Article Preview
TopIntroduction
Autism Spectrum Disorder (ASD) is a heterogeneous, neurodevelopmental disorder affecting approximately 1% of the population worldwide (Centers for Disease Control and Prevention [CDC], 2018). Behavioral manifestations of ASD include deficits associated with social-communication skills and pragmatics, as well as the presentation of stereotypical/repetitive behaviors, strict adherence to routines, and limited interests that can persist through the person’s lifetime. Furthermore, individuals with ASD often display sensory processing differences resulting in hypo/hypersensitivity to environmental sensory information (American Psychiatric Association, 2013). The combination of poor social communication skills, sensory sensitivity, and desire for sameness experienced by individuals with ASD, often results in extreme anxiety and/or stress in unfamiliar or novel situations during which social interaction is required. For some individuals with ASD, this stress and/or anxiety may manifest as inappropriate self-stimulatory or stereotypical behaviors, such as screaming, hitting, or running, which further impedes participation and inclusion in social interaction activities. Because individuals with ASD have difficulty predicting what will occur during novel situations, it is essential to identify and utilize empirically based methods that assist these individuals to prepare for unfamiliar or novel situations in advance. Exposing individuals with ASD to the potential activities and/or interactions that may occur during a novel situation in advance may reduce the occurrence of inappropriate behaviors rooted in stress and/or anxiety triggered by the situation. As such, the individual with ASD may become more amenable to experiencing novel or unfamiliar situations requiring social interaction, thereby facilitating an increase in successful social outcomes.
For over 20 years, educators and practitioners have been designing interventions for children and adolescents with ASD using social stories (Delano & Snell, 2006; Gray & Garland, 1993; Kokina & Kern, 2010; Kuoch & Mirenda, 2003; Reynhout & Carter, 2006; Sansosti & Powell-Smith, 2006; Scattone, 2008). Originally developed in 1993 by Carol Gray, Social Stories ™ are short books describing a social event from the perspective of the person reading the story (Gray 2004; Gray & Garland, 1993; Qi, Barton, Collier, Lin, & Montoya, 2018). Social stories are reviewed prior to a specific social situation and are not utilized to elicit a specific change in behavior, but to facilitate the understanding of social situations and the perspectives of other individuals in the setting (Gray, 2004). Traditional social stories often pair vocabulary and language, commensurate with the communication level of the child or adolescent, with a series of images or photographs that illustrate a situation, event, or expectation and provide descriptions of the roles others play in the sample situation. Furthermore, the social story provides the child or adolescent with ASD an example of the sequence of events and reflects environmental cues and social interactions likely to occur during the situation. Using social stories with children or adolescents who have ASD primes the use of appropriate social responses by providing a model of the skills needed to engage successfully in the situation (Delano & Snell, 2006; Sansosti & Powell-Smith, 2006; Scattone, 2008). As such, the use of social stories has resulted in positive outcomes such as reducing disruptive behaviors (Scattone, Wilczynski, Edwards, & Rabian, 2002); decreasing inappropriate social behaviors (Graetz, Mastropieri, & Scruggs, 2009), and increasing prosocial behaviors for preschool children with ASD (Crozier & Tincani, 2007). Additionally, social stories as an intervention are attractive to practitioners because of the ease of implementation, individualization, and modification (Bozkurt & Vuran, 2014).