Art Therapy Autism Spectrum Disorder Behavioural Family Care

Social Stories: A Great Skill Development Tool in Autism

As parents, it is very important to understand and be aware of the difficulties our children face in their daily life. While communicating with our children we use statements like “please stop it”, “I want you to listen to me”, “be good” expecting that they will follow what we are saying. However, parents of autistic children find it very strenuous to talk or have a conversation with their child. It is very often seen that children with autism have impairment of social understanding or behaving appropriately in social situations. It is essential for us to understand the reason behind the child’s outburst in public, avoiding interaction even with the peer group or social gathering. 

For example, while doing school lesson a child with ASD might just throw the book away or have constant laughter. In a noisy place, the child might scream or hit someone out of nowhere. These behaviours occur due to their inability to express their feelings at that moment. Children with ASD are unable to tell “this lesson is difficult for me” or “my ears are hurting because of loud noise”. It is sometimes also difficult for them to understand that the other person will get upset because of their behaviour. From the child’s perspective, the statements and actions of others may at times seem to occur without meaning or identifiable purpose, occurring randomly and without warning or logic. So, ‘hitting when angry’ or ‘throwing books away when studying is difficult’, becomes acceptable and easier than talking about it. 

 

Why are appropriate language and communication skills so crucial during social interaction?

Language and communication are integral parts of social interaction system. Language can be encoded into and transmitted through physical symbols (gestures), it can also be expressed and understood phonologically (pronunciation & sound) through speech and orthographically (spelling, punctuation, etc.) through writing. Any form of symbolic communication that uses words is considered verbal, even if not spoken.  So non-verbal and verbal communication goes hand in hand. 

Parents use facial expressions, gestures, tone of voice, along with speech when talking to their children. The emotional tone helps in conveying the message with great impact. Children with ASD, facing difficulties in social communication is a cardinal feature. Communication difficulties include lack of facial expressions, gestures or using unfamiliar phrases, for example; “pasta eat Sam”, “Granny house go”, “marker pen write I”, “Mamma put detergent in oven and pasta in washing machine”. Because of these difficulties, they are unable to express needs, if there is any form of pain or anxiety. 

The inability to interact with the peer group during school hours or at park play, caused by difficulty in giving eye contact, understanding gestures or facial expressions impairs them in developing friendships or maintaining relationships in the long run. Children with ASD who develop functional communication often display atypical communication style, such as echolalia, contact gestures, pronoun reversals and neologisms because these children have a limited understanding of the meaning and intentions of symbolic forms of language. Language delay and lack in social communication is one of the core clinical symptoms of children diagnosed with ASD.

 

How does lack of communication leads to behaviour issues in children with ASD?

Behaviour such as aggression, irritability and non-compliance are common in children with ASD. There are repeated movements such as rocking or flapping of fingers or hands, high sensitivity or less sensitivity to certain things around them such as light, sound, touch or taste. They also have rituals like asking the same question as they enter the house and the need to hear a specific answer.  Rituals are very important to children with ASD. They may like to eat, sleep, get ready for school, in the same pattern or use the same elevator in the same way every time. Breaking or changing the routine might upset the child or even lead to an outburst. 

Sometimes there is, obsession of objects or in the topic of conversation for example; after vacation the child may keep talking about the airline or airplane they traveled in or talking and reading about animals. Aggression and its persistence over time may result partly from ‘the absence of language’ or ‘communication difficulties’. There is also a possibility of, lack of empathy and inability to understand mental states of their own as well as of others. The frustration of being unable to communicate with others can lead to behaviour outbursts in some children. These behaviours can be observed through a wide range of expressions, like aggressiveness, self-harm, laughing, screaming, running around or throwing things. 

These behaviors in children occur as a form of communication, especially when their needs are not met. These difficulties in communication creates a necessity for tools and methods to help understand and manage the needs of children with ASD. There are many tools designed to address the communication strategies, with varying range of effectiveness. One such tool, with high effectiveness in enhancing the communication skill and behaviour modification in children with ASD is ‘Social Story’.

 

What are Social Stories? 

Social Stories are evidence-based strategy practiced with children with ASD. It was introduced by Carol Gray in 1991. Every child on the autism spectrum has different strengths and needs at different ages, therefore each child is unique. Each child also needs an individualized treatment plan based on their needs and difficulties. Social stories are child friendly intervention that are used to give children social information in a situation where they have social difficulties. These are short stories in which the content is descriptive, meaningful and safe for its audience. The content in social stories is tailored for the specific needs of each individual child, which can usually be prorated into the story. 

It is a social learning tool that supports the safe and meaningful exchange of information between parents, professionals and people with autism of all ages. The people who develop social stories are referred to as Authors and they work on behalf of a child, adolescent or adult with autism, “the Audience”. Social stories deal with one or more social capabilities that the individual needs to develop or to assist the person with overcoming challenges or problematic circumstances. For instance, if a child with ASD is unable to wait for his turn, his teacher or parent could develop a Social story that demonstrate approaches to wait till he gets his turn to sit on the swing or throw a ball. 

