Social Skills Training for Autism: What Helps Kids

Q: Do social stories work?

The evidence is mixed. A meta-analysis of single-case studies found low to questionable overall effectiveness, with better results for behavior that caused problems than for teaching social skills. They are low-cost and easy to make.

Key takeaways

Autism support levels describe support needed, not severity of the person — and they're assigned separately for social communication and restricted behaviors.⁠¹
Asperger's, PDD-NOS and Childhood Disintegrative Disorder were removed from the DSM in 2013. You'll still hear them; they aren't current diagnoses.⁠¹
Social difficulty runs in both directions. The double empathy problem frames the difficulty between autistic and non-autistic people as a question of reciprocity and mutuality, not a deficit in the autistic person alone.⁠²
Autistic people communicate effectively with each other — which reframes the difficulty as a mismatch rather than a deficit.⁠³
Masking has a cost. Autistic adults describe camouflaging to fit in and connect with others, and name exhaustion among its consequences.⁠⁹ Camouflaging heavily across settings is linked to poorer mental health.⁠⁴
Ask what the goal is before starting any program. "Fewer stims" is a different goal from "can ask for help."
The child's own preferences count. A child who prefers one friend to a group has a social preference, not a social deficit.

What do the autism support levels mean?

DSM-5 describes three levels of support need. They are not a classification of types of autism, and they are not a measure of a person's ability.⁠¹

Level	Description	What it means practically
Level 1	Requiring support	Difficulty initiating social interaction; problems with organization and planning can limit independence⁠¹
Level 2	Requiring substantial support	Marked differences in verbal and nonverbal communication, apparent even with support in place⁠¹
Level 3	Requiring very substantial support	Severe differences in verbal and nonverbal communication; very limited initiation of social interaction⁠¹

Levels describe support needed, not the person. DSM-5 assigns them separately for social communication and for restricted, repetitive behaviors.⁠¹

They're assigned twice. DSM-5 rates social communication and restricted, repetitive behaviors separately. A person can be Level 1 for one and Level 3 for the other.⁠¹

They say nothing about intelligence. DSM-5 records intellectual impairment separately, as “with or without accompanying intellectual impairment,” so a child requiring very substantial support may have no intellectual impairment at all.⁠¹

Asperger's and PDD-NOS: why you may still hear them

Neither is a current diagnosis. When DSM-5 was published in 2013, Asperger's Disorder, PDD-NOS and Childhood Disintegrative Disorder were consolidated into a single diagnosis: Autism Spectrum Disorder.⁠¹

Why you still encounter them: some people diagnosed before 2013 keep the terminology, and some identify with it and prefer it. That's their choice and worth respecting.

But if a clinician offers one of these as a new diagnosis today, ask about it. The current framework is autism spectrum disorder with specified support levels. Our page on atypical autism covers the older terminology in more depth.

Why is social interaction harder in autism? It goes both ways

The standard framing is that autistic children have difficulty reading social cues. That's part of it, and it's incomplete.

The double empathy problem describes the difficulty as two-way: it reframes social difficulty between autistic and non-autistic people as a question of reciprocity and mutuality, rather than a deficit in the autistic person.⁠² And a study of information transfer found that autistic-to-autistic chains passed information as effectively as non-autistic chains, while mixed chains did less well.⁠³

Why this matters for what you do next. If the difficulty is a mismatch rather than a deficit, then the intervention isn't only "teach the child to communicate differently." It's also: find peers they communicate well with, and help the adults around them adjust.

What can genuinely be harder for autistic children:

Processing spoken language quickly enough to respond in real time
Managing sensory input while also managing conversation; DSM-5 includes over- or under-reactivity to sensory input among the features of autism⁠¹ — see sensory over-responsivity
Unwritten rules that nobody states
Shifting attention between topics — see monotropism
Predicting what happens next in an unstructured setting; DSM-5 lists insistence on sameness and inflexible adherence to routines⁠¹

Those are real, and they're worth support. "Doesn't make eye contact" and "prefers one friend to a group" are not on that list.

Social skills training or masking: what is the goal?

This is the section to read before choosing any program.

