Generalization of social skills to peer interactions in a child with language delays

GENERALIZATIONOFSOCIALSKILLSTOPEERINTERACTIONSINACHILDWITHLANGUAGEDELAYS

ChristineJohnson andJeannie Golden*East Carolina University, Greenville, USA.

Researchers in this study have attempted to determine whether integrating generalizationpromoting strategies into intervention procedures would enhance the generalization andmaintenance of social skills to peer interactions in a preschool child with language delays. This

intervention took place in the natural environment of the day care facility where the child wasenrolled. A multiple baseline across behaviors design addressed social response behavior,approach behavior, and play organizers. The intervention utilized a prompting and social

reinforcement procedure with minimal adaptations of the onging classroom activities tosystematically improve the target child's peer interactions. Several generalization promotingstrategies were also used. Improvements in all three types of behavior and generalization of

treatment effects across persons, settings, and time were observed. These results lend support forthe value of integrating several generalization promoting strategies pre-experimentally into theintervention instead of relying on post hoc evaluation of intervention.#1997 John Wiley & Sons,Ltd.

Behav. Intervent. Vol 12:3 133±147, 1997No of Figures: 1. No of Tables: 0. No of References: 37.

Social skills deficits experienced during childhood can result in both short-term and long-term consequences (Elliot & Gresham, 1993) affecting numerousaspects of one's present and future life (Asher, 1985; Hartup & Sancilio, 1986;Matson & Ollendick, 1988; McEvoy & Odom, 1987; Parker & Asher, 1987;Strain & Shores, 1977). Factors associated with difficulties in language andcommunication are likely to leave children with language delays at a dis-advantage when it comes to social interaction (Guralnick, 1981; Howlin &Rutter, 1987; Michelson & Mannarino, 1986; Petrie, 1975; Prizant & Wetherby,1990). However, teaching children social skills they can use in their interactions(i.e. initiations, gestures, facial expressions, verbalizations) can be effective atincreasing positive peer interactions (Chandler, Fowler, & Lubeck, 1992;

CCC 1072±0847/97/030133±15$17.50#1997 John Wiley & Sons, Ltd.

Behavioral Interventions, Vol. 12, No. 3, 133±147 (1997)

*Correspondence to: Jeannie Golden, Department of Psychology, East Carolina University, Greenville, NC27858, USA.

Gaylord-Ross, Haring, Breen, & Pitts-Conway, 1984; Howlin & Rutter, 1987;Leblanc & Matson, 1995; Oke & Schreibman, 1990).Peer interactions allow the participants to learn from one another and

experience varying roles and routines that will assist in later social relationships(Warren & Rogers-Warren, 1982). Although simple exposure to peers is typicallyenough for children to acquire necessary social skills (Forrester, 1992), for youngchildren with social delays, exposure alone may not be enough (Cooke &Apollini,1976; McEvoy & Odom, 1987; Mastropieri & Scruggs, 1985; Storey, Danko,Ashworth, & Strain, 1994). As a result, research has turned to the use of peerexemplars (Lindeman, Fox, & Redelheim, 1993; Michelson & Mannarino, 1986;Pinkston, Reise, LeBlanc, & Baer, 1972) and the use of prompting andreinforcement procedures (Chandler, Lubeck, & Fowler, 1992; Leblanc &Matson, 1995; Lewis, 1994; Lindeman et al., 1993; Mastropieri & Scruggs,1985; Matson, Fee, Coe & Smith, 1991; McConnell, Sisson, Cort, & Strain, 1991).Although the researchers have been able to successfully demonstrate the

effectiveness of various social skills intervention procedures, findings of general-ization and maintenance have been somewhat inconsistent (Chandler et al., 1992;Fox & McEvoy, 1993; McEvoy & Odom, 1987; Ogilvy, 1994; Storey, Danko,Strain, & Smith, 1992; Storey et al., 1994). While structured training of specificsocial skills outside the natural setting is a strategy that is used frequently in socialskills interventions (Goldstein, Kaczmarek, Pennington, & Shafer, 1992; Leblanc&Matson, 1995; Matson et al., 1991; McConnell et al., 1991; Oke & Schreibman,1990; Storey et al., 1993), such procedures could be less efficient and causeproblems in transfer and generalization (Carey & Stoner, 1994; Fox & McEvoy,1993). Fox and McEvoy hypothesize that too many differences between trainingand generalization settings may be the reason for failure to reliably producegeneralization. Two reviews of the literature (Carey & Stone, 1994; Elliot &Gresham, 1993) and one application (Twardosz, Nordquist, Simon, & Botkin,1983) have recommended implementation of intervention in the naturalenvironment.Based on these findings, the researchers in this study have attempted to

