The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) lists 2 criteria for diagnosing autism: restricted and repetitive interests and/or movements, and social deficits. This means social skills challenges in children with autism aren’t just common, they’re a defining characteristic. As a professional working with children with autism, it’s critical you fully understand the challenges your learners face.
Social skills contain many component skills that may be difficult for children with autism. Teaching these skills independently allows you to break down this complex concept into much easier to teach tasks. The following components can be taught independently to drastically improve the learner’s social interactions.
- Joint attention
- Play skills
- Practice social situations
ContentsAutism and Social Skills Joint Attention Play Skills Practice Social Situations
Autism and Social Skills
Each child is unique in his understanding of and desire to interact with others. Some children with autism may be virtually unaware of those around them, while others will want to engage with others but lack the skills necessary to do this.
We live in a community, and learning how to relate to other people is a necessary skill, even if we don’t want to. Basic interaction is also an important step to teaching critical self-care and safety skills. While the learner may never desire friendships and connections, some level of interaction with others can’t be avoided. Helping learners become comfortable in these situations can benefit them throughout their lives.
Assessments and Treatment
For social skills assessment, professionals pull from a limited body of research demonstrating effective social skills interventions. Traditionally, professionals rely on a standardized assessment tool to help them identify appropriate treatment goals. This leads to prescribing the appropriate treatment to help that child reach those goals.
A comprehensive social skills assessment would identify these common deficits impacting social skills:
- A child with limited vocal communication skills. An individual with this deficit experiences more significant challenges interacting with their peers than a child with an intact vocal repertoire.
- A child with restricted interests. He may struggle with engaging in conversations about their peers’ interests.
- A child who resists sharing toys or taking turns. Some prefer to predict and control the behavior of others.
Identifying and treating these complex skills can appear daunting to even the most seasoned professional.
While many assessment tools include components of social behavior (AFLS, VB-MAPP, ABLLS, etc.), there are a limited number of research-based social skills assessments available to professionals. Of those tools available, many are expensive or complex to utilize.
Depending on the needs of the children you serve, Social Skills Solutions: A Hands-On Manual for Teaching Social Skills to Children with Autism by Kelly McKinnon, MA, BCBA and Janis Kempa, Med, BCBA may help provide solutions for your learners. This comprehensive program offers both assessment and programmatic support. Because it was written by BCBAs, their model falls easily into ABA programming.
An experienced professional can pick up this manual and quickly understand and implement the assessment. The assessment builds to targeted goals that easily lend themselves to hands-on activities for the children. For those less experienced, the authors offer sufficient foundational information to use the manual and implement interventions successfully.
McKinnon and Kempa provide an initial overview of autism and ABA. This overview allows you to share this book with parents and staff to help them understand your rationality as well as many basic ABA techniques. There’s a brief overview of prompts. The authors explain many other ABA terminology, all in this simple introduction.
Using Modules to Create Scaffolds for Learning
McKinnon and Kempa use a module approach to create a system for scaffolding learning. This means that they have broken down complex social skills (i.e. joint attention, self-awareness and perspective taking) into component parts. These parts can then be taught and strung together to create those more complex behavior chains.
It’s likely impossible to create a fully comprehensive assessment and treatment protocol to teach such complex behavior as social skills. The authors of Social Skills Solutions: A Hands-On Manual for Teaching Social Skills to Children with Autism use 10 Modules. Each module is then broken down into 3 levels. This allows the assessor to identify the child’s relative needs.
Assessors then determine if the child displays each skill within the module in a 1:1 setting, in a group, or in a natural setting. The assessment tracks the child’s progress through all the facets of the identified social skills.
Skills within each module are organized so that prerequisite or foundational skills are firsts. This allows a sequential order to the assessment. Each skill builds on the one before it.
Using the Assessment to Guide Treatment
Once the professional identifies the child’s current strengths and deficits, they begin to paint a picture of some of the missing pieces in the child’s social skills puzzle. For example:
Within Module 4: Ability to Calm Self, Level 2, is the skill: Accepts when things are different than planned. The professional identifies that the child fails to demonstrate this skill across settings (1:1, group, natural environment). The professional then builds programming to teach this skill first in a 1:1 environment as this makes it easier to contrive situations where the child is expected to demonstrate the skill. Perhaps the child responds well to social stories to teach self-management strategies and reinforcement for selecting one of those strategies appropriately. The professional then writes a goal that is both observable and measurable. As intervention begins, staff collect data and the professional continuously evaluates the data to ensure progress.