Masking, or camouflaging, means suppressing natural behavior to appear more typical — forcing eye contact, hiding stims, scripting responses, performing interest. In interviews with 92 autistic adults, motivations for camouflaging included fitting in and increasing connections with others, and its consequences included exhaustion.⁠⁹ In a study of 262 autistic people, camouflaging heavily across settings, or switching between camouflaging and not, was linked to poorer mental health.⁠⁴ It can be measured: a self-report questionnaire built from autistic adults’ accounts held up in testing with 354 autistic and 478 non-autistic adults.⁠⁵ See autistic burnout for where sustained masking leads.

Builds a genuine capability	Teaches concealment
How to ask for help	How to look like you don't need help
How to say no, or leave	How to tolerate something distressing quietly
How to join a game you want to join	How to sit still during a game you hate
Using AAC to communicate	Speaking aloud when AAC works better
Recognizing your own overload	Hiding overload until you get home
Finding people you click with	Fitting in with people you don't

The point of all of this is the adult the child becomes, and what they will need is an environment that accommodates them rather than a lifetime of concealment.

The test: does this skill give the child more control over their life, or does it make them easier for other people to be around? Both can be legitimate goals — but they're different goals, and a program should be able to say which it's pursuing.

Questions worth asking any provider: What are the goals, and who chose them? What happens if my child doesn't want to do something? Do you work on stimming, and if so why? How do you know it's working — and what would tell you it isn't?

Social stories are short, personalized narratives describing a situation and what typically happens in it. They are commonly used,⁠⁷ low-cost, and easy to make.

The evidence is mixed.⁠⁷ A meta-analysis of single-case studies found low to questionable overall effectiveness, with better results when stories addressed behavior that caused problems than when they taught social skills.⁠¹⁰

What went with better results: in the same meta-analysis, stories used in general education classrooms, and stories the child used on their own.⁠¹⁰

What to avoid: a story that tells a child how they should feel, or that frames their natural response as wrong.

Does ABA help autism social skills? What the evidence says

Applied Behavior Analysis is a behavioral intervention, and both its evidence and its goals are debated.

What the evidence shows, honestly. The largest meta-analysis of early childhood autism interventions, covering 252 studies, found that in randomized trials behavioral interventions improved social-emotional and challenging-behavior outcomes, but those results did not hold once caregiver- and teacher-reported outcomes were set aside; when outcomes at high risk of detection bias were also excluded, one significant effect remained, for naturalistic developmental behavioral interventions on measures of autism characteristics. Adverse events were poorly monitored.⁠⁶

What this means practically: ABA isn't a settled answer, and a provider presenting it as one is overstating. Our page on behavioral interventionists covers the credentials, the evidence and the debate in full, including the questions to ask before starting.

How to support an autistic child's friendships

Start from shared interest. A child who finds one other child who cares about the same thing has a friendship. A child who completes twelve turn-taking sessions has completed twelve sessions.

Interest-based groups rather than social skills groups — coding club, Lego, animals, a specific game
Parallel activity, where children do something alongside each other without needing constant interaction
Shorter, earlier, smaller. One friend for an hour beats a party
A structured activity to hang the interaction on, rather than open-ended free play
Autistic peers. In one study, autistic people passed information to each other as well as non-autistic people did, and mixed groups reported lower rapport.⁠³

What to be careful about: a child who prefers solitude some of the time is not necessarily lonely. Ask them. Loneliness and low sociability are different things, and only one needs addressing.

Visual supports and AAC for social communication

Visual supports — schedules, picture cards, written instructions — reduce reliance on real-time spoken processing and make expectations explicit.

AAC (augmentative and alternative communication) covers everything from picture boards to speech-generating apps.

The most important thing to know about AAC: it does not hold speech back. In a review of the most rigorous studies, covering 27 people with developmental disabilities, none showed a decrease in speech after AAC was introduced and 89 percent showed gains.⁠⁸ Communication access comes first; speech may or may not follow, and either outcome is acceptable.

Access matters more than the specific system. A child who can communicate is a child who can ask, refuse, and explain — which is worth more than any social skills curriculum. Our page on gestalt language processing covers a pattern often mistaken for a lack of language.

How speech therapy helps autism social skills

A speech-language pathologist works on far more than articulation: comprehension, conversational structure, AAC assessment and setup, and the pragmatic side of language.

