Interacting

Is your child:

• Having difficulty with sharing and turn taking?
• Tending to be bossy or controlling, and always needing to have his own way?
• Seeming to have trouble taking the perspective of classmates?
• Often walking away and playing alone if the other children don’t do it her way?
• Hitting other children in preschool?
• Insisting on being right, being first, or winning every game?
• Not interested in what other kids like? Only focused on her own thing?
• Having difficulty understanding that his baby brother is very young and therefore doesn’t understand that the Lego belongs to him?

Many children have difficulty with reciprocal play. By grade school, we should see children playing reciprocally. They are engaging in games like tag, kickball, and Marco/Polo that have rules and winners and losers. Children are expected to take turns and to be a good sport.

It is concerning when some children are oblivious to these social rules. They may only see it from their perspective; therefore, losing, playing another person’s game, or letting someone else go first may be intolerable.

Perhaps your child stalks off the playground anytime the kids won’t play Harry Potter. He’d rather sit alone on the bench and count butterflies than play a game of tag. Maybe when he plays pretend he always has to be a certain character and cannot see why it might be good to give someone else a turn. Conversely, maybe your child is sweet and oblivious and constantly is taken advantage of by other children.

Maybe your child never gets a turn and allows others to take the lead and have all the control. Either of these opposite situations indicates that your child is not engaging in reciprocal play.

Clinically, social engagement should continue to become more sophisticated as a child gets older. Children should demonstrate more and more skills in social perspective taking. Children should be able to read other children’s nonverbal cues and know what might hurt someone else’s feelings. In this way, children are able to become savvy at sharing, turn taking, and back and forth social interaction [4, 5].

Children should begin to make friends and have close friends who play together frequently and share common interests. Children should discriminate between friends (e.g., “I’d like to have Sally over today because she loves dolls, and I just got a new American Girl doll”).

Children with Autism Spectrum Disorders often lack social reciprocity. Cooperative and pretend play are evaluated through tasks on the ADOS-2 and through questions in interviews and on rating scales completed by parents. Children with Autism tend to have challenges with flexible, cooperative play and perspective taking.

One technique that clinicians use to assess for reciprocity is called ‘dropping bids.’ Clinicians might say, “The strangest thing happened to me today!” in order to see if the child will ask for information about the ‘strange thing’ or offer an empathetic response like, “Whoa! What happened?” Children who do not respond to bids are often showing signs of poor social reciprocity.

At home, you may notice that your child has to win every board game. A loss will send him or her into a temper tantrum, guaranteed. He or she is not able to take the perspective of the other player and to feel happy for him, knowing that he would like to win too. Sharing interests, toys, and ideas involves a degree of cognitive flexibility. The child has to stop to think about what another child likes better. Maybe he likes to play trucks but the other child wants to do a puzzle together.

In order for your child to have friends, the child would have to be willing to try the other child’s idea, at least occasionally. The author of this article has heard the question, “But, what if my child is a leader?” Yes, it is okay for your child to be in charge sometimes. However, the other children need some wiggle room, or they will give up on the relationship.

The book, “Big Dog…Little Dog” is a delightful illustration of this idea. The big dog likes one color; the little dog likes the other. The story starts out, “Fred and Ted were friends. Fred was big. Ted was little. Fred always had money. Ted never had money… When they walked in the rain, Fred was wet. Ted was dry.” The moral of the story is that even very different ‘animals’ can be friends.

Teach your child the same. Make sure that your child understands that, in order to be friends, he or she will have to be flexible. Give and take is part of friendship. Say something like,

“It cannot always be ‘your way’, but it will be more fun with a friend.”

The skills of social reciprocity and play skills need to be taught for many children. Parents can provide opportunities for guidance and practice. Often with ample time and supervision in social reciprocity, a child’s social skills will improve. Plan social activities for your child around his or her interests. Join a Lego or Robotics club; pursue the swim team or horseback riding. Find ways to have your child engage socially without leading to failure.

When activities are structured and turn-taking, back-and-forth interaction can be modeled, then children can improve their social skills. You may choose to avoid soccer teams or baseball teams, which are large activities that require a lot of cooperation.

Find something with an individual component but also social opportunities. Social groups in your community or at your child’s school may be a way for him or her to learn social skills and have these skills modeled for him or her.

Provide breaks and down time, but give your child social learning experiences. Foster and improve on those friendships that seem to be most connected. If your child loves Minecraft and finds another avid fan, work to get the boys together often and to guide them to maintain a friendship beyond just chatting at school.

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

• Pragmatic language: children who have trouble interacting socially may also have poor social communication
• Attention (Focusing) [9,10]: children who struggle socially may have attention problems
• Restricted Patterns of Behavior or Interests (Repetitive Behavior, Perseverating, Rigidity, Rigid Behavior): children who struggle with interacting may also have rigid behavior patterns or interests. This combination is often seen in autism
• Receptive language: children who have difficulty interacting with peers may struggle with comprehension of spoken language

