T. Rene Jamison, Ph.D.

Presented at the “Beyond the Diagnosis: Autism Across the Lifespan” Conference October 14, 2010

Promoting social competence in adolescents with autism and other developmental

disabilities: Overview of the "Girls Night Out" program.

Your Visual SupportDiscuss construct of social competence

Social skills training core components

Example program to promote social competence in girls with ASD / DD

“Girls Night Out”

Social Competence

What is it?

“Social, emotional, cognitive skills and behaviors thatchildren need for successful social adaptation” -Welsh & Bieman

“adequacy of a person’s social functioning” -Gresham, 1998-

Improvements in social skills likely resultin higher social competence.

Social skills, awareness, self-confidence

Social Competence

Who’s got it?

Those who other’s believe have it…..

And Probably those who believe they have it….(Perceived social competence)

Social Competence

How do you know you’ve got it?

Social Status

Friendships

Understanding of social skillsPeer nominations

Awareness

Social Adaptation

Perceived competence

Self Esteem

Changes in Social Competence When social skills result in peer acceptance

and positive judgments from important others

Change in target social behaviors should predict status on important social outcomes such as peer status

In other words….someone has to notice!!!!

Well then how can I get it?

Social Competence

Improved social skills

Increased awareness

Targeted self esteem and emotional wellness

Change perceptions of others

Build self confidence!

An empirical consensus states that physical appearance contributes most to self-esteem during adolescence compared with other domains of perceived competence (Harter, 1990). The second domain is social acceptance.

According to Renick and Harter (1989), 84% of adolescents in specialized classes want to compare themselves to typically developing peers because they want to be considered “normal”

General Components in Effective Social Skills Programs

Modeling

Coaching / Feedback

Reinforcement

Cognitive – Behavioral Strategies

Assessment

Peer Mediated

Generalization component / plan!!!!

Individual goals

Evaluation of outcomes

Gresham, Sugai, & Horner, 2001

Girls Night Out!

A social skills and self care program……………

Intervention Components in GNOVisual Supports Social Narratives Scrapbook Conversation Key rings

Targeted specific social conversational skills

Live coaching/specific feedback

role play / modeling

Reinforcement of specific behaviors / skills

GNO Bucks GNO Store Specific praise

Peer Mediated (trained peers)

Support / Motivation

Age appropriate activities in community settings

Personal goals and challenges

Homework “Buddy” system Self monitoring through

‘What I Did This Week’ sheets

Visual SupportsVisual Schedule

Scrapbooking

Social Narratives

Conversation Key Rings

Task Analysis

Social Narrative

Remember…..

1. Get my body ready

2. Find out: where they go, what they do, and things in common

3. Take turns: Listen and Talk

Salon VisitTask Analysis and Social

Narrative

Scrapbooks….Visual Supports!

Conversation Key Rings

“What kind of jewelry are you going to make?”

“What do you like to do after school?”

“What do you like to do on the weekends?”

“What is your favorite TV show?”

What colors do you think you look best in?”

•What are you going to have the stylist do to your hair?

“I like their hair or that it “looks cute” today.”

Targeted Conversation Skills

Examples: Personal InformationActivity Related Information Emotional Support / ComplimentsAppropriate transitions

