Using Social Stories and Comic Strip Conversations To Promote Socially Valid Outcomes for Children with Autism

ABSTRACT

Very little is documented regarding the efficacy of social stories and comic strip conversations for promoting an understanding of social situations and the appropriate social behaviors of individuals with autism spectrum disorder (ASD). In addition, few studies on the efficacy of social stories have examined whether outcomes are socially valid. The purpose of this article is to respond to some of the gaps in the literature on the efficacy of a frequently used intervention for children with ASD and to describe a family-centered collaborative approach to developing social stories and comic strip conversations. The results of intervention employing an A-B design are reported for two case vignettes. Clinical implications, limitations of the available data, and potential factors contributing to outcome variability are discussed.

KEYWORDS

Autism - social stories - comic strip conversations - intervention

REFERENCES

• 1 Gray C A. The New Social Storybook. Arlington, VA; Future Horizons 1994
• 2 Gray C A. Comic Strip Conversations. Jenison, MI; The Morning News 1994: 1-15
• 3 Gray C A, Garand J D. Social stories: improving responses of students with autism with accurate social information.  Focus on Autistic Behavior. 1993;  8 1-10
• 4 Gray C A. Teaching children with autism to read social situations. In: Quill KA Teaching Children with Autism: Strategies to Enhance Communication and Socialization. New York, NY; Delmar 1995: 219-242
• 5 Gray C A. Social stories and comic strip conversations with students with Asperger syndrome and high-functioning autism. In: Schopler E Asperger Syndrome or High-Functioning Autism?. New York, NY; Plenum Press 1998: 167-194
• 6 Smith C. Using social stories to enhance behavior in children with autistic spectrum difficulties.  Educ Psychol Pract. 2001;  17 337-345
• 7 Grandin T. The learning style of people with autism: an autobiography. In: Quill KA Teaching Children with Autism: Strategies to Enhance Communication and Socialization. New York, NY; Delmar 1995: 33-52
• 8 Kuoch H, Mirenda P. Social story interventions for young children with autism spectrum disorders.  Focus on Autism and other Developmental Disabilities. 2003;  18 219-227
• 9 Rogers M F, Smith Myles B. Using social stories and comic strip conversations to interpret social situations for an adolescent with Asperger syndrome.  Interv Sch Clinic. 2001;  36 310-313
• 10 Rowe C. Do social stories benefit children with autism in mainstream primary schools?.  Br J Spec Educ. 1999;  26 12-14
• 11 Safran S P, Safran J S, Ellis K. Intervention ABCs for children with Asperger syndrome.  Top Lang Disord. 2003;  23 154-165
• 12 Lorimer P A, Simpson R L, Myles B, Ganz B. The use of social stories as a preventative behavioral intervention in a home setting with a child with autism.  J Pos Behav Interven. 2002;  4 53-60
• 13 Baron-Cohen S. Mindblindness. London, UK; MIT Press 1995
• 14 Baron-Cohen S, Leslie A M, Frith U. Mechanical, behavioural and intentional understanding of picture stories in autistic children.  Br J Dev Psychol. 1986;  4 113-125
• 15 Leslie A M, Frith U. Autistic children's understanding of seeing, knowing and believing.  Br J Dev Psychol. 1988;  6 315-324
• 16 Dunn J, Bretherton I, Munn P. Conversations about feeling states between mothers and their young children.  Dev Psychol. 1987;  27 132-139
• 17 Ruffman T, Perner J, Parkin L. How parenting style affects false belief understanding.  Social Development. 1999;  8 395-411
• 18 Barry L M, Burlew S B. Using social stories to teach choice and play skills to children with autism.  Focus on Autism and other Developmental Disabilities. 2004;  19 45-51
• 19 Cullain R E. The effect of social stories on anxiety levels and excessive behavioral expressions of elementary school aged children with autism.  Dissertation Abstracts Int. 2000;  62 2383
• 20 Ivey M L, Heflin J, Alberto P. The use of social stories to promote independent behaviors in novel events for children with PDD-NOS.  Focus on Autism and other Developmental Disabilities. 2004;  19 164-176
• 21 Kuttler S, Myles B, Carlson J K. The use of social stories to reduce precursors to tantrum behavior in a student with autism.  Focus on Autism and other Developmental Disabilities. 1998;  13 176-182
• 22 Norris C, Dattilo J. Evaluating effects of a social story intervention on a young girl with autism.  Focus on Autism and other Developmental Disabilities. 1999;  14 180-186
• 23 Swaggart B, Gagnon E, Bock S, Earles T. Using social stories to teach social and behavioral skills to children with autism.  Focus on Autistic Behavior. 1995;  10 1-16
• 24 Thiemann K S, Goldstein W. Social stories, written text cues, and video feedback: effects on social communication of children with autism.  J Appl Behav Anal. 2001;  34 425-446
• 25 McCauley R. Assessment of Language Disorders in Children. Mahwah, NJ; Lawrence Erlbaum 2001
• 26 Crais E R. Families and professionals as collaborators in assessment.  Top Lang Disord. 1993;  14 29-40
• 27 Lord C, Rutter M, DiLovore P C, Risi S. Autism Diagnostic Observation Schedule-WPS Edition. Los Angeles, CA; Western Psychological Services 1999
• 28 Dunn L M, Dunn L M. Examiner's Manual for the Peabody Picture Vocabulary Test. 3rd ed. Circle Pines, MN; American Guidance Service 1997
• 29 Tawny J W, Gast D L. Single Subject Research in Special Education. Columbus, OH; Merrill 1984
• 30 Barlow D H, Hayes S C, Nelson R O. The Scientist-Practitioner: Research and Accountability in Clinical and Educational Settings. Elmsford, NY; Pergamon Press 1983

Appendix A Social Stories Developed for Timothy and Victoria

• Timothy

• “How To Be Nice to My Sister”

• I have a younger sister, [name].

• She is learning how to talk.

• Sometimes she uses hands to talk.

• Or she uses her picture book to talk.

• Sometimes I don't want to play with [name] because she makes me mad.

• Sometimes I get mad and frustrated because [name] can be hard to play with.

• Sometimes she might hit me and doesn't play how I want.

• She might do this because she has a hard time talking and using her words.

• When [name] makes me mad, I might yell or say mean things.

• I might say “I don't like [name]!”

• This makes [name] sad. This makes my Mommy sad too.

• My Mommy gets sad because she loves me and [name], and she wants us to get along.

• I'm the big brother so I can help my Mommy by being nice to [name].

• I can help teach her how to play and talk.

• When [name] makes me mad, I will try to remember to not say mean things.

• When [name] makes me mad, I can say “I don't want to play right now!”

• I could also ask a grown-up for help.

• My Mommy loves it when [name] and I play nicely.

• Victoria

• “Do I Know How Others Feel?”

• I like to swim and have fun in the water.

• My mom and my sisters like to have fun in the water too.

• Sometimes I like to keep doing things, like swimming, when others want to stop.

• My mom, my sisters, or my friends might not want to do what I want to do.

• It hurts my feelings when people don't want to keep doing what I want to do.

• When other people don't want to keep doing what I am doing, that's okay.

• They may be tired.

• They may want to go home.

• Or they may want to do something else.

• When they want to do something different, I will try to remember that they might feel differently than I do.

• It makes others happy when I understand how they feel.

• Even though I want to keep playing, I can say “Thank you for playing in the water with me. Maybe we can play in the water another time.”