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Section 15
Increasing Social Integration in Children with ASD

Question 15 | Test | Table of Contents

Intervention Object-Initiated
An important approach was demonstrated by Gaylord- Ross, Haring, Breen, and Pitts-Conway (1984) for two young men with autism, ages 17 and 20, with minimal language. The intervention taught the men to operate an age-appropriate object (radio with headphones, handheld computer game, pack of gum) and then to approach a person and offer to share the object. Generalization was tested during daily high school breaks with typical peers. Teaching the men to operate the objects did not result in changes in social behavior, but teaching them to offer the objects during a social script resulted in increased social initiations and interaction that generalized across persons and time but not across settings. This study is notable for its success with adolescents with severe levels of disabilities.

Self-Management Strategies
R. Koegel and Frea (1993) reported improving conversational skills using a pivotal response training approach in which two high-functioning teenagers with autism were taught self-management strategies for behaviors such as maintaining eye contact and topic maintenance. The children rapidly learned the desired behavior, achieving 100% on the first day of intervention. Careful fading of reinforcers resulted in conversational behaviors maintained for 30-minute intervals between token reinforcers, with generalization of skills to nontargeted situations and improvements in associated but nontargeted conversational social skills.

Circle of Friends
Haring and Breen (1992) described a peer-mediated approach for providing social supports for an adolescent with autism in an inclusive junior high school setting. Typical peers identified themselves as interested in supporting this teen. Weekly 30-minute group meetings were held with the network members to plan their social interventions with the targeted student. They were taught to initiate, prompt, and praise the target student. Interventions were targeted for transitions between classes in the junior high school. The target student was taught the names and photos of the students in his network. A self-management system was added after day 20 to reward social interactions with peers; this was withdrawn after increases in engagement were obtained, without a decrease in engagement. The interventions resulted in greater frequency of social interactions with peers and increased interactions consisting of multiple turns that were maintained over 2 months.

Social Skills Groups
The use of social skills groups for children and adults with autism has been a part of the TEACCH intervention approach for over a decade. Ozonoff and Miller (1995) reported a controlled group study of an intervention focused on teaching high-functioning adolescents a variety of social skills, including an understanding of other people’s mental states. The treatment group of five adolescents met weekly for 14 weeks with a structured curriculum. Compared to four control participants, the social skills group members demonstrated significant gains in understanding others’ mental states. However, parent and teacher reports failed to document generalization of the target skills to other situations.

Conclusions
As can be seen in the above review, children with autism, while demonstrating primary deficits in social interactions, are responsive to a wide variety of interventions aimed at increasing their social engagement with others, both adults and typical peers. Furthermore, several of the studies have demonstrated that such engagement directly affects other behaviors even when these behaviors are not specifically targeted by the teaching program. In verbal children, both the frequency of language used and the use of novel language constructions have been demonstrated to increase along with increases in social engagement (Krantz & McClannahan, 1993; Stahmer, 1995; Thorp et al., 1995). Additionally, inappropriate behavior has been found to decrease during periods of active social engagement (Lee & Odom, 1996). Thus, social engagement appears to be a pivotal response, a skill that leads directly to increased attainment of other important skills without the need for direct programming.

A second important theme in the above studies involves the role of typical peers. It is important to note that all of the successful strategies involving peers, both peer-mediated approaches and peer tutoring, have involved typically developing peers. Approaches that have taught social skills with adult partners have generally found that these did not generalize to peer interactions without specific peer training. Strain (1983) demonstrated that the effects of social skills training were dependent on social characteristics of the environment, with greater ratios of typically developing to atypically developing children supporting improved social interactions for peers with autism. However, note that while inclusive school experiences are heavily emphasized as an important means of increasing interactions of children with autism and typical peers, physical integration does not necessarily foster social integration, as is seen above in many of the control conditions. Social integration has to be seen as a goal and actively targeted for intervention (Frea, 1995). Adopting these lab- and lab–school-based strategies for implementation in regular public schools represents a significant challenge to educators. The above described successful strategies are complex in administration, data collection, and maintenance and generalization procedures, and they require trained staff and focused interventions that extend over weeks to months. The next generation of studies can advance treatment by focusing on the adaptation of these strategies to naturalistic contexts and public settings, as demonstrated by the work of Strain and colleagues.

Rogers, SJ. (2000). Interventions that facilitate socialization in children with autism. Journal of Autism and Developmental Disorders, 30(5).
(AS is now ASD per DSM-5.)

The box directly below contains references for the above article.

Personal Reflection Exercise #8
The preceding section contained information about interventions that increase adolescent peer interactions.  Write three case study examples regarding how you might use the content of this section in your practice.

Update
Effects of Integrative Autism Therapy
on Multiple Physical, Sensory, Cognitive,
and Social Integration Domains in Children
and Adolescents with Autism Spectrum Disorder:
A 4-Week Follow-Up Study

- Kim, Y., Kim, M., Park, C., & You, J. S. H. (2022). Effects of Integrative Autism Therapy on Multiple Physical, Sensory, Cognitive, and Social Integration Domains in Children and Adolescents with Autism Spectrum Disorder: A 4-Week Follow-Up Study. Children (Basel, Switzerland), 9(12), 1971.

Peer-Reviewed Journal Article References:
Alostaz, J., Baker, J. K., Fenning, R. M., Neece, C. L., & Zeedyk, S. (2021). Parental coping as a buffer between child factors and emotion-related parenting in families of children with autism spectrum disorder. Journal of Family Psychology.

Ashbaugh, K., Koegel, R. L., & Koegel, L. K. (2017). Increasing social integration for college students with autism spectrum disorder. Behavioral Development Bulletin, 22(1), 183–196.

Barnard-Brak, L., Richman, D. M., Chesnut, S. R., & Little, T. D. (2016). Social Communication Questionnaire scoring procedures for autism spectrum disorder and the prevalence of potential social communication disorder in ASD. School Psychology Quarterly, 31(4), 522–533.

Blackman, A. L., Jimenez-Gomez, C., & Shvarts, S. (2020). Comparison of the efficacy of online versus in-vivo behavior analytic training for parents of children with autism spectrum disorder. Behavior Analysis: Research and Practice, 20(1), 13–23.

Bos, D. J., Silverman, M. R., Ajodan, E. L., Martin, C., Silver, B. M., Brouwer, G. J., Di Martino, A., & Jones, R. M. (2019). Rigidity coincides with reduced cognitive control to affective cues in children with autism. Journal of Abnormal Psychology, 128(5), 431–441.

Field, T. (2017). Imitation enhances social behavior of children with autism spectrum disorder: A review. Behavioral Development Bulletin, 22(1), 86–93.

Peterson, C., Slaughter, V., Moore, C., & Wellman, H. M. (2016). Peer social skills and theory of mind in children with autism, deafness, or typical development. Developmental Psychology, 52(1), 46–57.

Rodriguez, P. P., & Gutierrez, A. (2017). A comparison of two procedures to condition social stimuli to function as reinforcers for children with autism. Behavioral Development Bulletin, 22(1), 159–172.

QUESTION 15
What was the result of teaching the two males to offer objects during a social script? To select and enter your answer go to Test.

Test
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