How to Integrate Social Skills into a Daily Schedule

1. How to Integrate Social Skills into a Daily Schedule Autism Summer Institute 2011 Donna Murray, Ph.D. CCC-SLP The Kelly O’Leary Center For Autism Spectrum Disorders Division of Developmental & Behavioral Pediatrics Cincinnati Children’s Hospital

2. Social Competence vs. Social Skills Social Skills Those discrete social behaviors that are typically exhibited by socially competent individuals Social Competence Other people’s perceptions of the social performance of an individual

3. “The specific level of social skills exhibited by the child may not be as important as the effect these skills have for producing positive and reinforcing interactions for all concerned” Frea 1995

4. Social Competency is important • There is a link between peer difficulties (social relationships) and poor social, emotional and academic adjustment (Rose-Kransor 1997) • In a study evaluating 52 adults with mild to moderate MR, The overwhelming consensus is that the major reason for unsuccessful employment was lack of social skills and inappropriate social behaviors rather than for issues related to emotional disturbance or antisocial behavior. Similar arguments have also been made for adults with autism (Huang, W, & Cuvo, A. 1997 )

5. Social Competency is important • Ingersoll, B., Schreibman, L. & Stahmer, A. (2001) recognized the variability in treatment outcome for individuals with autism. They postulated that perhaps this variable was social functioning. The authors studied the impact of peer interactions on outcomes. They evaluated the outcomes of children with high social avoidance versus low social avoidance and found that children with less social avoidance make the most gains. The study suggests that peer engagement may enhance cognitive and language development…. The results suggests that exposure to peers alone isn’t enough to reduce social avoidance.

6. Four General Operational Definitions of Social Competency (Rose-Krasnor, 1997) • Specific Skills – Set of desirable skills • Sociometric Status – Peer status • Relationships – Quality of individual’s relationships • Functional Outcomes – Focuses on outcomes of social behavior

7. Social Competency is impaired in persons with ASD • Social Skills are a core (central) deficit in ASD • “severe and pervasive impairment in several area of development: reciprocal social interaction skills, communication skills or the presence of stereotyped behavior, interests and activities.” (ASA 2000)

8. Social Competency is impaired in persons with ASD • “Social skill limitations are often larger than limitations in other areas of adaptive behavior” (these are more equal in persons with intellectual difficulties. i.e. social skills level often the same as other areas of development) (Volkmer 1987) • Persons with ASD have more impaired social skills than in individuals with intellectual deficits (mild/moderate) alone (Loveland & Kelly 1988) • The need for social skills training is greatest among persons with autism (Njardvik et.al. 1999)

9. The Iceberg Theory Tip of the Iceberg What we see – lack of social interaction, aimless wandering, aggression, tantrums, over focusing on solitary object directed acts, hoarding behavior, non-functional use of objects, limited repertoire of activities, non responsive to others

10. The Iceberg Theory(cont) Base of the Iceberg Difficulties in the Needed Supporting Skills – predictability, language, communication, able to tolerate others in close proximity to self and objects, reading verbal and nonverbal social cues, initiating, sustaining and exiting social interactions, getting attention, understanding “what to do,” negotiation, compromise, problem-solving, turn taking, waiting, commonalities with peers

11. Social Characteristics of Autism Quill 2000 Social Domain Tendency Weakness Solitary Play Functional Imaginative Perseverative Flexible Contextually driven Spontaneous Social Play Passive or awkward Reciprocal Parallel Cooperative Socioemotional Perceive emotions Infer emotional states Sensory Sensitivities Anxiety

12. Framework for Designing Social InterventionQuill 2000 “Do-Watch-Listen-Say” Framework Cognitive - the ability to know what to “DO” The ability to use toys,objects, and materials in the physical environment • Functional closed-ended activities • Functional open-ended activities • Creative activities

13. Framework for Designing Social Intervention adaptedQuill 2000 Socialization - the ability to “WATCH” others Observation skills contribute to an understanding of how to imitate, share physical space, toys, and materials and take turns. Contributes to understanding other’s nonverbal social behaviors • Share physical space • Share toys and materials • Take turns

14. Framework for Designing Social Intervention adaptedQuill 2000 Language - the ability to “LISTEN” Listen to others. Assign meaning to objects in the environment, own and other’s activities. Assign meaning to and respond to the verbal and nonverbal behaviors of others • Respond to nonverbal gestural messages of others • Respond to nonverbal prosocial behaviors • Respond to verbal messages of others

15. Framework for Designing Social Intervention adaptedQuill 2000 Communication – the ability to know what to “SAY” Initiate and maintain reciprocal interactions. Communicate messages that are relevant to the social context and others • Initiate nonverbal prosocial messages • Initiate nonverbal requests • Initiate verbal requests • Initiate verbal prosocial messages • Initiate commenting • Maintain conversational exchanges