determine whether integrating generalization promoting strategies into theintervention procedures would enhance generalization and maintenance (referto Elliot & Gresham, 1993; Michelson & Mannarino, 1986; Stokes & Baer,1977; Stokes & Osnes, 1986). Additionally, in order to bridge the gap that existsbetween the knowledge of effective social interaction interventions and theirimplementation in applied settings in the community (Peterson & McConnell,1993) and in an attempt to provide a more efficient intervention (Elliot &Gresham, 1993), this intervention took place in a natural setting with ongoingactivities as opposed to removing the child to an artificial setting.

134 C. Johnson and J. Golden

#1997 John Wiley & Sons, Ltd. Behavioral Interventions. Vol 12, No 3, 133±147 1997

METHOD

Participants

Colt (a pseudonym) was a two-and-a-half-year-old male exhibiting deficits inreceptive and expressive language. Colt was offered specialized early interven-tion services as provided by state law (NC, PL 99-457, Part H) on the basis ofstandardized test scores identifying him as borderline to mild receptive/expressive language delayed. Formal testing done at 2 years, 6 months, of agerevealed Colt's cognitive abilities to be at the lower end of the average range.Scores from the Bayley Scales of Infant Development: Second Edition (81+5.5)showed a 16% delay in overall cognitive development. However, the evaluationsummary indicated that performance was likely influenced by language delays,decreased imitation, and inconsistent attention. Colt's receptive/expressivelanguage skills, based on formal testing using the Preschool Language ScaleÐ3(Total Language Age Standard Score=69) and the Receptive±ExpressiveEmergent Language ScaleÐ2 (Language Quotient=65) clustered in the 19±20month level. These scores represent a significant delay in the 35% range.Observations noted from the psychology±speech arena assessment includeddecreased and variable attention skills, variable interactions, not seeking outothers for interactive play, and at times resistance to examiner intrusion. Thechild's play was described as more typical of a younger child with preferencesfor solitary play. Colt's vocalizations were noted to include the use of singlewords, some two-word combinations, numerous imitative words, and jargon. Itwas also stated that Colt's spontaneous speech was often difficult to interpretand that he frequently relied on contextual cues in order to comprehend simpledirections.Despite recommendations and eligibility for early intervention services based

on formal assessment, Colt's mother chose an individualized intervention planto be implemented for her child in the natural setting based on her concerns forintensive, consistent programming regarding her son's low level of social inter-action with his peers.Colt was enrolled in a regular, nonspecialized day care facility. At the onset of

the study, he was observed to have some spontaneous speech, although hisfunctional speech typically consisted of only single words or very simple phrases.His imitative speech was observed to be much better than his spontaneousspeech. Initial observations confirmed teacher reports that Colt spent most ofhis free play in solitary plays. His interactive play was substantially below thatof his peers. Prior to intervention, the frequency of initiated social interactionsmade by Colt toward his peers was rather limited. In addition, he rarely

Generalization of social skills 135


responded in a positive manner to his classmates' attempts to interact with him.Attempts made by his peers to interact often led to aggression on the part ofColt, and therefore disruption of the classroom. Colt was observed to have nodeficits in his appropriate use of toys.

