Hood, S. A., Luczynski, K. C., & Mitteer, D. R. (2017). Toward meaningful outcomes in teaching conversation and greeting skills with individuals with autism spectrum disorder. Journal of Applied Behavior Analysis, 50(3), 459-486. doi:10.1002/jaba.388
Reviewed by: Julia L. Ferguson, MS, BCBA and Mary Jane Weiss, PhD, BCBA-D, Applied Behavior Analysis Doctoral Program, Endicott College
Why research this topic?
Individuals diagnosed with autism spectrum disorder (ASD) have impairments in communication and social interactions (American Psychiatric Association, 2013). These impairments can also lead to difficulties in forming friendships and other meaningful relationships. Greetings and initial conversations with people are typically the gateways into learning more information about them, which can help to foster and develop a reciprocal relationship. This is true across the lifespan, as it remains crucial in adult employment and social contexts. Teaching greeting and conversation skills is difficult because it involves both speaker (i.e., talking) and listener (i.e., responding) skills, and these skills must be generalized and maintained across a wide variety of people, settings, and conversational topics. It is important to research procedures that will not only teach greeting and conversational skills to individuals with ASD, but to ensure that they are also socially valid and lead to generalization and maintenance across people, settings, and topics.
What did the researcher do?
Mike, Maggie, and Chris participated in this study (these are pseudonyms to preserve confidentiality). Mike was 16 with a diagnosis of Asperger’s Syndrome, Maggie was 15 with a diagnosis of ASD, and Chris was 8 with a diagnosis of ASD. All participants were in mainstream education without supports and could speak in full sentences. To assess greeting and conversation skill deficits, the researchers first conducted a parent interview, followed by a direct assessment. The information gathered during the parent interview helped inform the types of skills assessed during the direct assessment. During the direct assessment, the researchers engaged in a conversation with each participant and set up specific situations to test for the presence or absence of specific greeting and conversational skills (e.g., gave the participant a compliment, asked a question, mumbled a statement, etc.). The direct assessment then informed what target conversation and greeting skills the researchers taught each participant.
Behavioral skills training (BST) was used to teach the targeted skills. This training involved describing situations in which the targeted skill should be used, what the skill looks like, providing a rationale as to why the skill is important, observing a model of the correct and incorrect way to engage in the skill, and then having the participant practice the targeted skill. In addition to BST, the researchers also used differential reinforcement for correct use of conversational skills during teaching and textual prompts to increase the correct use of conversational skills. After teaching greeting and conversation skills, the researchers conducted post-teaching sessions to test for maintenance and treatment-extension sessions to assess generalization. Treatment extension sessions for Mike and Maggie were conducted with novel adults dressed in professional attire to simulate interactions that they would have with professional results when applying to colleges or interviewing for jobs. Treatment extension sessions were conducted with novel peers for Chris. Throughout all teaching sessions, post-teaching sessions, and treatment extension sessions, situations were arranged to provide the opportunity for the participants to engage in the targeted greeting and conversational skills, but none of the conversations were scripted or planned out in advance. These situations included acting bored, changing the topic of conversation, providing a compliment, asking a question, mumbling a statement, talking about preferred and nonpreferred topics, talking about controversial topics, and having a greeter enter the room during an ongoing conversation. The skills taught and assessed through the these situations included shifting the conversation, following the conversation, saying thank you, answering questions, making clarifying statements, asking questions, refraining from rude or offensive statements, refraining from distracting non-vocal behavior, refraining from perseverative speech, engaging in appropriate gestures, providing vocal positive feedback during the conversation (e.g., “uh huh”, “oh cool”), making eye contact, refraining from interrupting, engaging in a handshake, making an appropriate salutation, and making self-statements. Not having scripted or planned out conversations was important, as ABA intervention is often criticized for being too rote or for having a low level of embedded novelty. At the conclusion of the study, social validity measures were taken with the participants and their parents.
What did the researchers find?
All three participants learned all of the targeted greetings and conversational skills during teaching with the trainer. The skills learned during teaching also maintained for several months after teaching had concluded and generalized across several novel adults and peers. Results of the social validity assessment indicated that the participants’ parents were highly satisfied with the results of the teaching procedures, and each participant reported that they were moderately to highly satisfied with their greeting and conversation performances after teaching. The participants also rated the teaching procedures highly and noted that they would recommend the procedures to others.
What are the strengths and limitations of the study?
The study provided a comprehensive conversation assessment tool and an instructional package to teach a variety of greeting and conversational skills during unscripted conversations. Additionally, this study demonstrated the maintenance, generality, and social validity of the targeted skills, results obtained, and the procedures used through long-term maintenance probes and generalization assessments with multiple novel adults or peers. These results were also obtained with a relatively small dose of intervention per week (i.e., 1 session per week for 1.5-2 hours for Maggie and Mike, 2 sessions per week for 30 mins with Chris). Total intervention time including baseline, teaching, and post-teaching varied per participant. The entire intervention lasted 11 months for Maggie, 9 months for Mike, and 5 months for Chris.
What do the results mean?
The results of the study indicate that behavioral skills training with feedback, prompting, and differential reinforcement may be an effective treatment package for teaching multiple, complex greeting and conversational skills for individuals diagnosed with Asperger’s Syndrome or ASD. The conversational skills were not targeted in a scripted or rote manner, which led to generality and maintenance of the treatment effects. As was mentioned at the outset, teaching conversational skills can be difficult to teach and for some learners it may take some additional teaching sessions as was noted with some of the participants in the present study.
Future research should attempt to replicate the results obtained in this study and evaluate the skills’ long-term maintenance to see if these skills help facilitate meaningful and lasting relationships with others. Replication with individuals with different characteristics is also important; specifically, working with less vocal communicators or individuals who communicate with different modalities (e.g., augmentative and alternative communication [AAC] devices) would be valuable due to about half of individuals with ASD being candidates for AAC devices (Mirenda, 2003). Overall, this study demonstrates the utility of a behavior analytic instructional package to teach a variety of important conversational skills that generalize and maintain over time adding to the sparse literature to teaching social skills to adolescents with ASD.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids. Language, Speech, and Hearing Services in Schools, 34, 203-216. https://doi.org/10.1044/0161-1461(2003/017)
Citation for this article:
Ferguson, J. L., & Weiss, M. J. (2021). Research Synopsis: Toward meaningful outcomes in teaching conversation and greeting skills with individuals with autism spectrum disorder. Science in Autism Treatment, 18(3).
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