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Principle: Create an Optimal Social Learning
Environment
This weak central coherence processing style may then
impede the development of joint attention and shared
affect in children with Autism (Klin et al, 1992;
Rogers and Pennington, 1991). These are two fundamental
components of social interaction in which accurate
response to stimuli depends crucially on social context.
This explains why social situations are incredibly
challenging for those with Autism and why even high-functioning
adults who score well on explicit measures of social
reasoning fail to translate this to their everyday
social interactions (Klin et al, 2000).
A precursor to joint attention and
shared affect is social orienting––that
a child will spontaneously, or upon request, direct
attention to another person. Children with Autism
show social orienting impairments early in life by
preferentially orienting to non-social over social
stimuli. Osterling et al (2002) found 1 year olds,
who were later diagnosed with ASD, looked at people
and oriented to their own name less frequently than
children without a subsequent diagnosis. Lack of interest
in faces at 6 months (Maestro et al, 2002) and lack
of orientation to the human voice at 24 months (Lord,
1995) have both been shown to be robust predictors
of later ASD diagnosis. Dawson et al (2004) found
that autistic children tended not to respond to a
variety of stimuli more often than typical or developmentally
delayed children, but that the effect was more severe
in response to social stimuli. Numerous studies have
shown deficits in basic visual processing of faces
in Autism that were not paralleled by failures in
developmentally equivalent non-social processing tasks
(Langdell, 1978; Hobson et al; 1988, Klin et al, 1999;
Boucher and Lewis, 1992; Weeks and Hobson, 1987).
Children with Autism have been similarly shown not
to respond as typical children do to the human voice
(Klin, 1991, 1992; Osterling and Dawson, 1994; Werner
et al, 2000).
When children and adults do orient
to social stimuli they have been seen to process the
information differently than their typically developing
counterparts. Typically developing children show a
differentiated brain event-related potential when
viewing familiar and unfamiliar faces; children with
Autism do not show this effect (Dawson et al, 1994).
Klin et al (2003) found that autistic adults viewing
a naturalistic social scene focus twice as much on
the mouth region of faces than controls and 2.5 times
less frequently on the eye regions than controls.
Preferential looking at eyes rather than mouths has
been shown in typically developing infants as young
as three months (Haith et al, 1979). Typical children
will show large skin conductance responses when looking
at a person who looks back and much lower responses
when looking at neutral objects. Children with Autism
have been found to show no difference in skin conductance
response whether they are looking at a person or looking
at a cup (Hirstein et al., 2001).
These basic processing differences
then translate into higher order reasoning and attribution-making
tasks. When viewing an animation of geometric shapes
acting like humans, typical viewers recognize the
social nature of these interactions and provide narratives
describing relationships portrayed by the shapes and
attributions of mental states. Viewers with Autism
tended to use physical explanations of the movement
of the shapes (e.g. “because it’s heavy”)
even though these individuals had all earlier passed
explicit social reasoning tasks (Heider and Simmel,
1994).
It is not clear why children with
Autism avoid social stimuli. It may be due to a general
impairment in attentional functioning (Bryson et al,
1994). Others believe that the rapid shifting in attention
required to process social stimuli is to blame (Courchesne
et al, 1995). An additional suggestion holds that
children with Autism avoid social stimuli because
they are complex, variable and unpredictable and are
thus difficult to process (Dawson, 1991; Dawson and
Lewy, 1989; Gergely and Watson, 1999).
The autistic bias towards non-social stimuli is well
documented in psychology and serves as illustration
for the autobiographical descriptions offered by writers
with Autism (Williams, 1994; Grandin, 1986). This
body of evidence shows how children with Autism selectively
attend to non-social aspects of their environment––seemingly
to take care of their over-active perceptual systems––and
in so doing, deprive themselves of learning about
the social world from an early age. Klin points out
that “to impose social meaning on an array of
visual stimuli is an adaptive reaction displayed by
typical children, from infancy onwards, at an ever
increasing level of complexity. This spontaneous skill
is cultivated in countless hours of recurrent social
engagement.” (Klin et al, 2003, p. 356). It
is widely accepted that typically developing children
develop through reciprocal social interactions that
involve the child’s active participation (Stern,
1977; Bronfenbrenner, 1979; Piaget, 1963; Vygotsky,
1978; Bandura, 1986; Brunner, 1977; Wertsch, 1985).
These theories view developmental learning to be dependent
upon children’s voluntary involvement in social
interaction, not upon the specific activity or information
to which children are exposed (Kim and Mahoney, 2004).
It is becoming more widely recognized that this principle
holds true for children with Autism (Greenspan &
Wieder, 1998; MacDonald, 2004; Williams, 1988; Koegel
et al, 2001) as theorists and therapists begin to
develop treatment approaches that recognize the importance
of voluntary social orienting and joint attention
in the way SRP does.
It seems that due to their perceptual
processing challenges, children with Autism are selectively
avoiding this social education which negates the learning
of “pivotal developmental behaviors” (i.e.
attention, persistence, interest, initiation, cooperation,
joint attention and affect) (Koegel, Koegel and Carter,
1999). This lack of development subsequently impacts
all further learning. The development of the joint
attention skill is considered essential to language,
cognitive and social development in all children (Tomasello,
1995). The more time a child spends engaged with a
significant adult, the more that child will learn.
Children with Autism who demonstrate greater skill
with joint attention have been seen to reach greater
levels of language development (Mundy et al., 1990;
Sigman and Ruskin, 1997; Dawson et al, 2004). Individual
differences in social orienting also predict the degree
to which children with Autism process non-verbal affective
information (Dissanayake et al., 1996) crucial to
comprehending any social situation. A 25-year follow-up
of a group of 91 individuals originally showing serious
social or mental challenges showed that the best predictor
of outcome was social impairment––those
who were socially impaired, particularly those in
the aloof category, showed a poorer outcome (Beadle-Brown,
Murphy, Wing, 2005).
The implications for treatment are
clear––to provide an environment that
consistently and intensively favors social information
and endeavors to increase the salience of the social
world for children with Autism. Theoretically, the
SRP fulfills the treatment implications drawn from
this body of work. The SRP suggests that through hours
of immersion in this type of social environment, children
with Autism a) increase their frequency of spontaneous
social orienting, b) maintain joint attention for
longer and longer durations and c) intentionally initiate
social interactions more frequently. Rigorous, empirical
testing must be performed to substantiate these anecdotal
observations.
This treatment implication then raises
the question of how to provide an environment that
consistently and intensively favors social information
and endeavors to increase the salience of the social
world for children with Autism. The SRP proposes a
unique method, some key principles of which will be
outlined below in the context of current research.
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