In this excerpt, Scott Bellini addresses the results of his research published in 2007, which suggested that school-based social skills were only minimally effective for children and adolescents on the autism spectrum (Bellini, Peters, Benner, & Hopf, 2007), and the components needed for effective, systematic social skills programming, as detailed in his book, Building Social Relationships 2.
"Though hard to swallow for some, the results of these previous meta-analytical studies provided us with a great deal of useful information. Most importantly, they provided us with the “ingredients” of successful social skills programming, such as using a sufficient dosage (i.e., number of hours of intervention), implementing interventions in natural environments, discerning between types of skill deficits, conducting a thorough assessment of social skills, identifying the precise component skills that needed to be targeted, and perhaps most importantly, implementing social skills programming systematically. My research and clinical experience makes it abundantly clear to me that social skills training can be quite effective when these ingredients are applied to the social skills program (Bellini, Benner, & Peters-Myszak, 2009). This section briefly discusses the ingredients of successful social skills programming as elucidated by meta-analytical research and my own clinical experiences.
Gresham et al. (2001) recommended that social skill interventions be implemented more intensely and frequently than the level presently delivered to children with social skill deficits. Although the researchers did not recommend a specific dosage, they stated that 30 hours of instruction spread over 10–12 weeks was insufficient. If you are an educator, you are probably thinking “How in the world can we teach social skills for 30 hours over the course of 10–12 weeks?” The answer is that you can’t! Social skills training should take place throughout the day and in every environment that the child enters, including the home, the school, and the community.
Gresham and colleagues also noted that the weak outcomes of social skill interventions can be attributed to the fact that these interventions often take place in “contrived, restricted, and decontextualized” (p. 340) settings, such as resource rooms or other “pull-out” settings. The results of my meta-analysis supported this assertion. Intervention and generalization effects were significantly lower for interventions that were implemented in pull-out settings only (Bellini et al., 2007). Think about the absurdity here. We pull kids out of rich social environments (classroom or playground) to teach social skills in a contrived setting (resource room). That’s like a football coach pulling his team off the field and taking them to Starbucks to run through some plays!
Does this mean that we should stop teaching social skills in pull-out settings? No, but it does make it clear that we can’t only teach social skills in pull-out settings. In other words, social skills training should not stop the moment the child leaves the resource room or therapist’s office. Remember this mantra: Every environment the child enters presents an opportunity to teach social skills.
Matching the type of skill deficit with the type of intervention strategy is also an essential aspect of quality social skills programming (Gresham et al., 2001) and is a key feature of the BSR model (step two of the Five-Step Model, discussed later in this chapter). Discerning between types of skill deficits (skill acquisition deficits and performance deficits) is essential because it guides our selection of intervention strategies. It determines whether we need to teach a new skill or enhance the performance of an existing skill. In my meta-analysis, only 1 of the 55 studies purposefully matched the type of intervention strategy to the type of skill deficit. I should add that this one study also demonstrated positive outcomes.
Another ingredient of effective social skills programming is comprehensive assessment (Step 1 of the BSR model). It is imperative that we assess the child’s social functioning before, during, and after social skills programming. Without an assessment component, interventions are poorly conceptualized and lacking in direction and objectivity. Too often professionals and parents begin social skill interventions without conducting a thorough social skills assessment. When asked what they are teaching the child, they may respond “friendship skills” or “social skills.” What exactly does that mean? It would be analogous to a mathematics teacher responding to a similar question with “math skills” or a dance instructor with “dance skills.” Assessment allows us to identify and target the precise social skills the child needs to be successful in social interactions with peers. Quinn et al. (1999) found that social skills programs that targeted specific social skills (e.g., turn taking, social initiations) were more effective than programs that focused on more global social functioning, such as friendship skills, cooperation, and so on. We need specificity in our intervention planning. We do not teach friendship skills, we teach the specific skills that compose “friendship skills,” such as joining in an activity with peers, asking a peer to join you in an activity, responding to the greeting of others, initiating a greeting, reading and understanding the facial expressions of others, inferring the interests of others, maintaining reciprocal conversations, and so on. In addition, without assessment it is impossible to know for sure whether the social skills program is effective.
Another reason why social skills strategies—especially those designed for the general population of children, such as board games, classroom activities, and software packages about friendships and appropriate classroom behavior—may not be effective for children on the autism spectrum is because they tend to be too subtle or indirect. For instance, a school counselor was frustrated with the progress she was making with a student on the autism spectrum. She stated that the program was showing positive results with “other kids in the group,” but the student on the spectrum didn’t seem to “get it.” Indeed, he was not “getting it!” The reason was quite apparent. The school counselor was attempting to teach the students about the concept of friendship using board games and by showing videos depicting other children signing songs about being a “good friend.” This may be acceptable for some children, but for children on the spectrum it is too subtle a form of instruction. Instead of spending countless hours teaching the child about the concept of friendship, the instruction should have focused on skills that the child could use to make and keep friends. Plus, the concept of friendship is much easier to understand once you have had a friend or two! For example, I worked with one child who told me that he had two friends at school. When I asked his teachers about this they informed me that those two “friends” were actually two girls who followed him around calling him names and making fun of him. To him, they were friends simply because they were the only two kids on the playground who paid attention to him!
These ingredients to effective programming will permeate the content of this book, because they were considered very carefully when I developed and later modified the BSR program. The BSR program addresses the need for effective social programming for youth on the autism spectrum by providing a systematic social skills program that incorporates these ingredients at each step of the model."
Building Social Relationships 2 by Scott Bellini is now available for purchase at www.aapcpublishing.net.