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

• AD/HD: includes deficits in attention that can also cause social challenges. You may be likely to see impulsivity, hyperactivity, not reading other children’s cues of “this is too much.” AD/HD is characterized by challenges with sustained attention, hyperactivity and impulsivity [9,10]
• Autism Spectrum Disorder: includes deficits in social communication and restricted interests or behaviors. In children, social interaction is defined by cooperative and reciprocal play, which is more advanced than the parallel play exhibited by younger children
• Language Disorder: includes deficits in language that can make it hard for a child to connect. He or she may be frustrated and unable to voice wants or needs. Children with ASD sometimes have language impairments, so language is an important area to have assessed
• Intellectual Disability: includes deficits in cognitive ability (low IQ scores) that may lead to development and delayed reaching of social milestones. Global delays, not just in the area of social interaction, can be present

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

• CLEAR Child Psychology: to obtain a customized profile of concerns for your child, or to consult ‘live’ with a psychologist
• Psychologist or Neuropsychologist: to consider an evaluation for diagnostic clarification.
• Psychotherapist: to provide therapy for social skills and emotional regulation. CBT interventions have been shown to be effective in helping children with ASD make gains in recognizing and understanding emotions, improving perspective taking and social skills, and managing co-occurring depression and anxiety.
• ABA Therapist: to teach functional behavior. Applied Behavior Analysis uses principles of reinforcement to increase desired behaviors like communication and language and to decrease undesired behaviors like hitting/tantrums. For older children, ABA may be a good way to address social skills, turn taking, and social perspective taking.
• Speech and Language Pathologist: to teach the language skills needed to communicate effectively within a social setting. An SLP is an important member of your treatment team if your child has language delays. Treatment works best if all team members can communicate with one another to make sure your child is getting comprehensive services.

These professionals may recommend or administer the following tests for this symptom:

• CELF-5: Consider Vocabulary, Language Comprehension, Expressive and Receptive Language, Pragmatic Language, Language Memory
• WISC-V: This measure of intelligence provides information on abilities in verbal comprehension, fluid reasoning, visual spatial, working memory, and processing speed. Understanding a child’s cognitive profile can help us understand strengths and weaknesses that may be associated with ASD. The WISC-V can also help guide what other measures need to be administered to get a better picture of overall functioning. This may be very broad including language, motor, attention, memory, executive functioning, sensory processing, emotions, behavior, etc.
• ADOS-2 Module 3: For assessment of social communication and restricted, repetitive behavior to be administered to rule in or out the presence of an Autism Spectrum Disorder. The ADOS gives information that can guide the formation of treatment goals

[1] Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

• Springer
• Amazon

[2] Baker, Jed. (Retrieved 2017). Social skills books and resources for ASD.

http://socialskillstrainingproject.com/books.html

[3] Ozonoff, Sally & Dawson, Geraldine & McPartland, James C. (2014). A parent’s guide to high functioning autism spectrum disorder: How to meet the challenges and help your child thrive.

Amazon: https://www.amazon.com/Parents-High-Functioning-Autism-Spectrum-Disorder/dp/1462517471/

[4] Berns, Roberta M. (2010). Child, family, school, community: Socialization and support.

Amazon: https://www.amazon.com/Child-Family-School-Community-Socialization/dp/1305088972/

[5] Trawick-Smith, Jeffrey (2013). Early childhood development: A multicultural perspective.

Amazon: https://www.amazon.com/Early-Childhood-Development-Multicultural-Perspective/dp/0132868598/ref=dp_ob_title_bk

[6] Madrigal, S., & Winner, M.G. (2008). Superflex. A superhero social thinking curriculum.

Amazon: https://www.amazon.com/Superflex-Superhero-Social-Thinking-Curriculum/dp/0979292247/

[7] UCLA PEERS Clinic https://www.semel.ucla.edu/peers

[8] Barton, Erin. Educating Young Children with Autism Spectrum Disorders.

http://www.nasponline.org/books-and-products/products/books/titles/educating-young-children-with-autism

[9] Giler, Janet Z. (2000). Socially ADDept: A manual for parents of children with ADHD and / or learning disabilities.

Amazon: https://www.amazon.com/Socially-ADDept-Children-Learning-Disabilities/dp/0966696921/

[13] Giler, Janet Z. (2011). Socially ADDept: Teaching social skills to children with ADHD, LD, and Asperger’s.

Amazon: https://www.amazon.com/Socially-ADDept-Teaching-Children-Aspergers/dp/047059683X/

For kids:

[14] Eastman, P.D. (2003) Big Dog…Little Dog.

Amazon: https://www.amazon.com/Big-Dog-Little-Beginner-Books/dp/0375822976/

[15] Brown, Laurie Krasny & Brown, Marc (2001). How to be a friend: A guide to making friends and keeping them (Dino life guides for families).

Amazon: https://www.amazon.com/How-Be-Friend-Friends-Families/dp/0316111538/

[16] Cooper, Scott (2005). Speak up and get along!: Learn the mighty might, thought chop, and more tools to make friends, stop teasing, and feel good about yourself.

Amazon: https://www.amazon.com/Speak-Up-Get-Along-Yourself/dp/1575421828/

[17] Cook, Julia (2012). Making Friends is an art!: A children’s book on making friends (Happy to be, you and me).

Amazon: https://www.amazon.com/Making-Friends-Art-Childrens-Paperback/dp/B00DCVWAJI/

Image Credit:
Name: Children playing marbles, activity of student in Thailand.
Image ID: 243562870 (Big Stock)
Toddler-social-development-milestones
By: Still AB
Licensed: October 29, 2016
Stylized by Katie Harwood, exclusively for CLEAR Child Psychology

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