Developing Meaningful
Relationships among Adolescents
and Young Adults with ASD and
their Peers
Wesley H. Dotson, Ph.D., BCBA
Burkhart Center for Autism Education and Research
Texas Tech University
Acknowledgements:
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The participants, staff, and families of the KU
Social Skills groups
Jim Sherman and Jan Sheldon
Andrea Courtemanche
Justin Leaf
Faculty, staff, and students of Department of
Applied Behavioral Science at University of
Kansas
Goals for today’s session
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Discuss current state of affairs/importance of
developing friendships and other meaningful
relationships
Describe issues encountered in doing so
Provide suggestions for characteristics of
support programs
Provide an opportunity for questions and
discussion
Something to think about:
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As talk proceeds, keep these two young men
in mind
Kenny and Zane
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Both 15-yr-old boys with autism
Both participated in after-school social skills
group for adolescents with autism and
typically-developing peers
Both easily mastered social skills taught
during formal instruction with graduate and
undergraduate teachers
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Kenny:
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Regularly generalized skills to interactions with
peers in social skills group
Added all participants in group to Facebook,
called several regularly, and invited them to
outside social events (movies, bowling, etc.)
On last day of group, insisted on having picture
taken with all participants and staff
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Zane:
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Rarely generalized skills to interactions with
peers in group
Never attended outside events, no interaction with
peers outside group meetings
Dropped out of group before end of program
Part 1: Context for discussion
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Social skills deficits are core feature of
receiving a diagnosis on the Autism Spectrum
(DSM IV-TR, 2000)
What does the literature say about adolescents
and young adults with autism, social skills,
and building relationships?
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Orsmond, Krauss, & Seltzer, 2004
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Interviewed 235 families with adolescent or
young adult with autism
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Majority (>80%) in inclusive setting or employed in
community
Only 24% had relationship with same-aged peer
involving social meetings or activities outside of work
or classroom
46% had NO relationships with same-aged peers
Significant predictor of presence of relationships
with same-aged peers was level of social skills
development
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Longitudinal study from Office of Special Education
Programs (2005)
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Explored post-secondary and social experiences
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< 20% with ASD reported interacting with friend once weekly
40% belonged to community or social group of some kind
For most, over 75% of social interactions with family members
and paid care givers
Involvement in organized groups strongly correlated with
positive outcomes
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Enrollment in post-secondary education
Increased independence
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Few students with autism (~25%) attend any kind of
post-secondary educational institution
Less than 25% of those who attend earn a degree
within 6 years
Recent study suggests most common reason for
dropping out is failure to develop friendships and “fit
in” with peers (Barnard-Brak, Lechtenberger, & Lan,
2010)
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Failure to develop social relationships also
associated with:
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Increased anxiety about social situations with
peers (e.g., Browning, Osbourne, & Reed, 2009)
Other anxiety disorders (e.g., Farrugia & Hudson,
2006; White & Robertson–Ney, 2009)
Depression (e.g., Stewart, Barnard, Pearson,
Hasan, & O’Brien, 2006)
Conclusions:
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Few adolescents and young adults with autism
develop friendships with same-aged peers
Quality of life and successful independence
closely tied to development of relationships
Ability to develop meaningful relationships is
linked with level of social skills
An important point about friendships
for people with autism:
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People with disabilities report that their friends have
several characteristics (e.g., Carrington, Templeton,
& Papinczak, 2003; McVilly, Stancliffe, Parmenter,
& Burton-Smith, 2006):
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Shared interests
Loyalty
Helping when it is requested
Spending time together
Exact same characteristics typically developing
peers use to identify their friends
Part 2: Interventions
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Describe common interventions to teach
social skills
Describe interventions to develop positive
relationships
Teaching Social Skills
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A number of interventions used to develop
social skills, including:
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Video modeling
Script fading
Peer mediated strategies
Teaching Interactions
Virtual reality
All have successfully taught social skills
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Recent reviews suggest generalization of outcomes
remains a problem.
