Developing Meaningful Relationships among Adolescents and Young Adults with ASD and their Peers
Wesley H. Dotson, Ph.D., BCBABurkhart Center for Autism Education and Research
Texas Tech University
Acknowledgements: The participants, staff, and families of the KU
Social Skills groups Jim Sherman and Jan Sheldon Andrea Courtemanche Justin Leaf Faculty, staff, and students of Department of
Applied Behavioral Science at University of Kansas
Goals for today’s session Discuss current state of affairs/importance of
developing friendships and other meaningful relationships
Describe issues encountered in doing so Provide suggestions for characteristics of
support programs Provide an opportunity for questions and
discussion
Something to think about: As talk proceeds, keep these two young men
in mind
Kenny and Zane Both 15-yr-old boys with autism Both participated in after-school social skills
group for adolescents with autism and typically-developing peers
Both easily mastered social skills taught during formal instruction with graduate and undergraduate teachers
Kenny: Regularly generalized skills to interactions with
peers in social skills group Added all participants in group to Facebook,
called several regularly, and invited them to outside social events (movies, bowling, etc.)
On last day of group, insisted on having picture taken with all participants and staff
Zane: Rarely generalized skills to interactions with
peers in group Never attended outside events, no interaction with
peers outside group meetings Dropped out of group before end of program
Part 1: Context for discussion Social skills deficits are core feature of
receiving a diagnosis on the Autism Spectrum (DSM IV-TR, 2000)
What does the literature say about adolescents and young adults with autism, social skills, and building relationships?
Orsmond, Krauss, & Seltzer, 2004 Interviewed 235 families with adolescent or
young adult with autism Majority (>80%) in inclusive setting or employed in
community Only 24% had relationship with same-aged peer
involving social meetings or activities outside of work or classroom
46% had NO relationships with same-aged peers Significant predictor of presence of relationships
with same-aged peers was level of social skills development
Longitudinal study from Office of Special Education Programs (2005) Explored post-secondary and social experiences
< 20% with ASD reported interacting with friend once weekly 40% belonged to community or social group of some kind For most, over 75% of social interactions with family members
and paid care givers
Involvement in organized groups strongly correlated with positive outcomes Enrollment in post-secondary education Increased independence
Few students with autism (~25%) attend any kind of post-secondary educational institution
Less than 25% of those who attend earn a degree within 6 years
Recent study suggests most common reason for dropping out is failure to develop friendships and “fit in” with peers (Barnard-Brak, Lechtenberger, & Lan, 2010)
Failure to develop social relationships also associated with: Increased anxiety about social situations with
peers (e.g., Browning, Osbourne, & Reed, 2009) Other anxiety disorders (e.g., Farrugia & Hudson,
2006; White & Robertson–Ney, 2009) Depression (e.g., Stewart, Barnard, Pearson,
Hasan, & O’Brien, 2006)
Conclusions: Few adolescents and young adults with
autism develop friendships with same-aged peers
Quality of life and successful independence closely tied to development of relationships
Ability to develop meaningful relationships is linked with level of social skills
An important point about friendships for people with autism: People with disabilities report that their friends have
several characteristics (e.g., Carrington, Templeton, & Papinczak, 2003; McVilly, Stancliffe, Parmenter, & Burton-Smith, 2006): Shared interests Loyalty Helping when it is requested Spending time together
Exact same characteristics typically developing peers use to identify their friends
Part 2: Interventions Describe common interventions to teach
social skills Describe interventions to develop positive
relationships
Teaching Social Skills A number of interventions used to develop
social skills, including: Video modeling Script fading Peer mediated strategies Teaching Interactions Virtual reality
All have successfully taught social skills
Recent reviews suggest generalization of outcomes remains a problem. Matson, Matson, & Rivet, 2007 Rao, Beidel, & Murray, 2008 Tse, Strulovitch, Tagalakis, Meng, & Fombonne, 2007 Williams White, Koenig, & Scahill, 2007
Generalization most likely when peers involved, training is in natural environment, or training is carefully structured to promote generalization
Fewer studies explore teaching social skills to older learners relative to younger children
Skills targeted for intervention with older learners: Conversation Self-Advocacy Recreation skills Dating/Relationship skills
May require different instructional arrangements and considerations versus more basic social skills More sensitive issues More complex discriminations
“Skill” may look different based on who the social partner is OR who the person with autism WANTS the social partner to be
Class, status, and personality type also influence topography of skills (e.g., self-advocacy with a friend vs. a principal vs. a police officer)
Personal preference plays larger role
Developing positive peer relationships requires a different set of social skills than other social domains Manners and politeness versus having an
uncomfortable conversation with a friend Conversation in the hallway with platonic friends
versus conversation with potential dating partner
Teaching programs can still target more complex skills successfully Programming must account for increased
complexity Discrimination and generalization programs
become focal point of intervention
Building Relationships: In addition to teaching social skills it is
important to explore how and why positive relationships form:
Assumptions about formation and maintenance of relationships: Positive reinforcement is a privilege, not a
right. People choose to deliver positive things to others
Relationships are governed by concept of reciprocity.
