Effective social skills programming: The May Institute, Inc. (early childhood).

This article has been developed for parents of children with difficulties in social interactions. In particular, parents of children with special needs--mental retardation, pervasive developmental disorders (PDD) and other disorders where social behavior is of concern--may benefit from the information presented here on promotion of social skills in young people.

Good social skills are important tools for day-to-day living; they help children navigate social interactions effectively and smoothly. The most basic and essential skill is the ability to communicate with others. Social skills are the specific behavioral strategies that allow one to initiate and maintain positive social interactions with others, develop friendships and social support networks, and cope effectively with the social environment. Children have many important social relationships to negotiate:

With parents and direct support professionals (DSPs): they must be able to follow directions, sit quietly when needed, assist with household chores and self-care as possible, and communicate needs in an appropriate way.

With teachers: they must be able to respond to teachers' behavioral expectations.

With peers: they must meet the behavioral requirements of peers in free play settings.

Importance of promoting social skills and prosocial development

Studies have demonstrated that a child's social competence is a critical developmental achievement for later social success. Social competence has been strongly associated with successful school performance, transition into school and work settings, better job opportunities and corresponding adult support, and improved overall interactions with others. Without intervention, children who demonstrate poor social skills may continue to experience problems into middle childhood and beyond.

Children with good social skills are better accepted by their peers, have better coping and attention skills and make better adjustments to school and social situations. Children with poor social skills have a greater risk of developing patterns of aggressive behavior and experience higher rates of emotional and behavioral problems. Developmental delays, however, affect the ways children demonstrate and develop social skills.

People with mental retardation show impairment in at least two adaptive skill areas such as communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work.

There are several ways in which people with PDD may be weak in social skills.

Qualitative impairment in social interactions: People with PDD may have impairment in the use of such non-verbal behaviors as eye gaze, posture, facial expression or gestures; or they may fail to develop peer relationships appropriate to their developmental level. They may not understand social and/or emotional reciprocity and generally do not spontaneously seek to share their interests and achievements.

Restricted, repetitive, and stereotyped behaviors, interests, and activities: There may be preoccupation--abnormal in intensity or focus--with one or more restricted, stereotyped interests. People with PDD may demonstrate inflexible adherence to specific, non-functional routines or rituals, stereotyped or repetitive motor mannerisms, or persistent preoccupation with parts of objects.

Qualitative impairment in communication: This may be a delay in or total lack of the development of spoken language. If speech is adequate, there may be an impaired ability to initiate or sustain conversation. Stereotyped and repetitive use of language and idiosyncratic language are common, as is lack of varied, spontaneous pretend play or social imitative play.

Social Skill Deficits

With an acquisition deficit, the child does not know how to perform particular skills. For example, Jack stands by the wall while watching a circle of his friends; he wants to join in but doesn't know how to start the process. A child with a performance deficit has the skill but does not use it. So Jim can raise his hand in class, but instead he yells out to get his teacher's attention.

There are both formal and informal ways to help children with social skill deficits. Formal interventions for this purpose are usually called "social skills programming."

Developing Effective Social Skills Programming

Social skills programming is a psychological and educational intervention for students with social skill deficits; it is used to strengthen social interactions and improve self-control. As with academic subject matter, social skills can be taught, both at home and in school.

FOUR KEY AREAS

1.Social Skills Assessment

The first step in developing effective social skills programming is an assessment of your child's social skills, both strengths and deficits; it identifies areas to be worked on. As mandated by the Individuals with Disabilities Education Act (IDEA '97), school-aged children with developmental delays are required to have an Individualized Education Plan (IEP) that specifies the services necessary for a student's successful performance in a given setting. An assessment will thus provide guidance for this portion of the IEP.

Measurement Strategies

Informal observations and feedback from a parent, DSP, and other people who know your child very well can offer helpful information about his current skill level in areas such as joining an activity and asking for help in appropriate ways. Formal assessment strategies help to provide objective information about how a child's current abilities compare with those of her peers. Tools have been designed to test cognitive and intellectual ability, adaptive functioning, personality measurements, functional behavioral assessments, and others.

