Scenario Instructions

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Chapter Introduction

Learning Objectives

After reading this chapter, you will be able to:

· 7-1 Describe socialization characteristics present in many individuals with autism and implications of those characteristics for social functioning.

· 7-2 Differentiate between social competence and social skills.

· 7-3 Explain methods for determining social skills needed by students with autism.

· 7-4 Describe interventions for improving socialization in students with autism.

· 7-5 Describe strategies for facilitating the generalization of new social behaviors.

Children and youth with autism characteristically display low levels of social engagement. In fact, Kanner chose the term autism, from the Greek autos, meaning “self,” to reflect this cardinal symptom of the disorder. Attempts to interact by teachers or peers without disabilities may produce challenging behaviors such as self-injury, aggression, tantrums, or crying from a child with autism. Most typically developing children and youth initiate social interactions and respond to social initiations by others with little or no direct, formal instruction in socialization skills. Such informal social learning occurs, in part, because children imitate the behaviors of peers and social interactions are reinforcing for most children and adults. However, social learning is less likely to occur for children and youth with autism through traditional (e.g., informal) channels for reasons related to why autism develops in the first place (e.g., atypical neurocognitive development) and because of deficits in social awareness, imitation skills, and self-awareness (American Psychiatric Association [APA], 2013). In addition, naturally occurring social interactions may not be reinforcing enough to children with autism to motivate them to initiate and respond to those interactions, and children with autism may lack the skills to learn from socialization interactions that do occur.

It is important not to conflate a lack of social skills with disinterest in social interaction or relationships. Although people with autism may lack the skills necessary to establish or maintain social relationships, many desire meaningful social relationships and cherish their interactions with friends and family. Further, even though social deficits are emphasized in autism spectrum disorder’s diagnostic criteria, social skills can be taught to people with autism. Having the skills necessary to engage in more meaningful and successful social interactions is important regardless of whether or not those skills are consistently used. Improving the social skills of children with autism empowers them to make more choices regarding their social lives. Teachers of children with autism will need planned socialization interventions designed to address targeted socialization goals.

Did You Know That

· To improve social performance for children with autism, you must teach critical skills and provide opportunities to socialize?

· Teaching social skills is important but may not lead to better social relationships with peers?

· Sometimes we need to teach children how to be friends and provide opportunities for children to practice those friendship skills?

· Direct instruction of social skills does not necessarily result in improved friendships, increased social engagement, or richer social networks?

In this chapter, we will explore socialization characteristics common in individuals with autism and how those characteristics affect social engagement. In addition, we will describe interventions for improving social competence in children and youth with autism, in part by assessing students’ current socialization deficits with respect to the demands of social environments and the skills that are naturally reinforced in those environments. We will also describe intervention strategies to teach social behavior.

Chapter

Remediating Deficits in Socialization

· Chapter Introduction

· 7-1 Socialization Characteristics and Implications

· 7-1a Implications of Socialization Deficits

· 7-2 Social Competence Versus Social Skills

· 7-3 Assessment Strategies for Determining Socialization Curriculum

· 7-3a Assessment of Contexts and Determining Socially Valid Skills

· 7-3b Assessment of Student Skill Levels

· 7-4 Interventions for Increasing Social Skills and Social Competence

· 7-4a General Considerations for Socialization Interventions

· 7-4b Intervention Approaches

· 7-5 Facilitating Generalization of Social Skills

· Chapter Review

· Summary

· Key Points

· References

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Main content

Chapter Introduction

Learning Objectives

After reading this chapter, you will be able to:

· 7-1 Describe socialization characteristics present in many individuals with autism and implications of those characteristics for social functioning.

· 7-2 Differentiate between social competence and social skills.

· 7-3 Explain methods for determining social skills needed by students with autism.

· 7-4 Describe interventions for improving socialization in students with autism.

· 7-5 Describe strategies for facilitating the generalization of new social behaviors.

Did You Know That

· To improve social performance for children with autism, you must teach critical skills and provide opportunities to socialize?

· Teaching social skills is important but may not lead to better social relationships with peers?

· Sometimes we need to teach children how to be friends and provide opportunities for children to practice those friendship skills?

· Direct instruction of social skills does not necessarily result in improved friendships, increased social engagement, or richer social networks?

7-1Socialization Characteristics and Implications

Social behavior is complex and varied, and it can also be subtle. It involves both verbal and nonverbal behaviors, and relies heavily on communication as a facilitator. Social behavior differs by age, but several types of general social behaviors are critical throughout the life span. For example, children and adults alike are expected to initiate and respond to interactions, take turns, understand subtle social cues, be aware of another’s point of view, and engage in activities and conversations based on shared interests.

Unfortunately, these critical skill areas are characteristically absent or limited in individuals with autism (Koegel, Matos-Freden, Lang, & Koegel, 2012). A long line of research has demonstrated deficits in social functioning of such individuals and the effects of those deficits. For example, individuals with autism not only exhibit fewer or markedly underdeveloped discrete social behaviors (e.g., making eye contact, adhering to polite social conventions) but also have fewer friendships, smaller peer networks, and greater isolation in social settings (e.g., on the playground) (Chang & Locke, 2016).

As with any other person, social initiations by a student with autism may serve many different functions. For example, a child may take the teacher’s hand and lead him to the refrigerator and then place his hand on the refrigerator door. This form of social interaction typically involves physical contact, communicative intent, and joint attention (e.g., both people are aware that they are both attending to the refrigerator) and is maintained by positive reinforcement (i.e., the function is to obtain something to eat or drink). Leading someone by the hand to help obtain a desired object (e.g., food from the refrigerator) is sometimes referred to as autistic leadingautistic leadingA term used to describe a behavior of some children with autism in which the child pulls on another person’s hand or clothing to direct the person to an object the child desires. autistic leading A term used to describe a behavior of some children with autism in which the child pulls on another person’s hand or clothing to direct the person to an object the child desires., and this behavior can be shaped into more appropriate social communication with careful intervention (e.g., Carr & Kemp, 1989). Even though the behavior may function to obtain a nonsocial reinforcer (e.g., food), that does not mean the behavior is not a social skill. All of us use our social skills to help us obtain and avoid certain stimuli and contingencies. Teachers should be mindful of the various functions that the social skills in the student’s existing repertoire serve and use that knowledge to build new social competencies. For example, building from the autistic leading that functions to obtain food may involve teaching the student to verbally request food (Carr & Kemp, 1989).

Children and youth with autism who exhibit more socially oriented behavior (e.g., they watch people in their environment, initiate limited conversations, or respond to greetings) may still experience many social obstacles and related issues. For example, a student who initiates conversations may use unusual syntax or may talk only about one or two preferred topics. In some cases, socially oriented behavior does improve as individuals age (Scott, Clark, & Brady, 2000), but without intervention limited socialization opportunities and restricted social skills will continue to detract from the individual’s quality of life (Hochman, Carter, Bottema-Beutel, Harvey, & Gustafson, 2015). Well-planned and comprehensive interventions will increase opportunities for integrated placements and likely increase options for independent functioning.

In addition, individuals with autism typically do not exhibit joint attention, an important behavior necessary for both social and language development (Mundy, 2000; White et al., 2011). Joint attention, or shared attention, is a social experience shared by two or more people and often initiated by one person. For example, a toddler who is enjoying a toy may look away from the toy to the parent in the room and back to the toy as if to share the experience with the parent. Young students watching a magic act may look at and direct expressions of amazement toward their teacher on the conclusion of a dramatic trick. When adults experience a powerful stimulus (e.g., a good joke, a beautiful painting, a disturbing sight, a surprise), they often look at other people who are sharing the same experience and smile, nod, shake their heads, or exhibit other appropriate, shared responses. Joint attention is an essential prerequisite skill for later social communication and social interaction development (Kaale, Smith, & Sponheim, 2012) and should be a target for socialization interventions, especially with young children.

Other characteristics that interfere with socialization include deficits in social imitation skills, which are important for learning new social behaviors and also help us determine appropriate behavior in specific contexts, especially new contexts. Individuals with autism may also have difficulty with acknowledging or responding to the emotions of others (i.e., displaying appropriate empathy), perseverating on topics, choosing suitable conversational topics, maintaining conversations and other social interactions, and adhering to social norms of nonverbal social interactions (Howlin, 1986; Koegel et al., 2012; Pickles et al., 2016).

