A Scoping Review: Social Stories Supporting Behavior Change for Individuals with Autism

Autism Spectrum Disorder (ASD) is an advanced and complex developmental disability. Furthermore, it is described as a disorder that occurs during the early developmental stages, characterized by limited, repetitive behavioral patterns and interests or activities, problems in various forms of social communication and interaction that persist throughout life. The problems that children with ASD experience in social communication and interaction skills also lead to problems in acquisition of social skills. Children with ASD experience mutual social communication difficulties, as well problems in non-verbal social behavior and establishing social relationships. Social stories are written with a perspective of a child in a special format to explain social situations to children with ASD, to instruct social skills and allow them to cope with difficulties in social situations. In the present study, the effectiveness of social story tablet computer software on the acquisition of social skills by children with ASD was analyzed. Two male and 1 female 5-7 years old students who were diagnosed with ASD were included in the study. The social stories developed by the authors before the instruction were adapted to tablet computer environment. The teachers employed in the institution and were the instructors of the students in the study group were informed about the presentation of these stories to the children with ASD and the application. The “sharing” behavior was selected among the social stories that were developed based on the course requirements. In the first two study sessions, the authors provided feedback for the teachers who conducted the study. The study was conducted with a single-subject design with multiple probe model with probe conditions across participants design. The study findings demonstrated that social story tablet computer program was effective on the acquisition of social skills by children with ASD. An increase in the sharing behavior of all three participants was observed. Furthermore, three participating teachers expressed positive views on the social story tablet computer software.

The importance of social skills to achievement of important life outcomes has been long documented, as have the social skill deficits encountered by many children with disabilities. Numerous social skill interventions have been implemented in inclusive settings with young children with disabilities; however, many of the interventions were multi-faceted, making it difficult to identify specific intervention activities that accounted for behavioral change. The purpose of the present study was to compare two social skill interventions to determine whether changes in teacher behavior resulted in differential changes in preschool children's social skill behaviors. The results indicated that teacher behavior could be modified and that praise was a strong component in facilitating change among children. The results also demonstrated that the inclusion of young children with disabilities in small-group art activities did not negatively impact the social behaviors of the group. However, neither intervention resulted in significant changes in the social behaviors of the young children with disabilities. Continued research is needed to identify interventions that teachers can readily implement and that will positively impact the social skill development of preschool-age children, with and without disabilities.

Social insect colonies are characterized by an efficient division of labor, allowing high-value individuals (i.e., reproductives and brood) to be sheltered from tasks associated with increased risk of pathogen exposure, such as foraging or corpse disposal. This social organization helps limit the transmission of disease throughout the colony. Further, individuals can actively respond to imminent disease threats by altering their behaviors as a means of social immunity. In subterranean termites, although workers typically avoid detected pathogens, they can be attracted to pathogen cues when a nestmate is infected. Infected termites are usually groomed, but they may instead be cannibalized if the infection has already become lethal. The mechanisms governing these changes in behavior are unclear. We set out to examine immediate changes in individual behaviors, investigating the role that the infected individual plays in communicating its infection status to nestmates. We also assessed gradual changes in social organization after the re-introduction of an infected termite to the colony. Our results reveal that infected termites likely do not signal their infection status to nestmates through shaking behaviors and reduced movements, suggesting the occurrence of other mechanisms used in communicating infection. We also found that infected termites do not self-isolate and may travel to the densest part of the colony, where they can potentially benefit from grooming by large groups of nestmates. These results provide new insights into how individual changes in immune behaviors contribute to overall colony health, highlighting that, at early stages of infection, termites favor a rescuing strategy rather than isolation and/or cannibalization.

Human behaviour plays an important role in the spread of emerging infectious diseases, and understanding the influence of behaviour changes on epidemics can be key to improving control efforts. However, how the dynamics of individual behaviour changes affects the development of emerging infectious disease is a key public health issue. To develop different formula for individual behaviour change and introduce how to embed it into a dynamic model of infectious diseases, we choose A/H1N1 and Ebola as typical examples, combined with the epidemic reported cases and media related news reports. Thus, the logistic model with the health belief model is used to determine behaviour decisions through the health belief model constructs. Furthermore, we propose 4 candidate infectious disease models without and with individual behaviour change and use approximate Bayesian computation based on sequential Monte Carlo method for model selection. The main results indicate that the classical compartment model without behaviour change and the model with average rate of behaviour change depicted by an exponential function could fit the observed data best. The results provide a new way on how to choose an infectious disease model to predict the disease prevalence trend or to evaluate the influence of intervention measures on disease control. However, sensitivity analyses indicate that the accumulated number of hospital notifications and deaths could be largely reduced as the rate of behaviour change increases. Therefore, in terms of mitigating emerging infectious diseases, both media publicity focused on how to guide people's behaviour change and positive responses of individuals are critical.

