Maureen A. Conroy Elizabeth L.W. McKenney Brian A. Boyd University of Florida

1. A Functional Approach to Social Skills Intervention for Young Students with Autism in Inclusive Settings Maureen A. Conroy Elizabeth L.W. McKenney Brian A. Boyd University of Florida Supported by U.S. Department of Education Office of Special Education and Rehabilitative Services (#H324D020023)

2. Objectives of Presentation The participants in the session will learn: • A strategy for conducting informal functional assessment of social behaviors • Skills to link assessment information to the development of social skill interventions • Research-derived practices for addressing the social challenges of children with autism spectrum disorders (ASD)

3. Presentation Outline • Provide overview of the literature on the social deficits of children with ASD • Provide a brief overview of our research study and its purpose: Project GATORSS • Describe methods for assessing the social behaviors of children with autism: Social Skills Interview (SSI) & Snapshot Assessment Tool (SAT) • Present a case study and video examples to facilitate participant understanding

4. Why Do Children with ASD Experience Social Skills Deficits? • Some common theories…. • Theory of Mind: suggests that children with ASD have difficulty understanding and taking the perspectives of others (Tager-Flusberg, 2002) • Social Orienting: suggests that children with ASD have difficulty orienting to social stimuli (Mundy & Stella, 2000) • These are just theories!!! • Caregivers and practitioners need practical strategies

5. Why Examine the Social Behaviors of Children with ASD? • Children with ASD experience difficulty in three areas: • Behavioral excesses in display of restricted & repetitive behaviors • Behavioral deficits in display of developmentally and age-appropriate communication and social behaviors • Difficulty with social reciprocity is considered the central and defining feature of ASD (NRC, 2001)

6. Why Examine the Social Behaviors of Children with ASD (cont’d)? • Poor social skills and display of problem behaviors often interfere with successful inclusion in early childhood programs (Odom et al., in prep) • Placement in inclusive settings alone will not produce positive and lasting changes in the display of appropriate social behavior by children with ASD (McConnell, 2002) • We need evidence-based interventions to address and remediate their social skill deficits

7. Objectives of Project GATORSS • Overall goal…. • To develop a process for decreasing the maladaptive social behaviors and increasing the prosocial behaviors of young children with ASD in early childhood settings. • Development of functional assessment techniques designed to address social skill deficits • Development of individualized social skillinterventions using assessment-based behavioral intervention strategies

8. Method • Multiphase Assessment Process 1. Descriptive Assessments • Social Skills Interview with primary caregivers and teachers • Snapshot AssessmentTool (adapted from Conroy & Brown, 2001) • 6 observations conducted during opportunities for child with ASD to socially interact • Social Skills Observation form (adapted from Brown, Odom, & Buysee, 2000) • 10-min observations of child with ASD in different social contexts (manipulative area, art, pretend play area)

9. Method (cont’d) 2. Experimental Analyses • Functional analyses (Iwata et al., 1982/1994) • Conditions: ignore, tangible, attention, escape, free play • Structural analyses (Cooper et al., 1990; Peck et al., 1997) • Conditions: amount of peer attention, preference for social activity/materials, type of directions 3. Interventions • Replacement of inappropriate social behaviors with development of appropriate social behaviors that match the outcomes and function of behaviors • Utilization of contextual factors that reduce the likelihood of inappropriate social behaviors and increase likelihood of appropriate social behaviors.

10. Focus on Descriptive Assessments • Social Skills Interview (SSI) (Asmus et al., 2003) • Indirect assessment • Snapshot Assessment Tool (SAT) (Conroy et al., 2003) • Direct observation measure

11. Case Study: Allen • 5 years old • Diagnosis • PDD-NOS • Communicates with simple sentences: Repeats phrases from movies and TV shows • Academically precocious: Teachers reported superior reading skills • Montessori Preschool: Fully Included • 24 typically developing peers, including his younger brother • Child-directed philosophy • Behaviors of concern • Social withdrawal • Very limited interactions with peers across settings

12. Social Skills Interview (SSI) • Developed to find out from parents and practitioners • Communication abilities of child (e.g, verbal, nonverbal) • Current display of social behavior (e.g., maintain proximity, initiate) • Classroom settings/activities that permit social interaction and those settings/activities that promote/demote interaction • Classroom times when social behavior is appropriate • Antecedents of social behavior • Potential maintaining consequences of social behavior • Past and current intervention strategies • What has and what has not worked?

