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Running Head: VISUAL STRATEGY WRITE-UP 1

Visual Strategy EPSY 330: Autism and Pervasive Developmental Disorders:

Students with Special Needs

Kourtney J. Gorham

University of Regina

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VISUAL STRATEGY WRITE-UP 2

Abstract

This study focuses on a student who is diagnosed with autism and would benefit from

visuals in the classroom. This study outlines a description of the student, the target and goal

behaviors and data on the effectiveness of the strategies. The strategies implemented were a

Social Story, focusing on when a substitute teacher is in the classroom, and a mini-activity

schedule, focusing on changes in tasks and the environment. Results from the data sheets,

focusing on both the baseline and intervention results, show that the implementation of these two

strategies had great benefits for this student and allowed her to decrease her target behavior and

increase her goal behavior. The study also focuses on the inclusionary aspects of these strategies

and consults evidence-based practice literature.

Keywords: baseline, intervention, duration, frequency, autism, evidence-based practice,

inclusion

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VISUAL STRATEGY WRITE-UP 3

Visual Strategy Project (VSP) Write-Up

Student Overview

Donna Rocher is a 16 year old girl in an inclusive Grade Ten Classroom. When Donna

was in Kindergarten she was referred to an educational psychologist by a collaborative team,

who noticed that Donna struggled with change and had trouble making eye contact. Donna

scored a 37 on The Childhood Autism Rating Scale – 2nd Edition (CARS – II) and was diagnosed

with moderate autism. Her problem areas included adaptation to change, emotional responses

and fear and nervousness. However, Donna showed strengths in her level and consistency of

intellectual responses. The Wechsler Individual Achievement Test – 3rd Edition (WIAT – III)

was also administered to measure her academic strengths and weaknesses. She scored in the

average range in all subtests, except for a slightly below average score in the oral language

category. Her overall Intelligence Quotient (IQ) was 85, placing her in the average range.

Donna is currently functioning at grade level but requires a reduced workload and some

extra guidance from her teacher and the paraprofessional in the room. She is able to meet most of

the math, reading and writing outcomes in the curriculum. Donna’s oral conversation skills have

improved; she is only slightly below the level of her peers but is able to actively participate in

smaller group settings. Donna’s strengths include visual responses and her level and consistency

of intellectual responses. She is very witty, loves to tell Pokemon jokes and exceeds in spatial

and naturalist intelligences. Donna is interested in music, drawing, reading, writing and animals.

Donna’s areas of concern still include emotional responses, adaptation to change, and fear and

nervousness. She has extremely high anxiety levels and does not cope well in new situations and

environments, or with new people and tasks. If Donna gets extremely anxious, an unwanted

behavioural response is usually triggered. However, if music is used when the initial signs of a

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VISUAL STRATEGY WRITE-UP 4

behavior occur, Donna can stop a behavior from occurring. Donna carries an IPod at all times

and has the freedom to use it when she needs to. Although Donna usually knows when she needs

to listen to her music, sometimes an adult in the room may have to direct her to her IPod if they

notice any initial behavior signs.

Target and Goal Behavior

Target Behavior (to decrease)

Who: Donna Rocher

What/Observable Terms: Donna starts to panic when a substitute teacher is in the classroom.

The behavior is as follows:

- Behavior in the beginning: sweating, talking to self and eyes widen. *If possible,

music should be used to calm Donna down.

- Behavior in the middle: swinging arms, jumping and stomping. *At this point, Donna

should leave the room with the paraprofessional and go to the sensory room for a

break.

- Behavior near/at the end: screaming and crying. *Once the crying subsides, Donna

will be ready to talk about the situation. She will verbalize that she is ready to go back

to the classroom.

Where: Classroom/school/sensory room

When/Trigger: When a substitute teacher is present.

Why: Anxiety/resistance to change because of a substitute teacher in the classroom.

IPP Goal: By June 1, 2014 Donna will be able to remain in the classroom (with music) 4/5 times

(80% of the time) when a substitute teacher is present. *Ideally, music will be faded in the future

but this is not a realistic goal currently.