Setting

The intervention was implemented during afternoon free play periodsapproximately 5 d/week for 1 month at a local day care facility in which thetarget child was enrolled. Implementation occurred within the natural routineof the classroom, which included time outdoors on the playground as well astime in the classroom. Outdoor free play provided access to a jungle gym whichincluded a slide, a swing set, a sand box, a wooden house that the children couldplay inside of, and a grass field outside of the fenced-in playground where attimes the children were allowed to run and play organized games. Indoor freeplay was conducted in the regular classroom. Through the use of masking tape,lines were marked on the carpet to differentiate different play stations. Theroom was equipped with a housekeeping station; a station consisting of largestacking blocks, books, and trains; and a third station consisting of more finemotor activities such as beads, counting manipulatives, puzzles, and the like.The classroom composition consisted of one teacher and an average of tenpreschoolers, with variability due to child absences. During play sessions, thechildren were free to select the station and activity in which they wished to play.

Behavioral measures

The category of behavior recorded during the intervention was socialinteractions involving the target child. Social interaction was measured on thebasis of three target behaviors seen as subsets of the overall desired behavior.Definitions of each of the behavior are as follows:

Social response

A social response is defined as any time the target child reacts to anotherchild's initiated social behavior. It is measured at times in which another childattempts through verbalizations or gestures to interact with the target child orwhen another child comes within the same play station as the target child asdefined in the description of the setting. Appropriate response behavior includeany positive effort made by the target child through verbalizations or gestures



to acknowledge and/or maintain another child's initiation or presence (i.e.turning in the direction of the child, sustaining eye contact, imitative actions). Italso includes any verbal or nonverbal attempts made by the target child to joinin a play situation with another child.

Approach behavior

An approach behavior was defined as any positive approaches made by thetarget child to go up to another child when previously playing at a distance (i.e.from a different play station). This includes orienting his body toward that childand making eye contact with him/her. It would also include any behaviors madeto gain or maintain attention from that child using vocalizations or gestures (i.e.tapping on the shoulder, saying `hello').

Play organizers

A play organizer was defined as any positive verbalizations in which thetarget child specifies an activity, assigns a role, or maintains an activity bystating a rule or invites another child to participate in the specified activity. Thisincludes, for example, simple phrasing beginning with `let's play . . .'.

Experimental design

A multiple-baseline-across-behaviors design was used to determine whetherColt's social interactions improved as intervention was systematically applied toeach of the three target behaviors.

Observational procedures

The first author as well as numerous undergraduate students served asexperimenters in partial fulfillment of coursework. Experimenters randomlyrotated through the roles of both observer and prompter. Before beginningintervention procedures, undergraduate volunteers were trained regardingspecific procedures (including prompting, praise, and data collection).Intervention sessions lasted approximately 30min with intervention applied

to a maximum of ten trials, or social exchange opportunities, per session.Intervention took advantage of teachable moments rather than schedulingdiscrete learning trials. One prompter and one observer were present duringeach session. Observers used a frequency count recording system to record the



occurrence of each of the three target behaviors. This recording system was alsoreflective of the number of opportunities in which any or all of the targetbehaviors could have occurred. A `+' was recorded if the target childspontaneously performed the specified behavior or if he responded appro-priately to a general prompt geared toward the target behavior. A `7' wasrecorded if an incorrect response was made. In such cases, a neutral `no' wasgiven in order to acknowledge the incorrect response. An `NR' was recorded ifthere was no response made by the target child. Data was summarized as thenumber of occurrences of each of the target behaviors out of the total numberof opportunities to exhibit each of the target behaviors. Thus, a percent ofoccurrence for each target behavior is equal to the number of occurrences overthe number of opportunities to exhibit the behavior multiplied by 100.

Intervention strategies

Intervention was conducted by waiting for social exchange opportunities tooccur within the natural routine of the classroom, as defined by such situationsin which another child approached the target child who was previously notinteracting with his peers or when the target child remained in solitary play andthe circumstances of the classroom permitted the target child an opportunity totake the lead role and invite another child to play. Prompters kept attention andsocial reinforcement contingent upon Colt's behavior by refraining frominteraction between reinforcement periods. Prompters were also careful not tointrude upon the ongoing activities or interactions of the classroom.

Baseline

Ten minute baseline sessions were conducted during regular scheduled freeplay sessions. The target child was simply given one general orienting promptinstructing him to play. No further attempts were made to interact or influencethe child's play. Because the goal was to improve social interaction skills, initialbaseline continued until a low, stable, or descending pattern was established.Intervention then began for the first target behavior, while baseline continuedfor the remaining behaviors.