Empirically-based assessments are developed through careful testing with the targeted population. Testing is often conducted with a large number of children of various ages, backgrounds, and abilities to determine whether the assessment measure or tool is reliable and valid for understanding children's patterns of behaviors. Reliability means that the assessment tool consistently provides the intended information in an accurate fashion. Validity means that the test really does measure what it is supposed to measure: intelligence, social competence, achievement, etc.

Advantages of Using Empirically-Based Assessment Measures

Your child has both strengths and weaknesses in of social skills. These assessments will measure them more precisely. Your child's social competencies will be compared to those of "typical" students, allowing parent and others working with the child to better understand the child's progress in developing age-appropriate skills. Children commonly show different behaviors and skills when in different settings with different care providers, so social competencies as evaluated by different observers can be compared. By using the same assessment tool to track progress, parents and teaching staff can determine if the social skills intervention is working or if there are areas needing additional intervention.

Functional Behavioral Assessment (FBA) is one type of formal evaluation. For those students with challenging behavior, a functional behavioral assessment may be necessary. FBA is a process for gathering information that can be used to maximize the effectiveness and efficiency of behavioral support because the problem behavior is evaluated in context. An FBA is a means for understanding the antecedents and consequences associated with social skill deficits by providing information about when, where, and why problem behaviors occur. The underlying rationale of the process is the assumption Hat behavior is functional: individuals engage in patterns of behavior that work for them in some way; there is a logic to the target behavior, and functional assessment is an attempt to understand that logic. By looking at the relationship between behavior and a child's environment--schedules, activity patterns, curriculum, teachers, physical settings--we can identify clues about the factors that support the target behavior.

Several strategies are used to conduct an FBA, including interviews and direct observation. This type of assessment is especially helpful when there is no agreement about the processes that appear to maintain the behavior. An FBA is especially needed when severe problem behaviors are a concern; IDEA '97 now requires that an FBA be conducted for any child who is suspended from school for more than 10 days because of behavioral problems.

Answers to specific questions help to inform an FBA evaluation:

* What are the behaviors that are causing concern?

* What events or physical conditions that occurred significantly earlier in time than the problem behavior increase the likelihood that the problem behavior will recur?

* What events and situations that occur just prior to the problem behaviors reliably predict occurrence of problem behaviors?

* What events reliably predict when problem behaviors will not occur?

* In a specific situation when the problem behavior occurs, what are the consequences that appear to maintain the problem behavior?

* What appropriate behaviors, if any, could produce the same consequences that appear to maintain the problem behavior?

Priorities for Immediate Intervention

Behaviors that are physically dangerous; would enable the student to have better access to more inclusive activities; provide a positive approach; are precursors to later, more complex skills; or alter the perceptions of others and thus have long-term positive implications are priorities for intervention.

2. Curriculum selection and Implementation

The second key in developing effective social skills programming is selecting a well-designed social skills program that will address your child's deficits. The results of the social skills assessment should help guide the decision-making and selection process.

What to look for in a social skills curriculum of program

Numerous social skills curricula are available on the market (see Resources). A validated social skills curriculum has been research-tested and found to be effective for improving social skills. Implementing a social skills curriculum will require time and effort on the part of many people who work with your child; select a program that you can be confident will bring about the needed changes in your child's social skills and behavior. A validated curriculum can proVide that confidence, focusing on social skills development in areas that include pragmatic language development; flexibility in managing tasks, settings, etc.; attention skills and adaptive behavior.

The materials used to teach social skills should be as similar as possible to materials used in real life--this can result in a greater transfer of skills because the instructor can tailor the lesson to the needs of the student or class. Depending on the assessment results, social skills programming can occur on a daily, multi-day, or weekly basis; its duration should be adjusted based on developmental level, attention span, interest, and maturity level.

