Autism Spectrum Disorder

Journal Article Review #4

Jennifer Crumrine, Tammy Goodlett, Chance Ralphs, and Stacey Van Dyke

SPE/576

Sallie Long

March 9, 2015

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Social-Skills Treatments for Children with Autism Spectrum Disorders

The article, Social-Skills Treatments for Children with Autism Spectrum Disorders, focuses on the social limitations that a child with ASD might have as well as some different areas to consider when developing an appropriate intervention strategy. In the article it is made clear that many children with ASD tend to have various behavioral issues. It takes it a step further by pointing out the fact that many of those behavioral struggles relate back to challenges when it comes to social interaction and communication (Matson, 2007). It is clear that social deficits are typically one of the major areas targeted for interventions and trying to help a student with ASD grow. Many actually believe that social deficits might actually be independent from other ASD domains and as a result need their own specific treatment (Matson, 2007). Some of those major deficits would be eye contact and initiating social interaction. According to the article behavior is defined as “interpersonal responses with specific operational definitions that allow a child to adapt to the environment through verbal and nonverbal communication” (Matson, 2007). This all makes a lot of sense when one really sits down and thinks about it. All social interaction and communication relies on an individual’s ability to adapt to the conversation and the way the interaction as a whole is going. When one struggles with that ability within social interactions they either become awkward or do not run as smoothly. Being able to perform all of the behaviors common within social interaction under several circumstances is very important.

The article makes a lot of sense. I agree with several of the points that are made including the long list of intervention strategies that can be used. Peer-mediated, reinforcement, and modeling are some of the strategies that would probably be most effective. However, it is important to look at the child specifically because each child is different and brings their own set of challenges. Looking at the article and referring to past knowledge about children with ASD, the article only confirms past findings. Children with ASD suffer from several social and communication deficits and it is important to try and be there to support both the families and the child with ASD. Developing proper intervention strategies that are specifically geared towards the child’s need will only help the child become more independent. Teaching them the necessary social and communication skills so that they can adapt in any type of social environment will help them become more successful in all faucets of life.

I agree that all students are different and required different modalities. It is interesting to me that even in my article it focused on how each child is different. When we compare children we are not comparing apples to apples. Much of it is trial and error. Each new student brings a different way of thinking, behavior, and contribution to the class environment. It is our job to determine how we encourage these students to grown and thrive, within their disability. In my own classroom, we do a lot of modeling. This modeling comes in forms of video, role playing, and other activities that some of my students deem silly, but you would be amazed at what a close group of students we have developed. From your article, I particularly like the modeling portion, for this reason.-Tammy

It is apparent that the articles we chose all have similar conclusions of the best-established or promising interventions for learning social skills for students with an ASD. We all agree that we need to look at the student as an individual first to play to their ability strengths when choosing a strategy that may bring the most success to acquiring new skills and reducing inappropriate behaviors. I also like how Chance acknowledges that families also need to be supported along with their child. Providing families information and making them part of the intervention process allows them to help generalize the learning of skills across settings and sets the student up for the best chance for success.-Stacey

All of the articles we chose this week complement each other so nicely. The underlying theme is that social skills are essential for success and that individuals with ASD have trouble with them. There are many different approaches to teaching these skills and they can, and should, be tailored to the individual needs of the child. All of the approaches mentioned seem to be effective and the challenge is finding the one(s) that fits.-Jennifer

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Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework

Authors Reichow and Volkmar analyzed the studies of social skills interventions to increase social behaviors of individuals with autism with the purpose to examine empirical evidence within a framework of a best evidence synthesis (2010). For the synthesis, they outlined six specific criteria used in selecting studies for examination. The majority of participants in each study must have had an autism spectrum disorder (ASD), intervention must be intended to improve social skills, evaluated at least one outcome, intervention had to meet a specific research design, the study must have been published or accepted in a peer-refereed journal between 2001 and 2008, and studies required acceptable to strong rigor ratings (Reichow & Volkmar, 2010). Sixty-six studies with 513 individuals with ASD fit the criteria for review.

