Effective Instructional Practices for Teaching Students with ASD in the Classroom

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Effective Instructional Practices for Teaching
Students with ASDin the Classroom

• July 9th, 2007
• Kathy Thiemann, PhD, CCC-SLP (C)
• University of Kansas
• thiemann_at_ku.edu

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Social competence defined as

• the appropriateness of strategies he or she
  employs and whether he or she is successful in
  accomplishing specific social tasks (Guralnick,
  2002)

3
ASHA Position Statement (Oct, 2006)

• all individuals with ASD are challenged in the
  area of social communication
• SLPs role is critical in supporting the
  individual, the environment, and the
  communication partner
• Individuals with ASD should be eligible for SLP
  services due to the pervasive nature of the
  social communication impairment, regardless
  ofperformance on standardized testing of formal
  language skills

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ASHA Position Statement Contd

• The broad impact of the social communication
  challenges and problems with generalization
  necessitates service delivery models and
  individualized programs that lead to increased
  active engagement and build independence in
  natural learning environments
• provide pull-out services only when repeated
  opportunities do not occur in natural learning
  environments or to work on functional skills in
  more focused environments

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Effective communication interventions depend on

• Careful assessment to select useful objectives
• Environments that set the occasion for meaningful
  communication
• Functional reinforcers that are regularly
  available in natural environments
• Scaffolds (models, prompts, corrections, and
  praise)
• Fading of scaffolds to promote independent and
  spontaneous communication (Goldstein, 2002)

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Policy/Program Memorandum No. 140 (Ministry of
Educn)

• Gather assessment information to plan
  comprehensive programs
• Childs skills and needs
• Instructional level
• Learning style

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Skill and Needs Assessment

• Repertoire of communication skills
• Effective use in different social contexts with
  peers and adults
• Social reciprocity with peers initiation and
  response sequences (e.g., I-R-R)
• Peer relations and friendships
• Perceptions of child as socially competent (by
  peers, adults, and self)

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However

• Few standardized, norm-referenced social
  assessment tools
• Lack of peer-related social competency
  observations and standardized tests
• Limited assessments to evaluate skill levels an
  learning styles across natural school settings

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Gathering Assessment Data

• Direct observations of peer-peer and child-peer
  communicative interactions
• Rating scales, checklists, and standardized
  measures
• Adapted from previous social skill studies
• Interviews
• Multiple sources of information
• Negative influence on peer perceptions
• Child strengths and interests

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Direct Observations Peer-Peer and Child-Peer
Interactions

• Across multiple environments
• Natural unstructured social times
• Centers, Recess, Lunch, Art, PE
• Structured settings (set up with 1-2 peers)
• Short time periods (10-min)
• Rates of focus childs communication skills (both
  initiations and responses)
• Rates of peer responses and initiations

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Social and Communication Development

• Social Skills Rating System Teacher, Parent, and
  Student Report
• Social Skills
• Problem Behaviors
• Academic Competence
• Vineland Adaptive Behavior Scales
• Communication
• Socialization
• Daily Living Skills

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Rating Scales and ChecklistsResearcher
Developed Tools

• Social Interaction Teacher Impression Scale
  (Teachers, SLPs, School Staff)
• Community Social Network Questionnaire (Parents)
• Pre-Treatment Survey of Teacher Perceptions of
  Skills to Teach (Teachers)
• Peer Acceptance/Friendship Questionnaire (Peers)
• Social Network Questionnaire (Parents)

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Social Interaction Teacher Impression Scale

• 1. The child spontaneously responds to
  peers.
• 2. Peers seek out child for social play or
  classroom group activities.
• 3. The child initiates to peers (e.g., starts
  talking, begins an interaction)
• 4. The child uses appropriate social behavior to
  get a peers attention.
• 5. The child appears to be having fun.
• etc.

