Frank M. Gresham, Ph.D. Louisiana State University

1. Social Skills Training for Children and Youth:Linking Assessment with Intervention in a 3-Tier Model Frank M. Gresham, Ph.D. Louisiana State University

2. Definition of Social Skills or Prosocial Behaviors • Socially acceptable learned behaviors that enable an individual to interact effectively with others and to avoid or escape negative social interactions with others (Gresham & Elliott, 1990) • Major categories of social skills (CCAREES): SSIS Rating Scales • Communication • Cooperation • Assertion • Responsibility • Empathy • Engagement • Self-Control SSIS / Pearson Assessments 2007

3. 3-Tier Model of Social Skills Interventions 3-5% Few 10-15% Some 80-85% All

4. The PSG & CIP are part of a comprehensive model for improving children’s & adolescents’ social behavior! SSIS / Pearson Assessments 2007

5. Theoretical Foundations for SSiS IG • Social Learning Theory • Reciprocal determinism • Vicarious learning • Cognitive mediational processes • Cognitive-Behavioral Approaches • Behavior mediated via cognitive processes • Social problem solving • Self-control strategies • Attribution retraining • Applied Behavior Analysis • 3-term contingency (ABC) • Functional behavioral assessment (FBA) • Replacement Behavior Training (RBT)

6. SSiS IG Theoretical & Research Foundations • 5 Major Reasons for Social Skills Deficits • Lack of Knowledge • Lack of recognition of appropriate social goals • Lack of understanding of behavioral strategies to reach social goals • Lack of understanding of contexts & situations in which strategies would be appropriate • Lack of Practice • Fluency deficits • Inefficiency & response effort • Lack of Cues • Antecedent control (discriminative stimuli) • Setting events • Lack of Reinforcement • Competing Problem Behaviors • Externalizing behavior patterns • Internalizing behavior patterns

7. Evidence-Based Social Skills Interventions • Evidence-based treatments (EBTs) vs. Evidence-based practices (EBPs) • EBTs are interventions shown to be effective via rigorous research methods • Most rigorous research method is the randomized clinical trial (RCT)-Efficacy studies • EBPs are based on scientific research that supports use of interventions • EVIDENCE can be based on: • Careful summary of extant research literature on a class of interventions (box score reviews) • Meta-analyses of extant literature on a class of interventions (quantitative reviews) • Levels of Evidence and EBPs • False dichotomy: Evidence based or non-evidence based • Research evidence does not fall neatly into this false dichotomy • Distinguish among: Science, Pseudoscience, & Nonsense • Evidence falls along a continuum of strong evidence to weak evidence to no evidence • Determination of degree of evidence based on control of threats to valid inference • Internal validity • Statistical conclusion validity • Construct validity • External validity See Shadish, Cook, & Campbell (2002). Experimental and quasi-experimental designs for generalized causal inference

8. A Guide to Treatments that Work:Nathan & Gorman (2007) • Type 1 Studies • Randomized clinical trials (RCTs) • Comparison or control groups • Inclusion/exclusion criteria • Blinded assessments • Type 2 Studies • RCTs missing at least 1 of the above criteria • Type 3 Studies • Open trials • Quasi-experimental • Type 4 Studies • Based on secondary data analyses: Meta-Analyses • Type 5 Studies • Not based on secondary data analyses (box score reviews) • Type 6 Studies (case studies; anecdotal)

9. Evidence Based Practices(continued) • EBPs can be based on variety of research designs • True experimental designs (efficacy studies or RCTs)--randomization • Quasi-experimental designs (weaker evidence)—intact groups • Single case experimental designs (good internal validity/limited external validity) • Regression discontinuity designs (strong but rarely used in SST) • Correlation/regression designs (many variations) • Evidence Bases for CIP and IG Programs • Meta-analytic reviews based on 338 studies & over 25,000 children (3-18 years) • Social skills operationalized into 3 categories • Social interaction • Prosocial behavior • Social-cognitive skills • Mean effect size D= .63 (r=.30)=Moderate Effect Size • BESD shows about 65% will improve in SST & 35% will not improve Gresham,, et al., 2004 Behavioral Disorders, 30, 32-46 & Cook et al.,(2008), Journal of Emotional and Behavioral Disorders, 16, 131-144.

