Healing Thresholds Autism Therapy Topic Feed

Social Stories Therapy for Children with Autism

PWSMom — Fri, 06 Nov 2009 18:32:09 +0000

Body:

What is it?

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 be used in different situations. For example, social stories can help a child prepare for upcoming changes in routine, or learn appropriate social interactions for situations that they encounter ⁽²⁾. The idea is that the child rehearses the story ahead of time, with an adult. Then, when the situation actually happens, the child can use the story to help guide his or her behavior ⁽¹⁾.

Each social story uses several different types of sentences:

Descriptive sentences (De) give who, what, where, and why details about the situation so the child can recognize when that situation actually occurs.
Directive sentences (Di) tell the child the appropriate social responses in that situation.
Perspective sentences (P) describe one of the child's possible feelings or responses.
Affirmative sentences (A) often refer to a law or a rule or are a commonly shared opinion.
Cooperative sentences (Co) describe how other people will help out in a given situation.
Control sentences (Cn) are created by the child, to help remember strategies that work for him or her. ^{(1, 3)}.

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 usually written by teachers, speech therapists, and parents, and are individualized for the child with autism ⁽⁴⁾.

What's it like?

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 tapes, videotapes, or picture books 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." ⁽⁵⁾.

What is the theory behind it?

Difficulty with reciprocal social interaction is one of the main characteristics of autism. This impairment might result from unusual activity or functioning of certain areas of the brain that are used for social skills ⁽⁶⁾.

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. ⁽⁷⁾.

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 ⁽⁵⁾. Moreover, by using print, audio, video, or pictures to replace in-person teaching, social stories may take away some of the anxiety of social relationships ⁽⁸⁾. In this way, autistic children can concentrate on what is being said rather than their relationship with the person who is saying it.

Does it work?

Recent research studies show that social stories can help reduce problem behaviors, increase social awareness, and/or teach new skills. In some cases, the new behaviors were maintained and generalized to other situations, even after the story was faded out. Social stories are most useful for children who have basic language skills ⁽²⁾.

To date, research studies on social stories have only had very small numbers of children (one to five children per study). One review article found that social stories were shown to be significantly effective on average, but not in every case ⁽³⁾. Another recent review article found that the limited studies available showed generally positive results, and concluded that the approach is promising ⁽⁴⁾.

Social stories have been used by teachers in the classroom. The teachers found them to be helpful ⁽⁹⁾. Another study reported improved social skills using a computer to present the stories in a school setting ⁽¹⁰⁾.

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 ^{(4, 11, 12)}.

Is it harmful?

There are no known negative effects of social stories. However, 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 ⁽¹³⁾.

Cost

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) of 2004. 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).

Resources

Healing Thresholds has partnered with Natural Learning Concepts. They sell many different social story books as well as audiotapes and videotapes of several commonly used social stories.

Autism is a condition covered under the IDEA of 2004. Services covered by IDEA include early identification and assessment by an occupational therapist. 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).

Pediatricians can provide contact information for the state early intervention program (for children 0 to 3 years old). School districts can coordinate special services for children 3-21 years old. For some additional coverage information in the U.S. go to: http://www.asha.org/public/coverage/autism.htm. In addition, there is a listing on this Web site for state early intervention centers (http://autism.healingthresholds.com/wiki/early_intervention).

The Gray Center works to improve social understanding in autistic children, and provides details about the social stories approach.

Several books that might be useful:

Social Stories (a series for children) by Natural Learning Concepts and Jene Aviram. Each book has 2 social stories (for example, Getting Angry and Sharing). 2006.

Writing and Developing Social Stories: Practical Interventions in Autism by Caroline Smith. Speechmark Publishing. 2003.

The Social Skills Picture Book: Teaching Play, Emotion, and Communication to Children with Autism by Dr. Jed Baker. Future Horizons. 2003.

The New Social Story Book : Illustrated Edition by Carol Gray. Includes basic illustrated social stories as well as a kit detailing how you can write your own social stories. Future Horizons. 2000.