Prompting and social reinorcement

Each session began with a step-by-step assisted interaction in order tointroduce or review the expected target behavior. Intervention procedures were



implemented only when potential social exchange opportunities occurred withinthe natural setting. This involved conducting intervention both indoors andoutdoors, as well as with different peers and during different activities. At thebeginning of each trial, Colt was given 10 s to spontaneously perform the targetbehavior. If no response occurred, the prompter gave Colt a general prompt, ordirective, geared toward the target behavior and appropriate to the situation athand. Based on this prompt, Colt was given 30 s to perform the target behavior.If an appropriate response still did not occur, a `7' or `NR' was given and thetrial ended. A neutral `no' was given to acknowledge incorrect responses, while`NR' trials ended silently. Intervention was implemented for one behavior onlyuntil Colt demonstrated a consistent ascending trend. Once this occurred,intervention began for subsequent behaviors. Reinforcement was givenimmediately by the prompter, contingent on correct responses. Enthusiasticsocial praise, attention, and tickles were used as reinforcers since they appearedhighly reinforcing to Colt. In addition to being immediately available, theycould be easily distributed to all children in the interaction, as well as availablewithout needing to introduce more tangible reinforcers such as toys or primarieswhich may have interfered with the normal routine of the classroom.

Generalization probes

Generalization probes were conducted in the same fashion as baselinesessions. These probes were conducted before and after implementation ofintervention to the third behavior because this behavior, play organizer, showeda much lower operant level than the remaining two behaviors. Generalizationwas assessed in morning free play sessions which included a different teacherand additional classmates. Ten minute sessions were observed with no attemptsmade to influence or reinforce social interactions. These probes were conductedin order to measure any changes due to intervention.

Follow-up

A unique 4 month follow-up check was performed which assessed both short-term maintenance and generalization across persons and settings. At this pointColt had been moved to a new classroom (the next-oldest age group). Due to adecrease in staff on the day in question, Colt and three of his classmates werespending their afternoon free play with peers in another classroom that he didnot frequently attend. The probe was conducted in this setting in the samefashion as baseline sessions had occurred. Additional 7 and 15 month follow-up



checks were performed in Colt's regular classroom to see whether Colt wascontinuing to engage in positive social behaviors. Data for all follow-up sessionswas taken in a fashion similar to baseline.

Fading

A teacher-administered fading procedure was suggested at the end of inter-vention which encouraged praise to be continued throughout the day wheneverthe teacher observed appropriate social interactions. The fading procedure wasimplemented by having the experimenter intervene fewer days per week prior toformal termination. If success continued to be seen in free play sessions, it wassuggested that generalization and maintenance would be scheduled in othersettings throughout the day.

Generalization promotion strategies

The behaviors targeted for Colt were carefully chosen and sequenced forintervention to ensure the greatest likelihood of provoking positive socialconsequences and improvements in interactions with his peers. Because Colt'senvironment was observed to provide him with attention more often forinappropriate behavior, intervention procedures provided positive attentionsolely for appropriate, desirable social behavior in an effort to modify theenvironment supporting maladaptive behavior. Prior to intervention, adultattention had typically been provided when a teacher spoke with Colt or placedColt in time-out for his aggressive behavior. Appropriate play and social skillswere much less attended to than were inappropriate, aggressive socialbehaviors. Prompts and positive reinforcement during intervention procedurestherefore remained focused on appropriate and desirable behavior, whileinappropriate behavior was acknowledged with a neutral `no' and otherwiseignored. The use of social reinforcers such as attention and praise were chosenbecause they could be delivered immediately in a convenient and unobtrusivefashion, as well as in any situation and by any individual without interferencewith ongoing activities.Several stimulus and response exemplars were also employed to help ensure

that Colt's social skills would generalize to as wide a range of persons andsettings as possible. To prevent labeling or stigmatization, artificial trainingenvironments and discrete trial interactions, which the mother feared mightdraw attention to her child's deficit, were avoided. Instead, intervention wasblended into the natural environment, which included more than one setting