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Friendship Rating Scale

• Do you play with ___ on the playground?
• Do you play board games with ___?
• Would you like to be in an art or science group
  with ____?
• Do you talk to ___ during the day?
• Is ____ your friend?
• Would you like to invite ___ over to your house
  to play?
• (Scale of 1 to 5 given pre- and post-tx)

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Selecting Communication Goals

• How often do peers use the same skills?
• Baseline observations (no prompts)
• Immediately influence peer perceptions
• Parent concerns and identified goals
• Developmental milestones
• Pre-treatment survey of school staff
  perceptions/opinions
• Clinical intuition

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Why were peers successful?

• Reciprocal communication behaviors
• Introduce, extend, and maintain topics
• Request clarification if needed
• Respond to peers initiations and topics
• Verbal utterances used for a variety of purposes
• Use of and response to nonverbal behaviors and
  social cues

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Types of Verbal Utterances

• You have to hit it 4 times
• Hes gotta put his hat on
• How about we just do it that way
• Lets keep it in the middle
• It landed on line so I get to go again
• I got a star
• Thank-you
• We all are safe
• Cool
• Its my turnNo, its my turnIts her turn
• You gotta see it spin
• Press it
• Your turn Will

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Possible Social Communication Skills to Teach

• Strain Colleagues
• Play organizers
• Sharing materials
• Helping others
• Compliments
• Rough and tumble play
• Group entry skills

• Thiemann Colleagues
• Make suggestions/rules
• Offers to share and help
• Let others go first
• Compliments
• Talk about turns
• Ask questions
• Gain attention PLUS

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Average of Specific Utterance Types Used by
Peers Compared to Children with ASD (Year 1)
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Average of Specific Utterance Types Used by
Peers Compared to Children with ASD (Year 2)
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Rates of All Six Communication Skills Used by
Peers Compared to Children with ASD (Year 2)
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Rates of All Six Communication Skills Used by
Peers Compared to Children with ASD (Yr 3)
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Changes in Reciprocal Social Communication KW
Kindy Social Group
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Select appropriate goals to

• Meaningful access to regular educn curriculum
  both social and academic activities
• Decrease widening social gap
• Network of peer supports to build independence
• Possibly change longer term relationship and
  friendship outcomes as individuals transition,
  leave school and enter workforce

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Secondary Effects

• of appropriate conversations
• of turns in conversations
• Changes in peer initiations and responses to
  focus child
• Progress across social partners, new activities,
  and new settings
• Socially valid outcomes
• Teacher, parent, and peer perceptions

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Change in Conversational TurnsFollowing
Peer-Mediated Text Treatment (Mark)
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Supportive Social Environment

• Find out childs preferred activities to increase
  motivation (Baker et al., 1998)
• Favorite foods, cartoon characters, movies, video
  games
• Give children choice of 2 activities, projects,
  tasks etc. whenever possible
• Provide supports that increase knowledge of
  expectations and rules (e.g., job lists, post
  rules, session agenda, task steps)
• Use transition aides (e.g., timer, picture
  schedule)

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Supportive Social Environment

• Keep peer social groups small (1-2 peers, rotate
  in dyads with focus child)
• Seat trained peers beside focus child
• Give opportunities to take breaks if needed (I
  need a break card)
• Strategies to regulate emotions if needed
• Focus child engages in (at minimum) partial
  participation in social activities

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Classroom Learning Opportunities

• Small academic groups (math or reading)
• Class centers calendar and money activities,
  computers, puzzles and games, dramatic play,
  constructive play
• Special areas art, PE, library
• Card games memory and matching games, Go Fish,
  UNO
• Board games Trouble, Kerplunk, Dont Break the
  Ice, Memory, Ants in Pants

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Lunch Bunch Activities

• Topic cards child generates
• Topic starters open ended
• Funny photos or pictures
• Magazines
• Restaurant guides
• Children take photos then use as topic
  starters
• School subject/events topic cards

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Recess Games

• Four square
• Basketball
• Monkey in the Middle
• Skipping
• Frisbee
• Magic mitts with a Velcro ball
• Map games with bean bags

