RENEE MONTAGNE, host:
As we know for children with autism, social interactions are a struggle, so researchers in Baltimore have come up with a course designed to teach those kids social skills. NPR's Jon Hamilton has the story.
JON HAMILTON: Math and numbers are easy for Alex Lee. He can tell you what pi is out to 100 digits. But Alex doesn't do so well with chitchat. Here he is talking to psychologist Brian Freedman at the Kennedy Krieger Institute in Baltimore.
Mr. ALEX LEE: Do you know how to play the piano?
Dr. BRIAN FREEDMAN (Psychologist, Kennedy Krieger Institute, Baltimore): I don't know how to play the piano, but were we talking about...
Mr. ALEX LEE: What instrument do you play?
Dr. FREEDMAN: Hang on, were we talking about me playing the piano?
Mr. ALEX LEE: No.
Dr. FREEDMAN: What were we talking about?
Mr. ALEX LEE: What instrument do you play?
Dr. FREEDMAN: Were we talking about me playing instruments?
Mr. ALEX LEE: No.
Dr. FREEMAN: No.
HAMILTON: But Alex says he's doing better than he used to.
Mr. ALEX LEE: I had a perfect week last week.
Dr. FREEMAN: You did? What made it a perfect week?
Mr. ALEX LEE: I was like - I was never going into the red zone.
HAMILTON: For the past couple of months, Alex and several other children with mild autism have been meeting every week with Freedman and autism specialist Elizabeth Stripling. The idea is to teach the social skills that most kids pick up without even thinking about it. Freedman says the gap between kids with autism and other kids isn't so wide when they're in kindergarten. But after that it can become a chasm.
Dr. FREEMAN: This group is 10 to 12 years old. They're also starting to move toward middle school, and the social rules are changing all around them. And so it's incredibly hard for them to keep up. So that's why we need to have a group like this.
HAMILTON: During the sessions, Freedman and Stripling give pointers on how to do things like keep a conversation going. It's basic stuff. If someone says they like music, ask what kind of music. They remind the kids to make eye contact and listen when someone else is talking. Freedman says it's all about coaching and practice, not just rules.
Dr. FREEDMAN: One of the problems that kids with autism can run into is when they're taught very rigid rules, they only stick to those rules. So we try to create some - and help them understand some nuances with interaction.
HAMILTON: On this afternoon only two boys have shown up, Alex and another 10-year-old named Joseph Santana. A few minutes into the session, Joseph says he wants to talk about something that happened to him. Freedman and Stripling help Alex respond appropriately.
Mr. JOSEPH SANTANA: On Sunday, I went to the emergency room.
Dr. FREEDMAN: Oh, my gosh.
Mr. SANTANA: Because I couldn't breathe.
Dr. ELIZABETH STRIPLING (Autism Specialist, Kennedy Krieger Institute, Baltimore): Oh, my goodness.
Mr. ALEX LEE: So sorry to hear that.
Mr. JOSEPH SANTANA: They put sticky things and hooked them up to the...
Dr. STRIPLING: What could you ask Alex?
Mr. ALEX LEE: Why couldn't you breathe?
Dr. STRIPLING: Good job.
Mr. JOSEPH SANTANA: Well, I...
HAMILTON: It's not completely spontaneous. But Freedman says the conversations show how far Alex has come. He is clearly listening, and his responses even suggest empathy. And for Joseph, just telling the story is a big achievement. He has trouble communicating with other kids. But he's been trying hard with the children he's met in these sessions. Freedman says the first thing Joseph did after getting out of the hospital was send an email to the entire group.
Dr. FREEDMAN: The email wasn't just to check in and say hi, but it provided context to say that something had happened to him. The next sentence was followed by, I'm OK. And all of that was followed up by emoticons that showed the feelings that went along with that. So, I would say, especially for a kid like Joseph, that was tremendous progress.
HAMILTON: Joseph grew up loving the History Channel but hating school.
Ms. KATHLEEN SANTANA: Kids would pick on him, beat him up. You know, they were really not very kind to him at all.
HAMILTON: That's his mom, Kathleen Santana. She says when kids at school handed out invitations to birthday parties, Joseph never got one.
Ms. SANTANA: In the beginning, he just wasn't aware. But now that he's getting older and learning more that that is happening, he is becoming more aware, and I think that is a hurtful situation for him.
HAMILTON: Eventually, Santana decided to teach Joseph at home. Alex has been doing OK at school. But his father, Hugh Lee, says his son is lonely.
Mr. HUGH LEE: He wants to make friends with other kids. I think it's a disability in him that he doesn't know how to.
HAMILTON: After many weeks of practice, Alex and Joseph are getting ready for a kind of final exam. They'll be going to the Australia exhibit at the Baltimore Aquarium. Their parents will be going too. Their job is to award points when the boys do well and take points away when they don't. Points earn prizes. A week later, Alex, Joseph, and several other boys arrive at the aquarium. The main attraction is a really big lizard.
Dr. STRIPLING: That's a bearded dragon. Can you tell your friends, though, what type of lizard that is?
Mr. ALEX LEE: It's a bearded dragon.
Dr. STRIPLING: Yes. Did you tell one of your friends?
Mr. ALEX LEE: A bearded dragon.
HAMILTON: A little later they get a face-to-face meeting with another bearded dragon named Tinker.
Dr. STRIPLING: Do you guys want to see how she eats?
Mr. ALEX LEE: Yeah.
Dr. STRIPLING: OK. So, we're going to bring her over to this table.
HAMILTON: When it's time to actually touch the lizard, Joseph Santana is one of the first in line.
Dr. STRIPLING: What do you think it feels like?
Mr. JOSEPH SANTANA: Spiky.
Dr. STRIPLING: Spiky.
HAMILTON: Then it's time for the boys to ask each other questions. Alex Lee is ready. He turns to his friend.
Mr. ALEX LEE: Joe, what do bearded dragons like to eat?
Mr. JOSEPH SANTANA: Bugs.
Dr. STRIPLING: Bugs, very good. OK, do you guys want to write down that answer?
HAMILTON: It's time to add up the points and find out who got prizes. Alex checks in with his mom.
Ms. LEE: You did a very good job initiating conversations in the beginning. But I did deduct a couple of points, because sometimes you touched the objects.
Mr. ALEX LEE: I thought that's only 14(ph).
HAMILTON: This is the sort of conversation Alex likes. It's about numbers.
Mr. ALEX LEE: So, 18 minus 3 equals 15.
Ms. LEE: Yeah, that's your total points.
Mr. ALEX LEE: So, I have more than 10, and I have exactly 15. So a large prize.
Ms. LEE: Are you happy?
Mr. ALEX LEE: Yes.
HAMILTON: For kids like Alex and Joseph, the stakes are high. They're smart enough to go to college, find jobs, and live on their own. Freedman says his goal is to make sure they acquire the social skills to accomplish those things. Jon Hamilton, NPR News.