Social Stories

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Social Stories were devised as a tool to help individuals with ASD (autistic spectrum disorder) better understand the nuances of interpersonal communication so that they could "interact in an effective and appropriate manner". [1] Although the prescribed format was meant for high functioning people with basic communication skills, the format was adapted substantially to suit individuals with poor communication skills and low level functioning (e.g. children who are struggling with understanding social situations or when coping with change [2] ). The evidence shows that there has been minimal improvement in social interaction skills. However, it is difficult to assess whether the concept would have been successful if it had been carried out as designed.

Contents

Social stories are being used, though, in targeted ways to prepare individuals for social interaction and to prepare individuals with autism for public events.

Overview

Social Stories are a concept devised by Carol Gray in 1991 to improve the social skills of people with autism spectrum disorders (ASD). [3] The objective is to share information, which is often through a description of the events occurring around the subject and also why. [4] Social stories are used to educate and as praise. They can be told by an educator, parent, a social worker or school psychologist. [5] Social stories model appropriate social interaction by describing a situation with relevant social cues, other's perspectives, and a suggested appropriate response. About one half of the time, the stories are used to acknowledge and praise successful completion of an accomplishment. [6] [7] [8]

Social stories are considered a type of social narrative. [9]

Detail

Individuals with an ASD have significant impairments in the social domain as defined by the nature of the diagnosis as cited in the DSM-IV. The social impairment may include, but is not limited to, the use of body language, play skills, understanding emotions, and social communication ability. [10] There is a great emphasis placed on the importance of teaching social skills to individuals with an ASD as it has been identified as one of the best indicators of positive long-term outcomes. [11]

According to Attwood, "A social story is written with the intention of providing information and tuition on what people in a given situation are doing, thinking or feeling, the sequence of events, the identification of significant social cues and their meaning, and the script of what to do or say; in other words, the what, when, who and why aspects of social situations". [12] It breaks down a challenging social situation into understandable steps by omitting irrelevant information and by being highly descriptive to help an individual with an ASD understand the entirety of a situation. It includes answers to questions such as who, what, when, where, and why in social situations through the use of visuals and written text. [13] Social Stories are used to teach particular social skills, [14] such as identifying important cues in a given situation; taking another's point of view; understanding rules, routines, situations, upcoming events or abstract concepts; and understanding expectations. [15]

The goal of a Social Story is to reveal accurate social information in a clear and reassuring manner that is easily understood by the individual with an ASD. The improved understanding of the events and expectations may lead to a change in behavior, although it is suggested that the goal of a Social Story should not be to change individual behavior. [14]

Social Stories use a specifically defined style and format. [16] [17] In the initial version, four types of sentences were used (descriptive, perspective, directive, affirmative), along with a basic sentence type ratio. Control, co-operative and partial sentences types have been added to the model. [18]

While the primary mode of presentation of Social Stories remains written text, other formats have been trialled with younger children and people with intellectual disabilities. Such formats have included singing, [19] apron story-telling, [20] and computer-based presentations. [15] [21]

Types of sentences

There are seven sentence types that may be used in a Social Story. [16]

Social Story ratio: Two to five cooperative, descriptive, perspective, and/or affirmative sentences for every directive or control sentence. [18]

Research

Population

It was suggested originally that this method should be used with only higher functioning individuals who possess basic language ability; [17] however, these guidelines were expanded to include children with more severe learning disabilities. [22] To accommodate differences in ability, one sentence per page paired with pictures could help individuals concentrate on one concept at a time while the pictures enhance the meaning of the text. The addition of pictorial representation or visual is supported by claims that many individuals with an ASD learn visually. [10] [23] The efficacy of using Social Stories with other populations of individuals, other than those with an ASD, has not yet been sufficiently studied. [24]

Evaluating research

Although Social Stories have been recommended as an effective intervention for children with ASD since the early 1990s, the research on their effectiveness is still limited. [8]

The American Psychological Association has identified two levels of criteria which are used to consider an intervention "empirically supported". [25] An intervention is considered well established if it meets the following criteria:

An intervention is considered probably efficacious if it meets the above criteria for greater than three single-case studies.