10. Summary EBPs • Most effective SST strategies based on meta-analyses involving over 25,000 children & youth based on 338 studies are: • Modeling • Coaching • Behavioral Rehearsal • Reinforcement-based strategies • Cognitive behavioral interventions • Type 4 studies • CIP & IG programs use all of the above strategies for intervention • On average, about 65% of students will improve in SST • These findings hold for elementary as well as secondary students • SST equally effective for externalizing & internalizing students • Weakness in many SST studies is quality of outcome measures • SSIS-Rating Scales improve upon this weakness

11. Does Social Skills Training Work? % Improve Treatment % Improve Controls ES d N studies ES r M=.63 M=.30 M=65% M=35%

12. 3-Tier Model of Social Skills Training • Universal Interventions: CIP • All students • Schoolwide or classwide • 80-85% will respond • Selected Interventions: IG or Consultation Based • Some students • Pullout group for acquisition deficits • Classroom based for performance deficits • 10-15% will respond favorably • Targeted/Intensive Interventions • Individualized • Intense & powerful • Function based: Replacement Behavior Training (RBT) • 3-5% will respond favorably

13. Intervention to Improve Social Skills UNIVERSAL INTERVENTION Classwide Intervention Program SSIS / Pearson Assessments 2007

14. The CIP provides teachers with a structured, yet flexible and efficient way to integrate opportunities to teach 10 of the most important social skills. The CIP has been developed for use by general education teachers in mainstream classrooms. The CIP blends instructional best practices and proven intervention methods to teach social skills. It is intended for all students from preschool to middle school and thus represents a universal intervention for 3 developmental levels: Preschool/ Kindergarten, Early Elementary, and Upper Elementary/Middle. SSIS Classwide Intervention Program (CIP) SSIS / Pearson Assessments 2007

15. Top 10 School Social Skills!* • Listens to Others • Follows Directions • Follows Classroom Rules • Ignores Peer Distractions • Ask for Help • Take Turns in Conversations • Cooperates with Others • Controls Temper in Conflict situations • Acts Responsibly with Others • Shows Kindness to Others *Based on surveys of over 800 teachers rating importance of social skills SSIS / Pearson Assessments 2007

16. Listens to Others Follows Directions Follows Classroom Rules Ignores Peer Distractions Ask for Help Take Turns in Conversations Cooperates with Others Controls Temper in Conflict situations Acts Responsibly with Others Shows Kindness to Others 10 Units with 3 days of lessons per week. A lesson is typically 25-30 mins. Units and lesson plans are structured using a 6 phase instructional model. Units are supported with Student Booklets, video vignettes, and a number of other resources to support student and parent involvement. CIP Covers the Top 10 Social Skills that All Students Need to be Successful! SSIS / Pearson Assessments 2007

17. 6-Step Instructional Sequence • Tell (Coaching) • Show (Modeling) • Do (Role Play) • Practice (Behavioral Rehearsal) • Monitor Progress (Performance Feedback) • Generalize

18. CIP Results • 450 students & 22 teachers • Pre K/K: N=123 students (68 males/55 females) • Early Elementary (Grades 1-3: N=222 students: 105 males/117 females) • Upper Elementary (Grades 4-5: N=104: 53 males/51 females) • Approximately 7% dropped out (N=33) (moved/changed classrooms/expelled) • Based on Performance Screening Guide (PSG) • 13% (N=50) identified as potential Tier 2 students • 87% of students responded adequately to CIP • 50 students rated on SSIS-Teacher rating scale • Tier 2 selected based on Total Social Skills <85 (+/- SEM) • 37 classified as Acquisition Deficits (IG pullout groups) • 13 classified as Performance Deficits (consultation, classroom-based)

19. Social Skills Screening:Evaluation & Identification of Potential Tier 2 Students SSIS Performance Screening Guides SSIS / Pearson Assessments 2007

