Let’s SocializeLet’s Socialize Social Skills Training for Adolescents with Aspergers

Presented By:Lorra Kapteyn Simcoe Community

ServicesEvangelo Boutsis Behaviour Management

Services of York and Simcoe

Project funded by the Ministry of Child and Youth Services (MCYS).

Intent of project is to evaluate the outcome of Central East regional programs designed to provide clinical treatment services for transitional aged youth with ASD.

It is hoped that we gain an understanding of the best practices to use with this population.

Lake Ridge Community Support Services (2007)

Proposals submitted Three projects selected Annual funding provided for each project One time funding provided for service

evaluation. Preliminary reports submitted to MCYS

May 2007 May 2008

Final report to be submitted May 2008 Lake Ridge Community Support Services

(2007)

Autism Spectrum DisorderAutism Spectrum Disorder Autism is a complex neurological disorder

that affects nearly 1 in 165 children. In Ontario alone, there are approximately 70,000 people with one of a range of “Autism Spectrum Disorders” (ASD) - autism (the most severe), Pervasive Developmental Disorders, not otherwise specified (PDD-NOS), and Asperger’s Syndrome (Schopler & Mesibov,1986)

Susan Kasprzak (2008)

Autism Spectrum Disorder Autism Spectrum Disorder ContinuedContinued ASD is characterized by problems associated with

processing and responding to information Social deficits may be considered the primary

defining aspect of ASD (Schopler & Mesibov, 1986)

Problems tend to fall into three categories: Difficulty relating to others: Affection, eye contact Problems with speech and non-verbal communication Limited and repetitive interests and behaviour:

repetitive behaviours, rituals, and obsessions are characteristic of those with ASD

Susan Kasprzak (2008)

Autism Spectrum Disorder Autism Spectrum Disorder Continued…Continued… Research studies conducted with children with ASD

have shown that effective intervention can have a positive impact on social skills (Matson, Macklin & Helsel, 1983; Taras, Matson & Leary, 1988)

Applied Behaviour Analysis (ABA) has been well documented over the last fifty years as a positive treatment for autism, specifically in the areas of speech, social skills, self-help skills, play, and reducing acting out behaviours often consistent with autism (Autism Support Network, 2005)

Susan Kasprzak (2008)

Applied Behaviour AnalysisApplied Behaviour Analysis“the process of systematically applying interventions based

on the principles of learning theory in order to improve socially significant behaviours to a meaningful degree” (Baer, Wolf & Risley, 1968)

ABA is used in the following ways: To increase behaviours (reinforcement) To teach new skills (instruction and reinforcement) To maintain behaviours (teaching self control and self-

monitoring) To generalize or transfer behaviour To reduce conditions under which interfering behaviours

(e.g., self-injury) occur To reduce interfering behaviours

Susan Kasprzak (2008)

Introduction: Social Skills Introduction: Social Skills TrainingTraining Consistent with MCYS Autism Intervention

Program Guidelines (August 2006) the overall intent of these programs was to utilize Applied Behaviour Analysis (ABA) principles to teach teens on the ASD spectrum social skills

Applied Behaviour Analysis (ABA) principles are taught to caregivers so that they can be applied in the home to further develop and enhance their adolescents’ social skills

Susan Kasprzak (2008)

Introduction: Social Skills Introduction: Social Skills TrainingTraining

Two Types of Training Offered:1) Social Skills2) Social Sexual knowledge

Offered To:1) Adolescents diagnosed with Aspergers or

high functioning Autism2) Caregivers

Program OverviewProgram Overview Groups for adolescents and their caregivers

were offered once a week Six consecutive weeks Two hour weekly sessions Groups took place in same building (SCS) Caregivers were assigned weekly homework

Adolescent Program OverviewAdolescent Program Overview Adolescents ages 12-16 diagnosed with ASD Two curriculums developed:

Social Skills Training: Assertiveness skills: Greetings, starting conversations Self-Control Skills: calming strategies, anger management skills Empathy Skills: identifying emotions, non-verbal cues

Resources used : Preparing for Life by Jed Baker, Circles program, Be Cool Series

Social Sexual Knowledge Training:

Relationships, boundaries, private vs. public (behaviours/places/clothing), forms of intimacy etc..

Resources used : Circles program, YAI relationship series

Adolescent Group FormatAdolescent Group Format

Social skills and social sexual groups session order of tasks/activities includes:

1) Check- in 2) Review last week’s skill/topic 3) Teach this week’s target social skill/topic 4) Practice this week’s target skill/topic 5) Break 6) Activity 7) Free time 8) Reward Store (participants can submit earned

stickers for item for reward store)

Parent Program OverviewParent Program Overview Parent group ran concurrently to their adolescent group Two curriculums were developed:

Social Skills:

Introduction to applied behaviour analytic principles/strategies

Practice and discussion on strategies to facilitate target social skills/other appropriate behaviour

Discussions and support of parental concerns

Resources used: Preparing for Life by Jed Baker, Circles program/Be Cool Series

Social Sexual Skills:

Introduction/review of applied behaviour analytic principles/strategies

Resources used: Circles program/YAI relationship series

Discussions and support of parental concerns

Teaching Methods: Teaching Methods: Adolescent GroupAdolescent Group Individualized Building on skills Concrete Reinforcement Set Up for Success Repetition/Practice Taking advantage of opportunities Generalization Supportive Make it fun!!