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Settings and Activities

• Natural settings across-the-day
• e.g., recess, lunch, centers, games
• Marked play areas lines, boxes, maps
• Minimum of 2 to 3 different settings
• 15 minutes, twice/day, 3 days per week
• Choice of 2 activities each session
• 5 to 8 games rotated for 3 to 4 months
• Keep same group of 4 to 6 trained peers

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Lets Take a Break ?
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A Review of Communication Interventions
(Goldstein, 2002)

• Sign language
• Discrete-trial training
• Milieu language teaching paradigms
• Interventions to replace challenging behaviors
• Promote social and scripted interactions within
  peer-mediated programs

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Sign Language and Total Communication

• Lead to quicker and greater learning than speech
  training alone
• Increases in receptive and expressive vocabulary
• Children with more limited communication
  repertoires (echolalic, minimally verbal)
• Signs are less transient gestures easier to
  prompt than verbal productions
• AAC approaches

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Discrete-trial Training

• Differential reinforcement and correction
  modeling and prompting imitation fading
• Increases in language content, form, and
  phonology
• Limited generalization and effects on everyday
  functioning
• Foundation emphasis on increasing generalization
  into natural contexts, and on teaching more
  complex language skills

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Milieu Language Teaching

• Incidental Teaching
• Observe childs interest wait 30-sec
• Prompt child to ask for object
• Elaborated request, What is this?
• Model correct response
• Time delay
• Delayed prompt pause before modeling
• Mand-model (very low initiation rates)
• Observe childs interest
• Adult request tell me what you want
• Adult model say _____

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Outcomes of Milieu Procedures

• Increased requesting for objects
• Increased sentence length/syntax
• Preverbal communication (eye contact, joint
  attention, motor imitation)
• Social amenities (please/thank-you/welcome)
• Vocabulary and phoneme production
• Positive interactions with peers
• Increased generalized language productions
• Increased spontaneous language

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Replacing Challenging Behaviors

• Teach specific language skills to replace
  maladaptive behaviors
• Assumed to serve a communicative function
• Escape? Attention? Avoidance?
• Identify antecedent and consequent variables that
  motivate behaviors
• Functional communication training across contexts
  increased generalizn and maintenance
• Increase appropriate communication skills

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Changes in Inappropriate Behaviors Following
Scripted Text Treatment (Year 1)Thiemann and
colleagues (in prep)
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Changes in Inappropriate Behaviors Following
Scripted Text Treatment (Jay-Kindy)Thiemann and
colleagues (Yr 2, in prep)
Example Behaviors Whining, crying, angry words,
unrelated talk
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Teaching Social Skills and Scripted Interactions

• Peer-mediated interventions
• Teach child with ASD and/or peers to initiate and
  respond
• Model, prompt, and reinforce communication
• Teach in natural environments
• Combination of structured and unstructured social
  settings
• Teach scripted play interactions what to do,
  what to say, how to respond

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Outcomes of Teaching Social and Scripted
Interactions

• Improved play skills
• Improved duration and rates of interactions
• Increases in specific communication skills
• Requests, gain attention, social niceties,
  comments, make suggestions, talk about turns
• Increased generalization of skills across social
  partners, settings, and new skills
• Increased maintenance of skills
• Greater peer acceptance and friendship ratings

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Examples of Behavioral Teaching Strategies
(MOE, Ontario)

• PECS
• Incidental Teaching
• Activity-based Learning
• Peer-Mediated Strategies

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Principles of ABA Programming (MOE, Ontario)

• Program must be individualized
• Positive reinforcement must be used
• Data must be collected and analyzed, ongoing
• Generalization of skills should be emphasized

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Common Elements

• Teaching occurs in natural contexts
• Child preferred activities and focus on child
  interests
• Strategies to enhance generalization a part of
  program
• Use of natural reinforcers and praise
• Involvement of peers

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Rationale for Including Peers