Implementing a social skills curriculum

The curriculum may be implemented in many different ways, depending on the needs of the child and the target skills to be addressed. Instruction can be carried out at the district, school, classroom, and individual levels or in some combination; social skills programs can be conducted with whole classrooms, small groups, or on a one-on-one basis.

Often, children will not learn social skills just from being given an opportunity to interact with peers. Like any other skill, children need to be taught what to do--and when to do it.

Teaching Social Skills

There are several different approaches to teaching social skills. Some children learn as a result of incidental teaching. This is when children learn about social skills and how to do them through their own observations of others and the interactions they have with others in their natural environment. An example would be receiving reinforcement from the teacher for demonstrating a particular skill. Other approaches--peer-initiation strategies, peer tutoring--involve a child's peer network. A socially competent peer is paired with a child needing social skills; the goal is to assist the child in developing or refining a particular skill.

Some children can only learn social skills through direct skill instruction. This kind of instruction involves a direct and systematic way of teaching a social skill or behavior and can involve a curriculum that is used to teach various skills. Research has identified the critical features of this approach that will be most effective in bringing about long-lasting change and improvement. Studies have also found that there is a direct relationship between the amount and quality of social skills training and the extent of behavior change.

FEATURES OF DIRECT SKILL INSTRUCTION

Modeling and coaching: Children are shown examples of people (models) performing behavioral steps competently.

Role Playing: Children need to be provided with numerous opportunities to practice new skills.

Performance Feedback and Reinforcement: Children need to receive frequent feedback and positive reinforcement--praise, reward plans--for demonstrating skills to make it worthwhile to use them. The improved behavior must occur frequently enough so that reinforcement can be given. Through this process, children should understand why to use the skill and with whom; what skill should be chosen; when and where to use it; how to perform the skill; what to do if the skill is unsuccessful.

Generalization: In order to increase the strength of a social skills intervention, a number of service components should be in place to promote skill acquisition across settings. When a child begins to demonstrate success in using a skill across different settings or with different individuals, generalization of the skill has occurred. Generalization of social skills is improved when programming is conducted in the settings where the skills need to be performed, with different examples and models, involving socially competent peers.

The program should include teaching the difference between appropriate and inappropriate skills and teaching the child self-management of the behavior when possible; efforts should be coordinated with school staff. Transfer training refers to the specific procedures that are designed to help build generalization, such as the teaching setting, materials, personnel, reinforcement systems, and task instruction.

3. Program Monitoring and Evaluation

The third key to developing effective social skills programming is to monitor and evaluate program outcomes to determine whether the intervention is working. This step also involves identifying personnel who will monitor, evaluate, and communicate program progress over time.

The people monitoring behavior should look for instances when the skill is demonstrated, then assess the child's mastery and fluency of usage of the target skills. Data collection can involve both formal and informal observations and assessments using empirically-based rating scales or surveys. Ongoing data collection allows team members to track progress on a daily, weekly or biweekly basis. This level of monitoring can allow staff to quickly identify progress and/or areas in need of improvement in order to ensure the rate of student progress to meet annual goals.

4. Staff competencies

The final key to developing effective social skills programming is to have staff, support personnel, and case consultants who are adequately trained with the competencies needed to develop, implement, monitor, and evaluate programming. Individuals who provide social skills programming for students with developmental disabilities should be competent in the use of applied behavior analytic procedures.

Applied behavior analysis (ABA) is a highly individualized method of instruction based on scientific principles of learning theory. It is used to design student programs that are implemented systematically, evaluated empirically, and introduced within natural environments. This method has been validated by more than 25 years of research as the most effective way for individuals with and without disabilities to acquire skills, increase socially useful behaviors, and reduce problematic behaviors.

Competencies should include knowledge of:

* Mental retardation, PDD, and other developmental delays;

* Assessment: FBA, social skills assessment;

* Best instructional practices;

* Applied behavior analysis;

* Social skills training;

* Behavior support plans.

