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Promoting social interaction of children with disabilities in integrated preschools: a failure to generalize.

Much of the movement for mainstreaming children with disabilities is based on the compelling rationale of its social benefits for these children (Guralnick & Groom, 1988). Few empirical studies, however, have been completed on effective procedures for its implementation (Jenkins, Speltz, & Odom, 1985; Odom & McEnvoy, 1988). There is reason to believe that spontaneous improvement in the social behaviors of children with disabilities does not occur through admininstrative placement of these children with normally developing children (Gresham, 1984; Jenkins et al., 1989; Snyder, Apolloni, & Cooke, 1977). Compared with peers without disabilities, children with disabilities placed in regular pre-schools tend to be more socially rejected by peers, display more social isolation, place more demands on teacher time, are less attentive, and are more often the recipient of negative behaviors from normally developing children (Burstein, 1986; Honig & McCarron, 1988; Novak, Olley, & Kearney, 1980; White, 1980).

Successful integration of children with disabilities into regular preschools requires carefully planned and systemic procedures that result in positive social interaction between children with and without disabilities. One strategy for promoting social interaction in integrated preschools has been a "teacher mediated" approach, in which the teacher interacts with children with disabilities in ways designed to increase positive behaviors with peers (Odom & Strain, 1984). Another strategy for promoting social interaction has been a "peer mediated" approach, wherein normally developing peers are selected and trained to facilitiate improved social interaction of children with disabilities. Both of these approaches have been shown to produce initial positive effects, but results of the generalization of these effects across settings and over time are mixed at best (Odom, Hoyson, Jamieson, & Strain, 1985; Odom & Strain, 1984; Sancilio, 1987; Strain & Fox, 1977).

Durable generalization and maintenance of positive social interaction between preschoolers with and without disabilities may depend on the emergence of reciprocity intheir approach and response to social behaviors (Kohler & Fowler, 1985; Strain & Shores, 1977). Unfortunately, children with disabilities tend to be weak in social skills and are not well accepted by peers (Gresham, 1982). One way to promote social interaction among preschoolers may be to introduce a social interaction program within the context of the entire preschool class (Odom & Strain, 1984). This strategy may have a number of positive features:

* Since the intervention is focused on the group as a whole, there is minimal stigmitizing of children with disabilities.

* The regular teacher may acquire programming skills applicable across a number of situations.

* Generalization of effects may be enhanced by the use of a natural group of children.

The purpose of this research was to examine the effectiveness of a classwide social skills program (CSSP) in promoting social interaction of children with disabilities within regular preschools. The CSSP consists of a multimethod training package to promote social interaction among all children in the class, including children with disabilities. The training package included: (a) instructions on specific social behaviors (e.g., sharing) (Cooke & Apolloni, 1976); (b) puppet modeling of a social skill (Kelly, 1981); (c) rehearsal with feedback (Barton, 1981); (d) teacher prompting and praising of positive social interaction during free-play period (Cooke & Apolloni, 1976; Strain, Shores, & Kerr, 1978); (e) token contingencies for positive social interaction that are later systemically faded (Fox, Shores, Lindeman, & Strain, 1986; Odom et al., 1985); and, (f) teacher evaluation and self-evaluation of children's appropriate social behaviors (Fowler & Baer, 1981). The last two procedures were included to promote generalization of effects through recruiting a natural community of reinforcement and the use of self-mediated stimuli (Stokes & Osnes, 1986).

Specifically of interest was the question of the generalization of the CSSP across settings and over time. The CSSP was introduced during a daily play time for each of four preschool classes. Changes in the social behaviors of 14 children with disabilities were monitored during "training" sessions and during daily "generalization" sessions. Follow-up observations to determine maintenance of treatment effects were conducted at 1-, 3-, and 6-month intervals after termination of the CSSP

