Therapist Neurodiversity Collective

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By Julie Roberts, M.S., CCC-SLP
Cite: Roberts, J. (2023, February 22) Toxic Social Skills Training Goals. Therapist Neurodiversity Collective. 

Another day, another toxic social skills goal… I am an Autistic speech-language pathologist (SLP) in a PBIS public school setting with a caseload of 100+ special education students in grades K-12 who receive speech therapy services.  I supervise SLP assistants on a few campuses. Approximately one-fourth of my caseload is autistic children and adolescents, 15% are ADHDers, and the rest are learning or intellectually disabled, with just a handful of articulation-only kids sprinkled in. The vast majority of new-to-me students come with IEPs that are probably well-meaning but, in actuality, toxic social skills goals written by SLPs, Licensed School Psychologists, Special Education Teachers, and sometimes, parents. I discontinue these kinds of IEP goals as quickly as possible, and in the meantime, my SLP-Assistants are provided with guidance for how to proceed in the least damaging way to the kid until this can be done. 

A neurodivergent middle school student was recently assigned to me, and according to their last evaluation report, “XYZ is very social, “yet “struggles with being included by peers.” The report also indicates that XYZ doesn’t grasp sarcasm and “doesn’t perceive subtle bullying or manipulative behavior by their peers.” In the PBIS public school world, when a neurodivergent student’s peers are mean to them, it’s always the neurodivergent kid’s fault. And because it’s their fault, the IEP committee always writes a social skills training goal to “help them make friends.”

“With modeling, practice, and using all accommodations, XYZ will increase social interactions and build relationships with peers by initiating play, giving compliments, and adopting a problem-solving attitude during lunchtime and in their general education inclusion classes.”

As I am a professionally educated, trained, and seasoned SLP (in addition to being a late-identified autistic person who underwent social skills training as an adult), I am well aware that the theory behind this student’s “individualized” social skills goal is that it is XYZ’s fault, and only XYZ’s fault that their peers ignore and exclude them, subtly and outright bully them. It’s XYZ’s fault that their peers don’t see them as a potential friend, much less their equal.

If only XYZ would make an effort to blend in, well then of course XYZ would develop friendships with classmates.

I feel exasperated, and then, sad…

Why is it that actively training autistic and wider-neurodivergent children and young people to people-please in exchange for conditional inclusion (but not necessarily acceptance) is still considered “best practice” by professionals and parents? It’s not even evidence-based.

Social skills goals train autistic students to hide their authentic social communication style while simultaneously trying to perform with someone else’s often arbitrary expectations for “good” social interaction. The rationale behind social skills training is that hiding one’s autistic or wider-neurodivergent social communication “deficits” (differences) and using the new skills trained into them will improve their lives.

The first problem with this is that friendships and other important relationships that are developed through inauthentic communication are superficial and conditional. My students call these “fake friends.”

The second problem with these kinds of goals is that they have poor mental health outcomes for the child or adolescent. “Findings indicated that camouflaging was a significant predictor of internalizing (i.e., anxiety, depression, somatic complaints) symptoms” (Ross, Grove, McAloon, 2023).

If a neurodivergent kid is trained to consistently mask their authentic social communication inclinations and makes a friend based on this social expectation, what happens when the neurodivergent kid drops their guard with “Thinking about YOU thinking about me”? Most of the time, the conditional friendship ends when the friend sees a real person behind the social mask and they are ostracized again, and they are left feeling even worse about themself than before the conditional friendship was made.  This often becomes a pattern for someone who has been trained to mask authentic social communication – hide their true self, make a superficial friend, drop the mask, and lose the friend. And there are other repercussions.

Let’s break down XYZ’s toxic social skills training goal to demonstrate just how damaging and even dangerous these kinds of goals are for neurodivergent students.

Why is XYZ's Social Skills Training Goal a Toxic Goal?

“While one could assume that having fewer (autistic) symptoms would improve peer relationships, evidence suggests that stronger social skills may increase the likelihood of experiencing and reporting peer conflict.” (Libster, et al, 2022).

  1. XYZ, a neurodivergent middle schooler, will be trained by an adult to initiate play (most likely through a script), and then, when XZY is able to self-generate the “initiate play” scripts, they will have to literally walk up to a same-aged peer in their general education setting and say some variation of “Do you want to play?”
    What actually happens when XYZ, after practicing and practicing with the adult (who assures XYZ that learning how to do this will get them friends), eagerly goes to PE, Music, Art, Lunch, etc., and says some variation of “Do you want to play with me?” to a same-aged/grade peer who is not their friend. If XZY is lucky, most of the time, a peer will just say “no.”  Some peers will be much less kind. And research backs up this premise.

