FEATURE
]
SOCIAL SKILLS TRAINING
P H OTO CO U R T E S Y O F P H OTO E D IT I N C .
Social Skills Training
for Children on the
Autism Spectrum
Current Research and Integration
Brushing horses at a children’s ranch
T H E R E I S N O O N E M E T H O D T O T E A C H S O C I A L S K I L L S T H AT W O R K S F O R
A L L S T U D E N T S A L L T H E T I M E . H O W E V E R , E V I D E N C E S H O W S T H AT M A N Y
APPROACH E S C AN B E EFFEC TIVE .
BY JED BAKER, PH.D.
As clinicians and researchers learn from
of building intrinsic motivation.
each other, there has emerged a trend
Some of the major approaches to skills
towards blending the structured modeling
training can be categorized into three
and prompting strategies of behavioral
types as follows:
and cognitive-behavioral approaches
8 AUTISM ADVOCATE
• FIRST EDITION 2010
rewards and those stressing the importance
• Behavioral approaches, such as
with aspects of the relationship-based
Applied Behavioral Analysis (ABA),
approaches that stress the importance of
focus on altering observable events
respecting the child’s preferences in order
in the environment (antecedents and
to build intrinsic motivation. Too often in
consequences) in order to increase
the past, the field appeared unnecessarily
certain behaviors and decrease
split between those advocating extrinsic
undesirable behaviors. For example,
SOCIAL SKILLS TRAINING [
TABLE 1
many of the strategies described above
can lead to positive changes. Many of the
Major Types of Skills Training
APPLIED
BEHAVIORAL
ANALYSIS
쏡 Discrete Trial Training:
COGNITIVEBEHAVIORAL
쏡 Relationship
Lovaas, 1987
Therapy: Sundberg &
Partington, 1998
쏡 Pivotal Response
Treatment: Koegel &
Koegel, 2006
쏡 Video Modeling and
쏡 Social Thinking Model:
Communication and
Visual Supports used
in the context of ABA
(e.g., PECS system):
Frost & Bondy, 2006
Greenspan & Weider,
1998
쏡 Son-Rise Program:
Kaufman, 1994
Garcia-Winner, 2006
쏡 Social Stories: Gray,
2010
쏡 Structured learning:
Video Self-modeling:
Bellini & Akullian, 2007
쏡 Augmentative
RELATIONSHIP
BASED
쏡 DIR®/Floortime™:
Development
Intervention: Gutstein,
2007
쏡 Verbal Behavior
ABA strategies, which involve modeling,
McGuiness &
Goldstein, 1997;
Baker, 2003, 2005
쏡 Visual Supports to
expand understanding
of events and tasks
prompting and reinforcement, have been
shown to be effective in teaching a variety
of social skills, including attention/eye
contact, appropriate content and initiation
of conversation, play skills, and frequency
and duration of interactions (see Mateson,
Mateson, & Rivet, 2007, for a review of 79
studies). Strategies that involve showing
children what to do through videomodeling and Social Stories™, developed
by Carol Gray (see article in this issue),
have also shown positive results (Bellini
& Akullian, 2007). Michelle GarciaWinner’s Social Thinking strategies (see
article in this issue) are being investigated
with the ASD population (Crooke et al.,
2007) with positive feedback. Structured
...there is still a gap between the science and practice of skills
training in school settings.
learning enjoys a large evidence base
with varied populations not specific to
autism (McGinnis & Goldstein, 1997).
Trimarchi (2004) investigated the use
an instructor might prompt a student
relationship is a primary factor in
of structured learning with those with
to greet his peers and then reward the
influencing the development of new
Asperger’s Syndrome using my social
student for doing so.
skills. Through following the lead of
skills training manual (Baker, 2003) and
the child and respecting his or her
found at least minimal improvement on
share some of these assumptions
preferences, trust and motivation
90 percent of targeted skills compared to
about manipulating the environment
develop so that learning can occur.
a control group based on parental report.
• Cognitive-behavioral approaches
to change behavior, but they extend
See table 1 above for a listing of some of
the notion to consider how an
the most popular approaches in these
individual interprets or perceives
three categories.
what happens in the environment. To
Relationship Development Intervention
(RDI) and DIR /Floortime® have also
been shown to lead to positive changes in
behavior, yet there is a lack of controlled
studies evaluating these models.
in understanding how someone will
What Evidence Do We Have for
the Effectiveness of Social Skills
Training?
behave. For example, an instructor
Deciding whether social skills training
and practice of skills training in school
might explain to a student how others
works is challenging as the definition of
settings. In 2007, Bellini, Peters, Benner
would think and feel if he did not greet
social skills, the social skills targeted,
and Hopf challenged the social skills
his peers.
and the ways to teach, generalize and
world after concluding that most school-
measure progress differ across studies.
based social skills training efforts were
That being said, there is evidence that
minimally effective according to their
this end, individuals’ thoughts and
perceptions become a primary focus
• Relationship-based approaches
posit that developing a trusting
Despite these promising outcomes,
there is still a gap between the science
FIRST EDITION 2010 •
AUTISM ADVOCATE 9
]
SOCIAL SKILLS TRAINING
TABLE 2
review of 55 outcome studies. They
pointed out the problems with many social
Motivation Strategies
skills interventions in schools, including
EXTRINSIC
REWARDS
failure to match targeted goals to the
child’s needs, lack of generalization of
skills into natural settings, short duration
of treatment and failure to motivate skill
performance.
