Social Skills Training E-Book

Jed Baker

• Herausgeber: Future Horizons
• Kategorie: Für Kinder und Jugendliche
• Sprache: Englisch

Seitenzahl: 462

Veröffentlichungsjahr: 2023

Beschreibung

Social Skills Training is the complete package: whether learning how long to look at somebody; how to shift topics, despite a desire to stick with that all-consuming special interest; how to say no to peer pressure; or dealing with sensitive topics—it's all here. In this comprehensive and user-friendly book, the author translates years of experience working with students with autism and social communication differences.

This is not just another social skills curriculum, but instead, a manual that lays out the key components of effective social skills training. Detailed chapters contain critical elements of skills training, including how to collaborate with and motivate clients, target relevant skills, match teaching strategy to language ability, generalize skills, create accepting peer programs, and measure progress.

This 20th anniversary edition includes more than twenty-five new skill lessons and new research.

Leseprobe

Advance Praise for Social Skills Training 20th Anniversary Edition

“Jed Baker’s Social Skills Training has always been one of my go-to autism books. And his 20th anniversary edition continues that tradition. This book exceeds my expectations—which are always high! Why? Jed, sums it up in one sentence, ‘The model I have used to teach skills has moved from an approach that teaches skills to an approach that teaches children.’ His years of teaching and research have coalesced into a wonderful volume of instruction that will benefit any child or adolescent. Jed doesn’t just talk about social skills; he uses them in his daily life. He is a lovely person and an excellent role model. This is evidenced on every page of his book.”

— Brenda Smith Myles, PhD, autism researcher, consultant, and author of many books including The Hidden Curriculum and Autism and Difficult Moments

“The 20th anniversary edition of Jed Baker’s Social Skills Training book provides updated and timely information on a range of topics related to social skills. However, he does not stop there. Jed goes on to provide practical and well thought out lessons on topics ranging from Asking Someone to Play to Dealing with Teasing. Jed is a rare breed the combines both a thorough understanding of the research and practical clinical experience. I cannot recommend this publication highly enough.”

— Dr. Cathy Pratt, BCBA-D, Indiana Resource Center for Autism

Praise for the First Edition of Social Skills Training

“If you’ve been searching for a social skills curriculum that really works, you’ve found it! Jed Baker’s long-awaited, much antic¬ipated “how-to” manual is based on his enormously successful social skills training groups. The book covers everything from assessment and strategies for social skills training, to generalization of those skills, to behavior management, to the often-over¬looked importance of promoting peer acceptance through sensitivity training. The core of this book, however, is the inclusion of individual skill lessons and activities that address practically every social situation you can possibly think of. This book is a MUST-READ and should be part of every parent and professional’s autism resource library!”

— Lori Shery, president and cofounder, Asperger Syndrome Education Network (ASPEN®)

“This very user-friendly book provides a wealth of ready-to-use activities for both parents and educators. The centerpiece of the book is a series of 70 specific skills found to cause problems for individuals with autism and other social-communication disorders. Each skill is presented in a handy format, with the skill to be learned on one page and related activities on the facing page. The chapter on sensitivity and awareness training makes this a complete social skills training package.”

— Diane Adreon, associate director, Center for Autism and Related Disabilities, University of Miami

“Dr. Baker’s clinical expertise and personal concern for individuals with autism is evident throughout this wonderful book. The chapters contain many easy-to-use strategies to make and keep friends, specific examples for various age groups, and clear direction for assessment and intervention. This book is an essential resource for professionals who want to increase all students’ social and coping skills within individual and group sessions and in everyday life.”

— Suzanne Buchanan, Psy.D., BCBA, and Jenna Miller, M.A.T., The New Jersey Center for Outreach and Services for the Autism Community (COSAC)

SOCIAL SKILLS TRAINING:for Children & Adolescents with Autism &Social-Communication Differences

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© 2023 Jed Baker

All rights reserved. The owner of this book is granted permission to copy pages 126-361. With this exception, no part of the material protected by this copyright notice may be reproduced or used in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without the prior written permission of the copyright owner.

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ISBN: 9781957984223

CONTENTS

Chapter 1: What’s New in This Edition? 1

Chapter 2: What Are Social Skills, and What Are Common Social Skill Challenges of Individuals with ASD? 5

Chapter 3:Does Social Skills Training Work? 9

Chapter 4:Key Components of Effective Social Skill Training for Individuals withSkill Challenges 13

Chapter 5: Establishing Motivation to Learn 19

Chapter 6:Assessment of Relevant Skill Goals 27

Chapter 7 :Measuring Social Skill Changes 45

Chapter 8:Common Modifications to the Environment to Improve Social Functioning 51

