Intensive ABA Services
Teaching social skills to children with autism is an area of behavioral treatment that is continuously evolving, perhaps more than any other area. The Journal of Applied Behavior Analysis alone frequently includes articles discussing the teaching of interactive play skills, the development of creativity and spontaneity, and the development of conversational skills. These articles are now free to the public on the website, http://seab.envmed.rochester.edu/jaba/. (Begin with a "full-text search" or go directly to the "Table of Contents" section).
While the social skills programs at the Lovaas Institute are both numerous and complex it may prove helpful to become familiar with some general basic steps.
The behaviors we identify to teach the child may be defined broadly (e.g., participation in cooperative play) or more specifically (e.g., responding to a peer's comments). The chosen behavior may be verbal (e.g., maintaining a topic in conversation) or nonverbal (responding to a peer's facial expression such a as smiling by approaching). Whichever behaviors are chosen, the first step is to define these observable and measurable behaviors so that the instructor may record: whether or not the behaviors occur, what type of prompts are helpful (or not), prompt fading procedures, what kind of reinforcement is effective, a time-table for fading reinforcement, and finally, the kind of support that is needed to teach generalization of the new behaviors across persons, situations and time, as well as the fading of this support.
Examples of definitions of social behaviors may be found in Pierce and Schreibman's (1995) research article discussing complex social behaviors taught to children with autism. One example is their definition of "initiates conversation" as "Verbalizations that were not in direct response to a preceding question or that occurred at least 5 seconds after a preceding verbalization. For example, saying 'the ball is blue' or 'I like pizza' was scored as initiating conversation."1 Other behaviors that are defined in the article included: "maintaining interactions," "initiating play," "nonengagement," "onlooking," "object engagement," "supported joint attention" and "coordinated joint attention."
The language skills a child learns in the early and middle stages of behavior therapy provide necessary building blocks for learning complex and new social skills in later stages of the therapy. Structured discussions can be an effective technique for introducing social themes. We would caution against depending upon this method as the sole teaching technique for social themes; this will seldom lead to independent mastery of the skills discussed. However, discussion is often a crucial factor in the total learning process.
Stories that focus on teaching social comprehension themes may be read to and then discussed with the child. For example, the book The Rainbow Fish by Marcus Pfister is a story about a beautiful fish that learns to make friends by sharing his most prized possessions-- his shimmering scales-- and includes themes such as:
While being read to, the child is concurrently taught to answer questions such as:
Books should be read and discussed several times or until the child can readily answer questions related to specific social themes, showing that he or she comprehends the situation described. Book series such as Franklin, Arthur, and Berenstain Bears are often helpful for children who are learning to correctly comprehend social situations.
Besides stories, teaching specific kinds of social behavior is often critical. At the time Brian started first grade, he experienced some difficulty initiating conversations with his peers. He did attempt to talk to them, but over time was ignored because his peers grew tired of hearing the same couple of comments every time Brian approached them. To help him overcome this problem, the intervention plan included teaching Brian how to vary the beginning of a conversation. For example, first, in a one-on-one situation with his instructor, Brian learned to:
Second, once Brian had learned these skills with one particular instructor, it was repeated with (i.e., generalized to) other instructors, and finally, gradually generalized to Brian's peers at school.
To further help Brian, the instructors made posters with printed statements that Brian could use to begin an interaction with his peers. While referencing the comments on the poster board, Brian was taught to respond to the following instructions:
Eventually, Brian knew the answers by heart and the poster board was no longer needed. The next step was teaching Brian to use the statements at school (see Step Four).
As mentioned above, the ability to talk about what one should do is different from actually doing it. Thus, discussions of social behaviors are often followed by or occur concurrently with role-playing the social scenarios discussed. For example, once Brian had learned to answer questions such as those listed above, instructors would teach him through role-play how to start a conversation with them. The instructor would pretend to be a peer in school. Brian and the instructor would take turns initiating a conversation, based on different scenarios. In one scenario, the peer was playing with a toy, in another the peer was standing in the middle of the room, and in a third scenario, the peer was drawing a picture.
Video modeling has also been shown to be an effective teaching strategy in facilitating generalization of social skills.2
Contrived environments allow the instructors to teach new social skills in a controlled and systematic manner. However, eventually the child must practice in less predictable, real life social situations. During the transition from contrived to real situations the child is often supported by an instructor who can help him or her stay successful by prompting the behavior if necessary or by providing additional reinforcement in order to increase the likelihood that the child will indeed engage in the new social behavior vis-à-vis his peers.
During Brian's transition the instructors again used a poster board and added a token system to help him in the beginning. The poster board listed all the conversation starters Brian had practiced and the instructor taught him to record (self-monitor) the particular conversation starters he used each day by writing an X next to them on the board. If he had placed an X next to 3 different conversation starters by the end of a day, he earned a special surprise (i.e., token system). Since interaction with peers was naturally reinforcing to Brian, additional reinforcement from the instructor was not needed once the poster board was faded from the social situations. By varying his initiations Brian's peers were gradually responding with friendliness toward him thus providing the natural reinforcement he needed to sustain his use of a diversified social language. Concurrently Brian's instructors taught him novel starter comments with the goal that, over time, Brian would learn to generate his own variations.
One of the main goals of teaching social skills to children with autism is that they will learn to independently build rewarding social relationships. To this end, the final step when teaching social skills is to check for their social validity. In other words, the instructors need to make sure that the child can, in fact, use the social skills he or she has been practicing. For example, did an increase in the particular social behaviors the child was taught significantly improve the child's ability to interact with others? If not, we must reevaluate the situation. It would be important to closely observe and then record the child's social behaviors (or lack thereof) to determine whether the skills taught were generalized completely across situations, environments and persons. It may be the case that generalization strategies need to be practiced for a while longer. Or perhaps the observations show that the child needs to learn additional skills in this particular area in order to be helped along in his or her general social development.
Do you have an experience with a creative format to typical programming? Share them with us here
The names of all children in this newsletter have been changed in respect for family confidentiality.
Here again are some of the letters to the editor we have received recently. We will continue to take your requests into consideration when planning future articles. If you have insight into any of the requests, based on your own experience, feel free to forward your comments to us as well. I look forward to continuing our discussion next month.
Foot Flying! The child sits on your foot and you fly him high. Then say, "it's Barney's turn" and make Barney fly on your foot, then the child again.
Silly Telephone Calls! Make a ringing noise and pick up the telephone and say, "It's for you, (child)!" Add silly praise dialog. Alternatively, say that you've got to call Mickey Mouse and when talking to him praise the child's performance.
In March 2007, four days after his second birthday, Trent, who had been diagnosed at a very early age with Pervasive Developmental Disability, Not Otherwise Specified, PDD(NOS), began receiving Family-directed services supervised by Jennifer, a consultant at the Lovaas Institute.