Wednesday, June 6, 2007

Social Stories

What are Social Stories?

Social Stories are a tool for teaching social skills to children with autism and related disabilities. Social stories provide an individual with accurate information about those situations that he may find difficult or confusing. The situation is described in detail and focus is given to a few key points: the important social cues, the events and reactions the individual might expect to occur in the situation, the actions and reactions that might be expected of him, and why. The goal of the story is to increase the individual’s understanding of, make him more comfortable in, and possibly suggest some appropriate responses for the situation in question.

A sample Social Story

Before we go too far into the specifics of Social Stories, let's take a look a simple sample story.

Lining Up

At school, we sometimes line up.

We line up to go to the gym, to go to the library, and to go out to recess.

Sometimes my friends and I get excited when we line up, because we’re going someplace fun, like out to recess.

It is okay to get excited, but it is important to try to walk to the line. Running can cause accidents, and my friends or I could get hurt.

I will try to walk to the line.

As may be evident, Social Stories are relatively short, straightforward descriptions of social situations, specifically detailing what an individual might expect from the situation and what may be expected of him.

The need for social skills intervention

Qualitative impairment in social interaction is a defining quality for a diagnosis of autism (DSM-IV, 1994) and is thought by some to be the defining characteristic of autism: social dysfunction may be what makes autism something more than just a language delay, etc.

Theory of Mind

Recently, the notion that those with autism may lack a theory of mind has circulated among those who study social impairments in individuals with autism. This deficit is essentially a lack of understanding that others have their own thoughts, feelings, plans, and points of view result in in difficulty understanding the expectations of others and an inability to predict what others will say or do in social situations. This theory of mind phenomenon appears to be unique to those with autism and largely independent of intelligence. Regardless of where an individual may fall within the spectrum of autism-like disorders they seem to exhibit this deficit, though it seems to be slightly less prevalent in those with Asperger's syndrome.

The benefits of Social Stories

How, then, do Social Stories help to address these special social needs and the often unique learning styles of those with autism? Social Stories attempt to address the "theory of mind" impairment by giving individuals some perspective on the thoughts, emotions, and behaviors of others. They help the individual better predict the actions and assumptions of others. Social stories also present information on social situations in a structured and consistent manner, a particularly appropriate approach for kids with autism, especially when dealing with skills and behaviors which are so fluid as those involved in social interactions. Along that line, Social Stories also give individuals direct contact with social information, contact through pictures and text as opposed to speech or observation, notable areas of weakness for kids with autism. Finally, Social Stories provide a little distance between teaching and the possible stresses of the social situation itself; they give the child a chance to practice the skills often and on his terms.

Identifying student needs

Of course, before one begins writing a Social Story, it should be determined exactly which skill or situation one wishes to focus upon. Before even this, though, it is often helpful to look at how a child socializes overall and to determine the possible efficacy of Social Stories in addressing his needs.

There are three broad categories into which we can classify social impairments:

  • Social avoidance -- Kids who would fall into the category of socially avoidant might be those who tantrum, shy away from, or attempt to escape from social situations. Often, kids that are this avoidant of social situations are doing so because they have some hypersensitivity to certain sensory stimuli. Consequently, those sensory needs must be addressed prior to attempts at teaching social skills. A kid who is constantly overwhelmed by his environment is likely not going to be successful in many interventions. Social stories may well prove to be useful tools with such children, but only after the sensory needs of those children have been met (through sensory integration, vision therapy, auditory integration, etc.).

  • Social indifference -- Social indifference is the social impairment common to the majority of children with autism. Children who are socially indifferent are those who do not actively seek social interaction, but at the same time, do not aggressively avoid such interaction. Social Stories are often quite effective with socially avoidant kids: they can simplify and illustrate social interactions, with the hope that increased understanding of those situations will make them more attractive and reinforcing for the child.

  • Social awkwardness -- Socially awkward children are typically higher functioning kids who may try very hard to gain and keep friends, but are hindered by a lack of reciprocity in conversation and interest -- they focus on their favorite topic or topics to the exclusion of most everything else -- and an inability to learn social skills and taboos by observing others. Social stories are often very effective with these individuals as they teach explicitly those skills and taboos that these children do not just pick up from their environment. Social stories provide them with a framework for successful social interaction: perspective on the thoughts, emotions, and beliefs of others in their environment, and suggestions of appropriate behaviors.
Having determined how a child socializes generally, one can now look to defining specific skills and situations to which focus will be given.

