News and Knowledge

The Challenges of Learning and Teaching Social Skills

Social skills, which are centrally important to the success of individuals on the autism spectrum, are among the most elusive targets to teach. One impediment to teaching such skills is that there may not be much intrinsic interest on the part of learners with autism spectrum disorders (ASD) in learning these skills. Many learners with ASD lack social interest and fail to comprehend social nuances. Additionally, they often exhibit little social initiation, as well as reduced social responsiveness.

Furthermore, it is often difficult to conceptualize how to teach such skills. Most social skills are multi-element skills that require the individual to engage in several different and distinct tasks. And most of the skills in the social realm involve an element of judgment (i.e., is it appropriate to engage in this behavior at this time?) Such complexities make it difficult to teach such skills. How does one operationalize social judgment? How can we prepare learners for the myriad possibilities that exist in real life?

This article will review some of the ways in which such skills are commonly taught to individuals on the autism spectrum. Many of the commonly used approaches are package interventions, with several components, or are used in combination with other procedures. Weiss and Harris (2001) provide a thorough description of several strategies for teaching social skills to young children on the autism spectrum. A few of these strategies, which are also relevant for teaching older learners such skills, will be discussed in this article. One of the challenges for a behavior analyst in approaching instruction in such skills is that many of the commonly used strategies have limited empirical support to date. Alternately, some approaches have been empirically validated with other populations, but not with individuals on the autism spectrum. It is not always clear whether it is possible to extrapolate information from other populations, but the strategies may be useful in the clinical context of teaching social skills. Several commercially available social skills chapters and curricula have well-formulated and clear lessons for a variety of social skill instructional targets (e.g., Baker, 2003a; 2003b; McGinnis and Goldstein, 1990; Richardson, 1996; Taylor, 2001; Taylor and Jasper, 2001).

In clinical application, a number of commonly used strategies fall into the descriptions above (i.e., have limited data or have been used primarily with other populations.) Nevertheless, such procedures are often used to address social deficits and to teach pro-social skills. Often, they are used in combination with other, direct behavior change procedures, such as reinforcement and prompting. Commonly used procedures that will be reviewed here include social stories, role plays, rule cards, video modeling, and problem-solving techniques.

Commonly Used Techniques

Social stories. Social Stories™, an intervention developed by Carol Gray (Gray, 1993; 1994) to provide information about social situations and about behavior that is expected in those situations, are very commonly used. Gray has suggested that one directive statement be given for every three to five informational statements, to ensure that the story is largely a vehicle for conveying information about complex or hard-to-define social circumstances.

Social Stories™ can be written with pictures to accompany the text, and can be adapted for the individual (including using the names of those the individual knows and using the first person). The stories can be used to convey information and expectations for multi-element tasks (such as cleaning up or waiting in line.) They can also be used as part of a package of interventions to address challenging behaviors, offering functional alternatives to the target behavior, such as asking for help instead of throwing materials.

Some encouraging, preliminary empirical support for the efficacy of Social Stories™ in increasing social communication skills exists (e.g., Thiemann and Goldstein, 2001). A small body of research exists, and a comprehensive review article has been published (Reynhout and Carter, 2006.) However, the data is quite variable and there are many deficits in the level of our existing knowledge. Some of the problems that exist in this body of literature are: highly variable effect sizes, highly variable methodology, and a lack of reports of cognitive level.

Many clinical aspects of the use of social stories like those developed by Gray remain unclear from a research perspective. It does not appear that there is an effect for descriptive sentences. However, most other elements of story construction or clinical implementation remain unclear. For example, it is not known how frequently reviews need to be done, whether comprehension activities facilitate the acquisition of the material, or when the story should be presented to the individual to maximize effect. In general, the data is not robust, in terms of the ability of Social Stories™ to facilitate behavioral change. Furthermore, data on the maintenance and generalization of such changes do not exist. As maintenance and generalization are critical issues for this population, this is a serious limitation.

