Do social skills classes work?

[LynnS]

TLDNR: if your child with an ASD diagnosis attended social skills classes, were they useful? 

My son (8) was diagnosed with high functioning autism and ADHD (inattentive type) about a year and a half ago. Since then, we've enrolled him in various social skills classes to help him improve his sometimes awkward interactions with peers. These classes are really expensive, and not paid for by insurance. He's currently in a 1-hour weekday class that costs $100/session. ? The cost is a big financial burden, but we're willing to find the money if they are helpful for him. But we're not sure that they are.

All the classes he's attended have been based on the Social Thinking curriculum. During the classes, the kids play cooperative games, write up trading cards about each other (after finding out what their peers like to eat, favorite colors, etc), practice how to have conversations, and do other activities. But it all seems so artificial, and having the classes for only an hour a week doesn't seem like enough time to build a rapport with the the other kids or really get to know them, particularly given how adult-directed the sessions are. He attends homeschool park days and 2+ hour drop-off classes that give him a lot more time to be social with other kids, for much longer stretches. We've also noticed that he will imitate behaviors shown by others in his classes that he does not otherwise display (ie, hiding under tables or jumping around during sessions if others are doing so).

My husband and I want to be sure he has all the help he needs to help him build social skills going forward, but how do you tell if the classes are working? Our son tells us he doesn't feel they're that useful and that he doesn't find himself using the skills he's learned in the classes. For the $400/month we pay for the classes, we could enroll him in a couple great drop-off nature programs (he loves being outside), do interesting day camps, or pay for any number of other activities where he could interact with peers in supervised social settings.

Does anyone have advice or thoughts? Thank you so much! 

 

[PeterPan]

Well why is the cost so high??? Around here SLPs bill around $100-140 an hour, so you're basically paying for 1:1 intervention and doing that in a group. So even though I'm a BIG advocate of all forms of intervention, including Social Thinking, I'm just flabbergasted by what you're being billed. And you're in NC, which is a pretty average cost of living, right? So that's what I would start with. 

You could get a behaviorist to work through the Social Thinking materials with your ds, also billing at $100 an hour (at least around here), but it would be 1:1 intervention. You could buy the materials and go to the Social Thinking training yourself. I've done that. You can register at the parent price and attend and get the same training your SLP or whoever is making the killing off you did.

Around here, social skills groups are maybe $35 a session. I'd need to think because we paid in blocks. And that will be an SLP and OT in the room plus a couple interns, and usually 4-5, never more than 8 kids. And at that price, it's worth it. But at $100 an hour??? That's crazy.

So yes go enroll your ds in the nature group, mercy. And use that time to find someone else who maybe is covered by your insurance (a behaviorist, ABA, whatever) that will work with him. There's a TON that can be done that is good. Look into Interoception. There's a new curriculum coming out. But this is not stuff you have to pay $$$$$$$$$$$$$ for. It's worth $$$ but not $$$$$$$$$$$$$, kwim? You can buy the materials and get trained and do it yourself. See what your insurance will cover.

Also, I just, literally just, posted a link to the free webinars ST is doing. Get connected! https://www.socialthinking.com/eLearning/categories/FreeWebinars?utm_source=facebook&utm_medium=social&utm_campaign=webinar_all

[Crimson Wife]

The Social Skills group my DD did until they changed the day & time to one that didn't work for our schedule was $82 per 90 minute session vs. $145 per 45 minute session for 1:1 speech therapy. So no, I don't think you are necessarily being overcharged.

I thought the social skills group complemented the individual speech therapy and ABA therapy she was getting. Generalization is a BIG issue for my daughter, and just because she learns a specific skill 1:1 with an adult therapist does NOT mean she will use it with peers.

[lmrich]

geez! That is a lot! 

Not in the same category...but I teach a cotillion class and serve several autistic kids. I highly advise the parents (who ask) to put their older kid in our beginning class. We have had GREAT success with all the kids whose parents communicated with us ahead of time so we were able to prepare and have a member of our leadership team be their buddy at first. The parents say it is really hard to get their kiddo dressed for the event, but it was worth it. We charge $180 for a season (Sep- March) montly meetings. 

[PeterPan]

1 hour ago, LynnS said:

the kids play cooperative games, write up trading cards about each other (after finding out what their peers like to eat, favorite colors, etc), practice how to have conversations, and do other activities. But it all seems so artificial

Actually these things are all good. What they're doing is called making a "people file" and that's a totally normal thing to do, a best practice. So it sounds like what they're doing is good. The issue is just why the price is so high. 