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VISUAL STRATEGY WRITE-UP 5

Baseline: The baseline will be measured by a frequency/duration recording sheet. The sheet will

be used whenever a substitute is present. The paraprofessional in the room will be required to fill

out the sheet and observe the student for five hours (all five class periods). There are directions

on the sheet and the paraprofessional and teacher will meet beforehand. A tally will be made

each time Donna has to leave the room because of her behaviors and the duration (length) will be

recorded. The activity and class will also be noted. At the end of the day, the total time spent out

of the room and number of occurrences will be totaled. The paraprofessional and substitute

teacher will initial the document. The baseline will include results from three different days (15

hours of observations).

*Please see attached Frequency/Duration Recording Form (Baseline)

Intervention Plan/Instructional Strategies: Donna will be given an individualized Social Story

about what to do when a substitute teacher is in the classroom. The story will be read every

morning, as students are putting their coats in their lockers and grabbing their materials. The

story will be read at the teachers’ desk. Donna will read the story to the teacher and the

paraprofessional, as she is a fluid reader and the story does not include complex words above her

reading or comprehension level. After the story is completed, the paraprofessional will ask

Donna a few comprehension questions at her desk, as she gets ready for the day. The substitute

teacher will be made aware of this process but will not be required to teach the Social Story.

When the substitute teacher is present, Donna can read the story to the paraprofessional.

Reinforce: If Donna does not have to leave the classroom when a substitute teacher comes, she

gets a social reward of listening to music with a friend, once her teacher is back at school.

Fading: If the intervention is working, based on the data, the story will not be read every day

(increasing space between reading times). Since Donna is a young adult, it will be her choice to

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VISUAL STRATEGY WRITE-UP 6

bring the story to the teacher to be read. Therefore, verbal directions will be reduced to gestures

towards the book (Simpson et al., 2008, p. 127). However, if it is known that a substitute teacher

will be in the next day, the story will be read.

Generalization: The story applies to all subject areas. Furthermore, the pictures in her Social

Story match the pictures used for her mini-activity schedule and on the classroom activity board.

Review Date(s): This strategy will be reviewed at the end of term one to determine if it is

benefitting Donna and if it needs to be faded. Then it will be reviewed again halfway through the

second term by the collaborative team (LRT, teacher, principal, Donna, caregivers).

Goal Behavior (to increase)

Who: Donna Rocher

What/Observable Terms: The goal is to increase Donna’s independence. Donna’s

independence will be measured through her completion of her mini-activity schedule.

Where: Classroom/school/home

When: At the beginning of the day the teacher will go through the schedule and model how the

students’ should fill out their agendas. Donna will show her teacher the mini-schedule at the end

of the day, before she leaves. She will then take the mini-schedule home with her and get her

caregivers to initial it.

Why: The mini-schedule has been selected so that Donna is prepared for vertical transitions (life

after high school). The mini-schedule should increase her awareness of change and therefore,

help with her target goal while working on a new, positive goal. As Banda et al. (2009) notes,

“the ultimate goal of the activity schedule is to increase independent transitions within and

between activities and decrease problem behaviors during transition times” (p. 20). The mini-

schedule targets areas that the Social Story fails to, like environment and task changes. As

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Simpson et al. (2008) note, the mini-schedule “allows students to anticipate upcoming events and

activities… [and] predict change,” (p. 95) which is one of Donna’s areas of concern.

IPP Goal: By June 1, 2014 Donna will fill out her mini-schedule on her own 4/5 times (80% of

the time) with only a visual reminder on the board and/or small gestures. (Example: looking at

book).

Baseline: During the first week (5 days), Donna’s ability to fill out her own activity schedule,

get her caregiver’s signature, carry her own mini-schedule and utilize the choice activities will be

assessed by the teacher and Donna herself (self-assessment). Donna and the teacher will fill out a

quick student and teacher checklist each day, after checking in with each other at 3:30 pm. This

will promote Donna’s independence and give her control over her own learning and results. The

teacher will take these results and fill them in on the bar graph each week, to determine progress.

*Please see attached Behavioral Report Cards (Baseline).