20. The SSIS PSG is time efficient (25 to 30 minutes for an entire class), focuses on keystone classroom behaviors and skills, and provides documentation of the performance level of all students, not just those in greatest need of intervention. There are 3 development levels of the SSIS PSG: Preschool, Elementary, & Secondary. The SSIS PSG is a universal screening tool that provides baseline information prior to starting instruction and can also be efficiently used to re-screen students after instruction to provide a broad indicator of progress on the skill areas targeted for improvement. SSIS Performance Screening Guides (PSG) SSIS / Pearson Assessments 2007

21. The PSG measures preschool through secondary school students' skills against grade-level expectations in four performance areas: prosocial skills, motivation to learn, reading, and math. It should be noted that the definitions change from the Preschool level to the Elementary level and finally to the Secondary level to reflect well documented developmental differences and changing grade-level performance expectations. Skills Measured by the PSG SSIS / Pearson Assessments 2007

22. Each performance area guide is a criterion-referenced, behaviorally-anchored, multi-level performance descriptor that summarizes several weeks of teachers' observations and interactions with students. The Prosocial Behavior performance descriptor with 5 levels is comprised of a set of three specific social skills (communicate and cooperates with others, initiate and sustain conversations/ interactions with others, and self-control and a concern for others) modified by a statement concerning quality or frequency with which the collection of skills is exhibited. The more frequent a student exhibits a behavior or the more competently the skills are expressed, the higher the level of performance for the descriptor. Teachers are asked to choose the performance level that best represents each of their student's current level of functioning. Thus, teachers compare each student to the behavioral criteria as opposed to comparing students to each other as commonly done with norm-referenced assessments. Teachers Make Criterion-Reference Judgments Using Performance Level Descriptors SSIS / Pearson Assessments 2007

23. Evaluate CIP Outcomes &Assessment for Additional Services • Conduct post-CIP evaluation by completing SSIS PSGs and analyze change in performance levels. • Document the CIP units were implemented as planned. • Summarize classwide and individual progress monitoring records. • Recognize student successes with Certificates of Accomplishment & communications with parents. • Conduct more comprehensive assessments with SSIS Rating Scale for students who do not respond successfully to the CIP. • Consider additional small group interventions with the SSIS Intervention Guide for some students who need more skills training. SSIS / Pearson Assessments 2007

24. The SSIS Rating Scales (formerly called the SSRS) are comprehensive multi-rater (teacher, parent, & student) scale that measures social skills, problem behaviors, & academic competence. English and Spanish versions. Norm-referenced on a nationally representative sample of students ages 3-18. Results used to plan interventions that are provided in the SSIS Intervention Guide. The most widely used and technically sound social skills assessment in the world. Comprehensive Assessment for Students Who are Weak Responders SSIS / Pearson Assessments 2007

25. Uses of SSIS Rating Scales • Comprehensive assessment of social skills (communication, cooperation, assertion, responsibility, empathy, & self-control) along with screening for problem behaviors (externalizing, bullying, internalizing, hyperactive/inattentive, & autism spectrum) and general academic competence. Completed for individual students in 20 mins. • Used to compare students to a norm group of peers to identify individuals who are functioning below normative expectations and who may be candidates for intervention services. • Primarily designed to identify specific social behavior acquisition and performance deficits that can be directly addressed with skill building interventions. SSIS / Pearson Assessments 2007

26. Selecting Students for Tier 2 Social Skills Intervention • Have classroom teachers rate all students on the PSG prosocial behavior item • Select all students rated 1 or 2 on the PSG • Have teachers rate students on SSIS-Rating Scales • Select student with Total Social Skills <85 (+/- SEM) • Identify social skills acquisition deficits, performance deficits, strengths, and problem behaviors (details later)

27. SSiS Rating Scales:2 Dimensional Rating System Never Seldom Often Almost Always Not Important Important Critical

28. Classification of Social Skills Strengths & Weaknesses Description Criteria Social skills subscale is above average Item within subscale has a frequency rating of 3 & an importance rating of 1 or 2 Social Skills subscale is below average Item within subscale has frequency rating of 1 & importance rating of 1 or 2 Social Skills subscale is below average Item within subscale has a frequency rating of 0 & an importance rating of 1 or 2 Problem Behavior subscale is above average Item within subscale has a frequency rating of 3 • Social Skills Strengths • Student knows & uses social skills consistently & appropriately • Performance Deficits • Student can use the skill but does so infrequently • Acquisition Deficits • Student does not sufficiently know skill or how to use it appropriately • Competing Problem Behaviors • Behavior interferes with acquisition or performance of a given social skill

