Social Skills Training for Teaching Replacement
Behaviors: Remediating Acquisition Deficits
in At-Risk Students
Frank M. Gresham
Louisiana State University
Mai Bao Van
Garden Grove Unified School Disrtict
Clayton R. Cook
University of California–Riverside
ABSTRACT: Social skills training has been recommended as an intervention for students having difficulty
establishing meaningful social relationships with peers and teachers in school settings. Several metaanalyses of the relevant literature have shown weak to moderate effects, whereas other syntheses
have shown somewhat larger effects. The meta-analyses show that the typical social skills intervention
averages 2.5–3.0 hours per week for 10–12 weeks for a total of approximately 30 hours, which may
be insufficient to remediate long-standing social skills deficits. The current study identified students
who were homogenous on the type of social skills deficit (i.e., acquisition deficits) and provided them
with intense (60 hours) social skills training and classroom-based interventions. Students receiving
intense social skills instruction showed rather large decreases in competing problem behaviors that
were maintained at two-month follow-up and that were socially validated by substantial pretest/
posttest changes in teacher ratings of social skills and competing problem behaviors.
Social skills and social competencies
are important in students’ development of
interpersonal relationships with peers and
significant adults. Those who fail to develop
adequate social competencies are at risk for a
number of negative outcomes, including peer
rejection, later manifestations of psychological
disorders, dropping out of school, loneliness,
criminality, and poor academic performance
(Coie & Dodge, 1983; Gresham, 2002; Parker
& Asher, 1987). A large body of research
accumulated over the past 20 years suggests
that a number of at-risk students fail in their
social relations with the three most important
social agents in their lives—peers, teachers,
and parents (Patterson, Reid, & Dishion, 1992;
Reid, Patterson, & Snyder, 2002; Walker &
Severson, 2002).
Many students who are either at risk
for or classified as emotionally disturbed in
schools under the Individuals With Disabilities
Education Act (IDEA 2004) exhibit social
competence deficits (Forness & Knitzer,
1992; Gresham, 2002). The current federal
Behavioral Disorders, 31 (4), 363–377
BD_31(4).indd 363
definition of emotional disturbance specified
in the IDEA includes two criteria that involve
social competence difficulties: (1) an inability
to build or maintain satisfactory interpersonal
relationships with peers and teachers, and
(2) the expression of inappropriate behavior
or feelings under normal circumstances. It
is clear that long-term personal and social
adjustment of individuals is based to a large
degree on an ability to build and maintain
positive interpersonal relationships, skill in
establishing peer acceptance, the capacity to
form meaningful friendships, and skills that
allow for avoidance or termination of negative
or destructive relationships with others
(Kupersmidt, Coie, & Dodge, 1990; Parker &
Asher, 1987; Walker, Ramsey, & Gresham,
2004).
Conceptualization of Social Skills
Social skills can be conceptualized as a
response class made up of topographically
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9/6/06 7:46:19 AM
dissimilar social behaviors. These behaviors can
be grouped in same functional response class
because they produce the same outcomes or
serve the same function for individuals (Johnston
& Pennypacker, 1993). For instance, discrete
behaviors such as establishing eye contact with
others, greeting others verbally, listening to
others, and appropriately gaining entry into a
peer group can be grouped under the response
class of “peer-related social skills” (Walker,
Irwin, Noell, & Singer, 1992). These behaviors,
although topographically dissimilar, may serve
the same function—positive social attention
from peers (Gresham, Watson, & Skinner,
2001). Social skills can also be conceptualized
from a social validity perspective in which they
are defined as specific social behaviors and
response classes that predict important social
outcomes for students (Gresham, 1986). Using
a social validity view, social skills represent a
set of competencies that (1) facilitate initiating
and maintaining positive social relationships,
(2) contribute to peer acceptance and friendship
development, (3) result in satisfactory school
adjustment, and (4) allow individuals to cope
with and adapt to the demands of the social
environment.
Another important conceptual feature of
social skills is the distinction between social
skill acquisition and performance deficits.
Acquisition deficits can be described as either
the absence of knowledge about how to perform
a given social skill or difficulty in knowing
which social skill is appropriate in specific
situations (Gresham, 1981, 2002). Acquisition
deficits can also be characterized as “can’t
do” problems (i.e., the student cannot perform
the social skill under optimal conditions).
Performance deficits can be conceptualized
as the failure to perform given social skills at
acceptable levels even though the student may
know how to perform the social skill. These
types of social skills deficits are best thought of
as “won’t do” problems (i.e., the student knows
what to do but does not want to perform the
social skill).
Another feature in conceptualizing social
skill deficits is the competing problem behavior
dimension (Gresham & Elliott, 1990). Competing
problem behaviors effectively compete with,
interfere with, or “block” either the acquisition
or the performance of a given social skill.
