Autism Spectrum Disorder (ASD) is a neurodevelopmental disease which is expressly characterized by impairments in social communication, social skills, interaction, competences, and language, as well as the maintenance of restricted and repetitive behaviors, interests, and activities. Sadly, ASD has a high prevalence in children, affecting at least 1 in 160 subjects. Today, with the help of highly sophisticated diagnostic tools, children with Autism Spectrum Disorder (ASD) are getting diagnosed at earlier ages; while this might sound like a ray of hope it concurrently raises a greater need for immediate intervention.
Core Deficit Areas In ASD
According to the American Psychiatric Association’s report ‘Diagnostic and Statistical Manual of Mental Disorders (DSM-5)’, Autism is known as a “spectrum” disorder because of people with Autism exhibit a wide variety of symptoms involving multiple levels of type and severity. Known as a neurodevelopmental disorder, Autism Spectrum Disorder (ASD) is specifically characterized by 3 core deficit areas:
- Deficit in Social-emotional reciprocity
- Deficit in non-verbal communication e.g. eye contact, body language, understanding gestures
- Deficits in developing, maintaining, and understand relationships
Lack of social reciprocity is one of the most significant issues for children on the autism spectrum. It includes problems like inappropriate or limited responses to the approaches of others and limited offers of comfort shown towards others.
What is Social Reciprocity?
Social reciprocity is the flow of social interaction that takes place back-and-forth between 2 or more individuals. The term reciprocity refers to how the conduct of an individual influence and is influenced by the conduct of another individual and vice versa. It is the game of social interactions and involves partners working together and making adjustments towards the achievement of a common goal i.e. – Successful Interaction.
When it comes to children, social reciprocity skills include displaying interest in interacting with others and exchanging smiles. With time this builds to being able to share conventional meanings with words, and later topics, in conversation. In either case, children with ASD do not meet the expected levels in social reciprocity.
Social Reciprocity The Defining Feature Of ASD
American Psychiatric Association, 2013 defines, social reciprocity as a defining feature of Autism Spectrum Disorder. It confirms that ASD can prevent the child from making deep connections and respond empathetically to others.
Impairment in social reciprocity can be seen when an individual is not taking an active role in social games, preferring solitary activities, or using his/her hand as a tool or a person as if they are motorized objects. This can further lead to not observing another person’s distress or lack of interest in the focus or topic of conversation.
And there are a lot more to it….
Deficits In Social Reciprocity
Deficits in social‐emotional reciprocity; ranging from atypical social approach and failure of having normal back and forth discussion through restricted sharing of interests, emotions, affect, and response to total lack of initiation of social interaction. Here’s a quick break down:
- Abnormal social approach
- Unusual social initiations which could include intrusive touching or even licking of others
- Use of others as tools
- Limitations with maintaining turn-taking in interactions
- Failure of having normal back and forth discussions
- Failure to respond when one’s name is called or when directly spoken to
- Poor logical/social use of language that fails to provide clarity on understanding or background information
- Never initiates a conversation
- One‐sided conversations/monologues/peripheral speech
- Reduced sharing of interests
- Impairments in joint attention (including both initiating and responding)
- Lack of interest to share with others
- Lack of showing, bringing or pointing out objects of interest to other people
- Lack of sharing emotions
- Total absence or lack of responsive social smile
- Failure to express excitement, enjoyment, or achievements with others
- Failure to answer to praise
- Does not show the desire to have social interactions
- Irrelevance/dislike for physical contact and affection
- Lack of initiation of social interaction
- Displays no or very limited social initiations
- Poor social imitation
- Failure to occupy in easy social games
For transitioning children, social communication is a particularly important skill area to consider; thereby, increasing the need for early intervention.
Early Intervention Is Key
Astoundingly, there are around 700,000 people with ASD in the UK alone that’s practically more than 1 in 100 subjects. Even though Autism can be diagnosed at any age, studies confirm the symptoms become apparent at an early age of 2 or 3. Few developmental delays might even appear at around 18 months. All these years, much efforts have gone into developing tools and techniques to diagnose Autism Disorder Order (ASD), what remained unattended was the need for early intervention and effective therapies to address the core deficit areas which span over the developmental stage of the children.
Several studies and researchers confirm that implementation of early intervention will lead to prolific results.
Role Of Parents Is Imperative
Researchers found that generalization and maintenance of behavior changes were improved when parents were involved at early stages (Koegel, Schreibman, Britten, Burke, & O’Neill, 1982). Along with clinic-based intervention programs, early intervention of parents helps in actively addressing some of the challenges linked with ASD social reciprocity.
When children with ASD are dynamically engaged in everyday routines and activities, they have numerous opportunities to practice existing abilities and acquire new skills by using readily available people and materials. Parents should engage in more responsive interactions with their children when implementing early intervention in a very natural environment (Ref: Mahoney, Boyce, Fewell, Spiker, &Wheeden, 1998; Siller&Sigman, 2002). For responsive interactions, parents need to respond to their child’s emotions and language in a manner that supports the healthy development of both. For example, when a child is screaming “EEu! EEu!” the parent can respond, “Wow, Ashylin, that is really great talking! Can you say Pen, please?” This allows the parent the opportunity to concurrently acknowledge the emotion, model appropriate language, honor the request, and expand the length of the interaction.
The significance of parent involvement in early care and education programs has been assumed by several practitioners since the 1960s. Bronfenbrenner (1995) noted that responsive interaction styles of parents pointedly affect the learning and development of children. With responsive interactions, parents can positively influence their child’s interest levels, affect, and joint attention skills.
Again, not all fingers are of the same size; hence, no child with autism will respond in the same manner to specific strategies. Always remember, the more words autistic children hear as infants — and the more vocal interactions they have with their caregivers — the better will be their language skills. Also, the quantity of speech young children hear in the home has proved to have a very strong influence on their language development, reading skills, school readiness (Source).
The idea is to keep trying!
Therapies That Address Social Reciprocity Impairments
Sadly, there’s no cure for autism, but several approaches can help to improve social functioning, learning, and quality of life for children with autism. Remember that autism is a spectrum-based condition. Few may need little to no treatment, while others may require intensive therapy.
But the truth is, the current art therapy literature lacks specific step-by-step intervention plans to address the needs of this population. Today, there is an imperative need for efficacious therapies which can explicitly address the need of children with ASD exhibiting impairments in social-emotional reciprocity, which in turn can increase their social interactions. As per research, few suggested methods are:
- Cognitive behavioral therapy (CBT) (Source)
- Robot Assisted-Therapy (RAT) (Source)
- Music Interaction Therapy (Source)
- and Virtual Reality (Source)
Virtual Reality (VR) has emerged as a totally effective new treatment approach in different areas of the health field, including rehabilitation, promotion of emotional wellbeing in inpatients, diagnosis, surgery training, and mental health treatment. With respect to mental health treatment, VR is being used in the treatment of a wide range of disorders; these include phobias, obsessive-compulsive disorders, post-traumatic stress disorders, and, of course, Autism Spectrum Disorder.
In ASD, the use of VR enabled therapies have shown some unmatchable advantages. Virtual Reality (VR), i.e. a simulation of the real world based on computer graphics, can be useful in ASD as it allows parents, instructors, or therapists offer a safe, repeatable and diversifiable environment during learning.