It is typically fairly evident to the child and whomever may be working with him which situations -- at home, at play, or at school -- are proving difficult. Even if the child has little language, careful observation can often determine difficult situations. Situations from which a child withdraws, from which he attempts to escape, or in which he tantrums, cries, or becomes frightened may be appropriate targets for a Social Story. As Social Stories primarily address problems of social cognition -- situations in which it is the child's misunderstanding of the expectations and intricacies of the situation which are driving the difficulty -- it should be determined that it is indeed that deficient cognition that is the root of the problem and not some other issue (a sensory processing problem, for example).

Ideally, anyone who works with a child at school or at home -- parents, teachers, instructional assistants, specialists, etc. -- should be consulted prior to the writing of a story. Each may have some unique insight into the situation.

As a Social Story is intended to be written from the perspective of the child, it is paramount that the author is able to obtain that perspective. With higher functioning children, they can assist in the writing of the story, discussing those areas where they are having difficulty and helping the educator or parent to write from that perspective. With nonverbal or lower functioning children this task will require more careful observation on the part of the author. Focus of the story should typically be given to the motivation of current behaviors and not necessarily to the behaviors themselves. For example, if a child begins to tantrum or cry when his assistant leaves the classroom, your first instinct might be to write a story about crying, when and where it might not be appropriate, etc. However, a more effective approach might be to write a Social Story about being scared or frustrated (if indeed you have determined that fear or frustration are the underlying motivation for the behavior), and what things might make him scared, and how he might go about dealing with that.

It is also very important that the expected response is clearly defined. To continue the above example, again one may be tempted to define the expected response as "Kevin will reduce the number of incidences of crying each day," or something similar. A better expectation might be "We will attempt to make Kevin feel more comfortable when his assistant is out of the room.

Writing a Social Story

Having determined those areas on which one wishes to focus, the writing of the Social Story can begin. Again, a Social Story is usually a first-person, present-tense story used to provide a student with as much information about a social situation as possible, so he is better prepared to face, and act appropriately in, that situation.

There are four types of sentences used to present this information in a Social Story:

  • Descriptive sentences objectively address the “wh” questions: where the situation takes place, who is involved, what they are doing, and why they may be doing it.
  • Perspective sentences give a peek into the minds of those involved in the story; they provide details about the emotions and thoughts of others.
  • Directive sentences suggest desired responses tailored to the individual.
  • Control sentences are authored by the student himself as something of a mnemonic device -- a sentence to help him remember the story or deal with the situation. These are not used in every story and are typically used only with fairly high functioning children.
Below is another sample social story. Each of the sentences in this story has been labeled to illustrate each of the above sentences (except for the control sentence -- I've not yet had a child that has opted to use them, so I'm not going to even pretend to be able to dream up a good one yet).

Sitting on the Carpet

Sometimes our class sits on the carpet. (descriptive) We sit on the carpet to listen to stories and for group lessons. (descriptive) My friends are trying hard to listen so they can enjoy the story or learn from the lessons. (perspective) It can be hard for them to listen is someone is noisy or not sitting still. (descriptive) I will try to sit still and stay quiet during our time on the carpet. (descriptive)

Carol Gray, the developer of Social Stories, has edited two books on Social Stories. Each contain dozens of sample stories and a very helpful kit on writing social stories. In those kits Ms. Gray recommends that a ratio of at least three to five descriptive or perspective sentences for every directive sentence be used for each story. As a child becomes more and more successful with Social Stories, those stories can eventually be written with no directive sentences at all, leaving it up to the child to determine an appropriate and successful response (which is of course, the eventual goal of any social skills intervention). Remember, Social Stories are not scripts detailing appropriate behaviors, rather, they are descriptions of social situations which set the stage for the child to design successful, positive interactions. Along that line, you should avoid the use of absolute, inflexible sentences in your stories. Replace phrases like "I can" and "I will" with "I will try" or "I will work on" in directive sentences. "Usually" and "sometimes" should be used instead of "always" in perspective and descriptive sentences.

