teaching problem solving skills autism

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Teaching Autistic Students to Solve Math Word Problems

August 29, 2022

By: Jenny Root, Ph.D., BCBA

Categories: How To , Education

In the past three months, how many times have you had no choice but to use cash to make a purchase? Or tell time using an analog clock?  

Although you have undoubtedly made purchases, it is likely you used a card or smart device, especially if the purchases were made online. To check the time, you probably glanced at a digital clock on a screen or even just asked Alexa, Google Home, or another artificial intelligence device.   

While the functions of many activities of daily living, such as making purchases and telling time, have remained the same over time, how we accomplish these tasks has changed dramatically as technology has evolved.   

Math instruction for autistic students has historically had a limited focus on “functional” skills in order to prepare them for independence in their adult lives. Yet in addition to mastering a series of discrete skills, autistic young adults need to be able to problem solve . This includes:  

• Being aware of when there is a problem.  
• Identifying a reasonable strategy.  
• Monitoring their progress accurately.  
• Adapting as necessary.  

Word problem solving is one way to teach students how, when, and why to apply math skills in real-world situations they will encounter in a future we may not be able to envision yet.   

These research-supported strategies can help teachers and parents teach autistic students to solve word problems using modified schema-based instruction (MSBI). MSBI is an evidence-based practice for teaching word problem solving.  

Create a meaningful task.

Word problems need to depict a realistic and meaningful problem. This will help students better understand the “why” behind word problem solving and support generalization to everyday situations. You can begin planning by identifying high-interest, real-world contexts when the targeted math skills could be used, such as familiar community locations, family routines, or preferred activities. The quantities represented in the problem should be realistic for the situation. Use technology to build background knowledge for generalization by showing short videos or pictures, such as videos of people making purchases using a credit card or comparing rideshare costs between two apps.  

Consider accessibility.

Both the materials and word problems themselves need to be accessible to students. The reading level, quantities represented, structure, and visual supports can all be adjusted to address barriers students may face. If independently reading the problem is a barrier, students can use technology to access text-to-speech or ask a skilled reader—a parent, peer, or teacher—to read it aloud to them. Quantities in the problem can be reduced to match a student’s numeracy skills (e.g., quantities under 10) or they can be provided with a calculator for efficiency.   

Research has shown that autistic students can successfully fade this equation template once they become fluent in problem solving.   

Focus on problem types, not keywords or operations.

Teaching word problem solving using MSBI may differ from your prior approaches to math instruction. Many teachers and parents teach operations sequentially, meaning once addition is mastered, they move on to subtraction, then multiplication, then division. But this developmental mindset can put unnecessary ceilings on student opportunity by having a “not ready for” mindset. Waiting for students to be “ready for” problem solving by overly focusing on their skill deficits will hold them back from meaningful, age-appropriate instruction.   

MSBI also does not teach students to focus on keywords to identify operations, such as “more” meaning add and “left” meaning subtract. While this trick may initially work for some simple problems, it doesn’t help students conceptually understand the problem. Real-world problems won’t have keywords.  

Instead of teaching by operation or focusing on keywords, research has shown when autistic students learn to identify and represent the problem by the schema (pattern of problem structure), they are able to independently solve, discriminate between, and generalize problems. There are two categories of schemas, or problem structures. Additive problems use addition and subtraction operations and include group/total, compare/difference, and change schemas. Multiplicative problems use multiplication and division and include equal group, multiplicative comparison, rate, and proportion. Here is a great resource that explains each schema .   

Choose a problem-solving routine.  

The three key components of schema instruction are teaching:   

• The key features of each schema.  
• A solution strategy for each schema.  
• Important language and vocabulary related to the schema.  

MSBI provides additional support as needed for working memory, language, reading level, and numeracy skills so that students are engaged, motivated, and able to “show what they know” while problem solving.   

Problem-solving routines draw students’ attention to the decisions they need to make and actions they need to engage in to arrive at a solution. General attack strategies can be effective. These are two examples:   

UPS Check  

• Understand  
• Check work  
• Discover the problem type.  
• Identify information in the problem to represent in the diagram.  
• Solve the problem.  
• Check the answer.   

Students usually write these at the top of their paper or reference them on a poster or whiteboard in the classroom. Autistic students and those with more extensive support needs will likely need a more detailed and personalized routine that breaks down the mathematical decisions into more discrete behaviors.   

When developing routines to meet student needs, analyze the decisions that need to be made and behaviors involved in solving problems. Routines should always begin with reading the problem or requesting that a problem be read aloud. At least when students are initially learning the routine, they should have individual copies to follow, either printed directly on worksheets or as a separate visual support. Judiciously pair visual supports with text to give support but not so much that they are just relying on matching instead of demonstrating mathematical understanding. The general curriculum access lab at Florida State University has example problem-solving routines from research with students with autism and other developmental disabilities on their website.  

Support independence.

You must explicitly teach students to follow a problem-solving routine. Use think-alouds with clear and concise language while actively engaging students in the problem-solving process. Opportunities for guided practice are important for identifying points of strength and areas of misconception. A system of least prompts (starting with the prompt that provides the least amount of assistance) can be used when students are not independently correct:   

• A generic verbal prompt: Read/point to step of the problem-solving routine.   
• Direct verbal prompt: explain how to complete the step.   
• A model-retest: Model completing step and ask student to repeat.   

Self-monitoring and goal-setting can help facilitate independence in problem solving. Giving a space for students to check off steps as they are completed enables self-monitoring task completion to start as soon as they begin to solve the problem. The focus can shift to self-monitoring independence by having students check off steps completed “by myself” or “with help” as in the example below or self-monitoring duration by timing themselves.  

Word problem solving is an important skill for all students, as it puts math concepts and procedures into a real-world context. In addition, self-determinatio n skills such as choice-making, self-monitoring, and goal-setting can be feasibly embedded to enhance effectiveness and efficiency. To prepare autistic students for independence in their futures, they need instruction focused on skills of the future, not the past.  

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Teaching Individuals with Autism Problem-Solving Skills for Resolving Social Conflicts

Behavior Analysis in Practice

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Adrián Garrido Zurita

This study aims to examine the usefulness of an ad hoc worksheet for an Interpersonal Problem-Solving Skills Program (SCI-Labour) the effectiveness of which was tested by Bonete, Calero, and Fernández-Parra (2015). Data were taken from 44 adolescents and young adults with Autism Spectrum Disorder (ASD) (age M = 19.73; SD = 3.53; 39 men and 5 women; IQ M = 96.27, SD = 15.98), compared to a matched group (in age, sex, and nonverbal IQ) of 48 neurotypical participants. The task was conceived to promote the generalization of interpersonal problem-solving skills by thinking on different possible scenarios in the workplace after the training sessions. The results show lower scores in the worksheet delivered for homework (ESCI-Generalization Task) in the ASD Group compared to neurotypicals in total scores and all domains (Problem Definition, Quality of Causes, and Solution Suitability) prior to program participation. In addition, after treatment, improvement of the ASD Group was observed i...

Proceedings of the 4th International ICST Conference on Pervasive Computing Technologies for Healthcare

Rosa I Arriaga , Jackie Isbell

... B. Related Wark Social skills training interventions are an important part of the education of children with Asperger's syndrome and HF ASD. ... Following the Social Story's, format this passage was presented on a sheet of paper with brightly colored icons. ... The m_ing sta rts soon.' ...

Journal of Autism and …

ΕΙΡΗΝΗ ΛΥΚΟΥ-ΧΑΪΔΗ

Child and Adolescent Psychiatric Clinics of North America

Patricia Prelock

Research in Autism Spectrum Disorders

Patrice Weiss

Angela Livingston

Autism Spectrum Disorder (ASD) is characterized by detrimental deficits in social communication and interaction, restrictive and repetitive patterns of behaviors, interest or activities. It is estimated that 70% of children with ASD suffer from uncontrollable behavioral outbursts that increase their peer isolation along with the stress of their caregivers. These uncontrollable and involuntary behaviors are stressful to the individual in many ways. This research study is being conducted to review the benefits of encouraging an increase in organized social activities between people with and without ASD in hopes that some of the uncontrollable behavioral outbursts that previously increased peer isolation will decrease or disappear over experience with organized social activities. Previous research on this study has been thoroughly reviewed and examined in order to gain a crucial understanding of this topic. The research potential from the interview style experiment will assist in future programs with the complete integration of children, adolescents, and young adults into the mainframe of society.

Journal of Autism and Developmental Disorders

Revista de Investigación en Logopedia

Numerous studies reveal the benefits of early intervention for the adequate development of children with autism spectrum disorders (ASD). Most of the interventions designed for people with ASD focus exclusively on a sole methodology. This study proposes a Combined Early Intervention Program (hereafter CEIP) using different methodologies with scientific evidence: Early Intensive Behavioral Interventions (EIBI), Early Start Denver Model (DENVER), spatial-temporal organization (TEACCH), augmentative communication systems (the Picture Exchange Communication System—PECS—, Total Communication Program, Picture Communication Symbols—PCS), behavioral strategies, and training of the parents. This CEIP contemplates intervention in areas that are typically affected in ASD: socialization, communication, symbolization, and behavioral flexibility, producing considerable improvement in the children's behavior, decreasing problem behaviors and improving social communication.