Competing problem behaviors can be broadly
classified as either externalizing behavior
patterns (e.g., noncompliance, aggression, or
coercive behaviors) or internalizing behavior
patterns (e.g., social withdrawal, depression,
364 / August 2006
BD_31(4).indd 364
or anxiety) (see Achenbach & McConaughy,
1987). For example, a student with a history
of noncompliant, oppositional, and coercive
behavior may never learn “prosocial” behavioral
alternatives such as sharing, cooperation,
and self-control because of the absence
of opportunities caused by the competing
function of these aversive behaviors (Eddy,
Reid, & Curry, 2002). Similarly, a student with
a history of social anxiety, social withdrawal,
and shyness may never learn appropriate social
behaviors because of withdrawal from the peer
group and the absence of opportunities for
learning peer-related social skills.
One aspect of social skills conceptualization
that has been often overlooked is the
effectiveness of teaching positive replacement
behaviors to overcome competing behaviors.
Maag (2005) suggested that replacement
behavior training (RBT) might solve many of
the problems described in the social skills
training literature, such as poor generalization
and maintenance, modest effect sizes, and
social invalidity of target behavior selection.
RBT is based on the premise of functional
analysis of behavior. That is, the goal in RBT is
to identify a prosocial behavior that serves the
same function as the inappropriate behavior.
For example, a student engages in disruptive
behavior in a classroom and a functional
behavioral assessment determines that the
function of that behavior is social attention from
peers and the teacher. A RBT approach would
identify a prosocial behavioral alternative
such as work completion and paying attention
to the teacher that would result in peer and
teacher social attention (i.e., that would
serve the same function). Elliott and Gresham
(1991) recommended similar strategies based
on differential reinforcement techniques to
decrease occurrences of competing problem
behaviors and to increase occurrences of
prosocial behaviors.
Finally, several meta-analytic reviews
of the social skills training (SST) literature
have shown weak to moderate effect sizes
(Gresham, Cook, Crews, & Kern, 2004). Metaanalyses of research conducted with students
with or at risk for emotional and behavioral
disorders (Mathur, Kavale, Quinn, Forness,
& Rutherford, 1998; Quinn, Kavale, Mathur,
Rutherford, & Forness, 1999) and learning
disabilities (Forness & Kavale, 1999) showed
weak effect sizes. These small effect sizes,
however, are inconsistent with other metaanalytic reviews that show much larger effects
(Mdn D = .60) (see Gresham et al., 2004). These
Behavioral Disorders, 31 (4), 363–377
9/6/06 7:46:19 AM
differences in effect sizes notwithstanding, one
explanation for weak effect sizes produced
in some SST studies may be explained in
part by the relatively low intensity of many
SST protocols. For example, the studies in
the meta-analyses conducted by Mathur et
al. (1998), Forness and Kavale (1999), and
Quinn et al. (1999) averaged only 30 hours
for the entire SST program. This corresponds
to approximately 2.5 to 3.0 hours of SST per
week for 10 to 12 weeks. It may well be that
30 hours of social skills instruction may not
be sufficiently intense to remediate many
students’ social skills deficits.
Purpose of Present Study
The purpose of the present study was
threefold. First, we identified a group of students
who were homogenous on the type of social
skills deficit exhibited. Specifically, this study
targeted a group of students with social skill
acquisition deficits and involved giving those
students direct instruction in social skills in a
small group setting. Second, we investigated
the effects of a high-intensity SST intervention.
SST intensity was investigated because prior
SST research using 30 hours of training has
produced modest effect sizes (Gresham et al.,
2004; Mathur et al., 1998). Third, we evaluated
the effects of differential reinforcement of other
behavior (DRO) delivered in the classroom on
generalization and maintenance of intervention
effects across settings and over time and on
students’ standing on socially valid measures
of social skills and problem behaviors.
Method
Participants and Setting
Participants were four students from a large
suburban southern California school district.
These four students received 60 hours of social
skills training over 20 weeks (3 hours per
week). Kev was a 7-year-old boy in the second
grade. He did not have a history of referral to
school study teams or special education, but
his teacher indicated that he had substantial
difficulties in interpersonal relationships with
peers. Laurie was a 6-year-old girl enrolled
in first grade. Her teacher stated that she had
difficulties making friends and joining peer
playgroups at recess. Debbie was a 7-year-old
girl in the second grade; her teacher indicated
that she had difficulty with impulsivity and
Behavioral Disorders, 31 (4), 363–377
BD_31(4).indd 365
inattention. During the study, Debbie was
taking 18 mg of Concerta for attention deficit/
hyperactivity disorder. Nate was a 7-year-old
second grader. His teacher noted that he had
difficulty in temper control and aggressive
behavior with peers.
The school had universal interventions in
place for the entire school population based on
a positive behavioral support plan. Specifically,
the school had clear rules and objectives for
appropriate behaviors (e.g., “Be nice to others,”
“Help others,” “Be safe”). Specific examples
of each of these behavior classes were
posted throughout the school, and students’
occurrences of these behaviors were reinforced
using a lottery system. In the lottery, students
received a ticket that could be turned into the
office for a drawing at the end of the week.
