🤔 Is there such a thing as "Neurodiversity Affirming Social Skills Training"?
Let’s bust some myths that even therapists who provide “neurodiversity-affirming” social skills training may still believe!
☑ Did you know that it’ a MYTH that Autistic people are lacking in Theory of Mind, and that this myth is based on decades of poor science?
☑ Did you know that “Autistic people share information with other Autistic people as well as non-autistic people do with other non-autistic people”?
☑ Did you know that “misunderstanding or lack of understanding in social interactions with Autistic people is not a consequence of autistic “impairment” but a mutual failure in reaching consensus through bidirectional empathy?
☑ Did you know that Autistic Masking and Camouflaging (hiding Autistic traits such as extinguishing stimming, forcing eye contact, and performing with neurotypical social skills to “blend in”) can lead to “exhaustion, isolation, poor mental and physical health, loss of identity and acceptance of self, others’ unreal perceptions and expectations, delayed diagnosis”? suicidal ideation and suicide? Autistic masking is often trained and reinforce in social skills training, also known as social emotional learning.
Neurodiversity-affirming therapy approaches don’t focus on training social skills. Autistic and non-autistic people have different embodied experiences of the world and different norms and expectations for autistic to non-autistic social interactions. TNDC understands that communication is a shared responsibility – it’s about both sides working towards understanding each other, not just one side doing all the work.
Autistic people are often held responsible for communication misunderstandings and excluded as a result. Therapists and others in society might believe the best way to promote inclusion is by encouraging Autistic people to act more like non-autistic people in social situations.
A therapist may recommend “neurodiversity-affirming” social skills training, but “training” implies that the Autistic person is inherently deficient or disordered if they do not perform the trained skill, reinforcing the idea that their natural way of communicating is inadequate and needs to be corrected. This might involve hiding or masking their autistic traits, even if it doesn’t feel genuine to them. Because autistic masking has been linked with poor mental health, we don’t believe in this approach. We respect the ideals of the neurodiversity paradigm, and we don’t think that autistic people should have to change their natural communication styles to meet non-autistic social expectations. Autistic people deserve to be accepted and included while being themselves.
Did you know that Social Skills Training isn't even an evidence-based therapy?
Autistic Social Communication - Let's explore the research
Imagine two people with vastly different experiences of life trying to connect and understand each other. The theory of the double empathy problem sheds light on this challenging situation, suggesting that when people with contrasting life experiences interact, they may struggle to truly empathize with one another.
Breakdowns in communication between autistic and non-autistic people are almost always perceived to happen because of the autistic person’s “deficient social skills.” This viewpoint often categorizes autism as a social communication disorder, ignoring the fact that communication is a mutual interaction between autistic and non-autistic individuals and their challenges in relating to each other.
Because autistic people and neurotypical people have different lived experiences they may experience difficulties in building mutual understanding when interacting because of a mismatch in their expectations of what is important or relevant in a conversation. So,
- Autistic people might find it hard to form connections with people who are not autistic, and easier and more comfortable to form connections with autistic people.
- Neurotypical people might find it hard to connect with autistic people, and it is easier and more comfortable to form connections with neurotypical people.
The double empathy problem reminds us that when people with diverse perspectives try to connect, their differing priorities and expectations in a communication exchange can make it challenging to bridge the gap of understanding. It emphasizes the importance of recognizing these differences and finding common ground to foster effective communication and empathy between individuals.
Diversity in Social Intelligence
In a series of groundbreaking studies between 2018 and 2021, researchers at the University of Edinburg challenged the traditional presumption of poor social intelligence in autism by questioning the idea that there is a single valid form of social intelligence. They proposed that autistic people may have more effective social communication skills when they are in their own autistic-specific cultural context, especially if they are interacting with other autistic people. Through rigorous experiments and diverse methods, including surveys and observations, the researchers examined how well autistic individuals could transfer information to other autistic individuals. At the end of the project, the researchers concluded that when autistic and non-autistic people interact, breakdowns in communication are much more likely to happen, but when autistic people interact with each other, they communicate as well with each other as non-autistic people communicate with other non-autistic people.
