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Introduction

A universal characteristic of ASD is difficulty with social skills. Individuals with ASD usually display a lack of eye contact, limited conversational skills, and difficulty recognizing social cues (Case- Smith & Arbesman, 2008). Social skills training programs are designed to teach children and adults with developmental disorders, including ASD, the steps involved in social interaction. The goal of social skills training is to teach verbal and nonverbal behaviors involved in social interactions (minddisorderss.com, n.d.). It teaches them the ability to identify and interpret social signals, so they can determine how to act appropriately in conversations with others across different settings and situations.

Theory

Social skills training focuses on skills in meeting other people, starting and maintaining conversations, acting effectively in a variety of social situations, and starting and strengthening relationships. Social skills training treatment can be used with a number of psychological problems which can inhibit social interaction and interfere with the learning of appropriate social behavior. An aspect of social skills training is Theory of Mind, often referred to as TOM. The core concepts involved in Theory of Mind are beliefs, desires, and intentions, which are used to understand why someone acts in a certain way or to predict how someone will act (Kloo et al., 2010). Theory-of-mind (ToM) refers to knowledge and awareness of mental states in oneself and others to help navigate social situations. By utilizing social skills training, an occupational therapist will be able to help the child understand that someone may hold a belief about an event or object that does not match what the child knows to be true in reality. determine which stage of the transtheoretical model an individual is in and gives them the skills and knowledge needed to advance to the next stage to make a change to better themselves.

Evidence

Theory-of-mind (ToM) refers to knowledge and awareness of mental states in oneself and others. Various training programs have been developed to improve ToM in children and there is abundant evidence in the effectiveness of social skills training in individuals with ASD.Collectively, ASD is characterized by deficits in communication, impairments in social interactions, and restricted and repetitive patterns of behavior (Case-Smith, J., & Arbesman, M. (2008). According to Case-Smith & O’Brien (2015),    1 Level III and 4 Level IV studies showed positive impact on the following areas of social function when using social skills training as an intervention method: increased engagement, initiation, and generalization to non-preferred tasks.

Case Study

Sam is an 18-year-old boy who is diagnosed with autism spectrum disorder. He is currently a freshman at a local college studying marine biology. He lives at home with mom, dad, and sister. Sam is struggling with getting a girlfriend. Sam has gone on a few dates, however, they did not go well. He has an impulsive personality and makes blunt remarks which attributes to his struggle with dating. Sam was referred to occupational therapy services to work on acquiring and maintaining a romantic relationship.

Intervention Plan

Problem Statement

Sam demonstrates frustration with inability to maintain a romantic relationship due to a lack of knowledge about appropriate social and communication skills used in dating.

Long term goals

1- Sam will demonstrate two strategies for dealing with difficulties that may occur on dates by discharge.

2-Sam will use three appropriate social skills used when asking a girl out on a date through role play with the therapist for increased participation in dating by discharge.

Short term goals

1- Sam will be able to identify 3 out of 3 nonverbal social cues previously demonstrated by therapist during role play in 2 weeks to increase participation in dating.

2-Sam will verbalize 3 characteristics of theory of mind to demonstrate comprehension for increased participation in dating by discharge.

3- Sam will be able to accurately identify five inappropriate social responses in dating video by discharge in order to increase his participation in dating.

Intervention format

Individual

Setting

The occupational therapist will visit Sam in his home for two, 45-minute one-on-one sessions a week for four weeks.

Supplies

Dating videowi

Agenda & description

• Meeting with Sam to follow-up on his date last week (5 min)
• Engaging in Social skills training to increase Sam’s ability to get a date (25 minutes)
  • Introduce to Sam the video he will be watching of a dating scenario that shows some inappropriate behaviors and  appropriate behaviors
  • OT will pause video whenever a specific behavior appears and ask Sam:
    • “How do you think the date is going?”
    • “How do you think she feels the date is going?”- Theory of Mind
    • “How you do know that the date did not go well?”
    • “What do you think he could do instead?”
    • “What do you think went well on the date?”
  • OT will guide Sam with answering the questions asked above and point out the appropriate behaviors in the video. (15 minutes)
  • The OT will assign Sam a homework assignment that consists of making a list of ten ways to compliment a girl.

Documentation

S- Sam seemed calmed and comfortable speaking to the OT. “I would really like to get a date with Jackie but I do not know how to ask her or if she likes me”

O- Sam engaged in a 45 minute session focused on his dating experience using social skill training approach. Sam watched a 10 minute dating scenario video that shows inappropriate and appropriate behaviors. He was able to identify 5 out of the 7 inappropriate behaviors and 6 out of the 7 appropriate behaviors through the guidance of the OT.

A- Sam presents difficulties with demonstrating appropriate social and communication skills which is affecting his dating life. Sam has shown improvement in identifying inappropriate behaviors since last session when he only identified 3 out of 7 from the previous video. This session he identified 5 out of 7 which was one of his short term goals..  He is gaining more confidence in his social skills in order to be more prepared for dating. Sam will benefit from skilled OT services to help him to continue his readiness to implement a plan of action for being more successful in dating.

P- The therapist will continue with social skills training to identify how to apply appropriate social and communication skills during dates. OT will continue to guide Sam through dating life. He will benefit from OT services 2x/week for one month, 45 minutes each.

References

Case-Smith, J., & Arbesman, M. (2008). Evidence-based review of interventions for autism used

in or of relevance to occupational therapy. American Journal of Occupational Therapy,

62, 416–429.

Case-Smith, J., & O’Brien, J. C. (2015). Occupational therapy for children, (7th Ed.). Maryland Heights, MO: Mosby, Inc.

Hofmann, S., Doan, S. N., Sprung, M., Wilson, A., Ebesutani, C., Andrews, L., Curtiss, J.,Harris,   (2016). Training children’s theory-of-mind: A meta-analysis of controlled studies.

Cognition, 150, 200–212. http://doi.org/10.1016/j.cognition.2016.01.006

Kloo, D., Perner, J., Aichorn, M. & Schmidhuber, N. (2010). Perspective taking and cognitive

flexibility in the Dimensional Change Card Sort (DCCS) task. Cognitive Development,

25, 208–217

Social skills training. (n.d.). Retrieved January 24, 2018, from

http://www.minddisorders.com/Py-Z/Social-skills-training.html