Overview

While autism spectrum disorders (ASDs) are characterized by a triad of features including social deficits, restricted, repetitive, and stereotyped patterns of interests, behaviors, and activities, and communication deficits (APA, 2000), children with high-functioning autism spectrum disorders (HFASDs) exhibit relative strengths in language and cognitive ability. As a result, there is greater attention to their social deficits and circumscribed behaviors and interests. These areas significantly interfere with their social competence and development of meaningful social relationships.

The diagnostic criteria for the two primary areas of deficit include:

Though these children exhibit relative strength in formal language (e.g., vocabulary), they have difficulty with social communication (i.e., pragmatic communication) and exhibit a tendency for concrete and literal interpretation of language. Together, these significant social, behavioral, and communicative deficits severely limit the ability to develop and maintain appropriate social relationships, often resulting in children with HFASDs having few meaningful friendships.

While traditional non-therapeutic summer programs are available, such programs are not adept at treating and overcoming the unique social-communicative and behavioral needs of children with HFASDs. The Connections Program is designed to provide and research critically needed therapeutic programming that fosters the social and communicative development of children with HFASDs.

The program uses a highly structured treatment approach that targets and promotes the specific social and communicative skills that are needed by children with HFASDs. The rationale for this treatment approach is based on research indicating that children with HFASDs benefit from instruction focused on direct and explicit teaching of skills, accompanied by opportunities for repeated practice and feedback. Program staff implements specific cognitive and behavioral strategies in the development of higher-level skills, as well as for reduction of maladaptive behavior. Children in the program are encouraged and supported in their establishment of friendships and social relationships.

Connections is an annual intensive summer social development program. Program counselors receive extensive training in the program’s treatment protocol and are required to demonstrate proficiency in administering the program prior to working with program participants. Treatment teams also include a team leader with advanced training in HFASDs and the treatment protocol, and research assistants. Program directors also participate daily as members of the treatment team, as well as provide clinical supervision and support.

Daily Schedule

The daily schedule consists of multiple 70-minute treatment cycles, with additional time built in for transitions, bathroom breaks, and lunch. Each 70-minute treatment cycle includes 20 minutes of intensive-structured social skill instruction, followed by a 50-minute therapeutic activity, with debriefing. All social skills taught during structured social skill instruction have been carefully selected to correspond with deficits commonly exhibited by individuals with HFASDs. Similarly, all therapeutic activities have been designed to improve the social skills of these individuals, as well as increase skills in face and emotion recognition and interpretation of non-literal language. Program participants practice previously learned social skills during therapeutic activities and receive high rates of performance feedback from program counselors.

Program Components

Social Skills Program - Structured social skills instruction targets cognitive understanding of social interactions and behaviors, as well as the acquisition of skills needed for social relationships. Participants learn the precise behavioral sequence for a given social skill, observe the skills being modeled by program counselors, role-play the skill themselves, and receive feedback.

Behavioral Program - The behavioral program serves to prompt, reinforce, and strengthen appropriate and effective social skills, as well as reduce maladaptive and/or problem behaviors. It is based on a response-cost system that reinforces the occurrence of target social behaviors and appropriate behavior, while providing a consequence for engagement in an inappropriate behavior or failure to demonstrate an appropriate social behavior. High rates of performance feedback are provided throughout the program.

Face and Emotion Recognition - Specific instruction and structured activities are conducted to increase skills in face and emotion recognition. This instruction and these activities are based on increasing recognition and interpretation of facial-expression and the feelings associated with a range of emotions.

Interpretation of Non-Literal Language - Instruction and repeated practice is provided in interpreting non-literal language and the multiple meanings of language beyond simple concrete interpretation.

Interest Expansion - Interest expansion activities involve participation in non-self-selected activities that promote knowledge of and participation in a broad range of activities (beyond the narrow interests of the children). Children then discuss how they can use the newly learned information and activities in future social situations.

Therapeutic Activities - A broad range of therapeutic activities have been developed to directly address deficits commonly experienced by individuals with HFASDs. These activities promote interest expansion (expanding each child’s range of interests), pragmatic communication development (e.g., increasing understanding of non-literal social language), cooperative skills, face-emotion recognition skills, and social skills. While therapeutic in nature, all the activities are also recreational, engaging, enjoyable, and include a variety of outdoor and indoor tasks/games.

Parent Training - Parents participate in weekly parent education sessions that include information on characteristics of HFASDs, techniques used in the program, and how to promote social development in the home and community settings.