38 minutes ago, Crimson Wife said:

Generalization is a BIG issue for my daughter, and just because she learns a specific skill 1:1 with an adult therapist does NOT mean she will use it with peers.

This is very true!! We've done the social skills groups and we've had our behaviorist work with him with other kids. 

1 hour ago, LynnS said:

He attends homeschool park days and 2+ hour drop-off classes that give him a lot more time to be social with other kids, for much longer stretches.

How does he do in these settings? My ds would not fit well in those, especially a drop off situation, because he needs higher support. Disclaimer, those things apparently aren't important to me and he has other areas of strength that, when I talk with others with kids on the spectrum aren't so common, like he can fly, travel, etc. So we all pick areas we focus on. I've focused on recreation and living skills with ds and apparently don't think enough about peer interaction, hmm.

1 hour ago, LynnS said:

We've also noticed that he will imitate behaviors shown by others in his classes that he does not otherwise display (ie, hiding under tables or jumping around during sessions if others are doing so).

I'm about to rant. You've been forewarned.

That's the perpetual problem, sigh. You pull out for higher support and you lose peer models and positive herd effect. On the other hand, are you *sure* he doesn't do those things other places? If my ds did that, it would be because he's very impulsive and immature. Imitating the others would appeal to that. Have you talked with him about his behaviors to see if he could curb them himself? I mean, I'd probably have some stern chats about expected and unexpected behaviors and what the teacher is expecting (that he have his body in the group, ready to participate) and what the others are doing. Others having those behaviors is par for the course with autism. If they're overwhelmed or trying to regulate, they may need to move or may seek to hide. My ds goes under tables when he's overwhelmed. And frankly, that's part of the reason I'm so pissy down on SLPs doing Social Thinking these days. Even when they have an OT in the room, they don't always do enough to monitor the zones of the kids and where they're at and help the kids stay calm. You're doing kids' HARDEST THING, asking them to talk about social, and they're doing NOTHING, providing NO SUPPORT to help the kids' bodies stay calm. So then the kids are jumping, stimming, hiding under tables, etc. 

Remember, if you're not in Green Zone (Kuypers, Zones of Regulation), you're not ready to learn. So that SLP has the situation out of control enough possibly that several of the kids are NOT in ready to learn, not in green zone. But she's gonna charge them $100 an hour still, right? THAT is her fault and on her. (Side note: those other parents may know their kids are having those behaviors and actually that may be IMPROVEMENT for those kids. You can't know and sometimes what's going on IS accomplishing that parent's goal, hence being willing to pay so much.) Now the place where we went tried to improve that by bringing in an OT as well and higher support, but then you're really relying on the OT to be worth her salt and monitor 4-5 kids for an hour!

I've had these SLP/OT teams working with my ds and seen him come out totally flying, stimming down the hall, and he goes RED ZONE the absolute minute he leaves the building. That's DANGEROUS! And do these idiots take ONE IOTA of responsibility for what they've set up?? Nope. They're like we're experts cuz people pay us$$$ to work with their kids.

So think about what is really happening here. You're asking if you should feel guilty or whether there are more ways to do this. And you're assuming that the behaviors he's imitating or displaying are being bad, when they could reflect a suboptimal level of support. It's why my ds is better with 1:1 for anything like that. I've got another SLP now trying to do social with him, and I'm getting ready to whack her to and set her straight. These SLPs (sorry Crimson, who is amazing and is studying to be an SLP) are NOT trained in the body are NOT observant of the body and take NO RESPONSIBILITY for what they do. They just get the curriculum and go woo-woo I taught him something! Then the kid is left stimming and showing other signs of stress but they have NO CLUE. It can show up the next day, where the dc spends the whole next day stressed, and the SLP never catches on that her session the day before is causing that stress.

Rant over.

What if you were to hire a behaviorist or whomever for 1:1 and have them observe him in the co-op classes to see what his needs are and provide support? Then it could be more personalized. If you were to get some Social Thinking training, you might also be able to provide that carry-over. He might also be outgrowing the group or ready for a different kind of group. Our place for a while was offering a travel club, which was AMAZING in some ways. They managed to kill it by turning it into a harp on your skills group, sigh, and the other weakness was that everyone seemed to float as independent islands or at best pairs. There wasn't much sense of group or interacting together.