The authors were very thorough in breaking down the information into categories. The first level of breakdown was age range. Age ranges were categorized by preschool, school-aged, adolescent, and adult. The delivery agent such as delivered by parent, professional, peer, technology, and combination delivery also further categorized studies. They were further broken down into experimental rigor rating, study design, generalization, procedural fidelity, and dependent measures.

Review findings were given by age range and intervention specific results by applied behavior analysis (ABA), naturalistic, parent training, peer training, social skills groups, visual, and video modeling. The results of the synthesis were used to determine if an intervention could be considered an established evidence –based practice (EBP) or a promising EBP. Conclusions were that social skill groups had strong evidence to be classified as established EBP and video modeling as promising EBP.

An interesting segment of the article was the authors included a section on limitations touching on the topic of publication bias and the selection and exclusion of studies. Reichow & Volkmar (2010) state they used an extensive search with a variety of methods and sources to limit publication bias. The authors acknowledge that because there are no methods to determine the effects of publication bias, they alert readers to the possibility (Reichow & Volkmar, 2010).

Reichow & Volkmar make a statement that while results may show strong evidence for a particular intervention of social deficits, the strategies and outcomes do not permit conclusions about one method being more superior over another (2010). I agree that one method is not superior. I apply this statement to the fact that even when a method is considered EBP, not all methods are one size fits all for each student with autism. As educators, we have to remember to understand the unique needs of the student and implement the method that best suits that student. A student that likes computers may be better suited to video modeling. Another student may fare better with social skills groups. Another student may need a combination of approaches in home as an addition to school. For enhancing the learning of students, we do need to use research-based interventions and strategies that are proven successful to improve performance, but we cannot forget the student as an individual in the process. Even while being an established approach; it may not be the best fit for a student. Identifying the likes and strengths of a student and matching those to a proven intervention will have a higher probability of being a successful practice.

The interventions needed to increase social behaviors discussion increased my awareness in considering age and delivery method. I, too was also fascinated in the suggestion of considering publication bias in studies conducted. The main consideration that was common with the other articles read, was that one method is not superior, nor is there a one size fits all. Each student with autism requires a different style of teaching. Identification of the students strengths in learning is essential in providing successful teaching to a student with ASD.-Tammy

I think that the biggest thing that I agree with in the article is the fact that no one intervention strategy is superior to another. That really needs to resonate with teachers in a lot of areas. The same could be said for teaching strategies in the classroom. Every student is going to be different and even those multiple students that all have Autism Spectrum Disorders are going to be vastly different from one another. Some students might succeed in a peer-mediated intervention strategy while others would be better to learn various social skills with adult guidance instead. Every student is going to learn different and will need different kind of monitoring or support. It is important for the teacher to look at the individual and their unique needs and plan accordingly. They must also not be afraid to scrap something that does not work and try something new or even multiple strategies that might all be effective.-Chance

Once again, we have the common and important theme of using many methods to find what is the proper fit for each particular student. This is important to always keep in mind. Stacey's article brings up the difference in age which is something else to consider. Students at very young ages require quite different interventions than older students and while young peers may have trouble taking instruction on how to act with ASD students, they also have fewer friend requirements than older, more mature students. That stands out to me as something to take note of.-Jennifer

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Teaching Social Skills to People with Autism

The authors of Teaching Social Skills to People with Autism listed many social challenges faced by people with autism. These included difficulties in orienting to social stimuli, understanding facial expressions, responding to another’s distress, initiating interactions, using appropriate greetings, establishing joint attention, appreciating conventional humor, and spontaneous and pretend play. All of these difficulties make it difficult for individuals with autism to both initiate and continue meaningful social relationships and occur not only in children, but into adulthood.

Three different types of methods were looked at to help young children with social skills and spontaneous social behavior. The methods were adult-mediated, peer-mediated, and initiation by child with autism. All methods had varying degrees of success and drawbacks.

· First, they looked at adult-mediated strategies which while they can be effective, encourage adult dependence and must be faded quickly.

