Transcript Effective Strategies for Facilitating Inclusion of

Descriptive Assessment of Social
Skills for Young Children with Autism
Jennifer M. Asmus, Ph.D.
Maureen A. Conroy, Ph.D.
Crystal N. Ladwig, Ph.D.
Jennifer A. Sellers, M.Ed.
Brian A. Boyd, M.Ed.
University of Florida
Supported by U.S. Department of Education
Office of Special Education and Rehabilitative Services
(#H324D020023)
Panhandle Autism Society 2.28.04
Presentation Outline
• Review of relevant literature
• Overview of research project
• Details of descriptive assessment component
– Forms are under development and have not been
validated for use
– Please do not distribute
• Practice with 2 descriptive instruments
– Snapshot assessment
– Social skills observation screening
• Summary
• Questions
Rationale for the Study of Social Skills
in Young Children
• Increase in the prevalence of children identified as having
Autism Spectrum Disorder (ASD)
• Many children identified with ASD at age 2 to 3
• Experience difficulty in the areas of
– Language
– Behavior
– Social interaction skills
• Children with ASD often have difficulty socially interacting with
their peers
• Lack of social interaction skills and problem behavior often
interfere with successful inclusion in early childhood programs
– Placement in inclusive setting alone will not produce positive
and lasting changes in social skills (Koegel et al., 2001;
Strain & Hoyson, 2000)
Social Skills Intervention Research
• Target specific social behaviors such as
initiation and response (Matson et al., 1996;
Rogers, 2000)
• Child with ASD targeted interventions
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Teach child imitative behaviors
Play initiation strategies
Use of photographic activity schedules
Majority conducted in inclusive settings
Outcomes
• Effective way to increase social interactions
• Use of imitation alone poor outcome (did not teach
specific social skill)
Social Skills Intervention Research
Continued
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Peer targeted interventions
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Awareness activities paired with extrinsic
reinforcement for interacting with child with ASD
Focus on increasing peers’ initiations or
responsiveness to child with ASD
Majority of research done in inclusive settings
Outcomes
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More effect on the responsive behavior of children with ASD
Less of an impact to influence initiations of children with ASD
Social Skills Intervention Research
Continued
• Teacher Targeted Interventions
– One study identified the teacher as intervention
agent (Kohler et al., 2001)
– Inclusive preschool settings evaluated
– Taught teachers to use naturalistic teaching
strategies to improve social interaction of 4
preschoolers with ASD
• Stimulate child’s interest & play with activity
• Facilitate communication and social interaction with others
– Outcomes
• Significant improvements seen for 2/4 children
• Teachers did not like the naturalistic strategies
Social Skills Intervention Research
Continued
• Parent targeted interventions
– One study identified parent as intervention agent
(Kaiser et al., 2000)
– Three components to intervention
• Environmental arrangement of materials to promote child
engagement
• Responsive interaction techniques to build social skills
• Procedures to prompt, model, consequate use of new language
forms
• Conducted in clinic setting for 6 parents, generalized to home
– Outcomes
• All 6 parents used strategies appropriately
• 5/6 maintained and used 6 months later
• All children maintained increases in social language
Summary of Intervention Literature
• Interventions that directly target child with ASD most
effective
– Increases social interaction skills, initiations
– Generalization of skills to other people, settings, and
activities
– Facilitates language and social skills development
– Child with ASD must be taught direct and specific social
skills interventions not just be “physically” included with
typical peers
• Majority of literature on social skills for children with
ASD has emphasized interventions not necessarily
tied to experimental assessment findings
• Therefore, our understanding of why social skills
difficulties occur has not been advanced
Assessment of Social Skills Deficits
• Typical assessment examines pivotal or appropriate
skill targets (Peck et al., 1997)
• Very limited literature on systematic assessment of
social skills deficits prior to implementation of an
intervention
• Need to examine events related to occurrence of
both appropriate and inappropriate social skills
behaviors
• Use that information to match interventions to
address individual needs based on findings of
experimental analyses
• Use of applied behavior analysis (ABA) literature for
guidance
Assessment of Social Skills
Continued
• Very limited research on use of experimental
analyses of social skills deficits
– Peck & colleagues conducted structural analysis
(SA) to assess appropriate social skills behaviors
– Effective intervention identified, implemented, and
generalized
• More research needed on use of experimental
analysis to identify factors that serve to
facilitate and/or maintain appropriate and
inappropriate social skill behaviors for young
children with ASD in natural settings
Research Project Purpose
• To increase knowledge and understanding of
the usefulness of experimental analysis
techniques for evaluating social skills
behaviors of young children with ASD in
natural settings
• To utilize descriptive and experimental
evaluation information to develop
interventions to decrease inappropriate and
increase appropriate social skill behaviors
• To facilitate the success of young children
with ASD in general education classrooms
Project Specifics
• Participants: 18 children over a 3 year period
– Project began January 2003
– Current participants - 7
• Ages: 18 months to 5 years of age
• Diagnoses: Autism Spectrum
• Setting: Natural setting (home, childcare,
school setting)
• Behaviors: Social skills difficulties
(withdrawal, inappropriate or limited play
with peers)
• Assessment & Intervention: Multi-phase
process to link assessment to intervention
Method
• Descriptive Assessments
– Social Skills Interview Form with primary caregiver(s)
– Project DATA Social Skills Assessment (Schwartz, 2002)
• http://depts.washington.edu/dataproj/
– Snap Shot Assessment (adapted from Conroy & Brown, 2001)
• 6 observations conducted during opportunities for socially interact
– Social skills observation screening (adapted from Brown Odom, &
Buysee, 2000)
• 10-min observations of child with ASD in different social contexts
(manipulative area, art, pretend play area)
• Descriptive Observations of Contextual Factors
– 10 hours of direct, sequential recording of behaviors and
contextual factors in natural setting
– Observation of the interaction of peer and target child behaviors
in presence/absence of different contexts including: activity type,
play format, and level of adult engagement
– Outcomes of social interactions
Methods (Continued)
• 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 or adult attention,preference
for social activity/materials, type of directions
• Interventions
– Replacement of inappropriate social behaviors
with development of appropriate social behaviors
– Utilization of contextual factors that reduce the
likelihood of inappropriate social behaviors and
increase likelihood of appropriate social behaviors.