The professional repeats this process for each of the modules, beginning with the most foundational skills in that module. Through this process, a comprehensive and concrete social skills program emerges.
The complex nature of social skills makes it difficult to determine if the child makes progress. By breaking down the skills into modules, levels and setting, professionals have a tool for establishing meaningful gains for the children they serve.
Professionals should reassess their client’s skills regularly (i.e. every 3 or 6 months) to determine treatment effectiveness and identify new goals. If a child makes limited progress, the professional must objectively evaluate that child’s programs and the variables that contribute to the lack of progress. Without this monitoring and constant adjusting of interventions, the child and family suffer.
Who Should Use Social Skills Solutions?
Although this manual meets the needs of many children with autism receiving ABA programming, it’s not for all children. When working with children with exceptionally complex needs, this manual captures only the smallest glimpse into the child’s deficits. The same holds true for those children with pockets of social skills who may have significant behavioral and emotional needs.
Professionals must carefully consider the full scope of the child’s needs when choosing assessment and treatment programs. As these tools play a significant role in the course of ABA programming, this step can’t be emphasized enough. A program that routinely selects the same assessment tools for all of their children fails to provide the most appropriate treatment for many of those children.
As with any treatment, the strategies discussed here should only be used with the assent of the learner. Read our post Understanding Assent and Assent Withdrawal in ABA for more information on how and why to obtain assent.
Joint attention is a critical component of social skills that may not develop in children with autism without intervention. Joint attention is the action of two or more individuals paying attention to the same object at the same time. Creating these shared experiences allows us to connect and communicate with others socially. Through the use of joint attention, we establish shared experiences which builds bonds between individuals. It begins very early in development, getting more complex as a child grows and develops.
This interaction can be verbal or nonverbal. For example, a child saying “Mommy, look! There’s a dog!” communicates the same thing as a child tapping your shoulder and pointing at the dog. Although these two interactions look different, they serve the same social purpose. Children with no vocal communication skills still share experiences with those around them, just in a different way.
Watch Joint Attention – Why it’s important to teach your child to engage and enjoy the company of others by 1to1 Therapy Services:
This skill usually develops between 8-15 months of age. For children with autism, this skill may not develop independently and often requires specific teaching.
How to Teach Joint Attention to a Learner with Autism
Joint attention can be broken into two separate skills:
- Requesting joint attention
- Responding to requests from others
For children with limited communication skills, this is especially difficult. Although these skills are related, you will probably need to teach them independently. Through repeated practice, your learner will begin to interact more with those around her.
Whether teaching requesting or responding, this will involve 3 steps:
- Observe your learner
- Gradually encourage increased joint attention
- Continue to observe how your learner initiates and responds to joint attention
Observe Your Learner
Determine what your learner is currently able to do. Does she respond to verbal requests for attention by turning and looking? Does she show you something she is interested in, requesting joint attention? Or does she ignore you when you try to request joint attention?
Spend a session or two just observing whether she initiates or responds to joint attention. Write down your observations throughout each session so that you can identify how the learner currently initiates and responds to requests for joint attention.
Increase Use of Joint Attention
Beginning where she is already successful. Identify what she is currently able to do, then start to gradually push her to do just a little more than she does on her own. You can use prompting and reinforcement to increase her use of joint attention.
For example, if she ignores all requests for joint attention from others and appears only interested in her favorite things, start to look at some of her favorite things with her. Help her point to the item then provide her with reinforcement.
If your learner can show you things that she enjoys but does not look at other things with you, gently help her look at something with you and then immediately provide reinforcement.
Responding to Joint Attention
There are several ways to teach your learner to respond to requests for joint attention.
- If your learner doesn’t respond at all when you request joint attention you can begin by putting a favorite toy in front of them, then moving it so that their eyes follow the toy.
- If your learner sometimes responds to requests for joint attention trying putting a favorite toy a short distance away and saying “Look!” in a really excited voice. If that doesn’t work try having the toy make a noise that might draw the learner’s attention.
Be prepared with a reinforcer when your learner responds to a request for joint attention. The video Autism and Joint Attention | Fun Minute Tip 3 by Into the Spectrum discusses how you can do this:
Initiating Joint Attention
To teach your learner how to initiate requests for joint attention start by prompting her to gain your attention and gradually reduce the amount of prompting. Encourage her to show you a favorite toy by pointing. In the beginning you may need to teach her to shape her fingers and then use one finger to touch the toy.