Chapter 9:How and Where to Teach Social Skills 61

Chapter 10: Facilitating Group Sessions 73

Chapter 11:Generalization Strategies: Prime, Coach, and Review 89

Chapter 12:Peer Sensitivity Training 101

Chapter 13:Putting It All Together 121

Chapter 14:Skill Lessons 125

RECOGNIZING BASIC FEELINGS 126CATEGORIZING THE SIZE OF EMOTIONS 128UNDERSTANDING THE CONNECTION BETWEEN EVENTS, THOUGHTS, AND EMOTIONS

(JOURNAL PAGE) 132

UNDERSTANDING OUR ALARM SYSTEM 135KEEPING CALM 137PROBLEM-SOLVING 140TALKING VERSUS ACTING OUT YOUR FEELINGS 143UNDERSTANDING YOUR ANGER 145USING A GROWTH MINDSET TO MANAGE FRUSTRATION 154TRYING WHEN WORK IS HARD (APPLYING GROWTH MINDSET) 155DEALING WITH MAKING A MISTAKE 158ACCEPTING NO OR WAITING FOR WHAT YOU WANT 160STOPPING A FAVORED ACTIVITY 162DEALING WITH ANXIETY AND FEAR: UNDERSTANDING THE ALARM REACTION 164MANAGE FEARS BY CREATING A FEAR LADDER 166MANAGE FEARS BY THINKING LIKE A SCIENTIST 170MANAGE FEARS THROUGH PHYSICAL WAYS 172DEALING WITH UNPLEASANT, OBSESSIVE THOUGHTS AND COMPULSIVE BEHAVIORS 176DEALING WITH SOCIAL FEARS 181DEALING WITH BRIEF PERIODS OF DEPRESSION 184SHOWING AND READING WELCOME VERSUS UNWELCOME SOCIAL CUES 187LISTENING POSITION 189SHOWING INTEREST VERSUS BOREDOM 191DON’T BE A SPACE INVADER 193SARCASM VERSUS GENUINE EXPRESSIONS 195PERSONAL HYGIENE 197DEALING WITH ODD MOTOR MANNERISMS 199TONE OF VOICE 201GREETINGS 204HOW AND WHEN TO INTERRUPT 206TAKING TURNS TALKING (TWO-QUESTION RULE) 209MAINTAINING A CONVERSATION 211STARTING CONVERSATIONS WITH PEOPLE YOU KNOW 214JOINING A CONVERSATION 218INTRODUCING TOPICS OF INTEREST TO OTHERS 220DON’T TALK TOO LONG 222INTRODUCING YOURSELF AND OTHERS 225GETTING TO KNOW SOMEONE NEW 227POSTER: SUMMARY OF STARTING AND MAINTAINING CONVERSATIONS 229CONVERSATION REPAIR: SAYING I DON’T KNOW, I DON’T UNDERSTAND, AND GIVING BACKGROUND INFORMATION 230SHIFTING TOPICS 233ENDING A CONVERSATION 235ANSWERING THE TELEPHONE 237CALLING A FRIEND ON THE TELEPHONE 238Use Your H.E.A.D. When You Are Involved in a Conversation 240T.G.I.F.

(Means more than “Thank Goodness It’s Friday.” It’s about Having a Conversation) 243

ASKING SOMEONE TO PLAY 245JOINING OTHERS IN PLAY 247COMPROMISE 249PLAYING AND WORKING COOPERATIVELY IN GROUPS 251SHARING 255TAKING TURNS 257DECIDING WHO GOES FIRST 258PLAYING A GAME 260DEALING WITH LOSING 262DEALING WITH WINNING 265ENDING A PLAY ACTIVITY 267WHERE TO FIND FRIENDS 269MAKING A GOOD FIRST IMPRESSION WITH A POTENTIAL FRIEND 272GUIDELINES FOR CONTACTING OTHERS AND ARRANGING GET-TOGETHERS 274SHARING FRIENDS 278AVOIDING SENSITIVE TOPICS AND INSULTS 281RESPECTING OTHERS’ OPINIONS AND SUGGESTIONS

(When Others Do Things Differently) 284

DON’T BE THE “RULE POLICE” 287MODESTY 290EMPATHIC LISTENING 292SHOWING CARING FOR OTHERS’ FEELINGS (Preschool–Elementary) 296SHOWING CARING FOR OTHERS’ FEELINGS (Middle School and Up) 297DEEPENING RELATIONSHIPS; SHARING PERSONAL INFORMATION 300GETTING ATTENTION IN POSITIVE WAYS 304RESPECTING PERSONAL BOUNDARIES 307OFFERING HELP 309DO’S AND DON’TS ON SOCIAL MEDIA 311WHEN TO TELL ON SOMEONE 313ASSERTIVENESS 315CONFLICT RESOLUTION 317DEALING WITH TEASING 319GIVING CONSTRUCTIVE CRITICISM 324ACCEPTING CONSTRUCTIVE CRITICISM 326DEALING WITH PEER PRESSURE AND AVOIDING SETUPS 328DEALING WITH RUMORS 331DEALING WITH BEING LEFT OUT 333ASKING RESPECTFULLY FOR WHAT YOU WANT 335WHERE TO FIND POTENTIAL DATES 337ASKING SOMEONE OUT ON A DATE 341DO’S AND DON’TS ON A DATE 344READING THE SIGNALS TO PURSUE A ROMANCE 346SEXUAL HARASSMENT 349RESISTING PRESSURE TO DATE OR TO BE INTIMATE 351COMMUNICATING CLEARLY TO MEET EACH OTHER’S NEEDS 353HANDLING REJECTION 356WHEN (AND WHEN NOT) TO CALL EMERGENCY SERVICES 358

References 363

Skill Lessons

Chapter 1

What’s new in this edition?