• 5 years old
• Diagnosis
Garrett
– Autism
• Kindergarten: Included 80% of the day
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IQ 55 with Developmental Abilities Scale (DAS)
Average academics (below average math)
Communicates with simple sentences
Classroom aide part-time basis
• Behaviors of concern
– Social withdrawal
• Very limited interactions with peers
– Disruption (loud vocalizations)
– Stereotypy (repetitive use of phrases)
Indirect Assessment Information
• Strengths
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Communication - speaks in 3-4 word sentences
Learns and follows established routines
Tolerates being in proximity to peers
No inappropriate externalizing behaviors (no more aggression)
Appears to enjoy praise from teacher and aide
Music activities identified by teacher and aide as possibilities for
increasing likelihood that Garrett will socially interact with peers
– Observes play of others
– Remains with group during activities
• Needs
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Does not initiate toward peers
Typically chooses solitary activities (books)
Few activities/materials appear to stimulate social interaction
Avoids peer initiations by turning or walking away
Limited appropriate social behaviors
Summary of Indirect Information for
Garrett
• Appropriate social interaction skills limited
– Often physically turns away in response to peers
initiations
– Few if any activities known to increase likelihood
that he will interact
– Identified factors that decrease likelihood
• Noise, too many people
– Perception that Garrett uses appropriate social
behaviors currently to seek information
– Perception that inappropriate social behaviors are
used to avoid others and decrease stimulation
from environment
Snap Shot Assessment
• Developed to allow practitioners to observe and
gather information on child’s social strengths and
needs
• Purpose:
– Examine variables that surround occurrence of social
behaviors
– Identify the outcomes of social behaviors when they do
occur
• Identify 3-5 activities when target child is most
social or has most opportunities for social
interaction with peers
• Observe child for 6 observation intervals across
the 3-5 activities
Definitions
• Identify when child with ASD and peers:
– Social initiation
• Behavior directed toward a peer in an attempt to elicit a
social response, peer attention, or access
objects/activities
– Respond to social initiation
• Behavior that the child engages 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
• Child 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
Snap Shot Assessment Specifics
Type & Form
of Behavior
Context &
Appropriateness of
Behavior
Reciprocity of
Exchange
Perceived
Goal of
Behavior
Actual
Outcome
Snap Shot Definitions
• Type and form of behavior
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Describe behavior observed for child with ASD (target child)
Describe what behavior looked like (repeated phrase)
Describe situation in which behavior occurred (swinging outside)
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)
• Reciprocity of exchange
– State whether target child’s behavior was reciprocated (did peer
respond?; did exchange lead to interaction)
• Perceived goal of behavior
– Describe goal you perceive the target child wanted (e.g., escape social
situation, obtain tangible item, obtain peer attention)
• Actual outcome
– State whether perceived goal/outcome was successful or unsuccessful
– Describe what occurred (peer walked away, unsuccessful)
Snap Shot Findings for Garrett
• 5 observations (28 total)
• 3 to 5 of those minutes (total of 12 minutes) each
time did not include any social behavior
• Initiations - Garrett initiated 4/28 times
– 2 help/comfort (building, bumped child on swing)
– 2 requests (access to swing, teacher-prompted)
– Peers initiated to Garrett 4/28 times
• Requests for Garrett to comply with specific request (3) or
engage in play behavior
• When Garrett did initiate peers responded only 1
time/4
– When peers initiated to Garrett he never responded
• Outcome - unsuccessful to obtain peer attention
– Successful to obtain access to tangible (swing)
Snap Shot Examples for Garrett
• Outdoor play
– Garrett initiated by saying “hey” repeatedly to peer on swing;
peer did not respond; Garrett was trying to get a turn on the
swing; teacher gave him her swing; unsuccessful with peer,
successful to get tangible item
– Garrett initiated by saying “Uh oh!” repeatedly after peer was hit
by swing he was on; no peer response (walked away); appeared
Garrett wanted peers attention; unsuccessful
• Sensory (Play-doh) activity
– Garrett pointed to peer and made a comment (difficult to interpret
what he said) after she made a noise; peer did not respond;
unsuccessful outcome
• Block area and cognitive activity