Changing current dietary patterns into sustainable healthy diets (ie, healthy diets with low environmental impact and socioeconomic fairness) is urgent. So far, few eating behavior change interventions have addressed all the dimensions of sustainable healthy diets at once and used cutting-edge methods from the field of digital health behavior change. The primary objectives of this pilot study were to assess the feasibility and effectiveness of an individual behavior change intervention toward the adoption of a more environmentally sustainable healthy diet as a whole and changes in specific relevant food groups, food waste, and obtaining food from fair sources. The secondary objectives included the identification of mechanisms of action that potentially mediate the effect of the intervention on behaviors, identification of potential spillover effects and covariations among different food outcomes, and identification of the role of socioeconomic status in behavior changes. We will run a series of ABA n-of-1 trials over a year, with the first A phase corresponding to a 2-week baseline evaluation, the B phase to a 22-week intervention, and the second A phase to a 24-week postintervention follow-up. We plan to enroll 21 participants from low, middle, and high socioeconomic statuses, with 7 from each socioeconomic group. The intervention will involve sending text messages and providing brief individualized web-based feedback sessions based on regular app-based assessments of eating behavior. The text messages will contain brief educational messages on human health and the environmental and socioeconomic effects of dietary choices; motivational messages to encourage the adoption of sustainable healthy diets by participants, providing tips to achieve their own behavioral goals; or links to recipes. Both quantitative and qualitative data will be collected. Quantitative data (eg, on eating behaviors and motivation) will be collected through self-reported questionnaires on several weekly bursts spread through the study. Qualitative data will be collected through 3 individual semistructured interviews before the intervention period, at the end of the intervention period, and at the end of the study. Analyses will be performed at both the individual and group levels depending on the outcome and objective. The first participants were recruited in October 2022. The final results are expected by October 2023. The results of this pilot study will be useful for designing future larger interventions on individual behavior change for sustainable healthy diets. PRR1-10.2196/41443.

One intervention that has been evaluated in numerous empirical investigations and has been implemented clinically is Social Stories. Social Stories are a systematic form of intervention where a text is written describing a situation (e.g., social situation) and how the learner should respond during that situation. Previous reviews and analysis have shown that the literature on Social Stories have serious methodological flaws (e.g., Leaf et al., 2015; Styles, 2011) and/or are ineffective (e.g., Leaf et al., 2015; Reynhout & Carter, 2011). One reason for the methodological flaws is the lack of functional relations shown between the Social Story and the targeted behavior; usually with poor implementation of the experimental design. The purpose of this review was to evaluate if researchers implement both single subject designs and group designs in the correct manner, which show a convincing functional relation. Additionally, we evaluated studies where Social Stories were compared to another intervention (e.g., the Teaching Interaction Procedure) and if Social Stories were added to another intervention (e.g., differential reinforcement). Clinical implications as well as future research is discussed.

Among Attention-Deficit Hiperactivity Disorder (ADHD) diagnostic criteria is the obstacles in academic and social function across multiple setting. About 50% children with ADHD have difficulties to establish peer relationship, and made some impact to social skill deficit. Social stories can teach social skill to individu who have social problems. The aim of social stories is to provide the individual with a greater understanding of certain social situations. This research was held to identify the social stories influence toward social skill of children with ADHD. The research used single case experiment with A-B design. Participant selection was based on age, reading ability, Hiperactive Behavior Indonesian Child Rating Scale score, and Walker McConnel Social Competence and School Adjusment score. There are two partisipants that passed through all the criteria. The result of data analysis are (1) statistical analysis show there is no difference on frequency of target behavior after social stories treatment had given (asymp. signf. 0.242> 0.05 0.05< 0.464) (3) participant #1 and participant #2 showed improvement tendency based on visual inspection to the target behavior graph (4) social stories can increase participant’s knowledge regarded how to do a behavior, but could not help participant to carried out their knowledge in to behavior yet. The conclusion of this research is social stories do not have influence toward social skill of children with ADHD. Social stories only influenced on cognitive level, could not foster participant to carried out the knowledge in to behavior yet. Keywords : social stories, social skill, ADHD Permalink :