16. Framework for Designing Social InterventionQuill 2000 Socialization Typical Children Cognitive “DO” Communication “Say” Socialization “Watch” Activity Language “Listen”

17. Framework for Designing Social InterventionQuill 2000 Socialization Children with ASD Cognitive “DO” Socialization “Watch” Communication “Say” Language “Listen”

18. Social Hierarchy • Solitary Activities • Adult-Child • Child-Child (dyad) • Two Peers – Child (Triad) • Group

19. Group Activity Types Quill 2000 • Unison • Choral • Structured Nonverbal Turn-Taking • Structured Verbal Turn-Taking • Unstructured Play • Discussion

20. Group Activity Types Characteristics and Examples Activity Type Characteristics Examples Unison -Everyone doing the Ring around the same thing at the Rosie, activities same time where everyone -No Language has own set of demands materials -Minimal to no waiting

21. Group Activity Types Characteristics and Examples Activity Type Characteristics Examples Choral -Everyone doing the listening and/or same thing at the choral reading of same time a book, listening -Language required to music, singing -Minimal to no waiting Circle Time

22. Group Activity Types Characteristics and Examples Activity Type Characteristics Examples Structured -Social predictability playing catch, Nonverbal-No Language social games, Turn-takingdemands activities that -Waiting required require sharing toys and materials

23. Group Activity Types Characteristics and Examples Activity Type Characteristics Examples Structured -Social predictability adult-directed Verbal-Language required group activity Turn-taking -Waiting required where children share verbal information, some structured board games

24. Group Activity Types Characteristics and Examples Activity Type Characteristics Examples Unstructured-Nosocial Recess, Playpredictability Free play, -Language may Cooperative play or may not be required -Waiting required

25. Group Activity Types Characteristics and Examples Activity Type Characteristics Examples Discussion-NoSocial Conversation, predictability Group discussion -Language required -Waiting required

26. A Couple of Ideas:Early Social Skills • Imitation – necessary for the “Watch” and the “DO” portion of interaction. Often needs to be directly taught but is easily transferred into social activities such as “follow the leader” • Direct teaching • of the “DO” of activities or topics • Prosocial behaviors –use and responding • sharing, comforting, rescuing, and helping. • Early Negotiation – “trade” skill helps to reduce “hoarding” behaviors. Necessary for any level of socialization

27. A Couple of Ideas:Early Social Skills • Turn-Taking - • Establish early turn-taking – brief and simple • Expand the length of each turn • Increase overall duration of the turn taking activity • Elaborate the content of each turn

28. Strategies:Later Social Skills • Getting people interested in talking to you • Identifying common interests • Expanding topics • Complimenting • Conversation • Initiation, responding, maintaining, exiting • “talking stick” • Conversation starter cards • Reciprocal interaction • Reading and Responding to verbal and non-verbal cues

29. Strategies:Later Social Skills • Cultivating an environment of acceptance • Important at all levels, but especially important in upper grade levels • Trusted individual • Social Skills Groups • Conversation • Address perspective taking • Problem-solving • Address sportsmanship • Negotiation and compromise • Conflict resolution (plan A, B, C) • Cooperation • Video modeling • Video Teaching

30. Direct Instruction SequenceScheuermann & Webber, 2002 • Describe the skill and why it is being taught • Demonstrate the skill • Solicit student feedback on the skill • Have students role-play the skill • Provide feedback on student performance of the skill • Do generalization activities

31. Facilitating Generalizationadapted Scheuermann & Webber, 2002 • Teach skills that are naturally reinforced in target environments (responding to peers, greeting, extending invitations to play) • Teach peers (and teachers!) to respond favorably to students’ correct social behavior (and to ignore or redirect inappropriate behaviors). • Use many examples in the teaching process, each social skill should be demonstrated several times in several different contexts

32. Facilitating Generalizationadapted Scheuermann & Webber, 2002 • Make the training situation as much like real life situations as possible • Once student demonstrates acquisition of target behaviors begin to vary components of the instructional lessons (different teachers instruct/role play, different settings, different time of day) • Teach students to actively recruit their own reinforcement, especially secondary students where teachers often do not reinforce at high levels (How did I do today?) • Teach students to notice reinforcement used in general education (special education classes could also use)

33. Problem Solving Grid

34. Conflict Resolution A,B,C PLAN • Politely state the problem and what the person needs to do to remedy it • Negotiate and come to an agreeable compromise C) Involve a mediator

35. Helpful Hints • Structure the physical space • Visual supports ! • Brief but frequent quality attempts • Carefully select peers • Capture the motivators • Continue to expand the repertoire of activities • Teach flexibility

36. Integrate opportunities throughout the Day • One on one • Circle time/Morning Meeting • Academic instruction • Recess • Specials • Specific Intervention (social skills groups, SLP, OT, counseling)