Comparing the teaching interaction procedure to social stories: a replication study

Social Story Intervention for Training Expected Behaviors among Preschool Children: A Systematic Review and Meta-Analysis

Promoting appropriate behaviors in early childhood is crucial for children's future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. The references were systematically screened in accordance with the PRISMA statements. Randomized or non-randomized controlled studies, as well as single-subject studies, in which SSs served as a behavioral training approach for children aged 2 to 6 years were included. Information related to study design, characteristics of the participants, target behaviors, and implementation of SS intervention was extracted. A meta-analysis was performed using the random-effects model, where similar outcomes were evaluated by similar intervention across multiple studies. Twenty-one studies were identified for qualitative analysis, while two studies formed the basis of the meta-analysis. SS interventions were employed to teach a variety of behaviors among typically developing children as well as those with various disabilities, such as autism, developmental delay, hearing impairments, attention deficit hyperactivity disorder, or other disabilities. The target behaviors included oral health practices, peer interaction, staying on-task, self-regulation, sleep habits, and controlling aggressive behavior during group activities. The SSs were used either alone or combined with other strategies, such as positive reinforcement, music therapy, role play, group discussion, video self-modeling, immediate practices, or additional audio commentary. Most studies reported improvements in appropriate behaviors and/or reductions in unfavorable behaviors. The meta-analysis indicated that children practiced more toothbrushing steps when using SS interventions compared to conventional oral health instruction (Z = 3.60, MD = 0.66, 95%CI 0.30 to 1.02, p < 0.001). SS interventions have the potential to teach target behaviors, particularly toothbrushing behaviors, among preschool children. More well-designed randomized controlled trials are warranted to determine the efficacy of SS interventions among children with various developmental profiles.

"A scoping review: Social stories supporting behavior change for individuals with Autism"

Social Stories (also known as social narratives) help individuals participate in and understand social situations. This scoping review identifies and synthesizes social narrative research targeting behavior change in individuals with ASD. Using the following questions as a guide: (a) What is the scope of social narrative interventions used for individuals with ASD, (b) What behavior change outcome measures are evaluated, and (c) What research designs are used; five databases were searched from 2007-to-2018. Fifty-six articles met the criteria. Primary outcomes were sorted into two macro-categories: Reduce Disruptive Behaviors and Increase Desired Behaviors. Most, but not all, studies were found to be effective for various behaviors such as aggressive actions, verbal protests, identifying emotions, executive functioning, following directions, and responding in social situations. Social narratives can be used to promote skills/behaviors in individuals with ASD to enable participation, an important goal in occupational therapy practice. They are an accessible and feasible intervention that can be implemented in various settings for behaviors including activities of daily living, social skills, independence, and self-regulation. Most research reviewed the single subject design, which is a limitation of the research as it makes results difficult to generalize. However, through replication, functional relationships can be determined. Additional research utilizing randomized control trials is recommended.

A Systematic Review of Maintenance Measurement in Early Childhood Autism Spectrum Disorder Research

Single case research designs (SCRDs) are integral to identifying evidence-based practices (EBPs) for young children with autism spectrum disorder (ASD); however, the field lacks guidance on measuring response maintenance within SCRDs. We identified 103 studies in which researchers used SCRD to investigate the maintenance of behavioral intervention outcomes for children with ASD ages 0-5. Findings include: (a) maintenance conditions across most EBP categories, (b) limited within-case replication of maintenance assessment, (c) inconsistent use of maintenance terminology, (d) varying frequencies of maintenance assessment, and (e) wide range in latency to first and last maintenance probe. Results indicate a pressing need for the regular inclusion of maintenance conditions in behavioral research to increase our understanding of programming for and assessing maintenance.

Advances in Our Understanding of Behavioral Intervention: 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder

There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.

Efficacy of Social Story Intervention in Training Toothbrushing Skills Among Special-Care Children With and Without Autism

Toothbrushing is a routine practice for oral hygiene maintenance. It is also a challenging task for young children with special care needs. In this study, social stories were employed to teach toothbrushing skills for preschool children with special needs. Those children were recruited from the Special Child Care Centers, including 87 children with autism and 94 children without autism. A validated toothbrushing social story was used to demonstrate the toothbrushing procedure for all the recruited children. Parents were encouraged to show the stories to their children before or during their daily toothbrushing. Children's toothbrushing performance, oral hygiene status, and gingival health status were assessed at baseline and 6 months. Toothbrushing performance, oral hygiene, and gingival status of the recruited children were significantly improved after using social stories. Moreover, children with autism showed better oral hygiene status (P = 0.01) and better gingival status (P < 0.001) than their peers without autism. However, there were no significant differences in the toothbrushing performance among children with and without autism. The regression models indicated that the improvement of children's toothbrushing performance and oral health status were associated with children's intellectual functioning and parents' attitudes toward the usefulness of social story intervention. The principal findings suggested that social story intervention could be used to improve toothbrushing skills among children with or without autism, while it was more efficient in improving the oral hygiene status among children with autism. Autism Res 2020, 13: 666-674. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Toothbrushing is considered as a basic self-care practice that should be advocated in early childhood. We used social stories to train toothbrushing skills among preschoolers with special care needs. The toothbrushing skills of the recruited children were significantly improved after 6-months intervention, and children with autism showed better oral hygiene status than their peers without autism. These findings suggested that social story-based health promotion could be implemented among children with special needs.