METHOD

participants and Settings

Fourteen children with disabilities (12 boys and 2 girls) attending one of four integrated preschool classes in the Niagara Region, Ontario, Canada, participated in the study. They ranged in age from 3 years and 4 months to 5 years and 4 months (mean=4 years and 4 months) and varied in their classified handicaps (9 were moderately developmentally disabled; 2 had behavior disorders; 1 had a moderate hearing impairment, and 1 was visually impaired with mild cerebral palsy). The four preschool classes were each staffed by an early childhood educator who had completed a 2-year certificate program at a community college. For purposes of this study, one group of 4 children with disabilities in a class with 11 peers without disabilities, ranging in age from 3 years to 3 years and 5 months was designated as Group 1. Group 2 contained 2 children with disabilities in a class of 18 normally developing children who ranged in age from 3 years and 5 months to 4 years. Group 3 consisted of 4 children with disabilities in a class of 17 normally developing peers, ranging in age from 3 years to 3 years and 6 months. Group 4 contained 4 children with disabilities who were in a class with 14 normally developing children, ranging in age from 4 years and 1 months to 5 years and 7 months.

Therapists

CSSP was implemented by one of three trained female therapists working in conjunction with the regular teacher in the class. Two of the therapists were indigenous resource teachers who were employed at the first preschool to help "special needs" children by a combination of direct remediation of these children and consultation with regular teachers. The third therapist was a paid research assistant who implemented the social skills training for Groups 2 and 3. All therapists had work experience in a preschool setting, a university degree or a community college certificate, and specialized training in working with children with disabilities. The three therapists completed a total of 10, 3-hour (hr) training sessions conducted by the first author. The training consisted of verbal instruction, a written manual describing the rationale and procedures for the social interaction program, modeling of the procedures, role playing, and practice with feedback. A copy of the training manual for the CSSP is available from the first author.

Sessions

Two types of sessions were held daily in each class. During 20 minute (min) "training" sessions, children were free to choose from a number of alternative play activities available within "centers" located around the room. The centers included "dress-up center" (clothes for pretend play); "creative center" (materials for cutting, pasting, drawing, painting, etc.); "water play center" (a large basin of water with water toys); and, "kitchen center" (toy appliance and utensils). Children were free to move from one activity to the next, with the only restriction being that the water play and the dress-up centers could have no more than four children at any one time.

Daily "generalization" sessions were also 20 min in length and consisted of play activities held in the playground. Here, the class moved outside and could choose freely among a number of play activities, including tricycles, sleighs, sandbox, slide, swings, and plastic tunnels. Again, children moved from one activity to the next as they pleased.

Observation Procedures and Behavior

Categories

The positive play of children with disabilities and teacher reinforcement directed toward these children were measured during the daily training and generalization sessions. Using a partial interval recording procedure, one of two trained codes observed each child in turn, for a 10-second (s) interval, and scored the observed behaviors in a subsequent 5-s interval. Partial interval recording has been shown to be a more sensitive method than momentary time sampling for detecting relative changes in behavioral levels at low to medium rates, but a less accurate estimate of absolute levels or absolute duration of behaviors (Harrop & Daniels, 1986). Partial interval recording was used in the present study t detect the relative changes in levels of social behaviors.

A portable lap microprocessor was programmed to emit a sound to cue the end of the 10-s observation interval. Coders recorded the scored behaviors on the microprocessor, which then stored and converted the results to percent scores at the end of the session.

Coders scored a child as exhibiting positive play when he or she elicited any verbal or non-verbal behavior toward another child that involved cooperative play or that reflected positive regard (e.g., sharing a toy, hugs, holding hands). Teacher reinforcement was recorded when the teacher indicated her pleasure with a child either physically (e.g., a gentle touch) or verbally (e.g., "I like the way you are playing") within 10 s of that child's exhibiting positive play.

Coder Training

The two coders were paid research assistants who had completed or were about to complete an undergraduate degree in psychology. They received a total of 10 hrs training by the second author in the observation procedures and the definitions of the behavior categories. The training consisted of written behavior definitions, practice and feedback using recorded videotape segments of children's social interaction in a preschool setting, and two practice observation sessions with a preschool chass not involved in this research. Training continued with each coder until a mastery criterion of 90% agreement was reached with the trainer on two consecutive observation sessions.