· Next, peer-mediated strategies were explored: proximity which is when typical and ASD children just play together with no instructions, prompt/reinforce interventions which is when peers are trained to prompt and reinforce social behavior of ASD students, and peer initiation training where peers are trained to initiate interactions with ASD students. All of the peer-mediated approaches produced gains in social responsiveness, but the latter two are considered more effective. They authors also looked at a peer buddy system in which trained buddies were randomized in order to promote generalization and multiple peer relationships and social interactions resulting in significant increases in social interactions. Finally, they looked at peer-implemented pivotal response training (PRT) which produces generalized behavior improvement and addresses motivation and responsiveness to multiple cues. Peers were taught to use PRT which was then implemented with adult supervision. Initiation, engagement, and joint attention were all increased.

· Third was initiation by the child with autism. The ultimate goal is for the child with autism to be able to initiate interactions on their own and for them to have skills in this area and not only be responding to other people’s initiations. “Initiation skills of the child with autism may transfer across settings and across individuals” (Weiss & Harris, 2001). This strategy is successful but one problem is that it does require adult mediation and prompting. The authors reviewed another study which looked at teaching the children to initiate verbally when a device vibrated which minimized this adult interaction.

The article furthermore discussed how important self-management is for the children to further their social skills and the use of scripts in improving future interactions. Scripts are especially useful when being taught to an entire class or group that includes autistic students which helps everyone and does not single out the autistic child.

This article discussed many ways of helping autistic children improve their social interactions. Learning social skills is of great importance both for independence and general quality of life. All of the ways discussed seemed effective and promising but the peer-mediated strategies were the most exciting to me. There is a great benefit to both children with disabilities and those who are typical when they are paired together and working towards being able to interact appropriately. I have seen this work and will be sure to set this up with my future students.

Jennifer said that peer-mediated strategies were most exciting to her. I also lean towards peer training strategies. I feel it is a more natural intervention when training is between a student and a similar aged peer within their school community. The peer becomes a model of appropriate social behavior while also building a friendship of "give and take." I also believe skills are more generalized as they hopefully have opportunities to interact with their peers in multiple settings such as the classroom, playground, lunchroom, activities, etc. While peer programs take expertise and time to train students to mentor and use specific strategies, it is worth it for the result of the experience for all students involved. Peer programs offer so much more than just to the student with the social skill needs. It is also an invaluable experience for the peer and strengthens the collaboration within the school community.-Stacey

In the article Teaching Social Skills to People with Autism, I liked the three methods discussed: adult mediated strategies, peer-mediated strategies, and initiation by the child with autism. It is encouraging to see how each of these build off of each other. The first portion discussing the adult-mediated strategies was informative because it broadened my awareness of how the adult does not need to be the driving force of the activity, how adults can stimulate the play, especially when the child has an atypical personality that needs an extra push to be social. With peer-mediated strategies, it is necessary for an adult to be there to prompt. Through this prompting, there are social lessons learned that carry over into the future opportunities the student has and they gain a little more independence, ultimately not need the prompts any longer. Then finally the initiation of play by the child with autism may sometimes never occur, depending on the severity of ASD. Self-management is a difficult skill for children with out ASD, but when we play in the factor of ASD, it takes work, encouragement, and the natural environment.-Tammy

The article was very informative in regards to the various techniques that professionals can use in order to help those children with Autism Spectrum Disorder to better their social skills. It makes a lot of sense that two of the first strategies that were used were adult-mediated strategies and peer-mediated strategies. I think that it is common for teachers and parents that are trying to develop social skills for their children with ASD to start with adult-mediated strategies. It is found that often time children with ASD tend to learn social skills better when it is done with adults because their peers tend to struggle dealing with the atypical behavior. However, when a child with ASD can work with their peers to develop the social skills I think that it is even better. If they can feel comfortable with their peers and learn how to communicate and interact with them appropriate it makes their academic career much better. It is also going to be easier to build of peer interaction rather than transfer skills learned in adult interaction to peer interaction. Providing experiences and practices in various settings is important to try and make the child comfortable in multiple situations.-Chance

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Teaching Play Skills to Young Children with Autism

In the journal article “Teaching play skills to young children with autism”, Jung & Sainato research the importance of the development of young children and the importance of play in their daily routine. Research indicates play skills and stereotypical behavior are common with children diagnosed with Autism Spectrum Disorder (ASD). Twenty-six studies were reviewed and it was determined that combined interventions are required when teaching play skills. The improvement in play skills decreased inappropriate behaviors.

