Should Children With Autism (ASD) Be Taught Social Skills?

In my role as editor-in-chief for a scholarly journal, I recently received a letter criticizing intervention research on improving social skills in children with an autism spectrum disorder. Normally, letters of this type focus on methods or results interpretation of studies appearing in the journal, but this letter was striking because it focused on the rights of children with ASD rather than on the quality of the research.

Specifically, the author argued that it is a fundamental right of children with ASD to be viewed within the broad context of “neurodiversity” rather than “disability.” Essentially, this perspective insists that treatments focused on increasing communication and social skills directly violate the rights of children with ASD.

Candidly, this is an important conversation for our society to have. My work with late talking children, especially bright late-talking children who have a precocious interest in mathematics, science, and other analytic fields that sets them apart from other children–and is often a mismatch with preschool education–supports the argument that treating these late-talking children simply because they are a bit quirky and socially awkward and are “different” than their peers can be misguided. Having a narrow view of typical will potentially harm, or even derail, their education and development.

On the other hand, some of my clinical work–and intervention research–has focused on supporting the communication and social development of children with developmental differences, including those with ASD, Down Syndrome, or hearing loss.

What is the balance between supporting a broad view—and tolerance–of neurodiversity, disability rights, as juxtaposed with good faith efforts to support communication and social development by teachers, speech pathologists, special educators, and other clinicians? And what about family-caregiver perspectives as juxtaposed with children’s rights?

I have met many children with ASD who seem to prefer to be isolated from other people, including family members–and who spend nearly all their time engaging in the same repetitive activities. Many enjoy tracing letters and numbers over and over again. Some enjoy using specific apps on a phone or iPad. Others spend much of their time sitting in a corner, rocking and waving their fingers in front of their eyes. In some cases, efforts to guide these preferred activities into other learning and social interactions–and even self-care–can be met with resistance or meltdowns.

One could argue that because these are clearly preferred activities for these children, parents and other caregivers–and society at large–should respect this choice and not impose their values on individuals with ASD.

On the other hand, extensive literature and many effective programs can empower these individuals to participate in society and effectively communicate with others, including family members. And it is noteworthy that these programs fully embrace positive support so that the child is encouraged to participate rather than forced.

Also, as someone who has received several very critical emails and also aggressive criticism on social media due to my efforts to support communication and social development in children with ASD, I oppose subjecting clinicians and researchers to these campaigns when they are making good-faith efforts to discover and implement developmental supports for social and communication abilities in children with ASD–while at the same time absolutely respecting basic human rights and the dignity of these individuals and their families.

To be sure, there are, sadly, far too many examples of people with disabilities, including people with ASD, being treated inhumanely, including electric shock [1, 2, 3], being sprayed with ammonia or another noxious substance[4], forcibly placed in timeout rooms[5,6], and even being strapped into restraint chairs and forced to imitate words and phrases in the same manner that parrots are taught to speak[7]. These are clear violations of the child’s rights regardless of one’s perspective on whether social and communication skills should be encouraged positively.

This complex discussion is not limited to ASD: I have also seen a parallel debate about providing cochlear implants to children with hearing loss. On the one hand, cochlear implants improve hearing and increase participation in communication, social interaction, and education in the broader hearing community. On the other hand, some people in the deaf community, especially those fluent in American Sign Language, argue that cochlear implantation permanently segregates these children from deaf culture.

My perspective, which I freely admit comes from someone who is not a member of the deaf community nor an individual with ASD (although definitely quirky), is that fundamental human rights must always be respected but that this must be balanced against each individual’s right to receive an education and to participate in society.

Developmentally, one could argue that it is important to provide opportunities for social and communication development with the idea that an adult can then choose to participate (or not) in broader society as they wish. Of course, it is difficult to imagine how this might work for a toddler who receives a cochlear implant so that American Sign Language is unlikely to be one of their native languages.

Moreover, the nation underwent dramatic changes in the 1960s and 1970s regarding disability rights, and one could argue that there were many positive outcomes from this movement. However, it is time that the conversation about disabilities, neurodiversity, and individual and family perspectives–and rights–be reopened nationally and internationally.

What are basic rights? How is the right to be left alone and valued as an individual from a diverse community balanced against the right to receive a “free and appropriate education” and the right to participate in society? What about medical treatments such as cochlear implants? These are difficult conversations, but new guidance is needed.

[1] Lovaas, O. I., Schaeffer, B., & Simmons, J. Q. (1965). Building social behavior in autistic children by use of electric shock. Journal of Experimental Research in Personality, 1(2), 99–109.

[2]Lovaas, O. I., & Simmons, J. Q. (1969). Manipulation of Self‐Destruction in Three Retarded Children 1. Journal of applied behavior analysis, 2(3), 143-157.

[3] Lichstein, K. L., & Schreibman, L. (1976). Employing electric shock with autistic children. Journal of autism and childhood schizophrenia, 6(2), 163-173.

[4]Tanner, B. A., & Zeiler, M. (1975). Punishment of self‐injurious behavior using aromatic ammonia as the aversive stimulus. Journal of Applied Behavior Analysis, 8(1), 53-57.

[5]Leaf, J. B., Townley-Cochran, D., Cihon, J. H., Mitchell, E., Leaf, R., Taubman, M., & McEachin, J. (2019). Descriptive analysis of the use of punishment-based techniques with children diagnosed with autism spectrum disorder. Education and Training in Autism and Developmental Disabilities, 54(2), 107-118.

[6]Hansen, K. (2019) Light Oversight on School Time-Out Rooms Worries Parents, Advocates. https://www.nbcboston.com/news/local/light-oversight-on-school-time-out… Published February 7, 2019 • Updated on February 8, 2019. Accessed November 28, 2021

[7]Camarata, S. M. (2014). Late-talking Children: A Symptom Or a Stage?. Cambridge, MA: MIT Press.