• Exposure to peers alone is not enough
• Results in increased social communication
• Peers provide language models, natural social
  reinforcers, and give feedback
• Peers may reinforce inappropriate behaviors and
  ignore desirable behaviors
• Spill over effects to untrained peers (Sasso et
  al., 1998)
• Peers report enjoyment and learn new skills

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Example Skill Substeps to Teach

• Start Talking
• Say friends name
• Talk about what you are doing
• Talk about what your friend is doing

• Look, wait, listen
• Look at friend
• Sit quietly to listen
• Count to 5

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Example Skill Substeps to Teach

• Keep Talking
• Say same words as friend said
• Ask a question to find out more
• Add something new to what they said

• Answer
• Listen to words
• Say words back to answer
• Say What? if you dont understand

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Teaching Social Behaviors in a Peer Training
Session

• Define and label skill have pictures, cartoons,
  etc. of skill
• Discuss examples and why important to use with
  new friends
• Adult role plays with adult actor
• Adult role plays with child
• Child role plays with child
• Adult gives feedback and reinforces behaviors

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Outcomes of PM Programs

• Increased social communication and decreased
  inappropriate behaviors (Garrison-Harrell et al.,
  1997 Thiemann Goldstein, 2004)
• Spill over effects to untrained peers (Sasso et
  al., 1998)
• Peers report enjoyment and learn new skills
  (Kamps et al., 1998)
• Increased friendship ratings and peer acceptance
  (Gertner et al., 1994 Thiemann et al., 2004 in
  prep)

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Suggestions for Recruiting and Informing Peers

• Peers parent permission
• May or may not be necessary
• Organized social events after school
• Select up to 6 peers rotate in dyads (Lord
  Hopkins, 1986)
• Same age peers
• Keep peer groups the same for a minimum of 3 to 4
  months
• Transition trained peers to next grade

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Suggestions for Recruiting and Informing Peers

• Teacher recommends children who
• Are well liked (high status)
• Age-appropriate social skills
• Similar schedules or academic groupings
• Gender (esp as children mature)
• Willingness to participate
• Amount of talking, teaching, or parenting

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Peer Self-Monitoring Strategies

• Use checklists, rating scales, or tally sheets to
  track trained behaviors
• Provide self-evaluation books/cards
• Set criterion for performance and reinforce
• Fade feedback and reinforcement
• Check in frequently, esp. at beginning
• Give peers more responsibility as they mature

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TALKING TO MY FRIENDS     HOW DID I DO? Yes A
Little No
1. Did I start talking to my friend? ? ? ?   2.
Did I keep talking to my friend? ? ? ? 3. Did
I look, wait, and listen? ? ? ?   4. Did I
answer his questions? ? ? ?   5. Did I say
something nice to him? ? ? ?
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FRIENDSHIP SKILLS
START TALKING 1. Choose a friend to talk to,
say their name. 2. Talk about what you see a
friend doing. 3. Ask a friend a question. 4.
Tell a friend what you are doing.
I am a star at knowing how to Start Talking
Name Date
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Peer Driven Intervention Strategies

• Peers help focus child select other peers
• Peers meet weekly with adult to discuss social
  goals, problem areas, solutions
• Peers have a notebook that outlines social
  activities, times, goals for the week
• Peers provide ideas for hip social scripts and
  important skills
• Haring Breen, 1992

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Examples of How to Train Peers without
Disabilities

• Initial Buddy or Conversation Training
• Teach peers individually or as a small group,
  without focus child
• Teach all peers and focus child the same
  communication skills three to five 30-min sns
• Teach 2 peers and focus child same communication
  skill three 20-min sessions (other peers rotate
  into triads for training)
• Class wide empathy training

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Review of Peer-Mediated Intervention Research

• Combined with Incidental Teaching
• Self-evaluation procedures
• Scripted text treatment

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Combining Incidental Teaching and Peer-Mediation
(McGee et al, 1992)