Group ActivityGroup Activity Putting it all together!!!

Method: Participants & Method: Participants & SettingsSettings

Individuals served to date:20 Adolescents (5 Females, 15 Males)

37 Caregivers (Parent/Guardian)

Ages 12 – 16

Setting:Simcoe Community Services/Behaviour

Management Services Simcoe

Separate rooms in same building

Method: Data CollectionMethod: Data Collection

Design:

Single Case AB Design and Multiple Baseline Design

Pre-Post Questionnaires and Observational Measures

Method: Common Method: Common MeasuresMeasures

Social Skills Group: Social Skills Rating System (SSRS) (Student/Parent)

Vineland Adaptive Scale II (Parent)

Quality of Life (Student)

Behaviour measure by percentage of change (Student)

Social Sexual Groups (developed by SCS and BMS):

Social Sexual Knowledge Measure (Student)

Parent Comfort Talking about Sex (Parent)

Method: ProcedureMethod: Procedure

Pre-treatment assessment: Psychometric measures, skill probes

and interview.

Weekly 2 hour group training sessions for 6 – 8 adolescents for

six consecutive weeks.

Bi-weekly or weekly concurrent parent group training sessions.

Assigned bi-weekly or weekly homework for parents and teens

Follow-up period occurs between 1-3 months after the last session

Re-administer psychometric measures during follow-up period

Results: Social Skills Group Results: Social Skills Group #1#1

Adolescents 2,3, and 5 standard scores were statistically significant

Adolescents SSRS Standard Scores

0

20

40

60

80

100

120

1 2 3 4 5

Adolescents

Sta

ndar

d S

core

s

PRE

POST

Results: Social Skills Group Results: Social Skills Group #2#2

SSRS Standard Scores of Adolescents Rating of Adolescents (n=4)

0

20

40

60

80

100

120

1 2 3 4

Adolescents

Stan

dard

Sco

res

(mea

n=10

0,

sd=1

0) PRE

POST

Results: Social Skills GroupResults: Social Skills Group

Combined Social Skills Group Mean of SSRS Standard Scores

70

75

80

85

90

95

Teens Rating of Teens (n=9) Parent Rating of Teens (n=10)

Stan

dard

Sco

res

(mea

n=10

0,

PRE

POST

Results: Social Sexual Results: Social Sexual KnowledgeKnowledge

Student Social Sexual Knowledge Group Mean Scores (n=3)

0

10

20

30

40

50

60

70

PRE POSTSoci

al S

exua

l Kno

wle

dge

Gro

up M

ean

Mean Scores for Student SocialSexual Knowledge

Results: Social Sexual Results: Social Sexual KnowledgeKnowledge

Students Scores From Social Sexual Knowledge Measure (n=3)

01020304050607080

1 2 3

Students

Sco

res

PRE

POST

Results: Social Sexual Parent Results: Social Sexual Parent Comfort Talking about SexComfort Talking about Sex

Mean Scores for Parent Comfort Talking about Sex (n =9)

52

54

56

58

60

62

64

66

PRE POST

Mea

n Sc

ores

Mean Scores for Parent ComfortTalking about Sex

Results: Teen Participant Results: Teen Participant FeedbackFeedback

“Groups made me feel that others are similar to me”(Participant A,)

“I didn’t know the basic steps of conversations”(Participant B)

“Ever since I have started in your group I have been inspired. Through last week I made awesome progress in school. I still need to work on my skills at home and I

know you can help me. I thank you so, so, so, so MUCH!!

Thanks again”(Participant C)

Results: Feedback from Results: Feedback from ParentsParents

“I would like to offer my sincere thanks for the great job done by the workers operating the social skills

program. Our son took part and really enjoyed it. All of these young people were fantastic, and made the program very successful. Thanks again Vicki

Howard, John Clarke, Charity Gunn, Lorra Kapteyn, Evangelo Boutsis and Jamie Ellis. I hope your efforts

and expertise are recognized”.(Parent A)

Results: Feedback on Parent Results: Feedback on Parent TrainingTraining

“Enjoyed seeing their children progress through watching videos”

“Thought the program was terrific and truly enjoyed it!”

“It is therapeutic to share and sharing helped to bring out ideas”

“I found the leaders to be very informative, providing great strategies and caring”

“The best part was sharing similar experience, ideas, and solutions”

Future DirectionsFuture Directions Continue to provide both the social sexual

and social skills training groups in Simcoe County

Look into possible changes to the length of the group or sessions

Continue to integrate strategies to promote generalization

Continue with the evaluation of the program

Thank YouThank You All the teens and their families who

participated Jamie Ellis Kirsten Goodman Charity Gunn Deb Skelhorn John Clarke Vicki Howard