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Social Skills Training for Young Adults

with Autism Spectrum Disorder:


Overview and Implications for Practice
Francis J. DeMatteo
Patricia S. Arter
Christie Sworen-Parise
Michael Fasciana
Marcie A. Paulhamus
Abstract: Social skills training for individuals with autism spectrum disorder is essential across the developmental
lifespan. However, literature on this topic has historically focused on preschoolers and elementary students rather
than adolescents and young adults. Adolescents and young adults with autism spectrum disorder encounter unique
social challenges in college settings, employment environments, and communities. Thus, social skills training for this
population must adapt to the needs of the individual leading to complexities for educators during the development,
implementation, and monitoring of the training protocol. The current article provides an overview of social skills
training relevant to adolescent and young adults with autism spectrum disorder and implications for practice are
shared.
About the authors: Dr. Francis DeMatteo is an Assistant Professor and Director of the School Psychology Program
at Marywood University. He is a nationally certified school psychologist and has worked as a practitioner in the
public school setting for 10 years. Dr. Patricia Arter is an Associate Professor, the Director of the Special Education
Program, and the Department Chairperson at Marywood University. She taught in public schools for 13 years in
a variety of inclusive settings. Dr. Sworen-Parise is an adjunct instructor in the Department of Counseling and
Psychology at Marywood University. Michael Fasciana and Marcie Paulhamus are graduate students enrolled in
the school psychology program at Marywood University.
Keywords: social skills, training, Autism, special education

Social skills deficits are a central feature for many students


with disabilities especially those with autism spectrum
disorder (ASD). As such, federal and state regulations
require educators to develop meaningful social skills
interventions to be included in the academic programs of
students age 5 through 21 (Individuals with Disabilities
Education Act; 2004). These interventions often include
explicit social skills training and need to be adapted to
the developmental stage of the students (Cohen, 2011).
The current article defines social skills, examines the
importance of intervening with young adults, and
reviews core components of social skills interventions
for young adult students with ASD. Practical examples
are shared and implications for practice are discussed.

National Teacher Education Journal Volume 5, Number 4

Social Skill Deficits in Individuals with an Autism


Spectrum Disorder
Social skill deficits are central to the diagnostic
criteria of ASD, as individuals with this disorder
typically have difficulty initiating interactions,
sharing enjoyment, maintaining eye contact,
reciprocating conversation, taking anothers
perspective, and inferring interests of others
(American
Psychiatric
Association,
2000;
Individuals with Disabilities Education Act, 2004).
These deficits can significantly affect the ability to
establish lasting and meaningful relationships and
lead to rejection and isolation. Furthermore, the
deficits do not abate with age. The ease of living
independently, marrying, going to college, working

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in competitive jobs, and developing a large network


of friends are challenges for individuals with autism
spectrum disorder (Shattuck et al., 2007).
Howlin, Goode, Sutton, and Rutter, (2004) reviewed
several studies investigating the quality of life outcomes
for individuals diagnosed with ASD.
Although
some individuals acquired relatively high levels of
independence, the majority of the population was
classified as dependent on either family members, or
community resources. Adults with ASD generally do not
live alone and many did not establish close friendships.
Howlin et al., (2004) indicated that depending on the
individuals level of communication, his or her quality of
life ranged from very dependent to mostly independent
with the majority falling in the dependent range. Many
of the individuals in this sample lived in long-stay
hospitals, sheltered communities, or other restrictive
environments. However, a small portion of individuals in
the more independent range, held jobs and participated in
some form of post-secondary education. In one research
review, 61% of the population was classified as making
poor social adjustment (Howlin, et al.). In another study,
70% had not completed school, and only one of the 29
individuals in the sample held a job (Seltzer et al., 2003).
Defining Social Skills for Young Adults with an ASD
Social skills are the specific behaviors that an individual
uses to competently perform social tasks (Gresham, Sugai,
& Horner, 2001). This definition is largely based on the
individual, the context, and those around the individual.
Furthermore, social skills are behaviors exhibited in
specific situations that lead to social competency, whereas,
social competency refers to individuals perceptions of the
social behavior (Gresham et al., 2001; Gresham, 2002;
Lane, Menzies, Barton-Arwood, Doukas, & Munton,
2005). Thus, social skills are behaviors that must be
taught, learned, and performed while social competence
is the perception of these behaviors within and across
situations (Gresham et al., 2001; Kamps, 2010).
Social competency predicts adequate psychological and
social adjustment and it is typically observed through
demonstration of prosocial behaviors that include empathy
and perspective taking (Eisenberg & Harris, 1997;
Gresham et al., 2001, Lane et al., 2005). A young adult
is described as socially competent if he has the capability
of establishing and maintaining positive interpersonal
relationships in ways that are deemed appropriate as
judged by other individuals such as parents, teachers
and peers (Gresham et al., 2001; Lane et al., 2005). In
contrast, young adults who are perceived as socially
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incompetent tend to experience negative outcomes such