PRESYMBOLIC
LANGUAGE
Key Components of Effective
Social Skills Training
Based on the outcome research, there
are certain critical components of skills
training that must be considered in order
to ensure skills are taught effectively. I
Use of material rewards
or social praise provided
after skill enactment. The
reward may have no natural
connection to the skill in
that the reward may not
be available in naturally
occurring settings. This
characterizes the earlier
Lovaas discrete trial
approach, yet the more
contemporary Lovaas
approach utilizes intrinsic
methods as well.
INTRINSIC REWARDS
Pivotal Response Training often imbeds the
child’s interests into the skill lesson and
intersperses challenging tasks between
easier ones to maintain intrinsic motivation.
Verbal Behavior Training starts with “mand”
training in which the child learns to request
favored items or activities, so that the skill
lesson and reward are naturally connected;
the reward is intrinsic to the learning
situation.
DIR®/Floortime™ and the Son-Rise
Program follow the lead of the child to gain
motivation.
RDI attempts to make social referencing fun
and engaging in and of itself.
have outlined a flexible model to address
many of these issues (Baker, 2003, 2005).
The model involves the following five key
components: assess relevant skill goals,
establish motivation for skills training,
GOOD
SYMBOLIC
LANGUAGE
choose appropriate strategies for initial
Extrinsic rewards are
provided as above, yet often
through the accumulation
of symbolic rewards, such
as tokens or points on a
behavior chart.
skill acquisition, plan for generalization
and consider training typical peers.
• Explain rationale for working on
challenging skills (that it will help the
student reach their own future goals)
• For students who seem not to care about
their future, increase self-awareness of
strengths and talents to establish future
goals prior to focusing on their challenges
• Have students teach necessary skills
to others to help them feel competent
themselves
1 Assessment: Prioritize relevant skill
goals based on input from key stakeholders
(e.g., the student, parents and teachers)
• Make socializing fun through high-interest
activities
Trying to teach a universal set of skills
in a short amount of time has not been
effective (Bellini et al., 2007). Recent
research suggests that we focus on
specific, relevant skill deficits of a student
and work on them for a longer period
Based on the outcome research, there are certain critical
components of skills training that must be considered in
order to ensure skills are taught effectively.
according to a particular theory. Instead,
Examples might include violating
I take a functional approach in which
others’ space, interrupting others,
I ask what skills are necessary for the
talking at others about their interests,
student to function in a desired setting.
imposing their wishes on others,
To help articulate skill goals, I ask the
avoiding frustrating work, insulting
key stakeholders (i.e., student, teachers
others or handling disagreements in
consistently prompt these skills to ensure
and parents) to consider the following
aggressive ways. These are often what
generalization across settings.
questions:
we call “disruptive behaviors.”
of time. I typically ask that students,
caring professionals and family help
prioritize three to four skills to work on
for months at a time across settings. This
is a manageable number of goals if we are
going to require parents and teachers to
In deciding what skills to target, I do not
• What does the student do too much
• What does the student not do
ascribe to a model in which skills must
of that might interfere with social
enough of that might interfere
be taught in a certain sequential order
functioning in a desired setting?
with social functioning in a desired
10 AUTISM ADVOCATE
• FIRST EDITION 2010
SOCIAL SKILLS TRAINING [
P H OTO CO U R T E S Y O F P H OTO E D IT I N C .
Those with good symbolic language can
benefit from strategies in which skill steps
are explained in addition to being modeled
and prompted.
The computer is a useful tool for teaching skills.
setting? Examples might include
cannot talk about situations or events
There are two considerations in deciding
not responding to peers or teachers,
in the abstract versus those with good
how to teach skills to students. First is
not asking for help when needed,
symbolic communication skills who
the type of strategy used. This depends
not managing their hygiene or dress
can discuss past and future events, and
on the students’ symbolic language and
appropriately and not initiating
other abstract concepts like how people
cognitive skills. Those with good symbolic
interactions with others.
think and feel. For those with excellent
language can benefit from strategies in
symbolic communication, it is possible to
which skill steps are explained in addition
“talk them into” wanting to learn skills by
to being modeled and prompted. Many
highlighting the positive consequences
cognitive-behavioral strategies can be
in the future, such as the promise of
used with such students who are capable
extrinsic rewards or achieving their
of understanding others’ perspectives and
2 Motivation: Establish motivation to
learn and use skills across settings
Just because we identify skill goals does
not mean a student is motivated to learn
those skills. Table 2 on the previous page
describes ways to motivate students.
The table is divided into those strategies
that emphasize extrinsic motivation
(i.e., rewards after skill use) and those
that emphasize intrinsic motivation
(i.e., making skill use itself rewarding).
The table is also divided into those
strategies useful for students with less
symbolic communication abilities who
own personal goals. Those with fewer
symbolic skills, and therefore less ability
to maintain a future orientation, will
need more immediate extrinsic rewards
or experience intrinsic pleasure from the
activities themselves.