Coder Reliability and Drift

Intercoder reliability was calculated on 10 occasions for each coder when the second author simultaneously but independently observed and scored the behaviors of the children with disabilities and teachers' behaviors toward these children using a clipboard and data sheet. Observation intervals for the second coder were cued by the microprocessor of the first rater. Intercoder agreement was scored if the two coders scored the same behavior category during the same observation interval. A reliability coefficient was calculated using the following formula: number of agreements, divided by the number of agreements and disagreements, multiplied by 100. To control for observer drift (O'Leary & Kent, 1973), the two coders exchanged preschool settings about halfway through the study.

Sociometric Procedure

A modified version of the sociometric procedure described by Asher, Singleton, Tinsley, and Hymel (1979) was used to measure changes in the social acceptance of children with disabilities by their classmates. At the end of each experimental phase and at the 3-month follow-up period, all children in the four preschool classes completed a sociometric rating. In a separate room within the preschool, a research assistant presented individual children with photographs, one at a time, of each of the other children in the class. The use of photographs has been found to improve the reliability of sociometric rating by young children (Asher et al., 1979).

Children rated the degree to which the child in the photograph was judged to be a frined by pointing to a drawing of a smiling face (+1) or to a drawing of a frowning face (-1). A composite score was calculated for each child in the class and converted to a percentile score to reflect the child's relative sociometric ranking in the class, where a low score indicated that a child was of low popularity.

Experimental Design

A multiple-baseline design across groups of children with disabilities was used to measure changes in their social interactions during each of three experimental phases. The experimental conditions were introduced during the daily 20-min training sessions, and changes in the social interactions of children with disabilities in that setting and during the generalization sessions j were observed.

Baseline. During this experimental phase, the behaviors of both children with disabilities and their teachers were measured under natural conditions, with no changes in the classroom routines or procedures. This phase continued until stability in the slope of positive play was reached for each of the four groups as measured by Tryon's C-statistic (Tryon, 1982).

Program. Ten mins of instruction in specific social skills was provided to entire classes for the first five sessions of this phase. The skills taught were similar to those presented by Odom and Strain (1984): (a) giving play invitations; (b) sharing: (c) persisting at play; (d) complimenting; and (e) helping. Using a multimethod training approach, the therapist and the regular teacher introduced the skill by using puppet modeling, followed by participation of the class in isolating specific behaviors that composed the skill being taught (e.g., for play invitation, the composite behaviors were "go over to the person"; "look at him or her"; "ask to play"). Puppet modeling was followed by child-adult and child-child practice with class feedback on the specific behaviors of the social skill being taught. Following the instructions in social skills, the class was directed to begin a 20-min free-play period.

After the initial five sessions of this phase, no further social skills were introduced. In place of social skills training, the regular teacher reminded the class of the presented skills through a question-and-answer format.

During the daily 20-min free-play session, children were allowed to play with the available equipment and toys in the room. The teacher and the therapist circulated among the children, praising positive social interaction among all children and prompting children to interact, if necessary.

Concrete reinforcement for social interaction with a child with disabilities was provided on a variable time-interval schedule of 4 min. Using an audiotape and tape player, a bell sound was emitted five times during the session to cue the teacher and therapist. At the sound of the bell, the teacher and therapist provided "happy face" stamps to children with an without disabilities who were playing together. Happy faces were stamped onto a white label stuck to the front of the child's shirt.

For 5 min at the end of each training session, the class was seated and individual children were asked by the terapist or teacher to report on the behaviors that resulted in earning a happy face stamp. The adults also provided feedback to individual children on observed positive interactions. This experimental phase continued from 17 to 22 sessions.

Fading. The final experimental phase consisted of the gradual removal of the stamp contingency to result in a social environment more similar to natural conditions in the preschools for supporting children's social interaction. Without warning, the frequency of the bell sounds that cued reinforcement gradually and unpredictably was reduced to zero over 10 sessions. The class discussion before and after the play session remained unchanged, and teachers were encouraged to maintain their prompting and praising of prosocial behaviors.

Follow-up. Maintenance of training effects was evaluated 1 month, 3 months, and 6 months after the completion of fading. On these occasions, behavior observations of children with disabilities were recorded for the time period that corresponded to three consecutive training and generalization sessions.