The more tickets a student earned, the greater
the chance that student had of “winning” the
lottery. Reinforcers in the lottery included free
time, access to computers, and opportunities
to talk/play with friends. School rule infractions
resulted in response cost procedures such as
loss of recess time, loss of points in class, or a
note sent home to parents.
T
A
G
Selection Procedures
D
I
s
The four participants were between 6 and
8 years of age and were at risk for developing
emotional and behavioral disorders. A multiple
gating procedure similar to that used by Walker
and Severson (1990) was used. First, their
general education teachers nominated students
during the first month of the new school year.
Teacher nominations were based on clear
operational definitions of problem behaviors
exhibited by students often identified as being
at risk for emotional and behavioral difficulties.
Teachers were asked to identify 10 students
who exhibited behaviors that most closely fit
the definition of social skills problems. Teachers
rank-ordered the 10 students according to the
severity of behavioral difficulties on a 1 (most
severe) to 10 (least severe) scale. The specific
definition used by teachers was as follows:
Co
N
M
G
R
D
No
Some kids often start fights or arguments with
other kids. They may hit, kick, pinch, swear,
or are aggressive toward other kids. They
may also say mean or nasty things to hurt
others’ feelings. They may show signs of
hyperactivity, impulsivity, inattention, defiance,
and/or noncompliance toward others in class
or at recess.
In the second stage of the identification
process, teachers completed two standardized
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measures of social skills and problem behaviors:
the Social Skills Rating System (SSRS) (Gresham
& Elliott, 1990) and the Critical Events Index
(CEI) (Walker & Severson, 1990). Students
exhibiting a social skills deficit (Total Social
Skills < 85 and Total Problem Behavior > 115)
as well a CEI score of 1 or greater passed this
second gate.
In the third stage, students with social skills
acquisition deficits were operationally defined
using the SSRS social skills and problem
behavior scales as recommended by Gresham
and Elliott (1990). Specifically, students were
considered having social skills acquisition
deficits if they received a rating of 0 on the
Frequency dimension, a 1 or 2 rating on the
Importance dimension on more than 50% of
the 30 items (> 15 items), and a rating of 2 on
more than 50% of the problem behavior items
(> 9 items) (see Gresham & Elliott, 1990). Table
1 presents the Social Skills and Table 2 presents
the Competing Problem Behaviors for the four
participants based on the above operational
definition procedures.
Instrumentation
A combination of norm-referenced rating
scales/checklists and direct observational
data served as instrumentation in the current
investigation. These instruments and their
psychometric characteristics are described
below.
Social Skills Rating System-Teacher (SSRST). The SSRS-T (Gresham & Elliott, 1990) is a
teacher rating scale measuring three domains:
social skills (30 items), problem behaviors (18
items), and academic competence (9 items).
The elementary version of the SSRS-T was used
in the current investigation; it is a nationally
standardized instrument based on a sample of
2,400 elementary age students in grades K–6.
The SSRT-T documents the perceived frequency
and importance of behaviors influencing
students’ social competencies and adaptive
functioning at school. It has adequate internal
consistency reliability for the Total Social Skills
(α = 0.93), Total Problem Behaviors (α = 0.88),
and Academic Competence (α = 0.95) scales.
Four-week test-retest reliability coefficients for
the three scales range from 0.84 to 0.93 with
a median stability coefficient of 0.85. The SSRS
manual reports a number of studies offering
validity evidence for the SSRT-T based on test
content, relationships with other measures,
and the internal structure of items (Gresham &
Elliott, 1990).
366 / August 2006
BD_31(4).indd 366
Critical Events Index (CEI). The CEI is a
33-item behavioral checklist that assesses
whether a student has exhibited any of 33 high
intensity/low frequency externalizing and/or
TABLE 1
Social Skills
Controls temper in conflict situations with adults
Easily makes transitions from one classroom activity
to another
Attends to your instruction
Invites others to join in activities
Makes friends easily
Initiates conversations with others
Gives compliments to peers
Volunteers to help others with classroom tasks
Joins ongoing activity of group without being told
to do so
Ignores peer distractions when doing classwork
Appropriately questions rules that may be unfair
Compromises in conflict situations by
changing own ideas to reach agreement
Introduces him/herself to new people without being
told
Responds appropriately to teasing by peers
Responds appropriately when pushed or hit by
other children
TABLE 2
Competing Problem Behaviors
Interrupts conversations of others
Disturbs ongoing activities
Argues with others
Gets angry easily
Talks back to adults when corrected
Has temper tantrums
Acts impulsively
Fidgets/moves excessively
Easily distracted
Fights with others
Threatens or bullies others
Doesn’t listen to what others say
Behavioral Disorders, 31 (4), 363–377
9/6/06 7:46:20 AM
internalizing behavior problems within the
past 6 months (Walker & Severson, 1990). The
CEI was standardized on 4,500 cases collected
from 18 school districts in 8 states. Separate
norms are available for males and females,
grade
levels,
internalizing/externalizing
students, and nonreferred students. The CEI
has extensive reliability and validity evidence.