We've had groups where we made lots of friends and groups where we didn't. It's all networking of the moms though, not so much what happens in the group or the group's fault. And really, kids click and kids don't click. My ds has hung with kids that seemed to click and then as they got to know each other on playdates the spread was too big. Remember, ASD+ASD isn't really as cool as it sounds. If the dc can't compensate for the other dc's weaknesses, then you just have a mess and two people playing alone. Sometimes ADHD+ASD is a really good friend mix. You could look for people like that in your community or look for those more ADHD kids in the social skills groups. 

We rotated out because we had sort of maxed out the value of the current groups the place was offering. Now he's about ready to bump up to the next age bracket. We'll see. They were good, but they were limited good. Personally, I think for carryover the groups were flat worthless because the lessons were quickly forgotten. He really needs a lot of 1:1. He just needs that. And the higher we get his skills 1:1, the better he does with other kids. I was going to say we didn't have issues with doing things with adults but not kids, but that's not actually true. We had that issue BEFORE the social skills group. But he also didn't connect with kids at all. He barely connected with adults and wasn't connecting with kids at all. So that was more the gap. 

The other thing to realize is that all this is a super long process. I think it's right to be asking if your money is being spent effectively when you've got YEARS of input to do. I think it's totally fair to ask if you could buy the curriculum, do it with him, then go sit in his co-op class each week and observe and teach afterward and get gains. There are LOTS of ways to do this, not just one. I think it's good to rotate through options. Do something you can afford for a season, then rotate to something else. 

But yeah, I'd figure out why it's so expensive there. It's NC, not CA. Is NC really expensive or a high cost of living area??

Edited October 13, 2018 by PeterPan

[DawnM]

Sent you a PM.  If you are anywhere near me, I have a fantastic group to recommend to you that is not as costly.

 

[DawnM]

11 hours ago, PeterPan said:

But yeah, I'd figure out why it's so expensive there. It's NC, not CA. Is NC really expensive or a high cost of living area??

 

I moved from CA to NC.  It has been interesting to me to find that many things are the same cost or more in NC.  We live in a major metro area, and housing has been shooting up, but it is still less than LA by a long shot.

But so many things are the same or more.  I was shocked to find that private schools are often more than CA.  Health insurance for us has been WAY more (yes, I know this varies greatly for everyone), therapy has been more, and the biggest shock was that services are more.....housecleaning, gardening, house construction and repairs, etc.....

[PeterPan]

Dawn, guess it's hard to "like" that, but thanks for explaining. That's really incredible. Is it just popular? Can you tell what is causing it? 

Adding: Just for fun I popped some cities into a COL calculator, and you weren't joking! Charlotte is 97 overall, 103.8 on food (where the median is 100), and Columbus is 84 overall, 93.8 on food. Housing 65 vs. 91. Health is the same on both at 99. Hmm. So you weren't joking, overall some places in NC are quite expensive!! 

Edited October 14, 2018 by PeterPan

[LynnS]

13 hours ago, PeterPan said:

How does he do in these settings? My ds would not fit well in those, especially a drop off situation, because he needs higher support. Disclaimer, those things apparently aren't important to me and he has other areas of strength that, when I talk with others with kids on the spectrum aren't so common, like he can fly, travel, etc. So we all pick areas we focus on. I've focused on recreation and living skills with ds and apparently don't think enough about peer interaction, hmm.

He does ok, mostly, at drop-off classes. The biggest issue we've seen is frustration meltdowns, and he does not react well to being comforted in those situations, which is the default response from most adults (he just wants to be alone until he calms down).   

13 hours ago, PeterPan said:

I'm about to rant. You've been forewarned.

That's the perpetual problem, sigh. You pull out for higher support and you lose peer models and positive herd effect. On the other hand, are you *sure* he doesn't do those things other places?

These are all really good points. I haven't been informed specifically of those behaviors at other drop-off activities, but it may not have been seen as something that was worth letting me know about (ie, not an issue that needed correction by the parent or hurt another kid). You make an excellent point about whether the therapists have the group at a point where everyone is well-regulated enough to make the class productive.  This group is not specifically for ASD kids, and I'm not actually sure what diagnoses the other group members have, so the therapists may not be well-versed in techniques for working with all the different behaviors the kids exhibit. Which is kind of ridiculous, yes, given what everyone is paying. 

13 hours ago, PeterPan said:

But yeah, I'd figure out why it's so expensive there. It's NC, not CA. Is NC really expensive or a high cost of living area??

