group, especially peers, becomes the ultimate important activity. In fact, it may be even more important than family acceptance. At this level, individuals also realize that some people are not very nice and sometimes even someone who claims to be a friend may not act like a friend. Individuals start to decipher positive qualities and traits from negative qualities and traits of people and they know what a friend should look like.

So how does autism affect developing friendships at these levels? As children get older and move into adolescence and adulthood, communication becomes more abstract and complicated. Social competence is also more complicated. Finding peers who may have the same special interest can be a challenge. During middle school through high school, all individuals are maturing at a different rate and are not always as kind or empathetic as in elementary school. All of these issues make the need for teaching about friendship even more important at these ages.

Slide 26

In schools and homes, we spend a lot of time learning and preparing for our future jobs. Most of us would agree that, although we hopefully enjoy our work, that the best parts of our lives are with our families and friends. Therefore, we also need to spend some time nurturing the friendships that our children and students need in order to feel fulfilled. Each of the five topics listed are discussed in the following slides.

Slide 27

Understanding and using theory of mind is one important component for developing friendship skills. Knowing that other people have thoughts and that some of them are about me and about what we are talking about or doing is an important skill for social competence.

Some individuals with ASD lack an understanding of theory of mind. Therefore, individuals on the spectrum may have difficultly in the areas on the slide. Guessing what someone else is thinking is something that seems to naturally develop in neurotypicals, but needs to be explained and taught to individuals on the spectrum. Think about entering a friendship and how many times you need to try to read the other person: what do we want to do tonight; did you like that restaurant; should I call and ask them to do something or wait for them to call me; should I pay for the movie or are we taking turns paying for both of us; and on it goes forever. To make friendships work, we need to have some theory of mind skills.

Slide 28

So how do we help persons with ASD form friendships? We need to be sure there is a communication system in place and that the potential friends understand how it works. We need to help the person with autism know what their peers will be doing and talking about, such as the latest video games, music, and clothing. Also, knowing what slang and greetings are current is extremely important and needs to be taught and/or incorporated into the communication system. Being able to approach friendship situations with a framework for solving problems that crop up is imperative. We'll be sharing some of those later in Webinar 4. As parents and teachers, we need to assist the individual with autism by giving them the opportunities to practice their social competence with the supports we have provided. They will need a lot of positive reinforcement, support, and time to talk over things that are happening as they work at developing friendships. Sean Barron, an adult with autism, shares how important it was that his parents talked and talked with him about how other people were thinking and why they might have done or said what they did. He credits his parents giving up hours of sleep to talk with him as the factor that helped him emerge as a capable, working, independent adult.

Slide 29

Brenda Smith Myles wrote a book about the Hidden Curriculum. The Hidden Curriculum is the set of rules or guidelines that are often not directly taught but are assumed to be known. Some common phrases associated with the hidden curriculum include "I shouldn't have to tell you this, but..." or "everyone knows that..." or "It's obvious..." The hidden curriculum can cause confusion and misunderstandings for some individuals with ASD. Understanding the hidden curriculum is one important component for developing friendship skills. Therefore, these individuals may have to be directly taught the hidden curriculum. Let's look at some examples.

Slide 30

As this cartoon illustrates, there is a different thinking process and perception for the individual with autism when it comes to social understanding. Not understanding the hidden curriculum puts our persons with ASD at a severe disadvantage in developing friendships. Saying unacceptable things to other people, laughing too loud or too long, or wearing a tie to school every day can set you apart from the peers who you want to make into a friend.

Slide 31

This slide provides some examples of the hidden curriculum as it appears in school and social situations. We think that most students are going to come to school with these understandings and abilities, but that is not the case for the person with ASD. We need to teach these items. Each teacher has different rules and expectations that are picked up by neurotypicals naturally and quickly, while the individual with autism may really struggle with understanding the classroom environment.

Slide 32

Here are some more examples of hidden curriculum items. Again, these need to be discussed and taught to persons with ASD. How honest do we need to be? What can you say to one person but not another? Do I need to say everything that pops into my head? Learning Hidden Curriculum items can assist individuals with ASD in fitting in with their peers, their classrooms, their families, and their work associates. The OCALI Lending Library has materials that further explain the Hidden Curriculum. See the OCALI website at www.ocali.org for more information. So far we talked about theory of mind, the basics for establishing friendships, and the hidden curriculum. Wendy will now discuss anxiety issues.

Slide 33

Thanks Julie. Anxiety for persons with ASD is a serious issue in all areas of their life, but can be especially difficult in social situations. Since social interactions are unpredictable and constantly changing, there is anxiety for those on the spectrum before they even approach those situations. Although the level of anxiety will vary in each individual and in different situations, there is almost always some anxiety present. Learning how to approach situations and having a framework and skills to interact help relieve some of the anxiety. Not getting along socially can have grave affects on a person who wants to get along.

