Teaching social behavior to children with autism spectrum disorders using Social StoriesTM: Implications for school-based practice.

Abstract

Introduction Autism spectrum disorders (ASD), which include autism, Asperger's Syndrome (AS), and pervasive developmental disorder-not otherwise specified (PDD-NOS), are a group of disorders characterized by a host of difficulties with social interactions, communication, and repetitive behaviors or interests (American Psychiatric Association, 2000). Although currently defined by a triad of impairments, difficulties with social relationships and interactions have been one of the hallmarks of autism since its first description (Kanner, 1943) and, more recently, have been suggested to be the defining feature of ASD (Laushey & Heflin, 2000). Across the spectrum, characteristics of the social sequela manifest uniquely, rarely being the same from one individual to the next. In general, children with ASD demonstrate extreme difficulties engaging in even the simplest of social behaviors, such as engaging in appropriate eye contact, initiating and maintaining conversations, listening to or responding to verbal requests, developing and maintaining age-appropriate friendships , and interacting in basic games (Carter, Ornstein-Davis, Volkmar, & Klin, 2005; Dawson et al., 2004). Despite these generalities, some children with ASD may appear to be social in the presence of familiar adults or peers and, at times, socially engaged. However, the majority of children with ASD will demonstrate extreme social difficulty when in the presence of novel people or stimuli (Handleman, 1999). Given such difficulties, efforts to teach children with ASD skills that enhance participation in family, school, and community activities become paramount. Within the past two decades, the number of children identified as having ASD has increased substantially. Traditionally, ASD were considered a low-incidence disability, occurring in only 4 to 6 per 10,000 (or 1 in approximately 1,600) live births (Lotter, 1967). However, the most current estimates from the Centers for Disease Control and Prevention (CDC, 2007) estimate that ASD occurs in 1 in every 150 births, making it the fastest growing developmental disability in the U.S. Such an increase likely has had a direct impact on educators in public schools across the country in relation to demands for educationally related services. In fact, the U.S. Department of Education reports that the number of children receiving services under the autism category of the Individuals with Disabilities Education Act (IDEA) has increased 1,342% between 1993 and 2006 (Fighting Autism, 2008). Moreover, there has been an increasing trend to include students with ASD in general education classrooms (National Research Council, 2001). Examination of data on inclusion relative to each disability category under the IDEA suggests that students with ASD are increasingly served in inclusive settings (Office of Special Education Programs, 2004). While only 4.8% of students with ASD were included in 1990-1991, nearly 29.1% were in general education for 80% or more of their day in 2003-2004. Truly, educating students with ASD in inclusive environments has become a more common practice. Due to the increased number of students with ASD in schools and the push for providing educationally related services within inclusive environments, effective means of planning and implementing social skills interventions are needed. To be effective, interventions targeting social behaviors should capitalize on the visual learning strengths of students with ASD and allow for repeated imitation of targeted social skills or behaviors (National Research Council, 2001). Furthermore, such interventions should be presented in ways that are unobtrusive and can be implemented within natural contexts. Social Stories[TM] One strategy that has emerged as a common practice for teaching social behaviors to individuals with ASD in schools is the use of Social Stories[TM]. Social Stories[TM] are individualized short stories that can be used to assist persons with ASD in interpreting and understanding challenging or confusing social situations (Gray, 1997, 2003). …