Worth asking for if your child has difficulty being understood, wants to communicate more than they currently can, needs AAC, or has feeding or swallowing difficulties alongside. Find a speech-language pathologist.

Play-based social skills therapy for autism

Play is where children practice negotiating, taking turns and reading each other, and play-based approaches follow the child's interest rather than a curriculum. In the largest meta-analysis of early autism interventions, naturalistic developmental behavioral interventions, which teach within play and daily routines, improved social communication in randomized trials.⁠⁶

One caution: play-based doesn't automatically mean child-led. Ask whether the child chooses the activity, or whether the activity is chosen and made to look like play.

Social skills groups: what to ask before joining

Groups can genuinely help — practice with peers, in a supported setting, with someone to scaffold. Ask before enrolling:

Who sets the goals? The best answer includes the child
Are the other children autistic? A group of autistic peers works differently from one autistic child among non-autistic peers
What happens if my child wants to leave?
Is eye contact a target? If yes, ask why
How do you handle stimming?
How do you measure success?

A good group builds confidence. A poor one teaches a child that they're the problem in the room.

Social skills support to ask your child's school for

A quiet space available without asking each time
Interest-based lunch clubs rather than unstructured cafeteria time
A peer buddy who genuinely shares an interest
Advance warning of changes, substitutes and assemblies
Not being made to participate in group work as the price of inclusion
Adults who understand that not speaking isn't defiance

These belong in an IEP or 504 plan, and our resources for teachers include material to share.

How to build social skills at home

Follow the interest. The thing your child talks about at length is your best route to connection, not a distraction from it.

Let them communicate their way. Scripting, echolalia, AAC, gestures and typing are all communication.

Protect recovery time. A child who masks all day at school needs the evening to be easy. What looks like withdrawal at 4pm may be depletion — see living with sensory processing differences.

Don't make eye contact the goal. In first-hand accounts, autistic teens and adults described adverse emotional and physiological reactions and sensory overload while making eye contact.⁠¹¹

Model rather than instruct. Narrating your own social reasoning — "I'm going to say no to that, because I'm tired".

Signs a social skills program isn't right for your child

Signs worth raising

Your child dreads it, consistently, over weeks
Goals focus on appearance — eye contact, quiet hands, sitting still
You aren't allowed to observe
Distress is treated as an obstacle rather than information
Progress is measured only in compliance
Nobody can tell you what would make them stop
Your child is masking more, and more exhausted at home
Stimming is targeted for reduction with no explanation of why

Any one of these is worth raising. Several together is worth leaving.

Frequently Asked Questions

Is Asperger's Syndrome still a diagnosis?

No. Asperger's, PDD-NOS and Childhood Disintegrative Disorder were consolidated into Autism Spectrum Disorder when DSM-5 was published in 2013.⁠¹ Some people diagnosed before then keep the terminology, and some prefer it — but it isn't a current diagnosis, and a clinician offering it as a new one today is worth questioning.

What do autism Levels 1, 2 and 3 mean?

They describe the amount of support a person needs, not their intelligence or their worth. Level 1 requires support, Level 2 substantial support, Level 3 very substantial support. They're assigned separately for social communication and for restricted or repetitive behaviors, and they aren't fixed — support needs change with setting and with how much capacity someone has left.

How can I help my autistic child develop social skills?

Start with what your child wants to be able to do. Look for interest-based groups and shared-interest friendships, and make sure your child has a way to communicate. Ask any program what its goals are and who chose them.

What is the double empathy problem?

A term that reframes social difficulty between autistic and non-autistic people as a question of reciprocity and mutuality, rather than a deficit in the autistic person.⁠² A study of information transfer found autistic-to-autistic communication as effective as non-autistic-to-non-autistic communication, while mixed groups did less well.⁠³

Is social skills training harmful?

It depends entirely on the goals. Training that builds capability — how to ask for help, how to say no, how to join something you want to join — is useful. Training that teaches concealment, like forcing eye contact or suppressing stims, teaches masking, which autistic adults link to exhaustion.⁠⁹ Ask which one a program is doing.

Do social stories work?

The evidence is mixed.⁠⁷ A meta-analysis of single-case studies found low to questionable overall effectiveness, with better results for behavior that caused problems than for teaching social skills.⁠¹⁰ They are low-cost and easy to make.