Instructional Strategies/Intervention: Donna will be explicitly shown how to use her mini-

activity schedule. She has three transition symbols to use: an arrow that says “complete,” an

arrow that says “next,” and a clock that says “later.” At first, many verbal directions will be

given and the paraprofessional may guide her hand but eventually this will be faded to smaller

gestures (Simpson et al., 2008, p. 127). The teacher will model the daily schedule on the board

for everyone to follow along with. There are many choice making options throughout the book

so that Donna can work on her independence. There will be two choices at the start but more will

be added once she grasps the concept (Simpson et al., 2008, p. 107). The activity schedule is in a

story format, as this is one of Donna’s interests and if the mini-schedule interests her she will be

more inclined to use it.

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VISUAL STRATEGY WRITE-UP 8

Reinforce: If Donna completes her independence goals/tasks, she will be rewarded with 15

minutes of an activity of her choice on Friday. She will get to do this activity with a friend.

Fading: At the start, the paraprofessional will help Donna fill out the mini-activity schedule as

the teacher is modelling it on the board and as her classmates fill out their own agendas. This

guidance will slowly be faded out. By the end of the year, the paraprofessional or teacher will

only have to gesture at the book for Donna to take it out and fill out the mini-schedule as it is

modeled. Furthermore, I would fade out the within activity format and only use a between-

activity format if the results were positive. *The future plan is for Donna to reduce the schedule

into a list of pocket activities – a skill she can utilize in her adult years - but this will occur in

later grades.

Generalization: Donna will use the schedule in all of her classes. Furthermore, the pictures in

her Social Story match the pictures used for her mini-activity schedule and on the classroom

activity board.

Review Date(s): This strategy will be reviewed at the end of term one to determine if it is

benefitting Donna and if it needs to be faded. The strategy will also be reviewed halfway into the

second semester by the collaborative team (LRT, teacher, principal, Donna, caregivers).

Directions for Substitute Teacher: The substitute teacher will be given directions to start the

day going over the schedule on the board. They will be given an example layout so that they can

simply copy the schedule onto the board. At the end of the day, the substitute teacher will be

asked to check Donna’s book to see if she followed along and used her schedule. They will

simply report back if it is complete or not. They will not fill out the bar graph (even if it is the

end of the week) but can complete the teacher report card for that day.

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VISUAL STRATEGY WRITE-UP 9

Intervention Efficacy

To determine if the Social Story worked or not, the same Frequency/Duration sheet will

be filled out by the paraprofessional when a substitute teacher is present. The data will then be

compared to determine if the intervention is sufficient. The intervention data will include the

same amount of time (15 hours/3 days) of observations. If the intervention data meets the target

goal, then we will know the goal was reasonable and the strategy was beneficial.

*Please see the attached Frequency/Duration sheet (Intervention).

Based on the baseline and intervention data, Donna is meeting her goals. As depicted in

Chart 1 (below), the initial baseline duration was 1.5 – 2 hours of behaviors. After the

intervention, the intervention duration has been reduced to .5 – 1 hour of behaviors. The

baseline frequency was 3 behaviors on average and after the intervention frequency was

reduced in half to 1.5 behaviors on average. Based on a five hour viewing period (10 rows), in

order for Donna to meet the 80% time spent in the classroom goal, the results must only cover

two rows (20%). We can see that the intervention duration only covers 1 to 2 rows, meaning

that she was in the classroom for 80 – 90 % of the day when the substitute teacher was present.

Therefore, after the intervention was put in place Donna met and exceeded her new goal. Her

target behaviour was decreased.

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VISUAL STRATEGY WRITE-UP 10

Chart 1:

Baseline Du-ration

Baseline Frequency

Intervention Duration

Intervention Frequency

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Series 1Series 2Series 3

To determine if the mini-activity schedule is increasing Donna’s independence,

behavioral report cards were used. Example baseline teacher and student sheets are included, as

well as, the bar graph with baseline and intervention data. Donna’s initial baseline results were

averaging 4.5 across the board, meaning she sometimes accomplished her independence goals

(about 45% of the time). At the fourth week mark, Donna’s intervention results showed that she

accomplished filling out her own activity sheet and getting her caregiver’s signature 8.5 times on

average, meaning she usually accomplished this skill (about 85% of time). Donna’s average for

carrying her own schedule and using choice activities was around 8 (about 80% of time). This

means she has met the goal of completing these tasks 80% of the time (and in some cases

exceeded it). A visual of the first goal (filling out own activity sheet) is represented below in