Work in requests for joint attention throughout the session. Encourage her to request attention by keeping some favorite toys out of reach so that she has to initiation joint attention to ask for the toy. When offering choices have her point to the one she wants.
As above, be sure to use reinforcement with your learner. If her favorite toy has an on/off button try turning the toy on when your learner points to it.
Observe How the Learner Responds
Continue to observe your learner and determine what she is doing independently. Use this as a guide to help you determine what you can teach her next.
Gradually support your learner in using her new-found skills with other people. It’s best to begin with other adults before moving on to peers. Peers are less patient than adults and don’t always understand how the learner communicates. Once your learner develops more effective joint attention, begin to encourage him to approach peers. His peers might also need some help to understand the social interaction at first.Back to Top
Play is an important way children learn and practice socials skills, however children with autism often need to be taught how to play. Depending on where your learner starts you may need to begin by teaching basic play skills before moving on to teach more complex skills that will improve their social skills.
Why is it so important to teach play skills?
Children with autism develop restricted independent and social play skills. These literal thinkers also struggle with symbolic play. Restricted symbolic play can lead to difficulties with abstract language. Failure to learn basic play and social skills may also lead to a cycle of decisions that can further inhibit your learner’s ability to learn and grow.
Play is an important component of social interactions between young children. Joining in activities with their peers often requires specific teaching for children with autism. This form of instruction is not available within the general education classroom.
Children needing this level of intervention struggle in classrooms with their peers. Exclusion from the general education classroom compounds effects of limited interactions with peers. Without the availability of peers to interact with, their social deficits perpetuate. They lose the opportunity to practice social and communication skills during school hours. This cycle can continue through a child’s entire education.
Children learn valuable skills from watching their peers. Peer modeling reduces the burden of explicit teaching of every skill. These skills include a variety of social, academic, and leisure skills. Placement in a restricted educational setting negates this opportunity.
Learning Through Play
Children practice important skills through play: emotional regulation, problem solving, and creative thinking. They develop and rehearse communication skills. Even when playing alone, children practice dialog or babble.
Young learners encounter challenges during play that promote frustration tolerance. They learn creative thinking skills when practicing imaginative play, and can learn to use toys or everyday objects in new and creative ways. Yes, using the banana as a telephone is actually an important play skill.
Play encourages social development and interaction. Many children with autism prefer to spend time by themselves.This preference for isolation can make their experiences later in life more difficult. Once in school or in the workforce, individuals face a variety of social interactions. They need to have some repertoire of skills to handle these situations, even if it’s the ability to communicate their desire to be alone.
Play supports exploration and flexible thinking. Children with autism tend to be rigid in their routines and their view of the world. Learning to play in new and different ways can expand their ability to be creative and open to new experiences.
Understanding How Children with Autism Play
Children with autism play in unique ways. They might line up their toys or play in routine, ritualistic ways. Many children with autism enjoy sensory play. This includes activities like bubbles, cause and effect toys or things that light up. The cause and effect relationship is concrete and predictable. This makes it comfortable and familiar for your learner. However, it may take specific intervention to help your learner move beyond this type of play.
Why do children with autism line up toys?
Children with autism often play in routine, ritualistic ways, including playing with toys without the use of imagination. Because of this, they may line up toys or focus intently on one part of a toy. While other children may build a fort out of a pile of blocks, a child with autism may choose to line them up in neat rows or in seemingly random order around the floor. Some children may take a toy truck and use it to knock over their fort, while a child with autism might sit spinning one of the wheels or watch the wheel closely as it turns against the rug.
Why? Children with autism think concretely, have restricted or repetitive interests, and have difficulty with imaginative play. As a result, children with autism may not use items or objects in unique ways as other children do.
Is ritualistic play a problem?
Typically, playing in routine ways is not a problem. However, it becomes a problem when a child does this to the exclusion of all other forms of play.
A child’s tendency to play alone can inhibit social interaction. At school or in social situations a child with autism may feel more comfortable playing by himself. Other children may not understand how he likes to play and he may be confused by their games. But with patience and understanding they can benefit by learning to play together.
Additionally, ritualistic play can limit a child’s ability to develop other play skills. Many children, and even adults, tend to stick to things they are comfortable doing. A child with autism may need some extra help in learning to do things outside his comfort zone.
When attempting to get a learner to engage in other types of play, be sure to look for signs of assent, as discussed in our post Understanding Assent and Assent Withdrawal in ABA.
