Ryan, G., Brady, S., Holloway, J., & Lydon, H. (2018). Increasing appropriate conversation skills using a behavioral skills training package for adults with intellectual disability and autism spectrum disorder. Journal of Intellectual Disabilities, 23(4), 567-580. doi:10.1177/1744629517750744. Epub 2018 Jan 1. PMID: 29291670.
Reviewed by: Mary Catherine Patey, Master’s Candidate, and Frank R. Cicero, PhD, BCBA, LBA, Seton Hall University
Why research this topic?
In many individuals with developmental disabilities, particularly those with autism spectrum disorder (ASD), conversation skills do not always develop readily. Individuals with autism fail to display characteristics such as initiating conversations, taking turns during conversation, and maintaining a conversational topic. These deficits in conversation skills can have long lasting impacts on social relationships vocational success, and the expression of empathy well into adulthood. One method found to be effective for teaching conversations skills to children and adults with ASD is behavioral skills traaining (BST). BST is a teaching method relying on the use of instructions, modeling, rehearsal, and feedback to teach learners new skills. It has been shown to be successful for teaching a variety of social skills to children with ASD, including assertiveness, eye contact, loudness of speech, speech duration, and requesting.
What did the researcher do?
In this study, the researchers wanted to expand on previous studies where BST was used to increase appropriate conversation skills in adults with ASD. Specifically, the researchers employed a standard BST package that included eye contact as a target, the use of immediate feedback during BST, and implementing the BST in dyads instead of in a 1:1 format. Six adults with ASD served as participants in the study. The participants, consisting of five males and one female, were all between the ages of 19-20 years and had diagnoses of ASD made by independent psychologists. Their language skills ranged between developmental levels of three and seven years of age. The study took place across two settings, a rehabilitation facility and a private observation room located in the rehabilitation facility. The researchers probed performance on target conversation skills before treatment (baseline), after the BST treatment, and once a week thereafter as follow up. The first step in the BST treatment was to develop a task analysis of conversation skills based on that used in previous research. Steps included approaching a peer, greeting, posing a question or making a statement, waiting for a response, ending a conversation, and making eye contact throughout. During BST sessions, participants were first provided with verbal and written instructions on how to have a correct conversation. They were then exposed to a correct conversation modeled by the researchers. Practice with immediate, corrective feedback followed. Prompts and modeling were used until mastery was obtained. Target conversation skills were considered mastered when correct trials reached 80% of task analysis steps for three consecutive sessions or 100% for one session. Once mastered in the treatment room, BST was conducted in natural settings. The same BST procedures were used in the natural setting sessions with the addition of a preferred reinforcer earned upon correct trials.
What did the researchers find?
All participants reached mastery criterion in a mean of 9 sessions, with a range of 4-15 sessions. Analysis of the data indicate that the acquisition of appropriate conversation skills was a result of BST. Participant six showed the slowest rate of skill acquisition most likely due to more severe language and cognitive delays as compared to the other participants. Five out of six participants maintained appropriate conversation skills in follow-up. It was also found that the dyadic instructional model may have increased the rate of skill acquisition compared to previous studies that used a 1:1 BST model. In addition to these findings, ratings of social validity indicated that 100% of participants’ parents reported that they were very satisfied after intervention.
What are the strengths and limitations of the study?
This study was the first to implement BST using dyadic instruction. By observing peers during practice and feedback, this may have enhanced skill acquisition for participants and allowed for observational learning. Another strength of the study was the inclusion of a social validity assessment to examine the appropriateness of such an intervention for teaching appropriate conversation interactions to adult learners with ASD.
The authors identified some limitations of the current research. First, all sessions, including follow-up, were conducted with peers who attended the vocational training center. True generalization to natural conditions was, therefore, not displayed. Second, some participants showed an increase in appropriate conversation skills in the baseline phase (prior to BST). This could have been due to incidental observational learning; however, it causes an issue with establishing a cause-and-effect relationship between the treatment (BST) and the increase in appropriate conversation skills. Third, participant characteristics including autism severity and social skills were assessed by parent report. More objective measures could have been used
What do the results mean?
Based on the results, BST, implemented in dyads, was shown to be effective for increasing appropriate conversation interactions for all six participants. The learned skills were still evident 4 weeks post intervention in 5 of the 6 participants. These findings indicate that BST, taught in small groups, may be an effective intervention for the acquisition and generalization of conversation skills in adults with ASD. This may lead to a broader impact of success in other social skills areas, including the development of peer relationships and employment.
Citation for this article:
Patey, M.C., & Cicero, F.R. (2020). Research synopsis: Increasing appropriate conversation skills using a behavioral skills training package for adults with intellectual disability and autism spectrum disorder. Science in Autism Treatment, 17(12).
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