Social Stories are neither considered well established, nor considered probably efficacious, due to the limitations of the current body of research. [24]

Effectiveness

Reviews of the use of Social Stories have found that the reported effects were highly inconsistent, [8] [14] [24] [26] that they allow for stimulus control to be transferred from teachers and peers directly to the student with an ASD, [13] and that there was substantial variation in the delivery of the intervention. [8] Changes in target behavior were generally modest. [8] [14] A 2006 review found Social Stories to be in the non-effective range in interventions or at very best, in the low end of the mildly effective range. [26] It was often hard to attribute success to the Social Story technique since there were multiple interventions used simultaneously. [8] [14] [27] [28] Specifically, many of the studies used prompting methods such as verbal, visual or physical prompts and/or positive reinforcement. Two reviews suggested that continual implementation may be required; children should reread their Social Stories with some frequency to continue to benefit from their desired effects. [8] [18]

Targeted use

Preparation for social interaction

Social stories can be used to communicate ways in which an autistic person can prepare themselves for social interaction. [29] Comic strip conversations, a complementary technique developed by Carol Gray, are "visual representations" of conversations and social interactions that aim to help an individual understand social processes and increase their comprehension of other peoples thoughts and actions. [30]

Theatre

Social stories are used as part of Theatre Development Fund (TDF) Autism Theatre Initiative to "make theatre accessible to children and adults on the autism spectrum". Social stories which explain loud noises, needing a break and moving through a crowd were made available prior to the performance. [31] [32]

Related Research Articles

<span class="mw-page-title-main">Asperger syndrome</span> Neurodevelopmental diagnosis now categorized under ASD

Asperger syndrome (AS), also known as Asperger's syndrome, is a neurodevelopmental condition characterized by significant difficulties in social interaction and nonverbal communication combined with restricted and repetitive patterns of behavior and interests. The syndrome has been merged with other conditions into autism spectrum disorder (ASD) and is no longer considered a stand-alone diagnosis. It was considered to differ from other diagnoses that were merged into ASD by relatively unimpaired spoken language and intelligence.

The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), was a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. It was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the International Classification of Diseases (ICD).

Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narrow concept is used in the category "Specific Disorders of Psychological Development" in the ICD-10. These disorders comprise developmental language disorder, learning disorders, motor disorders, and autism spectrum disorders. In broader definitions ADHD is included, and the term used is neurodevelopmental disorders. Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life. However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.

<span class="mw-page-title-main">Controversies in autism</span> Controversies about both the cause of autism and the nature of the diagnoses themselves

Diagnoses of autism have become more frequent since the 1980s, which has led to various controversies about both the cause of autism and the nature of the diagnoses themselves. Whether autism has mainly a genetic or developmental cause, and the degree of coincidence between autism and intellectual disability, are all matters of current scientific controversy as well as inquiry. There is also more sociopolitical debate as to whether autism should be considered a disability on its own.

Autism spectrum disorders (ASD) are neurodevelopmental disorders that begin in early childhood, persist throughout adulthood, and affect three crucial areas of development: communication, social interaction and restricted patterns of behavior. There are many conditions comorbid to autism spectrum disorders such as attention-deficit hyperactivity disorder and epilepsy.

Discrete trial training (DTT) is a technique used by practitioners of applied behavior analysis (ABA) that was developed by Ivar Lovaas at the University of California, Los Angeles (UCLA). DTT uses direct instruction and reinforcers to create clear contingencies that shape new skills. Often employed as an early intensive behavioral intervention (EIBI) for up to 30–40 hours per week for children with autism, the technique relies on the use of prompts, modeling, and positive reinforcement strategies to facilitate the child's learning. It previously used aversives to punish unwanted behaviors. DTT has also been referred to as the "Lovaas/UCLA model", "rapid motor imitation antecedent", "listener responding", errorless learning", and "mass trials".