Reliability evidence is expressed in terms of
test-retest, internal consistency, and interrater
reliabilities. In terms of validity evidence, the
CEI correlates with other measures of behavior
problems, social skills, and sociometric status
and differentiates referred from nonreferred
students for emotional and behavioral
difficulties (Gresham, Lane, MacMillan, &
Bocian, 1999; Gresham, MacMillan, & Bocian,
1996; Gresham, MacMillan, Bocian, Ward, &
Forness, 1998).
Direct Observation Measures. These
measures were used to assess whether SST
had an effect on reducing competing problem
behaviors. A total of 23 observation sessions
per student were conducted during baseline,
intervention, and follow-up phases of this
investigation. Total Disruptive Behavior (TDB)
was defined as a class of behaviors that disturb
the classroom ecology and interferes with
instruction. These behaviors included being out
of seat without permission, not complying with
teacher instructions within 10 seconds, making
any audible noises or vocalizations that disrupt
ongoing classroom activities, yelling, cursing,
and taking others’ property. Each student
was observed for 23 sessions of 15 minutes
duration each session. TDB was measured
using duration recording in which the elapsed
time the student engaged in TDB was recorded.
Elapsed time was converted to a percentage by
dividing the elapsed time by the duration of the
observation session and multiplying by 100.
Alone time (AT) was assessed using duration
recording in 23, 15-minute observation sessions
conducted on the playground. The definition of
AT was based on the definition given contained
in the Systematic Screening for Behavior
Disorders (SSBD) (Walker & Severson, 1990)
and was defined as the target student not being
within 5 feet of another student, being neither
socially involved nor socially engaged, and
not participating in game or structured activity
with other students. Examples included sitting,
standing, shooting baskets, kicking balls off
walls, and so forth. A student engaged in selftalk (i.e., verbal behavior not directed toward
anyone else) would be coded as AT. AT was
calculated by recording the elapsed time the
Behavioral Disorders, 31 (4), 363–377
BD_31(4).indd 367
student was alone, dividing that number by the
duration of the observation session (15 minutes),
and multiplying by 100. This procedure yielded
a percentage of time the student spent alone on
the playground.
Negative social interaction (NSI) was
also based on the definition contained in the
SSBD (Walker & Severson, 1990) and was
assessed using duration recording in 23, 15minute observation sessions. NSI was defined
as the student engaging in behaviors such as
biting others, hitting others, pinching, cursing,
or verbally or physically threatening other
students. NSI was calculated by recording the
duration of time the student met the definition
of the behavior, dividing this number by
the duration of the observation session (15
minutes), and multiplying by 100. This yielded
the percentage of time the target student
engaged in NSI on the playground.
Interobserver Agreement
Two school aides who were blind as to the
specific purposes of the investigation served as
observers. Before the onset of the observation
procedures, the aides were trained in the
operational definitions of behavior and how to
use duration recording. Observers met for four
1-hour sessions that included the following
topics: (a) a discussion of the operational
definitions of behavior, (b) direct training on
the use of duration recording, and (c) directed
practice on using the observation protocol on
simulated cases.
A random sample of 20% of the observation
sessions was selected to assess interobserver
agreement. Interobserver agreement was
estimated using duration agreement in which
the shorter duration of behavior was divided by
the longer duration of the behavior. This was
converted to a percentage by multiplying by
100 (shorter duration/longer duration × 100).
Interobserver agreement estimates ranged from
84% to 95%, with a median interobserver
agreement of 90%.
Experimental Design
The experimental design consisted of
4 ABAB designs (1 design for each of the 4
participants). Each design consisted of 2
baseline and 2 treatment conditions with a 2month follow-up phase. Data were collected
during each baseline and intervention phase
for 5 sessions each in which each student’s
duration of the 3 target behaviors was recorded
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in 15-minute observation sessions. The followup phase consisted of 3 probes on each of the
target behaviors collected 2 months after the
termination of the intervention.
Procedures
All students received 20 weeks of
social skills instruction specifically using
the techniques found in the Social Skills
Intervention Guide (SSIG) (Elliott & Gresham,
1991). The second author instructed all four
students. Remediating social skills acquisition
deficits involved modeling, coaching, and
behavioral rehearsal as described in the SSIG.
The Appendix gives an example of how each of
the social skill acquisition deficits is remediated.
The same instructional procedures were used
for remediation of all social skill acquisition
deficits for all four students. The four students
(Kev, Laurie, Debbie, and Nate) received 60
hours of SST. The second author delivered all
instruction in a small-group pullout setting as
described in the SSIG. Students received two
sessions per week for 1.5 hours each session
(40 sessions).
