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Utilizing Social Stories to Reduce Problem Behavior And UTILIZING SOCIAL STORIES TO REDUCE PROBLEM BEHAVIOR AND INCREASE PRO-SOCIAL BEHAVIOR IN YOUNG CHILDREN WITH AUTISM ________________________________________________________________________ A Dissertation presented to the Faculty of the Graduate School at the University of Missouri-Columbia ________________________________________________________________________ In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy ________________________________________________________________________ By LISA A. WRIGHT Dr. Rebecca McCathren, Dissertation Supervisor DECEMBER 2007 The undersigned, appointed by the dean of the Graduate School, have examined the dissertation entitled UTILIZING SOCIAL STORIES TO REDUCE PROBLEM BEHAVIOR AND INCREASE PRO-SOCIAL BEHAVIOR IN YOUNG CHILDREN WITH AUTISM presented by Lisa A. Wright, a candidate for the degree of doctor of philosophy, and hereby certify that, in their opinion, it is worthy of acceptance. _________________________________________________ Dr. Rebecca McCathren _________________________________________________ Dr. Janine Stichter _________________________________________________ Dr. Erica Lembke _________________________________________________ Dr. Marilyn Hargrove _________________________________________________ Dr. Greg Holliday ACKNOWLEDGEMENTS First, I would like to thank Dr. Rebecca McCathren for her dedication and support throughout my educational pursuits. She has been a stable, encouraging force in my life for many years. Her patience and gentle manner have been much appreciated. The remaining members of my committee were uniquely suited to provide a variety of supports. I would like to thank Dr. Janine Stichter for her advice and expertise concerning experimental rigor in single-subject research. Dr. Erica Lembke helped me look at my research from a variety of angles while encouraging precise descriptions. Dr. Marilyn Hargrove provided an editorial eye that was always valued. Last, Dr. Greg Holliday was instrumental in encouraging me to look at the “big picture” and to offer encouragement along each of the steps. Many thanks to fellow graduate students who provided assistance throughout my studies: Julie Olive, Jena Randolph, and Shawna Hudson. Finally, I want to thank the teachers and families who participated in this research. ii TABLE OF CONTENTS ACKNOWLEDGEMENTS………………………………………………….……………ii LIST OF FIGURES………………………………………………………………….......vii LIST OF TABLES………………………………………………………………….…..viii ABSTRACT……………………………………………………………………….……..ix Chapter 1. INTRODUCTION AND LITERATURE REVIEW Significance of the Problem …………………...……………………………….…1 Implications…………………………………………………….…….………..…..3 Social Stories…………………………………………………………………...…3 Development and Implementation of Social Stories……………………………...4 Example Social Story……………………………………………………..……….6 Theory of Mind……………………………………………..……………………..7 Summary of Current State of the Field……………………………………………9 Review of the Literature…………………………………………………………10 Current Issues…………………………………………………….………………10 Three-tiered Classification Framework Process…………………………………12 Past Reviews……………………………………………………………….…….15 Literature Review………………………………………………………………...20 Inclusion Criteria………………………………………………………..……….20 Interrater Reliability………..…………………………………………………….21 Phases of the Three Tiered Framework Process…………………………………21 iii Current Review Compared to Previous Reviews……………………...…………25 Review of the Articles Not Meeting Minimum Quality Indicators……………....26 Review of the Articles Meeting Minimum Quality Indicators: Decreasing Problem Behavior…………………………………………………….…..…..32 Review of the Articles Meeting Minimum Quality Indicators: Increasing Pro- Social Behavior……………………………………………………………….39 Literature Review Summary………………………………………..………..…..43 Recommendations for Future Research………………………………………….44 Purpose of Study …………………………………………………………...……46 Research Questions………………………………………………………………46 Significance of Study…………………………………………………………….46 Need for Study………………………………………………………….………..47 Definition of Terms………………………………………………………………48 Chapter 2. METHODOLOGY Method……………………………………………………………………….......50 Participants……………………………………………………………………….50 Settings……………………..…………………………………………………….56 Materials and Measures………………………………………………………….56 Experimental Design………………………………………………..…………....60 Experimental Procedures……………………………………………………...…61 Data Analysis…………………………………………………………………….64 iv Chapter 3. RESULTS …………………………………………………………………...66 Interobserver Agreement…….