One of the most challenging aspects of improving social skills in students with autism is generalization of newly learned skills (Kasari et al., 2016). As you know, students with autism often do not automatically generalize new skills to different environments, unfamiliar peers or adults, or any other change from the original learning conditions. Lack of generalization can be particularly problematic for improving social behavior and social interactions in children and youth with autism. Effective social behavior is almost entirely a process of generalizing skills to novel conditions. For example, young children learn to say “hello” in response to a greeting. They probably exhibit this skill predictably in the presence of familiar adults, but they may turn away shyly or simply not respond when greeted by an unfamiliar adult. Eventually, with practice, prompting, and reinforcement, children learn to respond not only to unfamiliar adults but also to novel greetings (e.g., “Hi there!” “Good morning” or “What’s up?”) and in new settings (e.g., school, home, synagogue). Children with autism will not generalize most skills without structured interventions to achieve that goal.

Chapter

Remediating Deficits in Socialization

· Chapter Introduction

· 7-1 Socialization Characteristics and Implications

· 7-1a Implications of Socialization Deficits

· 7-2 Social Competence Versus Social Skills

· 7-3 Assessment Strategies for Determining Socialization Curriculum

· 7-3a Assessment of Contexts and Determining Socially Valid Skills

· 7-3b Assessment of Student Skill Levels

· 7-4 Interventions for Increasing Social Skills and Social Competence

· 7-4a General Considerations for Socialization Interventions

· 7-4b Intervention Approaches

· 7-5 Facilitating Generalization of Social Skills

· Chapter Review

· Summary

· Key Points

· References

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What is That?

7-1 Socialization Characteristics and Implications

As with any other person, social initiations by a student with autism may serve many different functions. For example, a child may take the teacher’s hand and lead him to the refrigerator and then place his hand on the refrigerator door. This form of social interaction typically involves physical contact, communicative intent, and joint attention (e.g., both people are aware that they are both attending to the refrigerator) and is maintained by positive reinforcement (i.e., the function is to obtain something to eat or drink). Leading someone by the hand to help obtain a desired object (e.g., food from the refrigerator) is sometimes referred to as autistic leading , and this behavior can be shaped into more appropriate social communication with careful intervention (e.g., Carr & Kemp, 1989). Even though the behavior may function to obtain a nonsocial reinforcer (e.g., food), that does not mean the behavior is not a social skill. All of us use our social skills to help us obtain and avoid certain stimuli and contingencies. Teachers should be mindful of the various functions that the social skills in the student’s existing repertoire serve and use that knowledge to build new social competencies. For example, building from the autistic leading that functions to obtain food may involve teaching the student to verbally request food (Carr & Kemp, 1989).

In addition, individuals with autism typically do not exhibit joint attention, an important behavior necessary for both social and language development (Mundy, 2000; White et al., 2011). Joint attention, or shared attention, is a social experience shared by two or more people and often initiated by one person. For example, a toddler who is enjoying a toy may look away from the toy to the parent in the room and back to the toy as if to share the experience with the parent. Young students watching a magic act may look at and direct expressions of amazement toward their teacher on the conclusion of a dramatic trick. When adults experience a powerful stimulus (e.g., a good joke, a beautiful painting, a disturbing sight, a surprise), they often look at other people who are sharing the same experience and smile, nod, shake their heads, or exhibit other appropriate, shared responses. Joint attention is an essential prerequisite skill for later social communication and social interaction development (Kaale, Smith, & Sponheim, 2012) and should be a target for socialization interventions, especially with young children.

7-1a Implications of Socialization Deficits

Many people believe that socialization deficits are related to—even rooted in—cognitive and communication deficits. Kanner (1943) attributed the characteristic social isolation of children with autism specifically to insufficient language skills. Furthermore, development of joint attention skills in infancy is thought to be an important prerequisite to cognitive and communication development in preschoolers. Perhaps most important is that higher-level skills in joint attention in very young children appear to be predictive of better language development later (Mundy, 2000; White et al., 2011). Thus, social skill deficits negatively affect future development in other crucial areas.

Social skills are important for successful functioning in nearly all aspects of life at home, school, and work, and fluency in social behavior can affect success in school, home, community, employment, and overall quality of life (Lovaas, 1987; McEvoy & Odom, 1987; Watkins et al., 2015). Even many daily living tasks that are not directly social activities require some degree of socialization: riding the bus, shopping for groceries, walking in the halls at school, interacting with fellow employees and supervisors, leisure activities, and so forth. The degree to which a child with autism exhibits social skills and social interest is an important predictor of successful functioning later in life (Hochman et al., 2015; Matson & Swiezy, 1994; Schopler & Mesibov, 1983; Watkins et al., 2015). Indeed, individuals who exhibit better social skills are more likely to be accepted in and benefit from integrated settings in school and the community, to live with a greater degree of independence, and to work in integrated settings.

Socialization and LRE

As you have learned, the Individual with Disabilities Education Act (U.S. Department of Education, 2016a) requires students with disabilities be educated in the least restrictive environment (LRE) , and to the extent educational progress can be made in inclusive settings, the LRE means that education should occur with peers without disabilities. Decisions regarding the LRE should be determined individually for students with disabilities based on each student’s unique skills, interests, and educational goals as well as the resources available to support the student in various settings. This mandate was predicated on three principles:

1. that children with disabilities have a civil right to participate in the same activities and environments as students without disabilities,

2. that integration would result in improved attitudes of children without disabilities and general education teachers toward children with disabilities, and

3. that children with disabilities would benefit from exposure to peers without disabilities who model appropriate social, academic, play or leisure, and language skills.

The interpretation and implementation of LRE has evolved over the years from simply sending a child with disabilities to lunch or recess with typical-age peers to full-time placement of a child with disabilities in an age-appropriate general education class with a variety of support services. In addition, our understanding of the instructional procedures that are essential for children with disabilities to gain maximum benefit from integrated placements has grown tremendously. We now know, for example, that improving socialization outcomes for students with autism requires structured interventions directed both toward the child with autism and typically developing peers, along with carefully designed opportunities to interact in authentic contexts with peers. When program philosophies and practices emphasize socialization interventions and provide a wide array of opportunities for socialization, and when these practices are supported by effective intervention procedures, children and youth with autism can be expected to achieve improved social performance (Camargo et al., 2014; Chang & Locke, 2016; Kasari et al., 2016).

7-2 Social Competence Versus Social Skills

Teaching social skills is an important but insufficient goal. The purpose for teaching social skills is to improve individuals social behavior and ultimately their social functioning. But social functioning does not occur in isolation. Social functioning requires interactions among individuals, and successful social functioning requires positive, healthy, and developmentally appropriate interactions. Successful social functioning for children and youth with autism requires not only that the child with autism exhibit skilled social behavior but also that social partners respond appropriately to that behavior and that others view the child favorably (or even neutrally). This describes the difference between social competence and social skills . Social competence refers to other people’s perceptions of the social performance of an individual (Hops, 1983). Socially competent individuals are usually able to initiate and maintain friendships and interpersonal relationships, interact appropriately with authority figures, and effectively manage stressful situations. Social skills are those discrete social behaviors that are typically exhibited by socially competent individuals, such as maintaining eye contact, asking relevant questions, greeting others, taking turns in conversations and other interactions, joining peers in play, standing an appropriate distance from others, and so forth.

The distinction between social competence and social skills is important. Appropriate use of discrete social skills does not necessarily result in social competence. This means that efforts focused only on teaching discrete social behaviors to students with autism (teaching the child to make eye contact, respond to adults’ greetings, etc.) may be inefficient; the child’s skills must be considered with regard to contexts in which he or she must function, including social behaviors needed for success in those contexts and desired social outcomes within those contexts. For example, little is accomplished by teaching a child with autism to respond to peers’ greetings if peers do not initiate greetings. Nor is it particularly useful to teach a child with autism how to participate in leisure activities if he is then excluded from those activities by typically developing peers. Contextual targets include both settings (e.g., cafeteria, general education classrooms, playground) and potential social partners within those contexts (e.g., classmates and teachers).

Finally, increasing a child with autism’s repertoire of social behaviors probably will not result in that child being viewed as socially competent if he continues to engage in high levels of stigmatizing behaviors that may dissuade others from interaction (e.g., stereotypy and challenging behavior). The child’s challenging stigmatizing behaviors would likely overshadow more appropriate social behaviors, with the result that peers would not wish to interact with the student regardless of the quantity or quality of her social skills.

7-3 Assessment Strategies for Determining Socialization Curriculum

The first step in intervention for any area of instruction is to determine what the child needs to learn. Determining socialization deficits means evaluating three areas:

· (1)

contexts in which the child functions to determine the social demands in each,

· (2)

the social culture of those contexts to determine socially valid skills (skills that are reinforced in the natural environment) to teach, and

· (3)

the child’s level of socialization in those contexts to determine skills the child needs to learn.

