Social Skills Interventions for Kids on the Spectrum
By Moira Lewis MS, CCC-SLP
YAI Autism Center
It is well known that people with autism spectrum disorders (ASD) often have difficulties generalizing newly learned skills. Children with autism frequently cannot apply what they have learned in one situation to a similar — though not identical — situation, especially one related to learned social skills. This has important implications in a therapeutic context. Parent-professional collaboration and community-based instruction are important ways to improve the generalization of social learning in students with autism. Generalization can be enhanced by incorporating treatment in the classroom and home, such as providing intervention within everyday classroom routines with typical peers, or within everyday routines at home whereby parents are taught to incorporate therapeutic techniques. As it relates to interacting with other children in everyday settings, generalized environments are the “acid test” for mastered social skills.
Research supports a number of social and language intervention models aimed at improving children’s social communication skills, across ages and ability levels. On the other hand, there are a number of social skills intervention approaches currently available to professionals and parents that have not been empirically tested, nor do they have data supporting children’s achievements or social successes outside the intervention setting. A few of the outlined interventions described here do include components and steps aimed at facilitating the individual’s ability to respond across many social situations, beyond the therapy setting. Social skills often need to be taught explicitly to children with autism by professionals who can provide teaching, reinforcement and replacement behaviors. Traditional social skills strategies (such as discussion and reflection of interactions or board games) may be too subtle of an approach.
Integrating Peers as Models
The use of peer mentors is one example of an effective social skill intervention model that inherently addresses generalization for children with ASD. Peer mediated interventions have been designed and used to promote positive social interactions among preschool and school-aged peers (Strain & Odom, 1986; Odom, McConnell & McEvoy 1992, Goldstein et al., 1997). Within these approaches, peers are systematically trained to respond appropriately to the initiations and communication of children with ASD during the course of their school day. The use of peer mentors allows the teacher or clinician to act as a coach, facilitating play among peers rather than participating in it. The use of peer mentors also facilitates generalization of skills by ensuring that the child’s acquired skills are monitored by adults and practiced with peers in an ordinary setting. Goldstein et al. (1997) describe how the tendencies of typically developing preschoolers to avoid interacting with children with disabilities can be mitigated if they are taught and encouraged to use special interaction strategies. The authors evaluated the effects of a peer intervention model that distributed participation across the school day within short periods of play. Three strategies for being a “good buddy” structure that program. This includes, “Stay with your friend, play with your friend and talk with your friend,” so that buddies were taught to “stay-playtalk.” The training of “buddy” strategies followed a standard protocol, including discussion, adult modeling, guided practice, feedback and independent demonstration, with a generalization period included.
This model did show effectiveness in increasing interactions among typically developing children and those with disabilities, with successful interactions observed within generalization probes.
A social story simplifies and explains social concepts, rules or situations that may be difficult for a child with a disability (Gray, 2000), and are often used as an intervention strategy for children and adults with autism. This strategy can be used to teach a number of social and pragmatic skills, such as joining play with others, taking turns and starting a game.
Carol Gray (1995; 2000) outlines essential components to a successful social story:
- The story should be written in response to the child’s personal need.
- The story should be something the child wants to read on his own (depending upon ability level).
- The story should be written according to the child’s comprehension level (including incorporating pictures).
- The story should use terms such as “can,” or “could,” instead of “will” or “must.”
Bellini (2006) states that children with ASD learn best when social stories are used in conjunction with practice, such as role-playing. For example, after reading a social story, the child then practices the skill introduced in the story, such as initiation or “politely interrupting.” Immediately after reading a story about joining an activity, the child can practice the skill outlined in the story with the clinician. Then, after reading the story and practicing the skill, the child would be given the opportunity to perform the skill in a second social situation, such as free play in a classroom or playground. Real peers would replace the clinician, who could serve to facilitate or monitor this practice, and then judge performance outside the teaching/therapy setting. Social stories, as a visual and portable tool, can remain available to the child and eventually “faded” to improve practice and support generalization of skills taught.
Including Parents and the Home
Gresham et al. (2001) recommends that social skills training be implemented as frequently as possible and more intensely than what is typical, emphasizing that instruction should be focused and include all environments where the child encounters opportunities to interact. Multiple settings where communication occurs include the home, classroom, therapy room, playground, extracurricular activities and social skills groups. Among those various settings, educational plans can be designed to facilitate transfer of skills, strategies and reinforcement in order to move to the natural environment with the least amount of prompting for effective interactions. Parents are a natural resource and can contribute to a child’s effective social practice, with appropriate strategies and training, to prompt and reinforce the skills that are taught.
More than Words, The Hanen Program for Parents of Children with Autism, is designed to help families support the communication and social skills of their children with ASD at home (Sussman, 1999). This program aims to teach caregivers to identify their child’s communication strengths, needs and methods to interact. Parents are taught to recognize their child’s communication attempts, and how to teach the child to socially communicate in new ways for new reasons. Depending on their child’s stage of communication, the parent is given facilitative strategies to reinforce communication opportunities and generate interaction within real routines, such as meal times, games, getting dressed, songs and outings. This particular program was found to be effective in a small group of children, whose caregivers increased their use of spontaneous interaction strategies and their children increased their vocabulary following participation in More Than Words (Girolametto et al., 2007). This program can serve as a means to promote generalization, because additional intensity and frequency is added to an existing program by targeting communication and interaction not only with new partners, but at home as well.
Regardless of the therapy method, involving parents, therapists, educators and peers in a variety of settings provides a more holistic method of intervention, and possibly more effective outcomes and skill performance. As children with ASD develop, it is important for educators, clinicians and parents to apply evidencebased social skill intervention models that both consider the needs of the individual child and also aim to target generalization.
This article originally appeared in a different forman in the Winter 2010 issue of Autism Spectrum News (PDF).