In 2003 I wrote my first social skills training manual based on the groups that I had been running for children with ASD. Back then, I was invested in teaching a curriculum of skills to children based on the evidence at the time for best practices in teaching skills: explanation, modeling, role-play, and practice with feedback and incentives. Now, close to twenty years later with the benefit of more outcome research, we have learned what areas need to be addressed more fully to achieve better outcomes, namely motivation and generalization.

Without sufficient attention to these issues, skill training efforts do not lead to meaningful outcomes that are sustained outside the training setting. This should come as no surprise; when kids are less motivated and little attention is paid to help them use skills in real settings, skills training effects are diminished (see Bellini et al., 2007).

The model I have used to teach skills has moved from an approach that teaches skills to an approach that teaches children. We don’t simply ask how best to teach a set of skills; rather, how do we individualize an approach to maximize a child’s motivation and create more lasting impact? To address motivation, it is crucial that children are optimistic enough about themselves that they are willing to work on any challenges. Too often children hear negative information about themselves that simply fosters a sense of hopelessness, resulting in apathy. Then adults may step in to impose behavior plans and skills training that the children do not necessarily accept. It is critical that children are willing participants in establishing goals and ways to solve their own challenges. The chapter on motivation addresses several important ways to create optimism and a willingness to work on skill improvement through self-awareness, collaborative problem-solving, and utilizing the child’s own interests.

To address generalization and thus create more lasting changes, it is best to teach and practice a small set of highly relevant skills rather than a large set of skills taught less frequently. This change is reflected in my chapter on generalization of skills, which covers how to help children actually use skills when and where they need them through the systematic use of cues and reminders.

In order to hone in on a small set of relevant skill goals for a child, I have refined my understanding of the assessment process. As is often the case in clinical practice, we continue to modify our approach to get better outcomes. Chapter 6 outlines the assessment process used to target individualized and clinically relevant skill goals in a way that respects the client’s wishes and engages them fully in the process.

Though much of the content of this book contains specific skill lessons that could be used as a basic curriculum for classrooms, these lessons are really just one part of entire model of skills training in which lessons are selected to meet the individualized needs of students. This model addresses the crucial issues I have described above, including motivation, targeting relevant skills, and generalization. No matter how one teaches skills (e.g., the structured learning method used in this book, video modeling, live modeling, picture books, cartoons, social stories, play based approaches, ABA approaches), certain key components lead to effective and more lasting learning. That understanding led to my model of THE KEY COMPONENTS OF SOCIAL SKILLS TRAINING, which serves as a decision guide to help professionals and parents ensure they are addressing all that is necessary to get better outcomes in social skills training. That model, summarized below, is detailed in Chapter 4.

Key Components of Social Skills Training

Establish motivation to participate in learning and using skillsTarget relevant skills that match the needs of the childrenConsider how to measures skill performance to assess progressConsider modifications to the environment to improve outcomesConsider the child’s cognitive abilities and language comprehension in choosing HOW and WHERE to teach the skillsPlan for generalization or transfer of learning by using homework assignments and reminders from key caregivers (like parents and teachers)Consider targeting the peer community to improve socialization and acceptance

To use this book most effectively, one should familiarize themselves with the model outlined in Chapter 4 and then use the SOCIAL SKILL ACTION PLAN (see Chapter 13) to create a specific plan for their child, student or client. One can certainly use the lessons to teach a group or class of students who need some of the same lessons, yet to maximize results for a particular individual, it is crucial to complete the SOCIAL SKILL ACTION PLAN. Once the SOCIAL SKILL ACTION PLAN is created, one can use the skill lessons in Chapter 14 as a reference for teaching specific skills.

Who Should Use This Book?

The lessons in this book are designed primarily, but not entirely for children with ASD, Level 2 and Level 1, which refer to children with enough language comprehension to understand and learn skills introduced through verbal explanation, modeling and role-play. That does not mean they won’t also benefit from adding visual supports like pictures and video modeling, but many of the skills involve verbal explanation. Individuals without ASD who also have social challenges will also greatly benefit from the model and lessons in this book. That includes children with ADHD, anxiety and mood disorders, non-verbal learning disabilities, and other social-emotional challenges. Thus any professionals, teachers or parents that have children with these social challenges and basic receptive language skill can use this book. I have included skill lessons relevant for young children starting in preschool through their teenage years to young adulthood. Where needed, I have indicated the age range for a particular skill.

