Kelly McKinnon & Associates, Inc. Using Neurotypical Peers to Determine Social Skills Goals to children with ASD Kelly McKinnon, MA, BCBA Kelly McKinnon & Associates, Inc. www.kellymckinnonassociates.com Kelly McKinnon & Associates, Inc.

Module 1: Joint attention DSM IV: Qualitative Social Impairment Impairment with nonverbal behaviors: eye gaze, facial expression, body posture, gestures Joint attention is considered by many researchers to be pivotal to deficits in language, play and social development (in the autism population), (Mundy, 1995) Researchers have noted the importance of joint attention deficits in the development of children with autism (Kasari C., 2004, Whalen, C., Schreibman, L., 2003 Mundy (1995) theorized that joint attention deficits in children with ASD by distort systems that motivate children to attend & engage in their social world All babies use eye contact to inspect; Pauline Filipeck, 2008 Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Neurotypical development Module 1: Level 1: Referencing/joint attention 7-12 months 12-18 months 18-24 months 24-36 months 4 years old 5 years old Attends to music or signing Imitates other children Watches the face of others for clues to their emotions or feelings Points to up to four items in pictures Interested in new experiences Likes to sing, dance, act, performing before others Maintains attention to speaker Shows toys or actions to others Watches others children in play and may join in Participates in simple group activities, such as singing clapping or dancing Can sit and participate in small group activities Looks at person saying child’s name Looks when parents are looking Points to events or toys of interest Sits for stories up to 20 minutes Looks at familiar objects and people when named Smiles when others are smiling; may cry when other babies cry Looks between events and people to share interest Gains attention with gestures, or declarations, “Look” Points to objects to indicate awareness Imitates interactions shows interest with other children References others to check if mood or emotion; should continue activity Performs for attention Extends arm to show object Kelly McKinnon & Associates, Inc.

Module 1: Joint Attention/Imitation Kelly McKinnon & Associates, Inc.

Neurotypical data points joint attention & referencing Video of: 4 year old boy & 3 year old girl playing: Data for 4 year old boy: Looked when he spoke: 100% Looked when listening to peer: 57% Held up object to showed: 3 times, in 3 min. Referenced adult in room: 4 times in 3 min Looked to watch: 2 times in 3 min Looked when called: 100% (1/1) Imitated actions in play: 0 Called peers name in conversation: 2 times Kelly McKinnon & Associates, Inc.

Neurotypical data points joint attention & referencing Data for 3 year old girl: Looked when he spoke: 100% Looked when listening to peer: 67% Held up object to showed: 2 times, in 3 min. Referenced adult in room: 4 in 3 min Looked to watch: 5 times Looked when called: 100% (2/2) Imitated actions in play: 1 Called peers name in conversation: 1 time Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Skill Boy-4 Boy-4 Girl-6 Girl-6 Look to watch 5 3 3 5 Show others 2 4 1 1 Imitate 3 2 3 0 Look-talking 60% 63% 90% 100% Look-answer 100% 40% 100% 80% Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Listening to a story Listening to a story on the floor Partial Interval sample data collection Criteria: Reference story at least every 30 seconds 3 year old: Reference 100%; Duration Ave: 1 min. 4 year old: Reference 100%, Duration Ave: 1.37 min. 5.5 year old: Reference 100%, Duration Ave: 2.5 min. Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Listening to story Montessori classroom Kindergarten, 1st and 2nd 5 minute sample; 2 girls, 3 boys Partial Interval sample data collection Criteria: Reference story at least every 30 seconds Girls: 100% (looked once per 30 seconds for 5 minutes) Fatigue? No> 100% after 7 minutes Boys: 2 boys, 100% criteria, 1 boy, 80% (looked 1x per 5) Fatigue?>Not really, boy at 80%, stayed there Other two boys at 92% Kelly McKinnon & Associates, Inc.

Additional referencing skills Using a point to choose: 25%, 100%, 100% Ave of 3: 75% of time Referencing for approval/Information: 100%, Responding to Yes/No: 100% Hearing a noise: Knock on door Look to noise: all three looked both times Comment to noise: 1 of 3 boys comment “What’s that” Comment on person entering room (purpose of knock) 2 of 3 boys commented Need larger sample! Kelly McKinnon & Associates, Inc.