Language, Speech, and Hearing Services in Schools

Linda R Watson

Purpose This study aimed to examine the initial efficacy of a parent-assisted blended intervention combining components of Structured TEACCHing and Social Thinking, designed to increase social communication and self-regulation concept knowledge in 1st and 2nd graders ( n = 17) diagnosed with autism spectrum disorder (ASD) and their parents. Method A randomized delayed treatment control group design with pre- and postintervention assessments of both parents and children was implemented within a community practice setting. Two follow-up assessments at 3 and 6 months postintervention were also completed. Results Overall, results indicate that the intervention is efficacious in teaching social communication and self-regulation concept knowledge to children with ASD and their parents. Both parents and children demonstrated an increase in social communication and self-regulation knowledge after participating in the Growing, Learning, and Living With Autism Group as compared to a delayed t...

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Lynn Koegel

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Social Problem Solving: Best Practices for Youth with ASD

• By: Michael Selbst, PhD, BCBA-D Steven B. Gordon, PhD, ABPP Behavior Therapy Associates
• July 1st, 2014
• assessment , problem solving , social information processing , social skills
• 8207    0

Joey, age 9, has been diagnosed with an Autism Spectrum Disorder (ASD), and due to his high functioning has been mainstreamed into a fourth grade classroom with a shadow. His […]

Joey, age 9, has been diagnosed with an Autism Spectrum Disorder (ASD), and due to his high functioning has been mainstreamed into a fourth grade classroom with a shadow. His challenging behaviors typically center on his peer interactions in spite of adequate academic performance. When in a group situation he becomes very argumentative when his ideas are not used, becomes very bossy on the playground, and has run out of the classroom when things do not go his way. Megan, age 14, has also been diagnosed with ASD. She isolates herself from her peers and rarely initiates or responds to greetings. Conversations are almost nonexistent unless they are focused on her favorite topics of anime or fashion.

Children with ASD described as above typically have significant social skills impairments and often require direct instruction in order to address these deficits. They often have difficulty in many of the following areas: sharing, handling frustration, controlling their temper, ending arguments calmly, responding to teasing, making/keeping friends, complying with requests. Strong social skills contribute to the initiation and maintenance of positive relationships with others and as a result contribute to peer acceptance. Social skills impairments, on the other hand, contribute to peer rejection. The ability to get along with peers, therefore, is as important to self-esteem as the ability to meet with academic success in the classroom. This article will review the domain of social skills, the assessment of social skills, the importance of social problem-solving and a social skills curriculum which incorporates evidence-based practices to address this very important area.

Social information processing (SIP) is a widely-studied framework for understanding why some children have difficulty getting along with peers. A particularly well-known SIP model developed by Crick and Dodge (1994) describes six stages of information processing that children cycle through when evaluating a particular social situation: encoding (attending to and encoding the relevant cues), interpreting (making a judgment about what is going on), clarifying goals (deciding what their goal is in the particular situation), generating responses (identifying different behavioral strategies for attaining the decided upon goal), deciding on the response (evaluating the likelihood that each potential strategy will help reach their goal and choosing which strategy to implement), and performing the response (doing the chosen response). It is assumed that the steps outlined above operate in real time and frequently outside of conscious awareness. Numerous studies have shown that unpopular children have deficits at multiple stages of the SIP model. For example, they frequently attend to fewer social cues before deciding on peers’ intent, are more likely to assume that peers have acted towards them with hostile intent, are less likely to adopt pro-social goals, are more likely to access aggressive strategies for handling potential conflicts, evaluate aggressive responses more favorably, and are less skillful at enacting assertive and prosocial strategies.

Deficits in social skills are one of the defining characteristics of children with ASD. These impairments manifest in making and keeping friends, communicating feelings appropriately, demonstrating self-control, controlling emotions, solving social problems, managing anger, and generalizing learned social skills across settings. Elliott and Gresham (1991) indicated that social skills are primarily acquired through learning (observation, modeling, rehearsal, & feedback); comprise specific, discrete verbal and nonverbal behaviors; entail both effective and appropriate initiations and responses; maximize social reinforcement; are influenced by characteristics of environment; and that deficits/excesses in social performance can be specified and targeted for intervention. Social skills can be conceptualized as a narrow, discrete response (i.e., initiating a greeting) or as a broader set of skills associated with social problem solving. The former approach results in the generation of an endless list of discrete skills that are assessed for their presence/absence and are then targeted for instruction. Although this approach has an intuitive appeal and is easily understood, the child can easily become dependent on the teacher/parent in order to learn each skill.

An alternative approach focuses on teaching a problem solving model that the child is able to apply independently. Rather than focusing on teaching a specific behavioral skill, the focus is on teaching a social problem solving model that the learner would be able to use as a “tool box.” The well-used saying “give a person a fish and she eats for a day but teach her to fish and she eats for a lifetime” is particularly relevant. The social problem solving approach offers the promise of helping the child with ASD to become a better problem solver, thereby promoting greater independence in social situations and throughout life.

After many years of conducting social skills training using the specific skill approach, the authors have developed a model of social problem solving that uses the easily learned acronym of POWER. The steps of POWER-Solving® include:

P ut problem into words

O bserve feelings

W ork out your goal

E xplore solutions

R eview plan

Each of the five steps of POWER-Solving® has been previously identified as reliably distinguishing between children with emotional/behavioral disorders and psychologically well-adjusted individuals. The ability to “Put problem into words” is critical in order to start the problem solving process. Children with ASD often have difficulties finding the words to identify a problem. Thus, the first step in this approach involves direct training in the use of the rubric “I was… and then…” Upon entering the classroom and finding a peer in his seat Joey immediately pushed the peer in an attempt to get him out of his seat. Through the use of POWER-Solving® Joey was taught to articulate “I was walking into the classroom and then I saw that Billy was in my seat.”

The second step of “Observe feelings” was addressed by helping Joey develop a feelings vocabulary (e.g., angry, frustrated, scared, sad) as well as measuring the intensity of these emotions using a scale from one to ten, with a one being “very weak” and a ten being “very strong.” Photographs and drawings were used extensively to capitalize on his strong visual skills.

The third step of POWER-Solving®, “Work out your goal?” involves identifying the goal and the motivation to reach the chosen goal. This critical step sets the stage for what follows. The goal must be specific and measurable, consistent with Applied Behavior Analysis (ABA) principles. Joey was able to identify that his goal consisted of two parts. First, he wanted to get Billy out of his seat and second, he wanted him to still be his friend. He reported that his desire to reach this goal was a nine on the ten-point scale.

The fourth step of POWER-Solving® involves “Explore solutions.” Socially skilled individuals are able to generate a range of effective solutions but those with impairments are more limited and often apply the same rigid solution over and over again in spite of repeated ineffectiveness. Joey was taught to “brainstorm,” which involves generating as many solutions as possible that might reach the stated goal, provided the solution is safe, fair, and effective. Joey was able to identify that approaching Billy and saying “Excuse me but I need to sit in my seat now” would help him to accomplish his goal(s). Behavioral rehearsal, combined with coaching and feedback, helped Joey to become fluent in applying this solution.

The final step of POWER-Solving®, “Review plan,” involved Joey reviewing his plan to use this skill the next time the situation presented and to reward himself by saying “I am proud of myself for figuring this out.”

POWER-Solving® has been applied successfully in multiple settings such as the classroom, a summer treatment program, clinical settings and home environments. The curriculum is systematic and relies heavily on visual cues and supports. Children are taught how to problem-solve first using their “toolbox” (i.e., the five steps of POWER-Solving®). The children are presented with specific unit lessons on each of the five steps of POWER-Solving®. All children have an opportunity to practice each step of POWER-Solving®. After learning each step of POWER, the children have acquired a “toolbox” which they can begin to apply to social situations.

When teaching social skills, it is important to coach the children through behavioral rehearsal activities to promote skill acquisition, performance, generalization and fluency. Additionally, daily activities reinforce these skills, some of which include designing their own feelings thermometer, developing novel products via group collaboration, and developing a skit to teach a specific skill.

To increase students’ performance of the desired skills, use of a token economy may be helpful, whereby points are earned during the day for displaying appropriate behavior, demonstrating a predetermined individualized social behavioral objective and for using the POWER-Solving® steps. At the end of every day, points could be exchanged for a reward. In addition to the direct instructional format, incidental teaching should be used in anticipation of a challenging situation as well as a consequence for failure to use the steps when confronted with a specific problem. An experienced social skills coach, generalization strategies, and a systematic plan to teach and reinforce skills are critical for success.

Please feel free to contact us at Behavior Therapy Associates for more information about best practices for social skills training, as well as information regarding the POWER-Solving curriculum. We can be reached at 732-873-1212, via email [email protected] or on website at www.BehaviorTherapyAssociates.com .

Crick, N.R., & Dodge, K.A. (1994). A review and reformulation of social information-processing mechanisms in children’s social adjustment.  Psychological Bulletin , 115, 74–101.

Elliott, S.T. & Gresham, F. M. (1991).  Social skills intervention guide: Practical strategies for social skills training . Circle Pines, MN: American Guidance Service.

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Home » Autism Parenting Advice » Teaching Autistic Children Critical Thinking Skills

Teaching Autistic Children Critical Thinking Skills

By   Donnesa McPherson, AAS

October 21, 2022

What is so important about teaching autistic children critical thinking skills? These skills are important to everyday decisions and obstacles an individual may face, there are many neurotypical and neurodivergent individuals that have a hard time with these skills.

This article is going to outline abstract and conceptual thinking skills development, practice, and use in the school setting and at home. I plan on including ways that both parents and teachers will best be able to encourage and build these skills in children with autism spectrum disorder (ASD).