Giving children strategies they can use when they get restless while waiting. The purpose of a Social Story is  to provide an understanding of socially appropriate behaviour, help a person become familiar to a situation, help a person respond appropriately, prepare for a new experience, provide positive feedback so that people can recognize their own appropriate behaviour, and prevent extreme reactions that stem from a lack of social understanding. To elaborate further, a Social Story, describes what happens in a specific social situation and presents information in a structured and consistent manner. 

Social Stories can also give out social information through pictures and text as opposed to speech or observation (notable areas of weakness). Each story provides clear, concise and accurate information about what is happening in a specific social situation. It describes what is obvious to most of us, but not to those with impaired social understanding. The story describes what people do, why they do it and what the common responses are. The principal actor in the story could possess similar physical characteristics as the individual with ASD for whom the social story is being developed. In some cases, using photos of the individual with ASD for the story’s central character helps them easily associate with the story and situation demonstrated in the story. 

Social stories are useful, creative and easily achievable mediation for use with ASD children at home and in school. However it must be highlighted that social stories are not a means to increase the ease with which parents and teachers deal with the behaviour of children with ASD, rather a means to enhance children’s understanding about their environment, expressing their needs, learning strategies to overcome their difficulties and to give appropriate responses in social situations. 

 

How do you create a Social Story?

As visual clues give better understanding along with text, it is better to have one picture per sentence. The size and the font of the text has to be appropriate for the Audience. The social story has to be written or printed on a white paper with black writing or font. The language used has to be easy and simple to understand. Addressing the person by name (not “I” or “You”). One aspect or step on per section or page. 

  • Setting A Goal: 

The author identifies a particular difficulty(problem) faced by an individual with ASD. Using a defined process to share correct information through pictures, text and voice. The shared information has to be physically, emotionally and socially safe for the Audience.

  • Two Step Discovery: 

While gathering information it is important to keep in mind that the information to be shared has been beneficial to the Audience in improving their understanding about their surroundings, situation, skill or concept. 

  • Three Parts and a Title: 

A title for a social story is of utmost importance. The title and introduction should be directly related to the topic. More details have to be added that is called a body of the story, and the conclusion that reinforces and summarizes the information. 

  • Four-mat of the story: 

As each individual has a different learning capacity, interest and skills, a social story is prepared, keeping in mind the capability of an individual like attention span, intellectual ability, language comprehension skill or interest of its audience. 

  • Five Factors Define Voice and Vocabulary: 

It has a patient and supportive voice and vocabulary that is defined by five factors,

  • First- or Third-Person Perspective
  • Past, Present and Future Tense
  • Positive and Patient Tone
  • Literal Accuracy
  • Accurate Meaning

 

  •          Six Questions Guide Story Development: 

Social Story answers relevant ‘WH’ questions. It includes “WHERE” questions that describe the place, “WHEN” questions describe about the time, “WHAT” questions describe important cues, “WHO” questions describe about relevant people, “HOW” questions describe basic activities, behaviour or statements and “WHY” questions describe the reasons behind them. 

  • Seven is About Sentences: 

A social story includes Descriptive Sentences that accurately describe relevant aspects of context which includes internal and external factors. It also includes Coaching Sentences, that gives gently guiding behavior via descriptions of effective Team or Audience responses. Informs about effective response to a situation. It may also include self-coaching sentences such as: When the teacher says, “Stand in a line and wait” I will try to remember that it means to listen to what the teacher says and wait till teacher calls my name”

  • A GR-EIGHT Formula: 

“One Formula ensures that every Social Story describes more than directs.”

  • Nine Makes it Mine: 

“Every Social Story is reviewed and revised until it meets all applicable Social Story Criteria.” 

  • Ten Guides to Implementation: 

“The 10 guides to implementation ensure that the philosophy and criteria that guide Story development are consistent with how it is introduced and reviewed with the Audience.” 

1) Plan for comprehension 

2) Plan story support 

3) Develop a story schedule 

4) Plan a positive introduction 

5) Monitor 

6) Organize the stories 

7) Mix and match stories to build concepts 

8) Story reruns and sequels 

9) Recycle instruction into applause 

10) Stay current.

 

Here’s a Social Story We Created for “The Audience”

Waiting in the queue

Sam likes to play at the park.

Playing at the park makes Sam happy and strong.

Sam loves to sit on the swing.

Sam waits in the queue with his hands down. 

Waiting in the queue is a good habit. 

Waiting in the queue makes mummy happy. 

Waiting in the queue makes friends happy. 

 

Social stories can be used by parents, practitioners, teachers, support staff, social workers, health care staff or anyone who supports an autistic individual. 

 

Fatima Sheikh

Special Educator/Clinical Psychologist/Arts Based Therapy Practitioner

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