as teacher rejection, school failure, social rejection, and
limited social involvement (Lane et al., 2005). Additional
negative outcomes may include juvenile delinquency,
employment difficulties, and mental health problems
(Miller, Lane, & Wehby, 2005).
To assist educators in developing effective social
skills programs for young adult students with ASD,
consideration must be given to the fact that social skills
demands change through development. As stated above,
young adults are faced with issues concerning success in
college, employment, social support outside the family,
and romantic relationships (Cohen, 2011; Miller et
al., 2005). These are vastly different social skills goals
then one would face in elementary school. Furthermore,
many individuals with ASD will continue to demonstrate
social skill deficits into adulthood. This is problematic
due to a lack of understanding and typically there are
fewer resources available (Cohen, 2011). If we do not
effectively intervene, then young adults with ASD may
develop delinquent behavior, mental health problems,
and continue to rely on other adults for support (Howlin,
et al., 2004; Miller et. al., 2005). Cohen (2011) further
discusses the need for better social skill interventions
with young adults with ASD stating that they continue
to lack friendships, have limited vocational success,
and spend much of their time alone. These findings are
supported by other research indicating that 50% of young
adults with ASD in one study had no social support or
friendships outside of prearranged settings (Orsmond,
Krauss, & Seltzer, 2004).
Developing an Individualized Social Skills Training
Plan
Social skills training focuses on building positive
behaviors, while using nonaversive methods. Because
training often serves as an intervention, it must be
designed to fit the needs of the student as opposed to
making the student fit the chosen strategy (Bellini, Benner,
& Peters-Myszak, 2009). Thus, an individualized training
plan is similar to a behavior support plan. Behavior
support plans are developed through a functional analysis
of behavior, defined as a process that explicitly links
behavior, environment, and intervention (ONeill et al.,
1997).
Developing an individualized social skills training plan
for a specified individual and targeted environment begins
by applying principles of functional analysis to variables
that underlie social skills deficits. Such variables then
become the framework to the training plan. Based on
National Teacher Education Journal Volume 5, Number 4

previous research, broad variables underlying social


skills deficits consist of: 1) a lack of social knowledge;
2) insufficient practice or feedback; 3) absence of cues
or opportunities to perform prosocial behaviors; 4) lack
of reinforcement for socially skilled behaviors; and 5)
interfering problem behaviors that hinder acquisition and/
or performance of prosocial behaviors (Gresham, Elliott,
& Kettler, 2010; Lane et al., 2005). Discussion of these
variables and practical examples follow.
Lack of Knowledge
Because prosocial skills are not readily observed,
adolescents and young adults with ASD are immediately
assumed to have acquisition deficits, or a lack of
knowledge of prosocial behavior. However, individuals
with ASD do not necessarily lack knowledge of skills, but
instead experience anxiety, uncertainty, and discomfort
when in the company of others (Stahmer, 1995). Thus
for this population, individualized training by default
needs to include content specific to knowledge deficits
supplemented with self monitoring techniques designed
to address interfering emotional and behavioral factors.
Content specific to addressing acquisition deficits is
typically didactic and is broken into concrete steps and
rules that can be memorized and practiced in a variety
of settings. Examples of acquisition deficits might
consist of greeting a potential employer and/or initiating
conversation with a peer of interest. While training such
skills, the trainer should note that young adults with ASD
can experience a lack of knowledge in three specific
areas. First, some individuals have difficulty recognizing
appropriate goals for peer associations. For example,
a young male with ASD might mistakenly perceive a
female peer who is a tutoring him to be his girlfriend.
Next, individuals with ASD may lack knowledge of
behavioral strategies to accomplish socially appropriate
goals. This form of knowledge deficit usually results from
insufficient practice of component skills for an activity.
For instance, given the previous example, the young
male with ASD may not know the appropriate steps for
asking out a female to whom he is attracted. Finally,
these young adults might not be sensitive to social cues
that indicate appropriate prosocial behaviors in specific
contexts. Thus, an individual with this type of deficit may
be reluctant to discontinue a social interaction with the
peer even though the peer is providing consistent verbal
and nonverbal indicators that he or she is uninterested in
the given activity. In the previous example, the young
man might continue to ask the girl out despite her refusal
to his initial requests, thus losing a possible friendship
and social support.