Should my child do ABA for social skills?

The evidence is not settled. The largest meta-analysis of early autism interventions found that behavioral interventions improved social-emotional and challenging-behavior outcomes in randomized trials, but those results did not hold once caregiver- and teacher-reported outcomes were set aside, and adverse events were poorly monitored.⁠⁶

Will using AAC stop my child from talking?

No. In a review of the most rigorous studies, covering 27 people with developmental disabilities, none showed a decrease in speech after AAC was introduced, and 89 percent showed gains.⁠⁸ Communication access comes first, and speech may or may not follow — either outcome is acceptable.

My child prefers to play alone. Is that a problem?

Not necessarily. A preference for solitude some of the time is not the same as loneliness, and only one of those needs addressing. Ask your child.

Sources

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Publishing; 2013. DSM-5 consolidated Autistic Disorder, Asperger's Disorder, Childhood Disintegrative Disorder and PDD-NOS into a single diagnosis of Autism Spectrum Disorder, and specifies severity as a level of support need rated separately for social communication and for restricted, repetitive behaviors.
Milton DEM. On the ontological status of autism: the ‘double empathy problem’. Disability & Society. 2012;27(6):883–887. doi:10.1080/09687599.2012.710008
Crompton CJ, Ropar D, Evans-Williams CV, Flynn EG, Fletcher-Watson S. Autistic peer-to-peer information transfer is highly effective. Autism. 2020;24(7):1704–1712. doi:10.1177/1362361320919286
Cage E, Troxell-Whitman Z. Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders. 2019;49(5):1899–1911. doi:10.1007/s10803-018-03878-x
Hull L, Mandy W, Lai M-C, et al. Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders. 2019;49(3):819–833. doi:10.1007/s10803-018-3792-6
Sandbank M, Bottema-Beutel K, Crowley LaPoint S, et al. Autism intervention meta-analysis of early childhood studies (Project AIM): updated systematic review and secondary analysis. BMJ. 2023;383:e076733. doi:10.1136/bmj-2023-076733
Chen T, Yang W, Wang Q. Effects of social stories intervention for children and adolescents with autism spectrum disorders. Medicine. 2020;99(38):e22018. doi:10.1097/md.0000000000022018 — a systematic review protocol, which records that evidence on the effectiveness of social stories is mixed.
Millar DC, Light JC, Schlosser RW. The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. Journal of Speech, Language, and Hearing Research. 2006;49(2):248–264. doi:10.1044/1092-4388(2006/021) — the abstract: “The remaining 6 studies, involving 27 cases, had sufficient methodological rigor for the ‘best evidence analysis’”; “Most of the participants (aged 2-60 years) had mental retardation or autism”; “None of the 27 cases demonstrated decreases in speech production as a result of AAC intervention, 11% showed no change, and the majority (89%) demonstrated gains in speech.”
Hull L, Petrides KV, Allison C, Smith P, Baron-Cohen S, Lai M-C, Mandy W. “Putting on my best normal”: social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders. 2017;47(8):2519–2534. doi:10.1007/s10803-017-3166-5 — the abstract: “This qualitative study examined camouflaging experiences in 92 adults with ASC”; “motivations for camouflaging included fitting in and increasing connections with others”; “short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception.”
Kokina A, Kern L. Social Story interventions for students with autism spectrum disorders: a meta-analysis. Journal of Autism and Developmental Disorders. 2010;40(7):812–826. doi:10.1007/s10803-009-0931-0 — the abstract: “While Social Stories had low to questionable overall effectiveness, they were more effective when addressing inappropriate behaviors than when teaching social skills.
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Social Stories also seemed to be associated with improved outcomes when used in general education settings and with target children as their own intervention agents.”
Trevisan DA, Roberts N, Lin C, Birmingham E. How do adults and teens with self-declared autism spectrum disorder experience eye contact? A qualitative analysis of first-hand accounts. PLOS ONE. 2017;12(11):e0188446. doi:10.1371/journal.pone.0188446 — the abstract: “Results suggest people with a self- declared ASD diagnosis experience adverse emotional and physiological reactions, feelings of being invaded, and sensory overload while making eye contact.”

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child.

Social Skills and Autism: What Helps, and What to Question