7-3a Assessment of Contexts and Determining Socially Valid Skills

Assessment of contexts means determining contexts in which the student will—or could—potentially function and the types of opportunities for social interaction within each of those contexts. However, identification of social contexts alone is insufficient. In addition, you must identify what skills are needed within those environments and the naturally occurring reinforcement and punishment contingencies found in these environments. For example, the socialization demands of using a library may involve initiating interaction with librarians for assistance. A student with autism who attempts to talk to other students about topics unrelated to the reasons for being in the library may be redirected by the librarian or even asked to leave if the off-task talking continues or is too loud. The rules for social interaction in the library are rather standard and consistent across time. By contrast, having lunch with same-age peers would require the far different social skills of responding to peer social initiations and possibly adult directives, initiating social interactions with peers, choosing appropriate topics of conversation, understanding slang and colloquialisms used by peers, and being familiar with popular cultural references. The “rules” for lunchtime conversations are more subtle, and social responses to “rule-breaking” behavior is far different. A student with autism who talks about characteristics of animal droppings may find that other students laugh at first, but if the discourse continues, other students may verbally disapprove or move away.

The demands of specific target environments should be identified using four steps (see Table 7.1 ). The first step is to determine the target environments where students with autism will have opportunities for social interactions: cafeteria, recess, group instruction or center time in general education classrooms, and so forth.

Table 7.1

Steps in Determining the Demands of Target Environments

1. Determine the target environments where students will have opportunities for social interaction.

2. Interview teachers and other adults who supervise students in those environments.

3. Conduct ecological assessments in those environments. As part of each ecological assessment, answer these questions:

· What activities occur within this environment?

· How are these activities structured?

· What types of interactions are directed to students from teachers or other adults in the environment?

· What is the nature of peer interactions?

4. Conduct direct observations of typically developing peers in those environments.

· Conduct anecdotal reports.

· Identify specific social behaviors exhibited by peers.

· Measure the most critical behaviors using event recording or duration recording.

Enlarge Table

The second step is to interview teachers and other adults who supervise those environments. Interview questions posed to these adults should focus on the type of social activities that occur (large or small groups of students, structured or unstructured, etc.), the nature of social interactions during those activities (informal or following specific rules or procedures, fixed groups versus fluid groups in which students come and go, etc.), and the types of social skills needed for success in those activities. The interviews should elicit the adults’ opinions about the social demands of those environments and activities.

The third step is to conduct an ecological assessment that is designed based on the information obtained from your interviews. This process will result in an inventory of socialization demands, as well as skills needed for communication, play, work, self-determination, and so forth. For this ecological question, we recommend answering the following four questions:

1. What activities occur within this environment? For example, activities in the cafeteria might include waiting in line, getting food, moving to a table, eating, disposing of trash, and then exiting the cafeteria.

2. How are these activities structured? Activities may be teacher directed (e.g., small-group instruction or a teacher-led game); structured, but not teacher directed (e.g., peer tutoring or cooperative learning activities, lunch, bus rides); or unstructured (e.g., free time, passing in hall between classes, recess, break time at work). Each type of structure may require social skills with a different nuance. For example, delivering an appropriate social greeting may be an important skill across many environments, but the form of that greeting (e.g., “Hello, how are you?” or “Hey, man! What’s up?) will likely depend on whether or not the environment is, for example, a formal work setting or a meeting with friends.

3. What types of interactions are directed to students from teachers or other adults in the environment? For example, do adults mostly give directives that require no response or directives that require a response? Or do they initiate social conversation with children in the area (e.g., a cafeteria monitor asking a student what she did over the weekend)?

4. What is the nature of peer interactions? This question addresses the important issue of selecting socially valid skills to teach. For example, in the cafeteria, students with autism will probably not only need to learn to talk to peers but also may find it beneficial to be familiar with popular TV, YouTube, video game, and music references. Elementary students may talk about their latest Minecraft™ world or a ROBLOX™ game they played. Secondary students may talk about texts they have received or sent, social media, or upcoming extracurricular activities. On the other hand, playground interactions may require a completely different set of skills, such as initiating a request to participate in an activity or share equipment, giving and following directions during a game, and talking to one another.

The last step in determining the social demands of target environments is to conduct direct observations of typically developing same-age peers in those environments as they engage in target activities. The behavior observation methods described in Chapters 2 and 3 can be used for this purpose. For example, if the target environment is center time in a general education kindergarten class, then you might first observe using A-B-C recording during center time. The A-B-C record will probably help you then generate informal ecological assessment questions to consider about the specific environment in which you collected that data (e.g., kindergarten class) and related subenvironments (dress-up center, sand table center, blocks center, etc.) and activities (stacking blocks, sharing sand tools, etc.). In addition, from information gathered in the A-B-C report, you could extrapolate specific social behaviors that are likely to be exhibited by the target group (joint attention to activities, asking for blocks, taking turns, laughing at silly dress-up combinations, etc.).

Next, you could use event recording (or duration recording as appropriate) to determine at what rate certain skills are demonstrated or for how long. For example, you might measure the average rate at which students initiate verbal interactions with one another or the average duration of a conversational exchange. This information will help teachers establish valid target skills and criteria.

Information gathered through informal ecological assessment will constitute the framework for skills needed by a given student to facilitate full participation in social contexts. This information will help in the curriculum-development process described in Chapter 4 . For example, as you will recall from Chapter 4 ( Table 4.3 ), the first step in the curriculum-development process is to establish goals. The following are sample goals for socialization.

· Long-term goal: The student will live with a roommate without the need for check-ins from support staff or family more than once per week.

· Intermediate goals:

The student will engage in cooperative cooking and cleaning activities (e.g., making lunch, tidying the living room).

The student will initiate conversations with others.

· Short-term goals:

The student will initiate questions directed to peers and teachers.

The student will share supplies during a cooperative activity.

The student will ask for supplies as needed.

The student will exhibit joint attention during an activity with an adult or peer (e.g., while playing a multiplayer video game).

Teachers will need to task analyze target skills to facilitate instruction. For example, one of the skills identified as important to success in the cafeteria might be “responding to and talking with a peer who initiates.” This general skill could be task analyzed into the following steps:

· Look at the person who spoke.

· Think about what he or she said.

· Respond appropriately (e.g., answer question or make a comment on the same topic).

· Listen for peer to respond.

· Repeat as appropriate.

Understanding the discrete steps involved in a complex skill such as “talking to a peer” will help you better identify what needs to be taught, prompted, or reinforced (Ledbetter-Cho et al., 2015).

Once the requisite skills have been identified, the next step is determining the student’s level of proficiency in those skills. Skills that the student lacks become targets for instruction. Skills that are present but weak need to be strengthened through either increased opportunities for practice or stronger reinforcement for exhibiting the skills.

7-3b Assessment of Student Skill Levels

Student proficiency in target skills may be evaluated directly using direct-observation techniques, indirectly using rating scales, or via a combination of the two approaches. Direct-observation techniques use event recording or duration recording to measure the number, rate, percent, or duration of discrete skills, as described in Chapters 2 and 3 . Table 7.2 lists the steps used in direct observation to assess the use of social skills.

Table 7.2

Steps in Assessing Social Skills Using Direct Observation

1. Determine the skills you wish to assess as described operationally. The following are examples of operational definitions of social skills.

· Conduct anecdotal reports.

· Taking turns: Student waits while other students take their turns in an activity; student participates without prompting when it is his turn.

· Initiating interactions with peers: Student stands 2 to 3 feet from peer; within 5 seconds of approach, student says peer’s name and makes a comment appropriate to the situation: asks a question, asks peer to play a game, asks to join a game, gives a compliment, and so on, and then waits for peer’s response.

· Responding to peers’ initiations: Given an initiation from a peer (question, invitation, etc.), student responds appropriately (answers question, says “yes” or “no” to the invitation, etc.) within 5 seconds.

· Playing with a friend: Student participates appropriately in an activity that requires turn taking or sharing with one or more peers (e.g., playing four square, jumping rope, playing a video game, playing a board game, using the slide).

2. Determine the most appropriate measurement system for each skill. For the skills previously described, appropriate measurement systems would include the following.

· Taking turns: Event recording

· Initiating interactions: Event recording

· Responding to peers’ initiations: Event recording (measure the SD [peer initiation] as well as the student’s response)

· Playing with a friend: Duration recording

3. Select a time and place to observe. Remember that you should observe when and where the skill is needed. Therefore, if you wish to increase a student’s participation in social interactions during recess, you should observe during recess.

