Teaching Children with Autism to Tell Socially Appropriate Lies
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JOURNAL OF APPLIED BEHAVIOR ANALYSIS 2016, 49, 1–6 NUMBER 2(SUMMER) TEACHING CHILDREN WITH AUTISM TO TELL SOCIALLY APPROPRIATE LIES RYAN BERGSTROM AND ADEL C. NAJDOWSKI CENTER FOR AUTISM AND RELATED DISORDERS, INC. MARISELA ALVARADO FOOTHILL CHILD DEVELOPMENT SERVICES, INC. AND JONATHAN TARBOX CENTER FOR AUTISM AND RELATED DISORDERS, INC. This study used a nonconcurrent multiple baseline across participants design to evaluate the use of rules, role-play, and feedback for teaching 3 children with autism spectrum disorder to tell socially appropriate lies when (a) presented with an undesired gift and (b) someone’s appearance changed in an undesired way. The intervention was effective in teaching use of socially appropri- ate lies, and generalization to untrained people and gifts or appearances was observed. Key words: autism, deception, lie, perspective taking, theory of mind Although lying is broadly considered to be (e.g., allowing someone to wear inappropriate problem behavior, there are situations in which clothing to work may be more detrimental than it is socially appropriate. For example, decep- hurting his or her feelings). Thus, the mediat- tion is used when keeping secrets, avoiding giv- ing responses associated with telling a socially ing away surprises, telling jokes (avoid giving appropriate lie are primarily verbal responses away punch line), and bluffing in games. It is and are highly conditional on other environ- also socially appropriate to be deceptive when a mental contexts. Given the advanced condi- friend solicits an opinion on his or her unat- tional discriminations and language repertoires tractive new haircut or when a spouse asks needed to tell a socially appropriate lie, it is how he or she appears in ill-fitting clothing. not surprising that individuals with autism For most individuals, the determination of spectrum disorder (ASD) may experience diffi- how to respond in the latter case involves culty understanding and telling such lies (a) assessing the appearance of the individual, (Happé, 1994). (b) envisioning the emotional effect of stating Although there are curricula that exist for the truth, and (c) envisioning the consequences teaching deception to individuals with ASD for that individual of telling the truth or lying (e.g., Skills), there is a dearth of research on teaching adaptive deception skills to this popu- Ryan Bergstrom is now at The Help Group, Adel Naj- lation. Reinecke, Newman, Kurtz, Ryan, and dowski is now at The ABRITE Orgnization, Marisela Hemmes (1997) investigated the effects of a Alvarado is now an independent consultant, and Jonathan Tarbox is now at First Steps for Kids. procedure for teaching children with ASD to We thank April Love, Angela Persicke, Aimee Fuentes, hide objects in their hands from an observer and Talya Vogel for their assistance with this project. who guessed in which hand it was hidden. Address correspondence to Adel Najdowski, The ABRITE Organization (e-mail: [email protected]). Modeling and delivery of praise were used dur- doi: 10.1002/jaba.295 ing baseline. Treatment included the addition 1 2 RYAN BERGSTROM et al. of edible reinforcement for independent displayed rule-governed behavior; and were able approximations toward the desired response. to learn via role-play. We selected participants Two participants learned the response during for inclusion based on parental indication that baseline, and one participant required edible their children made blatantly honest utterances reinforcement to learn the response. Although often interpreted as rude (e.g., asking, “Why that study lacked experimental control, results are you wearing a girl’s shirt?” when seeing a tentatively suggest that behavioral procedures boy wearing a pink shirt). might be effective for teaching deceptive skills. Therapists implemented one to three one- Another behavioral procedure, behavioral trial sessions per day during periods between skills training (BST), which involves the use of other regularly scheduled instructional therapy instructions, modeling, rehearsal, and feedback, programs. Baseline and generalization sessions has been demonstrated to be effective for teach- lasted less than 1 min, and training sessions ing social behavior in individuals with ASD. lasted 5 to 10 min. Specifically, Stewart, Carr, and LeBlanc (2007) and Peters and Thompson (2015) demon- Response Measurement and Interobserver strated that BST improved social skills related Agreement to attending to a conversational partner’s inter- Observers scored participant responding on est. BST has also been shown to be effective in each trial by assigning up to 3 points. To teaching children with ASD to detect and receive 3 points, a participant was required to respond appropriately to the deceptive state- tell a lie expressing approval (e.g., “I like it”), ments of others (Ranick, Persicke, Tarbox, & using a sincere tone (i.e., speaking in a higher Kornack, 