Effective social interactions depend on the seamless integration of three essential elements: thinking, feeling, and doing. Thinking encompasses social cognitive processes like understanding social norms, interpreting contextual cues, and reading nonverbal signals. Feeling involves emotional regulation, which can positively or negatively influence our thoughts and behaviors. Doing pertains to the execution of social skills, where we make and carry out decisions smoothly during interactions. These elements operate simultaneously and dynamically, adding complexity to social interactions. This article underscores the significance of these components and presents a conceptual framework for understanding social interaction skills in youth with autism. Seminal and contemporary research studies will be reviewed and integrated with the author’s experience as both a researcher and clinician in the field of autism over the last four decades. The conceptual model presented in this article highlights the necessity for strategies that enhance social cognition, improve emotional regulation, and facilitate behavioral execution.

Individuals with autism often experience significant difficulties in social communication and interpersonal functioning [1]. These challenges affect both social cognitive processing, such as perspective-taking, joint attention, cognitive flexibility, restricted interests, and social problem-solving, and social skills, including initiating interactions, responding to others, and maintaining reciprocal interactions. Social skill difficulties often result in substantial impairments in forming and maintaining peer relationships and are linked to negative outcomes like social failure, peer rejection, bullying, anxiety, depression, academic issues, substance abuse, suicidal ideation, delinquency, and other forms of psychopathology [2-6]. Longitudinal research shows that social skills at the start of kindergarten are strong indicators of future employment, criminal behavior, mental health, substance abuse, and educational attainment in young adulthood [7]. Despite its critical importance, finding effective social skills programs for children and youth with autism has been a challenging task for both practitioners and researchers [8].

There is a pressing need for effective social skills programs for children and youth with autism, however teaching these skills effectively is a complex and difficult process [8]. Numerous literature reviews and meta-analytical studies have examined social skills interventions for children and adolescents with and without autism [9-15]. While these studies show varied and conflicting results regarding the main effects of interventions, they consistently highlight issues with poor generalization of skills. Social skill difficulties are a pervasive and enduring feature of autism, and generalizing learned social skills can be particularly challenging for this group. Effective social skills programs that enhance acquisition of social skills and promote skill generalization are crucial for children with autism.

Successful social interactions incorporate the successful integration of three integrated components: Thinking (i.e., social cognitive processing), Feeling (i.e., emotional regulation), and Doing (i.e., behavioral execution) [2]. For example, every social interaction requires us to engage in social cognitive processing. This involves understanding social rules, social norms and customs, reading contextual cues from the environment, and interpreting the nonverbal signals of those with whom we are interacting. This cognitive processing also helps us to consider and understand another person’s perspective while also monitoring and regulating our own thoughts, feelings, and behaviors. Ultimately, these processes lead us to make more effective behavioral decisions. Alongside cognitive processing, we also experience emotions that can influence our thoughts and behaviors in both positive and negative ways. Positive emotions enhance social engagement and pleasure, while negative emotions can cause physiological stress, self-defeating thoughts, and behavioral avoidance. Therefore, successful social interactions require not only effective social-cognitive processing but also the ability to actively regulate emotions that might hinder performance. In addition to effective social-cognitive processing and emotional regulation, successful social interactions also require the integration of one additional component: behavioral execution, or Doing. Social interactions are dynamic performances that demand us to continually make behavioral decisions and then execute them smoothly and effectively. This involves coordinating our motor movements and language production while staying in sync and rhythm with the movements and speech of the person with whom we are interacting. Lastly, and perhaps most critically, it’s important to remember that all these components-Thinking, Feeling, and Doing-happen simultaneously during social interactions. Makes solving algebraic equations seem easy by comparison, doesn’t it? This article explores these three interconnected components, particularly in the context of social interactions of youth with autism and lays the conceptual groundwork for the development and implementation of effective social skill programming.