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The following outline is provided as an overview of and topical guide to autism:

<span class="mw-page-title-main">Autism therapies</span> Therapy aimed at improving quality of life and adaptive skills in autistic people

Autism therapies include a wide variety of therapies that help people with autism, or their families. Such methods of therapy seek to aid autistic people in dealing with difficulties and increase their functional independence.

Pivotal response treatment (PRT), also referred to as pivotal response training, is a naturalistic form of applied behavior analysis used as an early intervention for children with autism that was pioneered by Robert Koegel and Lynn Kern Koegel. PRT advocates contend that behavior hinges on "pivotal" behavioral skills—motivation and the ability to respond to multiple cues—and that development of these skills will result in collateral behavioral improvements. In 2005, Richard Simpson of the University of Kansas identified pivotal response treatment as one of the four scientifically based treatments for autism.

The floortime or Developmental, Individual-differences, Relationship-based (DIR) model is a developmental model for assessing and understanding any child's strengths and weaknesses. It has become particularly effective at identifying the unique developmental profiles and developing programs for children experiencing developmental delays due to autism, autism spectrum disorders, or other developmental disorders. This Model was developed by Dr. Stanley Greenspan and first outlined in 1979 in his book Intelligence and Adaptation. Evidence for the efficacy of DIR/Floortime includes results from randomized controlled trials of DIR/Floortime and the DIR/Floortime-based P.L.A.Y. Project; because of various limitations in these studies, the existing evidence is deemed to "weakly support" the efficacy of Floortime.

<span class="mw-page-title-main">Classic autism</span> Neurodevelopmental condition

Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism,Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.

<span class="mw-page-title-main">Autism spectrum</span> Neurodevelopmental disorder

Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder characterized by deficits in social communication and social interaction, and repetitive or restricted patterns of behaviors, interests, or activities, which can include hyper- and hyporeactivity to sensory input. Autism is a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.

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<span class="mw-page-title-main">Picture Exchange Communication System</span> A communication teaching method for people with limited speech

The Picture Exchange Communication System (PECS) is an augmentative and alternative communication system developed and produced by Pyramid Educational Consultants, Inc. PECS was developed in 1985 at the Delaware Autism Program by Andy Bondy, PhD, and Lori Frost, MS, CCC-SLP. The developers of PECS noticed that traditional communication techniques, including speech imitation, sign language, and picture point systems, relied on the teacher to initiate social interactions and none focused on teaching students to initiate interactions. Based on these observations, Bondy and Frost created a functional means of communication for individuals with a variety of communication challenges. Although PECS was originally developed for young children with autism spectrum disorder (ASD), its use has become much more widespread. Through the years, PECS has been successfully implemented with individuals with varying diagnoses across the aged span. PECS is an evidence-based practice that has been highly successful with regard to the development of functional communication skills.

Nonverbal autism is a subset of autism spectrum where the person does not learn how to speak. It is estimated that 25% to 50% of children diagnosed with autism spectrum never develop spoken language beyond a few words or utterances.

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<span class="mw-page-title-main">Social narrative</span>

A social narrative is an evidence-based learning tool designed for use with people with autism spectrum disorder (ASD) and other associated disabilities. Social narratives often use personalized stories to teach a skill, identify a situation, or tell a narrative; some examples of social narratives may cover topics such as getting along with others, interacting with others, or experiencing a new place or activity. It is referred to as a story or a written explanation that tells the learner not only what to do but also what the situation is, with the goal of addressing the challenge of learners finding social situations confusing. Social narratives have been found effective for learners ages Preschool-High School in several areas such as social, communication, joint attention, behavior, adaptive, play, and academic.

The diagnosis of autism is based on a person's reported and directly observed behavior. There are no known biomarkers for autism spectrum conditions that allow for a conclusive diagnosis.

There is currently no evidence of a cure for autism. The degree of symptoms can decrease, occasionally to the extent that people lose their diagnosis of ASD; this occurs sometimes after intensive treatment and sometimes not. It is not known how often this outcome happens, with reported rates in unselected samples ranging from 3% to 25%. Although core difficulties tend to persist, symptoms often become less severe with age. Acquiring language before age six, having an IQ above 50, and having a marketable skill all predict better outcomes; independent living is unlikely in autistic people with higher support needs.