National Teacher Education Journal Volume 5, Number 4

The role play technique seems particularly applicable


to training acquisition deficits. When role-playing, the
targeted skill is rehearsed in a practice setting and the
trainer has the opportunity to explicitly guide, as the
potential for anxiety is reduced. Role-playing provides
opportunity for behavioral cues to be emphasized
and scenarios consecutively practiced (Bellini et al.,
2009; Gresham, 2002; Mesibov & Shea, 2011). Roleplaying is most successful when used in repetition and
generalization for the skills practiced improve when
stimuli of the naturalistic environment are embedded into
the training setting (Bellini, et al., 2009; Fox & McEvoy,
1993; DuPaul & Eckert, 1994). Common stimuli can be
animate or inanimate, such as peers (Brady, McEvoy,
Wehby, & Ellis, 1987), proximics of the physical setting
(Gaylord-Ross, Haring, Breen, Pitts-Conway, 1984), and
interaction materials (Shafer et al., 1984). When using a
personal coach, maintenance of skills acquired through
role play have been documented at follow-up during one
month (Palmen, Didden, & Arts, 2008).
Lack of Practice or Feedback
Deficient social performances may result when young
adults with ASD have not had sufficient practice (fluency
deficits) demonstrating an acquired social skill or given
positive reinforcement for the behavior. The individual
knows the skill and attempts to perform the skill but
does so inappropriately; therefore, lacking positive,
reinforcing feedback.
According to Barton, Kinder, Casey, and Artman (2011),
feedback is information provided to an individual
regarding certain aspects of his or her behavior. Feedback
regarding performance is typically provided following
behavioral or social development. Feedback gives
the learner specific information regarding the reasons
for correct or incorrect performances of a given social
skill. Performance feedback is easily adaptable to fit the
needs of the individual. Feedback can take several forms
including: (1) verbal, (2) graphical, (3) checklists, and (4)
guided self-reflection. Verbal feedback can be presented
in a supportive, corrective, or a data-based manner to the
student.
Graphical feedback targets a specific behavior or
skill and is then charted in a visual manner for the
student to recognize their progress. Checklists can be
used independently or in additional to other forms of
feedback. The checklist targets specific strategies to be
observed during social interaction, and successful use
of the strategy will be noted for the student to monitor.
Finally, the student gains performance feedback when the

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trainer or social coach prompts self-reflection. The use of


