Using Motor-Based Role-Play to Enhance Social Skills in a Nonverbal Adolescent With High Functioning Autism: A Case Report

In this study the authors collected pilot data about the effect of a motor-based role-play intervention on the social skills of a nonverbal adolescent with high functioning autism. Single subject design was used to tally frequency of targeted social skills at baseline, intervention, and 3-month probe. Intervention was delivered once per week in 1-hour sessions over 4 weeks. The Evaluation of Social Skills was also used at baseline and 3-month probe to assess changes in social skill quality. Although the participant's verbal use did not change, the quality and frequency of nonverbal social skill use increased significantly from baseline to 3-month probe (p = .038, t = ?3.556).     

Occupational Therapy's Emerging Role With Transitioning Adolescents in Foster Care

The American Occupational Therapy Association's Centennial Vision advocates for an emphasis on intervention and prevention services for children, young people, the aging, and those with severe and persistent mental illness. This article discusses mental health issues among adolescents in foster care, a population that would greatly benefit from occupational therapy services emphasizing skill development in the areas of independent living, vocation, and health. Additionally, current intervention modalities used by other disciplines with adolescents in foster care are explored. Finally, a pilot study demonstrating the opportunities for occupational therapists to influence the long-term outcomes of adolescents in foster care is described.     

FUNCTIONAL ANALYSIS OF INAPPROPRIATE SOCIAL INTERACTIONS IN STUDENTS WITH ASPERGER'S SYNDROME

We analyzed the inappropriate social interactions of 3 students with Asperger's syndrome whose behavior was maintained by social positive reinforcement. We tested whether inappropriate social behavior was sensitive to social positive reinforcement contingencies and whether such contingencies could be reversed to increase the probability of socially appropriate responding. Our results show that social positive reinforcers can be identified for inappropriate social interactions and that appropriate social behaviors can be sensitive to reinforcement contingency reversals.     

Perceived Occupational Concerns and Sensory Processing Patterns of Mothers in a Temporary Assistance for Needy Families (TANF)-to-Work Program

In this study, the authors examine the perceived occupational concerns, typical daily routines, and sensory processing of mothers in a mandatory Temporary Assistance for Needy Families return to work program. Participants were five female members of a transitional work program for single parents with mental illness. The Canadian Occupational Performance Measure and the Adult Sensory Profile were administered. The study found that the most frequently identified occupational problems were leisure and self-care. All participants scored as having at least one atypical sensory processing pattern. Future research should investigate the efficacy of an occupational therapy intervention on this population's return to employment.     

Scene-Based Psychodramatic Family Therapy With Troubled Adolescents and Parents: A Pilot Study

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents’ problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants’ positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.     

Clinical Commentary

This paper describes a lengthy period of psychotherapy with a child. This treatment began only after a prolonged contact with other child and adolescent mental health services during which the child's difficulties, which had initially seemed to be ordinary behavioural problems, had proved puzzlingly intractable to a variety of interventions. Subsequent psychotherapy revealed a profound disorder of development which lay bath the Surface presentation. In a climate where Asperger's syndrome is often felt to be untreatable, this paper argues that some children, at least, can benefit from psychotherapy and can be helped towards real mental growth. Asperger's syndrome in children bears some striking similarities to narcissistic personality disorder as described in the adult psychoanalytic literature and this paper discusses some of the theoretical and clinical implications of the innate origins of Asperger's syndrome.     

Psychosocial mediation of fruit and vegetable consumption in the body and soul effectiveness trial.

In this study the authors examined psychosocial variables as mediators for fruit and vegetable (FV) intake in a clustered, randomized effectiveness trial conducted in African American churches. The study sample included 14 churches (8 intervention and 6 control) with 470 participants from the intervention churches and 285 participants from the control churches. The outcome of FV intake and the proposed mediators were measured at baseline and at 6-month follow-up. Structural equation modeling indicated that the intervention had direct effects on social support, self-efficacy, and autonomous motivation; these variables also had direct effects on FV intake. Applying the M. E. Sobel (1982) formula to test significant mediated effects, the authors confirmed that social support and self-efficacy were significant mediators but that autonomous motivation was not. Social support and self-efficacy partially mediated 20.9% of the total effect of the intervention on changes in FV intake. The results support the use of strategies to increase social support and self-efficacy in dietary intervention programs.     

Teaching children with autism to follow gaze shift: A brief report on three cases

This study evaluated the extent to which prompting and reinforcement increased three participants' correct selections of items following a therapist's gaze shift using a non‐concurrent multiple baseline design for two participants and an ABCD design for one participant. Results show that each participant learned to discriminate an adult's gaze direction to make a correct selection and each participant's responding generalized to selections with non‐reinforcing stimuli. Two participants also displayed the skill during probe sessions with their parents; however, the third participant required tangible reinforcement for correct selections to demonstrate the skill with a parent.     