     

  2. An adult successfully trains XYZ to memorize and generate compliment scripts to use with general education classmates so that XYZ’s likeability will increase. But the problem is that most middle schoolers don’t run around randomly complimenting their classmates, especially their same-aged/grade peers who aren’t close friends. They just don’t.
    What do XYZ’s classmates think when XYZ suddenly begins fawning all over them? That the “weird” disabled kid now comes across as even more off-putting… AND THIS IS SCARY – XYZ’s compliments have the potential to be wrongly interpreted by others, dangerously setting up XYZ for manipulation and exploitation because middle schoolers are pretty perceptive and can sense that XYZ is desperate to make a friend, maybe at any cost.

     

  3. XYZ will “adopt a “problem-solving attitude” when they are in general education settings with non-disabled peers. So, if a social problem arises, well then, it’s all on XYZ to fix it.
    Will XYZ’s non-disabled peers be expected to also adopt a “problem-solving attitude” when they are with XYZ? Doubtful. The prevailing rationale for this kind of social skills goal is that the special education student is always at fault if something goes sideways socially, but training them to have “good” social skills will fix them, leading to fewer difficulties with peers. It won’t. 

Social skills training IEP goals don’t result in authentic relationship building. Social skills training goals have incredibly poor mental health outcomes for the disabled kids they are written for, including a lifetime of constantly comparing themself with others, loss of identity and self-worth, heightened and even intense levels of chronic anxiety, depression, suicidal ideation, and sometimes, suicide.

How this particular story ends: Fifty percent of my SLP job is advocacy for my students. This includes discontinuing toxic goals and providing research and education to professional colleagues and the parents and caregivers of my students. In this instance, I email the campus special education to formally request to discontinue XYZ’s social skills training goal. I attach recent research studies that support discontinuing this toxic goal and suggest that XYZ’s peers could use some social skills training in empathy, acceptance, and inclusion – Yes, I wrote this in the email. After reading the entire assessment report, I conclude that what XYZ really needs to learn is how to self-determine the abstract qualities of authentic friendship and then distinguish between superficial and meaningful relationships with peers.

Every single one of the autistic students, along with several other kids on my very large caseload, struggle with identifying Friend, Friendly, Not a Friend.

XYZ also needs to evaluate whether a social situation is safe, neutral, or unsafe, learn how to detect subtle bullying and manipulative behavior through observing language and context, self-determine and enforce their own boundaries, and interpret various types of sarcasm. These targets are receptive, expressive, and pragmatic language-related and align with Common Core Standards for Language: Knowledge of Language, Integration of Knowledge and Ideas, and Vocabulary Acquisition.  More importantly, in addition to increasing XYZ’s language abilities, successfully meeting these goals will directly impact their safety, mental health, and self-determination in their educational and community settings.

Empowering Social Communication Goals

When provided with prompts from high-interest, language-rich sources, XYZ will demonstrate improvement with receptive, expressive, and pragmatic language skills in the academic setting:

With fading adult support and vocabulary definition assistance, XYZ will self-determine what specific qualities
a) they want in a friend (e.g., trustworthy, inclusive, supportive, respect her boundaries, shares similar interests and spends time with them, loyal, empathetic, funny, respectful, etc.).
b) a friendly person might have, even though they might not be a real friend. (e.g., approachable, polite, smiles, engages in small talk.)
c) a person who is not a friend or is a fake friend may demonstrate (e.g., belittles, manipulates, engages in peer pressure, bullying, violates physical body autonomy, and emotional or verbal abuse).

When given various social examples from short stories, hypothetical social scenarios, movie and tv video clips, passages from age-appropriate young adult literature, etc. XYZ will determine if a specific character demonstrates the quality of friend, friendly, or not a friend to another character.

In order to identify safe, neutral, and unsafe social situations, when provided with various social scenarios with fading adult support, XYZ will identify unsafe social conditions (e.g., subtle bullying, peer pressure, manipulation, exploitation, unknown people on the internet, etc.) by
a) evaluating the context to determine whether the social setting is safe (known people who are trustworthy), neutral (proceed with caution, go slow with forming a relationship), or unsafe (risky, vulnerable, or dangerous).
b) citing evidence to support the conclusion by answering why and how questions.
c) (with a fading adult model) demonstrate effective self-advocacy skills by determining their specific boundaries for safe, neutral, and unsafe social conditions.

Research:

Ross A, Grove R, McAloon J. The relationship between camouflaging and mental health in autistic children and adolescents. Autism Res. 2023 Jan;16(1):190-199. doi: 10.1002/aur.2859. Epub 2022 Nov 23. PMID: 36416274.

Libster, N., Knox, A., Engin, S. et al. Personal victimization experiences of autistic and non-autistic children. Molecular Autism 13, 51 (2022). https://doi.org/10.1186/s13229-022-00531-4

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Julie Roberts, M.S. CCC-SLP

One Response

  1. Thank you for a great article explaining toxic goals! I also appreciate your examples on strength based goals as well…so helpful!

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