Slide 34

So how can we support those with ASD to lessen some of this anxiety they experience? Teaching counting, deep breathing, and yoga techniques are some calming activities that can be helpful. Being sure to discuss social situations that are going to occur and practicing them allow the individual to develop social confidence. The Incredible 5 Point Scale and other visual supports work through the visual mode, which is usually the strongest modality for those on the spectrum. Drawing and using pictures allows the individual to take the time they need to review and learn a concept, while staying constant.

Slide 35

Displaying visual representations is really beneficial for individuals with ASD. One example is the Incredible 5-Point Scale. This helps students understand and work through their emotional reactions to everyday events. It's a scale that breaks down a given social behavior and, with the student's active participation, you can develop a unique scale that identifies the problem, and just as important, suggests alternative, positive behaviors at each level of the scale. Emotional understanding and knowing how to approach challenging situations can help the individual with autism be able to approach social situations with less anxiety and more confidence. A link has been included to learn more about the 5-point scale.

Slide 36

This is an example of the 5 Point Scale. This is a stress scale that uses both pictures and words. By using pictures only, pictures and words, or words only, the 5 point scale can be used for children of various ages as well as for various levels of functioning. This scale would be used by filling in the event that matches the feeling, like #1 that says "This never bothers me" up through #4 that says "This can really upset me." Including a support or intervention with each event that can help relieve the stress makes this an extremely useful tool to help relieve anxiety. And again, there is an autism internet module about this method.

Slide 37

This scale was developed for an adult in a work situation. Notice the description and ideas for supports at each level. For instance at level 1, he is chillin' and feeling good, while at level 4 he is almost over the edge and his support is to grab his stress ball, take a walk. Maybe a person is overwhelmed by 5 levels, and so you could develop a 3 level scale.

Slide 38

This slide shows an example of a visual support for anxiety. This visual support uses pictures and text in order to help the child relax. Each step of this sequence would need to be taught, practiced, and reinforced for it to become a habit an individual can remember in a time of anxiety. We are now going to move on to emotions.

Slide 39

Understanding and recognizing emotions is one important component in developing friendships skills. Many emotions can look and seem different in individuals with autism. Some emotions that may manifest differently include excitement, enjoyment, pleasure, confusion, misunderstanding, love and affection.

Slide 40

A typical child or individual may respond to excitement, enjoyment or pleasure by smiling, jumping up and down, singing, laughing or giggling. A child or an individual with ASD may respond to these emotions slightly differently. So they may smile, they also might flap their arms or hands or wrists; they could screech, squeal, rock or talk non-stop. Are they feeling the emotion and expressing their joy or excitement? Absolutely! Neurotypical children learn what are socially acceptable ways to express emotions, while persons with autism are showing what they feel in whatever way comes naturally.

Slide 41

A typical child or individual may respond to confusion and misunderstanding by asking questions, having a puzzled look on their face, scratching their head, or looking to others for clarification. A child or individual with autism may respond to these emotions slightly differently. A child or individual with autism may respond to confusion or misunderstanding by taking the meaning literally even though it may not make sense, or by exhibiting fear at the unknown or unpredictable, or by having a tantrum or meltdown if things do change. Picture the individual with ASD in a social interaction with anxiety levels already elevated, and then a person reacts to something he says in an unexpected way that confuses him, and that anxiety heads up to higher levels making cognitive reactions more difficult and possibly leading to a meltdown.

Slide 42

A typical child or individual may respond to love and affection by hugging, kissing, smiling, patting someone on the back, or holding hands. A child or individual with autism may respond slightly differently. That child or individual with autism may respond to love and affection by moving away or even avoiding eye contact. They may also be unresponsive to receptive affection, show more attachment to objects rather than people, or may oddly initiate touch yet retreat from approaching touch. Does this mean the person with ASD does not experience love or crave affection? Not at all. He or she just gives and receives it in a unique way that we need to understand, learn and respect.

Slide 43

So today, you learned about the different levels of play and how they are affected by autism.

You also learned some things to do to help teach individuals with autism how to play.

And you now know some friendship skills that need to be taught to persons with ASD so they have a better chance at developing and maintaining friendships.

Slide 44

If you would like more information, please contact me at wendy_szakacs@ocali.org.

Slide 45

The next and final webinar in the Social Competence series is about strategies for teaching social competence and keys to building relationships with individuals on the spectrum.

If you have any questions related to today's webinar, please type them in the Chat window and we'll be glad to answer them for you.

Slide 46 & Slide 47-no narrative

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