(indoors and outdoors), under multiple circumstances (whatever activity Colt orpeers were engaged in) and with different classmates. In addition, multiplechange agents providing stimulus cues and reinforcement were also rotatedthroughout intervention.In an attempt to maximize opportunities for successful experiences early on,

intervention was conducted with minimal control over situations chosen fortrial presentations and the correct responses allowed. By taking advantage ofteachable moments within the natural setting rather than contriving artificialsituations, the prompters were allowed some latitude in deciding what con-ditions required prompting and what responses were considered correct.Implementing intervention in his regular classroom was also helpful because itis the most similar to the typical environment where Colt will be using theseskills after intervention. More intense reinforcement, such as lengthening theamount of attention from the prompter or combining a number of positivecomments, tickling, or hugging was always given for unprompted responses andgeneralization to new settings or situations. And finally, by waiting for his peersto come to him instead of actively evoking their assistance, and by interveningwith Colt and his peers in their natural context, Colt was introduced to commonsocial stimuli that he will most frequently encounter throughout his day andafter intervention is completed.

Reliability

With multiple observers available for data collection, reliability checks weretaken among observers. Interobserver reliability was calculated by dividing thesmaller percentage of occurrences by the larger percentage of occurrencesmultiplied by 100 for each of the three target behaviors per session. Whenaveraged across sessions, the percentage agreement obtained was 81, 84 and83% for social responses, approach behavior, and play organizers respectively.

RESULTS

Figure 1 shows the average percentage occurrences for each of the targetbehaviors. Percentages were calculated by dividing the number of correctresponses per session by the total number of opportunities for that session andmultiplying by 100. Percentages provided a means of assessing improvementsin social interaction of the target child with his peers. Analysis of overall trendsas presented in Figure 1 shows improvements in each of the target behaviors asa result of intervention being applied. The most significant improvement and





Figure 1. Colt's average percentage occurrence of social responses, approach behavior, and playorganizers during free-play sessions across baseline, intervention, generalization, and follow-up

conditions.

lasting effect was seen when intervention was applied to social responsebehaviors. Social response behaviors produced a stable ascending trend fromthe onset of intervention and remained at a high level of responding throughoutintervention. The remaining two behaviors also produced improvements con-tingent upon intervention being applied. Some generalization was observedwhile these remaining behaviors were still in baseline (i.e. refer to sessions 8 and9 in Figure 1). In addition, their improvements were much more unstable thanthe social responses, but nonetheless still fluctuated around a higher mean thanduring baseline.Figure 1 also provides information regarding generalization and main-

tenance. A comparison of generalization probes performed before and afterimplementation of intervention to the last target behavior, play organizers,showed substantial improvement from 10 to 80% correct responding onceintervention was applied to play organizers. Analysis also showed highgeneralization to morning free play for social responses (90%) and approachbehavior (80%) averaged across both generalization sessions. A 4 monthfollow-up check which combined features of generalization across time, setting,and persons as well as maintenance over time showed Colt performing targetbehaviors at a frequency of 94% for response behaviors and 100% for approachbehaviors and play organizers. Furthermore, at a 7 month follow-up check,Colt was still demonstrating target behaviors at a frequency of 88% forresponse behavior, 66% for approach behavior, and 100% for play organizers.Colt continued to demonstrate maintenance of target behaviors across time asevidenced by frequencies of 100, 78, and 100% responding for social responses,approach behaviors, and play organizers during a 15 month follow-up check.Analysis of the mean level of responding during baseline and intervention for

each of the target behaviors shows social response behavior improved from 36.6to 72.47% correct responding once intervention was applied. Approachbehavior improved from 41.3 to 67.75% and play organizers improved from16.9 to 38.58%. Increases in target behavior ranged from 44 to 60% improve-ment over the short time in which intervention was in effect.