DRO Procedures
In addition to instruction in the pullout
setting, the second author provided direct
consultation and recommendations to the
students’ teachers and parents. After each
session, the second author provided a set
of explicit instructions regarding the use of
differential reinforcement of other behaviors
(DRO). Specifically, DRO involved delivering
a reinforcer (verbal praise) after an interval of
time in which a competing problem behavior
did not occur at the end of the interval (Repp
& Dietz, 1974). The DRO procedure consisted
of four steps: (a) identifying the reinforcer for
the competing behavior (e.g., social attention),
(b) identifying the reinforcer for appropriate
behavior (e.g., social attention in the form
of verbal praise), (c) specifying the DRO
time interval (i.e., DRO–5 minutes), and (d)
eliminating the reinforcer for competing
problem behaviors and delivering a reinforcer
for
appropriate
competing
behaviors
(Miltenberger, 2004).
The current investigation used momentary
DRO scheduling (as opposed to interval
DRO), which constitutes delivering verbal
praise at the end of a specified time interval
in which the target behavior did not occur.
Teachers used a momentary DRO–5 minute
368 / August 2006
BD_31(4).indd 368
schedule of reinforcement (i.e., verbal praise
was delivered after 5 minutes elapsed in which
inappropriate behavior did not occur at the end
of the interval). Using the direct behavioral
consultation procedures described by Watson
and Robinson (1996), the second author gave
the teacher a protocol containing examples
of DRO procedures and demonstrated DRO
techniques in that teacher’s classroom.
The second author also conducted weekly
monitoring and consultation sessions with
both teachers and parents to provide feedback
on students’ progress, discuss treatment
integrity data, and suggest modifications in the
intervention strategies.
Social Skills Training Procedures
We used four basic instructional variables
to remediate students’ acquisition deficits in a
small group setting: direct instruction, rehearsal,
feedback/reinforcement,
and
reductive
procedures. Instruction was delivered using
verbal (often called coaching) and modeled
instruction. Verbal instruction involves using
concrete and abstract concepts to teach social
skills. Modeled instruction, on the other hand,
delivers instruction visually to the learner
so that he or she can learn how to combine
and sequence the behavioral components of a
given social skill.
Rehearsal involves the repeated practice of
a social skill once it has been learned. Rehearsal
or practice leads to more effective and efficient
behavioral performances and can take three
forms: overt rehearsal, covert rehearsal, and
verbal rehearsal (Elliott & Gresham, 1991).
Overt behavioral rehearsal was used in the
present investigation and involved observable
behavioral performances of a social skill after
coaching and modeling of a given social skill.
Feedback and reinforcement procedures
were used to enhance students’ performances
of acquired social skills. The feedback given was
information on the correspondence between
social skill performance and the expected
standard of performance. The students received
specific information about the quality of social
skills exhibited in role-play performances of
specific social skills. Reinforcement involves
presenting (positive reinforcement) or removing
(negative reinforcement) environment events
to increase the frequency of social skills. We
used only positive reinforcement procedures to
facilitate social skills performances.
Reductive procedures are designed to
reduce or eliminate competing problem
Behavioral Disorders, 31 (4), 363–377
9/6/06 7:46:20 AM
behaviors that often interfere with the effective
teaching social skills. Reductive procedures
include techniques such as timeout, response
cost, and various forms of differential
reinforcement. We used only differential
reinforcement and response cost procedures to
reduce competing problem behaviors in both
the small group and classroom settings.
Treatment Integrity
Treatment integrity of the pullout group
social skills training procedures was evaluated
by the instructor’s adherence to the procedures
detailed in the SSIG (a manualized treatment
protocol) as recommended in the behavior
therapy literature (see Eifert, Schulte, Zvolensky,
Lejuez, & Lau, 1997). In the present study,
treatment integrity was ensured by a definitive
description of the SST techniques to be used
and specific statements of what operations the
instructor is to perform. The SSIG meets both of
these criteria for treatment integrity.
We assessed treatment integrity of the
teachers’ use of DRO and reductive procedures
by direct observation of intervention
implementation. Using a checklist of all
components of given treatment procedures,
the same teacher aides who recorded durations
of the three target behaviors recorded the
percentage of treatment components correctly
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implemented by the teachers. Interobserver
agreement estimates were collected randomly
for 20% of the observation sessions. Percent
agreement was calculated by dividing the
number of agreements by the number of
agreements + disagreements and multiplying
by 100. Percent agreement averaged
approximately 82% for the classroom-based
intervention implementation. Intervention
integrity estimates ranged from 65% to 86% (M
= 74.17%) for Kev, Laurie, Debbie, and Nate.
Results
Figures 1–4 depict target behavior
durations for Kev, Laurie, Debbie, and Nate.
Laurie, Debbie, and Nate showed substantial
decreases in AT on the playground compared to
Kev. Effect size estimates for each of the target
behaviors were quantified using the percentage
of nonoverlapping data points (PND) between
baseline and treatment phases (Mastropieri &
Scruggs, 1985-86). Although PND has some
methodological drawbacks (Faith, Allison, &
Gorman, 1997), outcomes were expressed
using this metric to be consistent with the single
subject meta-analysis provided by Mathur et
al. (1998).