– Peer building with blocks and initiated by asking Garrett to move;
Garrett did not respond (continued reading chart on wall with
aide) - same situation occurred 3 times, each time, no response
from Garrett
Summary of Snap Shot for Garrett
• Summary
– When Garrett initiates peers do not respond
– When peers initiate Garrett does not respond
– Garrett’s initiations were perseverative and appear
to perhaps occur when he desires a tangible item
– Garrett has limited social interactions
Snap Shot Practice #1
Snap Shot Practice #2
Snap Shot Practice #3
Snap Shot Practice #4
Snap Shot Practice #5
Snap Shot Practice #6
Snap Shot Practice #7
Snap Shot Practice #8
Snap Shot Practice #9
Snap Shot Practice #10
Snap Shot Practice #11
Snap Shot Practice #12
Snap Shot Practice #13
Snap Shot Practice #14
Snap Shot Practice #15
Snap Shot Practice #16
Snap Shot Summary
• Snap shot 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 social situation
– Outcomes of social situations
• What was the perceived goal of target child’s behavior
and was that achieved
• Utilize this information when developing
experimental analyses
Social Skills Observation Screening
• Developed to allow practitioners to
observe and gather information on
child’s social strengths and needs in a
more structured way than snap shot
• Purpose
– Measure rate/frequency of social behaviors
– Measure topography of social behaviors
Social Skills Observation Screening
Continued
• Identify 2-3 times/activities when there will be a high
likelihood that the target child will be interacting with
peers
• Observe each time/activity period at least 2–3 times.
• Each observation should be 10 minutes long using
partial interval recording (observe 10 seconds, record
for 5 seconds)
• Record anecdotal information regarding social
interaction in comments section (e.g., favorite peers,
materials, activities, physiological setting events)
• Summarize data by graphing the % of intervals the
participant engaged in social behavior across
activities and within each activity
Screening Definitions
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I = Target child initiation
R = Target child response
SI = Target child initiated social interaction
PI = Peer social initiation
PR = Peer social response
SIP = Peer initiated social interaction
Circle code if target child is appropriate
Underline code if target child is inappropriate
Slash code if teacher prompted
X over code if continued interaction from previous
interval
Screening Example
Time
10
1
I R
I R
I R
SI PI SI PI SI PI
PR SIP PR SIP PR SIP
I R
I R
SI PI SI PI
PR SIP PR SIP
I R
SI PI
PR SIP
2
I R
I R
I R
SI PI SI PI SI PI
PR SIP PR SIP PR SIP
I R
I R
SI PI SI PI
PR SIP PR SIP
I R
SI PI
PR SIP
20
30
40
50
60
Screening Practice #1
Screening Practice #2
Screening Practice #3
Screening Practice #4
Screening Practice #5
Screening Practice #6
Screening Practice #7
Screening Practice #8
Social Skills Observation Screening
Summary
• Screening is a descriptive observation
instrument that can be used to identify
– Frequency or rate at which social behaviors occur
over a 10 minute time period
• Summarize initiations, responses, interactions
• Identify if there are activities that increase or decrease
likelihood of social behaviors
• Utilize this information when developing
experimental analyses
Next Steps
• 10 hours of direct observation across a set of
9 specific activity types
– Determine target child and peer social behaviors
in relation to activity types, and level of adult
engagement
• Consider all information in the development
of experimental analyses
• Match outcomes of experimental analyses to
select target behaviors and intervention
strategy for treatment
• Train all care providers in use of treatment
strategies
• Follow-up for 1-2 years
Findings from DO for Garrett
• Kindergarten with 20 students, 1 aide
– Data collected across a 5 week period
– Overall rate of Garrett’s initiations .01/min
• Equals about 1 initiation every 2 hours
• Most often occurred during art, computer, games with rules
– Overall rate of Garrett’s responses .075/min
• Equals about 4.5 times per hour
• Most often occurred during computer and games with rules
• More likely to respond (and last longer) if child initiated play
and adult was disengaged from situation
– Perceived outcome of social behaviors was to obtain
tangible/peer attention
– When not engaging in social behavior 8% of time
engaged in stereotypy, 92% engaged in solitary play
Summary
• Social skills literature 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
• Snap shot and screening provide researcher or
practitioner low tech method to obtain information about
child’s social behaviors (or lack of behaviors)
• This information can be used to develop the experimental
conditions of FA and SA
• 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
QUESTIONS?