13. SSI Findings for Allen Conducted a focus group interview with 6 preschool teachers and director • SSI Findings: • Communication abilities: Allen is verbal and speaks in short sentences • Social behavior: Allen rarely initiated or responded to peers • Settings that permit interaction: All • Settings that promote interaction: None, but Allen enjoys puzzles, books, and “Thomas the Train” • Settings that demote interaction: Sensory-based activities • Consequences: Self-reinforcement (enjoys being alone) and/or Escape • Intervention strategies: None

14. What Did We Learn from SSI? • Allen’s strengths: • Has the ability to verbally communicate • Has good play skills, but chooses to play alone • Allen’s needs: • Does not initiate or respond to peer’s • Contextual Factors: • Sensory-based activities decrease the likelihood of Allen engaging in social interactions • Enjoys playing puzzles, books, & Thomas the Train

15. Snapshot Assessment Tool (SAT) • Developed to allow practitioners to observe and gather information on child’s social strengths and needs • Purpose: • Identify the types of social behaviors the target child is engaging in with peers • Examine variables that surround occurrence of social behaviors • Identify the outcomes of social behaviors when they do occur

16. SAT Form

17. SAT Definitions • Type and form of behavior • Describe behavior observed for child with ASD • Describe what behavior looked like • If teacher prompted social behavior note this as well • Context & appropriateness of play • State what play activity was (blocks, swing) • State if target child’s behavior was appropriate (both socially and developmentally)

18. SAT Definitions (cont’d) • Reciprocity of exchange • State whether target child’s behavior was reciprocated • Perceived goal of behavior • Describe goal you perceive the target child wanted (to obtain attention or a tangible, or to escape) • Actual outcome • State what outcome the child actually received

19. SAT Procedures • Identify 3-5 activities when target child is most social or has the most opportunities for social interactions to occur. During each observation session, observe long enough to complete 1 form. • If no target child social behaviors have occurred within 15 minutes, stop the session and begin again on another day or at another time. • If no social behavior has been observed within 1 minute, stop and record “No social behavior” in the “type and form of behavior” column. • Summarize the data.

20. Important to Define Behaviors • Identify behaviors when child with ASD is with his peers: • Social initiation • Target child or peer behavior that attempts to elicit a social response, attention, or access objects/activities • Response to social initiations • Behavior that the target child or peersengage in to overtly acknowledge an initiation (e.g., a target child asks a peer to play and the peer joins him in play) • No response • Target child or peer ignores the initiator, and/or continues to engage in the same play behavior • Interaction • Sequence of 3 social behaviors between a target child and peer (initiation-response-interaction). The interaction begins with the third behavior in the sequence

21. Completed SAT for Allen

22. SAT Findings for Allen • Conducted 9 observations across 4 days • Collected data during free play and outdoor play activities • Baseline IOA: • Collected during 57% of sessions • Averaged 100%

23. Summarizing Allen’s Data

24. SSI Allen rarely initiates Allen does NOT interact for self-reinforcement or to escape Allen likes puzzles and books Allen rarely responds SAT Allen rarely initiates (26%) Potential tangible function to his social behavior (86%) Allen typically responded (80%) Comparison of SSI to SAT

25. Assessment Allen rarely initiates, but has appropriate communication and play behaviors in his repertoire Potential tangible function to his social behavior He engages in social behavior to obtain access to toys- especially “Thomas the Train" Social Story Intervention Have Allen choose a peer so he could read the story to him/her Have Allen and peer “act out” scenario from the story during free play where there was access to tangible items that he likes (e.g., Thomas) Linking Assessment to Intervention

26. Function-based Intervention for Allen • Initial Intervention • Modified Social Story (Gray, 1995) • Social stories are written scenarios that provide social cues for children with ASD to facilitate appropriate behavior during social situations • Developed 3 social stories • How to initiate & respond to peers • How to share books with peers • How to share Thomas the Train with peers

27. Modified Intervention for Allen • Teacher noticed after 1 week that Allen’s initiations increased, but he was more likely to initiate if she prompted him • Teachers and research team decided to discontinue the social stories and use teacher prompting and praising • Revised Intervention • Specific prompts • To choose “what” to play with (e.g., Thomas the Train, puzzles, or books)Tangible Function • To select “who” to play withInitiations • To decide “how” to ask the peer to playInitiations