 

Central NC is seeing a huge influx of people and is getting to be pretty expensive overall, from housing to everything else.  And if the market will bear it, I guess they'll charge it. 

Thanks so much for taking the time to share your thoughts! 

[PeterPan]

2 minutes ago, LynnS said:

he just wants to be alone until he calms down

Would you be able to get your insurance to cover ABA and a behaviorist? Even if you're like oh no, ABA is terrible, it can be an umbrella for billing that gets you into play therapy, RDI, other things. Our behaviorist is a MIRACLE for us, so essential. She helps us problem solve so many things. 

So what he's doing there, wanting to be alone to calm down, is NORMAL. The behaviorist can help you quantify how long he needs, set up safe spaces, and then stretch him so he gets eventually to where he can sometimes calm down with a person in the room. But that's something you stretch to, not the starting point. So it sounds like a behaviorist could be really helpful to you. Ours has significant experience with homeschoolers and high IQ kids and comes to our home. You definitely want to choose carefully and look for a good fit.

 

[LynnS]

10 minutes ago, PeterPan said:

Would you be able to get your insurance to cover ABA and a behaviorist? Even if you're like oh no, ABA is terrible, it can be an umbrella for billing that gets you into play therapy, RDI, other things. Our behaviorist is a MIRACLE for us, so essential. She helps us problem solve so many things. 

So what he's doing there, wanting to be alone to calm down, is NORMAL. The behaviorist can help you quantify how long he needs, set up safe spaces, and then stretch him so he gets eventually to where he can sometimes calm down with a person in the room. But that's something you stretch to, not the starting point. So it sounds like a behaviorist could be really helpful to you. Ours has significant experience with homeschoolers and high IQ kids and comes to our home. You definitely want to choose carefully and look for a good fit.

  

 Oh, absolutely, his coping mechanisms are totally normal. We just have to train any adult supervisors to leave him alone so he can wind himself down on his own, or his emotional state will continue to ramp up. Everyone wants to cuddle an upset kid, and that is the opposite of helpful in his case. 

We'll need to do some checking on insurance, but it sounds like one on one therapy would definitely be worth seeking out to help him learn more regulation skills, before going back to group therapy. 

 

[PeterPan]

5 minutes ago, LynnS said:

I haven't been informed specifically of those behaviors at other drop-off activities, but it may not have been seen as something that was worth letting me know about (ie, not an issue that needed correction by the parent or hurt another kid).

How old is he? People put up with behaviors and cover over them when kids are younger, because lots of kids are still having behaviors at younger ages. You'll get to where they won't do that anymore because he'll get older. He's 8, yes? You're still in that window. My ds is 10, and that window is quickly shutting. You lose opportunities at this point and get censure. So it's definitely a reason to make some moves on getting some help, something like a behaviorist, someone who specializes in ASD and who is trained in behavior methods not just social thinking. Social Thinking is good, but you may need more.

7 minutes ago, LynnS said:

You make an excellent point about whether the therapists have the group at a point where everyone is well-regulated enough to make the class productive.  This group is not specifically for ASD kids, and I'm not actually sure what diagnoses the other group members have, so the therapists may not be well-versed in techniques for working with all the different behaviors the kids exhibit.

Bingo, that's how our groups were. And ds made friends in those groups and was a good fit!! It's what the Social Thinking people say to do clinically, because for social thinking deficits your ADHD and non-labeled and some ASD kids can go really well together. So it's not like it was wrong. It's just that then if the dc needs more support, the SLP isn't really ready to do that. 1:1 some SLPs can do it. We had an SLP who was very attentive the body and could do it. But in a group, when that's not their gig, that's hard. And reality is if you are attending to their bodies and their zones, sometimes you have to back off and do less. That's 1:1 instruction. I think it's good though to push and have all kinds of experiences. What would concern me is eating up all your money with this one type of support and not getting the 1:1 with someone ready to target him where he is. Would your insurance cover 1:1 if you tried to get it? And then your expense is only the groups? That's really different from saying it's 1:1 *or* groups, kwim? Our behaviorist bills at less than an SLP btw and is better-versed in autism and ultimately more helpful to us. So look where you're putting the dollars and what you can get coverage for and what you can make happen. When we first started on this road we had someone tell us not to do ABA, and it wasn't really good advice. Once you think of ABA as an umbrella term, getting in that loop of more experienced, autism-specific help is really helpful. It's rocket fuel. 

