Social story interventions for young children with autism spectrum disorders.

This study examined the effectiveness of social story interventions for 3 young children diagnosed with autism spectrum disorders. For 2 participants, an ABA design was used, with a social story presented in the B phase. For the 3rd participant, an ACABA design was used, with the C phase serving as a book + reminder condition that was used to examine the impact of adult attention and the B phase consisting of a social story. Results confirmed previous research with regard to the effectiveness of this intervention for reducing the frequency of target behaviors. For the 3rd participant, the B phase was more effective than the C phase (book + reminder). In addition, target behaviors for all 3 participants remained at a low level, even after the social story interventions were discontinued. This suggests that irreversible learning of appropriate behaviors may have occurred during the course of the interventions.

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Individuals with autism spectrum disorders experience social challenges that are pervasive and that present difficulties across the life span. Even the most capable individuals with autism often experience considerable difficulty in social situations. A lack of theory of mind, the ability to infer what other people think and feel, has been proposed to account for the social impairments experienced by people with autism (Baron-Cohen, Leslie, & Frith, 1985). Because a considerable amount of research has suggested that this population is indeed deficient in theory of mind skills (Baron-Cohen et al., 1985; Leekman & Perner, 1991; Leslie, 1987), this explanation seems to be plausible. The social story intervention (Gray, 1995, 2000; Gray & Garand, 1993) was designed to provide people with autism with the information they are missing (i.e., information about social situations and peoples' expectations in them) and thus help them foster both interpersonal understanding and appropriate behavior.

Social stories are often written to help an individual adjust to changes (i.e., in routines), to provide insight about what others are thinking or feeling, or to teach specific social skills as alternatives to problem behaviors. The construction of social stories has evolved over the years, based on the experiences of their originator, Carol Gray, and others. In an early description of social stories, Gray and Garand (1993) described three basic types of sentences that can be used: descriptive, directive, and perspective. Descriptive sentences provide information about specific social settings or situations and describe what happens and why. The following are all examples of descriptive sentences: "The bell rings when recess is finished. The children stand in line by the door. They wait for the teacher to come" (Gray & Garand, 1993, p. 3). Directive sentences provide information about what a person should do to be successful in the target situation, for example, "When the bell rings, I will try to stop what I am doing. I will stand in line. I will wait for my teacher." Finally, perspective sentences describe the internal states of other people, as well as information about their thoughts, feelings, or moods. The sentence "My teacher will be happy to see all the children in line" is an example of a perspective sentence (Gray & Garand, 1993). Gray and Garand (1993) suggested that most social stories should contain both descriptive and directive sentences and may also contain perspective sentences. They did not provide a recommendation about the proportion of each of type of sentence that should be used in a social story.

Over the next few years, Gray (1995, 1996) revised her notions regarding social story construction to include the suggestion that 2 to 5 descriptive and perspective sentences should be used for every 0 to 1 directive sentence. This "basic social story ratio" (Gray, 2000) is based on Gray's preferences rather than on specific theoretical or empirical rationales. In her most recent social story training materials, Gray (2000) identified three additional types of sentences that may also be used. Affirmative sentences enhance the meaning of surrounding statements and express commonly shared opinions. For example, the second sentence in this sequence is an affirmative sentence: "Many people wear bike helmets. This is an intelligent thing to do" (Gray, 2000, p. 18). Control sentences, which are unique in that they are written by the focus individual (with assistance as needed), identify strategies that the person can use to recall the social story at an appropriate time and place. Gray (2000) provided this example: "When someone says 'I changed my mind,' I can think of an idea becoming better ... like a caterpillar changing into a butterfly" (p. 33). Finally, cooperative sentences identify what other people will do to support the focus individual as he or she learns a new skill or behavior; for example, "My mom and dad will try to remain calm while I learn to use the toilet" (Gray, 2000, p. 34). In light of the addition of these new types of sentences, Gray (2000) changed the "complete social story ratio" to 2 to 5 descriptive, perspective, affirmative, and/or cooperative sentences for every 0 to 1 directive or control sentence.

Gray has consistently emphasized that stories that do not confirm to the suggested ratio are not properly constructed as social stories. Most recently, she also noted that sentences that appear to meet the criteria for sentence types that are on "opposite sides" of the social story ratio should probably be rewritten to clarify their meanings or intents (Gray, 2000). This is meant to ensure that each social story focuses on describing an event, concept, or skill that might be needed in a particular situation, rather than simply listing behaviors that the focus individual is expected to perform.

Ten case study or research reports on social stories have been published to date, all of which involved individuals with autism or Asperger syndrome, and seven of which were conducted in school settings. In the first study, Swaggart et al. (1995) described the impact of social stories combined with social skills training and response cost, using simple AB designs for three children. In the second study, Kuttler, Myles, and Carlson (1998) employed an ABAB design to examine the impact of social stories in addition to a visual schedule, token economy, and prompting on a single student. Hagiwara and Myles (1999) employed multiple-baseline designs across settings with three students and presented social stories on a computer, along with videotaped clips of the target behaviors. Norris and Dattilo (1999) employed an AB design to assess the impact of multiple social stories plus brainstormed examples of appropriate behavior on one student. Rowe (1999), Backman and Pilebro (1999), Chapman and Trowbridge (2000), and Rogers and Myles (2001) all used case study …