4. As you observe your target student, collect data for the same skills on a typical peer selected at random. This will provide an indication of the level of socialization that may be required for successful participation (if this step has not been completed during the process of identifying target skills). Data on peers’ skills may also help determine a target criterion for your student(s).

· Once data have been gathered, the last step is to compare your student’s data against that of peers and then develop objectives for intervention.

Enlarge Table

There may be circumstances in which you do not want to assess your students’ social behavior in authentic contexts. For example, if you have concerns that a student may exhibit challenging behaviors, especially aggressive or self-injurious behaviors, in the new or unfamiliar social context, then it would not be wise to place the child in that context to assess his or her social skills. For times when it is unwise or impractical to assess students’ social skills in real contexts, role-play assessment may be the preferred approach (Matson & Wilkins, 2007). Role-plays consist of adults playing the role of peers during target social activities (e.g., playing during recess, sharing a snack during a break between classes). The student’s social skill responses (or lack thereof) are recorded by the participating adults or by an observer (e.g., Ledbetter-Cho et al., 2016).

Another way to evaluate students’ use of social skills is with formal social and behavior scales. Table 7.3 lists commercially available scales in these areas. Note that some of these instruments have not been normed on students with autism and developmental delays but may provide helpful information, particularly about the student’s level of socialization in environments outside of school or progress in skill acquisition over time.

Table 7.3

Rating Scales for Assessing Social Skills

· Social Skills Improvement System (SSIS) Rating Scales, Gresham and Elliott (2008)

This classic social skills rating system intended for students from ages 3 to 18 measures social skills, competing problem behaviors, and academic skills across four subscales, including an “Autism Spectrum” subscale. Companion intervention guides are available from the publisher.

· Social Responsiveness Scale™, 2nd ed. (SRS™-2), Constantino (2012)

The SRS-2 is designed to assess the severity of social impairment in children and adults (ages 2.5 years to adult) with autism through the use of parent or teacher rating scales (or both). The rating scales provide a total score, plus five subscale scores and two subscales compatible with the DSM-5. A bachelor’s or master’s degree in special education, education, psychology, school counseling, or related fields is required.

· Matson Evaluation of Social Skills with Youngsters (MESSY), Matson, Rotatori, and Helsel (1983)

Parents or teachers complete the MESSY (or the MESSY-II), which consists of Likert-style items. Resulting scores are reported in three subscales.

· Behavioral Characteristics Progression (BCP), VORT Corporation (1997)

This is one of the most comprehensive programs available, a distinction that also makes it a bit unwieldy. The BCP includes 2,300 behaviors arranged in 56 strands. Social–emotional skills are addressed throughout the BCP. A companion instructional activities guide is available from the publisher.

Enlarge Table

We should also reiterate that functional behavioral assessments (explained in Chapter 3 ) should result in hypotheses that indicate social skill deficits that may become targets for instruction.

Discrepancies between social demands of target environments and a student’s level of proficiency in those skills becomes the basis for determining the social skills curriculum for that child. Target skills need to be directly taught via prompting and reinforcement in all pertinent environments. We discuss methods for teaching social skills in the remainder of this chapter

7-4 Interventions for Increasing Social Skills and Social Competence

As you learned in Chapter 1, the Individuals with Disabilities Education Act (U.S. Department of Education, 2016a) requires that students with disabilities be educated in the LRE and with general education peers to the greatest extent possible. Fortunately, general education settings and activities are valuable venues for interventions to improve social behavior in students with autism. Without opportunities to interact with typically developing peers, it would be difficult to teach socially valid social skills and achieve generalization of those skills to natural contexts. In the remainder of this chapter, we describe evidence-based interventions for improving social behavior in students with autism. We first discuss overarching considerations for improving social behaviors. Next, we describe specific strategies in two categories: teacher-mediated interventions and peer-mediated interventions. Finally, we discuss how to facilitate generalization of newly learned skills.

7-4a General Considerations for Socialization Interventions

Several approaches have shown promise for improving the social skills, and ultimately the social competence, of students with autism. However, no matter what techniques are chosen to increase social skills, educators are more likely to achieve desired outcomes if certain considerations are observed, many of which relate to contextual factors associated with socialization interventions. A good number of these recommendations revolve around the importance of providing opportunities for practicing social behaviors in actual social contexts that involve peers without disabilities.

Start Early

Children with autism often exhibit characteristics of social withdrawal at extremely young ages (Osterling & Dawson, 1994; Scott et al., 2000). Given the correlation between socialization, cognition, and communication and the predictive aspects of socialization, the earlier interventions are implemented, the better the outcomes (Chang & Locke, 2016; Dawson et al., 2012). Inclusion in general education environments at a young age helps children with autism better learn social and play behaviors, assuming formal interventions are provided to improve target skills (Camargo et al., 2014; Whalon, Conroy, Martinez, & Werch, 2015). Many early intervention programs (birth to age 3) and early childhood programs (ages 3–5) provide structured opportunities for interaction with peers—typically developing peers or peers who have disabilities but exhibit developmentally appropriate social skills.

Teach Social Skills in Context

Socialization interventions are far more effective when provided in socially rich contexts in which peers and naturally occurring social stimuli and reinforcers are present (Chang & Locke, 2016; Whalon et al., 2015). It is difficult, if not impossible, to accurately imitate the SDs and contingencies of natural social interactions outside of those contexts. For example, it is probably not feasible to duplicate those social stimuli present in a play group of typically developing children (e.g., requests to play, comments about ongoing play activities, peer-to-peer instructions regarding a play activity) in a group solely composed of children with autism. Teaching children with autism to recognize and respond to those stimuli requires that they are repeatedly exposed to natural social stimuli and naturally occurring social reinforcers.

Teach Activities Preferred by Peers without Disabilities

Students with autism should be taught to use the materials that are commonly part of the social repertoire of typically developing students. For example, Koegel, Werner, Vismara, and Koegel (2005) found that teaching students with autism to engage in activities preferred by peers without disabilities, such as playing board games, playing with dolls, and painting, resulted in improved reciprocal social interaction and child affect. Therefore, as part of the ecological assessment process, teachers should carefully observe the types of toys, games, activities, gestures, verbal expressions, popular culture references (e.g., Star Wars™), and perhaps even clothing that are preferred by peers without autism. Then children with autism should be taught typical use of these materials and activities as part of socialization interventions.

Reduce Challenging Behaviors

Before and even while placing students with autism in natural social contexts with typically developing peers, teachers and others must address challenging behaviors exhibited by the students with autism. Challenging behaviors should be assessed using functional assessment (see Chapter 3 ), and interventions should be implemented to reduce those behaviors and establish functional replacement behaviors. Behaviors such as self-stimulation, self-injury, and aggression will undoubtedly result in fewer social initiations from peers and may result in the student with autism being restricted from participating in those activities. Furthermore, children with autism who exhibit such behaviors may become targets of negative social interaction such as bullying (Didden et al., 2009). Children with autism probably do not need to be completely free of negative behaviors before socialization interventions (Simpson, Myles, Sasso, & Kamps, 1997), but they must be basically compliant and safe (e.g., pose no threat of harm to themselves or peers) and have ways to communicate their wants and needs.

Teach Pivotal Behaviors

Koegel and his colleagues recommend targeting pivotal behaviors , or behaviors that are central to many areas of functioning (Mohammadzaheri, Koegel, Rezaei, & Bakhshi, 2015). Pivotal behaviors serve a similar purpose in a variety of areas of functioning, including social functioning (Koegel & Koegel, 1995). As such, they can lead to higher-quality social interactions and can improve generalization across behaviors and environments. Comprehensive socialization planning should include interventions targeting pivotal social behaviors (Koegel et al., 2012). Potential pivotal behaviors for improving socialization include initiating interactions, communication, using appropriate affect, responding to initiations, engaging in joint attention, and terminating interactions.

Guard Against Potential Problems Related to Inclusion

In 2013, approximately 40 percent of students receiving special education services for autism were educated in general education classes for 80 percent of the day or more (U.S. Department of Education, 2016b). An additional 20 percent spent approximately half of their day or more in general education settings. Although inclusion in general education offers significant opportunities, especially for socialization interventions, educators must guard against “inclusion missteps” (Schwartz, 2006, p. 87). We describe potential problems of inclusion with respect to socialization goals in Table 7.4 . Fortunately, these problems can be avoided with the careful assessments described in Chapters 3 , 4 , 6 , and this chapter by ensuring that evidence-based interventions are applied in the general education settings where students are taught and by teaching general education teachers and peers to deliver these interventions (Giangreco, Halvorsen, Doyle, & Broer, 2004; Koegel et al., 2012).