PND is computed using the number of
treatment data points below the lowest baseline
data point (for target behaviors one is trying to
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Figure 1. Duration times for TDB, NSI, and AT for Kev.
Behavioral Disorders, 31 (4), 363–377
BD_31(4).indd 369
August 2006 / 369
9/6/06 7:46:21 AM
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Figure 2. Duration times for TDB, NSI, and AT for Laurie.
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Figure 3. Duration times for TDB, NSI, and AT for Debbie.
370 / August 2006
BD_31(4).indd 370
Behavioral Disorders, 31 (4), 363–377
9/6/06 7:46:21 AM
decrease). For example, if 8 of 10 data points in
the two treatment phases are below the lowest
data point in the first baseline phase, then PND
would be 80%.
Table 3 shows PND estimates for the four
students. All four students showed substantial
PND estimates across the three target behaviors
(M = 76.23%). Nate and Kev showed the largest
PND for TDB (100% and 92.31%, respectively)
and AT (100% and 76.92%, respectively). SST
was less effective for Laurie’s NSI (46.15%) and
for Debbie’s AT (46.15%). Table 3 also depicts
treatment integrity estimates for the four
students, which ranged from 65.42 to 85.58%
(M = 74.17%). Treatment integrity was very
good for Kev (79.12%) and Nate (85.58%) but
was substantially lower for Laurie (68.75%)
and Debbie (65.42%).
Table 4 shows the combined social
validation data as measured by the SSRS-T
for Kev, Laurie, Nate, and Debbie. The four
students moved from a pretest mean of 78.25
to a posttest mean of 101.25 on Total Social
Skills, or from the 7th to approximately the
50th percentile. For Total Problem Behaviors,
the students moved from a pretest mean of 124
to a posttest mean of 102.75, or from the 95th
to the 58th percentile. SST did not appear to
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TABLE 3
Percent Nonoverlapping Data Points
and Treatment Integrity
PND (%)
Treatment Integrity (%)
Kev
79.12
TDB
92.31
NSI
84.62
AT
76.92
Laurie
68.75
TDB
76.92
NSI
46.15
AT
84.62
Debbie
65.42
TDB
61.54
NSI
84.62
AT
46.15
Nate
85.58
TDB
100
NSI
61.54
AT
100
M
#BTFMJOF
76.23
74.17
*OUFSWFOUJPO
'PMMPXVQ
%VSBUJPO1FSDFOUBHFT
/BUF
4FTTJPOT
Figure 4. Duration times for TDB, NSI, and AT for Nate.
Behavioral Disorders, 31 (4), 363–377
BD_31(4).indd 371
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9/6/06 7:46:22 AM
TABLE 4
Social Validation Measures: Social Skills Rating System—Teacher
M
Total Social Skills
Pretest
SD
Posttest
SD
78.25
9.85
101.25
10.66
Total Problem Behaviors
124.00
11.33
102.75
12.42
Academic Competence
85.00
12.33
89.25
11.38
have an appreciable effect on the students’
Academic Competence ratings on the SSRS-T.
Follow-up probes collected two months after
the termination of SST showed maintenance
effects on some target behaviors. All students
showed similar maintenance effects for TDB
two months after intervention. Kev, Debbie,
and Nate showed good maintenance for NSI
at follow-up and all four students showed
adequate maintenance for AT during the
follow-up probes.
Discussion
The current findings indicate that students
receiving a relatively intense SST demonstrate
rather large decreases in competing problem
behaviors and improvement on social
validation measures. Sixty hours of SST also
produced large changes in NSI for Kev and
Debbie, a moderate effect for Nate, and a
relatively small effect for Laurie. Large effects
for TDB in the classroom were observed for
Kev, Laurie, and Nate, and moderate effect for
this behavior was shown for Debbie. Three of
the four students showed large decreases in AT
on the playground (Kev, Laurie, and Nate).
These results suggest that a higher intensity
or “dosage” of SST than has been reported in
the literature produces larger effects on target
behaviors and social validation measures than
lower intensity SST. This “dose effect” would
seem to argue for simply providing more SST to
achieve positive outcomes. Treatment integrity
levels, however, may also moderate these
findings. The effect of treatment integrity on
SST outcomes has not been studied extensively
in the literature. Three meta-analyses of the
SST literature have shown relatively weak
effects for SST with students (Forness & Kavale,
1999; Mathur et al., 1998; Quinn et al., 1999).
Mathur et al. (1998) analyzed 64 single-case
design studies conducted with students with
emotional and behavioral disorders. These
students, on average, received 2.5 hours per
week of SST for 12 weeks (M = 30 hours). This
372 / August 2006
BD_31(4).indd 372
M
synthesis of the 64 single-case studies showed
that the PND based on 463 graphs showed a
moderate effect of 62%.
