Budding Friendships

January 27, 2010
Social skills program helps children with autism.
Budding Friendships

Weekday mornings are always a struggle in the Smith household. Like most preteens, Joseph likes to sleep. The 12-year-old is slow to start and has trouble shifting gears -especially before breakfast. Constant prompting from his mom Kathleen keeps him on track, and eventually, he gets himself bathed, dressed, fed, and out the door to school.

Yet, unlike many students, Joseph's struggle does not end when the morning classroom bell rings. He has autism, and he struggles every day to make friends. Diagnosed at 6 years old, Joseph has limited social skills and friendships because of the impulsivity and social impairment associated with his disorder.

"Joseph plays video games online with other kids, and he calls them his friends," Kathleen says. "But they're virtual friends, not a buddy next door. I wanted so much for him to pick up the phone and talk to somebody."

Kathleen knew that wouldn't be easy for Joseph, so she enrolled him in Building Up Development of Socialization (BUDS), an innovative program of the Center for Autism and Related Disorders at Kennedy Krieger Institute that teaches social skills to children with autism spectrum disorders. The program's unique partnership with the National Aquarium in downtown Baltimore allows children to practice their newly learned skills in a real-world social setting.

A Real-World Classroom

Led by Dr. Brian Freedman, clinical director for the Center for Autism and Related Disorders, and Dr. Elizabeth Stripling, assistant director for outreach and training, the BUDS program addresses the social skills difficulty children with autism face and gives them a place to apply what they learn in the real world.

"As children start to move toward middle school, social rules around them change. It can be challenging for any child, but it's especially difficult for children with autism to keep up," says Dr. Freedman. "That's where BUDS comes in. We're able to provide these children the tools they need to succeed at a critical time in their lives."

Each 16-week BUDS session includes four to six children who range in age from 6 to 12. They spend the first eight weeks in the classroom, role playing and learning social skills basics like the rules of conversation and how to "catch up" with friends, Dr. Freedman says. These skills-which many people take for granted-are reinforced through homework assignments.

While the kids are busy in the classroom, the aquarium staff members are hard at work too. Before sessions begin, staff members receive special training on the strengths and weaknesses of each student. This allows them to understand why children may display certain behaviors, such as blank expressions, laughing or crying for no apparent reason, or saying words or phrases repeatedly.

"As trainers, we've been taught to use positive reinforcement", says Shannon Daisey Cos, senior marine mammal trainer. "We're taught to ignore the bad behavior and reward the good. It's not the same with children with autism."

If a child with autism becomes overly loud or irritated, it could be a sign he needs a break or needs to refocus, she says. The behavior is a clue, and not one to be ignored.

"That's why the coaching from Kennedy Krieger is so important," says Sue Hunter, the aquarium's director of animal programs.

After the students and the aquarium staff have learned some new skills, it's time to practice them during aquarium visits, which take place during off-peak hours to minimize noise and distractions. They always begin by reviewing the schedule as well as some ground rules, like raising hands to ask questions and talking in a quiet voice. Then, it's off to explore under the guidance of aquarium staff. Group activities include touring the exhibits, scavenger hunts, and learning about the reptiles, fish, birds, and mammals who call the aquarium home.

Birds like Margaret, a mild-mannered hyacinth macaw, and bearded dragons like Zig Zag and Houdini are just a few of the residents who make guest appearances. The dolphin show is always a group favorite, evident by the squeals of excitement as soon as students enter the amphitheater.

"Animals are an integral part of the program," Hunter says. "They provide a bridge to conversation."

Worksheets prompt students to ask their friends, parents, and the aquarium staff questions such as, "What is your favorite thing about Margaret, and why did you like that?" or "Did you like the bearded dragon or the macaw more?" And inevitably, the conversation takes off, says Daisey Cos.

"Without any coaxing, the kids get excited about the animals and share it with their friends," she says.

"It's great to see the progression," adds Hunter. "Parents come back to us and say they've never seen this in their child before."

Bringing the Experience Home

Parents also receive training so they can incorporate what their children learn through BUDS in social settings and at home. For example, moms like Kathleen provide positive reinforcement through a point system that has clearly defined rewards and consequences.

For Joseph, who benefits from structure and built-in motivators, the system seemed to work. During one aquarium visit, another child stood too close for Joseph's comfort. Instead of "getting bent out of shape" like he had in the past, Joseph told the child it bothered him and asked him to stand somewhere else. Though it might seem like a small step, for Kathleen it was wonderful to see Joseph communicating.

"The children grew to respect each other," Kathleen says. "They seemed to all want to be there."

"It was awesome," Joseph says of his BUDS experience. "I made a lot of new friends."

While they are not yet calling each other on the phone, Joseph and his BUDS friends do keep in touch by email. They write about everything, from what gifts they received during the holidays to what they do during their time off from school.

Joseph even adds a smiley or sad face in his emails to illustrate his emotions. And just a few months ago, Joseph did what his mother had been hoping for since he was a small child: He picked up the phone to call a friend he made at summer camp. -by Allison Eatough

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