Types of Play
Children play in a variety of ways. Young babies and toddlers engage in functional play as they begin to explore their world. This might include touching or squeezing objects, or even climbing on furniture and play structures. Exploratory play allows children to use their senses as they take in their environment, closely studying objects to experience their color, size, shape, feel and smell. With constructive play children develop a sense of accomplishment by building, creating and drawing.
While all these types of play are important, we’re going to focus here on two other types of play:
- Symbolic Play
- Social Play
These types of play have the closest correlation with social skills.
When children engage in symbolic play, they use objects to represent some other object or action through play. This might look like using a banana as a telephone, using a box as a car, or using a towel as a cape. When children use cushions and blankets to build a fort in the living room they’re engaging in symbolic play. Using sheets of paper to build a road for toy cars is another example.
Children usually begin to engage in this type of play around the age of 3; however, children with autism often struggle with engaging in symbolic play.
On the continuum of play skills, pretend or imaginative play is the most advanced of all play skills. This play requires the ability to separate an object from its true meaning and assign it an arbitrary meaning. Pretend play offers vital opportunities for children to practice roles outside of the every day, but also builds a long list of additional skills including:
- Problem solving
- Creative thinking
- Perspective taking
- Social relationships
- Abstract thinking
Social play is a series of skills that children use to engage with other children. Social play looks different at different ages and stages, but children with autism may not develop these skills on their own. It involves children interacting with each other during play. This play is typically structured and follows rules that have been established by the children. Many times these rules are established through communication, but even if your learner doesn’t communicate vocally, he can still develop meaningful play skills.
Social play often includes symbolic or imaginary play, so teaching symbolic play first can help build social play skills.
Teaching Play Skills
Play skills can be taught the same way other skills are taught – by breaking down big ideas into smaller, easy-to-understand steps. But play generally develops in set stages. Consider the stages of play as you design your task analysis to teach these skills.
Step 1: Understand the Stages of Play
There are 6 essential stages of play. This short video shows what each stage looks like:
Unoccupied play usually develops from the ages of 0-2. This includes sensory play and manipulating objects.
Solitary play usually emerges between 2-3. At this stage simple functional play such as building a block tower emerges.
Onlooker play is common among children 2 ½-3 ½. A child may begin watching what her peers are doing and taking in the information even if she’s not ready to join in on the fun.
Parallel play is also seen between the ages of 2 ½-3 ½. This involves the child going beyond observing to include engaging in the same activity next to a peer with minimal interaction,
Associative play happens as children begin to interact during play. They may both work on creating a building but there is no discussion about how it should be done or who should construct which parts.
Cooperative/social play is the final stage. At this level, children will negotiate and create rules in their play-
If your learner primarily engages in sensory play, it would be unrealistic to expect him to be able to engage in cooperative imaginative play. You will need to think about your learner’s current abilities and identify how best to inch him further toward more creative play
Step 2: Observe Your Learner
What does your learner do when she is left on her own? Does she play with toys the way they are intended to be used (functionally)? Or does she use items creatively? Does she use toys primarily for a sensory experience?
Step 3: Determine the Next Stage
Play often progresses in stages. Use your observations from watching her play to determine which stage her skills fall into, then focus on teaching her skills that will bring her to the next level of play. Remember that children with autism develop at their own pace. The ages above are guidelines indicating when you might see these skills in neurotypical children. Regardless of your learner’s age, begin at whatever stage they are in, and move from there.
Step 4: Identify one activity that your learner enjoys
This could include blocks, cars, characters, Play Doh, trains, animals, flags, fans, gears, plumbing, or anything that will hold your learner’s interest. If the learner is new to your program, consider asking care givers about their special interests.
Step 5: Break down the play goal
For example, if your learner loves ice cream, maybe the ultimate goal will be a play scenario where he works at an ice cream shop and a peer or sibling is his customer. Then create a task analysis to break the goal into small, concrete steps. This might look like:
- Pretend that an empty bowl has ice cream
- Use a cardboard box as the shop counter
- A peer is a customer
Depending on your learner’s skills, these steps may need to be broken down even further. For example, you might need to teach the idea that a box can be something else before introducing the idea that it can also be a shop counter. For example, you could have your learner pretend a large box is a car, then have him use it as a dog house and then a bookcase.
Step 6: Reinforce desired behavior
As you teach your learner the play scenario make sure you are focusing on just one step at a time. Then use a high rate of reinforcement when your learner attempts the new skill. Don’t expect the play to be the reinforcer.