References

  1. ↑ Taylor, Lori Ashley (2018-04-03). Dragonfly: A Daughter's Emergence from Autism: A Practical Guide for Parents. Simon and Schuster. p. 98. ISBN   9781510732186 – via Google Books.
  2. ↑ Hannah, Liz (2001). Teaching Young Children with Autistic Spectrum Disorders to Learn: A Practical Guide for Parents and Staff in General Education Classrooms and Preschools. London: AAPC Publishing. p. 83. ISBN   1931282099.
  3. ↑ Tobik, Amy (September 8, 2017). "Social Stories for Autistic Children". Autism Parenting Magazine. Retrieved November 29, 2019.
  4. ↑ Kershaw, Penny; Beaney, Joy (2006). Inclusion in the Secondary School Support Materials for Children with Autistic Spectrum Disorders (ASD). National Autistic Society. p. 40. ISBN   9781905722020 – via Google Books.
  5. ↑ Abraham, Michael; Irwin, Timothy (2010). Educating the Young Child with Autism Spectrum Disorders, Grades PK - 3: Moving from Diagnosis to Inclusion to Education. Minneapolis: Key Education Publishing. p. 44. ISBN   9781602688766.
  6. ↑ Goldberg Edelson, Meredyth (1995). "Social Stories". Autism Research Institute. Archived from the original on February 12, 2008. Retrieved 2008-02-26.
  7. ↑ White, Susan Williams (2011). Social Skills Training for Children with Asperger Syndrome and High-Functioning Autism. Guilford Press. p. 95. ISBN   978-1-60918-209-0 – via Google Books.
  8. 1 2 3 4 5 6 7 Sansosti FJ, Powell-Smith KA, Kincaid D (Winter 2004). "A research synthesis of Social Story intervention for children with autism spectrum disorder". Focus on Autism and Other Developmental Disabilities. 19 (4): 194–204. doi:10.1177/10883576040190040101. S2CID   145584601.
  9. ↑ Denning, Christopher (2017). Developing Motor and Social Skills: Activities for Children with Autism Spectrum Disorder. Lanham, MD: Rowman & Littlefield. p. 42. ISBN   978-1-4758-1764-5.
  10. 1 2 Quill KA (1995). Teaching Children with Autism: Strategies to Enhance Communication and Socialization. New York: Delmar Publishers. ISBN   0-8273-6269-2.
  11. ↑ Strain, Phillip S. (November 1, 2001). "Empirically Based Social Skill Intervention: A Case for Quality-of-Life Improvement". Behavioral Disorders. 27 (1): 30–36. doi:10.1177/019874290102700106. S2CID   142460981.
  12. ↑ Attwood, Tony (March 1, 2000). "Strategies for Improving the Social Integration of Children with Asperger Syndrome". Autism . 4 (1): 85–100. doi:10.1177/1362361300004001006. S2CID   145685068.
  13. 1 2 Scattone D, Wilczynski SM, Edwards RP, Rabian B (December 2002). "Decreasing disruptive behaviors of children with autism using Social Stories". Journal of Autism and Developmental Disorders . 32 (6): 535–43. doi:10.1023/A:1021250813367. PMID   12553590. S2CID   34404989.
  14. 1 2 3 4 5 6 Ali S, Frederickson N (December 2006). "Investigating the evidence base of Social Stories". Educational Psychology in Practice. 22 (4): 355–77. doi:10.1080/02667360600999500. S2CID   144893652.
  15. 1 2 Chatwin, I. (2007). "Why do you do that? Stories to support social understanding for people with ASD". In Carpenter, Barry; Egerton, Jo (eds.). New Horizons in Special Education: Evidence-based Practice in Action. Stourbridge: Sunfield Publications. ISBN   978-0-9550568-2-6.
  16. 1 2 Gray C (2000). The New Social Story Book. Arlington, TX: Future Horizons. ISBN   1-885477-66-X.
  17. 1 2 Gray, Carol A.; Garand, Joy D. (1993). "Social Stories: improving responses of students with autism with accurate social information". Focus on Autistic Behavior . 8 (1): 1–10. doi:10.1177/108835769300800101. S2CID   146442978.