Comparison Children

During fading and at each of the follow-up points, the positive play of five randomly selected, normally developing children in the class and teachers' behavior toward these children were observed in the manner previously described. The purpose of this measurement was to obtain information about the level of social interaction of children without disabilities to use as comparison with results for children with disabilities. Van Houten (1979) suggested that norms of competent individuals can be used as social validity standards against which treatment effects can be compared.

RESULTS

To simplify the results, means for each group of children with disabilities were calculated each session for both positive play and teacher reinforcement. Session-by-session fluctuation in group means tended to be representative of each member of the group. Individual results for each of the 14 children with disabilities can be obtained j from the first author.

Intercoder reliability was greater than the 80% agreement rate suggested By Hawkins, Axelrod, and Hall (1976) as acceptable (mean agreement for positive = 94.4%, range = 81%-100%; mean agreement for teacher reinforcement = 88.5%, range = 86%-92%).

Positive Play

The introduction of a social interaction program coincided with an immediate increase in levels of positive play during the training sessions for three of the four groups of children with disabilities (Groups 2, 3, and 4) (see Figure 1). The mean percent of positive play increased threefold from baseline to program phases (from 9.6% to 30.3% for Group 2; from 12.8% to 45.4% for Group 3; and from 9.3% to 42.5% for Group 4). Althouh the mean level of positive play for Group 1 increased from baseline to program phases (32.8% to 43.7%), the increase after the social interaction program was introduced was gradual rather than immediate.

There was no clear increase in the positive play of children with disabilities from baseline to program phases during the generalization sessions. Similarly, any increases in positive play for training sessions that occurred during the program phase, failed to be maintained through fading and follow-up periods. Levels of positive play during follow-up periods tended to return to those found during the baseline phase for all children with disabilities.

Teacher Reinforcement

Figure 2 shows the mean teacher reinforcement directed toward children with disabilities for each of the four groups during training and generalization sessions. Except for Group 1, there was a clear increase in teacher reinforcement during training sessions with the introduction of the social interaction program (from mean of 2.1% to 6.1% for Group 2; from 1.1% to 11.6% for Group 3; from 4.7% to 7.8% for Group 4). For Group 1, teacher reinforcement increased gradually during the program phase, similarly to the previously discussed increase in children's level of positive play.

As with positive play, the level of reinforcement declined during the program phase into the fading phase for all four groups. This decline continued into the follow-up periods, declining to near zero levels by the end of the study. The mean group teacher reinforcement during generalization sessions was at or near zero and continued at this low level of reinforcement for the rest of the study.

Positive Play/Teacher Reinforcement

Covariation

The session-by-session fluctuations in the positive play of children with disabilities corresponded to changes in teacher reinforcement. Higher levels of positive play tended to concide with higher levels of teacher reinforcement. A Pearson product-moment correlation coefficiet was calculated on the mean level of positive play of children with disabilities and teacher reinforcement for each of the four groups, each training session. Levels of children's positive play was significantly correlated with teachers' level of reinforcement (r = 0.55; n = 168; p <.001).

Comparison Children

During the fading phase, the mean positive play of all comprison children was 27.6%. During the same sessions, the positive play of children with disabilities (mean = 29.6%) was not significantly different than that of comparison children (t = 0.37; df = 32; p >.05). At the 3-month follow-up point, comparison children maintained a positive play of 33.4%, comparable to their level of positive play during the program phase. Yet, the mean positive play of children with disabilities declined and was significantly lower than that of the comparison children (mean = 16.0%; t = 2.97; df = 30; p <.01).

Sociometric Results

The mean percentile score of children with disabilities during baseline was 33.1 (SD = 29.4). There was a nonsignificant decline in these children's relative sociometric position in the class during the program phase (mean = 19.2; SD = 20.1), which increased slightly during the fading phase (mean =26.4; SD = 32.3) and at the 3-month follow-up period (mean = 28.2; SD = 24.7).

