Strategies to Enhance Performance of Existing Skills

Strategies to Enhance Performance of Existing Skills

Priming is used to provide a person with information and answers before they are presented with an activity or before they enter a social situation. Priming refers to the "incidental activation of knowledge structures" (Bargh, Chen, & Burrows, 1996, p. 230), which facilitates memory recall or behavioral performance. The positive effects of priming to facilitate social behavior is supported by researchers, who used priming to increase the social initiations of preschool children with ASD (Zanolli, Daggett, & Adams, 1996) and to decrease problem behaviors in the classroom (Koegel, Koegel, Frea, & Green-Hopkins, 2003). Video priming has been used to reduce problem behaviors during transitions for children with ASD (Schreibman, Whalen, & Stahmer, 2000). The researchers selected transitions in settings deemed most problematic by the children's parents. The researchers then videotaped the settings to show the environment just as the child would see it (moving through the store, getting ready in the morning, etc.). Social cognitions and social behaviors can be primed by presenting cognitive or behavioral "primes" just prior to performance of the skill or behavior in the natural environment.

Larry, a 26-year-old man with autism, had been working in the print shop for six years. Now that the print shop was moving to a new location, his supervisor, George, was concerned about how Larry would handle the change. George remembered that when Larry first started working at the print shop, his job coach took pictures of everywhere in the shop that Larry would need to walk through and work in, including the bathroom and lunch room. The job coach included text explaining what social behaviors were expected in each area. George decided to go to the new print shop location and take pictures of everywhere Larry would need to access when they moved. George made up a book about the move using the pictures, including text explaining expected social behaviors, and even made Larry a calendar showing when they were relocating. Larry looked at the book every day and asked George questions about the move. When the print shop relocated, Larry was ready and knew what social behaviors were expected at the new shop.

Prompts are highly effective in facilitating child-adult and child-child interactions in children with ASD (McConnell, 2002; Rogers, 2000). Prompts are supports and assistance provided to help the child acquire skills and successfully perform behaviors. Prompts may be used to teach new social skills (in the case of physical and modeling prompts) and to enhance performance of previously acquired skills. In addition, they may be used with novice or advanced performers; in individual sessions or in group sessions; with verbal children or with nonverbal children; and with preschoolers or with adults. Finally, prompts may be delivered by adults or by other children. A limitation of prompting strategies is that the child with ASD may limit social interactions to only instances in which prompting is provided. As such, a prompt-fading plan needs to be implemented to systematically fade prompts from most to least supportive.

1. Natural: saying or doing what would typically happen before a behavior

2. Gestural: pointing to, looking at, moving, or touching an item or area to indicate a correct response

3. Verbal: providing a verbal instruction, cue, or model

4. Modeling: the acting out of a target behavior with the hope the child will imitate

5. Physical: moving the child through the behavior; can be full, which is doing the whole behavior, or partial, such as just touching the hand

Self-monitoring strategies have demonstrated considerable effectiveness for teaching children with and without disabilities to both monitor and regulate their own behavior (Carter, 1993). Self-monitoring may be considered both a skill acquisition strategy because it teaches the child to monitor her own behavior and a performance-enhance technique because through self-monitoring, the child is able to enhance the performance of an existing skill. Self-recording of behavior can be used during the behavioral performance or after the performance (or both). Strategies can target a number of externalizing behaviors, such as time-on-task, work completion, and disruptive behaviors, as well as internal processes, such as thoughts (self-talk) and feelings (both positive and negative affect). Self-monitoring strategies may involve having the child record occurrences (whether the behavior was performed), duration (for how long), and frequencies of behaviors (how frequently it was performed) as well as the quality of the behavioral performance (how well the behavior was performed). Self-monitoring strategies have been used effectively to address the social and behavioral functioning of children with ASD (Coyle & Cole, 2004; Shearer, Kohler, Buchan, & McCullough, 1996). Shearer et al. used self-monitoring to increase the social interactions of preschool children with ASD. Coyle and Cole used self-monitoring in combination with video self-modeling (positive self-review) to decrease off-task behavior in school-aged children with ASD. Finally, self-monitoring strategies support generalization of skills because they teach children to independently monitor their own behavior.

Nate's mom and dad wanted him to start independently initiating interactions with people in the community when they went to a store, the local gym, or a restaurant. Nate and his parents decided on a couple of goals a week for him to target. They found an application on his cell phone that allowed Nate to track how often he independently started a social interaction with people in the community, which was always one goal, and then one other target goal. Every Saturday, Nate would review with his mom and dad who he talked to, what they talked about, and how he was feeling during the conversation. Nate really liked tracking his progress on the weekly goals and it helped him start to increase how often he initiated interactions with people in the community.

Peer-Mediated Instruction and Intervention (PMII) is an effective and strategy for facilitating social interactions between young children with ASD (and other disabilities) and their nondisabled peers (Laushey & Heflin, 2000, Sasso, Mundschenk, Melloy, & Casey, 1998; Odom, McConnell, & McEvoy 1992; Strain & Odom, 1986). In PMII programs, nondisabled children are selected and trained to be "peer buddies" for a child with ASD. As such, the nondisabled peers participate in the intervention by making social initiations or responding promptly and appropriately to the initiations of children with ASD during the course of their school day. PMII allows children with ASD to perform social behaviors through direct social contact and by modeling the social behaviors of peers. PMII enables us to structure the physical and social environment so as to promote successful social interactions. PMII may be used in naturalistic settings (classroom and playground), and also in structured settings (structured play groups). For more information, click here to see the AIM on PMII.

A critical aspect of all social skills programs is to develop a plan for generalization, or transfer of skills across settings, persons, situations, and time. The ultimate goal of social skills training is to teach the child to interact successfully with multiple persons and in multiple natural environments.