Table 7.4

Potential Problems with Inclusion

1. Placement without planning. Improvements in social behavior will probably not simply happen regardless of placement. Simply exposing students with autism to typically developing peers will not lead to acquisition of targeted social behaviors. Socialization interventions must be formally planned for general education settings, and they must be based on relevant ecological and functional assessment data.

2. Placement without objectives. Sometimes, particularly for students with autism who are educated in separate classes for much of the day, access to the general education class is determined by existing activities (e.g., lunch, recess, story time, library, PE) that “would be good for” the students with autism. Certainly, special educators need to take advantage of those existing activities as opportunities for students with autism—but with careful planning of instructional goals for the student with autism during those activities. Thus, general education activities should be selected by the individualized educational program team, along with the instructional objectives that will be taught in those activities and the instructional methods that will be used.

3. Placement with overreliance on adult support. The push for students with disabilities to spend all or most of their day in general education has led to significant increases in the number of paraprofessionals being employed to support those students in general education classes (Giangreco et al., 2004). Unfortunately, reliance on paraprofessionals as the primary support for special education services may be ill advised for many reasons, including concerns about training and preparation of paraprofessionals for these roles (Giangreco, 2009). Research has demonstrated detrimental effects of one-to-one support for students with disabilities, including lower levels of teacher and peer interactions directed toward the student with a disability, isolation within the general education classroom, insular relationships between the students and the paraprofessional, and increased dependency on the paraprofessional (Giangreco, 2009; Giangreco et al., 2004).

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Emphasize Generalization

Children can be taught to exhibit discrete social skills in structured situations relatively efficiently, in many cases. The challenge is teaching students to use those skills in new situations, where all of the familiar original learning conditions have changed. Generalization is among the most essential components of learning (Stokes & Baer, 1977). If skills do not generalize to real-life conditions, the student has gained little. A large body of research has delineated specific strategies for facilitating generalization, some of which were described in Chapter 5 . Later in this chapter, we will present generalization strategies that are that are particularly well suited for social skills.

7-4bIntervention Approaches

Three general approaches to intervention delivery have been used successfully to improve social behavior in students with autism: teacher-mediated interventionsteacher-mediated interventionsSocialization interventions that are directed by the teacher. Include direct instruction of social skills, story-based interventions, and antecedent prompting. teacher-mediated interventionsSocialization interventions that are directed by the teacher. Include direct instruction of social skills, story-based interventions, and antecedent prompting., self-mediated interventionsself-mediated interventionsSocialization interventions in which the student with autism does something to facilitate the use of target skills, such as self-monitoring or video self-modeling. self-mediated interventionsSocialization interventions in which the student with autism does something to facilitate the use of target skills, such as self-monitoring or video self-modeling., and peer-mediated interventionspeer-mediated interventionsSocialization interventions that rely on socially competent peers to initiate and maintain social interactions with students with autism. peer-mediated interventionsSocialization interventions that rely on socially competent peers to initiate and maintain social interactions with students with autism.. Although each of these intervention delivery approaches has been shown to improve the social performance of students with autism, research supports the use of multicomponent interventions, in which two or more of these procedures within or across these categories are applied in combination (Camargo et al., 2014; Simpson et al., 1997; Whalon et al., 2015). For example, teacher-mediated direct instruction could occur in the classroom, and then peer-mediated intervention could be arranged during recess. In the following sections we describe specific interventions in each of the categories previously described.

Teacher-Mediated Techniques

Two types of teacher-mediated interventions have been used to increase social behavior in children and youth with autism and developmental disabilities. The first is direct instruction of target skills, which typically involves discussion, modeling, and role-playing target skills. The second is social stories.

Direct Instruction of Social Behaviors

The first teacher-mediated approach to improving socialization is direct instruction of social skills. In a direct-instruction approach, specific social skills are taught using procedures much like those used to teach academic skills. Generally this means that specific skills are taught in a teacher-led small-group format using explanation, demonstration, practice, and feedback; and that other behavioral procedures (e.g., self-monitoring, prompting, reinforcement) are used to facilitate generalization of skills. In Vignette 7.1 , we present a description of a direct-instruction approach for teaching social skills.

Vignette 7.1

Ms. Jacobs Teaches Social Skills

Ms. Jacobs teaches an intermediate class for students with autism, ages 9–11. Each of her students participates in several different general education activities such as lunch, music, science, and language arts. Despite having many opportunities to interact with general education peers, Ms. Jacobs’ students typically interact little. They respond minimally to peer initiations and do not initiate interactions.

Ms. Jacobs believes that her students do not know many basic social interaction skills. To remedy the problem, she has implemented a social skills instruction program. First, she made careful assessments to determine skills to teach. She observed both her students and their peers in general education environments and interviewed peers and teachers. This assessment indicated approximately 15 skills that seemed critical for social success. Skills targeted for instruction included answering questions, asking questions, carrying on a conversation with peers of at least several sentences, using humor, sharing, and taking turns.

Next, Ms. Jacobs solicited four peers from general education classes to assist with social skills instruction. These peers were students familiar to her students and were selected because they had been observed attempting to interact with the students with autism. The general education peers simply participated in the group instruction, just as did the students with autism.

Finally, Ms. Jacobs began instruction. The social skills group met daily for 20 minutes per session. One or two of the four peers attended each group. The first skill taught was “answering questions.” Ms. Jacobs first explained what “answering questions” meant, and she gave several examples from her students’ daily lives. Next, Ms. Jacobs and her paraprofessional, Ms. Rogers, modeled the skill: the paraprofessional posed questions to Ms. Jacobs similar to the types of questions peers might ask. Ms. Jacobs would “think out loud” (“She asked me a question. I need to look at her and answer her.”) and then reply to the question. Ms. Jacobs and Ms. Rogers demonstrated several examples of “answering questions.” After each example, Ms. Jacobs asked for feedback from students (“Did I answer the question? Did I look at my friend?”). Next, one of the general education peers role-played the skill with either Ms. Jacobs or Ms. Rogers. Again, after each role-play, Ms. Jacobs asked other students for feedback about the peers’ use of the skill. After that, the peer and the students with autism (one at a time) role-played the skill, with other students giving feedback. The peer was instructed to ask questions similar to those typically posed at lunch or other noninstructional situations. Ms. Jacobs provided examples. Each successful role-play was accompanied by praise from the teachers.

As she was teaching the skill, Ms. Jacobs used a chart with a picture representing the skill and listing the steps to serve as a reminder for her students to use the skill. This chart was used at the start of each group to review the steps in the skill.

Once every student had successfully demonstrated the skill in role-play situations, students were shown a form that had the picture representing the skill at the top of the page and five blank boxes at the bottom. Students were informed that Ms. Jacobs or Ms. Rogers would be watching them at various times, and when students used the skill of answering questions, they would earn a sticker. When all five boxes were filled, they could take the form to the principal for a special treat.

Each time a student left the classroom to attend a general education activity, he or she was reminded about using the skill of answering questions and the steps involved. Ms. Jacobs and Ms. Rogers observed students at random times throughout the day. After each observation (e.g., at lunch), the adult gave the student feedback about his or her use of the skill and, if appropriate, gave a sticker for the student to apply to the form. In addition, any time any student was observed using the skill in any situation, Ms. Jacobs or Ms. Rogers would place a star on a chart that had a picture depicting the skill in the middle. When all the empty boxes on the chart were filled with stickers, the class could select a special group activity to do that day (e.g., make popcorn, play a game, go for a walk).

The last component of the direct-instruction approach was that Ms. Jacobs informed the general education teachers and peers as skills were being addressed. She asked these individuals to praise her students any time they observed the students using the skill correctly.

Ms. Jacobs spent approximately one and one-half weeks on each skill. In addition, from time to time, she conducted review sessions for all previously learned skills. According to Ms. Jacobs’ data, her students’ use of the targeted skills increased dramatically after instruction. Although work remained to be done to improve her students’ socialization skills, Ms. Jacobs knew her students were now far better prepared to interact with their general education peers.

The effectiveness of direct-instruction social skills lessons can be increased by including typically developing same-age peers who are skilled in the social behaviors being taught (e.g., Peters, Tullis, & Gallagher, 2016). Peers serve as models and help with the role-play practice. The advantages of using peers are the increased likelihood of students with autism modeling peers’ use of the skills being taught (e.g., Bandura, 1977), more realistic practice scenarios, and more realistic responses to target students’ use of skills during role-play practice.