Ideas to Teach Symbolic Play
Sometimes the best teaching methods take a little creativity. As adults we often move away from symbolic play and imagining different uses for everyday objects. These ideas will help get you started.
Model the use of objects in flexible ways
- Pretend a bowl is a hat
- Use a block as a car
- Imagine that a towel is a superhero cape
- Use a blanket to build a tent
Teach a variety of scripts for different objects
- Drive the fire truck to the block tower to put out a fire
- Order ice cream at the window, paying for it and give the imaginary ice cream
- Feed the baby doll and putting her to bed
- Make dinner in the pretend kitchen
- Create a “store” with some of her favorite items
- Make a restaurant where his friends can “order” from the “menu”
Develop and expand play routines using your learner’s interests
- If your learner likes the Cars movie, build a garage for Mater to take Lightning McQueen to when he breaks down.
- Are dinosaurs her special interest? Have other dinosaurs hiding behind table legs as the T-Rex goes on the hunt for dinner.
- Gears and gadgets are your learner’s thing? Maybe he is the mechanic fixing an important machine!
Practice Social Situations
Like all of us, children with autism get better at things they practice. It helps them learn what to expect from social interactions and allows them to prepare in advance.
One of the most well-known ways to do this is through social stories. Carol Gray developed the Social Stories tool that provides the framework that combines personalized text and illustrations or photos that help children with autism understand social situations. Social Stories must meet 10 defining criteria that you can find in her document The Social Story Philosophy.
You can find 150 premade social stories in her book The New Social Story Book or you can create your own.
Autism Speaks has partnered with the University of Washington READI Lab to create Personalized Teaching Stories. These free templates follow Carol Gray’s social story model. They allow you to use your own photos and text to develop stories that teach what to expect in various social situations such as:
- Going to a restaurant or store
- Handling a bully
- Participating in a play date
- Taking turns
How Do I Use Social Stories to Teach Replacement Behaviors?
Children with autism and other developmental disorders often engage in a variety of maladaptive behavior. This occurs for several possible reasons, but is often due to a deficit in adaptive ways to get their needs met. To learn more about identifying why a child engages in a particular behavior, read our post: Functions of Behavior in ABA: Complete Guide. When creating a plan to address challenging behaviors, professionals must teach adaptive alternative behaviors to take the place of maladaptive behavior. Social stories may be one way to teach these replacement behaviors.
Social Stories were created by Carol Gray, author of The New Social Stories Book, to teach children with autism how to respond in different situations. These short, simple stories help children understand expectations and learn coping skills. A Hard Times Board provides one format for accomplishing this. Let’s take a look.
Hard Times Board
A Hard Times Board pulls apart a behavioral event and clearly delineates each component of the Competing Behavior Pathway in a way that children understand. Including children who have the verbal ability in identifying each component improves buy-in and compliance in utilizing strategies.
Competing Behavior Pathway
The competing behavior pathway provides a visual depicting the ABCs of challenging behavior and includes an appropriate replacement behavior. It provides a roadmap for changing behavior.
Turning the Competing Behavior Pathway into a Social Story
Include children in the process of creating the social story. Children who feel ownership of the plan are more likely to utilize the interventions in the plan. Although it may be difficult, it’s worth the effort and provides the best outcomes for the child.
Consider the age and developmental ability of the child to determine what their role will be. For very young children (i.e. preschoolers), their involvement may be more limited. For children in early elementary school (i.e. kindergarten and first grade), have them help choose the pictures. As they become older, include them in the whole process to the best of their ability.
Components of a Hard Times Board
When you take the components of a Competing Behavior Pathway and put them into a social story, you create a Hard Times Board. How much information you include in the social story will depend on the individual child’s needs and abilities. The basic components include:
- Can’t Dos
- Can Dos
Take a look at this example where a teacher uses a Hard Times Board to help one of his students:
Helping children identify when they are likely to engage in a particular behavior helps them understand when to use coping skills. Children often are not aware of what triggers challenging behavior. When creating a Hard Times Board, guide the child into recognizing situations during which the behavior frequently occurs.
Choose your words carefully so that you avoid sounding accusatory. This is a problem solving activity, not a time to point out the child’s faults. Use phrases such as:
- I’ve noticed that you seem upset when X happens
- Sometimes when X happens, it looks like you feel pretty mad
- What are some things that make you angry?