guided self-reflection enables the student to reflect on his
or her progress and performance throughout the sessions.
Although no evidence suggests one feedback strategy
is superior to others, Barton et al., (2011) established
significant evidence for the use of performance feedback.
Opportunities for practice and feedback are inherent
when trainers utilize a peer-mediated training program.
Peer mediated training also increases the likelihood for
generalization of skills to other environments (DuPaul
& Eckert, 1994; Fox & McEvoy, 1993; Sheridan,
Hungelmann, & Maughan, 1999, Smith & Gilles, 2003).
Peer-mediated training refers to academic, behavioral, or
social strategies that employ peers as direct, or indirect
agents of change (DiSalvo & Oswald, 2002; Egel,
Richman, & Koegel, 1981; Kamps, Barbetta, Leonard, &
Delquadri, 1994). An individuals peer might consist of
another who is similar in age, status, grade, knowledge,
or developmental level. Current theory suggests that
individuals engage in reciprocal relationships with their
environment throughout the formation and organization
of social relationships (Bandura, 1977). The individuals
social interactions typically consist of reciprocal and
complementary interchanges with peers that support
the actions and behaviors of other peer group members
(Farmer & Farmer, 1996). Additional research indicates
that peers mutually reinforce behaviors, values, and
norms that are consistent with their own, and exert a
strong influence on one anothers behaviors and attitudes
with that group (DiSalvo & Oswald, 2002). Peers become
increasingly important throughout ones development,
thus they are exceptional candidates as positive behavior
change agents. Specifically, positive involvement with
peers provides increased opportunities to engage in
prosocial behaviors, and may improve social acceptance
and academic achievement (Hoff & Robinson, 2002).
Consider the following example. A young adult with
ASD may learn socially appropriate behaviors in a social
skills training program such as beginning a conversation;
however, he or she may not be provided ample
opportunity in the natural setting to begin a conversation
for skills to be tested and reinforced by others. As a
result, the skill is not likely to be maintained in the target
young adult. Most importantly, when the young adult
with ASD does implement an untested skill before it
is practiced to a sufficient degree, others may perceive it
as superficial or awkward. When others perceive the skill
in such a manner, the young adult will not be reinforced
for using the skill. Once reinforcement is nonexistent or
removed, the behavior will become extinct. Peers can aid
in this process by giving authentic feedback as to what
is acceptable and unacceptable. This feedback is much
more influential than feedback given from an authority
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figure or trainer. For example, imagine a young adult


with ASD were eating lunch in the cafeteria with peers
and the conversation was in progress about the score of
a football game. If the young adult with ASD entered
into the conversation and began talking about Star Wars,
peers would most likely redirect the conversation back to
the topic, commenting in some way that the discussion
on Star Wars was off-topic. However, these types of
authentic situations can only be effective if young adults
with ASD have access to, are included in, and participate
in activities with their peers. This is often not the case
when young adults with ASD are isolated and dependent.
Lack of Cues or Opportunities
Young adults with ASD may be deficient in performing
certain social skills because their environment does not
provide natural cues that are necessary to evoke a specific
prosocial behavior. Therefore, although the young adult
might possess the skill, he or she will not be aware of
when to appropriately exhibit it. Facilitating explicit
cues from all individuals in natural environments of
young adults with ASD is an impossible task. Thus, it is
necessary to combine the aforementioned principles of
peer mediated training with modeling to increase explicit
cues or opportunities across the environments.
The concept of modeling, or observational learning,
was introduced over 40 years ago by Albert Bandura
as part of his work on social learning theory (Bellini &
Akullian, 2007). Over the course of his career, Bandura
demonstrated that modeling has a profound impact on the
development of children. In particular, Bandura (1977)
showed that children acquire a vast array of skills by
observing other people perform the skills, rather than
just through personal experience. Bandura also found
that observers will imitate behaviors with or without the
presence of reinforcement, and will perform the behavior
in settings other than the setting where it was originally
observed. However, attention and motivation are essential
to observational learning. If a child does not attend to a
model, he or she will not be able to imitate the models
behavior. According to Bandura, children are most likely
to attend to a model that they perceive as competent, and
who is similar to them in some way (physically, age,
group affiliation, ethnicity, etc.).