• During classroom free-play (dyad)
• Bucket of preferred toys (rated by focus child
  prior to baseline)
• Peers taught to use incidental teaching
  strategies
• (a) wait for child to initiate
• (b) ask child to label object say duck
• (c) give child the requested toy
• (d) praise childs correct answer

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Teaching Steps (McGee et al., 1992)

• Adult models each incidental step for peer
• Adult checks off the 4 behaviors on a picture
  checklist reinforces children for playing nicely
• Adult fades checklist and moves away from group
  (listens from a distance)
• Adult prompts an interaction once per min if not
  observed spontaneously
• Teacher sets up play and gives bucket with one
  verbal cue (Here are some toys for you to play
  with) and rotates around groups

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Results of Peer-Mediated Incidental Teaching

• Increase in reciprocal peer interactions
  (Initiation Response sequence)
• Increase in responsiveness to peers
• Increase in independent play with peers
• Increase in teacher perception of social
  competence
• Increase in peer acceptance/play ratings
• Increase in reciprocal interactions in other free
  play settings (for 1 child)

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Peer Self-Evaluation Procedures(Sainato,
Goldstein, Strain, 1992)

• Settings Sociodramatic play areas
• Cooking, housekeeping, beauty shop, doctor, dress
  up
• Teach peers 4 facilitative strategies
• Cartoon picture posters of skills of children
  interacting with each other smaller photos in a
  booklet
• Strategy training (4 skills) followed by
  self-evaluation training
• Strategy training - Adult models, adult-child
  practice, child-child practice with feedback

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Peer Strategy Training (4 Skills)(Sainato,
Goldstein, Strain, 1992)

• Attention getters or Getting your friends
  attention (a) face child, (b) say name, and/or
  (c) tap childs arm
• Play organizers or Getting your friend to play
  (a) suggest play idea, (b) ask to join in a play
  activity, or (c) ask focus child to take part in
  play
• Shares or Sharing with your friend (a) offer a
  toy to focus child, (b) ask focus child for a
  toy, (c) offer to trade toys
• Responses or Talking back to your friend (a)
  repeat (imitate) what target child said, (b)
  restate, or (c) request clarification (Please
  say that again)

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Self-Evaluation Procedures (Sainato, Goldstein,
Strain, 1992)

• Peers predict how they would get a friend to play
  and practice with adult
• Four skills illustrated and in a booklet - Flip
  through book and plan strategy use
• Role reversal training with an adult peer
  checks if successful or unsuccessful
• Training with a focus child and one other peer
  (triad)
• After session - self-evaluate performance using
  smiley or sad faces
• Reinforced for meeting minimum criteria

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Outcomes of Peer Self-Evaluation Procedures
(Sainato et al., 1992)

• Increased use of all strategies by peers
  following self-evaluation training
• Trained peers maintained strategy use and
  generalized to other students with autism as
  long as self-evaluation procedures were available
• Increased social behaviors of focus children
  (same 4 skills)

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Comprehensive Peer-Mediated Social Interventions

• Environmental and activity supports
• Peer-mediated strategies
• Systematic, adult-guided instruction
• Focus on child strengths and learning styles
• Recently added written-text and picture cues
• National Research Council, 2001 Schwartz, 2000
  Thiemann Goldstein, 2001 2004

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Peer Training and Written-Text Cueing Combined
(Thiemann Colleagues)

• Combination of social pragmatic and developmental
  theory with principles of contemporary behavioral
  interventions
• e.g., teach age-appropriate, functional
  social-communicative skills in natural contexts
  (Prizant Wetherby, 1998)
• e.g., systematic instruction of language skills,
  manipulation of environmental variables,
  preferred activities (Horner et al., 1990 Peck
  et al., 1997)

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Written-text and Picture Cues

• Controlled, short phrases written at childs
  level (reading and vocabulary)
• Functional, age-appropriate, and directly related
  to target skill for each activity
• Assume some decoding or word recognition skills
  but not always
• General enough for many practice opportunities
• Available to child throughout activity and
  portable

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Skill Make suggestions

• Maybe we could ______.
• How about we _______.