A randomized clinical trial of three prompting systems to teach tact relations

Prompts are commonly used during discrete trial teaching for individuals diagnosed with autism spectrum disorder (ASD). Three commonly used prompting systems include constant time delay, most-to-least prompting, and flexible prompt fading. Most of the research demonstrating the effectiveness of these three prompting strategies have been completed through the use of single subject experimental designs. Some within the field of behaviorally based approaches to ASD interventions have called for more randomized clinical trials of these approaches. The purpose of the present study was to compare these 3 prompting systems to teach tact relations for 27 individuals diagnosed with ASD through a randomized clinical trial without a control group with respect to pre-post responding, generalization, sessions to mastery, and responding during teaching. Overall, minimal differences were observed across the 3 systems. The results are discussed with respect to future research and clinical application of the methods evaluated.

A treatment comparison study of a photo activity schedule and Social Stories for teaching social skills to children with Autism Spectrum Disorder: brief report

PURPOSE

To compare the efficacy of two procedures, a photo activity schedule intervention and Social Stories, to teach social skills to four children diagnosed with Autism Spectrum Disorder (ASD).

METHODS

An adapted alternating treatments design with an additional multiple baseline control was used, and two social skills were targeted for each of the four participants, one under each intervention condition.

RESULTS

Results indicated that all four participants learned the target social behaviours with the photo activity schedule intervention, but did not learn target social behaviours with Social Stories.

CONCLUSIONS

Findings support the use of a photo activity intervention for teaching social skillsto children with ASD; we discuss the implications of inconsistent findings of effectiveness of Social Stories.

Social Thinking®, Pseudoscientific, Not Empirically Supported, and Non-Evidence Based: a Reply to Crooke and Winner

J. B. Leaf et al. (Behavior Analysis in Practice, 9, 152-157, 2016) wrote a commentary on social thinking (ST), an intervention commonly implemented for individuals diagnosed with autism spectrum disorder (ASD). The authors described what constitutes scientific, pseudoscientific, and antiscientific evidence and contended that ST aligns with the definition of pseudoscience and, to date, is not empirically supported or evidence based. Crooke and Winner (Behavior Analysis in Practice, 9, 403-408, 2016) responded, arguing that ST meets their definition of an evidence-based practice and identifying purported misconceptions and inaccuracies described by J. B. Leaf et al. In the current article, the authors clarify the original arguments, critically evaluate Crooke and Winner's definition of what constitutes evidence-based practice, further evaluate the research on ST, discuss issues regarding how ST is conceptualized, and express concerns about the endorsement and use of an eclectic approach to treating ASD. As this response was written by behavior analysts, it specifically addresses the conceptual consistency of this approach from a behavior-analytic worldview.

An Evaluation of a Behaviorally Based Social Skills Group for Individuals Diagnosed with Autism Spectrum Disorder

In this study we evaluated a social skills group which employed a progressive applied behavior analysis model for individuals diagnosed with autism spectrum disorder. A randomized control trial was utilized; eight participants were randomly assigned to a treatment group and seven participants were randomly assigned to a waitlist control group. The social skills group consisted of 32, 2 h sessions. Teachers implemented a variety of behaviorally based procedures. A blind evaluator measured participants' behavior immediately prior to intervention, immediately following intervention, and during 16 and 32-week maintenance probes. Results of the study demonstrated that participants made significant improvements with their social behavior (p < .001) following intervention, and the results were maintained up to 32 weeks after intervention had concluded.

Using the Teaching Interactions Procedure to Teach Social Skills to Children With Autism and Intellectual Disability

This study implemented a modified teaching interaction procedure to teach social skills to 4 children diagnosed with autism spectrum disorder with an intellectual disability. A multiple baseline design across social skills and replicated across participants was utilized to evaluate the effects of the modified teaching interaction procedure. The results demonstrated that the teaching interaction procedure resulted in all participants acquiring targeted social skills, maintaining the targeted social skills, and generalizing the targeted social skills.