Jung and Sainato establish attention being focused on symbolic play, however there are many inconsistencies regarding these studies. They further discuss functional play as a means of using a simple less elaborate strategy. Symbolic play is discussed as a child’s ability to act on an object as if it were something else, “imaginary” or “pretend”. This involves three forms: object substitution, attribution of false properties, and attribution of presence to imaginary objects. Research has indicated that ASD children have deficits in symbolic play in comparison to other children at the same developmental age. It is suggested this is indicative of their limited language skills, however this type of play has been determined as a way to produce appropriate interventions.

Another type of play discussed in the article is sociodramatic play, an advanced form of symbolic play, where children role play around a particular theme. This type of play has been documented to be successful, but the quality of play maybe different than that of children with other development disabilities. Also discussed is the importance of playing games for younger children with ASD. The games were successful, especially when it is in line with their obsessive interests.

The research in this article was conducted based off of research studies, already conducted and published in journal articles, limited to English-language publications, peer-reviewed journals, and empirical studies. The articles were located using the following terms: autism and teaching play skills, autism and play intervention, autism and play, and autistic and play (Jung & Sainato, 2013). There were 292 articles related to play skills, and Jung and Sainato established 49 of the studies to be appropriate.

Strategies researched were: video and live modeling, systematic prompting strategies, pivotal response training, use of restricted interests, activity schedules with correspondence training, integrated playgroup model, script training, and social stories. Studies have indicated that the response to intervention for children with autism is successful when it is occurs in a structured environment. When play skills improve inappropriate behavior decreases. It is more difficult to teach a child with autism to play with peers than to play with adults. The reason being, because a child is less likely to adjust to the child with ASD’s atypical behavior. Focusing on a natural environment where the ASD child plays with peers, rather than a one-on-one session with adults may enhance a child’s interactions.

My current view of students with ASD, centers on increasing communication skills. This article supports my belief that not only is one model recommended, but there are different styles of teaching to promote language/communication skills. I chose this articles because I wanted to see the comparison of the various strategies, and how it concluded. Jung and Sainato stated, “Research demonstrates that improvements in play can facilitate social interaction, language skills, and decrease the self-stimulatory behavior of children with autism”, I could not agree more. As an educator, we are continuously challenged with how to reach our students at multiple levels through instruction. The article supports the idea that no two students are the same, no two students learn the same, and no two students play the same.

I agree with a lot of the findings within the article. I think that it is pretty common for those children with Autism Spectrum Disorder to struggle with various social challenges even at an early age. It is also apparent that children with ASD will not display some of the typical play behavior that their peers without ASD do. The article explains that a lot of that comes from the fact that they have limited communication skills and social skills. Intervention strategies at an early age should target the idea of trying to improve the play skills for young children with ASD. As a result they will see improvements in other skills like social interaction, initiating play, and communication skills. It can also make teaching other types of social interaction outside of play much easier as the child gets older.-Chance

The research results from this article and your views also support my comments from the article I reviewed. It my first introductory class for special education, I learned that there are many similarities between students with disabilities and those without. Whether students have a disability or not, they are unique individuals who process information in different ways and learn differently. Finding the best research-based intervention that matches the individual student, is the key to their success.-Stacey

I agree that teaching communication skills is vital for the child with ASD and that teaching and facilitating play is one important component of that. Several methods were discussed here and I agree that not only are different methods better for different individuals, but a combination of models are probably most effective.-Jennifer

References

Jung, S., & Sainato, D.M. (2013). Teaching play skills to young children with autism. Journal of Intellectual & Developmental Disability, 38(1), 74-90. doi:10.3109/13668250.2012.732220


Matson, J. L., Matson, M. L., & Rivet, T. T. (2007). Social-skills treatment for childen with Autism Spectrum Disorders: An overview. Behavior Modification, 31(5), 682-707.


Reichow, B., & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40(2), 149-66. doi:http://dx.doi.org/10.1007/s10803-009-0842-0


Weiss, M. J., & Harris, S. L. (2011). Teaching social skills to people with autism. Behavior Modification, 25.