There is also little evidence in various metaanalyses of the SST literature that interventions
were implemented as planned or intended
(Gresham et al., 2004; Gresham, Sugai, &
Horner, 2001). Given the absence of treatment
integrity data in the SST literature, one does not
know if a SST program is ineffective because it
is a poor treatment or if it would be effective
if it were implemented with high integrity. The
absence of treatment integrity data in the SST
literature does not allow one to draw definitive
conclusions about the effects of SST on
treatment outcomes. Assessment of treatment
integrity should be a high priority in future SST
research.
Forness and Kavale (1999) conducted a
meta-analysis of SST studies with students have
specific learning disabilities. These authors
analyzed 53 studies involving 2,113 students
who received, on average, 3 hours of SST per
week for 10 weeks (30 hours of SST). Based
on analysis of 328 effect sizes, the mean effect
size was 0.21, which is virtually identical to
the effect size reported by Quinn et al. (1999).
Forness and Kavale (1999), Mathur et al.
(1998), and Quinn et al. (1999) concluded that
SST has limited empirical support for students
with emotional and behavioral disorders and
learning disabilities.
The results of the current investigation
indicated that students receiving approximately
twice as much SST than has been reported
in the literature show much larger effects
(M = 76.23% versus 62.00%, respectively).
Additionally, the 4 students in this study moved
up by 46 percentile ranks on Total Social Skills
and down by 84 percentile ranks on Total
Problem Behaviors of the SSRS-T. The current
data suggest that doubling the amount of SST
from the usual amount (30 hours) produces
rather large, socially valid effects.
The relatively small effect sizes reported
in previous meta-analyses can be explained,
Behavioral Disorders, 31 (4), 363–377
9/6/06 7:46:22 AM
in part, by the failure of studies to match
specific types of social skills deficits to specific
intervention strategies. SST typically has four
objectives: (a) promoting skills acquisition,
(b) enhancing skill performance, (c) removing
competing problem behaviors, and (d)
facilitating generalization and maintenance
(Elliott & Gresham, 1991; Gresham, 1998).
Most SST studies reviewed in various metaanalyses deliver an intervention with an almost
complete disregard for the types of social skills
deficits of students. Most research suggests
that there is little systematic attempt to assess
whether students actually need to be taught the
specific social skills chosen in SST (Forness &
Kavale, 1999; Gresham et al., 2001).
The current investigation specifically
targeted students who demonstrated social skill
acquisition deficits using systematic assessment
procedures. Recall that in this study we defined
acquisition deficits operationally as students
receiving a rating of 0 (Never) on the frequency
dimension and a rating of 1 (Important) or 2
(Critical) in the importance dimension for 50%
or greater of the 30 items on the SSRS-T (15
or more items). Competing problem behaviors
were defined as receiving a frequency rating
of 2 (Very Often) on 50% or greater (9 or more
items) on the Total Problem Behavior scale.
The effectiveness of SST may be partially due
to matching intervention strategies (modeling,
coaching, and behavioral rehearsal) to students’
acquisition deficits.
Limitations
Four limitations of the current investigation
should be noted. One, the second author
conducted all SST sessions and the teacher/
parent consultation sessions. Although this
controls for the expertise level of the instructor,
it limits the external validity of the findings.
Future research should replicate the current
findings using different instructors to enhance
the generalizability of these results. Two,
teachers completing the SSRS-T ratings on all
students were not blind to the fact that these
students were receiving SST. They were not
aware, however, of the specific hypotheses of
the present study.
Three, the current investigation did not
conduct a systematic functional behavioral
assessment (FBA) to determine the controlling
functions of the competing problem behaviors.
The classroom-based DRO procedures
designed to decrease TDB were implemented
without the benefit of an FBA. It would have
Behavioral Disorders, 31 (4), 363–377
BD_31(4).indd 373
been advantageous to include a formal
descriptive FBA in both the classroom and on
the playground to identify the hypothesized
functions of the competing problem behaviors.
The information from this FBA could have been
used to formulate testable hypotheses about
predictable antecedent and consequent events
occasioning competing problem behaviors
(see Maag, 2005). Finally, the SST intervention
was a packaged intervention that contained
many components (small group SST, DRO,
and parent and teacher feedback). As such, it
was impossible using the current experimental
design to isolate the unique effects of each
intervention component. It could have been
that the DRO procedures for each student
accompanied by performance feedback on
its implementation were sufficient to promote
large decreases in the competing problem
behaviors. Future research should contrast
an SST-only intervention with a DRO-based
intervention to determine their effects on
problem behavior reduction.
Despite the above limitations, the
present study demonstrated that intense SST
and classroom-based DRO interventions
implemented with integrity can produce
relatively large changes in competing problem
behaviors and social validation measures
completed by teachers. Moreover, these
effects were maintained at 2-month followup. This investigation was one of the few to
have systematically classified the specific type
of social skill deficit (acquisition deficit) and
provide social skills instruction based on that
classification. Although much more research
needs to be conducted, this study offers
guidance into fruitful areas of future social
skills intervention research for students with or
at risk for emotional and behavioral disorders.
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Address all correspondence to Frank M.
