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Behavioral Intervention

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					Behavioral Intervention

  Elizabeth Roberds

     EDPSY 689

     May 4, 2010
Introduction

       Ted is an 8-year-old male currently enrolled in the 2nd grade at Wright Elementary

School. Ted first came to the attention of Ms. Roberds when she was asked to conduct an

evaluation of Ted to see if he qualified for special education services for autism. The evaluation

file was given to Ms. Roberds by Dr. Daisy, the school psychologist at Wright Elementary

School. At the case conference it was decided that Ted met requirements for special education

services for autism, and that he should recieve social skills training. The case conference

committee decided that social skills training could be carried out five days a week every three

weeks for a period of 30 minutes each session. This time was chosen because it was during the

time that Ted had music class, and as Ted experienced sensory discomfort in music class, he was

only required to stay for the first 15 minutes. Ms. Roberds offered to organize the social skills

training for Ted.

Behavioral Definition

       Ted’s 2nd grade teacher, Mrs. Peabody, reported that Ted had significant difficulty in

social interaction with other students in his class and grade. Mrs. Peabody reported that Ted

struggled to appropriately approach other students, initiate conversations, and maintain

conversations. Specifically, she reported that Ted frequently failed to make eye contact, come

close enough to other students, or speak loudly enough to other students. As such, other students

frequently did not understand or notice that Ted was trying to talk to them, and often did not

respond to him. The behaviors reported by Mrs. Peabody, in addition to the observation that Ted

tended to discuss only a few topics of interest to him, were confirmed by Ms. Roberds when she

observed Ted in his classroom and during gym class.
       Given the concerns presented by Mrs. Peabody and the observations made by Ms.

Roberds, the goal of the intervention was to increase the frequency of successful social

interactions Ted had with his second grade classmates. Specifically, the goal of the intervention

was to increase the frequency of successful social initiations. Within this intervention,

successful social initiations were defined as instances in which Ted approached a classmate or

otherwise got the attention of a classmate (such as a tap on the shoulder) and said something to

which the classmate responded in some way (including non-verbal responses such as nodding

yes or no, shrugging of the shoulders, or giving a thumbs up). A non-example of this behavior

would be a verbal statement directed at a classmate that was not acknowledged by that classmate

in any way. Another non-example of this behavior would be when Ted approached his teacher

or another school staff member and initiated conversation. Lastly, a non-example of this

behavior would be if Ted verbally or non-verbally responded to another student’s initiation of

conversation.

Problem Analysis and Problem Validation

       According to data obtained during Ted’s evaluation, Ted experienced slight

developmental delay, and received occupational, physical, and speech therapy beginning at age

18 months and ending at age 3 years. Ted was diagnosed with ADHD in kindergarten and takes

Ritalin 15mg three times a day. Ted currently sees a psychiatrist for ADHD and psychiatric

services. Ted does not have any apparent vision or hearing difficulties. Ted used a touch board

to communicate until age 3 years and has a history of unusual responses to sensory experiences

such as a dislike of water, swinging, being dirty, and certain food textures and smells. According

to his mother, Ted’s sensitivity to certain foods and substances, as well as loud noise, is still

severe. She described specific behaviors of concern to her as arm flapping while jumping,
spatial difficulty, sensory sensitivity, obsession, and impulsiveness. Ted has a history of being

obsessed with lights, fans, and numbers. Ted’s mother reported that he is extremely interested in

cars and videogames. She described Ted as obsessive, easily distracted, impulsive, and socially

awkward. She reported that Ted has difficulties such as arguments and power struggles with

both adults and other children.

       Cognitively, Ted had a profile of strengths and weaknesses that suggested Borderline to

High Average intellectual abilities with specific difficulties in perceptual reasoning and verbal

comprehension and specific strengths in processing speed and working memory. Ted appeared

to have specific difficulty reasoning about abstract or unfamiliar concepts. His Average to

Superior academic achievement in the areas of Oral Language, Reading, Written Language and

Mathematics were higher than expected given Borderline to Low Average Perceptual Reasoning

and Verbal Comprehension. Academically, Ted has received mainly A’s since kindergarten and

participates in an advanced reading group. The school reported no academic concerns.