Reinforcement of specific behaviors / skills

• GNO Bucks

•GNO Store

•Specific Praise

“Token Reinforcement”..paired w/ specific praise

GNO BUCKS

$$$

Peers / Support / Motivation

•Peer Mediated

•Age appropriate activities in community settings

•Personal goals and challenges

•Homework

•“Buddy” system

•Self monitoring through ‘What I Did This Week’ sheets

Activities in community

Take home data/ generalization form – PEER EXP

I called a friend

A friend called me

Went to a friend’s house

A friend came to my house

I participated in an after school activity

I gave a compliment

I talked to a friend over text or online

Wednesday XXX XXXXX X X X X

Thursday XXXX XX X X

Friday XXX XX X X X X

Saturday XXXXX XX X X X

Sunday XXX XXXXX X X X

Monday XX XX X X X

Tuesday XX X X X X

Take home data/ generalization form-Girl w/ DD Exp

I called a friend

A friend called me

Went to a friend’s house

A friend came to my house

I participated in an after school activity

I gave a compliment

I talked to a friend over text or online

Wednesday X

Thursday X

Friday

Saturday

Sunday X

Monday

Tuesday

Girls Night Out: Take

3

OverviewParticipants and Peers4 girls, ages 14 to 17 with a diagnosis of AS

3rd grade reading level or above4 typically developing peers, ages 15-18

SessionsTwo baseline (no intervention) sessionsNine intervention sessions across 7 weeksOne wrap up data collection session

Session OutlineSkills taught/practiced w/in leisure or self care activitiesTeaching Session Reinforcing Session

Skill taught through direct teaching Skill is reviewed from the previous week

Social narratives used to identify key steps involved in the skill and to reinforce the skill

Skill is modeled by peers and/or participants

Participants and peer brainstorm ways in which to appropriate use the social skills in different contexts

Group and partner activities used to practice the skill

The skill is modeled by facilitators and/or peers

Coaching/immediate feedback occurs during practice opportunities and throughout activities

Participants role play the skill

Participants use the skill in natural environments with other girls their age

Primary Research QuestionsIs there a relationship between

involvement in GNO and improvement in specific conversational social skill?

Do the adolescents involved in GNO show an increase in general social skills according to the Social Responsiveness Scale upon completion of the GNO program?

Outcome MeasuresPrimary MeasuresGirls Night Out Social Conversation Coding

System (GNO SCCS) based on the Social Conversation Coding System (SCCS; Thiemann, 2009)

Social Responsiveness Scale (SRS)-Parent Report Form (Constantino & Gruber, 2005)

Anecdotal MeasuresSatisfaction Surveys – Parent, Participant, and Peer

FormsFun-O-Meters

GNO-SCCS Data CollectionVideotaped 10-minute social interactions for each

participant per session

No intervention strategies were used with the target participant during this time

GNO SCCS was used to code the social interactions

Observers achieved 80% inter-rater agreement on practice tapes

% of intervals skills were used were graphed for each of the target conversational skills

Multiple Baseline DesignLooking at three specific social

conversational skills1. initiations and responses related to personal

information and activity related topics (ARI/PRI)

2. encouragement, compliments or emotional support statements (EMOT)

3. transitioning to a new and/or related topic (TRAN)

Satisfaction Survey – Parent Form

For the following questions, please circle the number you feel best represents your answer.

1.Have you noticed positive changes in your daughter’s conversational or social skills, as a result of her participation in the Girls Night Out program?

1 2 3 4 5

2.Have you noticed positive changes in your daughter’s self-care skills (e.g., hygiene, clothes, make-up, etc.), as a result of her participation in the Girls Night Out program?

1 2 3 4 5

Notice NO positive changes

Noticed a FEW positive

changes

Noticed barely any

positive changes

Noticed SOME

positive changes

Noticed LOTS of positive

changes

Notice NO positive changes

Noticed a FEW positive

changes

Noticed barely any

positive changes

Noticed SOME

positive changes

Noticed LOTS of positive

changes

Fun-O-Meter

1 2 3 4 5

Boring OK Not fun, but Fun REALLY Fun

not boring

Baseline SessionsInfo Night

One data point collected

Coffee ShopTwo data points

collectedFun-o-meter:

4.43/5

Personal Information and Activity Related Topics (ARI/PRI)

Jazzy Jewels Fashion 101 Salon

Teach session Reinforcing session Reinforcing session

Fun-o-meter:4.25 Fun-o-meter: 4.43 Fun-o-meter: 3.67

Encouragement, Compliments, or Emotional Support (EMOT)

Ceramic Café Fabulous Faces GNO-Literally Fitness Frenzy

Teach session Reinforcing session Reinforcing session Reinforcing session

Fun-o-meter: 4.57 Fun-o-meter: 4.5 Fun-o-meter: 5 Fun-o-meter: 4.63

Transitioning to a New and/or Related Topic (TRAN)

Fabulous Faces, Take 2 Photo Finish Wrap-up Session

Teach session Reinforcing session Reinforcing session

Fun-o-meter: 4.5 Fun-o-meter: 4.86

Girls Night Out!

