Autism Spectrum Disorders: Intervention
for High-functioning Students
Rhea Paul, Ph.D., CCC-SLP
Southern Connecticut State University
Yale Child Study Center
Feb. 11-15, 2008
rhea.paul@yale.edu
Goals of Treatment for High
Functioning Students with ASD
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Social Interaction skills
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Communication skills
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Pragmatic and conversational skills
Adaptive skills
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Peer relations
Self-help
Self-regulation, emotional regulation
Academic skills appropriate to developmental
level
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Reading comprehension
Social Interaction: Intervention
Methods
Social Stories
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Descriptive sentences: statements of fact
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Perspective sentences: refer to internal states
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Some children like to make a lot of noise.
Affirmative sentences: express a common value
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Many children play on the playground during recess.
One child goes down the slide at a time.
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This is a safe thing to do.
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When I have to wait my turn on the slide, I can count the
people in front of me to make the time go faster.
Control sentences: identify personal strategies
Cooperative sentences: what others can do to help.

The teacher can help me if I feel impatient. She can talk to
me while I wait.
Comic Strip Conversations
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Use ‘think’ and ‘word’ bubble cartoons
Sam, I saw a
cowcatcher on an
old-fashioned
train yesterday.
Do you know
what that is?
Sam doesn’t
know as much
as I do about
trains. I will find
out if he knows
what the
cowcatcher does
before I tell him
about the one I
saw
Games Based on Special Interests

Develop social games based on special
interests of target child
•
•
•
•
Involve target child in development of materials and
rules
Have target child teach game to peer
Set up special opportunities to play game
Take turns choosing games to play during interactive
game time
Video Modeling
Use commercial material such as My School
Day
 Video tape peers conducting interactions
such as greeting, negotiating, etc.
 Use video clips from TV shows to exemplify
interactions (may use negative interaction)

Video Modeling
 View
video, discuss reactions
 DESCRIBE VERBALLY
 Re-enact scene on video with clinician
 Re-enact with peer
 Improvise similar situation
Sample Video Models
Sample Video Models
Using Video Modeling
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Use video modeling and role playing to
become aware of listener cues
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Looking at watch
Taking a breath
Looking toward door
Yawning
Use role playing to practice giving and
perceiving these cues
Social Cognitive Skills Training
(Timler et al., 2005)

Role play social scripts in peer group
•
•
•
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Situation paragraph read to group
4-5 situations/ 2 hour session
6 weeks of 2 sessions/week
Children guided during role play to use checklist to
facility ability to identify what they know about
situation from own and other’s perspective
Further Qs helped identify a range of response
strategies by
•
•
•
selecting goal,
stating alternative strategies to reach goal
Evaluating consequences after response
Social Skills Groups
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Can use commercial curricula, such as
•
•
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Navigating the Social World (McAfee, 2001)
Skillstreaming the Adolescent (Goldstein & McGinnis, 2000)
Provide consistent group structure
•
•
•
•
•
•
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Check-in, greet
Review last meeting’s skill
Introduce new skill
Model and role play new skill
Snack, social time
Activity that allows real-life practice of new skill
Summary
Peer Support Networks