The skill lessons have been updated since 2003 to reflect our latest thinking about what skill areas are most relevant and how best to teach skill concepts. In addition, some skills lessons reflect changes in our society since 2003, such as the extensive use of social media to communicate with others.

Individuals with ASD (and many without ASD) often present with communication issues (e.g., nonverbal communication challenges, trouble initiating, responding and managing topics), perspective-taking and empathy difficulties, restricted patterns of play, difficulties maintaining friendships and romantic relationships, and emotional regulation issues. That last issue is the subject of two of my other books called No More Meltdowns (2008) and Overcoming Anxiety in Children and Teens (2015). Some of the content of those books is reflected in my skill lessons covering emotion management issues, including dealing with frustration, demanding work, handling imperfection (like mistakes or losing a game), not getting desired attention from others, managing upsets over having to wait for desired objects or activities, and handling fears like social anxiety that can become an obstacle to interacting with others. One skill area I have left out is related to employment, as this is well represented in another one of my books, Preparing for Life (2006).

Chapter 2

What are social skills, and what are common social skill challenges of individuals with ASD?

When I sat down with colleagues over twenty years ago to create a social skill curriculum for students in their school program, we confronted our first obstacle: defining social skills? Another way to ask this question is, “What are ‘not’ social skills?” Is doing math work a social skill? It could be, if you do it well and peers think you’re smart. Or if you answer every math question in a class, others could think you were bragging. So even doing math work could have social implications, affecting whether peers like you or not.

As we discussed behavioral challenges, friendship problems, manners, and other expected behaviors across settings, we discovered that every behavior is potentially social. Our working definition then was, “Any behavior that has a social impact on others can be considered a social behavior and thus a potential social skill.”

Great, then all we had to do was write a curriculum to account for all of human behavior. Not feasible. Rather than giving up, we realized that we did not need a curriculum of all human behavior but a way to figure out, for each student, what specific behaviors were needed to function successfully in a particular social setting.

So instead of teaching a one-size-fits-all curriculum for our students, we developed a process to hone in on relevant skills for each student. That assessment process is outlined in Chapter 6. We still needed a set of ready-to-go skill lessons as a useful reference after we decided what to teach a child. Those particular skill lessons you see in this book were based on the needs of our clients over twenty-five years of working with students with ASD and other social challenges. They fall into categories that are often considered problematic for individuals with ASD, including emotional regulation, communication (verbal and non-verbal), restricted patterns of play, challenges with empathy and perspective taking, and friendship management.

If we look at the current symptoms of Autism Spectrum Disorder, we can see that many of these skill themes are associated with the core symptoms of Autism (see Figure 1).

The symptoms described in letter A (Figure 1) highlight the communication challenges as well as difficulties with understanding others’ perspectives. The culmination of these symptoms described in letter A leads to difficulties with forming friendships.

The symptoms described in letter B refer to both sensory issues and difficulties regulating emotions when things do not go as expected or change unpredictably. These symptoms describe how many individuals with ASD can have meltdowns when overwhelmed by sensory input (e.g., too many people, sounds, instructions) or when they confront new tasks (e.g., difficult schoolwork) or unexpected changes (e.g., delays or obstacles to doing favored activities). These symptoms point to the need to identify triggers to challenging moments so we can alter those stressors and teach children better ways to manage those stressors. In my book No More Meltdowns (2013) I review common triggers to meltdowns and ways to both modify those triggers and teach skills to handle those triggers better. That work is reviewed in Chapter 8 and in the skill lessons on emotional regulation.

Level of Severity and Its Significance to Teaching Social Skills

Across both Letters A and B, the diagnostic system prompts us to rate the severity of symptoms on a three-level system, with Level 3 being most severe, and Level 1 being milder. When it comes to communication skills, Level 3 refers to what we used to call Classic Autism referring to individuals with severe language difficulties. These may be children who do not yet a have symbolic forms of communication. They may be primarily non-verbal. Level 2 refers to what we used to call PDD-NOS (Pervasive Developmental Disorder–Not Otherwise Specified). These are often children who have some symbolic language, yet their language functioning is still very concrete and rudimentary that they may need visual pictures to back up their ability to understand and express themselves with language. For example, I might ask a child what they ate for breakfast, and they may only be able to respond when I show them pictures of the different breakfast items and then they can point to or verbalize what they ate. Here, they are using symbols to communicate but still need a concrete picture symbol of the language. This is different from individuals at Level 1, who can communicate with others without the use of pictures. They are operating completely with language symbols, verbalized sounds and/or the written word. As you might imagine, these are individuals with the ability to converse and often have average to above-average measured intellectual functioning (as many tests rely on verbal comprehension skills to measure intellectual skills). Level 1 individuals often fall into the ASD category formerly referred to as Asperger’s Syndrome.