Teaching Social Interaction Skills Using Cool Versus Not Cool

We evaluated the cool versus not cool procedure to teach social behaviors to three children diagnosed with autism. The researchers demonstrated each targeted behavior four times (two appropriate and two inappropriate demonstrations). Each participant then had to discriminate and state why the demonstration was appropriate or inappropriate. This was followed by the participant role-playing the targeted behavior with the researchers. We utilized a multiple baseline design to evaluate the procedure and the results indicated that the procedure was effective in teaching each targeted social behavior.     

Effects of student pairing and public review on physical activity during school recess

The purpose of this study was to evaluate the effects of student pairing and feedback during recess on children's step counts. During baseline, participants wore a sealed pedometer during recess. During intervention, we paired participants with higher step counts with participants with lower step counts. We encouraged teams to compete for the highest step count each day and provided feedback on their performance during each recess session. Results showed a large mean increase in step count from baseline to intervention. These results suggest that children's steps during recess can be increased with a simple and cost‐effective intervention.     

Increasing Behavioral Variability and Social Skill Accuracy in Children with Autism Spectrum Disorder

Although social skills training for children with autism spectrum disorder (ASD) often addresses deficits in social communication, restricted and repetitive social behaviors are less frequently targeted in the literature. The present study evaluated a manualized social skills training program, modified to incorporate lag schedules of reinforcement, to promote appropriate and variable responding in three children in a school setting. Participants attended social skills once weekly, with probes of social skills taking place daily. A multiple baseline design across target skills was used to determine intervention efficacy. Results of the study indicated that the social skills curriculum incorporating lag schedules of reinforcement resulted in substantial increases in the number of appropriate and variable responses demonstrated by participants during each probe session, as well as the number of appropriate and variable responses demonstrated overall.     

Telephone-based guided self-help for adolescents with chronic fatigue syndrome: A non-randomised cohort study

The aim of this study was to gain preliminary evidence about the efficacy of a new telephone-based guided self-help intervention, based on cognitive-behavioural principles, which aimed to reduce fatigue and improve school attendance in adolescents with chronic fatigue syndrome (CFS). A non-randomised cohort design was used, with a two-month baseline period. Sixty-three 11–18 year-old participants recruited from a specialist CFS unit received the intervention. Participants received six half-hour fortnightly telephone sessions and two follow-up sessions. Fatigue and school attendance were the main outcomes and the main time point for assessing outcome was 6 months post-treatment. Using multi-level modelling, a significant decrease in fatigue was found between pre-treatment and 6 month follow-up, treatment effect estimate = – 5.68 (?7.63, ?3.72), a large effect size (Cohen's d = 0.79). The decrease in fatigue between pre and post-treatment was significantly larger than between baseline and pre-treatment. A significant increase in school attendance was found between pre-treatment and 6 month follow-up, effect estimate = 1.38 (0.76, 2.00), a medium effect size (d = ?0.48). Univariate logistic regression found baseline perfectionism to be associated with poorer school attendance at six-month follow-up. In conclusion, telephone-based guided self-help is an acceptable minimal intervention which is efficacious in reducing fatigue in adolescents with CFS.     

Teaching social skills to emotionally disturbed adolescent inpatients

A social skills training program was evaluated with emotionally disturbed adolescent inpatients. The targeted social skills required an action or reaction within six skill areas. The program was adapted from a commercially available social skills training game that features the use of response specific feedback, self-monitoring, individualized reinforcers, and individualized performance criteria. A peer conducted the baseline and posttraining sessions while the training was conducted by an adult who had no previous interactive history with the subjects. A multiple baseline design across groups demonstrated that the program increased appropriate responding in all skill areas and that these effects generalized during the posttraining peer conducted sessions. A generalization test indicated that the subjects used their newly learned skills with a novel adult outside the training setting. The program appears quite applicable to emotionally disturbed adolescents since it targets skills in a variety of areas and employs standardized procedures to enhance replicability.     

Validation of a component model of social skill with outpatient adults

Little social skills research has been generated from applied outpatient settings. The present study examined the relationship of behavioral social skill components to independent judges' social skill judgments. A secondary question was whether nonverbal components would demonstrate a curvilinear relationship to social skill ratings. Forty-two outpatient adults at a community mental health center were videotaped role-playing eight scenes (four commendatory and four refusal). Videotapes were viewed in random order by community members who rated the subject's social skill in the situation. Trained raters scored the videotapes on standard behavioral components. While both nonverbal and verbal components accounted for significant portions of unique variance, the percentage of eye contact was an overwhelmingly large contributor to skill judgments. No curvilinear trend was evidenced for the nonverbal components. The study extended prior findings with psychiatric inpatients into applied outpatient settings and indicated that a component social skills model is equally applicable with outpatient adults. The findings replicated with a second sample of outpatient adults.     