Skill Talk about turns
Its your turn. Its my turn.
Skill Talk nice, help, share
Way to go. Nice try.
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Ask For Something
 
                           
? ? ? ? ? ? ? ? ? ?
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Lacys Progress in Total Initiations
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Why are scripts effective?

• Help children organize social information
• Continuous access to ideas, comments, questions
  directly related to activity
• Help children learn conversational rules
• when to listen, take a turn talking, etc.
• Decreases adult dependency
• Peers use the scripts provide models
• Peers aware of what child is trying to
  communicate and respond appropriately

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Systematic Adult-Guided Instruction

• Adult defines and models skill
• Child practices skill with adult
• Child practices skill with peer
• Adult/peer prompts skill by pointing to text cue
  (once/minute)
• Adult provides feedback/reinforcement
• Adults monitor in scheduled and unscheduled
  social activities

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Short-term Social Skill Intervention

• Three 30-min sessions in conference room
• One communication skill taught per session
• Focus child and peers taught together
• Intervention steps
• Discuss and define communication skill
• Read social story about communication skill
• Adult-adult, peer-peer, and child-peer role-plays
  
• Prompt with written text cues
• Adult feedback and reinforcement

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Talk about Taking Turns   When friends play a
game or do an activity they take turns, because
this is fair.   Friends like to decide together
who goes first or second or third.   Everyone
likes to go first, so its nice to let a friend
go first.   Someone might ask, Can I go
first?, then I can answer, Sure, Ill go
second.   To keep the game going I could ask,
Whose turn is it?, or tell a friend, Go, your
turn   I will try to talk about taking turns
when we play together.  
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Role Play Props Actor, Co-Actor, Observer
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Table-top written-text cues2nd 5th Grade
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Recess written-text cues for 5th grader
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Just prior to social activity

• Adult involvement on SCR days (2-5 min)
• What talking skills are we working on?
• Child reads text cue related to target skill
• Cues left in front of child (or around neck)
• Adult/peer prompts at 1-min intervals
• Adult involvement on Non-SCR days
• Remember the talking skills we learned

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Total rates of all 3 communication skills
taught Ken
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Comparison of Ken and his Peers Communication
Changes
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Buddy Training and Scripted Text Treatment
(Thiemann et al., in prep)

• 15-minute buddy training (video)
• Monday, Wednesday, Friday in triads
• Introduce friendship vocabulary
• Introduce conversation skills vocabulary
• Start text treatment on one target skill
• Treat for approx. 3 weeks until unprompted
  improvements observed
• Two, 10-min activities across the day, 2
  days/week
• Add a second skill, encourage both
• Add a third skill, encourage use of all three
  prompt skills as necessary

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Initial Buddy Training

• Tell me what a friend is.
• Is a friend the same thing as a buddy?
• Do buddies help each other and play together?
• Is it a good feeling to be a buddy?
• How does having a buddy make you feel?
• Tell me one thing you could do to be a buddy when
  we play together.

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Scripted Text Treatment Steps

• Explain rules and roles
• Show and label target skill
• Discuss why it is important to use skill
• Children generate examples for scripts
• Read scripts to practice
• Ask peers to model scripts in role-play
• Elicit focus child correct response
• Set a target for production of skill
• Leave scripts in direct line of vision
• Monitor and prompt 1/min if necessary
• Teach peer to prompt child
• After activity give corrective feedback

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Talk nice, help, and share You can go first Way
to go! Nice try
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Childs Text Cues Targeting Two Communication
Skills
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Skill Reinforcement Cards One for adult, one
in front of child
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Average Use of 3 Communication Skills Before,
During, and Five Months after the Peer-Mediated
Text Intervention Karly
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Average Use of Communication Skills Not Targeted
in Peer-Mediated Text Intervention Kate
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Hierarchy of Prompts