Highlights

Participant Data

Average Fun-O-Meter Scores

1 2 3 4 5

Boring OK Not fun, but Fun REALLY Fun

not boring

4.48 / 5.0

Parent Satisfaction SurveyHave you noticed positive changes in your

daughter’s conversational or social skills, as a result of her participation in the Girls Night Out program? 4.33/5

• How satisfied were you with your daughter’s overall experience with Girls Night Out?• 5/5

Participant Satisfaction SurveyHave you noticed any positive changes in

your conversational or social skills, as a result of the Girls Night Out program? 3.66/5

How satisfied were you with your overall experience with the Girls Night Out program? 4.66/5

Peer Satisfaction SurveyHow satisfied were you with the training and

information you received on individuals with developmental disabilities throughout the program? 4.5/5

How satisfied were you with your overall experience with the Girls Night Out program? 5/5

Question 1Is there a relationship between involvementin GNO and improvement in specific conversational social skill?

Increase in initiations and responses related to ARI/PRI

No increase in majority of participants in EMOT/TRAN behaviors

Improvement in conversational social skills according to anecdotal observations and data

Question 2Do the adolescents involved in GNO show an increase in general social skills according to the Social Responsiveness Scale upon completion of the GNO program?

Participants’ general social skills stayed within the same range

Parent FeedbackMy daughter loved this-I almost did not sign her up as the cost was prohibitive to me-but it was the best money I’ve spent on her IN YEARS. She has grown socially, emotionally.

Thank You!

GNO is a blessing! What a life-changing experience!

We need GNO for 10 years at least!

Peer and Participant Feedback

I changed a lot.

I’ve come to realize that almost all [girls with disabilities] are capable of holding conversations in the right environment and all teenage girls really want the same things.

The part I liked was that it made me get more interaction with people and get out of my comfort zone.

I enjoyed getting to know all of the girls and I’m now able to effectively communicate with people with disabilities because of GNO.

I really enjoyed the program and had FUN!

GNO-2: Participant 1

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social initiation

GNO-2: Participant 3

jazz

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5

10

15

20

25

30

35

social initiationresponse to initiation

GNO-2: Participant 4

jazz

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5

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15

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25

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social initiationresponse to initiation

GNO-2: What the parents said… “One of my daughters is more social than the other, but I have

noticed the "quiet" one is talking to her peers more and trying to interact with them.”

“It was a very valuable experience for my daughters by giving them the opportunity to be with "typical" peers and learn "girly" info.”

“Definitely a valuable experience and I wish she had a group program to go to regularly.  I have seen an improvement with [our daughter ]and her attitude and ability to communicate with others.”

GNO-2: What the parents said...

“This was an incredible experience for [our daughter]. I wish it would continue forever.... I felt like you all really built a relationship with [her] and therefore, set goals that were designed specifically for her.  She looked forward to it every week. Last week, she wanted to go to a another activity instead but I made her go to Girls Night Out. There were no regrets. Her quote on the way home that night was: "this girls night out is the most fun I've ever had." I saw an increase in her self esteem.  Unfortunately, we live so far away that she can't really build friendships that can develop much but it was still worth it. My child does not seem happy often but on Wednesday nights she is and that's worth a lot. It was very well developed and well planned out. Each night had a purpose that was helpful. I wish we could have gone to the salon because I think that would have been very beneficial for [our daughter]. It is extremely difficult to find social skills groups and I was very pleased with the program. Thank you for making a difference in my child's life and mine. You are all incredible and extremely talented at what you do. You make a difference!”

Behind the Scenes… anecdotal evidenceTextingInviting girls from GNO overKaraoke—shy? No way!Decline in perseverationFriendshipsExperience of the girls without DDBreaking stereotypesBuilding community partnersSadness of group ending FUN!