Btw, this isn't like in my sig or something, but now that my ds is 9, newly 10, we're also using a counselor, a psych who is extremely versed in autism. The behaviorist and the counselor don't really overlap, because the behaviorist is our problem solver who helps us with the big picture. I run everything by her and she comes into the home and works with him, gentling him with play and getting to know him well enough that she can give us big picture advice. The counseling is in an office and she picks really targeted goals, like for communication and problem solving, and she sets up situations that provoke the need for those and allow her to target them. So it's hard work, not something he'd do by choice in our home where he's more used to maybe controlling the play and would just walk away. But that sort of cognitive level, get in your head, I'm gonna make you confront yourself and think hard for 45 minutes, is REALLY GOOD for my ds right now. 

So you can see where it's like if you are doing self-pay and your choices are that group or counseling, maybe that's something to think through. See what you can get coverage for. Rotate services. That group is not going to give him all the tools he probably needs. Now for ADHD kids, some kids, they go into those groups, do one 6-week session, and it's like the world opens up and life improves radically! Seriously, we had friends who did this. Things just clicked, one round, boom. Then there's my kid, this high IQ ASD2 presentation, and he goes in and comes out and just sorta has this overall "oh kids exist and I could say hi to them" effect, lol. So you can see why some people would pay $$$$ for the group and why some people would say ok, did that, now lets move on to 1:1, kwim? 

Given that he's still young, you might also try for funding through your county board of disabilities to see if he qualifies. Not all kids with autism do, but some will. If he qualifies, you might get some kind of stipend to help pay for services. The stipend in our county is small, but in some major cities those stipends can be SIGNIFICANT. It might help you get access to some of these services.

 

[PeterPan]

6 minutes ago, LynnS said:

 Oh, absolutely, his coping mechanisms are totally normal. We just have to train any adult supervisors to leave him alone so he can wind himself down on his own, or his emotional state will continue to ramp up. Everyone wants to cuddle an upset kid, and that is the opposite of helpful in his case. 

We'll need to do some checking on insurance, but it sounds like one on one therapy would definitely be worth seeking out to help him learn more regulation skills, before going back to group therapy. 

Yes, see what your insurance will cover. There are things people don't talk about but they are very real. Like you get a high IQ kid labeled ASD1 and people think oh, doesn't need services, and then the gaps start showing up and the kid is having trouble with xyz. I feel, and this is just me, that our resources are SO GOOD now that we should err on the side of MORE intervention, MORE instruction, MORE tools. More is really more better with this! The highest potential kids deserve the most intervention! That's my opinion. But I kinda caught that from our behaviorist, this vision of where he could be. The more you get in his head with good interventions, the better.

So then is the gap that the adults don't know how to handle him or that he can't self-advocate and say for himself what he needs? You need to think about that. That's what you're going for with good interventions, the 1:1 stuff, is the ability for him to begin to recognize what he needs and self-advocate. If he were in the ps, that is what they'd be working on. My ds has an IEP, so I'm there, seeing what they'd expect, and self-advocacy is HUGE.

Edited October 14, 2018 by PeterPan

[Ivey]

Neither of my boys (14 & 21) attended social skills classes at that age, but Ds14 is participating in the PEERS teen class this semester, and I am hoping Ds21 will be open to taking the young adult class some time soon. Looking back, I can see that starting social skills classes a little earlier could have been beneficial (I wish the PEERS class had been around when Ds21 was 14), but 8 is very young and I feel like the skills taught at that level can likely be taught through other means. Kids that young also tend to do better with shorter, more frequent sessions, so meeting weekly may not be the best format. The teen class meets weekly for 90 minutes, and the parents meet at the same time with another facilitator to learn how we can help our kids apply their new skills throughout the week. He comes away each week with homework, which he (so far) has really enjoyed and has completed with enthusiasm. They have a very thorough intake process, and one of the criteria for being accepted is that the teen is highly motivated to improve their social skills and relationship. My son says that all the kids pay attention, try their best, and complete the homework, and we haven't heard of any disruptive behavior so far. We pay roughly $100/week, and the program is 16 weeks long.

[Janeway]

The social skills class here was a complete waste for my son. I am sure not all programs are the same. But I wouldn’t pay $10 for what we had here.

[PeterPan]

17 hours ago, Janeway said:

The social skills class here was a complete waste for my son. I am sure not all programs are the same. But I wouldn’t pay $10 for what we had here.

Yup, once ASD is on the table, the social skills classes and groups are better for APPLYING instruction that has previously been done 1:1 by a behaviorist or other worker.