FIGURE 1: Diagnostic Criteria for Autism Spectrum Disorder (DSM-5, APA)

To meet diagnostic criteria for ASD according to the DSM-5, a child must have persistent deficits in each of three areas of social communication and interaction (see A.1. through A.3. below) plus at least two of four types of restricted, repetitive behaviors (see B.1. through B.4. below). Finally, the level of severity is assessed (C through E).

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Specify current severity. Severity is based on social communication impairments and restricted, repetitive patterns of behavior.

Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Specify current severity: Level 1, 2, or 3.

Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life). Severity is based on social communication impairments and restricted, repetitive patterns of behavior.Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

(American Psychiatric Association, 2013)

Chapter 3

Does Social SkillsTraining Work?

Chapter 4

Key Components of Effective Social Skill Training For Individuals With Skill Challenges

Despite the promising outcome studies described in the preceding chapter, there is often a gap between the science of skills training in the lab and the practice of skills training in schools and community settings. In 2007, Bellini, Peters, Benner, and Hopf challenged the social skills world after concluding that most school-based social skills training efforts were minimally effective according to their review of fifty-five outcome studies. They pointed out the problems with many social skills interventions in schools, including failure to match targeted goals to the child’s needs, lack of generalization of skills into natural settings, short duration of treatment, and failure to motivate skill performance. Gates et al. (2017), in a more recent review of group social skills training programs, found social skills interventions are modestly effective for youth with ASD but may not generalize to school settings or self-reported social behavior.

One of the issues that can impact generalization of skills is the lack of specific strategies to help students practice skills in natural settings. Systematic cues and reminders to use and practice skills in real life is a critical component of effective skills training.

In addition, even if we teach children skills and manage somehow to get them to use them in natural settings, it does not ensure that peers in the environment will suddenly welcome those peers. Thus, to ensure better outcomes, we must also target the peer community.

Furthermore, when it comes to getting better outcomes with frustration-related problems, research on positive behavioral supports tells us we cannot simply teach replacement skills (i.e., better ways for kids to get what they want). We must also modify the triggers (antecedents in the language of behaviorists) in order to make gains (see www.pbis.org). For example, you cannot simply get a child to calmly ask for help or persuasively negotiate an assignment with a teacher if you always throw overly difficult work at the child. Similarly, you cannot easily teach a child to play with other kids in a loud, overwhelming environment if they have severe sensory issues. You may first need to modify the play environment.

When we take the lessons from well-designed skills training outcome studies and consider the challenges that exist in real community settings, we are left with several key issues that must be addressed for social skills training to be effective. I call these issues “The Key Components of Effective Social Skills Training,” outlined below:

The Key Components of Effective Social Skills Training:

Establish motivation to participate in learning and using skillsTarget relevant skills that match the needs of the childrenConsider how to measures skill performance to assess progressConsider modifications to the environment to improve outcomesConsider the child’s cognitive abilities and language comprehension in choosing HOW and WHERE to teach the skillsPlan for generalization or transfer of learning by using homework assignments, cues and reminders from key caregivers (like parents and teachers)Consider targeting the peer community to improve socialization and acceptance

Schools do not always address all seven of these components, and sometimes for good reason. There is some research that certain one-size-fits-all curriculums can have positive effects on a school, though they often fall short of addressing the more specific needs of individuals with ASD or other social challenges. This discrepancy can be explained by understanding the tiered approach that schools use to support students.

A Tiered Approach to Social Skill Intervention in Schools

School systems typically offer behavioral, social, and emotional support to students in a multi-tiered prevention model. The National Technical Assistance Center on Positive Behavioral Interventions and Supports (PBIS), which is part of the US Department of Education (www.pbis.org), outlines the following tiered approach:

Tier 1: Usually refers to “Universal Prevention,” or what all students receive in a school system. These often include defining and teaching all students about what kinds of behaviors are expected. For example, antibullying programs often begin this way by educating all students about how they are expected to treat others.

Tier 2: “Targeted Prevention” is meant for some students who may need more help improving specific skill deficits. Interventions may include learning and practicing both social and self-regulation skills as well as providing access to greater academic supports to prevent frustration and avoidance behaviors. Often interventions are provided to students in a group format to benefit many children.

Tier 3: “Intensive, Individualized Prevention” is targeted to students who need more individualized help. These services are often, but not always, part of the special education supports a student may receive. Many interventions focus on understanding the function and triggers of challenging behaviors and seek to teach alternative ways for students to handle these triggering situations.

