Krasny Lori, Williams Brenda J, Provencal Sherri, Ozonoff Sally
Department of Psychiatry, University of Utah, 421 Wakava Way, Suite 143, Salt Lake City, UT 84108, USA.
Child Adolesc Psychiatr Clin N Am. 2003 Jan;12(1):107-22. doi: 10.1016/s1056-4993(02)00051-2.
This article outlines the ingredients the authors feel are critical to making social skills interventions successful for children with autism spectrum disorders. The authors described basic principles for teaching social skills that capitalize on the strengths of such children, while specifically addressing their deficits. The authors applied these widely used principles to group social skills intervention. In particular, social skills groups for children with ASD need to break down complex social behaviors into concrete steps and rules that can be memorized and practiced in a variety of settings. Abstract concepts must be made concrete through a variety of visual, tangible, "hands-on" activities that make socialization fun. Visual structure and predictable routines are essential. Also critical to the success of social skills intervention are instruction and activities that provide necessary support for the language abilities of the participants. A variety of learning opportunities must be used to teach the goals and skills most relevant to children with ASD. These skills must be integrated as intervention progresses. Furthermore, interactions that require the children to focus on peers create a positive social group culture. Within this culture and environment, self-awareness and positive self-esteem can be fostered. A behavior plan that specifies individual goals for group members and a specific system for delivering rewards should be included. Other important ingredients include generalization, which is encouraged through community outings, skill practice in more naturalistic settings, and collaboration with parents and teachers to work on skills outside the group intervention. Weekly therapy does little to change basic deficits of ASD unless there is daily practice and reinforcement of the skills being learned in more natural situations. The authors hope that outlining these principles and specific techniques will encourage more clinicians to offer social skills groups and thus increase their availability around the nation and world. Continued research and treatment for social skills is necessary to provide much needed empiric evidence to determine effectiveness of such interventions.
本文概述了作者认为对于自闭症谱系障碍儿童社交技能干预取得成功至关重要的要素。作者描述了教授社交技能的基本原则，这些原则利用此类儿童的优势，同时具体解决他们的缺陷。作者将这些广泛使用的原则应用于团体社交技能干预。特别是，针对自闭症谱系障碍儿童的社交技能团体需要将复杂的社交行为分解为具体的步骤和规则，以便在各种环境中能够记忆和练习。抽象概念必须通过各种视觉、可触摸的“实践操作”活动变得具体，使社交变得有趣。视觉结构和可预测的日常活动至关重要。对于社交技能干预的成功同样关键的是为参与者的语言能力提供必要支持的指导和活动。必须利用各种学习机会来教授与自闭症谱系障碍儿童最相关的目标和技能。随着干预的推进，这些技能必须得到整合。此外，要求儿童关注同伴的互动营造了积极的社交团体文化。在这种文化和环境中，可以培养自我意识和积极的自尊。应包括为团体成员指定个人目标的行为计划以及提供奖励的具体系统。其他重要要素包括泛化，通过社区郊游、在更自然的环境中进行技能练习以及与家长和教师合作在团体干预之外练习技能来鼓励泛化。每周一次的治疗对改变自闭症谱系障碍的基本缺陷作用不大，除非在更自然的情况下对所学技能进行日常练习和强化。作者希望概述这些原则和具体技术将鼓励更多临床医生提供社交技能团体，从而在全国乃至全世界增加其可及性。持续进行社交技能的研究和治疗对于提供急需的实证证据以确定此类干预的有效性是必要的。