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References

Dentists Use Social Stories to Ease the Fears of Children with Autism

scottie — Wed, 08 Jun 2011 17:11:20 +0000

Teaser:

Dr. Alan Milnes and Dr. Terry Farquhar are dentists who wrote an article about taking your child with autism to the dentist.

Body:

Dr. Alan Milnes and Dr. Terry Farquhar are dentists who wrote this article about taking your child with autism to the dentist. These pediatric dentists have advanced training in working with children with special needs. One of the tools they suggest is social stories, which can be made by the parents to show what will happen at the dental office. The dentists also suggest using the child’s natural desire for routine and excellent memory. Visits to the office can begin with a simple tour, and then expand to sitting in the chair, and looking at the equipment. It's a good idea to meet the hygienist and dentist beforehand to become more comfortable with their interactions. The kids learn new behaviors that may be repeated at each visit. Milnes and Farquhar explain, “This process is identical to that used in applied behavioural analysis (ABA) and relationship development intervention (RDI) therapies.” The dentists remind parents that good dental hygiene should happen at home on a daily basis; they have suggestions to help with tooth care at home.

Read original article: Dentistry and Autism

School District Works to Keeps Kids with Autism in General Ed Classrooms

scottie — Tue, 24 May 2011 13:24:08 +0000

Teaser:

Anchor Bay School District is training their educators to be autism team members.

Body:

Anchor Bay School District is training their educators to be autism team members. Elementary school teachers, administrators, social workers, including several from Sugarbush Elementary, created plans, handbooks, and sensory boxes so that children with autism could remain in general education classes as much as possible. Autism team members returned to their schools to educate the remaining staff. Areas of focus include handling transitions from class to recess to lunch, using social stories, and visual schedules.

Read original article: Anchor Bay Expands Approach to Autism

Teen with Autism Uses Talents to Help Others

scottie — Mon, 23 May 2011 13:51:58 +0000

Teaser:

Michael Wang, a high school senior with autism, has added Courtwarming King to his list of achievements.

Body:

Michael Wang, a high school senior with autism, has added Courtwarming King to his list of achievements. “Being crowned Courtwarming King shows people with autism can have special gifts," Wang said. "People with autism can change things." Meg Wang, his mom and a pediatrician at Thompson Center for Autism and Neurodevelopmental Disorders and Green Meadows Pediatrics Clinic, knew after his diagnosis, at age 2, that she had a small window of time to work with Michael using applied behavior analysis (ABA) therapy. She also reinforced Michael’s social interactions having friends over for play dates. She practiced telephone conversations with him and used social stories to increase peer interactions. Besides his school activities such as the breakdancing club and yearbook staff, Michael is very involved with the youth group at his church. He plans to attend college to become a preschool teacher.

Read original article: Rock Bridge's Michael Wang Transforms Social Struggles Into Strengths

Teacher Uses Social Stories to Help Child with Autism Deal with Death

scottie — Mon, 06 Dec 2010 18:44:19 +0000

Teaser:

A special education teacher, was asked by a parent to help her child with autism understand the death of his grandmother.

Body:

A special education teacher, was asked by a parent to help her child with autism understand the death of his grandmother. The teacher, using a program called Writing with Symbols, began a social story for the child. She included family photos and images from Google. She used simple language that the youngster would understand, "Grandma Mary Died. My Grandma Mary grew old. Grandma Mary lived a long time. She died because her heart stopped. Her breathing stopped too. Now, Grandma Mary does not feel sick. She does not hurt anymore.” An additional tool to help the child may be a visual schedule. For example, if the child sat quietly for the prescribed length of time at the funeral home, then he would get his favorite pizza. While the Internet has links to lots of tools to help parents with autism and death, the main tool is to be prepared.

Read original article: How to Explain Death to a Child with Autism

Two Moms in the Philippines Offer Tips on Good Dental Health for Children with Autism

scottie — Fri, 17 Sep 2010 15:00:00 +0000

Teaser:

Going to the dentist can be scary for any child, but two moms in the Philippines have some tips for going to the dentist with a child with autism.