- “These results, however, are the first empirical evidence that suggest the difficulties in autistic communication are apparent only when interacting with non-autistic people, and are alleviated when interacting with autistic people…
- These results challenge traditional assumptions of autistic social impairment. The findings are inconsistent with the social-cognitive deficit narrative of autism.”
A follow up joint research project, Diversity in Social Intelligence Replication, ran across three sites in three countries – the University of Edinburgh (Scotland), the University of Nottingham (England), and The University of Texas at Dallas (USA)”.
Autistic Masking, Camouflaging, Adaptive Morphing
Autistic masking, also known as camouflaging or Adaptive Morphing, is an everyday self-protective social survival strategy done by Autistic children, teens, and adults in an effort to appear non-autistic to non-autistic people. Autistic people describe feeling pressured to camouflage so they can stay safe. Research findings indicate that masking is a trauma response to Autistic lived experiences of autism stigma,
Autistic masking involves consciously or unconsciously hiding authentic autistic traits by
- altering verbal and non-verbal social communication to mirror neurotypical social expectations, including eye contact, intonation, and scripting
- concealing personal information
- suppressing reactions to sensory experiences
- cognitive difficulties and differences
- altering or reducing stimming or other body movements, gestures, and facial expressions while deferring to and centering the non-autistic social partner, in an effort to people-please.
Autistic masking can be learned explicitly through therapies such as social skills training or sensory tolerance exposure therapy. It can also be developed implicitly through observing and imitating neurotypical behaviors. The practice of autistic camouflaging can lead to a delay in diagnosing autism. Alternatively, it might even cause a diagnostic professional to miss the identification of autism altogether. Engaging in masking comes at a cost, as it often leads to increased stress and anxiety, and trauma, even for young autistic children.
Autistic masking significantly contributes to poor mental health outcomes for Autistic people, even in Autistic children, including
- Exhaustion
- Burn-0ut
- Chronic debilitating anxiety
- Depression
- Low-self-esteem
- Confusion or loss of identity
- Thoughts of suicide
- Suicide attempt
- Death by suicide
Research has shown that the act of camouflaging can be equally grueling in specific situations as it is when done consistently all the time. If we want to decrease the harmful impacts tied to the act of autistic camouflaging then it’s critical to address autism bias and stigma and flip the dehumanizing autism narrative.
🤔 Why is social skills training a harmful practice?
💡 When therapists use a ‘curative’ therapy approach by training autistic people to mimic neurotypical social skills through masking, fawning, and ignoring sensory distress it can cause significant harm and trauma. There are better ways to approach social communication.
Neurotypical-centric social skills therapies conflict with the ideals of the neurodiversity paradigm and the goals of the Neurodiversity Movement.
🤔 What about peer-mediated interventions?
Autistic young people are viewed as the social skills “novices” who have deficient social skills, and the non-autistics peers are considered to be the “experts” with “good” social skills. The intervention consists of non-autistic peers, parents, educators, and clinicians modeling “the appropriate” “expected” or “correct” (neurotypical) social skills that autistic participants are expected to imitate.
The programs are always behavioral-based, and praise is used as a reinforcer when an autistic person successfully masks their autistic social communication characteristics. A successful outcome is determined by the level of parent, teacher, or provider “satisfaction,” and there are no considerations for internal shame and other harmful mental health ramifications that the autistic participant may experience as a consequence of learned masking and camouflaging.
Examples of Social Skills Training Interventions:
- IPG® (Integrated Play Groups)
- PEERS® The Program for the Education and Enrichment of Relational Skills
- Social Thinking®
What does social skills training look like in action?
→ The therapist or educator uses strategies that focus on molding desired social behavior, the autistic or neurodivergent person is trained by a therapist, teacher, and even similarly-aged neurotypical peers to perform with neurotypical social skills.
→ The goal is for the individual is to learn how to successfully mimic communication standards that the trainer views as “normal” or “appropriate.” At the same time, the individual is expected to suppress their authentic and natural ways of interacting and communicating.
→ The individual is indoctrinated to believe that they must be hyperaware of what others might be thinking about them and then adjust their social behavior to maximize the other person’s comfort.