A Summary Checklist

Assessment

[] 1. An assessment has been conducted to measure my child's social skills.

[] 2. Standardized, empirically-based measures are used to assess my child's social skills.

[] 3. Results provide information about my child's social skill deficits and strengths.

[] 4. If my child exhibits challenging behaviors, Functional Behavioral Assessment is conducted by a qualified professional.

IEP Development

[] 1. Goals and objectives target specific social skill deficits.

[] 2. Goals target priority areas for intervention.

[] 3. Goals and objectives are measurable.

[] 4. Goals allow for change over the course of a year.

[] 5. Goals and objectives include measurable benchmarks.

[] 6. Data collection systems are in place to measure progress toward each of the goals and objectives.

[] 7. Changes are made to social skills programming or goals as indicated by the data.

Social Skills Programming

[] 1. Social skills programming is matched to the target areas for which my child needs intervention.

[] 2. For direct skill instruction, key features are incorporated: modeling, coaching, role-playing, performance feedback, reinforcement, and regeneralization procedures.

[] 3. If a curriculum is used, it is one that has been validated.

[] 4. Includes instruction for skills that are useful at home

Staff Qualifications

[] 1. Consultant is qualified to develop appropriate social skills programming based on assessment results and needs of my child.

[] 2. Staff are qualified to implement social skills programming.

[] 3. Staff who implement social skills programming are knowledgeable in mental retardation and/or pervasive developmental disorders, functional behavioral assessment, social skills assessment, best instructional practices, applied behavior analysis, social skills training, and behavioral support plans.

[] 4. The behavioral consultant has the qualifications in applied behavioral analysis and school consultation necessary to address your child's needs.

[] 5. The behavioral consultant is part of the team of providers and monitors and provides feedback to me and the staff about program progress and needed modifications.

Parent Involvement

[] 1. We have discussed concerns about our child's social skills deficits.

[] 2. We are invited to, and attend, each planning meeting.

[] 3. Our opinions are solicited and valued at these meetings.

[] 4. The plan reflects out input.

[] 5. All parties work toward generalization of our child's skills at school. and at home.

What Can a Parent Do?

At Home

Look for and find appropriate behavior; Define and quantify the behavior operationally; Use reinforcement; Take advantage of natural opportunities; Try to ignore inappropriate behavior; If needed, find a competent behavior analyst to help you; Look at the long-term; Prepare for transitions.

At School

Do you know whether your child is making progress? "Show me the outcomes." Has the school asked you what you think is important for your child? Have you indicated what are you long-term goals? What is your child's curriculum? Ask yourself: "How can I help the educational staff working with my child?" Attend meetings; Communicate, COMMUNICATE, COMMUNICATE!

Additional Reading

J. L. Matson. Handbook of Behavior Modification with the Mentally Retarded. NY: Plenum Press, 1990.

C. Maurice, S. Luce and G. Green, Behavioral Intervention for Young Children with Autism: A manual for parents and professionals. Austin, TX: Pro-Ed, 1996.

D. Rotholz and J. Jacobson. Behavioral consultants: Who are they and how do I find the right one? Columbia, SC: Center for Disability Resources. 2001.

This article has been adapted by the EP editorial staff from a workbook on social skills programming being developed by the Consultation Services Department of The May Institute, Inc. [c] 2002, The May Institute, Inc.

The May Institute, Inc. is a private, nonprofit organization providing behavioral healthcare, education and rehabilitation. Headquartered in Norwood, MA, with facilities throughout the country, the Institute maintains affiliations with more than 40 universities, hospitals, and human services agencies in the US and abroad. The organization was founded in 1955 by Jacques M. May, MD, and his wife, Marie Ann May, who wanted to provide a progressive treatment and living environment for their twin boys with autism.

For information The May Institute and its services, check their Web site at http://www.mayinstitute.org or call [phone] (toll-free) or [phone]; TTY: [phone]. The street address of the corporate headquarters is One Commerce Way, Norwood, MA 02062.