In general, however, consumers like Social Stories™ and are fairly compliant about implementing them. There is also a tremendous volume of anecdotal reports of success with their use. The question for the clinician then becomes one of whether, how, and when to use them. It may be possible to use them as part of a package of interventions, in which more direct change procedures are also in use.

Role plays. Role plays provide an opportunity for behavioral rehearsal of desired behaviors (e. g., Snell and Janney, 2000; Weiss and Harris, 2001). Students with ASD often need multiple opportunities to learn and practice desired skills. Role plays can create such additional opportunities, to supplement a low number of naturally occurring events in their natural environments. Role plays can be used to target aspects of interaction that are central to social success. These include orientation to the speaker, maintaining eye contact, and answering questions appropriately. Role plays can be done with characters and puppets or with people (including the target student). The student can take on different roles, demonstrating the initial skill or the response. Role plays are always used in combination with the provision of feedback on performance. While there is not a body of research on role-play procedures, there is some support for the broad use of behavioral rehearsal strategies.

Rule cards. Rule cards assist students in following the social rules that are associated with a particular activity (e. g., Weiss and Harris, 2001). A rule card clearly states the behavioral expectations for that activity. Rule cards can be reviewed prior to an activity and can be used in combination with other procedures (such as behavioral rehearsal.) Rule cards are very helpful for targeting skills such as sharing toys, taking turns, asking peers for desired items, and accepting a peer’s answer. They can also be used for explaining expected behavior in a particular environment or activity, such as the media center or school assemblies. While there is not a body of literature on the use of rule cards, they are a common clinical intervention and are related to a variety of visual prompting strategies and behavioral rehearsal techniques (e.g., Cooper, Heron, and Heward, 2007; Snell and Brown, 2000).

Scripts. Some students with autism have a difficult time engaging in conversational exchange. They may also have difficulty in creative play. In these circumstances, they may engage in much less interaction than they might if these skill deficits were addressed. One way to address this issue is to provide scripts for prolonged conversations or creative play. Scripts can be in the form of sentences, words, or pictures, and they can be used in a variety of circumstances (e.g., Snell and Janney, 2000). Scripts can also be developed for specific games and activities. Scripts can help the learner to engage in these interactions for longer durations and stay on topic while engaged in interaction. A number of studies document the effectiveness of scripts, including facilitating social initiation and social interaction in individuals with autism (e.g., Krantz and McClannahan, 1993, 1998).

Roteness of response can be a concern, so it is important to program in and reinforce variability. It will not be functional if the learner can speak about a topic in only one way. We need to prepare learners for the wide variety of circumstances they are likely to encounter in their interactions.

Video modeling. Video modeling is an area in which more research literature does exist. Video modeling has been shown to be an effective means of imitating peers (Haring, Kennedy, Adams, and Pitts-Conway, 1987), learning sign language (Watkins, Sprafkin, and Krolikowski, 1993), developing play skills (Charlop-Christy, Le, and Freeman, 2000), and developing conversation skills (Charlop and Milstein, 1989; Sherer et al., 2001). Because so much research supports its utility in teaching skills, video modeling has been used increasingly to build a variety of skills, including functional academic skills, community-relevant skills, conversational exchanges, and play skills (e. g., Snell and Brown, 2000; Taylor, 2001; Weiss and Harris, 2001).

Many students with ASD are strong visual learners, and many enjoy watching videos. They may attend better to a model presented in a video clip than they would to a live model demonstrating a skill. Clinically, video modeling is often done with an adult demonstrating the skill first. It is easier (with an adult model) to ensure that the salient aspects of the target behavior will be highlighted. Alternately, older peer tutors or mature peers can be used as models. These choices have obvious advantages, because of their similarities to the target students.