It may take some creativity and thinking outside the box when interacting and teaching these skills. It is important to remember and take note of the differences and potential difficulties that your child may have when taking these ideas into consideration.

As always, these are merely the tip of the iceberg and may not work for everybody. That is why the ability of parents and educators to think outside the box and use their own critical thinking skills when figuring out what will work best for the child.

Neurodivergence, autism, and critical thinking skills

It has been thought that neurodivergent children, particularly autistic children, have a harder time with an abstract idea. In the article, Associations Between Conceptual Reasoning, Problem Solving, and Adaptive Ability in High-functioning Autism, they state that this thought is not entirely correct and cannot cover the spectrum that autism covers.

For instance, the article states that there are children that have learned some conceptual reasoning skills, along with abstract thinking in a therapy or school setting and do well. Then when they go about their everyday lives they tend to forget or have a hard time applying these skills to everyday occurrences.

There are also autistic children who have no need to further their problem solving and conceptual skills. As I stated, with the spectrum that autism falls under, it can be challenging to address all the differing areas of development in these areas.

Ways to promote and enhance abstract and conceptual thinking skills

In this section I will mainly focus on ways of developing these skills in the classroom environment. Also, what alterations and support can be put in place to help the individuals develop these skills.

Problem solving and critical thinking development in the classroom

The presentation, Understanding Autism Professional Development Curriculum: Strategies for Classroom Success and Effective Use of Teacher Supports, starts with explaining what autism is and moves into what affects the autistic students and ways to help and support these students.

What can affect the student with autism?

• Unpredictability this can be daunting and even a little scary for a student that may rely on knowing what they should expect next when school events, like an unexpected pep rally in the loud gym, can be met with extreme difficulty and be more of a stressful event than something fun
• Transitions knowing what is coming up next and have the time to prepare for these transitions can be key with some students keeping transitions and how they are handled in mind can help decrease difficult behaviors before they begin by making it easier for the student to transition smoothly
• Environmental changes these changes can be anything from seating changes to adding a new plant to the classroom and can stimulate certain sensory sensitive individuals or be an unwelcome surprise they were not ready for
• Sensory overload if a student is exhibiting unusual or difficult behaviors, it can occur from all the sounds in the hallway to the buzzing from the lights and can affect the individual that may have a sensitive sensory response
• Sensory seeking these students need some type of sensory stimulating activity, or could be the individuals that need to move around during discussion because that is how their brain best functions
• Navigation it can be confusing, especially if the student has any of the various communication difficulties and may lack the social skills needed to ask when navigating from classroom to classroom or learning center to learning center and can be further irritated by loud and unexpected sounds of voices and chairs scraping the floor
• Expectations not knowing what is expected of them, if the student is still developing social skills they may not do what is asked because they are unsure of what the expectations were before the activity and/or task and are unaware of how to ask appropriately
• Decision making if given too many possibilities for decisions, the student may become confused and irritated because they don’t know what to do and there are too many choices that have been presented to them

Ways to help and support these students

• Provide structure and consistency organizational skills are so important when it comes to this step because it can require a posted classroom schedule and one that the students also have in their notebooks that they can refer to, if needed try to stay clear of visual clutter, as that can cause more confusion
• Make information and supplies readily accessible label where items, homework, lessons, etc. go for the day don’t forget to verbally explain and show the students where they can find these areas and labels, if they haven’t been introduced
• Predictability this is where having a schedule and following it helps and is a nice starting point also having different tools and visual supports that are easily accessible to the student makes it easier for them to use and understand
• Consider potential distractions try to remember that open windows, fluorescent lighting, strong smells, and loud noises can be extremely distracting and are a few of the things that can affect a sensory sensitive student keeping these distractions down or altering them in a friendlier way can help the individual with paying attention to the task at hand
• Provide plenty of visual supports visual supports are your friend and ones that are interactive, more so for younger students but can benefit older students who like the sensory stimulation when the student physically removes a piece to the complete side or has a visual schedule in front of them and knows to expect gym class after recess

What are five ways that teachers can support critical thinking in the classroom?

Whether the student is in a general education classroom or special education program, there are five ways that teachers and teaching aids can help support students:

• Expose and prepare this a way that the teacher or aid could show and talk about the assignment before the assignment is taught and helps expose the student to the material and prepare them for what is going to be expected of them and what the assignment will entail
• Provide and plan for necessary adaptations for the student if the student already has an Individualized Education Plan (IEP) there could be modifications and adaptations already outlined
• Visual supports these could be token charts that allow the student to interact and add tokens when they have accomplished something all the way to an interactive visual board that the student carries around, to a visual schedule that changes as the tasks change throughout the say letting the students know what to expect next
• Reinforcement the reinforcement discussed here is a way of rewarding the child for following school rules, finishing assignments, interacting with other students, or whatever they are working on for the moment
• Offer a safe space this is an area where the student can decompress and can either be a place where they go by themselves when they become overwhelmed

Free your mind

As a parent, it can be difficult changing around your thought patterns and expectations when it comes to different aspects of your child and what is being expected of them. It is an important thing to remember, though, that as your child is learning all kinds of things like new ways to interact in a more socially acceptable way to keep all your interactions as light and fun as possible.

As a parent you can look at things in a creative way. This can be fun and add a sense of adventure to how you and your child continue to learn and respond, especially when it comes to critical thinking, abstract skills, conceptual skills, and problem solving skills.

For instance, if you know your child doesn’t like doing their school work at the table, you can ask them where they would like to do their school work, be careful and avoid verbal overload by talking too long. It is best to keep to shorter sentences and questions and offer two to three potential answers.

If they say they would prefer to practice spelling on the couch, just make sure to minimize distractions and voila they have a new place to do work and where able to practice some abstract concepts to where homework can be done.

In her article, 3 Simple Habits to Improve Your Critical Thinking, Helen Lee Bouygues states three ways of improving critical thinking, and they are things parents can do at home to practice with their children!

What are the three things that parents can do at home to help these skills?

• Ask questions this can seem super simple, but the act of asking and answering repetitive verbal questions can help build problem solving skills because the child has to use their thinking skills and reason with the question to come up with potential answers
• Be logical if your child is very logical, this exercise could help them expand beyond their logic, although they would start with logic, and expand as you both come up with more questions and concepts to talk about
• See things differently you and your child have had a discussion about homework and they have figured out that they can do spelling practice on the couch, maybe come up with what other subjects may be done on the couch? Or where else could be a good place to practice spelling words and find out that they love spelling while swinging on their sensory swing.

Key takeaways

There are many ways that teachers and parents can both support and help develop critical thinking and other skills that will help the student in their future. Some of these ideas include ways that the classroom can help or hinder development and education.

Also, challenging parents to think outside the box when helping develop thinking skills and those needed for problem and organizational solving on a daily basis. Although there are children that may be able to express these skills during some times and forget about them during daily tasks, practice can help further the skill set.

As with anything else in life, practice can make perfect. Or, it can at least help by making steps toward the ultimate goals of using these skills as a student and beyond.

Bouygues, H. (2019). 3 Simple Habits to Improve Your Critical Thinking. https://hbr.org/2019/05/3-simple-habits-to-improve-your-critical-thinking

Goldstein, G., Mazefsky, C., Minshew, N., Walker, J., Williams, D. (2018). Associations Between Conceptual Reasoning, Problem Solving, and Adaptive Ability in High-functioning Autism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067678/

The Center on Secondary Education for Students with Autism Spectrum Disorders & Organization for Autism Research. Understanding Autism Professional Development Curriculum: Strategies for Classroom Success and Effective Use of Teacher Supports. https://csesa.fpg.unc.edu/sites/csesa.fpg.unc.edu/files/imce/other/Presentation%202%20(Strategies%20for%20Classroom%20Success%20and%20Effective%20Use%20of%20Teacher%20Supports)(2).pdf

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Episode 4: Teaching Problem Solving Skills

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Teaching Individuals with Autism Problem-Solving Skills for Resolving Social Conflicts

Affiliations.

• 1 Endicott College, Beverly, MA USA.
• 2 Pepperdine University, Malibu, CA USA.
• 3 University of Southern California, Los Angeles, CA USA.
• 4 Halo Behavioral Health, Valley Village, California USA.
• PMID: 34484617
• PMCID: PMC8404753
• DOI: 10.1007/s40617-021-00643-y

Resolving social conflicts is a complex skill that involves consideration of the group when selecting conflict solutions. Individuals with autism spectrum disorder (ASD) often have difficulty resolving social conflicts, yet this skill is important for successful social interaction, maintenance of relationships, and functional integration into society. This study used a nonconcurrent multiple baseline across participants design to assess the efficacy of a problem-solving training and generalization of problem solving to naturally occurring untrained social conflicts. Three male participants with ASD were taught to use a worksheet as a problem-solving tool using multiple exemplar training, error correction, rules, and reinforcement. The results showed that using the worksheet was successful in bringing about a solution to social conflicts occurring in the natural environment. In addition, the results showed that participants resolved untrained social conflicts in the absence of the worksheet during natural environment probe sessions.

Keywords: Autism; Executive function; Perspective taking; Problem solving; Social conflict.

© Association for Behavior Analysis International 2021.

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• v.11(4); 2018 Dec

How Teaching Perspective Taking to Individuals with Autism Spectrum Disorders Affects Social Skills: Findings from Research and Suggestions for Practitioners

Lindsay c. peters.