Mike is a 22 year-old adult with CHARGE Syndrome and autism spectrum conditions. Mike often struggles to greet and interact appropriately when people come to visit him and his family at his house. The purpose of this project was to help Mike improve his greeting and overall social skills. One event that seems to provoke problem behavior in people with autism is sudden unannounced schedule changes. Advanced warning of schedule changes have been used to prepare people with disabilities similar to Mike’s to teach social and behavioral skills. Social stories have also been used as an intervention to give individuals with disabilities scripted information that they can follow in social situations. This study used an advanced warning strategy during intervention 1. This strategy did not prove to be successful. Therefore we implemented a second strategy consisting of an advanced warning as well as a social story intervention. Social stories were created involving Mike and each of his seven nieces and nephews. Baseline data was collected before the interventions were implemented on whether Mike greeted his nieces and nephews in a friendly manner, on Mike’s attitude, outbursts, and on whether he engaged each child in an activity during the visit. This same data was collected during each phase of the study. Intervention one, advanced warning phase proved to be unsuccessful. The second, social story intervention, including an advanced warning plus social story, required Mike to read the social story aloud to an adult before the visiting children arrived. This intervention resulted in an increase in friendly greetings, positive attitude, and involvement in activities with the visiting children. Engaged in activities with the nieces and nephews, and outbursts showed little change. Mikes overall attitude during the visits made some improvement. Proposal Project to Improve Greeting Skills of an Adult with Disabilities Using Social Stories 3

Background and objectiveThe increasing prevalence of childhood obesity has led to interest in its prevention, particularly through school-based and family-based interventions in the early years. Most evidence reviews, to date,...

Behaviour Change to Promote Diabetes Outcomes: Getting More From What We Have Through Dissemination and Scalability

IntroductionApproximately half of adult Americans suffer from musculoskeletal disorders (MSD). Significant risk factors for musculoskeletal disorders include poor diet, obesity, and insufficient physical activity. Studies show that lifestyle change education and interventions reduce MSD risk factors. However, little is known about the relationship between physician advice for behavior change and reported behavior change by MSD patients. This study explored the association between physician advice for lifestyle change and reported change in MSD patients, as well as the effects that patient education levels have on compliance.MethodsThis study used data from the 2017 National Health Interview Survey, a nationally representative cross-sectional survey of non-institutionalized US adults. The research team limited analysis to adults who reported a limitation due to musculoskeletal problems (n = 2,672). Outcomes included physician recommendations to increase physical activity, reduce fat/calories, or lose weight, and whether they enacted these behavioral changes. Adjusted logistic regression models examined whether compliance with doctor's instructions differed by education level.ResultsAdjusted models show patients advised to change physical activity, diet, and weight were more likely to report attempted behavior change. Education was positively associated with likelihood of complying with physician advice to increase physical activity. Among patients not advised to change behaviors by a physician, education was positively associated with current behavior change attempts.ConclusionThis study suggests that physician recommendations are relevant predictors of reported behavior change in individuals with MSD. Although education plays an important role in this association, the relationship is complex and multifaceted. Future studies should explore how compliance may be impacted by other factors, such as physician message type.

Social Communication: A Framework for Assessment and Intervention

This study adopts a Sequence Learning Strategy based on social stories and designs a sequential social story situation board game system using Augmented Reality (AR) technology (SL-ARS). In the system, the content of social stories is decomposed into social situation units with a Sequence Learning structure, different social situation judgment tasks are added into the stories, and autistic children are taught to think about the order of social events and situations that occur in their daily environment, correctly prioritize social situational states, and learn how to give appropriate social responses to others in a given situation.

BackgroundLarge changes in health behaviors achieved through intensive lifestyle intervention programs improve cardiovascular disease (CVD) risk factors among adults with type 2 diabetes. However, such interventions are not widely available, and there is limited evidence as to whether changes in behaviors affect risk of CVD events.MethodsAmong 852 adults with screen-detected type 2 diabetes in the ADDITION-Cambridge study, we assessed changes in diet, physical activity, and alcohol use in the year following diabetes diagnosis. Participants were recruited from 49 general practices in Eastern England from 2002 to 2006, and were followed through 2014 for incidence of CVD events (n = 116) and all-cause mortality (n = 127). We used Cox proportional hazards regression to estimate hazard ratios (HR) for the associations of changes in behaviors with CVD and all-cause mortality. We estimated associations with CVD risk factors using linear regression. We considered changes in individual behaviors and overall number of healthy changes. Models adjusted for demographic factors, bodyweight, smoking, baseline value of the health behavior, and cardio-protective medication use.ResultsDecreasing alcohol intake by ≥ 2 units/week was associated with lower hazard of CVD vs maintenance [HR: 0.56, 95% CI 0.36, 0.87]. Decreasing daily calorie intake by ≥ 300 kcal was associated with lower hazard of all-cause mortality vs maintenance [HR: 0.56, 95% CI 0.34, 0.92]. Achieving ≥ 2 healthy behavior changes was associated with lower hazard of CVD vs no healthy changes [HR: 0.39, 95% CI 0.18, 0.82].ConclusionsIn the year following diabetes diagnosis, small reductions in alcohol use were associated with lower hazard of CVD and small reductions in calorie intake were associated with lower hazard of all-cause mortality in a population-based sample. Where insufficient resources exist for specialist-led interventions, achievement of moderate behavior change targets is possible outside of treatment programs and may reduce long-term risk of CVD complications.Trial registration This trial is registered as ISRCTN86769081. Retrospectively registered 15 December 2006

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