How to Increase Skill Development and Reduce Inappropriate Behaviors
By: Deirdre Kozyrski, MS, BCBA, LBA
In providing ABA services to individuals with a diagnosis of autism, proactive strategies are often used to help our clients gain critical language, social & self-help skills and reduce inappropriate and/or behaviors of concern. A proactive strategy is used before a behavior of concern occurs to help prevent that behavior from occurring. One such proactive strategy is the use of social stories. This article will focus on the following aspects of social stories.
- What are social stories?
- What skills can they help teach?
- Has there been research on the effectiveness of social stories?
- How can social stories be implemented in home- based ABA treatment?
Social stories are great tools to help to prepare people with the diagnosis of autism for new settings and for learning new skills. Social stories are written stories that provide information about a specific topic/setting. They can also provide some instruction on choices of appropriate behaviors that can occur within that topic/setting. Social stories can be used with all different ages, being able to read is not a requirement. For those clients who do not read, a social story could be read to them. Social stories often have pictures in them to help increase understanding of the topic, but do not have to have pictures/photos. The length of a social story often depends upon the age and skill level of the reader.
Guidelines of a how social story is written can vary depending upon the author. Social stories are often written in the first or third person. For example, a first – person sentence is “I am going to the beach with my family”. An example of a third person sentence is “Some families go to the beach for their vacation”. In her book, The New Social Story™ Book, 2015, Carol Gray describes 10 components of a Social Story™. (When the words Social Story™ are capitalized that is indicative that the story meets all of the Gray’s current 10.1 criteria). She also includes a CD in this book that has printable Social Stories™ that can be edited to meet a reader’s individual needs.
Carol Gray initiated the use of the Social Story™ approach approximately 30 years ago. In her 2015 book, she describes using both descriptive sentences and coaching sentences in a Social Story™. A descriptive sentence provides information about a topic without any kind of judgement or opinion. A coaching sentence offers choices of appropriate words or actions that could be used in the specific setting or situation. Throughout her book, Gray emphasizes the importance of respecting the intended readers. Aligning with that respect is her dedication to using positive statements in a Social Story™. She also suggests including sentences about the reader’s strengths & accomplishments in the Social Story.™
There are thousands of topics that can be written about in a social story. Here are some topics that I have helpful with my clients:
- ADL /Safety Skills – Learning how to : tie shoes, brush teeth, safely take medicine, take a shower, get dressed/undressed in a private setting, brush hair, accept getting a hair – cut without a tantrum, safely cross a street, safely walk through a parking lot, safely use a pool, appropriately interact with the family cat, etc.
- Social Skills – Learning how to: acclimate to a new school, how to play on the school playground, how to order lunch in the lunch room, go to the supermarket with your parents, go through security at the airport, use safe behaviors while on a family vacation, take turns with peers for choices of games/activities, eat at a restaurant, etc.
- Communication Skills – Learning how to: ask a peer to play, what can be said if that peer says “no”, ask for help, etc. Learning about the choices one can say when: a game is lost, a game is won, when a food is disliked, when a gift is disliked, feeling frustrated, angry, etc.
Some research that have been done on the effectiveness of Social Stories™ are:
- Thiemann & Goldstein (2001) combined the use of social stories with written text cues and video feedback to improve specific social communication skills ( contingent responses, securing attention, initiating comments and initiating requests) in 5 students with diagnoses of autism. They used Carol Gray’s 1995 criteria for social stories. Comprehension questions were also used after the reading of the social stories. A 10 minute social interaction time with typical peers was implemented after the instructional phase ( reading of the social story, comprehension questions & practice written text cue cards). This social interaction time had a specific social goal. The interaction times were video recorded and the 5 students were able to view their interactions. Students checked off on a yes/no form if they saw themselves demonstrating the specific social goal. The results of this study determined the combined treatment package did in fact increase the above specific communication skills.
- Chan & O’Reilly ( 2008) used Social Stories™ in an intervention package for 2 students with diagnoses of autism who were in a kindergarten inclusion classroom. The Social Stories™ were written using Carol Gray’s 1995 criteria. The reading of Social Stories™ were followed with comprehension questions and role play. The specific social communication skills targeted during this study were : increase in appropriate hand raising, increase in appropriate social initiations, decrease in inappropriate social interactions (personal space difficulties) and decrease in inappropriate vocalizations. The results of the study were increased appropriate social communications skills and decreased inappropriate social communication skills for both students.
Based on the above research, I have found it helpful to implement social stories/Social Stories™in combination with both comprehension questions and role play in home-based ABA treatments. I have also found it helpful to involve the parents of the client in the creation of the story by asking them to provide details of the topic/setting. Parents also are a great resource for providing pictures/photos for the story. Once we have the details of the story, I can ask the parents to provide specific photos that will help clarify the information in the story.
If a client is going on a family vacation, I usually start using the story in the client’s sessions at least 1 month before the vacation. I also ask the parents to read the story to the client a few times a week before the vacation and to take the story with them on vacation for further review. During the client’s session, I usually include 3-4 comprehension questions regarding the story in his/her program. I have found the client’s answers to the comprehension questions to be helpful in determining on how many times a social story needs to be read/reviewed. If the client continues to have difficulty correctly answering the questions, the story probably needs to be modified. After the comprehension questions have been discussed, we start to role play the targeted skills of the story.
Depending upon the topic/skills being learned and the age of the client, role play can be done with stuffed animals/dolls or with the client and team members. For example, with a 6-year old client learning how to accept taking medication without tantrumming, we role play with stuffed animals/dolls who are “sick or injured” and need to take “pretend medicine”. For an 8 -year old client who is going on a family vacation that requires him to go through airport security, we set up a mock security station with him and other team members in his home. He practices putting his belongings in a bin and walking through a mock metal detector. We practice different potential scenarios – the metal detector going off and the client having to walk back through it again, the metal detector not going off, etc.
Social Stories™ /social stories have been implemented as part of proactive interventions to help increase socially significant skills in people diagnosed with Autism. Many skills can be introduced through these stories. If you would like more information about this topic, please refer to a review of literature by Karel & Wolfe (2018).
Additional Resources:
References:
- Chan, J.M., & O’Reilly, M.F. (2008). A Social Stories™ Intervention Package for Students with Autism in Inclusive Classroom Settings. Journal of Applied Behavior Analysis, 41, 405-409.
- Gray, C. (2015) The New Social Story™ Book, 15th Anniversary Edition. Arlington, TX: Future Horizons.
- Karal, M.A., & Wolfe, P.S. (2018). Social Story Effectiveness on Social Interaction for Students with Autism: A Review of the Literature. Education and Training in Autism and Developmental Disabilities, 53(1), 44-58.
- Thiemann, K.S. & Goldstein, H. (2001). Social Stories, Written text Cues, and Video Feedback: Effects on Social Communication of Children with Autism. Journal of Applied Behavior Analysis, 34, 425-446.
Are you interested in joining the Attentive Behavior Care team? Apply today!