DISCUSSION

The prompting and positive social reinforcement procedures employed in thisstudy were proven effective in improving Colt's social interaction with his peers.Marked improvements in social responses, approaches, and play organizerswere observed as a result of intervention. Breaking down social interaction intomanageable behaviors that could be mastered one at a time appeared helpful in



Colt's overall success of generalizing social skills to his peer interactions.Providing simple verbal prompts and contingent praise were enough for thischild to experience successful pro-social interactions with his classmates.Viewing Colt's social deficits as a result of his language delays seemed to be themost reasonable approach for intervention. Using simple, direct prompts in aone-on-one fashion can be an effective strategy for working with a child withlanguage delays who may be having trouble understanding what is expected ofhim. In the short period of time in which intervention was in place benefits wereobserved through Colt's increased positive peer interactions. Although notempirically verified, observations also supported an apparent reduction inaggression and isolated play.According to teacher report and informal observation by the researcher, Colt

appeared more sensitive and accepting of peers in his proximity as demon-strated through less shoving, grabbing, and hitting as well as less time spent intime-out. Additionally, Colt appeared to be spending increasing proportions ofhis free play interacting appropriately with another classmate as opposed toplaying by himself. By tailoring the intervention to meet Colt's unique needs,the intervention was successful at integrating Colt's language abilities into asocial skills package which he would be able to use successfully in communi-cating and interacting with his peers. By the time Colt was observed in his 7month follow-up check, Colt's play seemed to be very active, imaginative, andsophisticated. He consistently labeled and animated the various structures hebuilt while playing with Legos. He was following directions, responding to hispeers, and sharing ideas about his creations. Anecdotal reports from thedirector of the day care facility show that Colt has become increasingly able tocommunicate his wants and needs to his peers and his teachers and that he hasfound a peer group that he frequently socializes with. The slight decrease infrequency of responses and approach behavior from the 4 to the 7 monthmaintenance check does not represent a reduction in the amount of socialinteraction. It should be noted that although the number of interactionsdecreased, each interaction increased in duration. During the 15 month follow-up session, Colt continually engaged in reciprocal social interactions. In fact, hiscurrent teacher commented that he is `never by himself'. At this time Colt wasexhibiting numerous verbal responses, and both offered and accepted playsuggestions throughout his interactions. He was also able to approach peersengaged in different play activities without hesitation, and was persistent insuggesting various play ideas until the classmate he was playing with agreed toengage in an activity. On occasions when Colt became visibly upset by an actionof his peer (i.e. knocking over a house Colt had built with blocks) Colt wasobserved to appropriately exhibit and verbalize his emotion by crying and being



able to label his emotions to his peer when asked how the situation made himfeel. He was also observed asking for the teacher's assistance rather thanutilizing aggressive or other inappropriate behaviors to deal with the situation.During follow-up sessions, teachers provided consistent verbal reinforcementfor appropriate behavior (following directions; sharing his toys and ideas withhis peers). It was also noted that teachers provided Colt with appropriatealternatives when behaviors he was exhibiting were deemed inappropriate orundesirable. Such behavior is likely to have aided in Colt's successful main-tenance and increased improvement of social skills over time.The uniqueness of the intervention procedure, which required no artificial

training conditions and which provided variability within the training circum-stances and involved peers, is believed to have facilitated the rate of success,generalization, and maintenance observed. By working in the natural setting,conditions and cues provided were most similar to the situations in which Coltwould apply his newly acquired skills. Taking advantage of teachable momentsrather than scheduling discrete learning times helped to minimize adaptations ofongoing activities and interactions among classmates. This strategy most likelyaided in the transfer of skills beyond intervention sessions and in the fadingprocess that occurred at the end of intervention. Implementing intervention inthe setting in which he would later be using these skills proved efficient in that itprovided Colt with cues helpful in shifting to contingencies operating in thenatural environment.Because of the combination of generalization promoting strategies used

throughout intervention, it is difficult to conclusively determine what factor(s)contributed to Colt's success in generalization and maintenance of targetbehaviors. It could very well be the case that the combination of facilitatorsused, rather than a single factor, was responsible for the success seen. Althoughthe researchers feel that the use of multiple exemplars was an importantcomponent in transfer and generalization of target behaviors, they supportclaims made by Fox and McEvoy (1984) of the need for future research to moreefficiently address what would be a sufficient number of exemplars to reliablypromote generalization across persons, settings, and/or responses. Replicatingthis study with more participants who have similar difficulties is recommended.

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Generalization of social skills to peer interactions in a child with language delays

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