1 Psychology Department, Western New England University, Springfield, MA USA

2 Elmtree ABA Services, LLC, P.O. Box 1401, Framingham, MA 01701 USA

Rachel H. Thompson

Behavior–analytic practitioners working with individuals with autism spectrum disorders (ASDs) may be approached to incorporate perspective taking into a client’s programming. Teaching perspective taking to individuals with ASDs has received attention in both the developmental psychology and, more recently, the behavior–analytic literature. The results of our review of the current evidence suggest that although perspective-taking repertoires believed to be related to social skills can be taught (false belief task performance, deictic frames), only directly teaching the social skills of interest (or applied perspective-taking skills) results in improvements in socially important behavior. The aim of this article is to provide practitioners with the current state of research on how teaching perspective taking affects social skills and to provide suggestions on how these findings might be incorporated into their practice.

Perspective taking, also referred to as theory of mind, 1 is thought by some to underlie social skills (e.g., Frith, 1989 ; Happé, 1994 ), and there is evidence for positive correlations between measures of theory of mind and general social functioning (e.g., Frith, Happé, & Siddons, 1994 ). This suggested link has led researchers to evaluate strategies for teaching perspective taking with individuals with autism spectrum disorders (ASDs) as a way to improve social skills. This trend is even more evident in the numerous commercially available curricula with this same goal (e.g., Brennan, 2011 ; Howlin, Baron-Cohen, & Hadwin, 1999 ; Ordetx, 2012 ; Toomey, 2002 ; Winner, 2005 ). The goal of this article is to review the research on the effects of teaching perspective taking on social skills with individuals with ASDs. We also provide recommendations for practitioners on how to proceed when asked to incorporate perspective taking into a client’s programming. These suggestions are guided by both research and the Professional and Ethical Compliance Code for Behavior Analysts published by the Behavior Analyst Certification Board (BACB, 2014 ; effective January 1, 2016; hereafter referred to as “the BACB Code”).

Perspective taking was defined by Howlin et al. ( 1999 ) as “the ability to infer other people’s mental states (their thoughts, beliefs, desires, intentions, etc.), and the ability to use this information to interpret what they say, make sense of their behaviour, and predict what they will do next” (p. 2). Howlin et al. ( 1999 , pp. 9–11) give examples of perspective taking, such as reading and responding to intentions, reading the listener’s level of interest in one’s speech, detecting a speaker’s intended meaning, and deceiving or understanding deception.

Three Types of Perspective Taking

Research on teaching perspective taking has generally taken one of three routes: teaching performance on false belief tasks, teaching deictic frames, and teaching socially important behavior that requires accounting for the knowledge of others (or applied perspective taking ; Hutchins, Prelock, Morris, Benner, LaVigne, & Hoza, 2016 ).

The “litmus tests” of theory of mind are false belief tasks. 2 False belief tasks were initially developed for the purpose of determining the capacity of chimpanzees (e.g., Premack & Woodruff, 1978 ) and children (e.g., Dennett, 1978 ) to infer the private events of others. On average, individuals with ASDs fail false belief tasks more often than typically developing children matched for language ability and mental age (e.g., Baron-Cohen, 1989a ; Perner, Frith, Leslie, & Leekam, 1989 ; Reed & Peterson, 1990 ; Yirmiya, Erel, Shaked, & Solomonica-Levi, 1998 ). The dependent variables in false belief tasks are verbal (vocal or point) responses by a participant to an evaluator’s question regarding the false belief of a character in a story. In the most well-known task, the Sally–Anne or unexpected transfer task (Baron-Cohen, Leslie, & Frith, 1985 ; Dennett, 1978 ; Wimmer & Perner, 1983 ), for example, the participant is asked to watch a skit in which Sally places a marble in a basket before walking away. Next, Anne moves Sally’s marble from the basket to a box. When Sally returns to get her marble, the participant is asked where the character thinks the item is, where the character will look for the item, or both. Several other tasks are also frequently used, such as the unexpected contents or “Smarties” task (Baron-Cohen, 1989a ; Hogrefe, Wimmer, & Perner, 1986 ; Perner, Leekam, & Wimmer, 1987 ) and the second-order false belief task (Baron-Cohen, 1989b ; Perner & Wimmer, 1985 ).

Because these tasks became the accepted measure of theory of mind and because theory of mind was hypothesized to be a core deficit in ASDs (e.g., Baron-Cohen et al., 1985 ; see also the discussion by Tager-Flusberg, 2007 , on a shift away from this view), researchers have attempted to teach individuals with ASDs to pass these tasks. Several strategies have been successful in teaching individuals with autism to pass false belief tasks, such as direct teaching (e.g., Feng, Lo, Tsai, & Cartledge, 2008 ; Swettenham, 1996 ), video modeling (e.g., Charlop-Christy & Daneshvar, 2003 ; LeBlanc, Coates, Daneshvar, Charlop-Christy, Morris, & Lancaster, 2003 ), thought bubbles (e.g., Paynter & Peterson, 2013 ; Wellman, Baron-Cohen, Caswell, Gomez, Swettenham, Toye, & Lagattuta, 2002 ), and the “mind is like a camera” analogy (e.g., Fisher & Happé, 2005 ; McGregor, Whiten, & Blackburn, 1998a , b ; Swettenham, Baron-Cohen, Gomez, & Walsh, 1996 ).

Over the last several years, behavior analysts working under a relational frame theory (RFT) perspective have begun investigating perspective taking as relational responding, particularly as deictic relations (see Montoya-Rodríguez, Molina, & McHugh, 2017 , for a recent review). Lovett and Rehfeldt ( 2014 ) stated that “deictic relations involve a specification of the stimuli to be related based on the perspective of the speaker as opposed to the formal properties of the stimuli” (p. 22). Deictic relational responding has been successfully taught to individuals with autism using multiple-exemplar instruction of the three deictic relations (I–you, here–there, and now–then) at three levels of complexity (simple, reversed, and double-reversed). Typically, participants are presented with brief descriptions of relations and are asked to respond to questions (McHugh, Barnes-Holmes, & Barnes-Holmes, 2004 ). For example, a reversed relation would be “I have a red brick and you have a green brick. If I was you and you were me, which brick would I have? Which brick would you have?” (Lovett & Rehfeldt, 2014 , p. 23).

Social skills thought to require perspective taking might be called “applied perspective taking.” Applied perspective-taking skills are likely to result in socially mediated reinforcement, excluding “educational” reinforcement (Skinner, 1957 ), and therefore are socially functional. Examples of applied perspective taking include deceiving, providing listener-appropriate detail in conversation, persuading, and helping (Frith et al., 1994 ; Howlin et al., 1999 ; Hughes & Leekam, 2004 ; Peterson, Garnett, Kelly, & Attwood, 2009 ).

We sought to review the research on the effects of teaching perspective taking on social skills of individuals with ASDs. To identify relevant research, we conducted online database searches using EBSCOhost (PsycINFO, PsycARTICLES, Academic Search Premier, and Education Research Complete). Specific search terms were designated for each of the three types of perspective taking. To determine the relation between improved false belief performance and socially important behavior, the following subject terms were used in the search in relevant three-word combinations: perspective taking , theory of mind , and false belief ; teaching , training , and intervention ; and autism . To determine the relation between improved responding to deictic relations and socially important behavior, the following subject terms were used in the search in relevant three-word combinations: perspective taking , relational frame theory , deictic frames , and autism . To determine the effect of teaching applied perspective taking on the socially important behavior taught, teaching , training , intervention , and autism were combined in relevant three-word combinations with the following words or phrases: deception , lying (lie) , white lie , game , game strategy , hide and seek , cheat , sabotage , joke , secret , fairy tales , double bluff , listener appropriate detail , conversation , conversation detail , referential communication , persuasion , correcting false belief , and helping (examples from Frith et al., 1994 ; Howlin et al., 1999 ; Hughes & Leekam, 2004 ; Peterson et al., 2009 ). We reviewed abstracts or full texts to determine the relevance of each study. Reference lists and subsequent citation lists (i.e., “cited by” lists) also served as additional resources.

Studies chosen for inclusion met the following general criteria:

• The study was published in English in a peer-reviewed journal prior to January 1, 2017.
• A primary aim of the study was teaching (i.e., included manipulations of the presentation of materials, prompting, and/or consequences for responding).
• Teaching was conducted with at least one participant diagnosed with ASD (consistent with the current Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM–5 ], American Psychiatric Association, 2013 , definition, including Asperger’s disorder and pervasive developmental disorder not otherwise specified).
• Baseline and posttreatment measures (direct or indirect) of functional social skills (i.e., the taught response would likely result in socially mediated reinforcement, excluding “educational” reinforcement; Skinner, 1957 , p. 84) were taken.
• The report included enough methodological detail on teaching procedures to be sufficiently technological or included enough detail that a “typically trained reader could replicate that procedure well enough to produce the same results, given only a reading of the description” (Baer, Wolf, & Risley, 1968 , p. 95).
• The response or responses being taught required belief-based perspective taking (i.e., accounting for the beliefs or knowledge of another person).

Interrater Agreement

A second researcher independently conducted online database searches for 33% of keyword combinations. This second researcher then independently determined if each paper identified in those searches met the inclusion criteria described previously. Interrater agreement was calculated by dividing the number of agreements on articles that met the inclusion criteria divided by the total number of agreements plus disagreements multiplied by 100. Interrater agreement was 100%.

A summary of the results of the literature investigating the effects of teaching perspective taking on social skills is presented in Table ​ Table1 1 .