  18. 1 2 3 Crozier S, Tincani M (2007). "Effects of Social Stories on prosocial behavior of preschool children with autism spectrum disorders". Journal of Autism and Developmental Disorders . 37 (9): 1803–14. doi:10.1007/s10803-006-0315-7. PMID   17165149. S2CID   14701367.
  19. ↑ Brownell M (2002). "Musically adapted Social Stories to modify behaviors in students with autism: four case studies". Journal of Music Therapy. 39 (2): 117–144. doi:10.1093/jmt/39.2.117. PMID   12213082.
  20. ↑ Haggerty, N., Black, R. & Smith, G. (2005). "Increasing self-managed coping skills through Social Stories and apron storytelling". Teaching Exceptional Children. 37 (4): 40–47. doi:10.1177/004005990503700406. S2CID   141271981.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ↑ Hagiwara T, Myles B (1999). "A multimedia Social Story intervention: teaching skills to children with autism". Focus on Autism and Other Developmental Disabilities. 14 (1): 82–95. doi:10.1177/108835769901400203. S2CID   141189088.
  22. ↑ Swaggert BL, et al. (April 1995). "Using Social Stories to teach social and behavioral skills to children with autism". Focus on Autistic Behavior. 10 (1): 1–16. doi:10.1177/108835769501000101. S2CID   144163096.
  23. ↑ Grandin T (1996). Thinking in Pictures . New York: Vintage Books, Random House. ISBN   0-679-77289-8.
  24. 1 2 3 Nichols SL, Hupp SD, Jewell JD, Zeigler CS (2005). "Review of Social Story interventions for children diagnosed with autism spectrum disorders". Journal for Evidence-Based Practices for Schools. 6 (1): 90–120.
  25. ↑ Chambless, Dianne L. (1995). "Training in and dissemination of empirically-validated treatments: Report and recommendations". The Clinical Psychologist. 48: 3–24. doi:10.1037/e554972011-003.
  26. 1 2 Reynhout G, Carter M (2006). "Social Stories for children with disabilities". J Autism Dev Disord. 36 (4): 445–69. doi:10.1007/s10803-006-0086-1. PMID   16755384. S2CID   14871166.
  27. ↑ Rust J, Smith A (March 2006). "How should the effectiveness of Social Stories to modify the behaviour of children on the autistic spectrum be tested? Lessons from the literature" (PDF). Autism. 10 (2): 125–38. doi:10.1177/1362361306062019. PMID   16613863. S2CID   2592455. Archived from the original (PDF) on 2019-03-04.
  28. ↑ Reynhout G, Carter M (2007). "Social Story efficacy for a child with autism spectrum disorder and moderate intellectual disability". Focus on Autism and Other Developmental Disabilities. 22 (3): 173–82. doi:10.1177/10883576070220030401. S2CID   144968972.
  29. ↑ Social stories: their uses and benefits. The National Autistic Society. Retrieved September 8, 2012.
  30. ↑ Comic strip conversations. Archived 2012-10-28 at the Wayback Machine The National Autistic Society. Retrieved September 8, 2012.
  31. ↑ Piepenberg, Erik. (August 31, 2011). "Program Hopes to Make Broadway Friendlier to Those With Autism." The New York Times. Retrieved September 8, 2012.
  32. ↑ Moving through crowds. Archived 2021-09-06 at the Wayback Machine Theatre Development Fund. Retrieved September 8, 2012.
Samples of Social Stories
  1. An Interactive Story to Teach Kids About Restaurant Behavior
  2. All About Going to School (to help a child prepare for the school day)
  3. I Am Going to the Doctor (to help children prepare for doctors appointments; can be used with adults too; good for people with fear, anxiety, or resistance at check-ups)
  4. I Am Going to the Dentist (to prepare children for dental appointments)
  5. I Hate the Word No (a story to teach kids to calmly respond to the word no)
Examples of targeted use of social stories
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