3 Initial skill acquisition: Teach skills
using strategies that match the student’s
language, cognitive and attention abilities
social cues when they are explained or
highlighted for them. For students who
have great deficits in symbolic language,
one cannot “talk about” how to perform
a skill; instead, the instructor must
model and prompt the skill in the actual
situation, and perhaps supplement this
process with the use of pictures or video
of skill steps.
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SOCIAL SKILLS TRAINING
P H OTO CO U R T E S Y O F P H OTO E D IT I N C .
]
Peers can be taught to
be “helpers” or coaches
to students with autism
during play or work.
Family eating together at the park
The second issue to consider is where
and coaching to perform skills in natural
worse yet are being teased, it is crucial
to teach the skills: in a group, classroom
settings. In Bellini et al.’s (2007) review of
that training of “typical” peers become
or individually. There is evidence that
skills training studies, coaching in natural
part of the social skills intervention. Peers
teaching in a classroom can increase
situations was often a missing ingredient
can be taught to be “helpers” or coaches
generalization (Bellini et al., 2007). There
in social skills training efforts and one
to students with autism during play or
are, however, benefits to smaller group
of the reasons for mediocre results. I
work (see Dunn, 2005). They can also be
instruction in which students have a
have found it crucial to create written
taught to be good “bystanders” by taking a
chance to befriend each other. Positive
reminders (cue cards, behavior charts
protective role when their disabled peers
results were found for the type of group
or skill lesson sheets) for those parents
are teased or bullied (see Baker, 2003,
instruction provided in my social skills
and teachers working with students.
2005). In addition, they can participate
training manual (see Trimarchi, 2004,
These written reminders are sent home
in social skills groups with their autistic
for a controlled outcome study on group
to parents and distributed to the child’s
peers to provide opportunities to interact
training described by Baker, 2003). If
teachers. Ideally, parents and teachers
in conversation and play.
students have significant behavioral
should have the opportunity to not only
challenges and difficulties attending in
hear what they should prompt their
group settings, it may be best to begin
students to do, but to actually observe how
with individual treatment prior to
the student can be prompted.
considering a group.
5 Peer sensitivity training: Target
Conclusion
There continues to be a gap between
the science and practice of social skills
training in typical settings such as
schools. We need to move away from a
typical peers as necessary to increase
one-size-fits-all curriculum in which
to use the skills in natural settings and
generalization, reduce isolation, increase
students are taught skills in isolated
capitalize on interests and preferences
opportunities for friendship and decrease
settings. We must instead target relevant
In addition to establishing contrived or
bullying
skills, select teaching strategies that
intrinsic motivation to perform skills as
When targeted students have little
match the child’s language abilities,
described above, students need reminders
opportunity to interact with peers, or
increase motivation to use skills and
4 Generalization: Coach students
12 AUTISM ADVOCATE
• FIRST EDITION 2010
SOCIAL SKILLS TRAINING [
ensure generalization of skills by involving Crooke, P.J., Hendrix, R.E., & Rachman,
Koegel, R.L., & Koegel, L.K. (2006).
peers, teachers and parents in prompting
J.Y. (2007). Brief report: Measuring
Pivotal response treatments for autism:
skills across natural settings.
the effectiveness of teaching Social
Communication, social, & academic
References
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Baker, J.E. (2006). The social skills picture
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Dunn, M. (2005). S.O.S. social skills in our
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Baker, J.E. (2005). Preparing for life:
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The complete guide to transitioning to
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Asperger’s Syndrome. Arlington, Texas:
Future Horizons, Inc.
Baker, J.E. (2003). Social skills training for
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Shawnee Mission, Kan.: Autism Asperger
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Lovaas, O.I. (1987). Behavioral treatment
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T.T. (2007). Social skills treatments for
children with autism spectrum disorders:
An overview. Behavior Modification, 31, 5.
Frost, L., & Bondy, A. (2006). A common
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teaching prosocial skills. Champaign, Ill.:
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and Applied Behavior Analysis, 1, 103-110
Sundberg, M.L., & Partington, J.W.
Baker, J.E. (2001). Social skills picture books. Gray, C. (2010). The new Social Story book
Arlington, Texas: Future Horizons, Inc.
(10th anniversary edition). Arlington,
(1998). Teaching language to children with
autism or other developmental disabilities.
Bellini, S., & Akullian, J. (2007). A meta-
Texas: Future Horizons, Inc.
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analysis of video modeling and video
Greenspan, S., & Wieder, S. (1998). The
Trimarchi, C.L. (2004). The
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About the Author JED BAKER, PH.D.
Dr. Baker directs the Social Skills Training Project in Maplewood, N.J. He consults for schools across the U.S. and Canada. He has published five books:
one dealing with challenging behaviors (Baker 2008), picture books on social skills training ( Baker, 2001, 2006) and manuals on social skills training
(Baker, 2003, 2005). Dr. Baker and his resources can be reached at www.socialskillstrainingproject.com.
FIRST EDITION 2010 •
AUTISM ADVOCATE 13