LimitationsSmall sample sizeTargeted conversational skills were not

individualizedActivities did not always incorporate

participants’ interestsShort duration of programTargeted low rate behaviorsScheduling of community partners

Implications for the FutureMatch social skills taught to areas of needFind participants and peers that are in the

same community settingsIncorporate activities that are of interest to

the participantsAllow more time for practicing of skills and

use of skills in natural environments

How can I apply some of these ideas?????Focus Groups in Schools (what are girls doing,

why are girls not included)Social “clubs”Themed afterschool or evening activities“lunch bunch” or “dinner bunch” Include social skills in IEP goals with

generalization planIncrease “frequency” by generalization Personalized scrapbookInclude in transition plan or PCPBe focused, start small, take data

Special Thanks to… Mallory Smith Nicole Clark Bridget Cibulskis Emily Bellacera and Jessica Pangborn Amanda, Erin, Sam & Jordan: GNO-2 facilitators Karen Hinkle All who contributed to the GNO Store Our community partners

JavaNut Beauty Obsessions Salon Ceramic Café Nikki Bauer-Arbonne Consultant Mission Bowl Kirmayer Fitness Center Bare Ecsentuals Red Robin

Matthew Braun, Lisa Walsh, and Charles Coffey for technical assistance Center for Child Health and Development Women’s Foundation for Greater Kansas City KCART

And of course the girls who participated and their families!

Questions / Comments

ReferencesAmerican Psychiatric Association. (2000). Diagnostic and statistical manual

of mental disorders (Fourth Edition – Text Revision). Washington, DC: Author.

Autism Speaks. (2010). What is autism? Retrieved February 19, 2010, from http://www.autismspeaks.org/whatisit/index.php

Barry, T. D., Klinger, L. G., Lee, J. M., Palardy, N., Gilmore, T., & Bodin, S. D. (2003). Examining the effectiveness of an outpatient clinic-based

social skills group for high-functioning children with autism. Journal of

Autism and Developmental Disorders, 33(6), 685-701.

Bellini, S., Peters, J. K., Benner, L., & Hopf, A. (2007). A meta-analysis of school-based social skills interventions for children with

autism spectrum disorders. Remedial and Special Education, 28(3), 153-162.

Elder, L. M., Caterino, L. C., Chao, J., Shacknai, D., & De Simone, G. (2006). The efficacy of social skills treatment for children with Asperger Syndrome. Education and Treatment of Children, 29(4), 635-663.Gresham, F. M., Sugai, G., & Homer, R. H. (2001). Interpreting outcomes of social skills training for students with high-incidence disabilities. Teaching Exceptional Children, 67, 331-344.Kamps, D. M., Leonard, B. R., Vernon, S., Dugan, E. P., & Delquadri, J. C.

(1992). Teaching social skills to students with autism to increase peer interactions in an integrated first-grade classroom. Journal of Applied Behavior Analysis, 25(2), 281-288.

Mackay, T., Knott, F., & Dunlop, A. W. (2007). Developing social interaction and

understanding in individuals with autism spectrum disorder: A groupwork intervention. Journal of Intellectual & Developmental Disability, 32(4), 279-290.

Matson, J. L., Matson, M. L., & Rivet, T. T. (2007). Social-skills treatments for children with autism spectrum disorders: An overview. Behavior Modification, 31(5),

682-707.Mesibov, G. B. (1984). Social skills training with verbal autistic adolescents

and adults: A program model. Journal of Autism and Developmental Disorders, 14(4), 395-404.

Newschaffer, C. J., Croen, L. A., Daniels, J., Giarelli, E., Grether, J. K., Levy, S. E., Mandell, D. S., Miller, L. A., Pinto-Martin, J., Reaven, J., Reynolds, A. M., Rice, C. E., Schendel, D., & Windham, G. C. (2007). The epidemiology of autism spectrum disorders. Annual Review of Public Health, 28, 235-258.Rao, P. A., Beidel, D. C., & Murray, M. J. (2008). Social skills interventions for

children with Asperger’s Syndrome or high-functioning autism: A review and recommendations. Journal of Autism and Developmental Disorders, 38(2), 353-361.