2013). Specifically, in the Ranick pitched, nonmonotone voice) while smiling et al. (2013) study, participants learned to iden- (and not engaging in inappropriate facial tify when others were lying to them either expressions such as eye rolling). To receive (a) to take their things or (b) to leave them 2 points, a participant was required to tell a lie out. Although no previous research has been expressing approval using either a sincere tone conducted on using BST to teach individuals or smiling, but not both. To receive 1 point, with ASD to use deceptive statements, previous the participant was required to tell a lie expres- research is promising. sing approval with an insincere tone and with- The current study evaluated whether BST, out smiling. Failure to tell a lie expressing which consisted of rules, role-play, and feed- approval, regardless of tone or facial expression, back, could be used to teach children with resulted in a score of zero. ASD to use socially appropriate lies when given A second observer simultaneously collected an undesired gift and when someone’s appear- data on 57%, 54%, and 56% of sessions for ance changed in an undesired way. Leo, Kathy, and Carl, respectively, to calculate interobserver agreement. We compared obser- METHOD vers’ records of the presence or absence of the lie, tone, and facial expression on each trial. Participants and Setting Observers agreed on 100% of trials across all Two boys (5 and 9 years old) and one girl participants. (7 years old) who had been diagnosed with ASD participated. Each received one-on-one behavioral intervention for 8 to 30 hr per week Procedure in his or her home. Each spoke in full sen- We taught participants to tell lies in two tences using mands, tacts, and intraverbals; contexts. During gift sessions, an adult SOCIALLY APPROPRIATE LIES 3 presented the child a wrapped gift containing nice like, ‘Thanks! I like it!’” Appearance ses- either a nonpreferred or already owned item sions began by the therapist saying, “If some- and asked, “What do you think?” These items one is wearing something you don’t like or were determined by parental nomination and changes how they look, you need to make sure included board games, dolls, pens, stickers, or not to hurt their feelings by saying something puzzles with disliked character themes (e.g., nice if they ask you what you think. Something princess, Simpsons, Cars, popular singer); aca- like, ‘It looks good’ or ‘that’s cool.’” Note that demic workbooks; pink items (e.g., magic the therapist did not provide any instruction wand, candles); items to do with coloring (e.g., regarding tone or facial expression but did coloring books, crayons, colored pencils); and model the target response. plush toys. After stating rules during gift sessions, the During appearance sessions, an adult’s therapist initiated a role-play opportunity by appearance was altered in a way that the child presenting a gift and saying, “Hey! I got you a did not like based on parent report. When the present!” After it was opened, the therapist adult arrived at each participant’s home, the asked, “What do you think of it?” After stating adult expressed satisfaction with his or her new the rules during appearance sessions, the thera- appearance (e.g., “Check out my awesome new pist left the room and changed his or her shirt!”) and asked, “What do you think?” The appearance (e.g., put on a cowboy hat) and stimuli used to alter appearance included hair then returned and solicited the participant’s (e.g., styles, clips, large bows, blonde exten- opinion (e.g., “Check out my awesome hat! sions); pink clothing (e.g., shirt, sunglasses, What do you think?”). glove); baggy clothing; hats (e.g., sideways, The therapist praised correct responding cowboy); eyeglasses and eyeglass chains; unu- (i.e., gave a score of 3) if it occurred within 3 s. sual shoes; fake facial hair; and bright lipstick If no response occurred within 3 s, the thera- colors. Across sessions, gifts and changes in pist provided a rule reminder and model of the appearance were presented by experimenters, correct response (e.g., “You need to smile and therapists, or confederates; all are referred to as say something nice like, ‘Wow! This is awe- therapists hereafter. some!’”). If the participant response did not Baseline. Three to five therapists presented a receive a score of 3, the therapist provided feed- gift or change in appearance across sessions; back regarding the missing elements (e.g., they did not deliver feedback or other conse- “That was good, but remember you need to quences for participant responding. smile and sound excited.”). The therapist did Training. Training procedures (adapted from not require participants to repeat the response, the “deception” lesson in the Skills curriculum; but instead began the next session. The thera- (www.skillsforautism.com) included providing pist did not present any of the gifts or appear- descriptive rules, role-playing, and when ances presented in baseline during training; needed, corrective feedback.