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(This is a presentation I gave in a graduate course at Johns Hopkins in 2006.)
We all know that individuals who are diagnosed with autism spectrum disorders (ASD) have deficits in understanding and effectively using social skills to interact and communicate with others. To compensate with this deficit, Social Autopsies have been found to be successful with ASD individuals to interpret social and behavioral situations. Rick Lavoie (cited in Bieber,1994) developed this intervention to help students with severe learning and social problems understand social mistakes and learn to problem solve solutions. According to Lavoie, this intervention has been field tested with socially deficient children and has been highly successful.
A social skills autopsy is used to review the child’s behavior, piece by piece so that they can learn from their mistakes. This intervention is particularly helpful for students with Asperger Syndrome (AS) because it helps them to see the cause and effect of their behavior. When a social mistake occurs, the individual meets with a teacher, counselor, or parent. Together, in a non-punitive fashion, they identify the mistake and determine who was harmed by it. Then a plan is created to avoid making that mistake again in the future. Social autopsies provide practice, immediate feedback and positive reinforcement that is necessary for an AS individual to understand their mistake. Social Autopsies can also be used to analyze successful social interactions. When the child has been appropriate in a social setting, an adult can help them examine and identify the behaviors that contributed to these positive situations. In this way, he is more likely to repeat those behaviors in other settings.
Because of the visual strengths, problem-solving deficits, and language-processing problems of the student with AS, Social Autopsies can be used with written words or phrases or pictures to help illustrate each of the stages (Myles & Simpson, 2001).
The Social Autopsies intervention is not a punishment. It is a supportive and constructive problem solving strategy to promote social competence. Social Autopsies also gives the student the opportunity to actively participate in the process. By using the techniques of analyzing the behavior step-by-step, it allows the student to see precisely what they did and how to change it.
According to Lavoie (cited in Bieber, 1994), the success of the strategy lies in its consistent structure of practice, immediate feedback, and positive reinforcement which is required for special needs children in order to develop and learn. This problem solving technique should be done by an adult in the child’s environment and is most effective when used immediately after the social error. Social Autopsies are generally held as a one-to-one session and is not a one time cure for the target behavior or skill. To make certain the success and generalization of social autopsies, Lavoie recommends that the process should be taught to all adults who have regular contact with the child (bus drivers, administrators, grandparents, cafeteria workers, baby-sitters, etc.). This will allow the child to participate in dozens of autopsies daily, in a variety of settings. The intense exposure will foster growth and generalization of target skills.
Myles also states that Social Autopsies can help prevent tantrums, rages, and meltdowns. This is done by increasing social understanding and problem solving, which helps sensory awareness, and promotes self-awareness (Myles & Simpson, 2001).
When looking at the Social Autopsies worksheet, it is pretty self explanatory of how to do the intervention. First, what happened? What was the social error? Who was hurt by the social error? What should be done to correct the error? What could be done next time? The teacher asks one question at a time, which is thoroughly discussed by the student and the teacher. By the time the worksheet is filled out, the student will understand what happened, who was hurt, what they should do to correct the error, and what they should do next time so it will not happen again.
Currently, the effectiveness of Social Autopsies with students with AS is based on anecdotal records (personal communication, B. S. Myles, October 5, 2001) and undocumented success stories from Lavoie. Further research to support these records are needed. Even though we do not have any clear scientific evidence of whether and how this strategy is successful, it does provide a source of ideas for future research and an intervention that teachers and parents can use.
Curious to the effectiveness of the intervention and how simple it was to conduct, I used Social Autopsies on my 14 year old son who is diagnosed with Asperger Syndrome. When any social problems arose, I sat my son down in a quiet location and did the Social Autopsies worksheet. At first, my son was a little apprehensive about what we were doing, but he adjusted quite easily to the new technique that was different from the norm. I found that not only was the Social Autopsies worksheet easy to use, I kept me from loosing my temper and helped us see what he did wrong, who was harmed by what he had done and what he should do to correct the problem, and how he could done it differently so it would not happen again. When asked, he said he liked the intervention and he would remind me to use it when I forgot. In the brief time that we used the intervention (one month), I did notice that my son would repeat the social error again (it was usually a similar situation, but not exactly the same); however it was not as frequent as before. Even though we did not use the Social Autopsies to prevent tantrums, rages, and meltdowns (none of these incidents arose), I did find it beneficial for my son and myself. It helped us to communicate better and thus understand what his problems were and why they occurred and how to remedy them. Plus, I did not loose my temper and it was more positive alternative to what we used to do when problems arose.
For school, this strategy is a team effort using both the teacher and the student, which leaves a few limitations. First, not every teacher or adult that comes in contact with the child has time to stop and go through a behavior with just one student. Second, this intervention is very much open to the interpretation of the teacher as to what is an appropriate response to a social situation and what is not, which once again removes the control of the behavior out of the hands of the student. Also, the student must be able to converse well enough to discuss their actions and think of alternative ways to handle the situation. Even with prompting from the teacher, the student’s limited communication skills could alter the effectiveness of the intervention.
I do however, recommend using Social Autopsies with individuals with AS. It is easy to use, beneficial for the student, and behaviors can be modified.
Since each individual with ASD is different and will respond differently to interventions, one must be open to new ideas and be willing to try alternative methods. Such methods can result in increased appropriate responding, but they vary in their effectiveness among children and the results have not always generalized to performance in real-life settings.
As with any technique or service, the effectiveness of any social skills intervention depends upon the ASD individual and the person working with them. Without proper training in ASD and in the proper implementation of the intervention, the effectiveness is greatly altered as well. Frequent checks on the improvements in the ASD individual’s social skills is needed to see if the intervention is beneficial and if it should be continued or changed. Further research and studies are needed to see what is successful and utilized this knowledge in designing and implementing social skills intervention.
Here is an example of the Social Autopsies Worksheet
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