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Matson, Matson, & Rivet, 2007
Rao, Beidel, & Murray, 2008
Tse, Strulovitch, Tagalakis, Meng, & Fombonne, 2007
Williams White, Koenig, & Scahill, 2007
Generalization most likely when peers involved,
training is in natural environment, or training is
carefully structured to promote generalization
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Fewer studies explore teaching social skills to older
learners relative to younger children
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Skills targeted for intervention with older learners:
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Conversation
Self-Advocacy
Recreation skills
Dating/Relationship skills
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May require different instructional arrangements and
considerations versus more basic social skills
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More sensitive issues
More complex discriminations
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“Skill” may look different based on who the social partner is OR
who the person with autism WANTS the social partner to be
Class, status, and personality type also influence topography of
skills (e.g., self-advocacy with a friend vs. a principal vs. a police
officer)
Personal preference plays larger role
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Developing positive peer relationships
requires a different set of social skills than
other social domains
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Manners and politeness versus having an
uncomfortable conversation with a friend
Conversation in the hallway with platonic friends
versus conversation with potential dating partner
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Teaching programs can still target more
complex skills successfully
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Programming must account for increased
complexity
Discrimination and generalization programs
become focal point of intervention
Building Relationships:
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In addition to teaching social skills it is
important to explore how and why positive
relationships form:
Assumptions about formation and
maintenance of relationships:
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Positive reinforcement is a privilege, not a
right.
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People choose to deliver positive things to others
Relationships are governed by concept of
reciprocity.
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Both parties must give and receive in a healthy
relationship
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Value of a relationship is a direct function of
amount of reinforcement people receive.
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Relationships are strongest when people reinforce
each other on a regular basis
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Goal is to create relationships that involve the
regular, voluntary exchange of reinforcers
between both people
Teaching Family Model
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Groups of adolescents live in homes with a “family”
who is responsible for providing social support and
structured teaching
Constant embedded and formal teaching
Widely replicated and successful teaching
procedures
Most teaching focused on developing social skills
and helping adolescents build positive relationships
with adults
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Provided measures of relationship strength
between residents and teaching family
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Proximity during free time
Joking
Asking staff opinion about things without
prompting
Smiles, laughs when staff member present
Methods to develop positive
relationships between staff and clients
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Work suggests that there are ways to
systematically foster relationships
Research involving staff and clients in
Teaching Family Model homes for clients
with DD
Steps to building positive relationships
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Step 1: Staff member provides noncontingent access to preferred items
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Approaches client and offers access to known
preferred items “for free”
Waits longer before approaching client each time
to set the occasion for client to approach staff
member
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Step 2: Staff member begins shaping specific
approach and request responses using
preferred items as reinforcers
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Initially requires client to approach before
delivering item
Shapes an approach response (e.g., tap on
shoulder)
Shapes a request response (e.g., sign for “drink”
or “toy”)
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Step 3: Staff member shapes reciprocity by placing
increasingly effortful demands on client before
delivering preferred item
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Following a request response, asks client to do something
before preferred item delivered
Initial demands small and highly likely (“Come over
here…”)
Move to larger demands “equivalent” to value of
reinforcer being requested (“Please unload the dishwasher
first”)
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Results:
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Clients spent more time in proximity with staff
members
Clients more compliant with demands from staff
members
Discussion:
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Social skills can be taught
Involving peers in teaching can increase
likelihood of generalization
Positive relationships can be systematically
built
Next steps: further explore programs to build
relationships and extend to peers (as both
targets of relationships and teachers)
Part 3: Suggestions, Issues, and
Discussion
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Developing relationships between adolescents
and young adults with ASD and their peers:
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What, then, do we do?
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How do we approach programming?
Back to Kenny and Zane
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What do you think were some of the
differences between the two cases?
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Motivation:
 Adolescents more likely to build relationships with
preferred people
 Kenny liked peers and shared many interests with them
 Zane didn’t share interests with peers and thought they
weren’t “cool”
Engagement:
 Adolescents more willing to participate when learning
environment fun/preferred
 Kenny enjoyed group social games and enjoyed sports
 Zane did not like many games selected and did not like
playing sports
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Relevance:
 Adolescents more willing to engage in target behaviors
which they see as functional and important
 When teaching adolescents how to ask and answer
questions to get to know a friend better:
 Kenny saw skills as helping him be friends with peers
in group
 Zane “Why should I do this, I don’t even like these
people anyway?”
Implications for programming:
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What, if anything, could we have done
differently with Zane?
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Setting
Skills
Teaching Approach
Ownership
Summary:
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Few adolescents and adults with autism develop and
maintain meaningful peer relationships
The ability to develop relationships is closely tied to
social skills development
Both social skills and relationship-building skills can
and have been taught
Active involvement of participant and compatibility
with peers and social environment are key to
achieving generalized and meaningful outcomes
Thus:
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Intervention and support services for adolescents and
young adults with autism should:
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Focus on developing the complex social skills needed to
navigate various kinds of adult relationships
Provide/identify opportunities for increased participation
in community activities
Teach/work where peer relationships are most likely to
form for that person
Involve the person directly in their own program to
increase likelihood of compatibility with goals, target
peers, and desired outcome
Thanks for coming!