Table 7.5 describes the steps in a direct-instruction approach to teaching social skills. One major disadvantage of a direct-instruction approach is that skills acquired and demonstrated in the instructional setting often fail to generalize—that is, students may demonstrate proficiency in a skill during the social skills lesson but never use the skill in a natural environment (e.g., the cafeteria, playground, hallways, inclusion classes). Teachers can increase the likelihood of generalization by incorporating the strategies for enhancing generalization described in the next section and by observing the general recommendations for socialization interventions noted earlier in this chapter.

Table 7.5

Direct-Instruction Sequence for Teaching Social Skills

Direct instruction of social skills typically involves the following steps:

1. Describe the skill and why it is important (rationale). The description should include the task-analyzed steps of the skill being taught.

EXAMPLE: “Today we’re going to learn how to ask a friend to play with you. When you know how to ask a friend to play, you can play games that you like during recess and after school. Toni, you like to jump rope. You might ask a friend to play jump rope with you. Blake, you like to run. You could ask a friend to play tag with you.” (Teacher would continue giving an example of how this skill could benefit each student.)

“Here’s how you ask a friend to play” (pointing to a chart with written or pictorial steps of the skill):

· Think about what game you would like to play.

· Decide which friend you want to ask.

· Walk over to your friend.

· Look at your friend and say in a nice voice, “Would you like to playwith me?”

· If your friend says “no,” choose another friend to ask.

2. Demonstrate the skill. Usually the paraprofessional or another adult assists the teacher with this step. You should demonstrate the skill several times; the more examples, the more likely students are to understand how to perform the skill.

EXAMPLE: “Let me show you how you ask a friend to play. Let’s pretend we’re on the playground. I’m standing here by myself but I want to play.” (Now teacher begins to act the part of a student on the playground as the other adults or students without disabilities are engaged in “playground” activities away from her.)

· (Teacher talks aloud to herself): “I’d really like to play catch. I think I’ll ask Alicia if she wants to play with me….”

· (Teacher approaches “Alicia”): “Alicia, do you want to play catch with me?”

· (Other adult or peer): “Sure! I’ll get the ball.”

(NOTE: If students without disabilities are participating, they can be called on to demonstrate the skill).

3. Solicit student feedback on the skill. The teacher asks individual students to identify whether she correctly performed each step.

EXAMPLE: “Did I decide what game I wanted to play?” (get student responses); “Did I ask someone to play?” (have students name the friend); and so forth.

4. Have students role-play the skill. Each student should practice the skill at least once and more if needed. During the students’ role-play, other participants are needed to play the roles of other students. These can be the adults in the class or, preferably, peers without disabilities. Each role-play situation should reflect individual student preferences, styles, and so forth. If peers without disabilities are participating, they should demonstrate the skills first.

EXAMPLE: “Toni, it’s your turn to practice asking a friend to play. Let’s pretend we’re on the playground after lunch. What game do you like to play?” and so forth. Teacher arranges the role-play to reflect the situation on the playground.

5. Provide feedback on student performance of the skill. After each role-play, the teacher should solicit feedback from other students in the group about the role-play. The teacher should also give feedback to the student doing the role-play.

EXAMPLE (to other students): “Did you see Toni decide what game she wanted to play? What did she want to play? Did she ask her friend nicely?” and so forth.

Role-play continues until each student has had the opportunity to practice the skill.

6. Do generalization activities. Generalization activities take place after each student has demonstrated proficiency in the skill during the role-play sessions. The purpose of generalization activities is to facilitate use of target skills in natural settings. Generalization activities might include games that require students to use target skills, self-monitoring procedures in which students keep track of their use of skills in generalized settings, and reinforcement contingencies for use of target skills in generalized settings. One important generalization strategy is to conduct social skills lessons in environments in which skills are to be used (Frea, 1995). For example, the skill of asking a student to play might be taught on the playground. The skill of responding to greetings might be taught in the hallway and at the bus area.

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Social Skills Curricula

Several commercial social skills curricula use a direct-instruction approach and may be helpful in guiding social skills instruction (see Table 4.4 in Chapter 4 for a listing of social skills curricula). The ACCEPTS (A Curriculum for Children’s Effective Peer and Teacher Skills) and ACCESS (Adolescent Curriculum for Communication and Effective Social Skills) curricula are highly structured, even providing a script for teachers to follow. These are easy to use, and teachers who have never taught social skills appreciate the guidance that the script offers. The Skillstreaming series [Skillstreaming in Early Childhood, Skillstreaming the Elementary School Child, and Skillstreaming the Adolescent (all McGinnis, 2011)] are less structured, presenting each lesson in a brief outline form. Helpful features include the fact that each skill is task analyzed, and several self-monitoring forms are included for use with each skill. The Social Skills Improvement System (SSIS) Intervention Guide is coordinated with the Social Skills Improvement System (SSIS) Rating Scales (Gresham & Elliott, 2008; see Table 7.3 ).

However, commercial curricula should be used with three caveats in mind. First, most commercial social skills curricula have been field tested with students with autism. Second, the skills included in each curriculum may not match the skills needed by your students, as indicated by your ecological assessment data. Finally, the instructional procedures recommended may need to be slightly modified, depending on your students’ language levels.

Instructional Scripts

One variation on the direct-instruction approach involves using social scripts as a part of social interaction training. Haring and Ryndak (1994) describe social scripts as “routine social interaction patterns that can be repeated many times in a variety of contexts” (p. 303). As you have learned, social skills deficits and communication deficits are strongly interrelated. Children and youth with autism may have difficulty generating situation-appropriate words and phrases because of their language and communication deficits. Social scripts are useful in prompting students to use appropriate words in social interaction situations. Students are able to focus on other variables of the social situation without the obstacle of not having the words to say. Social scripts have been shown to be an effective intervention component with both preschoolers and adolescents with autism (e.g., Camargo et al., 2014; Goldstein & Cisar, 1992; MacDuff, Ledo, McClannahan, & Krantz, 2007).

To use social scripts, first identify situations in which scripts may be beneficial to facilitating social interaction. For example, perhaps the teacher’s assessment reveals that peers without disabilities often extend verbal greetings to one of his students in the halls as the student is walking to class in the morning, but the student does not respond. The teacher could develop a generic script that would enable the student to respond appropriately to any greeting, such as “Hi, how are you?” or “Hey, how’s it going?” or “Hi, see you later!” The teacher could then use a direct-instruction approach to teach the student to say these words in response to greetings.

Social scripts may be written or pictorial and can provide specific instructions or general prompts. As students begin consistently exhibiting the target social behaviors, the social scripts should be altered or faded to reduce the likelihood of the student becoming dependent on the script (Ledbetter-Cho et al., 2016).

Story-Based Interventions

In story-based interventionsstory-based interventionsA socialization intervention in which a brief, individualized story is read to a student immediately before a situation where challenging behavior is expected to occur. The purpose of the story is to remind the student of expected behavior(s) to use in that situation. story-based interventionsA socialization intervention in which a brief, individualized story is read to a student immediately before a situation where challenging behavior is expected to occur. The purpose of the story is to remind the student of expected behavior(s) to use in that situation., a brief, individualized story is read to the student immediately before a situation where challenging behavior is expected to occur. The purpose of the story is to remind the student of expected behavior(s) to use in that situation. Social Stories™Social Stories™A commercial story-based socialization intervention in which brief situation- or behavior-specific stories are read to the student immediately before certain activities. Social Stories™A commercial story-based socialization intervention in which brief situation- or behavior-specific stories are read to the student immediately before certain activities. are one version of story-based interventions. Social Stories™ consist of brief, structured stories that describe specific social situations a student will encounter and appropriate responses to the social stimuli that will be encountered in that situation (Gray & Garand, 1993).

Story-based interventions are individualized to each student’s social needs and can be developed for virtually any social situation the student will encounter (initiating greeting, waiting turns, sharing, responding to social initiations, etc.). Story-based interventions have been demonstrated to improve social behavior (communication, interpersonal, and self-regulation skills) and decrease challenging behaviors for some students with autism (e.g., Chan & O’Reilly, 2008; National Autism Center, 2015; Whalon et al., 2015). This intervention is thought to be beneficial because the individualized stories combine information about needed social skills with visual cues (pictures or words or both). We recommend, however, that stories not be used in isolation but as one component of a comprehensive social intervention plan that includes direct instruction of target skills, antecedent prompting, or peer-mediated interventions.