While there is some variability in how video modeling is implemented to build play skills, it usually involves having the learners observe a video clip of play and then enact it themselves. At times, there may first be concurrent imitation of what is being watched (doing the actions along with the model on tape), followed by delayed imitation of what was observed (watching the clip and then engaging in the play). As in scripting, roteness of response can also be a concern, so it is important to program in variability. Eventually, the learner can also be rewarded for expanding upon the modeled skills.

Another extension of video teaching is to use videotape as a source of feedback to the learners on their performance during play activities. Reinforcement and corrective feedback can be provided, and better strategies for targeted areas of weakness can be modeled and rehearsed (e.g., Taylor, 2001). This may be especially useful for circumstances in which a learner has demonstrated difficulty comprehending social nuances, such as staying on topic in a conversation.

Several guidelines for the use of video with learners have been given (Krantz, MacDuff, Wadstrom, and McClannahan, 1991). Specifically, these authors suggest: assessing learners for appropriate prerequisite skills; removing extraneous stimuli from the videotape; attending to the history of the learner with the persons presenting the video or modeling on video; and considering cognitive level as a possible variable of importance (as learners with more developed cognitive skills may respond to the approach better).

Problem solving. Solving problems is an important part of success in school. In addition, it is central to navigating the social world of friendships. Many students with other types of presenting problems, such as ADHD, have benefited substantially from problem-solving approaches. Problem-solving training usually involves helping learners to identify problems and select appropriate solutions. Children with ASD often have difficulties with the ambiguity of presenting problems, and with evaluating options for a course of action. They may be impulsive or fail to see the range of options. Problem-solving training (e. g., Shure, 2001a; 2001b; 2004) can help students with ASD to identify problems, generate alternative solutions, evaluate the effectiveness of different potential courses of action, and choose the best option. This can be done as a class-wide intervention or as an individual approach.

A variation of problem solving is the social autopsy (Bieber, 1994). This approach facilitates the identification of cause-and-effect relationships between one’s behavior and the reactions or consequences from others. This clinical approach includes a discussion of the situation after the event and a plan to prevent recurrence (Dunn, 2006.)

Summary

A variety of techniques are commonly used for teaching social skills to individuals with autism spectrum disorders. Some of those techniques are not empirically validated or have been used primarily with other populations. Nevertheless, they may be useful additional components to a package of behavioral interventions. Such package interventions may assist the clinician in teaching these multi-element skills. Additionally, they may provide more practice/learning opportunities and increase the degree to which training prepares learners for the range of possible experiences in the social world. As in the case with all interventions, direct behavior-change procedures should always be used to affect behavior. In addition, data on the effectiveness of all strategies used with individual learners should be collected.

References

Baker, J. E. (2003a). Social Skills Training. Shawnee Mission., KS: Autism Asperger Publishing Co.

Baker, J. E. (2003b). Social Skills Picture Book: Teaching Play, Emotion, and Communication to Children with Autism. Arlington, TX: Future Horizons.

Bieber, J. (1994). Learning Disabilities and Social Skills with Richard Lavoie: Last One Picked…First One Picked On. Washington, D.C.: Public Broadcasting Service.

Charlop, M. H. and Milstein, J. P. (1989). Teaching autistic children conversational speech using video modeling. Journal of Applied Behavior Analysis, 22, 275-285.

Charlop-Christy, M. H., Le, L., and Freeman, K. A. (2000). A comparison of video modeling with in vivo modeling for teaching children with autism. Journal of Autism and Developmental Disorders, 30, 537-552.

Cooper, J. O., Heron, T. E., and Heward, W. L. (2007). Applied Behavior Analysis. 2nd edition. Upper Saddle River, New Jersey: Prentice Hall.

Dunn, M. (2006). S. O. S.: Social Skills in Our Schools: A Social Skills Program for Children with Pervasive Developmental Disorders, Including High Functioning Autism and Asperger Syndrome and Their Typical Peers. Shawnee Mission, KS: Autism Asperger Publishing Company.

Gray, C. (1994). The New Social Story Book. Arlington, TX: Future Education.

Gray, C. (1993). The Original Social Story Book. Arlington, TX: Future Education.

