If treatment doesn't offer a cure, then what's the point?

Michelle Garcia Winner

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I recently spoke to a group of 200 or so parents and professionals in a conference setting. I was explaining that even with the best of our teachings, our treatment goal is to help our students/clients improve their Social Thinking and related social skills compared to themselves. As I continued to explain that this means we are not able to "catch students up" to the norm of their classroom or their neurotypical peers in the adult world, a woman raised her hand with a question: "If the goal of what we do is not to work to make our students 'normal' then what's the point of doing it?"

This was a brave question to ask and one that has been asked before by other professionals attending our conferences. My response to her is food for thought for all of us who work with, or live with, individuals with social learning challenges. It's something I think parents and professionals should be discussing with other members on our students' treatment teams, especially the administrators of programs our students are enrolled in.

Social abilities vary from individual to individual. We each have personal strengths and weaknesses in our learning capacities. This includes our social learning. Our students' weak social abilities didn't originate with our students opting out of social experiences and it's not because they just didn't pay attention or care about people. Instead, it started with their brains and how they developed, or more accurately, didn't fully develop when it comes to their social cognition and self-regulation. When we encounter students who struggle with social learning, we are witnessing students whose brains struggle with processing social information and producing related social skills. For some, they are even unaware of how others perceive them. Their brains make it difficult for them to interpret their surroundings, think about people's thoughts and emotions, figure out how to adapt their behavior, and respond in social contexts in a way that is viewed as socially on target.

An even more important idea to hold tight to is individuals with social learning challenges don't all have the same level of social weaknesses or the same innate capacity toward social success. Because of this, our teaching and treatment needs to vary to meet their individual needs. In our work, we call these varying capacities the "levels of the social mind" which we explain in detail in our free online article, "The Social Thinking-Social Communication Profile." Individuals whose brains help them better detect, interpret and the respond to basic social information will need a different type of treatment, and are expected to respond to treatment in a different manner, than our students functioning at a lower level of the social mind, whose brains struggle for them to attend to and detect social cues and have little awareness of the social thought process. Therefore, given that our students do not all start with the same level of social learning ability or challenge, it's logical that students would be taught differently and have different treatment outcomes based on what they bring innately to the treatment process. Right?

As logical as it may seem, the reality is something different. As I travel and lecture around the world, I observe parents and professionals, from different countries and different cultures, holding one global expectation, which is this. When it comes to teaching Social Thinking and related skills, people tend to expect that social skills treatments can "fix" our students' social skills problems. "Fix" often translates as cure, correct, restore, omit, take away, or transform.

Interestingly, these same adults have no difficulty understanding that some students are born very capable of learning math or science or reading skills while other students are born with less native academic capabilities. They even agree that we adjust how we teach these subjects based on what skills we see a child presenting in the classroom and at home. We teach math or science or reading at different levels aligned with the learning capacities of the students. We would never expect a teacher to work with all her math students in one group, offering one lesson to help kids who are struggling to learn basic math while simultaneously teaching the same lesson, with the same expectation, to students who are now learning pre-algebra.

Yet this is a common treatment model in our schools and clinics when teaching social skills!

The spectrum nature of social learning challenges seems to be overlooked or forgotten. People tend to think that all students (especially those diagnosed with Autism Spectrum Disorders (ASD), Asperger's syndrome, PDD-NOS or "mild social skills" problems), should be, or can be, treated in the same "social skills" group, as though the existence of any and all social skills problems dictates a "one size fits all" treatment plan. This type of thinking leads administrators to push their social skills treatment therapists to work with groups of poorly matched students all in one treatment session. It also leads conference attendees to expect that any conference on Social Thinking or social skills treatment will teach them how to "normalize" students with ASD or other social learning challenges. Even though it is common knowledge that there is no "cure" for ASD or related social learning issues, this widespread belief about the outcome of social skills treatment still persists.

Many people do not realize that teaching Social Thinking and related social skills is, essentially, aiming treatment at a moving target. Not only do our students come to us with different levels of social learning/social skills abilities, while they are spending time learning what they need to learn, their neurotypical peers are steadily evolving in their social abilities across their school years and even into adulthood without direct intervention. So even if a student made great leaps in social learning within the course of a school year, his or her peers would have been going through their own social learning and social development during that same time period, moving further ahead in their natural social emotional maturity and the student would still end up lagging behind. The key message here is that our teachings not only have to be sensitive to our students' present social learning abilities but also their developmental age. We have different social expectations for students each year they are in our schools, homes, and communities and our teaching needs to adapt to these shifts and changes also.

Furthermore, our social world is an emotional experience. Our teaching needs to connect the dots for our students between thinking, feelings, behavior responses, and consequences as a means for students to understand that people act not just on their thoughts, but on their feelings too. Some of our students are aware that their social abilities lag behind their peers. For these individuals, social skills teachers also have to help students manage their emerging social anxiety, depression, etc. that results from this awareness. Individuals with social learning challenges often amass mental health challenges as our social expectations increase and become more complex and nuanced with age!

Finally, if you stop to think about social learning and the spectrum nature of the process, it may also make sense that our social learning affects our academic learning. Through our ability to notice and think about our teacher's directions, our peer's social cues and our parent's interactions, the typically developing social brain evolves from early childhood and seeds our social interpretive abilities. This knowledge forms the thinking foundation through which we can engage in reading comprehension of literature, produce written work tailored to a specific audience (a teacher, a peer group, a colleague), and even helps us interpret math word problems. The actively engaged social mind helps us understand and work toward achieving academic goals presented in our state or country's educational standards, no matter what label we use to name these standards (e.g., "Common Core", "State Standards")!

In short, there is nothing simple about the social learning process. This is true for typically developing children and is especially relevant in thinking about the teaching and learning processes we undertake with our students with social learning challenges who are not on the same developmental social trajectory as their neurotypical peers.

Social Thinking offers a large number of articles and products written for parents and professionals to read together to help them understand treatment choices we recommend for students with social learning challenges, and the logic behind these choices. We encourage people interested in Social Thinking to begin at the beginning: by reading and understanding the core information we wrote for our students' adult guides before jumping right into materials developed for direct use with preschool or school age students. This approach will help you form new insights about the social learning process and be more effective in teaching socially-based concepts and strategies to students or clients. It will certainly help you help others understand that no person, profession, or treatment model, regardless of what is suggested otherwise in marketing material or in IEP meetings, is able to "cure" a person's social learning challenge. Our social learning, no matter who we are, is a continuous work-in-progress across our lifetimes.

Focusing on the individual treatment needs of our students and grouping students who need similar levels of lessons not only makes sense, it is more cost effective! If we can dedicate treatment time to teaching information relevant to each of our students, the time is far better used than when grouping students recklessly and providing lessons that often are not on point for the students attending the group. Realize how limited a reach our treatment dollar has if our students cannot even pay attention in the groups we put them in for social learning!

By focusing on helping each of our students/clients develop better social knowledge and related social skills compared to their own baseline ability, we can all (administrators, teachers, speech pathologists, parents, etc.) feel good about the work we are able to offer! Step by step, progress is cumulative, and we help our students continue to evolve their ability to interpret and engage in increasingly complex social relationships. And we, in turn, learn to become better teachers and stronger social thinkers ourselves.

Courtesy of Social Thinking