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Social Skills Interventions for Individuals with Autism: Evaluation for Evidence-Based Practices within a Best Evidence Synthesis Framework

Reichow, B. & Volkmar, F. (2010). Social Skills Interventions for Individuals with Autism: Evaluation for Evidence-Based Practices within a Best Evidence Synthesis Framework. Journal of Autism and Developmental Disorders, 40, 149-166.

Objective:   This article presents evidence on various techniques to support the acquisition of social skill development for students with autism.  Using evidence based criteria, two techniques (social skill groups and video modeling) have met the classification of being established or promising evidence based practices.

Method:  In this literature review, seventy-one reports (including 66 studies) were analyzed.  Two types of analysis were conducted.  First, groups were compared by age group and second, groups were analyzed by the type of instruction that was used.   Five categories or types of social skills instruction were reviewed.  They were: 1) technological delivery – instruction delivered through some form of computerized or electronic means. 2) Parental delivery – direct instruction was provided by the parent.  3) Non-parental adult delivery – direct instruction was provided by someone other than the parent. 4) Peer delivery – instruction was provided by a same aged peer and 5) Combined or multiple delivery – instruction was provided using multiple interventions.

In the interventions across age groups (preschool, school aged, and adolescents and adults) most of the studies used the principles of applied behavior analysis to teach and shape new social skills.  One significant finding was that the majority of studies did not actively teach generalization and/or maintenance  of learned social skills. 

In regards to the type of social skills instruction discussed in the research, applied behavior analysis was the most common intervention type.  The use of reinforcement and prompting strategies, imitation/ modeling, and self-monitoring were the most prevalent applied behavior analytic techniques used.  Naturalistic instruction for preschool students was also documented to be effective when paired with naturalistic reinforcers.  There is also ample evidence to support peers as teachers for social skills development.  In several studies peers were taught to instruct students with autism using pivotal response training, visual supports, and prompting.  In the analysis of social skills groups for students with autism, the findings were inconsistent.   In addition, most studies looking at social skills groups reported poor transfer of learned skills (generalization) or that generalization of skills was not measured.  The use of visual supports such as activity schedules and social stories were also analyzed.  The research conducted suggests that these visual schedules may be very helpful in enhancing social understanding and in structuring social interactions.  Finally, video modeling as a technique to teach social skills was also analyzed.  Many of the studies on video modeling describe its effectiveness for students with autism.  However, video modeling is typically utilized with other social skills intervention techniques.  More research is needed to determine the specific factors that contribute to video modeling effectiveness. 

Discussion: In this review of the social skill literature, two practices emerged with the classifications necessary to be considered an evidence based practice.  Social skills groups met the criteria for being an established evidence based practice and video modeling showed promise as an emerging evidence based practice.  Areas for future research might focus on the generalization and maintenance of acquired social skills, while another area of future research might look at teaching siblings to be direct instruction providers.