Looking for a reason & imitating Stopping and starting to music (Criteria: stopping in 1-2 seconds) 3 year old boy: 60% 4 year old boys (2): 100% Stopping and starting, based on Yes/No head nods 3 year old boy 80% (possibly momentum from previous experience 4 year old boy (2) 100% Imitation of others’ “different” behavior 3 year old boy: looked at peers: 2 times, copied change 2 times (100%) 4 year old boy: looked at peers 4 times, copied change 3 times (75%) 4 year old boy: looked at peers 2 times, coped 1 time * Leader* Kelly McKinnon & Associates, Inc.

Programming considerations Teach social referencing: looking, to see if others are listening, if you are doing something correctly Teach imitation of peers: watch peers, copy peers; especially if you don’t know what to do Teach joint attention: show others items you have! Look when you talk! Teach sitting quietly in a group: a school must! Use data provided as your criteria aims for mastery Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Sample Goals: Kelly will orient toward others when speaking, at least 1 time per statement, checking if listener was listening and heard his statement. Kelly will follow others points toward an object (at a distance of a minimum of 25 feet), reference back to pointer for approval, obtain the item and/or comment on the object, completing 3-4 steps of the sequence, independently Kelly will orient to a speaker when listening both in a group and 1:1, orienting and glancing at least 1 time every 30-40 seconds, (to watch in anticipation of and action or a movement), for a duration of 5 minutes Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Module 3: Play skills DSM-IV -Autism Lack of varied, spontaneous, social imitative play, preoccupation with parts of objects Failure to develop peer relationships at developmental level Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Play Skills In 2001 the book Educating Children with Autism ranked social skills and the teaching of developmentally appropriate play, “among the eight types of goals that should have priority in the design of effective educational programs for children with ASD” “Children with autism often gravitate to repetitive play activity, to pursuing obsessive and narrowly focused interests. Without specific guidance, they are less likely to engage in functionally appropriate play with objects” (Wolfberg, 1999) Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Module 3: Level 1: Social Play- Developmental Milestones Module 3: Level 1: Social Play- Developmental Milestones Module 3: Level 1: Social Play- Developmental Milestones 7-12 months 12-18 months** 18-24 months 24-36 months 4 years old 5 years old Imitates familiar actions with caretaker Demonstrates functional use of objects Uses vocalizations and words during pretend play Uses most toys appropriately Associative Play common (engaged in same play, interacting, yet going own way) Acts out characters Plays pat a cake Shows symbolic use of objects Uses two toys together in pretend play Demonstrate parallel play Follows rules in simple games without being reminded More likely to agree with others on rules- more cooperative play Participates in games with adults Plays with a toy in a different way Stacks and assembles toys and objects Performs longer sequences of play activities Plays “Mom” or “Dad” Sometimes demanding, sometimes cooperative with friends Explores environment with curiosity Imitates simple actions of others in play Engages in pretend and symbolic play~ performs several steps (such as feeding doll, cover with blanket) Pretends to perform caregivers routines Emerging Cooperative play with other children (working together toward common goal) My visit friends independently Plays ball with adults Uses one object to represent many objects Has plan when building with items- using models Stories/narration have sequences of actions, no central character or theme Imitates interactions shows interest with other children Emerging Associative Play Organizes doll furniture & use imaginatively Will build a block tower- up to 9 blocks Silly in play, may do things wrong on purpose Likes to dress up and act out characters Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Module 3: Social Play Play can be simple, or very intricate Some common play scenarios: Play with closed ended toys (stacking cups) Open ended purposeful play (block building) Independent play Parallel play Symbolic/Pretend play Dramatic play Basic cooperative play Team play Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc.