From a behavioral perspective, the inability to generalize a skill or behavior is a result of too much stimulus control. That is, the child only performs the skill or behavior in the presence of a specific stimulus (person, prompt, directives, etc.). For instance, the child may respond to the social initiations of other children, but only if his mother is there to prompt him. If Mom is not there, he does not respond. Or the child might initiate with her special education teacher, but with nobody else. Generalization is particularly important for children with ASD who often have pronounced difficulties transferring skills across persons and settings.

A number of strategies may be used to facilitate generalization of social skills across settings, persons, situation, and time, including:

1. Reinforce the performance of social skills in the natural environment

2. Train with multiple persons and in multiple settings

3. Ensure the presence and delivery of natural reinforcers for the performance of social skills

4. Practice the skill in the natural environment

5. Fade prompts as quickly as feasible

6. Provide multiple examples of social rules and concepts

7. Train skills loosely (i.e., vary the instruction, directives, strategies, and prompts used during skill instruction)

8. Teach self-monitoring strategies

9. Provide "booster" sessions (i.e., provide follow-up training after initial instruction has been discontinued)

Case Study: Carl

Carl is a 13-year-old boy with Asperger Syndrome. His teachers report that Carl engages in many "socially inappropriate" behaviors when in the presence of peers, such as inappropriate touching and mimicking the behavior of peers. In particular, Carl often stands behind other children in the hallway and repeats everything they say. An interview with teachers revealed that Carl has no friends but frequently expresses an interest in making friends. A social skills assessment revealed significant difficulties in social initiations, including joining in interactions with peers. A social skill intervention was implemented to teach Carl how to effectively join in activities with peers. First, it was taught by his teacher in the classroom. Then, an aide used the same intervention in the cafeteria. Also, Carl's mom tried the intervention when he was going to swim team practice at the local pool. Carl started approaching small groups and was able to join in their activities.

Gaining social competence through the teaching of social skills and the application of interventions gives individuals with autism spectrum disorder a better chance at getting along with others, making friends, and being able to obtain and sustain a job. Learning how to initiate, reciprocate, and think about social interactions is key to decreasing the challenges persons with ASD experience. People on the spectrum need to be assessed and have an individualized program developed for them to move them towards a higher level of social competence. There are many interventions described in this module to assist with teaching how to interact socially.

Discussion Questions

1. 
   Describe common social skill deficits in individuals with ASD.
   

"(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction; (b) failure to develop peer relationships appropriate to developmental level; (c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people; and (d) lack of social and emotional reciprocity." (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (American Psychiatric Association, 2000, p. 145.)

2. 
   Why is it important to teach social skills to individual with ASD?
   

Effective social skills allow children to elicit positive reactions and evaluations from peers as they perform socially approved behaviors (Ladd & Mize, 1983).

3. 
   How are social skills and social competence evaluated?
   

Evaluations of social competence are typically conducted through the use of interviews or rating scales. Interviews are a valuable method for obtaining information regarding social functioning in a relatively short time by allowing us to collect and synthesize information from a variety of respondents, representing a wide range of settings.Rating scales are indirect assessment tools that provide information across a variety of functioning areas. These measures range from informal checklists to standardized rating scales and may be administered to parents, teachers, and the child. Rating scales can measure social functioning, anxiety, self-concept and self-esteem, and behavioral functioning.

4. 
   Distinguish between a skill acquisition deficit and performance deficits. How is this dichotomy important to intervention?
   

A skill acquisition deficit refers to the absence of a skill or behavior. For example, a young child may not know how to effectively join in activities with peers. If we want this child to join in activities with peers, we need to teach her the skills to do so.

A performance deficit refers to a skill or behavior that is present but not demonstrated or performed. To use the earlier example, a child may have the skill (or ability) to join in an activity but for some reason fails to do so. In this case, if we want the child to participate, we would not need to teach her to do so (since she already has the skill). Instead, we would need to address the factor that is impeding performance of the skill, such as lack of motivation, anxiety, or sensory sensitivities.

A skill acquisition/performance deficit model guides the selection of intervention strategies. Most intervention strategies are better suited for either skill acquisition or performance deficits. The selected intervention should match the type of deficit present (Gresham, Sugai, & Horner, 2001).

5. 
   What social skills training strategies are available to teach social skills to individuals with ASD?
   

Social Stories (TM), Video modeling and Video self-modeling, Social problem-solving, and Pivotal Response training, social scripting and script fading, priming, prompting, self monitoring, and Peer Mediated Instruction.

Post-Assessment

Post-Assessment

What is the primary purpose of social skills assessment?

Select an answer for question 574

Why is it important to interview the child or adolescent himself if possible?

Select an answer for question 575

Which of the following best represent criteria for quality social objectives?

Select an answer for question 576

What is a skill acquisition deficit?

Select an answer for question 577

What is a performance deficit?

Select an answer for question 578

Why is it important to determine whether an area of challenge is due to a skill acquisition deficit or a performance deficit?

Select an answer for question 579

Which of these statements best describes priming?

Select an answer for question 580

Which of the following strategies can be used to prime social cognitions and behaviors?

Select an answer for question 581

What is generalization?

Select an answer for question 582

What is meant by the term social accommodation?

Select an answer for question 583

Bottom of Form

Citation and References

Citation

If included in presentations or publications, credit should be given to the authors of this module. Please use the citation below to reference this content.

Bellini, S. (2011). Overview of Social Skills Functioning and Programming (Columbus, OH: OCALI). In Ohio Center for Autism and Low Incidence (OCALI), Autism Internet Modules, www.autisminternetmodules.org. Columbus, OH: OCALI.

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