Summary of the results of the literature investigating the effects of teaching perspective taking on social skills

a No improvement on false belief performance outcome measure

False Belief Performance

Our search revealed four papers (Chin & Bernard-Opitz, 2000 ; Feng et al., 2008 ; Fisher & Happé, 2005 ; Hadwin, Baron-Cohen, Howlin, & Hill, 1997 ) that taught false belief performance, measured the effects of that teaching on social skills, and met our additional inclusion criteria. Generally, research showed that improvements in false belief task performance did not also produce improvements in socially important behavior.

Hadwin, Baron-Cohen, Howlin, and Hill ( 1996 ) taught 10 participants with ASDs five levels of belief-based perspective taking (simple visual perspective taking, complex visual perspective taking, seeing leads to knowing, predicting actions based on true belief, and predicting actions based on false belief). Teaching, however, was limited to eight sessions; thus, not all participants learned to pass each task. Results did show that the mean number of levels that participants passed after teaching was statistically greater than that passed before teaching. In a subsequent paper, Hadwin et al. ( 1997 ) also compared the conversation skills of these same participants before and after teaching. Conversation skills were measured during adult–child interactions with a book, and vocalizations were categorized as answers (“if a child just comprised a one-word or a one-sentence response to a prompt,” p. 525), developments (“if a child produced an utterance that was two or more sentences,” p. 525), perseverations (“if responses were echolalic or repetitive,” p. 525), or unclear responses (“if responses were unclear from the tape or were unrelated to the book,” p. 525). The number of mental state words (categorized as emotion, volition, cognition, or perception) spontaneously used was also recorded. Results showed that there were no changes in measures of appropriate conversation skills, “developments,” or the number of mental state words used following teaching.

Chin and Bernard-Opitz ( 2000 ) evaluated the correlation between false belief performance and social skills by first teaching conversation skills and then measuring the effect on false belief performance. The researchers taught three participants with ASDs five conversation skills: initiating a conversation, taking turns, listening, maintaining a conversation topic, and changing the topic. Teaching was limited to nine sessions, and only one participant experienced training in each of these skills. Outcomes of the teaching were measured in 3-min conversations. In addition, false belief task performance (unexpected transfer and contents tasks for two participants, second-order false belief task for the other) was measured intermittently before, throughout, and after teaching. Although participants improved in some aspects of conversation skills relative to baseline, none of the participants ever passed false belief tasks.

Using a “mind is like a camera” analogy (Swettenham et al., 1996 ) to teach the unexpected contents false belief task across a maximum of 10 sessions, Fisher and Happé ( 2005 ) found that the number of participants who passed this task was statistically greater following the teaching. When teacher responses on a questionnaire about socially important perspective-taking behavior were compared before and after teaching, however, the difference between the scores was not statistically significant. Following teaching, participants also improved on a penny-hiding game (Gratch, 1964 ; see also Baron-Cohen, 1992 )—a more socially functional measure of perspective taking in which the participant hides an item in one hand and then presents both fists for the other player to choose. Although participants who experienced teaching in false belief task performance improved on this game, another group of participants who experienced executive function teaching also improved. Thus, it is unclear which variables were responsible for the improvements.

Feng et al. ( 2008 ) taught an 11-year-old boy with ASD to pass both the unexpected transfer and second-order false belief tasks. The participant was also taught other skills thought to contribute to false belief performance (e.g., two types of visual perspective taking, seeing leads to knowing, true belief) and other social skills (anger control, greetings, and needs expression). Once these skills were mastered, role-plays with feedback with both adults and peers were also conducted. Before, during, and after teaching, the researchers also periodically measured the participant’s appropriate and inappropriate social interactions with peers. Although increases in appropriate social interactions and decreases in inappropriate social interactions were observed, these results cannot be attributed to learning false belief task performance alone, as other social skills were also taught.

Deictic Frames

Our search revealed that although four studies have successfully taught individuals with ASDs to respond to deictic relations (Belisle, Dixon, Stanley, Munoz, & Daar, 2016 ; Gilroy, Lorah, Dodge, & Fiorello, 2015 ; Jackson, Mendoza, & Adams, 2014 ; Lovett & Rehfeldt, 2014 ), none evaluated the effects of this teaching on social skills. Two of these studies (Jackson et al., 2014 ; Lovett & Rehfeldt, 2014 ) and an additional study with typically developing children (Montoya-Rodríguez & Molina Cobos, 2016 ) did evaluate the effects of improved deictic responding on false belief performance, but none of these studies showed any changes in the latter measure.

Given the increase in empirical investigations into the relational frame account of perspective taking (Montoya-Rodríguez et al., 2017 ), this body of research was included despite the lack of studies into the relation between improved deictic framing and social skills. Based on the current lack of evidence of this relation, we do not recommend that practitioners adopt teaching deictic framing as a way to improve social skills.

Applied Perspective Taking

Our search produced three studies that directly taught applied perspective taking (Bergstrom, Najdowski, Alvarado, & Tarbox, 2016 ; Ranick, Persicke, Tarbox, & Kornack, 2013 ; Reinecke, Newman, Kurtz, Ryan, & Hemmes, 1997 ), but this search also revealed several areas of related research that could inform behavior–analytic practice.

Dependent Variables

Reinecke et al. ( 1997 ) taught participants to hide an object in a guessing game similar to the penny-hiding game. Participants were required to engage in five responses: hiding their hands while hiding the object, ensuring that the object was not visible in the fist, keeping both fists closed (two responses), and not indicating which fist held the object. Bergstrom et al. ( 2016 ) taught participants to tell socially appropriate lies—or “white lies”—when presented with two scenarios: receiving an undesired gift and being asked about another’s appearance. The target response had three parts: the lie that he or she liked the gift or the appearance, a sincere tone of voice, and a sincere facial expression that included smiling. Reinforcement, however, was contingent upon only the lie. Ranick et al. ( 2013 ) taught participants to identify and respond to deceptive statements made by others with the intention of excluding them from activities or gaining access to their items. A correct response was determined when “the participant identified that the therapist or peer was being deceptive by asserting that he/she could not exclude the participant or take his personal items” (Ranick et al., 2013 , p. 505).

Independent Variables

All three studies taught applied perspective taking using modeling and contingent feedback. In the study by Reinecke et al. ( 1997 ), baseline sessions of the penny-hiding game consisted of two experimenters modeling two trials of the game prior to the participant taking the role of the guesser for five trials (Condition 1) and then taking the role of the hider for 10 trials (Condition 2). Independent guessing resulted in edible and social reinforcement, and incorrect responses resulted in prompting. While the participant acted as the hider, noncontingent social reinforcement was delivered throughout sessions and noncontingent edible reinforcement was delivered at the end of sessions. Thus, baseline conditions consisted of both modeling and contingent feedback, and two of the three participants’ hiding improved. For the third participant, edible reinforcement was made contingent upon “independent approximations” (Reinecke et al., 1997 , p. 131) of hiding and produced modest gains. In addition to modeling and contingent feedback, Ranick et al. ( 2013 ) and Bergstrom et al. ( 2016 ) both also used rules and incorporated multiple exemplars of both discriminative stimuli and social partners. Results from both studies showed that responding generalized when untrained discriminative stimuli and social partners were presented. Ranick et al. also assessed skill maintenance after 1 month, and responding remained above baseline levels for all three participants.

Perhaps the greatest clinical limitation of these studies is that none assessed the social validity of the response, treatment, or outcome. Ranick et al. ( 2013 ) stated that “participants’ parents and clinical teams prioritized the ability to identify and respond appropriately to deception as an important target for clinical intervention” (p. 505), and Bergstrom et al. ( 2016 ) “selected participants for inclusion based on parental indication that their children made blatantly honest utterances often interpreted as rude” (p. 2). It is not clear, however, if the changes they made in participants’ behavior, albeit graphically convincing, were sufficient to be rated as favorable to stakeholders.

Conclusions of the Review

To date, only teaching applied perspective taking has resulted in improved social skills. In other words, although theory of mind and deictic framing are thought to be necessary for social behavior that accounts for the knowledge or beliefs of others, the evidence thus far indicates that learning either of these repertoires is not sufficient to improve social skills.

Practitioners should note the paucity of research into the effects that teaching any of these types of perspective taking has on social skills (see Table ​ Table1). 1 ). In particular, there has not been any research into the effects of teaching deictic framing on social skills with individuals with ASDs. In addition, limitations to the studies teaching false belief performance may have contributed to the lack of support for teaching these skills. Neither Chin and Bernard-Opitz ( 2000 ) nor Hadwin et al. ( 1997 ) taught to mastery, and improvements in outcome measures may have been seen if the participants had experienced additional teaching. Fisher and Happé ( 2005 ) used an indirect measure of social skills—a questionnaire completed by teachers—that may not have accurately shown improvements after learning false belief performance. Feng et al. ( 2008 ) taught other social skills in addition to false belief performance, making the effects of teaching on improvements in measured social skills unclear.

Despite the evidence supporting teaching applied perspective taking to improve social skills, practitioners should again be cautioned that there are currently only three studies describing effective procedures, and these demonstrations lack social validity data, particularly with respect to stakeholders’ satisfaction with the outcomes. In addition, the previously noted experimental design limitation of Reinecke et al. ( 1997 ) should be taken into consideration.