Chart 2:

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VISUAL STRATEGY WRITE-UP 11

Chart 2:

Changes:

I would make a few changes to my Social Story. I think the word “regular” can be

changed, since the schedule is not always the same. Furthermore, if I was working with Donna

right now I would allow her to write the Social Story. I may also include a comprehension

checklist to see if she is grasping the concepts. For the mini-activity schedule I used both within

and between activity formations and I think that makes it confusing. I think it would be more

beneficial to provide Donna with a between-activity schedule. I like that the schedule is in a

story format, since that is one of Donna’s interests, but it needs to be clearer. Preferably, Donna

could use an actual agenda and just have picture icons to put inside of it.

Goal 1 - Week 1 Goal 1 - Week 2 Goal 1 - Week 3 Goal 1 - Week 4

2 36

47

2 2

4 5

67 7

8 9

99 9

8 7

9

Chart TitleSeries 1 Series 2 Series 3 Series 4

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Social Validity and Inclusionary

To make the Social Story strategy inclusive, I would have an explicit discussion with my

class about what to do when a substitute teacher is in the classroom. The specific strategies used

in Donna’s social story can be applied to all students. The expectations I have for Donna are the

same expectations I have for the rest of my students. Having a substitute teacher is not a free-for-

all day and all of the students still have responsibilities. Furthermore, this strategy will be taught

while other students are getting busy for the day so Donna is not signaled out. Donna’s reward

involves including her classmates. This strategy meets Donna’s current needs and hopefully it

would not be needed in the future (after sufficient intervention time).

The mini-activity schedule is inclusive because all of the students have their own agenda.

Donna’s strategy is an adaptation of what is already happening in the classroom. This holds

Donna to the same standards as everyone else and does not single her out. Her mini-activity

schedule is the same size as her peers’ agendas and should not draw any unwanted attention. All

students will be expected to keep their agendas with them, and Donna’s mini-schedule is also

portable. Agenda time will be modeled by the teacher for the entire class and the prompts will be

faded for everyone; therefore, Donna’s independence will increase at the same time as her peers.

Everyone will be required to participate in this activity because following a daily timetable and

knowing what assignments and events are occurring is a skill adults need. To make this a

lifelong tool, the schedule could be reduced to a list of activities that could be put in her IPod or

in her pocket because this is something that adults use to organize themselves. Therefore, this

strategy has the potential to meet both Donna’s future and current needs.

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Evidence-Based Practice

Article #1

Activity Schedules: Helping Students with Autism Spectrum Disorders in General

Education Classrooms Manage Transition Issues by Devender R. Banda, Eric Grimmett and

Stephanie L. Hart was an article I consulted before constructing my mini-activity schedule. The

article describes the need for activity schedules, defines activity schedules, consults research to

prove that it is an evidence-based practice and outlines the steps for implementing and creating

an activity schedule. Banda, Grimmett and Hart describe activity schedules as “a visual support

system that combines photographs, images, or drawings in a sequential format to represent a

targeted sequence of the student’s day. Activity schedules provide predictability throughout the

student’s day and allow a student to anticipate changes in the daily routine” (2009, p. 17). The

article describes activity schedules as an inclusive practice because these schedules can benefit

all students and compliment verbal instructions. Furthermore, the article outlines that activity

schedules are an evidence-based strategy that can “reduce problem behaviors during transitions

and increase daily living skills, social behavior, and social imitation in students with ASD”

(Banda et al., 2009, p. 18).

I followed the steps provided in the article quite closely. The steps can be found on page

18 – 20 and are listed below:

1. Identify and Define Target Transition Behaviors: They recommend doing this with the student, teachers and caregivers, which I did to the best of my abilities (since I am currently a pre-service teacher). Donna is based off of a student I used to work with.

2. Collect Baseline Data on the Problem Behavior: I clearly described the target and goal behaviors. They recommend collecting the baseline date “for 2 to 3 days” (Banda et al., 2009, p. 19) and I decided to collect my baseline data for 3 days.

3. Choose a Between-Activity of Within-Activity Schedule: I choose to use both types, in hopes of fading the within-activity schedule.