Neurotypical data points Independent play: Children play alone, short or long periods of time, and using a variety of toys! They explore & access toys INDEPENDENTLY, playing FUNCTIONALLY Boy, age 2: played trains, 4 min. before looking bored & referencing adult; built, used trains, built some more; quiet, references to adult often, then plays again Girl, age 2: played kitchen, babies & house together, 13+ minutes; some play narration, reference to adult when name called Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Independent play Boy age 4: Picks a theme (power rangers), moves around, incorporating many toys into play; narrates play, shifts play, nearly constantly; durations Boy age 6: Narrates play, explores objects, then finds one, has a plan when you ask, duration up to 20 minutes at a time! Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Associative Play Associative play~ involves sharing same play materials, showing others own activities, commenting; both engage entire duration allotted (5 minutes) Boy, age 4 (in yellow) Look/watch other boy: 7 times Imitated peers actions: 4 times Make sounds/actions: 3 times Shows others~ gains attention of others “I...” or shows object : 3 times Narrates play (note directed at anyone in particular): 3 times Coordinates idea (“Lets....”): 2 times Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Boy, age 4 (in red) Look/watch other boy: 3 times (more of a leader) Imitated peers actions: 2 times Make sounds/actions: 3 times Shows others~ gains attention of others (“I...” or shows object): 3 times Narrates play (note directed at anyone in particular): 4 times Coordinates idea (“Lets....”: 3 times Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Play data points Boy, age 6 Look/watch other boy: Imitated peers actions: Make sounds/actions: 3 times Shows others~ gains attention of others (“I...” or shows object): 3 times Narrates play (note directed at anyone in particular): 4 times Coordinates idea (“Lets....”: 3 times Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. More data points Boy, age 6 Look/watch other boy: 3 times (more of a leader) Imitated peers actions: 2 times Make sounds/actions: 3 times Shows others~ gains attention of others (“I...” or shows object): 3 times Narrates play (note directed at anyone in particular): 4 times Coordinates idea (“Lets....”: 3 times) Kelly McKinnon & Associates, Inc.

Programming considerations Teach: Independent play: access & play with toys on your own, functionally; give mom a break! Teach: Imitation in play: watching, copying & responding to others actions Teach: Initiating play ideas: generate new ideas in play Teach: Pretend play; acting out scenarios, characters Use data provided as your criteria aims for mastery Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Sample Goals Kelly will expand her play-skill repertoire, to include the ability to build several items (at least three different objects) with three different types of building toys (blocks, K’nex, Lincoln logs), independently Kelly will expand her play-skill repertoire, to include the ability to use objects for pretend play actions including several items (army men, cars, transformers) initiating at least a 10-action play scheme with each play item, independently Kelly will engage in functional, independent play, using 1-3 toy items, sustaining play for at least 10 minutes Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Sample Goals Kelly will demonstrate emerging parallel play skills by playing in the same area and sharing play materials with a peer, for at least 5 minutes, or until the activity is over Kelly will expand dramatic/pretend play skills with peers, by initiating at least 5 new pretend play ideas, and observe and imitate at least 3 play actions, in a 10 minute play period Kelly will join into play of others, sustaining and participating in the activity at least 10 minutes, or until activity is over. Kelly McKinnon & Associates, Inc.

Social Language & Communication DSM-IV –Autism Qualitative Impairment in Communication Delay or lack of spoken language Delay in ability to initiate or sustain conversations Stereotyped and repetitive use of language Children with autism exhibit a range of problems associated with communication and language (Schopler & Mesibov, 1985). Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Module 5: Level 1: Social Language (see speech chart for complete speech & language information) 7-12 months 12-18 months 18-24 months** 24-36 months 4 years old 5 years old Vocalizes during games Responds to other children’s vocalizations Uses words to interact with others Uses 3-word phrases frequently Uses attention getting words, “Look”, “Hey” Speaks in five to six words Speaks in sentences of more then 5 words Sings along familiar songs Uses words to protest Understands meaning of action words- answers to “What doing?” Uses action words consistently- uses “is” & contractions (he is running, he’s running) Follows three-part commands Uses future tense, irregular tense Uses one-two words spontaneously Shakes head No Uses two-three word phrases spontaneously Talks more in play with children Recalls parts of a story Tells longer stories Uses a word/sound to call out to someone Asks to have needs met Uses 50 different words Follows 3-step unrelated commands Tells beginning stories Responds verbally to friends favorably Imitates three animal sounds Understands commands to sit down, come here Identifies parts of an object and function of objects Mastered some grammar Sings independently Identifies body parts and clothing items Responds to questions- “Who, What, Where” (in, on, under) Correctly tells two events in order of sequence Responds to give me commands Chooses five familiar objects on request Answers Yes/No questions correctly Fills in the blank/intraverbals Asks what’s that Follows a two-step related command Establishes likes and dislikes Uses fillers to acknowledge others Identifies objects by categories Takes turns during conversations Engages in conversations from past ideas, own items Uses language for fantasy, jokes Kelly McKinnon & Associates, Inc.