Haring, T., Kennedy, C., Adams, M., and Pitts-Conway, V. (1987). Teaching generalization of purchasing skills across community settings to autistic youth using videotape modeling. Journal of Applied Behavior Analysis, 20, 89-96.

Krantz, P. J ., MacDuff, G., S., Wadstrom, O ., and McClannahan, L. E. (1991). Using video with developmentally disabled learners In P. W. Dowrick (Ed.), Practical Guide to Video in the Behavioral Sciences (256-266) New York, NY: John Wiley and Sons.

Krantz , P. J. and McClannahan, L. E. (1998). Social interaction skills for children with autism: A script-fading procedure for beginning readers. Journal of Applied Behavior Analysis, 31, 191-202.

Krantz, P. J. and McClannahan, L. E. (1993). Teaching children with autism to initiate to peers: Effects of a script-fading procedure. Journal of Applied Behavior Analysis, 26, 121-132.

McGinnis, E. and Goldstein, A. P. (1990). Skillstreaming. Champaign, Illinois: Research Press.

Reynhout, G. and Carter, M. (2006). Social stories for children with disabilities. Journal of Autism and Developmental Disorders, 36, 445-469.

Richardson, R. C. (1996). Connecting with Others: Lessons for Teaching Social and Emotional Competence. Champaign, Illinois: Research Press.

Sherer, M. , Pierce, K. L., Parades, S., Kisacky, K. L., Ingersoll, B., and Schreibman, L. (2001.) Enhancing conversation skills in children with autism via video technology: Which is better, “self” or “other’ as a model. Behavior Modification, 25, 140-158.

Shure, M. B. (2004). I Can Problem Solve (Preschool). Champaign, Illinois: Research Press.

Shure, M. B. (2001a). I Can Problem Solve (Kindergarten and primary grades). Champaign, Illinois: Research Press.

Shure, M. B. (2001b). I Can Problem Solve (Intermediate Elementary Grades). Champaign, Illinois: Research Press.

Snell, M. E. and Brown, F. (2000). Instruction of Students with Severe Handicaps. Upper Saddle River , NJ: Prentice Hall.

Snell, M. E. and Janney, R. (2000). Social Relationships and Peer Support. Baltimore, MD: Brookes.

Taylor, B. A. (2001). Teaching peer social skills to children with autism. In C. Maurice, G. Green, and R. Foxx (Eds.), Making a Difference: Behavioral Intervention for Autism. (pp. 83-96). Austin, TX: Pro-Ed.

Taylor, B. A. and Jasper, S. (2001). Teaching programs to increase peer interaction. In C. Maurice, G. Green, and R. Foxx (Eds.), Making a Difference: Behavioral Intervention for Autism. (pp. 97-162) Austin, TX: Pro-Ed.

Thiemann, K. S. and Goldstein, H. (2001). Social stories, written text cues, and video feedback: Effects on social communication of children with autism. Journal of Applied Behavior Analysis, 34, 425-446.

Watkins, L. T., Sprafkin, J. N., and Krolikowski, D. M. (1993.) Using videotaped lessons to facilitate the development of manual sign skills in students with mental retardation. Augmentative and Alternative Communication, 9, 177-183.

Weiss, M. J. and Harris, S. L. (2001). Reaching out, Joining In: Teaching Social Skills to Young Children with Autism. Bethesda, MD: Woodbine House.

Mary Jane Weiss, Ph.D., BCBA, a member of OAR’s Scientific Council, is an associate research professor at the Graduate School of Applied and Professional Psychology at Rutgers, the State University of New Jersey and the director of the Division of Research and Training at the Douglass Developmental Disabilities Center. Her interests center on identifying best practice ABA techniques for individuals with autism and on providing intensive services to young children with autism, and she has presented at local, national, and international conferences regarding these issues. Additionally, she has published extensively in the field of Applied Behavior Analysis, including articles, book chapters, and books.