Modeling is the progenitor of social skills training.
Modeling involves the use of live or filmed performances
or enactments of social skills (Bandura, 1977; Bellini &
Akullian, 2007). These interventions rely on an adult or
peer providing a demonstration of the target behavior that
should result in an imitation of the target behavior by the
National Teacher Education Journal Volume 5, Number 4

individual with ASD. Modeling is almost always coupled


with some form of verbal instruction. Verbal instruction
involves the use of spoken language to describe, prompt,
explain, define, or request social behavior. Direct
instruction may involve the use of concrete or abstract
concepts to facilitate the acquisition of social skills.
The training procedure of coaching relies heavily on
verbal instruction and modeling. The major advantage
of modeling with verbal instruction is that individuals
with ASD learn how to combine, chain, and sequence
behaviors that comprise a particular social skill (Egel,
Richman, & Koegal, 1981; Robertson & Biederman,
1989). Modeling can include simple or complex behaviors
(i.e., eye contact vs. maintaining a conversation), and is
usually combined with other strategies such as feedback,
role-playing, and reinforcement. When combined with
these additional strategies, modeling is more effective in
eliciting the target behavior, with longer maintenance and
generalization effects (Bellini & Akullian, 2007).
For example, a young adult with ASD may say, excuse
me whenever he interrupts his teachers conversation
because his teacher gives him a stern glance immediately
prior to the interruption. However, during lunch in the
cafeteria, the young adult does not say, excuse me when
interrupting a peers conversation because the peer holds
her finger up indicating one-minute. In this example,
the young adults response of saying excuse me has
only come under the control of the teachers stern glance;
instead of under a variety of other possible social cues
that might be made explicit in the moment by a peer
mediator.
Lack of Reinforcement
Reinforcement is based on operant techniques, and
involves the presentation or removal of environmental
events that increase the frequency of behavior (Rathvon,
2008; Shinn, Walker, & Stoner, 2002). Reinforcement
can either be positive or negative. With positive
reinforcement, an environmental event is presented,
which increases the frequency of a behavior. Positive
reinforcement is frequently used in social skills training
in the form of praise, access to preferred activities,
and/or tangible items. With negative reinforcement,
an environmental event is removed that increases
the frequency of a behavior. Negative reinforcement
involves either escape or avoidance learning. An
individuals behavior will be negatively reinforced if
that behavior allows the person to escape or avoid an
aversive stimulus. Negative reinforcement is not used
as frequently as positive reinforcement in the context
of social skills training programs (Rathvon, 2008). The
National Teacher Education Journal Volume 5, Number 4

overall consensus is that the usage of reinforcement in a


social skills training intervention is vital to produce the
most desirable outcomes (Krasny, Williams, Provencal,
& Ozonoff, 2003; Matson, Matson, & Rivet, 2007).
As a training technique, coaching provides natural
opportunities for reinforcement, practice, and feedback.
Coaching occurs when a trainer or peer interact with the
target individual to teach or increase performance of a
skill (DiSalvo & Oswald, 2002). Coaching, also referred
to as prompting, is similar to modeling, but instead of
observing a skill, the target individual is prompted to
perform the skill and then receives constructive feedback.
This feedback is essential to coaching, as it explicitly
emphasizes the individuals response to training and
directly facilitates interaction between the coach and
target individual (DiSalvo & Oswald, 2002). For best
results, prompts used during coaching are gradually faded
from specific to general (Bellini et al., 2009). Including
fading techniques actively programs for generalization of
skills (DuPaul & Eckert, 1994; Fox & McEvoy, 1993).
Consider the following example of a peer coaching a
young adult with ASD to initiate a conversation in the
bookstore.
Peer: Okay when we enter the bookstore who
will you approach to ask about the book for
class?
Young adult: I will ask the lady behind the
counter. She works there.
Peer: What will you ask? Ask me.
Young adult: Do you have the book for Chemistry
101.
Peer: You need to greet her first before you ask
the question. Try again.
The coaching technique would continue with feedback
from the peer. The young adult would then enter the
bookstore and initiate the conversation while the peer
watched. Following the interaction, the peer coach would
give feedback and praise based on the young adults
performance.
Interfering Problem Behaviors
The acquisition and performance of social skills in young
adults with ASD might be diminished by internalizing
and/or externalizing problem behaviors. These behaviors,
often related to the individuals ability to self-regulate
(Gumpel, 2007), serve as blocks to successful
acquisition and performance of necessary social skills
and must be addressed in order for a young adults true
social ability to be unveiled.