Social skills training involves various therapy techniques, such as
- Video, peer, or therapist modeling (direct instruction or ‘coaching’) of neuromajority Social Skills where the client or student imitates the ‘social skill standard’
- Role-playing scenes where neuromajority social performance outcomes are the target (also called behavioral rehearsal by ABA therapists)
- Corrective feedback: “Yes, the child or adolescent is correctly mimicking the targeted social skill, or no, it’s incorrect.”
- Behavior modification
- Natural Environment Teaching (NET)
- Naturalistic Developmental Behavioral Interventions such as Pivotal Response Treatment (PRT) and Early Start Denver Model (ESDM)
- Scaffolding
- Proactive strategies (social stories, role play, priming)
- Verbal Behavior Training
- Extinction per function
- Planned ignoring
- Redirection
- Behavior contracts
- Token systems
- Positive behavior support
🤔 Why is social skills training a harmful practice?
💡 When therapists use a ‘curative’ therapy approach by training autistic people to mimic neurotypical social skills through masking, fawning, and ignoring sensory distress it can cause significant harm and trauma.
Autistic masking research indicates that continually camouflaging one’s autistic traits leads to suicidal ideation, decreased self-esteem, PTSD, depression, and self-doubt because the person is taught to intently judge and dissect all of their social exchanges and communication, and interactions. Social skills training removes autonomy. Even when social skills intervention appears successful, what does that mean? Successful for who, to what end? By what measure do we define success?
Social skills training can lead to a lifetime of autistic people experiencing chronic anxiety about social skills expectations, self-doubt, and even self-hatred. Therapists face the risk of unintentionally harming their clients or students by teaching them to camouflage their autism while mentally exerting themselves to respond “appropriately.”
Constantly monitoring one’s own interactions is mentally, physically, and emotionally exhausting, which eventually results in autistic burnout. Regardless of how hard an autistic person tries to mirror non-autistic social communication, it is unlikely to bring them joy or feel natural. The autistic person may spend hours ruminating over past social exchanges, worrying about whether they handled them correctly. This is an unnecessary burden to bear throughout life and contributes to internalized ableism and shame and external social bias against autistic people.
Rethinking Social Skills Training: Neurodiversity-Affirming Approaches
✅ Download a free copy of our “Why we don’t train social skills” infographic here.
✅ Read free articles about “neurodiversity affirming” and Social Skills Training.
✅ Want to learn more? Take our 10 hour professional development course: The Neurodiversity-Paradigm Framework for Autistic Social Communication.
Examples of damaging social skills goals that train autistic masking and camouflaging include
- (Non-medically relevant) Tone of Voice Modification
- Neuro-normative conversation goals
- Making eye contact
- Compliance without complaint
- Responding to bullying or teasing in an ‘appropriate way’
- Topic Maintenance of communication partner’s choosing for so many turn-takes
- Body Language (imitating neuromajority body language through masking)
- Facial Expressions (imitating neuromajority facial expressions through masking)
- ‘Active Listening,’ or ‘Whole Body Listening’ (Quiet hands, sitting in the seat without movement, etc.)
- Learning and repeating ‘rote scripts’ to use in social situations
- ‘Increasing comfort levels’ in social situations or group activities
- Eliminating stimming behavior, monotropism (focus or attention on a small number of interests in conversation)
- Interactive play skills with peers (based on the neuromajority what constitutes ‘play’) rather than true Autistic play, free time, or recreational time
- Initiating play with peers on the playground (even when solo free time is preferred)
- Reciprocal play (turn-taking on a peer’s terms)
- Tolerating changes (Sensory system is overwhelmed, demonstrating anxiety with unexpected changes in routine, tolerating auditory or physical distress)
- Tolerating unwanted touch (high five, shaking hands, hugs, kisses, arm around them)
- Identifying and using ‘appropriate vs. inappropriate behavior
- Reduction or elimination of ‘problem behaviors’
- Accepting compliments ‘appropriately’
- Refrain from interrupting others
- Eliminating echolalia
- Compliance with acknowledging communication initiated by others by giving ‘appropriate’ responses
- Cooperation in group decisions when the student is not in agreement
- Conveying emotions/feelings ‘appropriately’ by masking or fawning (Fawning – Walker, 2013: People-pleasing” or deferring to the needs and wishes of others, and surrendering one’s own in order to ‘blend’. )