Tie the information about triggers to some of the child’s challenging behaviors by creating a list of behaviors that they shouldn’t engage in. Again, be careful to avoid statements that blame or point fingers. Try phrases like:
- What are some things you can’t do when you’re mad?
- I’ve noticed that when you’re angry sometimes you do X. I know you don’t want to hurt anyone, so let’s add that to the list of Can’t Dos.
This section is the most important one as it provides those appropriate alternative behaviors. Many children need help identifying more appropriate responses to their triggers. Some children may suggest alternatives that are inappropriate. Guide them in creating a list of coping skills that are likely to lead to success. Use statements such as:
- Since one of the things that makes you upset is being asked to do something hard, let’s add “asking for help” on the Can Dos list.
- I like that you’re coming up with ideas, but playing on the iPad when you’re angry probably won’t change the situation. What if we add X to the list instead?
Not every Hard Times Board needs to contain all 3 components and your learner may ask to add something else. If the child says she doesn’t want her triggers listed on the board, respect her wishes. The only component that is non-negotiable is the Can Dos section. Without the coping skills, there’s no point in the social story.
These social stories can be used with individuals from preschool to adulthood, but must be adjusted according to the individual’s developmental needs. Let’s look at some examples:
This first example is a social story developed with a preschooler who often became aggressive when he heard unexpected loud noises or when the classroom became too overwhelming.
This Hard Times Board contains 2 plans, 1 for at home and 1 for when the child was in the community or at school. the young teen that helped create this plan often became angry when discussing his challenging behavior and felt strongly that having his behaviors or triggers listed would not be helpful. In addition, he loved superheroes and wanted a picture on the board to remind him to act like a superhero when he felt mad.
Finally, this social story was created with a 21-year-old woman with autism and developmental delays who also became upset when discussing her behaviors. She came up with all of the components with only a little guidance and was allowed to include coping skills that might be inappropriate (watching TV or going on the computer) because she was an adult. Over time, we were able to point out to her that the other coping skills benefited her more.
Many children refuse to talk about their challenging behavior. For others this discussion triggers more challenging behavior. Don’t be discouraged if you need to guide the conversation or work through speed bumps along the way.
Rather than using a direct approach with these children, try having an indirect conversation during a preferred activity or while driving in the car. Sitting face-to-face for these conversations can be particularly difficult. Find creative ways to bring up the topic and tell the child you just want to write down some of their ideas.
Dealing with inappropriate suggestions
When you include children in developing a plan for responding to triggers, you inevitably encounter suggestions that are inappropriate to include. This might be things like “watch TV” or “send everyone else away.” You do not need to include these on the child’s plan. The child needs your guidance to select appropriate replacement behaviors.
Always acknowledge their ideas, but be prepared to gently direct them to more appropriate ones. For example:
The child you’re working with states that when he gets mad watching his favorite show on TV will calm him down. While this might be true, it also might reinforce him acting mad and is not an appropriate coping skill. You can simply state something like “Hmm, that is one idea. I like that you’re coming up with ideas, but when you’re mad isn’t the best time to watch TV. You could listen to music. We could include music in your plan.”
Teach Replacement Behavior with a Social Story
It’s not enough to simply help the child write the plan for the Hard Times Board. You must also teach the child to use the strategies in the social story. There are 4 steps to teaching your client to use a Hard Times Board effectively: practice, prompt, reinforce and fade.
During times when the child is at baseline. Ideally include this practice in the child’s schedule and follow it with a preferred activity (for more information about using the Premack Principle, read our post: Premack Principle: A Guide to Using the First/Then Rule. Read the social story and have the child choose one of the “Can Dos” listed to practice.
Once the child has had sufficient opportunities to practice, present the Hard Times Board when the child engages in precursor behaviors. Do not read the entire social story during this time. Present the board and prompt the child to choose one of the coping strategies. If the child chooses a coping strategy, provide reinforcement in the form of social acknowledgment and access to the coping skill.
As the child begins to utilize the coping strategies in their social story independently, provide reinforcement. This reinforcement should be of value to the individual child. As with all tangible reinforcement, pair it with social praise. At this stage, you should reinforce only independent use of the coping skills. When you need to provide a prompt to the child (either in the form of presenting the social story or a verbal prompt to choose a coping skill), reinforcement should only be in the form of access to the coping skill.
Over time, begin to thin the schedule of reinforcement for independent use of the coping skill and reinforce remaining exposed to triggers without maladaptive behaviors on a denser, richer schedule.