Strategies that promote independence for children and young people with autism

Activity schedules

There are two ways of using activity schedules, one could either make a schedule for a whole day, using images or pictures to sequentially describe activities that are going to happen on that day or for a particular activity – sequentially describing the steps within that activity.  They can be straightforward, using drawings in a sequence and laminating the papers or sent to the child via mobile phones or tablets. There are apps for scheduling activities, which can be used for making activity schedules.

 

Activity schedules can also provide prompts for transition. They can be combined with rewards for completing tasks, rewarding progress on tasks, and prompts such as sounds. Children can be given prompts to learn how to use such schedules and then gradually decrease such prompts – the ultimate goal should be to reduce adult prompting and support.

Tactile prompts

Tactile prompts (such as a vibrating alarm from a mobile phone) can be sued as a discreet prompt help the child do something that needs to be done at certain fixed intervals (returning to the task at hand or initiating interaction in a play setting) and the child knows what is to be done. The child can learn with the help of such prompts, gradually reducing the prompts and the level of close support required and the stigma that goes with it.

Peer support

Peers can provide social and academic support through tutoring and cooperative learning. Peers can help in various settings such as conversations, learning and cooperative sharing during social and play activities. Peers provide support by asking and reminding, rewarding good behaviour, adapting activities, and creating a positive social environment. The adult’s task shifts from prompting the student with autism to rewarding and guiding the peer. Peer support can come from one individual or a pair of rotating buddies. Peers are natural support that has a positive effect on the social-communicative skills of the child with autism.

Self-monitoring

When individuals self-monitor, they notice certain aspects of behaviour on which they would otherwise not focus.  A person can be taught to self-monitor to increase the desired behaviour or to decrease an unwanted behaviour. Four issues need to be addressed for successful training in self-monitoring:

1. What behaviour needs to be monitored?
2. How the child will be praised or rewarded for successful self-monitoring?
3. What device or a method will be used to act as a reminder for the child? and
4. How will the child be helped to learn?

Self-monitoring can help in reducing stereotypic behaviour, increase appropriate play, increase independent daily living skills in the absence of an adult, increase on-task behaviour and pro-social behaviour.  Self-monitoring has been combined with support from peers and siblings and has been successfully paired with video modelling.

Video modelling

In video modelling, the child learns the right behaviour or the right way of doing a task from watching a video.  A target skill or behaviour is first chosen for video recording. Then, a recording is made of someone (preferably of the same age) playing the role and modelling the behaviour. The child with ASD can also be videoed doing (with help and prompts that can be edited out of the final recording) what needs to be learnt and practised. The video should usually be two to four minutes in length and watched by the person with ASD, often repetitively. The child is then encouraged to imitate the skill observed on the video in a real-life context.

Many people with ASD are better able to remember visual information they’ve seen on a video. Children with autism may also be able to focus better where the camera is focusing. Video modelling can be successfully combined with other approaches such a self-monitoring and practising. It has the potential to promote independent behaviours and can reduce the over-reliance on prompts from other people.

Individual work systems

A structured work system helps in doing tasks independently. The work system communicates four pieces of information to the child:

1. the task that is required to be done
2. how much work there is to be completed
3. how the student knows the work is finished or how much progress they have made, and
4. what to do when the work is finished.

The work system should have

1. a) a structure, such as labelled boxes or spaces,
2. b) visual schedules depicting the steps and the sequences to be followed,
3. c) a visual description of what to do while in a work area, and
4. d) visually clear information on when the task ends and what is the achievement for the child.

Social stories

Many children with autism spectrum disorders who have reasonable verbal and cognitive abilities find it challenging to understand others’ thoughts, desires and intentions. Social stories (Gray & Garand, 1993; Gray, 1997) have emerged as an effective intervention in helping children overcome such difficulties.

A social story about a chosen situation tells the reader or the listener what people in that situation may be doing, thinking, or feeling and about the sequence of events happening in that situation. Depending on the child’s need and ability, the story can be tailored to include further details of social cues (for example, body language or expressions) and their meaning.

The family can construct a social story, often with the child’s involvement, and include recent situations and events. Such social stories used by families have proven to improve the social understanding and behaviour of children with autism spectrum disorders. They can also increase pro-social or socially acceptable behaviour and social flexibility in children.

Social stories can be combined with other ways of helping the child, such as creating video feedback or video modelling. Such combined ways of help have proven to be more effective than any single type of intervention.

How are social stories written?

Gray (1998, 2000) advises using more descriptive or affirmative sentences than controlling or directing language or sentences in a story.  Swaggart et al. (1995) have provided guidance on practical steps for creating a social story:

1. Decide the behaviour that you want to change as the result of reading or listening to this story
2. Gather information about what is currently happening to later compare and see whether any change is happening or not.
3. Write a short story; yes, keep it short. Keep your language mainly descriptive and use very few directive or control sentences.
4. Make use of photographs or drawings and try not writing more than three to four lines per page.
5. Make this story interesting, motivate the child to read it with you or with others creating an enjoyable environment while doing so.
6. If possible, discuss the story with the child encouraging the child to talk about what has happened in the story. Try to show and share interest rather than behave like a teacher.
7. Revise the story with time, add new elements, and involve the child in making it more interesting and relevant.
8. If possible, make an audio or video recording of the story that the child can listen to or watch.

Websites for further information about social stories:

https://carolgraysocialstories.com/social-stories/what-is-it/

https://best-practice.middletownautism.com/approaches-of-intervention/social-stories/

References:

Gray, C.A. (1997). Social stories and comic strip conversations: Unique methods to improve social understanding. Paper presented at the Autism 1997 Conference of Future Horizons, Inc., Athens, GA. INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol 21 No.3 2006 173

Gray, C.A. (1998). Social stories and comic strip conversations with students with Asperger syndrome and high-functioning autism. In E. Schopler, G.B. Mesibov, & L.J. Kunce (Eds.), Asperger syndrome or high-functioning autism (pp. 167-198)? New York: Plenum Press.

Gray, C.A. (2000). The new social storybook. Arlington, TX: Future Horizons.

Gray, C.A., &Garand, J.D. (1993). Social stories: Improving responses of students with autism with accurate social information. Focus on Autistic Behavior, 8(1), 1-10.

Swaggart, B.L., Gagnon, E., Bock, S.J., Earles, T.L., Quinn, C., & Myles, B.S., et al. (1995). Using social stories to teach social and behavioral skills to children with autism. Focus on Autistic Behavior, 10(1), 1-15.