Functional Assessment and Intervention of Social Skills for Young Children with Autism

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Functional Assessment and Intervention 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.
• Danielle D. Madera, B.S.
• Brian A. Boyd, M.Ed.
• University of Florida
• Supported by U.S. Department of Education
• Office of Special Education and Rehabilitative
  Services (H324D020023)

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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
• Questions

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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)

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Social Skills Intervention Research

• Target specific social behaviors such as
  initiation and response (Matson et al., 1996
  Rogers, 2000)
• Child with ASD targeted interventions
• 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)

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Social Skills Intervention Research Continued

• Peer targeted interventions
• 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
• More effect on the responsive behavior of
  children with ASD
• Less of an impact to influence initiations of
  children with ASD

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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 childs 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

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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

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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

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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

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Assessment of Social SkillsContinued

• 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

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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

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Project Specifics

• Participants 6 children per year for 3 years
• Project began January 2003
• Current participant - Garrett
• 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

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Method

• Descriptive Assessments
• Social Skills Interview Form with primary
  caregiver(s)
• Project DATA Social Skills Assessment (Schwartz,
  2002)
• Snap Shot Assessment (adapted from Conroy
  Brown, 2001)
• 6 observations conducted during opportunities for
  child with ASD to 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

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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.

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Garrett

• 5 years old
• Diagnosis
• Autism
• Kindergarten Included 80 of the day
• 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)

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Indirect Assessment Information

• Strengths
• 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
• 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

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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

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Snap Shot Assessment

• Developed to allow practitioners to observe and
  gather information on childs 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

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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

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Snap Shot Assessment Specifics
Type Form of Behavior Context Appropriate-ness of Behavior Reciprocity of Exchange Perceived Goal of Behavior Actual Outcome





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Snap Shot Definitions

• Type and form of behavior
• 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 childs behavior was appropriate
  (both socially and developmentally)
• Reciprocity of exchange
• State whether target childs 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)

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Snap Shot Findings for Garrett

• 3 observations to date (18 total)
• 3 to 5 of those minutes (total of 12 minutes)
  each time did not include any social behavior
• Outdoor play 3/6/03
• 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

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Snap Shot Findings for Garrett to Date

• Sensory (Play-doh) activity 3/11/03
• 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 3/20/03
• 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
• When Garrett initiates peers do not respond
• When peers initiate Garrett does not respond
• Garretts initiations were perseverative and
  appear to perhaps occur when he desires a
  tangible item
• Garrett has limited social interactions

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Snap Shot Practice 1
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Snap Shot Practice 2
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Snap Shot Practice 3
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Snap Shot Practice 4
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Snap Shot Practice 5
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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 childs
  response?
• What is the context of social situation
• Outcomes of social situations
• What was the perceived goal of target childs
  behavior and was that achieved
• Utilize this information when developing
  experimental analyses

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Social Skills Observation Screening

• Developed to allow practitioners to observe and
  gather information on childs social strengths
  and needs in a more structured way than snap shot
• Purpose
• Measure rate/frequency of social behaviors
• Measure topography of social behaviors

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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 23
  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

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Screening Definitions

• 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

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Screening Example
Time 10 20 30 40 50 60
1 I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP
2 I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP I R SI PI PR SIP
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Screening Practice 1
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Screening Practice 2
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Screening Practice 3
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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

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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

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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 childs 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