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Select 2-5 peers to serve as social
support for student with ASD
Assign each support peer a 20 minute
period/day to structure activities for student
with ASD, e.g.:
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Lunch: use Prompt and Praise to engage with
others at table
Recess: teacher creates scripts for entering games;
peer support and target student practice in
private, then on playground
Effective Adult Techniques: Social
Skills Training (Timler, 2006)
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Teacher Redirects
Prompting children to play with one another
Rephrasing or restating one child’s statement for another
Praising children for playing together
Direct instruction in social language
Modeling and practice with explicit cues
Role play with prompting
Corrective feedback
Authentic contexts (peer involvement)
Self-monitoring for older students
Pragmatics and Conversation
Video examples: ASD Conversational
Behaviors
Pragmatic Domains
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Communicative functions
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Discourse management
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Turns
topics
Register variation
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Intents
Frequency
Politeness
Social roles
Presupposition
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Grice’s maxim of Quantity
‘mind-reading’
Pragmatic Assessment
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Children’s Communication Checklist (Bishop,
2003)
Pragmatic Rating Scale (Landa et al., 1992)
Pragmatic Rubric
Pragmatic Protocol (Prutting & Kirchner,
1984)
Social Skills Rating System (Gresham, 1990)
Pragmatic Language Skills Inventory
Gilliam & Miller, 2006)
Improving Conversational Skills
Enhancing Pragmatic Skills
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Conversational participation and reciprocity
 Take turns w/o interrupting
 Responding appropriately to others’ speech
 Adding something new and relevant information to a topic
 Terminating/changing topics appropriately
Initiating and maintaining peer interactions
 Entering peer play and conversation
 Maintaining and expanding play themes
 Terminating play appropriately
Reduction of obsessive, perseverative topics
Understanding and telling stories
 Understanding social sequences
 Understanding psychological motivation
Scripting
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Provide explicit written script of interaction, e.g.,
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Walk up to a classmate
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Make eye contact
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Say, “Hi ____________”
Practice script w/ adult
Practice w/ peer
Script Fading: Cut off increasingly large parts of script, until
client can do the scene independently
Scripts and Script Fading
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Provide topic lists, guide students to write
and fade their own scripts
Use favored topics to bridge to new ones
•
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trains→dining car →food
Have students choose a strip to talk with a
teacher/clinician
Fade scripts with adult
Encourage student to repeat with peer
partner
Scripting with Peer Training
Peers taught 5 facilitative skills w/o target child present:
1.
2.
3.
4.
5.
Look, wait, and listen
Answer questions
Start talking
Say something nice
Keep talking
Target children given written scripts for social
interaction
(“Can I play checkers with you?”)
Direct Instruction
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Make
conversation:
Go up to person.
Say ‘hello.’
Smile.
Listen to what s/he says and respond.
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Maintain topic:
Listen.
Think about what the person says.
Talk about the same thing.
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Change topic:
Keep quiet and listen.
Wait until the person pauses.
Say, “Let’s talk about something else.
Like…”
Direct Instruction: The “Conversation Can”
(Brinton, Robinson & Fujiki, 2005):
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Brainstorm a list of topics classmates might want to
discuss
Write each on a slip of paper
Put slips in can
Take turns pulling out a topic
Start conversation:
 Think first: What should I say
 Say two things about the topic
 Ask interlocutor a question about the topic
 Listen while interlocutor answers
Graphic Supports for Conversation
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Checklists
When I had a conversation, did I
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Look at my friend? _____________
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Stand one arm’s length away? _____________
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Appear interested by asking questions and listening? ______
Talk about what my friend is interested in? ______
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Posters
Important Parts of Conversations:
•Topic: Pick something your friend wants to talk about
•Questions: Use these to keep the back-and-forth going
•Comments: Say something new that your friend doesn’t know,
but would find interesting
Graphic Supports for Conversation
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Choice Boards
Pick your conversation topic for today:
Graphic Supports for Conversation
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Choice lists
•Yo, __________!
•Hey, Pal!
•High 5!
•What’s up?
•Hi, how ya doin’!
Principles of Pragmatic Intervention
Strategies
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Students with ASD will not acquire social skills
from exposure; they require mediated
experiences
Verbal, written and graphic supports are
effective
Peer involvement is an essential element
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Peers need training, but it is not extensive
Encourage ‘mind reading’
Adaptive and Self-Regulatory Skills
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Same principles as with lower functioning.
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Visual supports
Social Stories, Comic Strip Conversations
ABA approaches
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Task analysis
Functional Behavior Analysis
Consequences-natural and contrived
Self-Management Skills
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Picture Schedules: visual supports
Self-management: Social Stories
Recess
* After lunch we go to recess.
* Sometimes recess is on the playground.
* A lot of the children play on the playground equipment.
* It is fun to play on the playground equipment.
* Everyone should play safely.
* When the whistle blows that means it is time to line up and go
inside.
* I will try to line up as soon as the whistle blows.
* This will make my teachers happy.
* After I line up I will try to stay in line.
* Everyone will be proud of me!
Academic Skills
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Reading can appear a strength
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May be early, precocious w/ keen interest in letters,
numbers
May show interest in words (read dictionary)
BUT, difficulties in comprehension often occur.
Narratives (stories) may be a good vehicle for
improving reading comprehension
Narrative Intervention
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Understanding motives: make character
motivation explicit
Understanding intentions: discuss reasons for
actions
Understanding emotions: discuss how
characters feel and why