4. Choose a Mode of Presentation: I choose to use a notebook with pictures. They recommend that “higher functioning students in later grades can generate their own

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written schedules. If the notebook is small, the student can take it from class to class to provide support throughout the day” (Banda et al., 2009, p. 19) and I followed this advice.

5. Choose a Medium for the Activity Schedule: I choose to use Boardmaker pictures, as suggested in the article. They recommend that “for higher functioning students, use abstract representations, such as clip art, line drawings, or words” (Banda et al., 2009, p. 20). I used written sentences and colored drawings based on this information and Simpson’s and Myles’s “Hierarchy of Levels of Visual Representations” (2008, p. 96-7).

6. Choose a Location for the Activity Schedule: They recommend labeling the schedule and talking to the student about where they should keep it (which I would do if this was a real scenario).

7. Train the Student to Use the Activity Schedule: It is recommended to model how to use the schedule and continue with prompts. I have used Simpson’s and Myles’s “Hierarchy of Prompts” ranging from verbal directions to gestures (2008, p. 127). The schedule would be modeled for the class every morning.

8. Collect Intervention Data: I have determined if the goal and target behaviors increased or decreased from the baseline.

9. Add New Pictures or Words: I have included many symbols that can be added as Donna gets comfortable with her schedule.

10. Fade Prompts: I have ideas on how I would fade prompts. They recommend an only making a simple gesture towards the book after independence is mastered, which I have decided to use.

11. Fade the Prominence of the Activity Schedule: Some of their ideas included making it smaller, reducing it to words, laminating one page to their desk and/or making a pocket schedule (Banda et al., 2009, p. 20). One of their ideas that I think I would add to mine, after the fact, is putting “protective plastic sheets [over the pages] so that the student can use an overhead or dry erase marker to cross off the completed steps each day” (Banda et al., 2009, p. 20)

12. Promote Generalization Across Activities and Settings: They believe that “the strength of activity schedules is the ease in which they can be planned, constructed, and incorporated into existing activities across a number of settings)” (Banda et al., 2009, p. 20). I have incorporated Donna’s schedule to be used in all classes and at home.

Article #2

Transitions: Perspectives from Parents of Young Children with Autism Spectrum

Disorder (ASD) by Julia B. Stoner, Maureen E. Angell, Jennifer J. House and Stacey Jones Bock

was an article I consulted to consider the best ways to assist Donna with transitions. The article

outlines that “individuals with autism spectrum disorders (ASD) frequently have difficulty with

transitions, which can cause confusion and anxiety” (Stoner et al., 2007, p. 23). The article also

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outlines the need for any implementation to be student-centered, constructed through

collaboration, being consistent in all environments and based on a deep “understanding of the

child” (Stoner et al., 2007, p. 23). There are two types of transitions – vertical and horizontal –

both of which are important. Vertical transitions are larger life transitions and Stoner et al.

(2007) provide the example of going “from school to adult life” (p. 24). Horizontal transitions

are smaller daily activities, such as going from Math to English class. The article outlines a study

where parents were interviewed about their child with ASD and their transitions. The study was

done through “qualitative research” (Stoner et al., 2007, p. 25) and four couples were

interviewed three times within a year.

The article influenced my creation of the mini-activity schedule and my Social Story

because it outlines some effective transitions strategies. For horizontal transitions, visuals were

recommended. Routines could be broken down into pictures. A three-step process, called

“identify-observe-explore” (Stoner et al., 2007, p. 26), was outlined and suggested identify the

change, getting the child to observe the new setting beforehand and giving them time to explore

the new setting once the transition happened (Stoner et al., 2007, p. 32). Taking physical pictures

of settings was also suggested, and this is something I would do for classmates (if I was actually

a teacher). In regards to the Social Story I created, the article outlined not surprising the student

with ASD with change. One mother stressed the importance of telling a student beforehand that a

substitute teacher would be in so they are not concerned (Stoner et al., 2007, p. 33). I then based

my Social Story around this very idea. For vertical transitions it was suggested that students

should have the “opportunity to explore the new classroom” or environment (Stoner et al., 2007,

p. 34). Through the mini-activity schedule, Donna is able to explore a new environment and

prepare for it before the change occurs. One idea that I took from the article was to address

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horizontal transitions first and then vertical transitions. Although the article suggests looking at

vertical transitions early in life, I think it is better to focus on each small step first. Furthermore, I

decided to make the mini-activity schedule something that Donna takes home with her to foster

open communication and consistency, both of which the article promotes (Stoner et al., 2007, p.