A tiered approach helps us understand the sometimes confusing outcomes in social skills training research. One-size-fits-all curricula have not been terribly effective in teaching skills tospecial education students, according to some reviews of social skills outcome studies in schools (Bellini et al., 2007; Gresham et al., 2001). Yet at the same time, school-wide interventions have been shown to increase achievement scores, increase prosocial skills and decrease disruptive behaviors, and increase self-esteem (for example, see Payton et al., 2008). How do we square these findings: that some school-wide skill interventions can positively impact the student body, but many of these programs do not do a sufficient job of teaching skills to kids with specific social challenges?

The intensity and specificity of intervention depends on the needs of the students. For many children with typical social skills, school-wide (Tier 1) efforts to increase typically developing skills like empathy and problem-solving can be very helpful. However, for students with specific skill challenges due to ADHD, autism spectrum disorders, or other learning differences, a more targeted skills training intervention (Tier 3) may be needed. The table below summarizes an example of one-tiered approach to Social Skills Training that I developed over the course of a year consulting with a school district in New York:

Tier 1: School-Wide Efforts to Increase Positive Social Functioning

Common language and instruction for resolving conflicts Creating more options for play and structure during recessInterest-based clubs available to increase social opportunity Training of aides and other staff on how to facilitate social interaction and resolve conflict rather than relying only on disciplineStudent sensitivity training that encourages inclusion and discourages teasing/bullying If students are identified as having persistent difficulties interfering with academic/social functioning despite school-wide programs, staff may refer them to Tier 2 intervention (case conference)

Tier 2: Case Conference for Particular Students/Classrooms

Push in-class discussionsConsultation/observation at lunch/recess Theme-based groups and counseling to teach social skills and create more opportunities for socializationTeacher consultation with specialistsIf students do not respond successfully to Tier 2 interventions after six to eight weeks or the severity of the problem intensifies, consider Tier 3

Tier 3: Individualized Social Skill Action Plans

Plans must address the following 7 key components:

Establish motivation to participate in learning and using skillsTarget relevant skills that match the needs of the childrenConsider how to measures skill performance to assess progressConsider modifications to the environment to improve outcomeConsider the child’s cognitive abilities and language comprehension in choosing HOW and WHERE to teach the skillsPlan for generalization or transfer of learning by using homework assignments and reminders from key caregivers (like parents and teachers)Consider targeting the peer community to improve socialization and acceptance

The key components described in Tier 3 in the example above reflect the model utilized in this book for effective social skills training for individuals with social skill challenges. Often these may be students with IEPs or 504 plans (legal documents in US schools that demonstrate a student’s eligibility for educational modifications and supports). Often these children have been diagnosed with ASD, ADHD, mood-related disorders, or specific learning disabilities that also impact their social functioning. The next chapters review each of these Tier 3 components in greater detail.

Chapter 5

Establishing Motivationto Learn

External versus Intrinsic Motivation

In the world of autism, the traditional way to address motivation is to use rewards after a particular behavior to increase the likelihood that the behavior will occur again (referred to as operant conditioning). In this case the reward is “external” to the behavior. For example, if we wanted to teach a youngster to say hello when they see their friend, we might cue them, say “hello,” and then reward them with their favorite food or access to a favored toy after they say hello. Such an approach was embraced early in the autism field for several reasons. There was a rich history in behavioral research with animals whose behaviors we could increase with external reinforcement. Lovaas applied this approach to children with severe autism in one of the first studies to show that kids with autism could in fact learn through systematic reinforcement. As this external reward system was applied to students with greater language functioning, symbolic reinforcement became the favored methodology, where points or tokens were used to reward students in the moment and then later those tokens could be used to purchase more tangible rewards like food, favored objects, or activities.

Some researchers began to notice a phenomenon in which external reinforcement could in fact undermine someone’s desire to engage in an activity when the external reinforcement was not provided (Deci et al., 1999). For example, if I get $10 each time I do a math problem, then I no longer get $10 to do math, I may become uninterested in doing math. However, if you make the math fun to do, I might do it even without getting paid. This last notion represents what we call intrinsic motivation, in which the behavior (in this case, doing math) is rewarding in and of itself; that is, the reward is intrinsic to the activity itself.

When there are no intrinsically rewarding reasons to engage in a behavior, one may need to use external rewards to get things started. Yet to help an individual want to behave in a particular positive way when external rewards are no longer provided, it is crucial to transition to an intrinsically rewarding system in which the activity itself becomes naturally rewarding. How can we apply this to the students who walk through our doors because their parents or others have said they need social skill help but the children themselves are not motivated to work on these skills? How can we make working on social skill intrinsically motivating?

Building Positive Self-Awareness

There are plenty of reasons why a child may be against any social skill interventions if they have been told repeatedly that something is not right and they need help. To maintain self-esteem, students may need to deflect any criticisms and instead blame the surrounding social community for being overly harsh, mean, and incompetent. Most students who arrive at my clinic have been worn down by such criticisms (even if constructive) from others, and the last thing they want to hear is more about what’s “wrong” with them.

