Developing social competence is an essential skill for all children, but a particularly important goal for children with autism spectrum disorders (ASD), who experience significant deficits in social interaction, communication, play, and behavior (Prelock, 2006). It evolves through relationships that have been established between children and their interventionists, and even more importantly, with their primary caregivers or families. Because of their challenges in interpersonal interactions and relationships, children with ASD often avoid social encounters, have limited opportunities to participate in recreation and leisure activities, and experience social isolation. Therefore, it is important to increase understanding of interventions for supporting the social communication of children with ASD. Furthermore, understanding the families' role in addressing the social communication needs of children with ASD is critical because they are a constant in their children's lives, with insights about their children's unique strengths and challenges.
In this issue, readers will experience an interdisciplinary perspective on the role of families in the implementation of intervention to support the play, communication, and perspective taking of children with ASD. Articles are written not only by speech-language pathologists but also by professionals in nursing, occupational therapy, and psychology. This broader perspective on the social communication needs of children with ASD and their families is important as children with ASD present with complex problems requiring comprehensive interventions that address all aspects of learning and function.
Beatson offers a notable context in which to think about service delivery for children with ASD. She reports on a qualitative study describing the transformation of family-centered care values and beliefs to the practices of speech-language pathologists. Beatson identifies practice implications for training programs that suggest family-centered curriculum be integrated in preservice training and offered through ongoing professional development. In addition, she suggests that family-centered training requires opportunities for skill building through a variety of experiences with families.
Prelock and Hutchins apply the principles of family-centered care beyond expected practice in service delivery to the role of families of children with ASD in intervention research. They describe two ongoing intervention studies designed to support the social communication of children with ASD in which they applied specific elements of family-centered care. They note both the value and the challenge of implementing intervention research that considers and integrates the perspective of the family. Prelock and Hutchins offer clinical researchers ideas for including elements of family-centered care in their research endeavors.
Underlying the social communication challenges characteristic of children with ASD are deficits in theory of mind (ToM). Hutchins and Prelock present a developmental framework for considering ToM difficulties in children with ASD and review those methods most often used to assess ToM. In addition, they examine some of the challenges in facilitating ToM in children with ASD. Using a case vignette, they provide preliminary evidence supporting the value of social stories and comic strip conversations in fostering perspective taking. Hutchins and Prelock encourage professionals to include ToM assessment and intervention in program implementation for children with ASD. Furthermore, they capitalize on the knowledge that families' know their children best and are valuable partners in the implementation of assessment and intervention. Potvin, Prelock, and Snider encourage the reader to think about social communication for children with ASD in the context of community, where authentic opportunities for recreation and leisure exist. Potvin and colleagues raise a critically important program issue because participation in recreation and leisure leads to higher quality of life and life satisfaction (Allik, Larsson, & Smedje, 2006). Children with ASD often experience restriction in the range of recreational activities in which they participate. Because of the complexity of factors that affect full participation for this population, Potvin and colleagues emphasize the need for professionals to work collaboratively with parents to scaffold participation in recreational activities.
Finally, Bolick introduces the concept of social capital (i.e., social participation through interactions with others that leads to benefits for both the individual and the community). She describes the self-regulatory challenges of individuals with ASD, which interfere with their ability to be involved in those personal connections that establish social capital. Bolick notes that the community is deprived of learning from the unique skills of individuals with ASD when they are denied opportunities to participate in their community. Moreover, when individuals with ASD exhibit social errors, they are frequently misunderstood and denied opportunities to contribute to the larger social community. Bolick provides suggestions based on her own clinical experience and the emerging literature to support the experience of social capital for individuals with ASD.
Difficulties processing social information interfere with the ability to engage in appropriate social behavior and impact learning (Koegel, Koegel, Frea, & Smith, 1995; Prelock, 2006; Webb, Miller, Pierce, Strawser, & Jones, 2004). Because of their challenging interpersonal connections and often poorly developed theory of mind, individuals with ASD may avoid social encounters and experience social isolation. Therefore, it is critical to consider interventions for supporting the social communication and community participation of individuals with ASD. It is also invaluable, as described in the articles in this issue, to fully engage families in clinical service delivery and to consider their role in research designed to assess intervention effectiveness.
Patricia A. Prelock, PhD, CCC-SLP
Issue Editor, ASHA Fellow, Professor and Chair, Department of Communication Sciences, University of Vermont, Burlington, Vermont
REFERENCES