When writing your stories, ensure that you are writing with the child in mind: use an appropriate vocabulary and an appropriate type size. Try to make each story resemble as closely as possible the other literature the child may be encountering at home and school. If you are working with a Kindergartner this may mean a single idea on each page, with an accompanying illustration. A middle school student might require a much longer story, maybe resembling a newspaper or magazine article: multiple columns, small type size, etc.

Presentation and authoring styles

While text on paper is likely the easiest presentation to prepare and use, it may not be the most appropriate for every child (non-readers, etc.). There are, however, a variety of presentation styles and options that can be used to meet the needs of a variety of children.

  • Illustrations -- The child (or parent/teacher) can illustrate each page of the story, or photographs can be taken of the child and his peers in the social situation. These pictures can add interest and visual support for the presented ideas. Be wary, though, of images that are too complex. Children with autism do not always focus on pictures as we would expect (they sometimes fail to focus on a prominent object in the foreground in favor of some other item in the background), so the pictures (photographs, especially) should be as visual uncluttered as possible.

  • Symbols -- The text of the story can be augmented with pictures representing various words or ideas. The Mayer-Johnson Picture Exchange symbols (often generated through their Boardmaker computer program) are typically good choices for this use. For beginning readers, PECS symbols or simple blackline drawings can be substitutes for written words not yet mastered. Or a single, large symbol can represent a complete idea on a particular page.

  • Social Stories on tape -- A reading of a particular story can be recorded on audio tape with a tone or verbal cue for the child to turn the page.

  • Video -- A film could be made of the student and peers acting out applicable scenes from the story. The text of the story should be edited in before the applicable scene, and the written story presented along with the video when it is presented to the child, however, with the hope of eventually fading the video for the written text (as the text is much less labor intensive to create and use than a video).

  • Story boxes -- The child and an adult can act out scenes from the stories with small figures, rooms made of shoeboxes, etc. This too, can add interest and increase understanding of the concepts for children who are not strong readers.
Implementation, monitoring, and fading out

Prior to the introduction of a story, the story should be shared with as many people who are involved in the child's program as possible. Accessing this variety of viewpoints can call attention to finer points that may have been overlooked or misstated in the initial authoring of a story. Before, or shortly after, the introduction of the story to the child, those who may be involved in the situation or with the skill targeted should be presented with a copy of the story. It is often helpful to actually have the child present the story to these other students, staff, or family members, and then to have those people read back or discuss the story with the child. These can help the child understand that everyone is on the same page, operating with similar assumptions and expectations. These other students, staff, or family members should be encouraged to refer to the stories when the appropriate social situations arise. As an example, if a child were currently working with a story about raising his hand before he speaks out at school, the classroom teacher might want to refer back to that story prior to circle time. But, as the child has to use this skill in other locations as well, the story should probably be introduced to his speech teacher, his music teacher, the librarian, and so on. Each of these individuals can refer the child back to elements of the story as the need arises.

A consistent schedule for reviewing each story should be maintained. At first this is typically once a day, usually right before the targeted situation (e.g. right before the bell dismissing the class to recess, if the story is about the need to take turns on the monkey bars). However, for some kids, especially during the first few readings of the story, the time just prior to the situation may be too exciting or busy to completely hold their attention for the story. For those kids, consequently, it may be helpful to read the story early in the day and then simply review the highlights prior to the activity.

The effectiveness of the story should be monitored consistently. If after a week or two of working with a particular story, there is little noticeable change, the story should be reworked. Elements that may be vague or confusing should be removed or rewritten. The motivation behind the behavior may need to be re-evaluated. Is the story truly addressing the reasons why the child may be confused or misreading a situation? Is the problem in the situation really one of cognition, or could something else be affecting the child (environmental stimuli, etc.).

As the child becomes more and more successful with the situations presented in a particular story, that story can begin to be faded out or changed to meet the new needs of the child. The number of review sessions can be lessened from once a day, to every other day, to once a week, to twice a month, and so on until they are no longer needed. Or the directive sentences in the story can be reduced or eliminated,

As each story is mastered, it should be kept visible in the child's environment for review when needed. Because the stories are so personalized, so much about the child, they can often be favorites, something the child might want to look through on his own, even when not working on them specifically. A special basket or notebook of mastered stories are good to keep around.

1 comment:

julia ward said...

Wonderful post. I'll be using this for one of my special needs kids that I help in reading.

julia ward - a BLINDING heart - a writer's blog