29. Base Rates of Social Skills Difficulties • Base rates rarely reported in assessment literature • Impossible to know whether an assessment device will produce a greater number of correct decisions than base rate • Base rates will vary depending on the population considered • Practical decisions should reflect true positive/true negatives • Base rates using SSIS based on 4,550 children/youth 3-18 years • Base rates calculated for : 3-5 years; 5-12 years; 13-18 years • Acquisition deficits: Frequency=0 & Importance=1 or 2 • Performance deficits: Frequency=1 & Importance=2 • Social skill strengths: Frequency=3 & Importance 1 or 2 • Problem behavior: Frequency=3 • Base rates calculated for: >50% of items; 33-49% of items; 25-32% of items; 15-24% of items

30. Results of Base Rates • Base rates for acquisition deficits less than 1% across all age groups • Base rates for performance deficits not difference for teachers & parents • Base rates for performance deficits reported by students lower than teachers & parents • Base rates for performance deficits for teachers & parents not different • Base rates for social skills strengths similar for teachers & parents • Base rates for social skills strengths reported by students lower than those reported by teachers & parents • Base rates for problem behaviors very low in general population (<1% for teachers & parents, but higher for students (Mdn=5%)

31. Examples of Social Skills • COMMUNICATION SELF-CONTROL • Takes turns in conversations Makes a compromise during a conflict • Makes eye contact when talking Stays calm when teased • COOPERATION • Follows your directions • Follows classroom rules • ASSERTION • Asks for help from adults • Questions rules that may be unfair • RESPONSIBILITY • Respects the property of others • Takes responsibility for own actions • EMPATHY • Forgives others • Feels bad when others are sad • ENGAGEMENT • Makes friends easily • Invites others to join in activities SSIS / Pearson Assessments 2007

32. Definition of Competing Problem Behaviors • Competing problem behaviors are those behaviors that compete with or “block” either the acquisition or performance of socially skilled behaviors. These competing problem behaviors my be externalizing, internalizing, bullying, hyperactivity/inattention, or autism spectrum (Gresham & Elliott, 1990) • Major categories of competing problem behaviors • Externalizing • Internalizing • Bullying • Hyperactivity/Inattention • Autism Spectrum SSIS / Pearson Assessments 2007

33. Examples of Competing Problem Behaviors • EXTERNALIZING • Fights with others • Talks back to adults • BULLYING • Bullies others • Keeps others out of social circles • HYPERACTIVITY/INATTENTION • Fidgets or moves around too much • Gets distracted easily • INTERNALIZING • Acts sad or depressed • Acts anxious with others • AUTISM SPECTRUM • Has nonfunctional routines or rituals • Becomes upset when routine is changed SSIS / Pearson Assessments 2007

34. A Tier 2 Intervention Program:Social Skills Improvement System: Intervention Guide

35. SSiS Intervention GuideA Tier 2 (Selected) Intervention Program • Teaches 20 keystone social skills • Re-Teaches the “Top 10” social skills • Teaches 10 additional keystone social behaviors • Levels • Preschool/Kindergarten • Early Elementary • Upper Elementary/Middle School • Delivered in 2 Formats/Approaches • Acquisition Deficits: (“Can’t do”) • Small, pullout group instructional format • Performance Deficits: (Won’t do”) • Classroom-based consultative problem-solving approach 6-Step instructional sequence • Tell - Practice • Show - Monitor Progress • Do - Generalize

36. Social Skills Taught in IG • Communication Behaviors • Takes turns in conversations • Says “Please” & “Thank you” • Cooperation Behaviors • Pays attention to others • Follows directions • Pays attention to work • Assertion Behaviors • Expresses feelings • Asks for help • Stands up for others • Responsibility Behaviors • Respects others’ things • Does the right thing • Does part in group