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The primary training techniques to address interfering


problem behaviors are reductive methods. Reductive
methods are often paired with direct instruction
procedures, such as role play. Basically, reductive
methods are operant techniques, designed to decrease
or extinct the occurrence of inappropriate behaviors and
increase the frequency of alternative, prosocial behaviors
by manipulating environmental reinforcement (Elliott
& Busse, 1991; Elliott & Gresham, 1993). Specifically,
environmental reinforcement may include providing
opportunities for the young adult with ASD to engage
in desirable behaviors, praising prosocial behaviors,
ignoring inappropriate behavior, and/or removing
the young adult from an activity that is perceived
uncomfortable. Reductive methods are typically time and
resource intensive while requiring ongoing adaptation
contingent on variables in the target environment.
For example, a young adult with ASD might have an
externalizing behavior of tongue clicking when nervous.
This behavior may inhibit his ability to start and maintain
a conversation when meeting new peers. A peer might
point out to the young adult that tongue clicking is
distracting and interrupts the flow of conversation. It
might be suggested that the young adult engage in an
alternative behavior, such as chewing gum or sucking
on a mint (since these activities are non-complementary
to tongue clicking) while initiating a conversation. The
peer would then provide opportunities for the young
adult to practice a conversation, while verbally praising
the young adult when there is a reduction or extinction of
tongue clicking.
Implications for Practice
The previous sections of this paper provided an overview
and practical examples of social skills training relevant
to adolescent and young adults with ASD. The current
section will review implications for practice that is useful
for educators who want to use social skills training with
adolescent and young adults with ASD. A best-practices
approach requires the educator to critically review the
skills targeted for training in terms of the five influential
factors of social skill deficits (lack of social knowledge,
insufficient practice or feedback, lack of cues or
opportunities, lack of reinforcement, interfering problem
behaviors). Afterwards, classify the social skill difficulty
into acquisition or performance deficits with or without
interfering problem behaviors. Acquisition deficits
without problem behaviors are to be remediated through
direct instruction methods (i.e. role play, modeling);
whereas, acquisition deficits with problem behaviors
require direct instructional methods accompanied by
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operant procedures (Gresham, 1995). In contrast,


performance deficits without problem behaviors are to
be addressed through indirect instructional methods (i.e.
coaching); whereas, performance deficits with interfering
problem behaviors require indirect instructional methods
with operant techniques (Gresham, 1995). Regardless of
the social skill deficit category, constructive feedback is
necessary in all cases.
When examining the specific characteristics and training
approaches to acquisition and performance deficits, an
issue in programming arises. For example, training
for acquisition deficits require approaches that rely
more heavily on direct instruction. Thus, emphasis
on a detached social skill training approach, such as a
prepackaged program, in a separate setting outside the
natural environment seems applicable whenever the
individual requires explicit opportunity to learn target
social skills. While these skills are being learned,
significant adults and peers in the natural environment
must put forth effort and reinforce target skills in order
for them to be exhibited at an appropriate level. Hence,
effective social skill training for acquisition deficits is
to place significant emphasis on detached training while
also facilitating integration into the natural setting. In
contrast, training for performance deficits emphasize
the manipulation of antecedents and consequences in
the natural environment. Therefore, with young adults
who exhibit performance deficits, a detached training
approach might not necessarily be needed; however,
it may be beneficial to include when addressing more
severe cases, as appropriate social skills in the individual
may need to be refreshed.
Acquisition and performance deficits for young adults
with ASD require different modes of intervention.
Researchers suggest that a greater number of individuals
demonstrate performance deficits, rather than acquisition
deficits, in regard to prosocial behavior (Gresham 1995,
Gumpel, 2007). Hence, a common practice of treating all
social skill deficits with a detached, prepackaged training
program that emphasizes direct instruction seems faulty.
This notion is particularly applicable to young adults
with autism spectrum disorder (Mesibov & Shea, 2011)
especially given that most prepackaged programs do
not necessarily emphasize developmentally appropriate
realistic situations for this population. In all cases, social
skills training needs to involve the significant adults and
peers in the natural environment.

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