Suggestions for a Behavior–Analytic Approach to Teaching Applied Perspective Taking

Based on the results of our literature review and because clients have the right to effective treatment (Element 2.09 of the BACB Code, 2014 ), we recommend that practitioners teach applied perspective-taking skills directly when stakeholders report a lack of perspective taking to be a problem. Practitioners should convey the lack of supporting evidence for teaching false belief performance or deictic framing to stakeholders when appropriate. Because there is limited research targeting applied perspective taking, we have also examined related research and the BACB Code ( 2014 ) to develop suggestions for practitioners. In the following section, we offer guidance for determining the most appropriate dependent and independent variables and provide suggestions for assessing social validity.

Determining the Dependent Variable

Stakeholder interviews.

When approached by a client’s stakeholder to incorporate perspective taking into the client’s curriculum, we advise practitioners to begin by interviewing the stakeholder requesting the programming and any other relevant stakeholders (see Fig. ​ Fig.1). 1 ). These interviews will help the clinician to operationally define the behavior(s) the stakeholder would like to see improved.

Suggestions for a behavior–analytic approach to teaching applied perspective taking

During interviews, the clinician may find that the stakeholder’s concerns have been prompted by a poor score on an assessment of perspective taking, such as a developmental neuropsychological assessment (NEPSY–II) theory of mind subtest (Korkman, Kirk, & Kemp, 2007 ) or a Theory of Mind Inventory (TOMI; Hutchins, Prelock, & Chace, 2008 ). Such assessments, however, typically focus on false belief performance or stakeholder report of perspective-taking skills. If this is the case, we encourage practitioners to discuss with the stakeholder the lack of evidence for teaching false belief performance as a way of improving social skills and our ethical obligation to ensure clients’ right to effective treatment (Element 2.09 of the BACB Code, 2014 ). In conjunction with this discussion, the clinician might provide examples of applied perspective-taking repertoires that might be relevant and could be taught to address this deficit.

Stakeholder interviews can also help determine the priority of teaching perspective taking (Element 4.02 of the BACB Code, 2014 ). For some clients, particularly those who exhibit dangerous challenging behavior or whose access to treatment is limited, improving perspective-taking skills may not be a high priority (Element 4.05 of the BACB Code, 2014 ). Although intuitively compelling arguments can be made for improved understanding of the knowledge and beliefs of others having a positive impact, teaching perspective taking is not an evidence-based treatment for challenging behavior (Element 1.01 of the BACB Code, 2014 ). Care should also be taken if there is concern that the introduction of an additional teaching target would hinder the progress of ongoing treatment (Element 4.05 of the BACB Code, 2014 ). This should also include consideration of the client’s current repertoire and prerequisite skills needed for the identified target response (Element 4.05 of the BACB Code, 2014 ).

Should the stakeholder and clinician determine that teaching perspective taking is a priority, additional interview questions can also help the clinician gain insight into the social context of concern and what more appropriate response(s) might be taught. For example, questions may be about specific environments, the most relevant social partners (e.g., specific peers, siblings), and the particulars of the social context (e.g., during games, conversations). In addition, questions about how the client typically responds, how others in the environment have reacted to the client’s response and the client’s subsequent reaction to their behavior, and how the stakeholder would like to see the client behave instead may inform the response to be taught.

Client Observation(s)

Following interviews, we also advise the clinician to directly observe the client under the conditions identified as areas of concern. These observations should be conducted across environments in which the relevant antecedent conditions might occur, with the clinician noting all aspects of the current contingency. These observations also provide an opportunity for the clinician to observe the behavior of others in the client’s verbal community. Specifically, the clinician may take note of how often the social situation of interest occurs, specific aspects of that situation for use as discriminative stimuli, and the consequences that follow both appropriate and inappropriate responses in that context. These variables should then be incorporated into programming.

Formal Assessment

Although some contexts may lead to a relatively obvious target response, for others, coming to the most socially valid target response may be more challenging. For example, a client may frequently report the inappropriate behavior of his peers to authority figures (i.e., “tattling”). Determining the situations under which this response is and is not desired may prove to be difficult, and teaching must then incorporate these finer discriminations. When identifying the most relevant target response proves to be challenging, the work of Minkin, Braukmann, Minkin, Timbers, Timbers, Fixsen, et al. ( 1976 ) provides a useful model for practitioners. These researchers acknowledged the difficulties that can arise when designing social skills programming and presented a four-step process to ensure that the targeted response is socially valid:

• specification of the potential relevant behavioral components,
• social validation of the importance of each of the behavioral components,
• training of the components, and
• social validation that the increases in the specified behavioral components resulted in increased level of judged skill. (p. 128)

A clinician could also apply this strategy to identify perspective-taking responses. To specify the relevant behavioral components (Step 1), the clinician might observe both the client and the peers who are likely to be more skilled socially, focusing on responses that distinguish the behavior of the more skilled person. Observing more socially skilled peers may also indicate which social responses will be reinforced in their specific shared environment(s). The clinician might gain social validation of the behavioral components identified from these observations (Step 2) by asking the stakeholders to point out peers they consider skilled in the social context of concern. The acceptability of those peers’ responses should also be confirmed with stakeholders. To provide social validation of the behavior changes (Steps 3 and 4), practitioners should assess stakeholder opinions of the client’s performance after teaching and when opportunities to engage in the target response occurred within the client’s typical verbal community.

Possible Dependent Variables

Here, we provide some suggestions for dependent variables that behavior–analytic practitioners might consider when teaching applied perspective taking. First, we encourage practitioners to consider responses outside the realm of deception given potential ethical implications. Next, we suggest that false belief performance could be extended such that responding is more socially valuable. Finally, we review dependent variables from related research that may also be relevant to individuals with ASDs.

Because the dependent variables used in the aforementioned applied perspective-taking studies all related to deception, we should note here that the BACB Code ( 2014 ) states that “behavior analysts do not implement contingencies that would cause others to engage in fraudulent, illegal, or unethical conduct.” It can be argued that the types of deception that have been taught in research thus far would not garner significant concern. In fact, Jaarsma, Gelhaus, and Welin ( 2012 ) argued in favor of teaching individuals with autism deception, citing care ethics. They stated: “We think that persons with autism need to be trained in lying and deception in order to live healthier lives in relationship with others” (p. 277). They emphasized that teaching should incorporate rules about the circumstances under which deception is appropriate and gave the examples of lying to prevent insulting or offending others and when the safety or well-being of others would be threatened by telling the truth (e.g., an armed person asks the location of the intended victim). When a deceptive response is chosen as a target, the clinician is advised to do so responsibly. The ethical implications should be considered and openly discussed with stakeholders throughout programming. In particular, practitioners should discuss and prepare for the possible generalization of deceptive responses to situations where truthfulness is the desired response. Despite the current focus on deceptive responses in the research, we encourage practitioners to consider other applied perspective-taking responses, which we will discuss in greater detail later in this article.

Bell and Kirby ( 2002 ) stated that predictions like those required in false belief tasks “are then thought to provide guidelines for reciprocal social interactions (where social interaction is fueled by social understanding)” (pp. 18–19). This speaks to what may be missing from teaching the false belief task alone: teaching individuals how to apply what they have learned in a way that will be socially maintained. Should a client have difficulties with social situations similar to false belief scenarios, practitioners might consider extending false belief performance to include socially appropriate responses to the situation. For example, related to unexpected transfer task performance, the client might also be taught to point out to “Sally” that her item is now in a different location (i.e., to correct a false belief). This response would likely result in some form of social reinforcement from “Sally,” whereas merely predicting that she would look in the location she had last put the ball would be unlikely to be met with social reinforcement. Should “Anne” include the client in on the trick, the client might be taught to withhold the information from “Sally” so as to not give away the joke. This could be further extended to revealing the true location of the ball should “Anne’s” intentions appear to be malicious or if “Sally” becomes upset by the trick. Responding in the context of the other false belief tasks could be similarly extended when these are socially relevant for the client.

Descriptive research from developmental psychology can also inform applied perspective-taking targets. O’Neill ( 1996 ) described how when a caregiver did not see where a toy was placed, typically developing 2-year-old children supplemented their requests for the toy by tacting the toy, tacting its location, or gesturing. Another example of social responding discriminated on the basis of the social partner’s knowledge is giving listener-appropriate detail in conversations. For example, in a questionnaire developed to assess applications of perspective taking, Peterson et al. ( 2009 ) asked parents, “Does the child expect you to know things you could not know (e.g., events at home when you were not there)?” (p. 109). Studies teaching referential communication (e.g., Grossman, Peskin, & San Juan, 2013 ; Olivar-Parra, De-La-Iglesia-Gutiérrez, & Forns, 2011 ), which use tasks that require that enough detail be given to re-create something (e.g., picture, magic trick) from the instruction alone, may prove to be useful when developing programming to teach listener-appropriate detail. The task used by Begeer, Malle, Nieuwland, and Keysar ( 2010 ) is particularly relevant, as it requires the participant’s behavior to be discriminated based on the knowledge of his or her social partner. Two participants were seated on opposite sides of a vertical grid that held objects, some of which were very similar (e.g., a large spoon and a small spoon). Some of the sections of the grid were blocked such that only one participant could see the object it contained. The task was for one participant to instruct the other in moving the objects between the sections of the grid. This task may serve as a starting point, but as with false belief tasks, we encourage practitioners to also extend this performance to more socially valuable behavior.

DeBernardis, Hayes, and Fryling ( 2014 ) suggested that, in perspective taking, responding is also discriminated on the basis of the history with the other person. They described a continuum of perspective taking that ranges from predicting the behavior of someone based on only the current situation to having a lengthy enough history with the other person that predictions can be made in novel situations. One strategy for teaching such a discrimination has been suggested in a commercially available curriculum that involves clients learning pertinent information about peers for later use in conversation (“friend files”; Winner, 2005 ), but the efficacy of this strategy has not yet been demonstrated.