28. Intervention Findings for Allen • Collected data using 2 instruments: • Snapshot Assessment Tool (SAT) • Social Skills Observation form • 10-s partial interval recording system to determine the % of time Allen engaged in social initiations, responses, & interactions during a 10-min time period • Collected data during free play activities only • Intervention IOA: • SAT • Collected during 33% of sessions • Averaged 95% (range: 92-100%) • Social Skills Observation form • Collected during 54% of the sessions • Averaged 97% (range: 95-100%)

29. Allen’s SAT Intervention Data

30. Social Skills Observation Form

31. Allen’s Social Skills Observation Intervention Data

32. Summarize Findings for Allen • Using SAT, Allen’s social initiations increased from 26% to 44% • Using Social Skills Observation, Allen’s sustained interactions with peers increased from .7% to 23% • Linking assessment information to the intervention allowed us to: • Narrow the range of possible intervention options • Tailor the intervention to Allen’s unique social skills deficits • Include in the intervention contextual factors that addressed his play behavior (e.g., puzzles) and potentially maintained his social behavior (i.e., access to tangible items)

33. SnapShot Practice

34. Jenny • 5 years old • Diagnosis: Asperger’s syndrome • Based on Asperger’s Disorders Scale • Kindergarten: Included 79% of the day • IQ 80 with Developmental Profile II • Problem Behaviors • Screaming • Difficulty sharing toys • Communication • 1-4 word sentences and gestures • Social Behavior • Socially passive

35. Jenny’s Social Behavior • Strengths • Engages in parallel play • Remains in proximity to peers • Responds to peers • Knows acceptable ways to join group • Plays cooperatively during simple games • Follows one-step directions • Improved play activities with socially mature peers • Needs • Does not initiate toward peers • Passively responds to peer initiations • Improve sharing and turn-taking behavior

36. Snapshot Findings for Jenny • 5 observations to date • Summary • Initiated with peers during 10% of observation periods • Responded to peer initiations 75% of the time • Majority (86%) of social behavior was to maintain or gain access to a tangible item

37. SnapShot Practice

38. Next Steps for Allen & Jenny • Conduct experimental assessments • Functional Analyses (FA) • To verify function of social behavior • Structural Analyses (SA) • To determine additional contextual factors that effect the occurrence of social behavior • Link interventions to experimental assessment information

39. Snapshot Summary • Snapshot Assessment Tool is a descriptive observation instrument that can be used to identify • Variables when social behaviors occur • Did target child initiate? • When peer initiates what is target child’s response? • What is the context of the social situation? • Outcomes of social situations • What was the perceived goal of target child’s behavior? • What the did the target child actually achieve? • Utilize this information when developing experimental analyses or for preliminary interventions

40. What Are Some Potential Social Skills Interventions? • Based on work of National Research Council (2001) • Environmental Arrangement • Target Child Reinforcement • Peer Reinforcement

41. Environmental Arrangement • “Social” Groups • Inclusion of high status, socially-skilled peers (Sasso et al., 1998) • Structured, cooperative activities help to increase the social interactions of children with ASD (McConnell, 2002) • Decrease need for teacher involvement • Free play is hard for kids with autism

42. Example of a Structured Activity

43. Target Child Reinforcement • Identify what is reinforcing for the child (e.g., being alone, hand-flapping, a certain toy) • “Set-up” social situations with peers to provide opportunities for child to obtain the reinforcer • Reinforce the various components of social behavior • Social initiations • Social responses • Social interactions • Generalize behavior to more naturally occurring social situations

44. Peer-mediated Interventions • Reinforce peers for engaging in social behavior with target child • Individual contingencies • Provide reinforcement to each peer who engages in a prespecified social behavior directed to target child (e.g., greeting the child when they arrive to school) • Have peers self-monitor • Group contingencies • May include child with autism • Group reward for engaging in social behavior • Have group self-monitor • Peer buddies

45. Peer Self-Monitoring Form

46. Summary • Social skills literature has focused on specific intervention strategies not on methods to systematically assess the reasons or functions of those skill difficulties • Need to develop instruments that will provide information for experimental analyses of social skills behaviors • SnapShot Assessment Tool provides a researcher or practitioner a low tech method to obtain information about the child’s social behaviors (or lack of behaviors) • This information can be used to link assessment information to the development of interventions • All of this information will lead to the development of more effective and efficient interventions for young children with ASD to increase opportunities for meaningful inclusion

47. For More Information • Contact us at autism@coe.ufl.edu • Check project website: http://www.coe.ufl.edu/centers/Autism/gatorss/

48. Are you interested in pursing a doctoral degree? • Come to the University of Florida! • Contact: www.coe.ufl.edu