DISCUSSION

The purpose of this research was to examine the generalization of the CSSP across settings and over time for a group of 14 children with disabilities, attending four integrated preschool classes. The results indicated that during training, the children with disabilities increased their rate of positive social interaction to levels comparable to normally developing children in their class. This result is consistent with previous studies, which have reported increased social interaction with children with disabilities when either a teacher-mediated (Sancilio, 1987) or peer-mediated (Strain & Odom, 1986) strategy is used.

The CSSP used in this study differed in significant ways from previous efforts to increase the social interaction of children with disabilities in integrated preschool settings. These previous efforts have mainly consisted of teaching social interaction to these children in a specially formed group (Strain, Kerr, & Ragland, 1981) or have focused on increasing the social behavior of children with disabilities in the natural setting through the use of peers selected and trained to interact with these children (Odom & Strain, 1984). The CSSP was an attempt to alter the natural environment to elicit and support positive social interaction among all children, rather than placing the children with disabilities in a new social environment, or promoting interaction solely with selected children.

Although the rate of positive play of children with disabilities increased when the social interaction program was in effect, this increased rate was neither maintained nor transferred to a second play setting during the day. In the present study, the level and type of reinforcement was gradually faded t a level similar to that available in the natural setting, a generalization strategy suggested by Stokes and Osnes (1986). A response-dependent fading procedure was used by Fox et al. (1986) which resulted in maintenance of social interaction for two normally developing preschoolers but as found in the present study, nt for a developmentally handicapped preschooler.

Temporarily increasing children's rate of social interaction may not be sufficient to produce enduring changes in their social behaviors across unprogrammed settings, at least for children with handicaps. The type of social behaviors a child with handicaps displays, more so than its frequency of occurrence, may be important in eliciting a positive peer response (Beckman, 1983; Tremblay, Strain, Hendrickson, & Shores, 1981). Certainly, an increased rate of social interaction did not improve the peer rating of the children with handicaps in this study, nor in a previous study (Gottman, 1977).

A number of authors have suggested that generalized social behaviors depend upon the development of natural patterns of reciprocal social exchanges among children (Fox et al., 1986; Kohler & Fowler, 1985; Odom et al., 1985; Strain & Shores, 1977). A social initiation must be followed by a positive response from a peer for future social initiations to occur under natural conditions. Unfortunately, the poorly developed social behaviors of children with disabilities often extinguishes the social initiations of normally developing peers (Strain & Shores). Moreover, when given a choice, children without disabilities prefer to play with other children without disabilities rather than children with disabilities (Guralnick, 1986). Strain, Kerr, and Ragland (1981) found that even if socially competent children participated in the training of socially withdrawn peers, they avoided these peers when more socially responsive children were available to play. Normally developing children may gravitate away from social exchanges with children with disabilities, thus leaving these children to interact with other equally unresponsive children.

Perhaps it is not reasonable to expect natural child/social exchanges to develop between children with and without disabilities. Guralnick (1986) described the pattern of interaction between childrenw tih and without disabilities as more adultlike than "co-equal." If so, contextual factors may need to play a significant role in setting the stage for continued social interaction in integrated settings. Both Odom et al. (1985) and Sancilio (1987) have pointed out the importance of ongoing teacher intervention to support the lasting develoment of social interactions of children with disabilities and their normally developing peers. In the present study, no teacher intervention was evident at the 3- or 6-month follow-up periods.

Procedures to encourage the persistence of teacher performance to facilittate social interaction may need to be specifically trained as part of a multifocused intervention to promote social interaction in integrated settings. This multifocused intervention may include participation of peer groups (Jenkins et al., 1985), teacher training in specific intervention strategies (Peck, Killen, & Baumgart, 1989), supervisor feedback (Reid et al., 1985), and a social skills curriculum (Odom & McEnvoy, 1988).

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ABOUT THE AUTHORS

JOEL HUNDERT is the Director of the Behavior Therapy Consultation Service at the Chedoke-McMaster Hospitals, and Associate Professor in the Psychiatry Department at McMaster University, Hamilton, Ontario. ANNE HOUGHTON is Research Coordinator at Early Childhood Integration Support Services, Hamilton, Ontario.
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Title Annotation:Classwide Social Skills Program
Author:Hundert, Joel; Houghton, Anne
Publication:Exceptional Children
Date:Feb 1, 1992
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