Given the history of criticism many of these students have heard, my starting point when I first meet them is to introduce the idea that all of us have strengths that take us places in the world as well as some challenges that can occasionally interfere with those strengths. Together we then generate a long list of their talents and strengths, and a much shorter list of challenges. In order to accomplish this, I like to be prepared with background information in case the student struggles to come up with strengths. I talk initially with the parents and teachers to get a list of their concerns and a lengthier list of the student’s strengths. Typically the student’s interests or hobbies represent areas of expertise that can be seen as strengths, along with positive personality characteristics. Keep in mind that challenges associated with certain diagnoses often have an upside. For example, the obsessive interests of those on the spectrum can be areas of expertise that lead to careers. For those with ADHD and bipolar disorder, distractibility and impulsivity are often associated with high energy and an extremely entertaining, interactive style. I typically will list these strengths and challenges on a large white board and give a paper or cell phone photocopy to the student afterwards. Below is a sample list of strengths and challenges for a student who had Autism Level 1 (formerly termed Asperger’s Syndrome):

In addition to listing the strengths, I often review parts of past testing reports to show the student where their strengths are. Too often students are evaluated and no one reviews with them their particular strengths and challenges. I will cherry-pick the strengths from these reports and summarize some of the challenges so that there are always more strengths than challenges. We then discuss how their strengths can take them places in life, leading to success in both school and work. Finally, I explain to them that no one needs to overcome their challenges; they just need to get to a point where the challenges are small enough not to get in the way of their strengths. We then brainstorm together ways to lessen these challenges, culminating in a list of proposed strategies or supports like those listed in the previous figure.

Use of Diagnostic Labels?

I am not wedded to using diagnostic labels to characterize an individual’s pattern of strengths and challenges; however, as children age, there is often practical utility in children knowing labels that can help them obtain desired accommodations. In schools and eventually the workplace, one might need to invoke an official diagnosis to justify getting certain modifications and accommodations. In keeping with a positive self-esteem-enhancing approach, it is critical to convey the growing cultural understanding of autism as a neurological difference rather than as a disability. Some of the characteristics of autism have clear advantages for tasks (especially visual ones) that require attention to detail or collections of factual information. The perseverative interests of those on the spectrum often lead to greater knowledge of a subject area than neurotypicals may possess. There are a variety of biographies of talented autistic individuals that can help inspire and support a strength-based view of autism (see for example, “History’s 30 Most Inspiring People on the Autism Spectrum,” 2017).

Collaborative and Proactive Solutions (Ross Greene, 2021)

The second key strategy to increase a student’s motivation to address challenges: ensure that they are active participants in understanding problems and coming up with potential solutions. All too often, adults create behavior plans without consulting the students, only to find that their efforts to help are rejected. The key to Collaborative and Proactive Solutions (CPS) is to understand and respect the child’s view of the challenge and to invite them to solve the problem.

Although Ross Greene was certainly not the first to describe a collaborative process between client and therapist, he has nicely articulated his CPS model in concrete, replicable steps so that others can use it and researchers can evaluate its effectiveness. The interested reader is referred to his website www.livesinthebalance.org for greater detail, current and past research, and additional readings. I will offer a brief overview here of how I adopt his language to collaborate on solutions and skill goals with our clients. Following the outline is an example of a student with whom this collaborative approach was used to pinpoint solutions and skill goals.

CPS General Philosophy

Understand the problem from the student’s point of viewRespect the student’s preferred way to solve life’s issues with our guidanceDon’t impose behavior plans on students, create these plans with students

Getting the Child’s Perspective on the Issue

The first step to solving unresolved problems is to explore the student’s perspective:“I noticed that ... What’s up?Explore the student’s reasons for the problem Reflective listening: “So let me see if I understand the issues ...”“Is there more?” Validate and Empathize, “It makes sense that you feel that way ... ”

Collaborating on Solutions

Solutions are sought by inviting students to solve the identified problemsChoose an issue that the student identified and ask, “I wonder if there is a way ...” Solutions must work for both parties and be realisticConsider the probability that it will work

Michael was an eleven-year-old bright, verbal boy with a history of ASD, Level 1 (formerly Asperger’s Syndrome). His teachers had reported to his parents that he was frequently disruptive in class, talking with peers to the point of annoying them and not stopping when teachers reminded him to quiet down. Apparently, some of his jokes in class also poked fun at some peers.

I interviewed his parents and the staff at school and discovered that this was a new pattern of behavior; in previous years he had been a very compliant and relatively quiet student. In addition, most of the talkativeness and non-compliance took place in language arts and dedicated reading time. Also, Michael and his peers had only recently come back to school after months of working from home due to the COVID pandemic.

While talking with Michael, we first made a list of all his strengths and talents as described previously in the section on building positive self-awareness. He was certainly a highly intelligent and articulate young man who, despite ASD, had developed friendships and a reputation for being funny. He also had a great deal of knowledge about various sports and could be relied upon by peers for scores and standings for many of the major sport teams. This was certainly an interest that connected him to peers in his school.

