Social stories are used to teach social skills to children with autism (1). A social story is a simple description of an everyday social situation, written from a child's perspective. Social stories can help a child prepare for upcoming changes in routine, de-mystify social interactions, and relate academic skills to real-life experiences (2). The idea is that the child rehearses the story ahead of time, with an adult. When the situation actually happens, the child can then use the story to help guide his or her behavior (1).
Each social story uses several different types of sentences:
For example, a social story using all six sentence types is:
When we go to the shoe store,
There will be many shoes to choose from. (De)
I might not know which shoes I like. (P)
That is okay with everyone. (A)
I can hold onto my string while I decide. (Cn)
When I decide about the shoes, I will tell the grown-up. (Di)
The grown-up will go get the shoes for me. (Co)
It has been suggested that social stories should use each of these types of sentences only in specific ratios or amounts. For example, some researchers suggest that directive sentences should not be used as much as descriptive sentences (1). However, social stories can still be effective without following these rules (3).
Social stories are written in the first person, in the present tense, and from the child's point of view. The parent, teacher, therapist or counselor should write the story to match the child's vocabulary and comprehension level. The story is written and put into booklet format. Once it is ready, an adult should read the story with the child at least twice, even if the child is capable of reading it. The adult then checks to make sure the child understands the important elements, either using a checklist or role-playing the situation ("Let's pretend we're at the shoe store. What happens next?") After that, the child reviews the story each day. For children who cannot read, audio and/or videotapes of the story can be made for the child to review each day. Finally, the effectiveness of each story should be monitored, with the story being faded out when the behavior has been learned. (1).
Social stories can be enlightening and enjoyable. One child responded "Now I'll know what to do!" after the first reading of a social story about lunchtime behavior at school. Later, after using the story for about six weeks, that child remarked, "I don't even read the story. Now I just remember it." (4).
An impairment in reciprocal social interaction is one of the main characteristics of autism (DSM-IV, 1994). This impairment might result from the unusual activation of certain areas of the brain that are used for social skills (5).
Social stories were developed to help improve social interactions in children with autism by giving simple and clear descriptions of social cues and appropriate behaviors (1). However, it is not clear why social stories work for children with autism when picking up social cues from the everyday environment does not. Some researchers believe that individuals with autism have trouble understanding what others believe, know, or don't know. This difficulty is sometimes called the theory of mind deficit in autism. (6 ).
There are several ways that social stories may help improve a child's theory of mind. One is that, by giving examples of specific social cues and behaviors, social stories may improve social problem-solving in general (1). Social stories may also help organize social ides and cues that were previously disorganized (4). Moreover, by using print, audio, or video to replace in-person teaching, social stories may take away some of the anxiety of social relationships (7). In this way, autistic children can concentrate on what is being said rather than their relationship with the person who is saying it.
Recent research studies show that social stories can help reduce problem behaviors, increase social awareness, and/or teach new skills (4, 7-9). In some cases, the new behaviors were maintained and generalized to other situations, even after the story was faded out.
However, these studies were based on very small numbers of children (one to five children per study). A review article found that social stories were shown to be significantly effective on average, but not in every case (3). Social stories are most useful for children who have basic language skills (2).
Although social stories in picture-book form are available for children with hearing impairments, there is no research to date on whether social stories have the same effectiveness if communicated with sign language.
More research is needed to understand what factors make social stories effective in some cases and not in others (10, 11).
There are no known negative effects of social stories. Among physicians, there is a belief that social stories may train children with autism to learn only one response to a given situation. As a result, some physicians recommend RDI, Relationship Development Intervention, which seeks to teach children how to have appropriate responses in any situation. However, to date there are no studies of the effectiveness of RDI.
Social stories may be included as a component of speech therapy. The cost of speech therapy is covered by the government through the Individuals with Disabilities Education Act (IDEA). This law protects the rights of patients with autism and provides guidelines to assist in their education. It covers children from birth to age 21 (U.S. Department of Education Web site, http://www.ed.gov/index.jhtml). Private speech therapy can be expensive (approximately $100/hour or more). Parents, teachers, counselors, and caretakers can also learn how to use social stories (2).
Books, audiotapes, and videotapes of several commonly used social stories for children with autism are available at a fairly low cost (see Resources).
The Gray Center (www.theGrayCenter.org) works to improve social understanding in autistic children, and provides details about the social stories approach.
Natural Learning Concepts (http://www.nlconcepts.com/) offers communication tools, including illustrated social stories, audio, and videotapes for children with autism.
The New Social Story Book by Carol Gray (Future Horizons, 2000) includes basic illustrated social stories as well as a kit detailing how you can write your own social stories.
Comic Strip Conversations by Carol Gray (Future Horizons, 1994) includes more social stories.
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