37. Social Skills Taught in IG • Empathy Behaviors • Making others feel better • Doing nice things for others • Engagement Behaviors • Asks others to do things with you • Gets along with others • Introduces self to others • Self-Control Behaviors • Makes compromises • Stays calm when criticized • Stays calm when disagreeing • Stays calm when pushed or hit

38. SSiS IG Instructional Strategies • Tell (Coaching) • Provide learning objective for featured social skill • Introduce skill via questions • Define specific skill & stress key words • Discuss why skill is important • Outline steps for performing the skill • Show (Modeling) • Model the behavior (positive example & negative example) • Discretely model each of the major steps for performing the skill • With a student helper, direct a role play of a typical situation • Lead a discussion of alternative behaviors to accomplish social behavior objective • Do (Behavioral Enactment) • Ask students to define the skill • Ask students to state steps in performing the skill • Ask students about the importance of the skill • Ask students to model the skill in role plays • Asks students to provide performance feedback

39. SSiS IG Instructional Strategies(continued) • Practice (Behavioral Rehearsal) • Review & apply skill in workbook activities • Have pairs of students practice the skill steps & provide feedback • Encourage use of skill in class sessions outside SSiS IG lessons • Monitor Progress (Self Monitoring) • Ask students to think about well they are performing the skill • Ask students to complete a self-monitoring chart • Generalize (Generalization & Maintenance) • Give a homework assignment to use skill in other settings • Have students demonstrate skill with other people

40. Strategies for Promoting Skill Acquisition • Coaching • Modeling • Role Playing • Social Problem Solving • Performance Feedback • Generalization Training

41. Strategies for Enhancing Skill Performance • Antecedent-Based Strategies • Peer Mediated Strategies (e.g., Positive Peer Reporting) • Cuing & Prompting • Precorrection • Consequence-Based Strategies • Reinforcement-Based Strategies • Group-Oriented Contingency Systems (“Good Behavior Game”) • Behavioral Contracts • School-Home Notes

42. Tier 3 Social Skills Intervention:Replacement Behavior Training

43. Tier 3:Functional Behavioral AssessmentReplacement Behavior Training • Weak responders to Tier 2 program • Logical extension of Tier 1 & Tier 2 programs • Focuses on both social skills & competing problem behaviors • Requires a functional behavioral assessment (FBA) • FBA yields: • Function of competing problem behavior • Identification of replacement behavior serving same function • FBA involves 3 steps: • Formulation of behavioral hypotheses • Construction of competing behavior pathway model • Comprehensive intervention planning based on hypotheses

44. Competing Behaviors & Matching Law • Relative rate of behavior matches relative rate of reinforcement for behavior • Response rate=Reinforcement rate (“matching”) • Matching involves “choice” behavior • Behaviors having higher rate of reinforcement will be “chosen” more frequently • Example of matching: • Aggressive behavior reinforced every 3 times it occurs • Prosocial behavior reinforced every 15 times it occurs • Aggressive behavior will be 5 times more frequent than prosocial behavior • 15/3=5 (matching)

45. Replacement Behavior TrainingRBT • RBT based on premise of functional behavioral assessment • Goal is to identify positive replacement behavior • RBT depends on identifying functionally equivalent behaviors” • 2 or more behaviors are functionally equivalent if they produce similar amounts of reinforcement • Example of functionally equivalent behaviors: • Child engages in disruptive classroom behavior • FBA hypothesizes that disruptive behavior is maintained by social attention • RBT would identify prosocial behavior that results in social attention (work completion, paying attention to teacher, compliance with class rules)

46. Strategies for Removing Competing Problem Behaviors • Differential Reinforcement Strategies • DRO • DRI • DRA • Response Cost • Timeout • Exposure-Based Methods • Cognitive-Behavioral Methods • Cognitive restructuring • Problem solving • Relaxation training • Goal setting • Self-monitoring

47. Strategies for Facilitating Generalization • Train Diversely • Teach Relevant Behaviors • Teach Functional Mediators • Make Social Skills More Efficient • Make Social Skills More Reliable

48. Frank M. Gresham, Ph.D. Department of Psychology Louisiana State University Baton Rouge, LA 70803 gresham@lsu.edu Thanks for your interest in the improvement of children’s social skills! SSIS / Pearson Assessments 2007