Following the enumeration of strengths, I began the CPS steps. Step 1: I asked, “Michael, I heard that your teachers said you sometimes talk in class, especially language arts and reading. What’s up with that?” “I am just bored,” he said. “And also it’s the only time really to talk to my friends.” I then went to Step 2: “Let me see if I’ve got this right so far: you are feeling bored in those classes, plus it feels like the only time you can talk to peers?” He confirmed. I asked, “What makes it boring?” He explained that both those classes involve reading, which he hates. At home he indicated he reads with books on tape, but in school there are no audible books, and he finds it exhausting to read. I checked again to see if I understood his feelings, reflecting what he said. This may seem like rudimentary therapy, and it is, but it sends the message to the student that I am not an adult who is simply going to tell him what not to do or what to do, but rather, I will take the time to understand his point of view.

Finally, after confirming that he hates reading and prefers books on tape and that he has no other time to talk with friends, I asked if there was more to say on this topic. He went on to say that since the pandemic, there had been very few times to talk with peers, and even now that they are back in school, there was no recess or social lunch time due to pandemic restrictions. As such, language arts, which typically involve discussions, felt like the only time to socialize with peers. I asked if he knew that the teachers indicated some peers might be annoyed by his talking and that it also seemed to disrupt the teacher’s lesson. He understood but said most of his friends didn’t seem to mind his conversations.

We then went on to the problem-solving steps. I started with the issue of being bored and hating reading, and asked, “I wonder if there is a way to make the reading less onerous and boring?” He suggested getting access to books on tape in school. We then planned a time for him to request that from the school staff, who indicated they would be open to any recommendations to help Michael. I then asked him about the next challenge of talking to peers and asked, “I wonder if there is a way for you to socialize with peers at a time that won’t annoy the teacher and some of your peers?” This question represents one of the keys of collaborative problem-solving, namely, finding realistic solutions that can work because they work for everyone involved. He suggested that the school should create another social time during the day for kids to just chat. We rehearsed a way to request that from the school administrator, who was open to our suggestions, and she created a home room/social time in the morning and one in the afternoon, which ended up benefiting all the kids. Michael and I also talked about the social skill of picking the right times and ways to be “funny.” We carved out some social goals of saving socializing for designated downtimes rather than during a lesson and selecting comments or jokes that do not insult his peers (see chapter 14 lesson on Getting Attention in Positive Ways).

Utilizing the Individual’s Interests

Another critical way to motivate involvement in learning skills or anything else is to incorporate the interests of the individual. Brain studies often suggest that those on the spectrum may have different sensitivity in the regions of the brain that control drive and motivation (Kohls et al., 2013). Typical reinforcers that work for neurotypicals may not always work for them. However, the individual on the spectrum may have more brain activity and general responsiveness when engaged with their interests. Thus it is crucial to utilize their interests when teaching social skills. One way to do this is to create social activities related to their interests. Rather than creating formal social skills groups to learn skills (as so often occurs in schools), systematic practice on social skills can occur in the context of theme-based groups related to the child’s special interests, such as anime, books, film, robotics, cooking, Legos, or video game clubs. In this context, children can practice talking with each other (about those things that are inherently motivating), learn to compromise, and regulate their comments and other behaviors in order to continue to pursue their interests.

Troubleshooting Resistance: “But I Don’t Care What Others Think!”

Creating motivation to work on skills is easier when children recognize that they need to work on a particular skill to reach their own goals. But what if the behavior in question only seems to bother others and the child does not care if it upsets anyone else? How do we help individuals care about others’ feelings? Well, they need to see the logical consequences that occur if you do or do not care about others and how it does ultimately impact something they do care about.

For example, I worked with a teenage girl who frequently cursed and used provocative language out in public when shopping with her parents. Her family was quite embarrassed about her behavior, and when she was given feedback how her words might make others feel extremely uncomfortable, she exclaimed that she does not care what others think. However, she soon realized that her parents would no longer take her shopping or to places she wanted to go, and thus she came to realize that she needed to care about what they and others thought in order to go where she wanted. It is important to note that she received the feedback about her behavior much better when she was reminded about how smart and talented she was and that what they were asking her to do was a just a small thing, as she was free to curse if she wanted to in the privacy of her room at home. When she was complimented and their upset over her infraction was downplayed, her defenses lowered, and she was able to take in and use the feedback.

Strengths

Challenges

Good memory for factsOrganizationGood readerFocus and frustration in classesGreat at video gamesSocializing comfortablyExpert in Japanese animeLoves animalsGood singerKind and caringEntertaining

Can lead to a great academic andwork career!

Possible Supports: HW system, notes for missed info, possible med for focus, teach a few social/frustration-related skills.

Chapter 6

Assessment ofRelevant Skill Goals