…………………………………………………..66 Construct Validity………………………………………………………………..67 Research question 1: Does Social Story intervention increase socially appropriate behavior in preschoolers with diagnoses of ASD?........................67 Research question 2: Does Social Story intervention decrease problem behavior in preschoolers with diagnoses of ASD?...........................................74 Research question 3: In preschoolers with diagnoses of ASD, do the social behavior rates approach those of age and gender-matched typically developing peers?..............................................................................................82 Research question 4: In preschoolers with diagnoses of ASD, are the effects of intervention maintained over a one month period?.......................................... 83 Research question 5: Do teachers support the social validity of Social Stories?...84 Chapter 4. DISCUSSION ………………………………………………………….……87 Discussion of Findings...........................................................................................87 Limitations…………………..………………………………………..………….92 Implications for Practice…………………………………………………………95 Implications for Research………………………………………………………..96 Recommendations for Future Research………………………………………...99 Summary…………………………………………………………………….….101 v APPENDICES A. Three-tiered Classification Framework Coding Form …………..……..102 B. DSM-IV Criteria for Autistic Disorder and Asperger’s Disorder...…...106 C. Parent Permission Participants …………………………………...…….109 D. Parent Permission Peers ………………………………………………..114 E. Social Story Information Form ………………………...............………119 F. Behavior Assessment Interview Form …………………...…..……...…120 G. Operationally Defined Dependent Measures …………………………..121 H. Data Collection Recording Form ………………………………………124 I. Social Story Construction Checklist ………………….…………..……125 J. Social Story for participant 1………………………….………….….…127 K. Social Story for participant 2 ……………………..………….….….….129 L. Social Story for participant 3………………………………….………..130 M. Social Story for participant 4 …………………………………..………132 N. Treatment Fidelity Checklist ………….……………………………..…133 O. Intervention Social Validity Measurement Tool....…………………..…134 REFERENCES …………………………………………………………………….…..135 VITA……………………………………………………………………………………145 vi LIST OF FIGURES Figure Page 1. Literature Review Process……………………………………………………….13 2. Target Pro-social Behavior………………………………………………………68 3. Frequency of Problem Behavior………………………………………………....75 4. Duration of Logan’s Off-task and Wandering Behavior………………………...78 5. Duration of Peter’s Off-task and Wandering Behavior…………………..……...81 vii LIST OF TABLES Table Page 1. Three-tiered Classification Framework………………………………………….14 2. Studies Included and Excluded from Literature Review…………………..…….21 3. Studies That Met or Did Not Meet Minimum Quality Indicators…………….….24 4. Descriptive Statistics for Nick’s Target Behaviors……………………..………..70 5. Descriptive Statistics for Logan’s Target Behaviors………….………..………..71 6. Descriptive Statistics for Trevor’s Target Behaviors………………….…..……..73 7. Descriptive Statistics for Peter’s Target Behaviors……………...……..………..74 8. Descriptive Statistics for Nick’s Problem Behaviors…………………..………..76 9. Descriptive Statistics for Logan’s Problem Behaviors……………….…..….…..77 10. Descriptive Statistics for Logan’s Off-task and Wandering Behaviors…….…....79 11. Descriptive Statistics for Trevor’s Problem Behaviors…………………...……..80 12. Descriptive Statistics for Peter’s Problem Behaviors………………...…...……..81 13. Descriptive Statistics for Peter’s Off-task and Wandering Behaviors……..….....82 14. Pro-social Median Behavior……………………………………………………..82 15. Intervention Validity Tool Ratings………………………………………………85 viii ABSTRACT The purpose of this study was to evaluate the effects of a Social Story™ intervention on the social behavior rates of 4 young children with autism. This study used a multiple-baseline across participants design to evaluate the effects of the Social Story on the pro-social and problem behaviors of each of the participants in comparison to gender and age-matched peers in the inclusive preschool classroom. The results of this study indicate that the Social Story was effective in increasing pro-social behavior rates in 3 of the 4 participants, though none of the participants reached the pro-social behavior rates of age and gender-matched peers. The problem behaviors of all 4 participants decreased with the intervention. Maintenance of skills over a 1-month period was demonstrated for all of the participants. The present research adds to the current small though growing literature base in support of the use of Social Stories. Due to the call for scientifically based research in the classrooms, this study contributes to the support of Social Stories as an evidence-based practice for recommended use by practitioners in the field. ix Utilizing Social Stories 1 Chapter I Introduction Significance of Problem Recent federal policy mandates of No Child Left Behind (NCLB, 2001) and the Individuals with Disabilities Education Improvement Act (IDEIA, 2004) reflect
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