To create a story-based intervention, a target social situation is identified, along with the social stimuli the student will encounter in that situation and desired student response( s) to those stimuli. Next, the stories are put in written format, using approximately two to five sentences, and written using language and print size appropriate for the student. For students who need visual cues, one or more pictures or icons should be used to represent each sentence.

Gray and Garand (1993) recommend including three types of sentences in a social story:

· (1)

descriptive sentencesdescriptive sentencesUsed in social stories to provide information about the social context (setting, people, activities, etc.) targeted in the story. descriptive sentencesUsed in social stories to provide information about the social context (setting, people, activities, etc.) targeted in the story., which provide information about the social context (setting, people, activities, etc.);

· (2)

directive sentencesdirective sentencesUsed in social stories to instruct the student what to do in a particular social situation. directive sentencesUsed in social stories to instruct the student what to do in a particular social situation., which tell the student what to do; and

· (3)

perspective sentencesperspective sentencesSentences used in social stories to describe feelings of individuals involved in particular social situations. perspective sentencesSentences used in social stories to describe feelings of individuals involved in particular social situations., which describe feelings of individuals involved in the situation.

For example, say you need to teach a student how to transition from a preferred activity to a less preferred one without tantrums. Figure 7.1 shows an example of a story that might be used for that purpose.

Figure 7.1Example of a Social Story

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The teacher reads the story to the student just before the target social situation several days in a row. In the example in Figure 7.1 , the story should be read to the student just before center time. Once the story has been introduced, students should be allowed access to it throughout the day. In addition to these guidelines, Scott, Clark, and Brady (2000) recommend having the student practice the target behavior in conjunction with reading the story. For example, the story in Figure 7.1 might be read to Brent; then during or after the story he should practice the target behaviors (putting a toy back on the shelf, walking to group, sitting in his chair).

Antecedent-Prompting Procedures

Antecedent prompting is a strategy in which the teacher uses one or more types of prompts to facilitate the student exhibiting an interactive behavior, which is then reinforced by peers and the teacher. Antecedent promptingAntecedent promptingInstructional technique in which an adult remains in proximity to the student in natural settings and uses words, gestures, pictures, or touch to encourage the student to engage in a particular behavior. Antecedent promptingInstructional technique in which an adult remains in proximity to the student in natural settings and uses words, gestures, pictures, or touch to encourage the student to engage in a particular behavior. requires placing the student in a natural context that involves social interaction with one or more socially competent peers (e.g., sharing a toy, sharing a video game, playing a game, sharing a snack). The teacher remains in proximity to the child with autism and provides prompts to the child to initiate or respond to a social interaction. Although verbal prompts are the most common, other prompts could be used as well (gestures, pictures, etc.; see Chapter 5 ). Typically, peers are instructed to respond positively to any initiations by the student with autism.

Ms. Jacobs, whom you met earlier in this chapter, uses antecedent prompting, in addition to direct instruction, as part of her socialization program. Vignette 7.2 describes how Ms. Jacobs uses antecedent prompting.

Vignette 7.2

Ms. Jacobs Uses Antecedent Prompting

Remember Ms. Jacobs from Vignette 7.1 ? In addition to directly teaching social skills, she also uses antecedent-prompting procedures with each of her students. To do this, she and her paraprofessional, Ms. Rogers, accompany their students to activities that involve social interaction with peers and adults without disabilities. In these situations, any time there is an opportunity for their students to initiate or respond to a social initiation, they first wait 5 to 10 seconds to give their students an opportunity to respond independently. If they do not, Ms. Jacobs or Ms. Rogers prompts the correct behavior. Some of the many instances in which they use antecedent prompting include the following:

· During game time, in which general education students join the class for a variety of games and leisure activities. Stations are set up around the room, and students choose their preferred activity. During the game or activity, students are expected to make appropriate social initiations (“Do you want to play checkers?”—asking questions pertinent to the game) and responses (answering questions pertinent to the game).

· While waiting for the bus, students are expected to interact with peers by making greetings, asking questions, and responding to greetings and questions.

· In the lunch line, students are expected to indicate their food choices either verbally or by pointing. At the end of the line, they are to say “Thank you” when given their food and “You’re welcome” when the cashier says “Thank you.”

Antecedent prompting has been found to effectively increase social interaction, particularly when the intervention includes multiple interaction opportunities with competent peers in natural contexts (Simpson et al., 1997; Whalon et al., 2015; White et al., 2011). However, potential negative aspects of the procedure have been noted. These include interruption of a naturally occurring social exchange (Strain & Fox, 1981), and children with autism becoming prompt dependent, exhibiting social behavior only when prompted to do so (Odom & Strain, 1986). We recommend the following guidelines for using prompts, as well as the guidelines described in Chapter 5 :

1. Use prompts only if needed. Prompt only if the student has not initiated or responded within a reasonable period of time (e.g., 5 to 10 seconds). When using prompts for social behavior, be careful not to interrupt the natural flow of social interaction to provide a prompt. The prompt is used only if the student fails to respond.

2. Use the least intrusive prompts needed to solicit target behaviors. Use verbal prompts if possible; if those fail to produce desired responding, physical prompts may be needed. Use partial verbal prompts; if those do not produce the desired response, use full verbal prompts.

3. Fade prompts as soon as possible. Use prompts as needed at first and then gradually increase the time that elapses between the opportunity for a social behavior and the teacher prompt. Also fade the level of prompts used. For example, if you begin training using full verbal prompts (“Eric, say ‘Yes, I’d like to have a turn.’”), move to partial verbal prompts as soon as possible (“Eric, what do you say?” or “Eric …?”).

4. If you detect that students are becoming prompt dependent, switch to another intervention or add a contingency in which unprompted initiations or responses are reinforced, using reinforcers in addition to naturally occurring social reinforcers. For example, a prompt-dependent student might earn tickets for each unprompted social initiation or response. Prompted social behaviors do not earn tickets. When he has accumulated 10 tickets, he may exchange them for use of a preferred material or activity for 10 minutes.

Self-Mediated Techniques

Self-mediated techniques use strategies that involve the student doing something to facilitate the use of target skills. For purposes of this discussion, the self-mediated techniques we present are self-monitoring and video self-modeling.

Self-Monitoring

Self-monitoringSelf-monitoringA self-mediated socialization intervention in which a student is taught to systematically record each time a target behavior is performed. Self-monitoringA self-mediated socialization intervention in which a student is taught to systematically record each time a target behavior is performed. involves targeting a specific behavior, then teaching the student to systematically record each time that behavior is performed. Self-monitoring should also be considered a generalization strategy. It would not be appropriate to have students self-monitor skills that have not yet been taught. Once students have attained the acquisition level in a given skill, self-monitoring of that skill can be introduced as one tactic for facilitating attainment of fluency, maintenance, and generalization levels of performance.

Examples follow of self-monitoring systems that would be easy for students to use to record each time a target social skill is exhibited:

· Record a tally mark on an index card. The card can be kept on the student’s desk or carried in a pocket.

· Place a poker chip in a jar.

· Place a star on a chart.

· Drop a small block in an egg carton section.

· Use a handheld or wearable digital counter.

These items are easy to use in generalization settings such as the playground or cafeteria.

Once the student has learned to use the system, a target performance criterion can be set, with reinforcement delivered on attainment of the criterion. For example, the student could be encouraged to make 10 social greetings during the day. If the self-monitoring system indicates 10 or more greetings were exhibited by the end of the day, the student earns a special reinforcer.

Self-monitoring has been used to effectively increase social behavior in children and youth with autism and developmental disabilities (e.g., Camargo et al., 2014; Koegel & Koegel, 1990; Koegel, Koegel, Hurley, & Frea, 1992; Parker & Kamps, 2011). In addition, self-monitoring can produce collateral decreases in challenging behavior and facilitate generalization of newly learned skills (Koegel et al., 2012).

One major consideration in using self-monitoring as an intervention to improve social behavior is the probability that many students will be able to self-monitor only one response at a time rather than multiple, complex responses (Haring & Ryndak, 1994). Because of this, the nature of the behavior targeted for self-monitoring is especially important. Koegel and his colleagues recommend that students self-monitor pivotal behaviors. For example, students may be taught to self-monitor the number of social questions initiated during the day. Social questions are pivotal because they invite responses and may result in extended social interactions. Even self-monitoring is considered a pivotal behavior because it can be used to facilitate generalization of many different behaviors across a wide variety of natural contexts (Verschuur, Didden, Lang, Sigafoos, & Huskens, 2014). Other examples of pivotal behaviors that students might self-monitor include eye contact, appropriate facial and verbal affect, initiating interactions, functional communication skills, and awareness and responsivity to environmental stimuli (Haring & Ryndak, 1994; Moes, 1995).