Body:

Going to the dentist can be scary for any child, but two moms in the Philippines have some tips for going to the dentist with a child with autism. Tiffany Tan from Autism Society Philippines interviewed Barbara and Chyril about their boys and visits to the dentist. The moms spoke about preparing their children for the visit using social stories, visual schedules, and augmentative and alternative communication (AAC). They have also both found dentists willing to learn about autism and to accept their children’s behaviors. The moms both say that flossing is the most important thing to do, along with brushing. Other tips included finding a dentist who will allow your child to touch the dental tools, visiting a dental office before the procedure visit, and bring a favorite toy or book along.

Responding to adults with autism

Sun, 12 Sep 2010 21:20:12 +0000

I would be very interested in research studies which have focussed on the use of social stories and video-modelling for adults with autism who have aggressive outbursts when triggers to anxiety and frustration are hit. My son responds very well to social stories and these have helped him to accept many difficult situations in life which in the past would have caused him huge anxiety. But it has not been possible to help him cope when he is not prepared in time for situations which tend to trigger his frustration and on these occasions he can be very difficult to manage for the short time period of the outburst - these outbursts are very extreme, happen very quickly, and since teenage years often result in someone nearby being physically assaulted, or property being smashed. Once this assault or smash has taken place he calms down quickly, so medication isn't particularly effective for this.

If anyone has information on strategies which have helped minimise such behaviours in young adults (he is 22 years old) I would love to know of them.

Thanks

Does your Child’s School Provide Behavior Analysts to Help Ease Back to School Anxieties?

scottie — Fri, 10 Sep 2010 15:00:00 +0000

Teaser:

This article provided some information on what to ask about your child’s school as your child re-enters the classroom.

Body:

This article provided some information on what to ask about your child’s school as your child re-enters the classroom. There needs to be prior planning that includes school staff and you, the parent. Your child needs an education team to help him thrive; the team should include a board-certified applied behavior analyst (ABA). The behavior analyst can coordinate the team and make sure the student is receiving skill assessments along with transition activities, such as social stories. The analyst can ensure that all the professionals and para-professionals who work with your child have been properly trained to work with autism and other developmental delays.

Read original article: Behavior Analysts Help Children With Autism

Special Ed Teacher Gives Tips on Helping Children with Autism Adjust to New School

scottie — Fri, 27 Aug 2010 15:00:00 +0000

Body:

A group of kids with autism in Brownsville, Texas got some practice navigating their new school before the school year started. Their teacher helped with social stories and videos on a Flip video camera of the new school. In the spring, the children and their parents went to the new school late in the afternoon when it was quiet and calm. The children and their parents were allowed to visit the school over the summer as well. Other ideas to help children make the transition include driving the route to the new school, making a calendar with changing activities as the summer ends, pictures of school supplies, and beginning the fall schedule of school, homework, and bedtime.

Read original article: Beginning a New School Year For Children with Autism

iPad Provides New Opportunities for Child with Autism

scottie — Mon, 21 Jun 2010 14:22:46 +0000

Teaser:

Shannon Des Roches Rosa bought a $5 raffle ticket that resulted in a new iPad for Leo, her son with autism.

Body:

Shannon Des Roches Rosa bought a $5 raffle ticket that resulted in a new iPad for Leo, her son with autism. Leo had tried the iPod Touch, but his motor skills make the iPad much easier for him to use. His mom says it’s sturdy and can handle Leo’s touching, swiping, and tapping. Leo has already mastered more detailed drawings. He enjoys apps such as the spelling programs, First Words, and IwriteWords. One program the entire family has used to help Leo is Stories2Learn. Shannon says, “Our entire family had a great time putting together the photos, captions, and voiceover for this social story about Leo visiting a local cafe – the process was so easy, and fast, and Leo loves the story so much I had to have his sister demo it, as Leo likes the voiceovers to repeat several times.” Shannon shares with readers other iPad applications and augmentative and alternative communication (AAC) apps she’s found that help children with autism.

Read original article: The iPad: A Near-Miracle for My Son with Autism