Social Language & Communication Mark Sundberg, CALABA 2006 “Children with ASD often present extensive tacting repertoires & receptive repertoires >absent or low rates of mand & intraverbal repertoires” Creates a scenario of language solely under SD’s These are the children that have hundreds of words, only when prompted! Kelly McKinnon & Associates, Inc.

What we need to teach Module 5: Social Language Kelly McKinnon & Associates, Inc.

Types of social language Most social language of young children involves: Showing others what you have to gain attention “Look”, “Watch this” Sharing information “I have”, “I like”, “I went” Making contingent statements “Me too”, “I have that too” Asking questions “Where did you get that” Kelly McKinnon & Associates, Inc.

Neurotypical data points Boy age 4 Makes sounds & actions 7 times (in 5 min) Shows others items: 4 times (in 5 min.) Shares information or idea: 6 times (in 5 min.) Asked questions: 2 Narrates own play (no intended listener) 4 times Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Boy age 4 Makes sounds & actions 3 times (in 5 min) Shows others items: 3 times (in 5 min.) Shares information or idea: 3 times (in 5 min.) Asked questions: 1 Narrates own play (no intended listener) 4 times Kelly McKinnon & Associates, Inc.

Kindergarten Lunch data: 3 boys, 3 girls at lunch table (5 minute sample) Ave. comments by boys: 7 Ave. comments by girls: 8 Types of comments: “Can I have that?” (6 times) “I have M&M’s” “I have a fruit roll up” “I love those” “I have two chips” “Look at this. Everyone wants this” Kelly McKinnon & Associates, Inc.

Neurotypical data points Children eating, don’t talk that much! “Lunch bunches” or “snack & talks” should not be primary social skill teaching Children ages 2.5-7 all knew at least 1 thing: -favorite foods -new toy items -things they like & don’t like -places they like to go Kelly McKinnon & Associates, Inc.

Neurotypical data points Children rely on similar constructs to talk They talk about what they are doing They show each other what they are doing They make statements about what they have, what they are doing They comment back when others make these statements They ask some questions to gain information, however this is not the pre-dominant method of conversation Kelly McKinnon & Associates, Inc.

Language Programming considerations Teach showing others, and calling for attention Teach sounds paired with actions Teach talking about your play actions or idea Teach narration of play> so others will know what you are doing! Teach knowing information> what child likes, toys they have, places they have been Use data provided as your criteria aims for mastery Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Sample Goals Kelly will comment to others/mand for attention about her play activities (“Look, I build a robot” or “Watch me”!) at least five times in a five minute play period Kelly will make basic contingent statements, when peers make statements, (such as, “I like, I have too”) at least 70% of instances, in a 5 minute activity Kelly will approach others with an opening starter statement (“I statement”) or with a related question, to appropriately engage a peer in conversation (vs. blurting out a statement or making and inappropriate statement) 80% of opportunities. Kelly McKinnon & Associates, Inc.

Kelly McKinnon & Associates, Inc. Thank you Social Skills Solutions, A hands on manual for teaching children with autism; Kelly McKinnon, www.difflearn.com Sources: for developmental milestones: Hawaii Early Learning Profile Checklist, 1984, The Rosetti Infant-Toddler Language Scale, ages Brith-3 (1990), The Developmental Assessment of Young Children: Adaptive Behavior, Communication, Social-Emotional and Cognitive sub-tests, Inventory of Early Development II (2004) and Developmental Profile (1984) and Speech & Language Development chart, Addy Gard, Leslea Gilman, Jim Gorman, Desired Results Developmental Profile, California Dept. of Education; Theory of Mind Development Chart, DeCurtis, Schryver-Stahly & Ferrer, CSHA Magazine, Fall 2003; Kelly McKinnon & Associates, Inc.