Designing the Independent Variable

The results of our review show that very few empirical studies on teaching applied perspective taking have been published. However, the available literature does provide at least initial evidence supporting the use of repeated exposure to the social scenario with models of the appropriate response paired with contingent feedback. Practitioners might also consider presenting participants with rules and incorporating multiple exemplars of the discriminative stimuli and social partners to promote generalization based on the successes of Ranick et al. ( 2013 ) and Bergstrom et al. ( 2016 ).

We also encourage practitioners to ensure that responding is under the control of the desired stimuli by incorporating nonexamples (S-delta) into teaching. For example, Bergstrom et al. ( 2016 ) could have also included scenarios in which a white lie might not be appropriate, such as when a friend asks if he has food in his teeth. Practitioners teaching deception in games might incorporate team games that would require the client to deceive his opponents but not those on his own team. Ensuring that responding is under the appropriate stimulus control may also prevent unwanted generalization, particularly of deceptive responses, to situations in which the taught response is not socially valid.

Practitioners should also take care to incorporate the necessary discriminative stimuli into teaching. As exemplified in Ranick et al. ( 2013 ), responding to another’s deceptive statement may not necessarily require the participant to infer the knowledge of the other person. For example, one lie included in this study was “This is mine. I brought it from home” (p. 505). It is not clear if the participant had sufficient information to infer the other’s beliefs. Perhaps the person had brought that same item from home that day and was simply mistaking the participant’s identical item for his own. A more convincing demonstration that the participant was accounting for the knowledge of the other person might include exposure to the other person gaining specific knowledge coupled with opportunities to respond to both accurate and deceptive statements. For example, a show-and-tell activity could provide the context for others to gain knowledge of the items and to whom they belong. Then, when another person stated the participant’s item was his, the participant could not mistake the deceptive statement for an unintentional error. Assessing participant responses to interspersed true statements, such as the same statement but in reference to an item that actually was owned by that person, would then provide evidence that the participant’s behavior was discriminated on the basis of an inference about the other person’s knowledge. Rarely, however, are the lies we encounter in our everyday lives so evident, and more skilled deceivers likely take measures to ensure that this is the case. We hope that this brief discussion encourages the reader to recognize and carefully consider the complexity of the stimuli to which the client must respond when designing programming.

Practitioners might also consider teaching applied perspective taking as a form of problem solving. Recently, Taylor-Santa, Kisamore, Reeve, and Sidener ( 2015 ) suggested that this might be done by teaching rules (e.g., seeing leads to knowing) and problem-solving strategies, such as self-prompts (Sautter, LeBlanc, Jay, Goldsmith, & Carr, 2011 ) and visual imagining (Kisamore, Carr, & LeBlanc, 2011 ). To use a previous example, a clinician may be interested in teaching participants to vary the degree of detail given in a conversation according to the conversation partner’s previous knowledge of the topic. To do this, the clinician might teach the participant to apply a “seeing leads to knowing” rule before bringing up a topic. For example, before telling a story about another person, the participant should ask himself privately, “Did John [current conversation partner] see Sam hit that home run?” If the participant is able to respond that John did not, then it would be appropriate to tell John about the home run. If the participant knows that John did see Sam’s home run, then the appropriate response might be to include comments about the event (e.g., “Wasn’t Sam’s home run awesome?”) or to choose a different topic of conversation. Should the participant be unable to give a definitive answer about whether or not John saw Sam’s home run, then asking John directly (e.g., “Did you see Sam’s home run?”) would be appropriate. Visual imagining could also be incorporated as a remembering strategy by imagining watching Sam hit the home run. The supplemental stimuli provided by this imagining may aid the participant in responding to the question of whether John was also there. Teaching similar to behavioral skills training (e.g., Himle, Miltenberger, Flessner, & Gatheridge, 2004 ) has been shown to be effective in teaching both self-prompts (Sautter et al., 2011 ) and visual imagining (Kisamore et al., 2011 ) as problem-solving strategies to typically developing children, but this finding has not been replicated with children with ASDs.

Practitioners may also consider teaching more than one appropriate response to a social situation. Particularly with social skills, it may be difficult to predict the reliability with which a response will be reinforced by a client’s verbal community. One way a client could be taught to respond to extinction is to try another appropriate response if the first one is ineffective. For example, Peters and Thompson ( 2015 ) taught participants two responses to regain listener interest during conversations and then also taught participants to engage in the other response if their first was ineffective. Because the schedules of reinforcement for social responses will likely vary somewhat unsystematically, it may be helpful to expose new skills to indiscriminable contingencies under teaching conditions (e.g., Stokes & Baer, 1977 ).

Assessing Social Validity

Finally, we encourage practitioners teaching applied perspective taking to assess the social validity of the target response, the teaching methods, and the outcome. Ensuring the social validity of the response and outcome is essential to the maintenance of social skills by the client’s verbal community. Evaluating social validity, in general, will increase the likelihood that clients are satisfied with the services being provided. Social validity assessments (e.g., Hanley, Jin, Vanselow, & Hanratty, 2014 ; Haring, Roger, Lee, Breen, & Gaylord-Ross, 1986 ; see also Schwartz & Baer, 1991 , for further discussion of conducting social validity assessments) are typically brief and easily incorporated into conversations about client progress.

The primary aim of this article was to provide guidance for behavior–analytic practitioners who have been asked to incorporate perspective taking into a client’s programming. We reviewed three lines of research on teaching perspective taking and subsequent effects on social skills. We found that only directly teaching applied perspective-taking skills has resulted in improved social behavior. Based on these findings, the BACB Code ( 2014 ), and related research, we provided suggestions for how a behavior–analytic clinician might go about teaching perspective taking. We would like to encourage behavior–analytic practitioners to consider designing their programming in such a way that the findings will meet publication standards. Our understanding of teaching applied perspective taking will greatly benefit from more research guided by clinical experience and need.

Acknowledgements

We would like to thank Gregory Hanley, Amanda Karsten, and David Palmer for their helpful comments and guidance on an earlier version of this manuscript and Jill Harper for interrater agreement.

This study was conducted in partial fulfillment of Lindsay C. Peters’ requirements for her doctoral degree at Western New England University.

Compliance with Ethical Standards

The authors declare that they have no conflict of interest.

1 As behavior analysts, we prefer to use the term perspective taking because (a) it does not invoke the same mentalistic assumptions associated with theory of mind and (b) the verb perspective taking better directs us toward an analysis of behavior . However, we also recommend that practitioners choose their battles over semantics when speaking with those outside the field to help build collaborative and more productive working relationships (see arguments by Axelrod, 1992 ; Bailey, 1991 ).

2 Given the extensive body of research on theory of mind and perspective taking, we have limited the scope of our review to research related to belief-based perspective taking (also referred to as cognitive perspective taking ; e.g., Mori & Cigala, 2016 ), or behavior that accounts for others’ private events that fall under the heading of belief (know, think, believe, etc.).

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Restricted and repetitive behavior patterns in autism spectrum disorder

Repetitive and restricted behaviors (RRBs), a hallmark of autism spectrum disorder, are a broad category that can include unusual motor manners as well as one or more patterns of interest. Some interests, such as toy cars or vacuum cleaners, help individuals with ASD cope but could interfere with social relationships or self-care. However, scientists have increasingly adopted the view that taking away restrictive behaviors can do more harm than good. 1

Consider the case of Raya Shields, who is on the autism spectrum and has Tourette syndrome and obsessive-compulsive disorder. Now 28, she recalls rocking back and forth in school to cope with noisy environments—and still does. 2 When teachers scolded her for being disruptive, she began suppressing these behaviors (also called “stimming” or “self-stimulatory”). 2 With no alternative, she resorted to snapping her fingers—to the point where it became too painful to write. As a result, her schoolwork suffered. 2

When individuals like Raya experience stigma due to their RRBs, this can result in increased loneliness, poor academic outcomes, and the masking of autistic traits to fit into a neurotypical world—all of which can negatively impact their mental health. 3 With an estimated 256,000 individuals on the autism spectrum in U.S. high schools, there is a call to provide them with more inclusive and supportive environments. 4,5

This post explores types of RRBs and their impact on quality of life, effective interventions at home and in school, and better ways to support individuals with ASD.

Types of RRBs

Repetitive behaviors and fixed interests constitute one of two criteria that define autism in the Diagnostic Manual for Psychiatry (DSM). Simply preferring a strict routine is not enough for an autism diagnosis. 6

According to the DSM, the behavior must be “abnormal in intensity or focus,” and changes to these behaviors must cause "extreme distress.” 6

Repetitive behaviors may include: 6,7

• Motor: Repetitive movements of the body or objects, hand-flapping, body rocking, spinning objects, or finger-flicking
• Fixated Interests: Intense focus or preoccupation with specific topics, objects, or activities, often to the exclusion of other interests
• Compulsions: Rituals performed to alleviate anxiety or distress, such as counting or arranging objects
• Self-Injury: Actions that result in physical harm to oneself, such as head-banging, biting, or scratching

Course Connection: SPED 743: FUNCTIONAL BEHAVIOR ASSESSMENT

This course provides a problem-solving approach and the framework for teaching and assessment strategies to develop pro-social behavior in students with disabilities and their typical peers in classrooms and whole school contexts. Students assess problem behavior, discover the functions of problem behavior, and learn pro-social alternatives in home, school, and community settings.