A PROBLEM-SOLVING APPROACH TO SOCIAL SKILLS TRAINING IN EMPLOYMENT SETTINGS WITH MENTALLY RETARDED YOUTH

The present study examined two approaches to teaching social behaviors to 3 developmentally disabled youths in work contexts. In one approach, a problem-solving procedure was learned and transferred to different materials. Conversational probes monitored interactions between disabled employees and their co-workers and customers. A multiple baseline design demonstrated that the training produced generalization and maintenance of the targeted social behaviors to the work settings. A second approach based on a role-playing intervention produced no substantial generalization in the work setting. A social validation questionnaire administered to co-workers supported the efficacy of the problem-solving training procedure. The efficacy of social problem-solving training was discussed in terms of sufficient exemplars, common stimuli, and self-mediations.     

The Transtheoretical model’s processes of change in the heart of a physical activity intervention: A series of n-of-1

The objectives were a) to test whether a Processes of Change (POC)-personalized Transtheoretical model (TTM)-based intervention could increase physical activity (PA) among inactive adults, and b) to examine whether the intervention increased the level of TTM theoretical constructs. The following hypotheses were formulated: 1) PA levels will be significantly higher during and after the intervention in comparison to baseline measures; 2) the level of targeted POCs will increase during the intervention; 3) non targeted POCs will stay stable, and 4) self-efficacy and decisional balance levels will increase during the intervention. A series of N-of-1 with A (1 to 2-week)-B(10-week)-A'(2-week) design were conducted with 12 inactive adults. Behavioral counselors used behavior change techniques to target TTM constructs and supervise PA. Interventions were individualized based on the 5 POCs with the lowest pre-intervention level. Device-based and subjective PA along with TTM measures were collected weekly online. PA data were analyzed with piecewise linear models. A visual analysis was run to examine the TTM constructs. Device, self-reported and TTM data were available for five, seven and five participants, respectively. A significant self-reported PA increase for six participants was found during the phase B and A2. A significant device-measured PA increase was observed in two participants during the study. A substantial increase of targeted POC from baseline for all participants with available data was observed. This study provides the first evidence of behavioral and psychological effects of a POC-personalized TTM-based intervention in inactive adults.     

A Picture-Based Activity Schedule Intervention to Teach Adults with Mild Intellectual Disability to Use an iPad During a Leisure Activity

Individuals with developmental disabilities have limited opportunities to participate in leisure activities, frequently due to lack of skills. The purpose of the current study was to teach three adults diagnosed with mild intellectual disability to use an iPad in the context of playing the video game Angry Birds. We used an adapted multiple baseline across participants research design to teach the task, which included opening the cover of the iPad, unlocking the device, opening Angry Birds, playing the game, and putting the iPad away. Instruction took place during breaks in a private room at a sheltered workshop. During intervention, participants had access to an activity schedule to aid in completion of the task. In some cases, extra prompts were provided to increase attention to the activity schedule. All three participants showed improvement in the target skill with intervention and gains were sustained during the maintenance phase.     

Effects of positive youth development programs on school, family, and community systems

A review of efforts at social system change in 526 universal competence-promotion outcome studies indicated that 64% of the interventions attempted some type of microsystemic or mesosystemic change involving schools, families, or community-based organizations in an attempt to foster developmental competencies in children and adolescents. Only 24% of the reports provided quantitative data on the change that occurred in targeted systems. However, studies containing the necessary information produced several mean effect sizes that were statistically significant, and ranged from modest to large in magnitude. These data indicate that attempts to change social systems affecting children and adolescents can be successful. Future work should measure more thoroughly the extent to which the systemic changes that are targeted through intervention are achieved, and investigate how such changes contribute to the development and sustainability of the outcomes that might be demonstrated by participants of competence-promotion programs. The authors wish to thank David Wilson for supplying the macros used to calculate study level effect sizes and Mark Lipsey for supplying the SPSS macros used to weight effect sizes and calculate mean effects across studies. This study was supported in part by a grant from the William T. Grant Foundation (#2212) awarded to the first and last authors.     

Controlling competitive anger among male soccer players

Abstract

This study examined the effectiveness of anger awareness training (i.e., self-monitoring) and role-playing (i.e., modeling and behavioral rehearsal) in reducing participants’ angry behavior and angry feelings. Male participants (N = 57) from intact soccer teams were randomly assigned to a role-playing, an anger awareness, or a control group. Pretreatment anger scores indicated that all three groups exhibited similar anger dispositions before the study began. Following pretreatment assessment, angry behavior and self-reported anger were observed and measured during a 15-game round-robin soccer season. Analyses revealed that although angry feelings remained consistent across the duration of the study, the role-playing group was more effective than both the anger awareness and control groups in controlling angry behavior. Findings indicate that although the use of anger awareness and role-playing interventions can reduce angry behavior, the role-playing intervention was a more effective method.