Difficulty with social and emotional skills is a hallmark of autism, or autism spectrum disorder (ASD). Research suggests that this may be because certain areas of the brain that are tied to social-emotional functioning are less developed in children with ASD. While all individuals with ASD face challenges navigating the world of emotions and social interaction, quality intervention (the earlier the better) can help children with ASD improve their social-emotional skills.

Highlights:  Research suggests that because certain areas of the brain that are tied to social-emotional functioning are less developed in children with autism spectrum disorder (ASD), they face more challenges managing emotions and navigating social interactions.  It’s difficult for children with ASD to do things like understand and express emotion, pay attention to facial expressions, and participate in joint attention.  Because ASD is common, many interventions have been developed to address these challenges. These are often led by a team of professionals that may include speech-language pathologists, psychologists, occupational therapists, and clinical social workers.  Parents can help nurture social-emotional development in children with ASD by: Engaging with your child several times a day, since they may not initiate interaction.  Encouraging joint attention by playing turn-taking games.  Pointing out, labeling, and talking about emotions.  Keeping playtime interesting and brief, and using lots of positive reinforcement.

What are common ASD-related social-emotional challenges?

It’s common for children with ASD to have difficulty with:

Understanding and Expressing Emotion

Children with ASD often struggle to read, interpret, and respond appropriately to others’ emotions. It can also be hard for them to imitate emotions and feel empathy. It’s important for others to understand that a child with ASD isn’t intentionally being rude or uncaring – they simply don’t have the skills to understand, for example, how to return a smile or show concern if someone is upset.

Paying Attention to Facial Expressions

Children with ASD may scan a person’s face in a different way than their typically-developing peers. Normally, someone focuses on a person’s eyes first, and then moves on to the rest of the face. A child with ASD, on the other hand, may focus solely on the other person’s mouth, which offers less emotional information than they eyes.

Participate in Joint Attention

Joint attention, or two people actively focusing on the same thing while also focusing on each other, can be challenging for children with ASD. In fact, pointing is one of the first signs of toddlers initiating joint attention, which is why lack of pointing by age 1.

Other Social Skills

Other areas where children with ASD tend to struggle are:

• Understanding others’ intent or perspective
• Orienting to new people
• Participating in turn-taking activities (including conversation)
• Differentiating their own feelings from others’ feelings
• Using social referencing (looking to parents or caregivers to see how to respond when confronted with unfamiliar or unexpected events)

Emotional Skills

Children with ASD may resist change in routine or environment, exhibit repetitive behavior (such as spinning around or flapping hands), display unprompted negative emotion, struggle to self-regulate, have unusual attachments to certain objects, and experience anxiety or social withdrawal.

What are common interventions for ASD-related social-emotional challenges?

Because ASD is common (1 in 59 children in U.S. as of the Centers for Disease Control and Prevention’s last report), dozens of interventions have been developed to address social-emotional challenges. These interventions can be led by various pediatric professionals, including speech-language pathologists, occupational therapists, psychologists, clinical social workers, and others. The American Speech-Language-Hearing Association provides a comprehensive list, with summaries, of treatment options.

Tips for Parents and Caregivers

All children benefit from social-emotional support, but those with ASD need extra attention and practice.

• Engage your child several times each day. Because children with ASD may not initiate interaction, it’s important that you do the initiating. To encourage social referencing, play peek-a-boo; create a tunnel for your child to crawl through, and peek through one end to encourage her to crawl towards you; and play back-and-forth games like rolling a ball.
• Be sure you have your child’s attention before engaging her. Get into her line of vision and use a phrase like: “Listen, please.”
• Encourage joint attention by playing turn-taking games or activities that involve synchronizing movements: Dancing, jumping, racing cars side-by-side, etc.
• Point out, label, and talk about emotions – hers, others’, and your own.
• Use emotion cards, which show a facial expression, and ask your child to tell you what the image represents (you can make these yourself using drawings, magazines, or photographs).
• For children ages 2 ½ or older, use pretend play to get your child used to playing with another person.
• To maximize play with your child (including doing BabySparks activities), base play on your child’s interests, keep playtime short, and use lots of positive reinforcement.

As with any other area of development, continuous and open communication with your child’s therapists is essential. Carrying therapy goals into your home is a key to helping your child reach her individual potential.