The impact that autism spectrum disorders (ASD) can have on an individual’s ability to develop social communication skills, as well as the recognition of the importance of early intervention, has led to a large body of literature within applied behaviour analysis, evaluating social skills interventions to support social inclusion for children with ASD [1, 2, 3]. These interventions, based on evidence based practices, have demonstrated success in improving a wide variety of social skills for children with ASD (e.g., play, social initiations, social interactions, social responses) [4, 5]. However, while systematic reviews demonstrate the efficacy of different interventions in increasing social skills, gaps in knowledge regarding generalization and maintenance are repeatedly highlighted [6, 7]. It is important for children with ASD and their families, that targeted skills become meaningful, through use within everyday social situations.
Learning social skills should enable a child to navigate complex social interactions and environments, and support the development of relationships, such as friendships [8]. When social skills are taught, it is necessary for further social development that they occur across individuals (e.g., peers, siblings, cousins) and contexts (e.g., home, school, community) [8, 9]. Social skills must also continue to occur and develop across the lifespan to support the development of the complex domain of social competence [9]. Generalisation and maintenance of social skills are fundamental to overall continued social development, and especially given the complexity of the ever changing social environment for children with ASD.
In a recent systematic review on this topic [9], we examined the literature regarding social skills interventions for preschool children with ASD. In recognition of the importance of early intervention supporting longterm gains for individuals with ASD, we explored the methods employed to support generalization and maintenance of intervention outcomes for young children with ASD. We conducted a systematic evaluation of the use of the strategies to promote generalization within the literature [10, 11], and analysed 57 studies (59 experiments) to determine evidence based strategies for promoting generalization of social skills.
We identified the generalization promotion strategies incorporated within social skills interventions (e.g., having common stimuli across the teaching and natural context, teaching with multiple examples and training others in the child’s environment). The majority of the most successful strategies to support generalization involve adapting the teaching environment to be as similar to the natural environment as possible, particularly with regard to the consequences for social skills or problem behaviour. If certain reinforcement items (e.g., stickers or a chart) are used in teaching, it is important to fade these to more naturally occurring reinforcers (e.g., parent praise, peer gratitude). Similarly, if prompts or reminders are used in teaching, these should be faded to more accurately reflect the natural environment. It is also important to teach people who interact with the children regularly to respond positively to social skills and to reduce problem behaviour. Another successful strategy is to embed some flexibility with the social skills being taught, for example, to teach, catch and reinforce lots of different ways of greeting someone or playing cooperatively.
Historically, researchers described teaching skills without planning for generalization as the “Train and Hope” approach. The findings from our review suggest that there has been progress over the past 40 years within the social skills literature toward a “Train with Strategies and Hope” approach. Increasingly, researchers are designing social skills interventions which incorporate the strategies to promote generalization and these demonstrate success for preschool children with ASD. However, a complete understanding of how these strategies work and the factors that influence their effectiveness requires future research toward an empirical technology of generalization promotion.
Ciara Gunning and Dr. Jennifer Holloway
School of Psychology,
National University of Ireland Galway
References
1 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2 Vernon, T.W. (2014). Fostering a social child with autism: A moment-by-moment sequential analysis of an early social engagement intervention. Journal of Autism and Developmental Disorders, 44, 3072-3082. doi: 10.1007/s10803-014-2173-z
3 Gresham, F. (2014). Evidence-based social skills interventions for students at risk for EBD. Remedial and Special Education, 36, 100– 104. https://doi.org/10.1177/0741932514556183.
4 Bellini, S., Peters, J. K., Benner, L.,& Hopf, A. (2007). A meta-analysis of school-based social skills interventions for children with autism spectrum disorders. Remedial and Special Education, 28, 153–162. https://doi.org/10.1177/07419325070280030401.
5 McCoy, A., Holloway, J., Healy, O., Rispoli, M., & Neely, L. (2016). A systematic review and evaluation of video modeling, role-play and computer-based instruction as social skill interventions for children and adolescents with high-functioning autism. Review Journal of
Autism and Developmental Disorders, 3, 48–67. https://doi.org/10.1007/s40489-015-0065-6.
6 Boudreau, A. M., Corkum, P., Meko, K., & Smith, I. M. (2015). Peer mediated pivotal response treatment for young children with autism spectrum disorders: A systematic review. Canadian Journal of School Psychology, 30, 218–235. https://doi.org/10.1177/0829573515581156.
7 Schmidt, C., & Stichter, J. P. (2012). The use of peer-mediated interventions to promote the generalization of social competence for adolescents with high-functioning autism and Asperger’s syndrome. Exceptionality, 20, 94–113. https://doi.org/10.1080/09362835.2012.669303.
8 Rao, P. A., Beidel, D. C., & Murray, M. J. (2008). Social skills interventions for children with Asperger’s syndrome or high-functioning autism: a review and recommendations. Journal of Autism and Developmental Disorders, 38, 353–361. https://doi.org/10.1007/s10803-007-0402-4.
9 Gunning, C., Holloway, J., Fee, B., Breathnach, Ó., Bergin, C.M., Greene, I., & Ní Bheoláin, R. (2019). A systematic review of generalization and maintenance outcomes of social skills intervention for preschool children with autism spectrum disorder. Review Journal of Autism and Developmental Disorders, online. doi: https://doi.org/10.1007/s40489-019-00162-1
10 Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349–367. https://doi.org/10.1901/jaba.1977.10-349.
11 Stokes, T. F., & Osnes, P. G. (1989). An operant pursuit of generalization. Behavior Therapy, 20, 337–355. https://doi.org/10.1016/s0005-7894(89)80054-1.