37).

Article #3

A Research Synthesis of Social Story Interventions for Children with Autism Spectrum

Disorders by Frank J. Sansosti, Kelly A. Powell-Smith, and Donald Kincaid influenced the

creation of my Social Story. The article synthesizes the research around Social Stories and

explains what they are and how to develop them. Their findings show that their needs to be more

research done about Social Stories so that it can be considered an evidence-based practice.

Sansosti, Powell-Smith and Kincaid describe Social Stories as “an individualized short story that

can be used to assist individuals with ASD in interpreting and understanding challenging or

confusing social situations” (2004, p. 195). They suggest that the use of Social Stories, when

repeated, helps foster inclusion because students with ASD will be able to understand what

others are “doing, thinking or feeling” (Sansosti et al., 2004, p. 195). In Donna’s case, the Social

Story fosters inclusion because she will be able to remain in the classroom when a substitute

teacher comes to school. They suggest that the first step is “targeting a specific problematic

social situation” (Sansosti et al., 2004, p. 195). Then you must identify the “salient features of

the context or setting… where a situation occurs, who is involved, how long it lasts, how it

begins and ends, what occurs” (Sansosti et al., 2004, p. 195). This information influenced how I

set up my target and goal behaviors and what information I included. They suggest that this

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information can be gathered through observations and taking the time to get to know the child,

which I have done to the best of my abilities.

The article outlines Gray’s guidelines for writing Social Stories. A Social Story contains

directive, descriptive, perspective, and affirmative sentences and sometimes also includes control

and cooperative sentences. These sentences must be tailored to “the student’s comprehension

level” (Sansosti et al., 2004, p. 195). It is appropriate to have the sentences individualized for the

students and include a ration “of two to five descriptive, affirmative, or cooperative sentences for

every directive or control sentence in the story” (Sansosti et al., 2004, p. 196). Donna’s Social

Story has a ratio of 3:10 or 3:1, which meets the guidelines. It is written in simple sentences and

with colored drawings to meet her comprehension and reading level (Simpson et al., 2008, p. 96-

7).

One thing that I had never thought of was having the “student complete a checklist or

answer questions in writing at the end of the story” to see if they grasped the concept (Sansosti et

al., 2004, p. 196) and this is something I wished I would have incorporated. The teachers in the

article “individually read to the target participants at the beginning of each day” and prompts

were used throughout the day (Sansosti et al., 2004, p. 197). I decided that the morning is also

the best time but I would have Donna read the story herself. The article outlined different

students’ intervention results and I have tailored Donna’s around these results, so that I could

portray a realistic situation. The article also recommends implementing the Social Story in

multiple settings, and Donna’s can be generalized for all classes (Sansosti et al., 2004, p. 201).

Social Stories seem to increase results but the article suggests that other interventions need to be

in place (Sansosti et al., 2004, p. 202), thus why I also created a mini-activity schedule.

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Article #4

The Effects of Social Stories on the Social Engagement of Children with Autism by

Monica Delano, and Martha E. Snell was another article I consulted for more information about

Social Stories. This article summarizes much of the same information about Social Stories as the

previous article. Social Stories are explained in the same way, although this article adds the point

that “the story describes the situation and does not merely direct the child’s behavior” (Delano et

al., 2006, p. 29). This study looked at three children with autism and six of their same-age peers

to determine the effect of social stories in increasing play and socialization. The data collection

was done in the same way as the above article with 10 minute observation times, comprehension

questions and collective information about other children and the setting (Delano et al., 2006, p.

33). This article suggested fading the intervention after 15 training sessions or when results are

40% higher than the baseline, even though Gray’s work mentions that “fading might not always

be appropriate” (Delano et al., 2006, p. 34; p. 40-1). I think fading is a slow process, so I chose

to “increase the amount of time between readings of the social story” (Delano et al., 2006, p. 41),

rather than omitting the intervention completely, like the educators in this article did.

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Works Cited

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