A Systematic Approach to Teaching Social Skills to Children with Autism Spectrum Disorders: A Guide for Practitioners.

S ocial skills training (SST) is a topic of great importance in the field of autism as social skill deficits are a prominent feature of autism spectrum disorders (ASD). Common social deficits include (a) difficulty with receptive and expressive use of nonverbal cues such as facial expressions, gestures, and body language; (b) difficulty establishing peer relationships and friendships; (c) lack of shared enjoyment and failure to consider the interests of others; and (d) lack of social and emotional reciprocity (American Psychiatric Association, 2000). Deficits in social cognition are also common, including difficulties taking another person’s perspective, difficulties with social problem solving, and lack of self-awareness (Bellini, 2006). Thus, improving and/ or facilitating the acquisition and performance of social skills across multiple settings should be the primary purpose of SST. Unfortunately, few children receive SST as an integral part of their treatment and educational programming (Hume, Bellini, & Pratt, 2005). To make matters worse, those youth who are receiving SST may not be benefitting from the programming. Although SST can be viewed as an essential component of any treatment or educational plan for children with ASD, the results of numerous meta-analytical studies have questioned the effectiveness of this modality. In general, these studies have demonstrated that traditional SST programs are only minimally effective in teaching social skills to youth with learning disabilities, emotional and behavioral disorders, and ASD (Bellini, Peters, Benner, & Hopf, 2007; Forness & Kavale, 1996; Gresham, Sugai, & Horner, 2001; Mathur, Kavale, Quinn, Forness, & Rutherford, 1998; Quinn, Kavale, Mathur, Rutherford, & Forness, 1999). Results of these studies indicate that traditional SST is particularly ineffective in promoting the transfer of skills across settings and persons. In addition, when compared with 12 other intervention modalities, SST training ranked as the ninth most effective strategy, well behind behavioral, language, academic, and psychopharmacological interventions (Forness & Kavale, 1996). Bellini et al. (2007) conducted the only meta-analysis of SST for youth with ASD. The meta-analysis included 55 published research studies investigating school-based SST for youth with ASD. Nearly half of the reviewed studies produced low treatment effects, and a majority of the studies produced low generalization effects across persons, settings, and play stimuli. Although the collective outcomes of schoolbased SST for youth with ASD were disappointing, the results do help to elucidate factors that lead to more beneficial social outcomes for youth with ASD. A synthesis of the Bellini et al. (2007) meta-analysis with other meta-analytical reviews reveals the following eight recommendations for effective social skills programming (Bellini, 2009): (a) Increase the dosage of social skill interventions, (b) provide instruction within the child’s natural setting, (c) match the intervention strategy with the type of skill deficit, (d) conduct a reliable and valid social skill assessment, (e) develop clear and measureable treatment objectives, (f) facilitate the generalization of skills across settings and persons, (g) ensure intervention fidelity, and (h) implement systematic social skills programming. The final recommendation (i.e., implement systematic social skills programming) is critical as it incorporates many of the other recommendations for programming. That is, SST cannot be systematically delivered without the inclusion of reliable and valid social skills assessment. The present article will focus on the eighth and final recommendation by outlining a program to systematically deliver social skills instruction to children with ASD. The article will discuss the structure, format, procedures, and methods used at the Social Skills Research Center (SSRC) to teach social skills and measure the social outcomes of youth with ASD. The primary purpose of the article is to provide a model for practitioners seeking to deliver systematic social skills programming to children with ASD. The collective outcomes of children participating in the SSRC program over the course of a 15-month period will be presented. The purpose of presenting these data is to provide an example of how to use data to evaluate overall program effectiveness and to make programming modifications. The article will conclude with a discussion of clinical observations gleaned from the analysis of these data.