Robert L. Koegel

Differences in social communication are common in highly verbal autistic adolescents and can interfere with development of friendships as well as lead to other co-occurring challenges. The purpose of this initial study was to assess whether targeted areas of social communication would improve following the implementation of a manualized social communication package with parent participation and school coordination. Autistic adolescents who demonstrated challenges with social communication participated in this study in the context of a rigorous concurrent multiple baseline experimental design. Weekly intervention targeting social communication was implemented over a period of six to seven weeks (depending on preintervention scores). Additionally, parents and participants completed standardized assessments of anxiety and depression and a post-intervention questionnaire was administered to assess their satisfaction with the intervention. This study demonstrated that social communication could be improved with a short-term intervention program with parent and school participation. All participants showed improvements in social communication, which was maintained at follow-up. Also, all participants and their parents reported high satisfaction with the program. These findings corroborate a growing literature base suggesting that support in the area of social communication is needed and can benefit autistic adolescents.

Many individuals with Autism Spectrum Disorder (ASD) experience challenges with social communication, including recognizing and responding to non-verbal cues. The purpose of this study was to assess the efficacy of self-management combined with textual cues to teach adults with ASD to recognize and respond to nonverbal expressions of boredom and confusion during social conversation. A multiple baseline across participants design was used to assess the efficacy of this intervention for three participants. Results showed substantial gains across all participants in their recognition and responsiveness to the targeted nonverbal cues. Moreover, this skill maintained after the completion of intervention and generalized to novel conversation partners and settings with large effect sizes. The findings add to the literature base on interventions for adults with ASD, and further support the use of self-management and textual cues as effective intervention strategies for improving nonverbal communication.

Purpose Individuals with autism spectrum disorder (ASD) often have difficulty asking questions during social conversation, which can negatively impact their interactions with peers. The purpose of this study was to assess whether a question bank intervention would be effective in improving question asking during social conversation. Method In the context of a multiple-baseline experimental design, we implemented an intervention using prepractice with question banks designed to increase the number and diversity of questions asked by adolescents and adults with ASD during social conversations with their peers. Results Following intervention, all participants improved their use of questions in natural settings with their neurotypical peers. Generalization to novel questions occurred, and gains were maintained at follow-up. Finally, supplemental measures of social validity showed that similarly aged neurotypical peers who were naïve to the experimental hypothesis rated two of the three participants with higher social desirability following intervention. Conclusion Individuals with ASD can improve their appropriate question asking during social conversation using a brief question bank intervention with generalization to their peers in natural settings.

Individuals with autism spectrum disorder (ASD) experience challenges maintaining fluid, reciprocal conversations, resulting in prolonged, awkward pauses. Such pauses disrupt the pacing of an interaction and create (a) less favorable social impressions and (b) perceptions of limited social competence. To help these individuals succeed socially, there is a need for intervention techniques specifically targeting this area. Using a multiple baseline experimental design, this study evaluated the efficacy of a video-feedback intervention to improve conversational fluidity in young adults with ASD. Specifically, number of long pauses and questions asked during a conversation were measured. In addition, social desirability was examined as well as participant-reported confidence in their skills and satisfaction with the intervention. Following intervention, all participants improved in their ability to maintain a fluid conversation. Furthermore, supplemental assessments indicated that each participant improved in their confidence in communication skills and was rated as more socially desirable by their same-aged peers.

Given the increasing number of individuals diagnosed with autism spectrum disorder (ASD), there is a critical need to develop programs that facilitate positive behavior outcomes during the transition to adulthood. Furthermore, many adults with ASD do not have access to intervention programs due to remote locations, lack of qualified personnel, and/or long waitlists. This study, conducted within the context of a combined multiple baseline and changing criterion design, examined the use of videoconferencing (VC) to provide intervention from a remote location. Results showed that following intervention participants were able to independently perform the targeted skills and all targeted skills maintained during follow-up probes. All participants rated the intervention highly and said that they would recommend the intervention to others. These results are discussed in relation to potential avenues to increase access to services for individuals with ASD, particularly in remote and underserved areas, using VC.

Children with autism spectrum disorder demonstrate challenges in socialization that can interfere with their participation in common childhood activities and can persist or worsen if not addressed. The purpose of this study was to assess whether individualized education program (IEP) social goals could be targeted by a supervised paraprofessional during a short-term inclusive summer camp program. Data were collected using a concurrent multiple baseline design across four children. Results showed that following a 2-week summer camp program all participants made social improvements, reaching their year-long IEP goals, that maintained at follow-up in natural environments. Further, the paraprofessionals reached fidelity of implementation. Findings are discussed in terms of the value and feasibility of providing social interventions in inclusive summer camps.

Restricted repetitive behaviors (RRB) are one of the core symptoms of autism spectrum disorder (ASD). Evidence suggests that higher-order RRB (H-RRB) are particularly challenging and can negatively impact family functioning (e.g., insistence on sameness, following idiosyncratic routines). The study examined the effects of a parent-implemented behavior intervention using a multiple baseline single case experimental design in three young children with ASD. The intervention involved self-management procedures and included principles of pivotal response treatment during which parents provided bids for children to vary from H-RRB and children obtained points for engaging in these other interests and activities. Results showed improvements in child behavior, parent and child affect and interactions, children’s engagement in family activities, and overall parent ratings of RRB.

Research has demonstrated that incorporating restricted interests of an individual with autism into recess activities is effective at increasing socialization with typically developing peers. However, certain activity contexts may alter the reinforcing influence of the restricted repetitive behaviors (RRBs) depending on an individual’s history in that activity. Using an alternating treatment design, this study examined whether an individual’s history with an activity affected socialization. RRBs were embedded into activities with a reported positive history (i.e., prior history of positive experiences) and activities with a reported negative history (i.e., prior history of aversive experiences) for participants. Data indicated that socialization increased and remained above baseline levels when RRBs were introduced during activities with a positive history, whereas socialization was minimal when RRBs were introduced in activities with a negative history. Social significance and implications for designing activities that incorporate a child’s RRBs are discussed.

Recent research suggests that children with autism spectrum disorder (ASD) may now be reliably identified in later infancy, highlighting the need for empirically-validated interventions for infants and toddlers with early symptoms of ASD. Using a multiple baseline design across 15- to 21-month-old toddlers, this study implemented a brief, parent-mediated, Pivotal Response Treatment program, focusing on improving expressive communication. The results indicated that verbal communication improved as a consequence of the intervention, with concomitant improvements in untreated areas for all participants. Following the intervention, symptoms of autism decreased and parents reported satisfaction with the program’s ease of implementation and observed child gains. The results are discussed in terms of developing very early interventions to improve developmental trajectories for infants and toddlers.

Increasing numbers of individuals with Autism Spectrum Disorder (ASD) are entering postsecondary education; however, many report feeling lonely and isolated. These difficulties with socialization have been found to impact students’ academic success, involvement within the university, and overall well being. Therefore, the purpose of this study was to assess, within the context of a multiple-baseline across participants design, whether a structured social planning intervention would increase social integration for college students with ASD. The intervention consisted of weekly meetings to plan social activities around the student with ASD's interests, improve organizational skills, and target specific social skills. Additionally, each participant had a peer mentor for support during the social activities. The results showed that following intervention all participants increased their number of community-based social events, extracurricular activities, and peer interactions. Furthermore, participants improved in their academic performance and satisfaction with their college experience. Results are discussed in regards to developing specialized programs to assist college students with ASD.