Autism is defined as a complex, lifelong developmental disability typically appearing during the first three years of life. It is a pervasive, handicapping condition that compromises social, adaptive, language and cognitive development.¹ More common in boys than girls,² autism affects one person in 500, making it more common than Down syndrome or childhood cancer.³

The profound and poorly understood developmental disorder severely impairs a person's abilities, particularly in the areas of language and social interactions. Children with autism typically are normal in appearance and physical development. Although its cause is unknown, there are several theories of possible etiologies.⁴

Autism interferes with the normal development of the brain in the areas of reasoning, social interaction and communication skills, resulting in impaired communication and social interaction. The disorder makes it difficult for individuals to communicate with others and relate to the outside world. In fact, people with autism have been described as being withdrawn and in a world of their own.⁵

Social impairment is one of the major identifying characteristics of autism. The primary characteristics include the following:

an inability to engage in developmentally appropriate play interactions,

atypical nonverbal behaviors and gestures, and

a lack of apathetic awareness of others' feelings.⁶

Some researchers suggest deficits in social interactions may be the primary difficulty of autism because they are so common.⁷

People with the disorder have deficits in social cognition, which is the ability to think in ways necessary for appropriate social interaction. Attempts to understand the psychological processes underlying autism focus on the area of social cognition or theory of mind. As a result, the area of social knowledge has begun to draw attention.

A poor awareness of social expectations may be one aspect of social knowledge presenting the most difficulty for persons with autism, Loveland and Tunali have suggested.⁸ Therefore, there is a critical need for attention to social skills and social interaction in autism research.

Observing that social interaction appears to be the cardinal feature of autism, Carol Gray, MEd, a consultant to students with autism in the Jenison Public Schools, in Jenison, MI, developed Social Stories. This technique, in the form of a story, can be used to help individuals with autism read and understand social situations.

Through this approach, Gray and J. Garand seek to include answers to questions that people with autism may find necessary and need to know so they can interact appropriately with others.⁵ Social stories attempt to describe and explain the sometimes subtle yet necessary cues in situations requiring social interactions. These short and personalized stories can be written by parents or teachers of children with autism.

To examine the effectiveness of Social Stories on social behaviors, three children with a diagnosis of autism were selected from an elementary school in Jackson, MI. All of the subjects (A, B and C) were 8 years old. Each participant received exceptional educational services in a self-contained classroom. A social story was written by the researcher to address the behaviors the teacher considered most disruptive or socially inappropriate.

Subject A presented with disruptive behavior, which consisted of taking her shoes off consistently during the day. This behavior was chosen because the teacher reported she repeatedly was forced to stop instruction to ask the student to put her shoes back on. When asked to put her shoes on, the girl often would have tantrums or refuse to do so. Because this student had minimal literacy skills, the teacher read a social story to her.

The story written for subject B addressed gaze aversion. When spoken to, this student would avoid making eye contact. When asked to look at the speaker, his teacher stated, the boy would injure himself by pulling his fingers back and biting his hands. In addition, he would isolate himself when he was asked to look at the teacher, the teacher assistant, or other students when they were speaking to him. Because this student also had minimal literacy skills, the teacher read a social story to him.

Subject C displayed disruptive behavior consisting of impulsively jumping out of his chair during instruction time. He would run from one side of the room to the other, climb a pole in the middle of the classroom as high as he could, and jump from it. This behavior would disturb the entire class and sometimes cause other students to act out. The student could not read independently, so the teacher read a social story to him.

Prior to introducing the social stories, the classroom teacher and researcher had established that the stories must be read once a day for a period of two-and-a-half weeks. The teacher suggested reading the story during the morning because the students were more attentive at that time.

Baseline data for subject A was collected for three hours. She removed her shoes a total of 36 times during the three-hour observation period. Each time the student removed her shoes, the teacher asked her to put them back on. Following implementation of the Social Stories intervention program, the student showed a reduction in the number of times she removed her shoes. When compared to baseline data, she removed her shoes 13 times after social story intervention for an improvement of 36 percent.

While the stories for subjects A and C were written to reduce their disruptive behaviors, the social story for subject B was written to improve his social skills. Baseline data for this student was collected during a period of three hours. His story addressed gaze aversion. The student would hold his head down when spoken to, make eye shifts away from the speaker's face, or turn his head completely in another direction while being spoken to. These behaviors were observed when someone was speaking only to him, as he is nonverbal. During baseline data collection, the student averted eye contact while being spoken to 17 out of 20 times. Following implementation of the social story, he did not make eye contact 10 out of 20 times.

Baseline data for subject C was collected during a three-hour period as well. His social story was written to improve his disruptive behavior. During baseline data collection, he would jump out of his chair, run from one corner of the room to the other at a high rate of speed, and jump on a pole in the room and climb it, and then jump down. This behavior occurred 12 times during baseline data collection. Following implementation of his social story, the behavior occurred seven times during a post-test observation period of three hours.

As a result of intervention with Social Stories, disruptive behaviors were reduced for subjects A and C. The intervention improved subject B's social skills with a reduction in his gaze aversion behaviors. Although the level of improvement for all three subjects varied, the results of this study validate the use of Social Stories as an effective means of intervention to modify behavior.

References

1. Centers for Disease Control and Prevention. (2001). Autism among children in the United States. Accessed online via www.cdc.gov.

2. Harrington, K. (1998). Autism: For Parents and Professionals. East Moline, IL: LinguiSystems Inc.

3. Cowley, J. (2000). Understanding autism. Newsweek, July 31, 46-54.

4. Cole, C., Arndt, K. (1998). Autism in L. Phelps (ed.) Health-Related Disorders in Children and Adolescents, 82-92. Washington, DC: American Psychological Association.

5. Gray, C., Garand, J.D. (1993). Social stories: Improving responses of students with autism Accurate social information. Focus on Autistic Behavior, 8: 1-10.

6. Harris, S.L., Glasberg, B., Ricca, D. (1996). Pervasive developmental disorders: Distinguishing among subtypes. School Psychology Review, 25: 308-15.

7. Fein, D., Waterhouse, L., Lucci, D., Synder, D. (1985). Cognitive subtypes in developmental disorders. Journal of Autism and Developmental Disorders, 15: 77-95.

8. Loveland, K., Tunali, B. (1991). Social scripts for conversational interactions in autism and Down syndrome. Journal of Autism and Developmental Disorders, 21: 177-86.

Ursula Bailey-May is on staff at Jackson Public School District in Jackson, MS. She can be contacted via e-mail at umay144527@aol.com.