New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 3: Education for learners with ASD
Generalisation and maintenance
The teaching of skills by themselves will
seldom be effective if generalisation to other
settings and people is not actively addressed 228
(Recommendation 3.2.2.5). Interventions need
to be available throughout the day and in a
variety of activities 208 . Where generalisation
occurs, it is often attributable to high levels of
peer responsiveness; therefore, peers need to be
primed and supported to recognise and respond
to interaction attempts 231 .
Other interventions which have anecdotal
support
Social stories
‘Social stories’, developed by Gray and Garand,
is a relatively new intervention 235 (see also
Appendix 8, Educational interventions). Social
stories are narratives written by adults about
difficult social situations to help the child’s
understanding. These stories help promote selfawareness,
self-calming and self-management 232 .
Only a few small studies have been undertaken;
one showed a decrease in the frequencies of
inappropriate behaviours and anxiety levels
and another showed an increase in social skill
levels 224 236 . Other studies have demonstrated the
utility of this intervention for increasing sharing,
play and appropriate independent social
initiations and responses, as well as for reducing
aggression. Social stories probably need to be
used in combination with other strategies 218 .
There is a need for further research to consider
which children and young people will benefit
from such approaches 237 .
Other interventions
Other techniques that have been shown to be
useful for improving social skills include:
• visual cueing – printed cues in work
schedules to stimulate social initiations to
other peers with ASD
• social games – teaching socio-dramatic scripts
or games revolving around a child’s special
interest (both interventions increased peer
interactions in multiple ways)
• video modelling – some studies have shown
better skill acquisition of maintenance and
generalisation than for in-vivo teaching
techniques
• acting lessons – learning to express emotions
verbally and non-verbally and interpret the
feelings of others
• self-esteem building – from placing the child
in the role of tutor or helper (eg, the teacher
compliments the child and teaches him/her
to compliment him/herself)
• social autopsies – conversations with adults
which review and interpret social situations
which have happened
• cartooning – the use of cartoon drawings to
understand social situations 202 224 232 .
Other issues
Interventions for home settings
Without family involvement, interventions
are unlikely to generalise to home and
community settings 229 . Several studies have
shown measurable improvements from simple
interventions such as teaching parents and
siblings to imitate a child in play with toys and
other play skills on a daily basis, or daily early
childhood education service programmes with
positive child–adult interactions and play 96 218 223 .
Support and education should be provided for
families to facilitate the use of home-intervention
strategies (Recommendation 3.2.2.6).
Strategies can include:
• rehearsing scripts
• videotaping conversations, reviewing and
coaching
• structured ‘play dates’ (social opportunities
with peers usually conducted within the home)
• structured conversations
• involvement in groups around a special
interest 202 .
Siblings can also be involved in home interventions
using many of the peer-mediated techniques 202 .
Part 3
New Zealand Autism Spectrum Disorder Guideline 107