Course Connection: SPED 843: ADVANCED METHODS AND ASSESSMENT

This course is designed to introduce educators and related service professionals to prevention and intervention related to a broad range of antisocial, aggressive, and behavioral problems. Approaches focus on understanding and addressing the precipitating factors related to inappropriate behavior, short-term approaches for immediate crises, and problem-solving strategies for longer-term change.

Prevalence and variability

The CDC reports more boys are diagnosed on the autism spectrum than girls: four boys for every autistic girl. 8 Experts point to several factors to explain the gap.

ASD diagnosis criteria have been based on observations primarily made in boys, resulting in a skewed understanding of the disorder's presentation. 8 Second, many higher-functioning autistic girls are often overlooked or misdiagnosed because they tend to mask repetitive behaviors. 8

Here are some differences to look for:

• Girls: Present repetitive verbal behaviors, such as echolalia (or scripting), which involves repeating words or phrases from media or conversations. 8
• Boys: Display more overt and stereotypical repetitive behaviors, such as hand-flapping, rocking, or intense fixations on specific objects or topics. 8

Educators and clinicians need to consider diverse expressions of ASD in both girls and boys to ensure accurate diagnosis and appropriate support. When girls aren’t correctly diagnosed, they don’t have access to early interventions. Lack of support can increase the risk of depression, anxiety, and low self-esteem by the time they enter middle school or high school.

Understanding the function of RRBs

In 2014, journalist Ron Suskind published the book, “Life, Animated,” chronicling the struggles of his son, Owen, who was diagnosed with regressive autism at age three. The Suskinds chose to encourage their son’s special interest in Disney movies and characters, which helped him learn to speak and read again. 2 “Life, Animated” was later turned into a movie by the same name, shedding light on the positive side of RRBs.

Research studies are becoming more inclusive, focusing on the lived experiences of individuals with ASD. Many autistic adults report that pursuing their intense interests is rewarding and brings them happiness. 2 While these interests have been labeled restrictive, they provide a coping mechanism, enhance self-confidence, and sometimes facilitate connections with peers. 2

In light of these studies, there has been “a major paradigm shift in perceptions of special interests,” notes psychologist Rachel Grove of the University of Technology Sydney. 2 Autism advocates and scientists argue for treatment approaches that respect the dignity and independence of individuals with ASD, including the need to build on special interests, rather than discouraging them. 2

Course Connection: EPSY 715: UNDERSTANDING RESEARCH IN EDUCATION

This course introduces the concepts and skills involved in understanding and analyzing research in education and related areas. The course provides an overview of basic, general knowledge of various research methodologies used in the online master’s in autism spectrum disorder program.

Impact on daily functioning

While there are reported benefits of RRBs, individuals can also engage in disruptive or harmful behaviors. It’s important to pay attention to signs that these behaviors impair an individual’s daily functioning. Some parents may not know the severity of the repetitive behavior, such as hair pulling, until they find clumps of hair in the child’s bedroom. There are resources for parents and caregivers that may be helpful .

In addition, if an individual is neglecting self-care to the point of sacrificing sleep or forgetting to shower, then it’s time to seek support. 10

These questions can serve as a starting point for professional evaluation:

• Is the student approaching the special interest with such intensity that they cannot stop when they need to? 9
• Is the intense interest or repetitive behavior disrupting family life? 9
• Is it interfering with the student’s enjoyment of other activities? 9
• Is it resulting in the student harming themselves? 9
• Is it interfering with the student’s academic success or social development? 9

Before developing any treatment plan for a student with ASD, special education teachers and medical teams can use questionnaires and other assessments to evaluate the impact that RRBs have on academic success, socializing, and family dynamics . Then, they can include parents in critical decisions and recommend targeted interventions that can be implemented at home and in school.

Management and intervention

When repetitive behavior impairs an individual’s ability to function or poses a threat to family members, medication can seem like the only hope for managing problematic behaviors. Risperidone and Aripiprazole are the only FDA-approved drugs that can be prescribed to treat irritability in children with autism spectrum disorder, but they don’t work for all individuals with ASD. 10 Glen Eliot, medical director of the Children’s Health Council encourages families to first try behavioral interventions, especially with very young children. 11

One alternative to medication is a cognitive-behavioral approach, which teaches students to use other coping mechanisms, problem-solving skills, and relaxation techniques so that they have the tools to self-manage anxiety and distress that triggers RRBs.

Another option is Applied Behavior Analysis (ABA) therapy, which uses positive reinforcement. Some research shows it has been effective in teaching life skills and reducing harmful behaviors.

However, a 2018 study found that ABA therapy, which involves intense repetition, can be grueling and put individuals with ASD at higher risk for developing post-traumatic stress disorder. 12

Parents and advocates are critical of it because of these negative experiences. 12,13 In school settings, structured teaching such as the use of visual schedules, can promote greater independence in students with ASD.

Supporting individuals with RRBs

Creating structured environments involves establishing routines and predictable schedules to help individuals with RRBs feel supported. If the student has an Individualized Education Plan (IEP) or 504 plan, some accommodations could include allowing them to stim at their desk or leave the classroom and go to a quiet, calming space. 14

Another way to support students with ASD is to integrate their special interests into the curriculum. New York teacher Jenny Licata, who teaches autistic students in a mainstream classroom, has found this approach has academic and behavioral benefits. 2 For example, one 6-year-old girl, who has an intense interest in outer space, routinely struggled with transitions. 2 So, Licata turned her folder into a spaceship. Then, she cues the student to put work into the folder and switch activities by saying, “blast-off in 10,” which makes transitions less stressful. 2

Depending on the student’s school placement, effective supports might include:

• Modified environments: Reduce sensory overload with soft lighting, eliminate visual clutter, and provide quiet spaces 14
• Sensory-friendly strategies: Allow use of fidget toys, chewelry (jewelry designed for chewing), or stress balls 14
• Visual supports: Provide visual schedules to help reduce anxiety and promote predictability to ease transitions during the school day 14
• Social stories: Promote social skill development in settings, such as the supermarket, doctor’s surgery, and playground 14

By drawing on evidence-based best practices, special education teachers can develop personalized accommodations and integrate the special interests of students with autism spectrum disorder.

These measures can go a long way toward reducing the impact of challenging behaviors, while fostering a greater sense of belonging.

Collaborating with families of children with ASD

Families are vital in supporting children with autism spectrum disorder (ASD) and restricted and repetitive behaviors (RRBs). Understanding these behaviors, like repetitive motor movements or ritualistic behavior, is crucial for effective home support.

Parents manage repetitive behaviors by creating supportive routines and advocating for services outlined in the diagnostic criteria. They offer emotional support, aiding their child's navigation of social and communication deficits.

Educators play an essential role as partners in the collaboration between schools, parents, and caregivers; they can help align strategies between home and school environments.

Through open communication channels, all stakeholders can share insights, enabling a holistic understanding of the child's needs, including those related to stereotyped behaviors, autism repetitive behaviors, and repetitive sensory motor behavior.

This collaborative approach ensures that interventions are tailored to the unique characteristics of children with ASD and autistic children, as outlined in the diagnostic criteria. Through this shared understanding, educators, parents, and caretakers can develop effective support plans that address the child's restricted interests and repetitive body movements, promoting success in both academic and social settings.

Gain the expertise to help transform ASD education with KU's Online Master’s in special education

Master cutting-edge teaching methods for diverse learners with a top-ranked online special education master's degree in ASD * from the University of Kansas.

KU’s School of Education and Human Sciences is a national pioneer in ASD education for today’s educators and offers three practicum electives to help online master’s students become effective classroom leaders.

Get your questions answered by scheduling a call with one of our helpful admissions outreach advisors. Start building master’s-level expertise in the ASD specialization you want to excel in most.

* Master of Science in Education (M.S.E.) in special education with an emphasis in autism spectrum disorder (ASD)

• Retrieved on March 18, 2024, from spectrumnews.org/features/deep-dive/the-benefits-of-special-interests-in-autism/
• Retrieved on March 18, 2024, from spectrumnews.org/features/deep-dive/rethinking-repetitive-behaviors-in-autism/
• Retrieved on March 18, 2024, from sciencedirect.com/science/article/abs/pii/S1750946721001707
• Retrieved on March 18, 2024, from ascd.org/el/articles/deepening-supports-for-teens-with-autism
• Retrieved on March 18, 2024, from aane.org/autism-info-faqs/library/are-autistic-students-traumatized-in-school/
• Retrieved on March 18, 2024, from verywellhealth.com/repetitive-behaviors-in-autism-260582
• Retrieved on March 18, 2024, from autismparentingmagazine.com/repetitive-behavior-autism-children/
• Retrieved on March 18, 2024, from childmind.org/article/autistic-girls-overlooked-undiagnosed-autism/
• Retrieved on March 18, 2024, from autismparentingmagazine.com/autism-children-special-interests/
• Retrieved on March 18, 2024, from autismspeaks.org/medications-autism
• Retrieved on March 18, 2024, from childmind.org/article/autism-and-medication/
• Retrieved on March 18, 2024, from verywellhealth.com/educational-options-for-children-with-autism-260393
• Retrieved on March 18, 2024, from childmind.org/article/controversy-around-applied-behavior-analysis/
• Retrieved on March 18, 2024, from undivided.io/resources/school-supports-and-iep-504-accommodations-for-autism-1340
• Retrieved on March 18, 2024, from usnews.com/education/online-education/education/online-special-education-rankings

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