• Wait for child to initiate 30sec to 1min
• Prompt peer to use time delay or gestures
• Prompt peer to point to picture cue card or text
  script
• Adult points to picture cue card or text
• Adult gives a general verbal prompt while
  pointing to cue Jay, what can you say?
• Give a specific verbal prompt Jay, talk about
  taking turns
• Give a sentence completion cue Say, its my
  ____.
• Tell focus child what to say, Its my turn

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Reinforcing Skill Use

• Refrain from offering candy or prizes for
  positive peer interactions socially rewarding??
• Reward with social activities run a school
  errand, take pictures of school events, play a
  game together
• Use cooperative award systems
• Try not to interrupt flow of activity unless
  necessary (e.g., with praise, tokens, rewards)
• Show child reinforcement card after activity and
  give praise or tell how to improve
• Fade out the reinforcement card gradually

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Fading use of visual cues

• Photo frame with card label of skill, scripted
  text cues, and skill picture
• Decrease length of text script (sentence
  completion cues)
• e.g., I have an idea I have__ I ___)
• Label of skill and picture only
• Photo frame with blank card
• Take frame off table

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Materials to get started

• Boardmaker/pictures of kids socializing
• Wipe off boards and markers
• Laminated paper strips/bubbles
• 5 x 7 clear, plastic photo frames
• Digital camera
• Easel binders
• Velcro
• Laynards with smaller cards of skills

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Successful communicators

• Have shared knowledge of social situations
• Desk work, small and large groups, lines,
  assemblies, substitute teachers
• Can communicate for a variety of purposes
• Linguistic and non-linguistic behaviors
• Can use language appropriately for a wide range
  of purposes
• Understand vocabulary related to social language
  (e.g., talk, listen, ask, answer, etc.)
• Can read and interpret social cues in context
• Can repair communication breakdowns

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Measures to Evaluate Program Effectiveness

• Increase in targeted skills used spontaneously
  (initiations and responses) with trained peers
• Increase in total and type (e.g., imitation,
  sentence completion, time delay) of prompts
  needed
• Decreases in inappropriate social and
  communication behaviors
• Increase in targeted skills used with new social
  partners and social settings
• Improved conversations topic maintenance, range
  of topics, length of conversations
• Achievement of IEP social communication and peer
  interaction goals

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Other Ways to Measure Social Progress

• Socially valid outcomes
• School staff Satisfaction Survey
• Changes in teacher or school staff perceptions of
  child-peer interactions
• Perceptions of individuals unfamiliar with the
  child and social program (videotaped vignettes of
  interactions)
• Peer perceptions rating scales
• Focus child perceptions self-evaluation rating
  scales

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Changes in Teachers Perceptions of Social Skills

• Social Interaction Teacher Impression Rating
  Scale (15-items)
• Overall ratings increased for 3 children
• Social Skills Rating System (SSRS) Teacher
  Report
• Percentile scores increased for 3 children e.g.,
  
• e.g., 25th to the 37th for Ken
• e.g., 14th to 75th for Michael

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Naïve Judges Pre- and Post-Intervention
Questionnaire

• Child is actively involved in the conversations
  or play with peers.
• Child talks to his peers, for example, comments,
  asks questions, talks about the rules, or says
  nice things
• Child appears to have the ability to express
  words to engage in positive social interactions
  with his peers
• 1 Not at all, 3 Sometimes, 5 Constantly

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Naïve raters perceptions of changes in
reciprocal social communicative interactions
103
Friendship Rating Scale

• Do you play with ___ on the playground?
• Do you play board games with ___?
• Would you like to be in an art or science group
  with ____?
• Do you talk to ___ during the day?
• Is ____ your friend?
• Would you like to invite ___ over to your house
  to play?
• (Scale of 1 to 5 given pre- and post-tx)

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Conclusions

• Combine evidence-based practices to individualize
  communication interventions
• Reinforce use of trained skills across-the-school
  day (entire team)
• Monitor changes in rate and quality of child-peer
  interactions - ongoing
• Program in effective generalization strategies