Video Self-Modeling

Video self-modeling (VSM) involves making a brief video of the student with autism engaging in a target social behavior. VSM is a variation of video modeling. In video modeling (VM)video modeling (VM)An intervention in which the student with autism views a brief video of a model (another child or an adult) demonstrating a target skill. video modeling (VM)An intervention in which the student with autism views a brief video of a model (another child or an adult) demonstrating a target skill., a model (another child or an adult) demonstrates the target skill in the video. In both VM and VSM, the student with autism views the video and is instructed (and taught) to imitate the behavior of the model (either the other student or adult, or the student him- or herself). Both VM and VSM are widely used, evidence-based interventions for teaching a variety of skills, including social behaviors, for students with autism and other disabilities (Bellini & Akullian, 2007; Wong et al., 2015).

In addition to efficacy, VM and VSM as socialization interventions offer other benefits, including ease of use and versatility. The relatively simple steps to create a VM or VSM are:

1. Identify the target skills to be modeled. A single video should focus on only one skill, but that skill may have multiple steps that should be clearly identifiable in the video. Also, a single skill may be depicted in multiple videos that depict different scenarios in which the skill should be used.

2. Task analyze the skill. If some of the steps are not observable (e.g., student must think about his response), then the hidden steps should be demonstrated by talking aloud in a quiet voice.

3. Write a script for the VM or VSM. Be sure that the script includes a clear antecedent for using the skill, a salient demonstration of each step in the skill, and a positive outcome for the scenario. The scenario(s) depicted in the VM or VSM should reflect a situation that the student will encounter as closely as possible.

4. Record the video. If possible, record the video in the environment where the target skill will be used. Videos are easily recorded using a cell phone or tablet. If you are making a video for VSM, you may need to prompt the student for some or all of the steps in the skill.

5. Edit the video, if needed. You may need to edit out mistakes, interruptions, or other elements that detract from the core message of the video. Many cell phone and tablet recording apps include simple editing features.

6. Plan for when, where, and how many times the student will view the video. Typically, videos are viewed just prior to the activity in which the skill is expected to be used.

Peer-Mediated Interventions

Peer-mediated interventions (PMIs) involve using socially competent peer confederates to initiate and maintain social interactions with students with autism. The peer confederatespeer confederatesPeers who are trained to assist with socialization interventions by initiating or maintaining social interactions with students with autism. peer confederatesPeers who are trained to assist with socialization interventions by initiating or maintaining social interactions with students with autism. receive training in effective methods for accomplishing these outcomes before intervention. PMIs have been used successfully to increase social behavior in a variety of age groups of students with autism from preschool through secondary (Chang & Locke, 2016).

A substantial research base provides strong support for engaging typically developing peers as social change agents for students with autism using a wide variety of PMI formats. No single PMI format stands out as producing superior results (Chan et al., 2009). In general, PMI formats reflect the following elements:

· Peers are taught behavioral skills for initiating, prompting, and reinforcing desired social behaviors before starting the PMI.

· A high-interest activity (e.g., lunch or snack time, interest-based clubs, playtime, center time) is used as the venue for the PMI.

· PMIs are one component of a socialization intervention package that includes other evidence-based socialization interventions (e.g., direct instruction of target skills, scripts, self-monitoring, visual supports, communication supports).

· Some PMIs incorporate the novel or perseverative interests of the participants with autism by designing social interaction activities based on those interests.

· PMIs (and other socialization interventions) can address the function(s) of challenging behaviors by providing reinforcement socially acceptable behaviors.

The number of socially competent peers paired with a student with autism seems to affect the level of social behaviors exhibited by the students with autism. Using dyads (one peer without a disability paired with one student with autism) seems to result in a greater level of social responding than do triads (two peers without disabilities with one student with autism) (Sasso, Mundschenk, Melloy, & Casey, 1998). This suggests that when more than one peer without disabilities is present, those students tend to interact more with one another than with the student with a disability (Sasso et al., 1998).

7-5 Facilitating Generalization of Social Skills

We next discuss strategies that should increase the likelihood of generalization of social skills. These include the Stokes and Baer (1977) generalization strategies (described in Chapter 5) as they relate to social skills as well as additional recommendations that were not presented in Chapter 5.

1. Teach skills that are naturally reinforced in target environments. In school, these might include smiling, responding to peers, greeting teachers, and extending invitations to play. Many pivotal behaviors are selected because they typically result in natural reinforcement.

2. Teach peers (and teachers) to respond appropriately to students’ correct social behaviors and to ignore or redirect inappropriate behaviors. Many PMIs teach peers to do this as part of the PMI training. Differential reinforcement of correct responses is especially important as students begin to exhibit new skills. In our experience, peers often do not respond spontaneously to these new skills, perhaps because peers do not recognize them as appropriate social behaviors that warrant a response or because the new behaviors are “out of character” for the student with autism.

3. Use many examples in the teaching process (Baer, 1999). We would never teach long division by using only one example. Each social skill taught should be demonstrated several times in several different contexts.

4. Program common stimuli or make the training situation as much like real-life situations as possible (Stokes & Baer, 1977). This might mean having role-players use similar language, topics, even mannerisms, as would be used in the actual situation.

5. Once students demonstrate acquisition of target behaviors in the instructional setting, begin to vary the components of instructional lessons, what Stokes and Baer (1977) refer to as general case programming . For example, different teachers could conduct the social skills group at a different time of day and in a different setting. New students could be introduced into the group, and the instructional session might be conducted in a slightly different format (different order for role-players, for example).

6. Teach students to actively recruit their own reinforcement (Morgan, Young, & Goldstein, 1983). General education teachers, secondary teachers especially, often do not provide the high levels of reinforcement familiar to students with autism. Students can be taught to ask teachers “How did I do today?” or “Did I do a good job playing today?” as a way of soliciting reinforcement in case it is not provided automatically.

7. Teach students to recognize the types of reinforcers used by general educators (Graubard, Rosenberg, & Miller, 1974). As part of the initial ecological assessment conducted before developing socialization interventions, teachers should assess the types of reinforcers used in general education environments and then apply those in the special education setting as well.

Incorporating well-planned generalization strategies as part of an overall socialization program will increase functional use of social skills, including a greater likelihood that social behaviors will be used in appropriate contexts, with reinforcing social consequences from peers and adults.

Chapter Review

Summary

Perhaps one of the most critical areas of intervention for students with autism is socialization, and improvements in social behavior often produce concomitant improvements (i.e., collateral changes in nontargeted behaviors) in other areas of functioning such as communication and play. Although children and youth with autism characteristically do not exhibit functional social behaviors that lead to social competence, intervention efforts to remediate socialization deficits can result in significant improvements in social behavior, particularly when applied to pre-school-aged children.

Socialization interventions have evolved from rather simplistic interventions designed to improve discrete social skills in students with autism to interventions that emphasize the importance of the contexts in which those students participate and the social actions of peers in relating to students with autism. A variety of socialization interventions have been shown to produce desired outcomes, including teacher-mediated techniques (direct instruction, antecedent prompting, social stories), self-mediated techniques (self-monitoring), and peer-mediated techniques. The most robust outcomes will occur when two or more of these techniques within or across these categories are used in combination and when these techniques are used in conjunction with well-planned generalization strategies. For example, a teacher might directly teach students how to initiate social questions (a pivotal behavior) and may provide scripts for the students to follow in specific situations. Next, students could be taught to self-monitor their initiations involving social questions during activities with peer confederates. In those activities, peers would be taught to prompt and reinforce social questions from the students with autism in a way that extends the social interaction.

The goal of socialization interventions is social competence. Students with autism may never be viewed as highly socially competent and may never like social interaction to an extent similar to that of typically developing peers. However, thoughtfully planned socialization interventions designed to target critical skills and generalization of those skills should result in improved social outcomes, including a greater likelihood of social relationships such as friendships between students with autism and peers.

Effective social behavior is necessary for successful functioning in all areas of life and has been shown to be an important prerequisite to mental health and happiness. As educators, we must begin addressing socialization deficits in children with autism and developmental disabilities at a young age and continue applying effective interventions to continually expand these students’ repertoires of social behaviors. Anything less may increase the likelihood of more restrictive placements for students, especially in adulthood.

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