       As stated previously, the behaviors reported as of concern by Mrs. Peabody were

confirmed by Ms. Roberds when she observed Ted in his classroom during a language arts

period. During this class period, students were expected to complete a series of activities,

including finding a partner and playing a game with that partner. During this time, Ted

approached students on multiple occasions and attempted to ask them to be his partner. On all

five occasions, Ted failed to gain the attention of the other students; he spoke too softly to be

heard, did not make eye contact, and did not physically approach them close enough to be

noticed. Only when a classmate approached Ted was he able to find a partner. Within the

context of the structured game, Ted was able to respond appropriately, but did not engage in

conversation. Ted was also observed to struggle in the ways described by Mrs. Peabody when he
was observed during gym class. On four occasions Ted attempted to converse with other

students and did not receive a response. In addition to the concerns described by Mrs. Peabody,

during the course of the evaluation and during testing, Ms. Roberds observed that when Ted was

one-on-one, he did manage to be engaged in conversation with her, but strongly preferred to talk

about specific topics that were of interest to him, such as a specific cartoon television show and

specific video games. Overall, it appeared as though Ted struggled the most with initiating

conversation successfully with other students, and that this one skill deficit was what was

negatively impacting his social experiences most of all. Observation of random peers revealed

no instances in which other children in Ted’s classroom attempted to initiate conversation with

other students unsuccessfully. Clearly, a discrepancy was evident between Ted’s social approach

skills and those of his peers.

Baseline Data

       Baseline data was collected by Ms. Roberds on three occasions, over the course of two

weeks. More observations were planned within this two week period, but were unable to be

completed. Ms. Roberds chose to observe Ted in the lunchroom because it was an uninterrupted

period of time during which he was free to converse with classmates, that took place while Ms.

Roberds was at Wright Elementary (for example, due to scheduling, recess was not an option).

However, this plan was complicated by the fact that following the third observation, Ted was

required by school staff to eat alone at a desk in the hallway. As such, only three data points

make up the baseline. While Ms. Roberds would have preferred to collect additional baseline

data, the three data points suggest a fairly stable range of behavior.

       At each observation session, Ms. Roberds recorded the frequency of Ted’s successful

social initiations for 15 minutes during lunch. Ms. Roberds made a tally mark every time Ted
attempted to initiate a conversation and the attempted initiation was successful. During the

baseline period, during 15 minutes of lunch, Ted successfully initiated an average of 0.33 times.

Overall the data indicate that Ted successfully initiated conversations zero to one times per 15

minute period. This baseline data is displayed in the following graph.


                        Baseline - Successful Initiation of
                     Conversation during 15 minutes of Lunch
               1.2

                1

               0.8
   Frequency




               0.6                                                                    Baseline
                                                                                      Average
               0.4

               0.2

                0
                            1                   2                   3


Goal Setting

               Given that Ted’s poor social behavior appeared to be negatively impacting the frequency

and quality of his peer interactions, it was hoped that considerable improvement might occur if

he were taught social skills relating to conversation initiation in a concrete way. After consulting

the book Building Social Relationships: A Systematic Approach to Teaching Social Interaction

Skills to Children and Adolescents with Autism Spectrum Disorders and Other Social Difficulties

(Bellini, 2006), which emphasized dynamic, individuated goal setting based on understanding of

the child’s abilities through observation, Ms. Roberds decided to set a goal of two successful

social initiations during fifteen minutes of lunch (one more than his very best day of baseline,

which would double the number of his highest day of baseline). This goal was set with the
understanding that Ted would remain unaware of any specific goal, other that he was being

encouraged to converse with his classmates more frequently, and with the understanding that any

improvement in Ted’s successful initiations with his peers over the nine weeks would be

celebrated by school staff.


                        Baseline and Goal Setting of Successful
                     Initiation of Conversation during 15 minutes
                                        of Lunch
               2.5

                2
   Frequency




               1.5
                                                                                    Baseline
                1
                                                                                    Average

               0.5

                0
                     Base. Ob. 1 Base. Ob. 2 Base.Ob. 3   Goal Wk 1 Goal Wk 9


Intervention Plan

Procedures/Strategies

               The intervention chosen for Ted was based on recommendations from Building Social

Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and

Adolescents with Autism Spectrum Disorders and Other Social Difficulties (Bellini, 2006).

During each session, Ted and the BSU student would play a short word association game as a

warm up, during which time they took turns saying the first word that came to their minds,

followed by an activity in which the BSU student and Ted would take turns asking each other

questions about common topics such as family, pets, foods, and hobbies. Ted and the BSU

student would then create a “conversation map”, which plans in detail a conversation that might
be had with one of Ted’s classmates. Ted was asked to consider who he wanted to talk to, how

and when he would approach them, what he might say to start the conversation, how the other

student might respond, and how Ted would respond, and so on. At each level of the

conversation planning, Ted was asked to come up with at least three possibilities of what he

might say and what his classmate might say in response. At the end of the session, if there was

time, the BSU student read Ted a social story that they had written that related to approaching

others to talk to them in a school setting, such as the lunchroom, recess, during group work, or

free time. Necessarily, this intervention was somewhat fluid, as the BSU student responded to

Ted’s difficulties and offered encouragement and suggestion based on the specific topic at hand.