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State University, Baton Rouge, LA 70803.
E-mail: gresham@lsu.edu.
APPENDIX
Example of Social Skill Instruction
Skill: Compromising in conflict situations by changing own ideas to reach agreement
Objective: The student will compromise in conflict situations with others by changing opinions,
modifying actions, or offering alternative solutions.
Coaching
Coaching includes the following ten steps: (a) present a social concept; (b) ask for definitions
of the social concept; (c) provide clarification for the group’s definition of the concept; (d) ask for
specific behavioral examples of the concept; (e) ask for specific behavioral nonexamples of the
concept; (f) elicit potential outcomes for performing the skill and for not performing the skill; (g)
generate situations and settings in which the skill would be appropriate, generate situations and
settings in which the skill would be inappropriate; (h) use behavioral rehearsal to practice the skill;
(i) use specific informational feedback about behavioral rehearsal performances; and (j) based on
feedback of the initial behavioral rehearsal, have students replay and practice the skill.
1. Introduce skill and ask questions about it: “Today we are going to talk about compromise. This is
a way to get along with others when we disagree with them.”
When was the last time you had an argument with one of your classmates? What was the
argument about and what did you do?
What does the word compromise mean?
What are some ways people can compromise? (People can calmly present an opinion; listen to
others’ opinions, and so on.)
How do people show that they are not willing to compromise?
What are some good things that might happen if you compromised in an argument or disagreement
with your friends or with your parents?
What might happen if you did not compromise with friends or parents?
2. Define the skill and discuss key terms.
Skill: Ending disagreements or arguments with others by offering alternative ideas, actions, or
suggestions.
Key terms: compromise, negotiate, alternatives, listening, opinions.
3. Discuss why the skill is important.
Sometimes you can avoid arguments or disagreements by compromising.
Many times you can come up with a better solution to a disagreement by compromising and
listening to another person’s opinions.
A lot of times people will think better of you if you calmly end disagreements rather than yell and
scream.
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4. Identify the following skill steps; have students repeat them.
a. Recognize that you are in a conflict situation that has the potential for arguments, yelling, or
other conflict behaviors.
b. Identify what main source of disagreement is and why the other person(s) is/are upset.
c. Listen to what other person(s) is/are saying.
d. Calmly present your side and see how the other person(s) react.
e. Offer a compromise.
f.
If the other person(s) accepts/accept your compromise, do the compromise.
g. If the other person(s) does/do not accept your compromise, offer another solution or ask the
other person(s) for alternative solutions.
h. Negotiate alternative solutions to the problem and implement the agreed upon solution.
Modeling
Using one of the following situations, model and role-play the situation. Modeling includes
the following six steps: (a) establish the need to learn the skills; (b) identify the skill components;
(c) present the modeling display; (d) rehearse the skill; (e) provide specific feedback on rehearsal;
and (f) program for generalization. For negative modeling, respond in one of the following ways:
Misidentify the cause of the conflict, refuse to listen to the other person, present your side by yelling
and screaming, refuse to offer a compromise, and so on.
Modeling/Role Play Situations
You are at your friend’s house on Saturday, and the two of you are watching TV. Your friend wants
to watch one show and you want to watch another show. Your friend says “It’s my house and
we’re watching what I say!”
Mary wants to play kickball at recess, but you and Julie want to jump rope. Mary says “We
always do what you two want to do! Now it’s my turn to decide what to do!”
Your friend wants to play basketball but you want to play baseball.
Behavioral Rehearsal
Behavioral rehearsal includes the following five steps: (a) describe a role-play situation, select
participants, and designate roles for each participant; (b) have participants role-play the social
situation and instruct observers to watch the performances of each participant closely; (c) discuss
and evaluate the performances in the role-play and provide suggestions for improved performance;
(d) ask participants to incorporate feedback suggestions as they rehearse the skill; and (e) select new
participants to role-play the same social situation.
Ask the students to:
a. Define the skill.
b. Tell why the skill is important.
c. State the skill steps, read them aloud together, and think of cues or prompts to help them
remember.
Follow Through and Practice
1. Review the skill: Discuss the skill of compromising in the next session and in the end of unit
review.
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2. Assign homework: Encourage students to practice compromising at home with their parents,
siblings, and neighborhood friends.
Generalization and Maintenance
1. Encourage self-monitoring.
Have students monitor for one week the use of compromising at school and at home. Tell
students to record at the end of each day the number of times they compromised. Stress that
students should record the situation in which they compromised, the way in which they
compromised, and the result of their compromise.
2. Assign homework.
Invite students to discuss the use of compromise with their parents. Ask them what
compromise they have made with their parents and how they went about compromising.
Encourage students to give examples.
3. Generate situations
Invite students to generate a list of situations in which they could and could not compromise.
Try to find examples from history or from current events that show people successfully and
unsuccessfully compromising.
4. Discuss newspaper article
Bring a newspaper article to the group that describes an example of compromise. Discuss the
article and determine ways the people in the article could better compromise.
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