Both parties must give and receive in a healthy relationship
Value of a relationship is a direct function of amount of reinforcement people receive. Relationships are strongest when people reinforce
each other on a regular basis
Goal is to create relationships that involve the regular, voluntary exchange of reinforcers between both people
Teaching Family Model Groups of adolescents live in homes with a “family”
who is responsible for providing social support and structured teaching
Constant embedded and formal teaching Widely replicated and successful teaching
procedures Most teaching focused on developing social skills
and helping adolescents build positive relationships with adults
Provided measures of relationship strength between residents and teaching family Proximity during free time Joking Asking staff opinion about things without
prompting Smiles, laughs when staff member present
Methods to develop positive relationships between staff and clients Work suggests that there are ways to
systematically foster relationships Research involving staff and clients in
Teaching Family Model homes for clients with DD
Steps to building positive relationships Step 1: Staff member provides non-
contingent access to preferred items Approaches client and offers access to known
preferred items “for free” Waits longer before approaching client each time
to set the occasion for client to approach staff member
Step 2: Staff member begins shaping specific approach and request responses using preferred items as reinforcers Initially requires client to approach before
delivering item Shapes an approach response (e.g., tap on
shoulder) Shapes a request response (e.g., sign for “drink”
or “toy”)
Step 3: Staff member shapes reciprocity by placing increasingly effortful demands on client before delivering preferred item Following a request response, asks client to do something
before preferred item delivered Initial demands small and highly likely (“Come over
here…”) Move to larger demands “equivalent” to value of
reinforcer being requested (“Please unload the dishwasher first”)
Results: Clients spent more time in proximity with staff
members Clients more compliant with demands from staff
members
Discussion: Social skills can be taught Involving peers in teaching can increase
likelihood of generalization Positive relationships can be systematically
built Next steps: further explore programs to build
relationships and extend to peers (as both targets of relationships and teachers)
Part 3: Suggestions, Issues, and Discussion Developing relationships between adolescents
and young adults with ASD and their peers: What, then, do we do?
How do we approach programming?
Back to Kenny and Zane What do you think were some of the
differences between the two cases?
Motivation: Adolescents more likely to build relationships with
preferred people Kenny liked peers and shared many interests with them Zane didn’t share interests with peers and thought they
weren’t “cool” Engagement:
Adolescents more willing to participate when learning environment fun/preferred
Kenny enjoyed group social games and enjoyed sports Zane did not like many games selected and did not like
playing sports
Relevance: Adolescents more willing to engage in target behaviors
which they see as functional and important When teaching adolescents how to ask and answer
questions to get to know a friend better: Kenny saw skills as helping him be friends with peers
in group Zane “Why should I do this, I don’t even like these
people anyway?”
Implications for programming: What, if anything, could we have done
differently with Zane?
Setting Skills Teaching Approach Ownership
Summary: Few adolescents and adults with autism develop and
maintain meaningful peer relationships The ability to develop relationships is closely tied to
social skills development Both social skills and relationship-building skills can
and have been taught Active involvement of participant and compatibility
with peers and social environment are key to achieving generalized and meaningful outcomes
Thus: Intervention and support services for adolescents and
young adults with autism should: Focus on developing the complex social skills needed to
navigate various kinds of adult relationships Provide/identify opportunities for increased participation
in community activities Teach/work where peer relationships are most likely to
form for that person Involve the person directly in their own program to
increase likelihood of compatibility with goals, target peers, and desired outcome
Thanks for coming!
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