       Ted did not receive any reward for his participation in the intervention. He was generally

happy to participate, with the understanding that the alternative was to return to music class,

which he did not enjoy. Ted was unaware that he was being observed in the lunch room. The

data obtained from these observations were used to evaluate the effectiveness of the intervention.

Materials

       The materials utilized in this intervention included paper and pencils for conversation

mapping, as well as social stories related to social initiation in a school setting, which were

written by BSU students. The intervention plan, including the word association, conversation

game, conversation mapping, and social stories, came from Building Social Relationships: A

Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with

Autism Spectrum Disorders and Other Social Difficulties (Bellini, 2006), which was used in the

planning process.
Time and Location

       This intervention took place at Wright Elementary School in the conference room and the

library – whichever was available. The intervention was conducted every three weeks, during

the last 30 minutes of music time, for all five days of that week, over the course of nine weeks.

Ted’s class only had music class every three weeks.

People Responsible

       Ms. Roberds was primarily responsible for this intervention. This responsibility included

organizing three other BSU school psychology students who aided in the implementation of this

intervention. Ms. Roberds conducted regular observations of Ted in the lunchroom and was

solely responsible for progress monitoring, charting, and analyzing the data collected. Treatment

integrity was assessed through interview of other BSU students and was reported to be generally

good, though BSU students reported rarely having time to read the social story. Due to

confusion with BSU student scheduling, Ted missed the intervention on two occasions. Likely

due to Ted being excessively tired on one occasion, Ted refused to participate in the intervention

and put his head down on the table.

Measurement Strategy

       Ted was observed by Ms. Roberds during his lunch period in the lunchroom for periods

of fifteen minutes each time. During these observations, Ms. Roberds tallied the number of

times that Ted successfully initiated conversation, based on the behavioral definition, with a

classmate. This time period was selected due to the unrestricted and social nature of lunch. Ted

was to be observed once a week on Mondays, the day that Ms. Roberds was generally at Wright

Elementary.
Decision-Making Plan and Progress Monitoring

               Including baseline data, there were a total of seven data points spanned 9 weeks. This

data was graphed and analyzed by Ms. Roberds as it became available and was compared to the

initial goal. Ted’s progress throughout progress monitoring suggested that he was on track to

reach the goal of two successful social initiations during fifteen minutes of lunch and as such the

intervention was not modified at any time. The following graph illustrates Ted’s progress.


                     Progress Monitoring - Successful Initiation of
                       Conversation during 15 minutes of Lunch
               3.5

                3

               2.5
   Frequency




                2                                                                       Ted
               1.5                                                                      Average

                1                                                                       Goal

               0.5

                0
                       Obervation 1   Observation 2   Observation 3   Observation 4


               The data obtained from this intervention process may be used by school staff to guide

additional social skills training.

Evaluation

               The graph below represents the overall results of this intervention.
                        Successful Initiation of Conversation
               3.5

                3

               2.5
   Frequency




                2

               1.5                                                                      Ted
                1                                                                       Average

               0.5                                                                      Goal

                0




               As the intervention phase has just been terminated due to the end of the BSU semester,

no post-intervention data is yet available. Evaluation of the existing data suggests that the

intervention was effective. Ted met, and on one occasion exceeded, the goal of two successful

initiations. The increase and fairly consistent data following the introduction of intervention may

suggest that this intervention introduced basic social “rules” that Ted lacked, but that he readily

learned and could apply given direct instruction and practice. Feedback from adults who know

Ted at Wright Elementary School indicated that they felt over the course of the intervention he

improved significantly in his conversation initiation skills, made better eye contact, and did a

better job at engaging others and maintaining conversation. Such feedback supports the

conclusion that this intervention was effective, even at a wider level. Social skills training with

Ted will necessarily be ongoing, but responsibility for future intervention has been transferred to

Wright Elementary School staff.
                                          References

Bellini, S. (2006). Building Social Relationships: A Systematic Approach to Teaching Social

       Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and

       Other Social Difficulties. Autism Asperger Publishing Company: Shawnee Mission, KS.

				
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