improving social skills by building fluency on deictic relational classes

Improving Social Skills by Building Fluency on Deictic Relational Classes

Donny Newsome, MAUniversity of Nevada, Reno

The Challenge of Teaching Social Skills

• Slippery – difficult to define• Subtle• Contextually dependent• Subjective• Impacts Quality of Life• Collateral problem behaviors– Verbal abuse– Theft– Property destruction

Traditional Approaches

• Component Skills Deficit Model - Views knowledge of rules as being key component skills of the broader social repertoire

• “eye contact is good, but not for too long”• “don’t stare”• “do unto others….”• “always say please and thank you”

The Problems with Rule-Based Approaches

• Infinite number of rules• Limited applicability of a single rule

– ‘always say please and thank you…..well, not always….just most of the time….well, really just when it is socially appropriate to do so…but not at times when it isn’t…..’

• Rigidity – Lack of contextual sensitivity• Insensitivity to changes in contingencies not described

in the rule – (Haas & Hayes, 2006; Hayes, Brownstein, Haas, & Greenway,

1986; Hayes, Strosal & Wilson, 1999; Skinner, 1957)

Alternative: Experiential Contact

• Non-specific feedback on performance, but not rules – (Azrin & Hayes, 1984; Rosenfarb, Hayes & Linehan,

1989) • Outperformed rule-based strategies

*Requires a certain minimal repertoire to be sensitive to feedback and subtle differences in social contingencies

New Conceptualization of Component Skills Deficit Model

• Emerging approaches: Component skills identified at a more fundamental level of cognitive processes– Similar to Johnson & Layng (1992) definition of

tool skills: “the most basic elements of more complex skills” (pg 1479).

New Conceptualization of Skill Deficit Model

• Deficits are at the level of basic verbal processes (relational responding), not in knowledge of rules

• Basic relational operants are not situation-specific• Allows for a generative approach to social skill

acquisition• Promotes meaningful contact and sensitivity to

subtle social cues and contingencies– Making room for shaping to occur

RFT – Perspective Taking

• Deictic Frames– 3 Types of relations

I – youHere – thereNow – then

– 3 Levels of ComplexitySimpleReversed Double-reversed

RFT – Perspective Taking

• Validity in Evidence:– Performance on ToM tasks in social anhedonia and

schizophrenia (Barnes-Holmes, et al. 2004; Villatte, et al. 2008; Villatte, et al. 2010; Weil, et al. 2010)

– Deficits in perspective-taking tasks in ASD relative to controls (Rehfeldt, et al 2007)

– IQ (RFT–PT) (Gore, et al. 2010)

Case Study - Background• 24 yr old Male, JP• Autism, Mild MR, ADHD, Speech impediment (stutter) • Problem Behaviors: – Verbal abuse– Stealing– Property destruction– Refusals

• Acquisition Targets:– Appropriate conversation skills– Coping skills– Compromising

Case Study – Initial Protocol

• Began with standard differential reinforcement protocol combined with replacement behavior training (RBT)

• RBT protocols included role-playing with feedback and hypothetical-situation exercises

• Some acquisition targets moved, but problem behaviors also increased

Case Study – Revised Protocol• Included fluency training on simple deictic relations

– Daily training on I – You relations – Weekly probes for Here – There and Now – Then relations

• Additional fluency programs for socially relevant skills– F/S Emotion terms– H/S Complete sentence with emotive term– H/S Emotion for event– F/S Positive statements– H/S What you can do to help– F/S Thoughts about standing in line– F/S Thoughts about life in 10 years

Baseline Differential Reinforcement + RBT

Differential Reinforcement + RBT + Deictic

Replacement Behaviors

Problem Behaviors

May June July August September October November December January February0

20

40

60

80

100

StealingPhysical AggressionVerbal AbuseRefusals

Problem Bx

Baseline Differential Reinforcement + RBT

Differential Reinforcement + RBT + Deictic

May June July August September October November December January February0

50

100

150

200

250

300

Appr.ConversationCompromisingCoping Skills

Replacement Bx

Baseline Differential Reinforcement + RBT

Differential Reinforcement + RBT + Deictic

Case Study - Results

• Targeting deictic relational skills appeared to improve sensitivity to programmed social contingencies

• This was accomplished by only training simple relations

• Also found that training all 3 deictic relations was not necessary

I - You

Incorrect Responses

Here – There & Now - Then

Case Study – Caveats & Questions

• Idiosyncratic?• ‘True’ fluency was difficult to measure due to

stuttering issue• Unable to say which programs were critical to

success• Incremental utility of training reversed and

double-reversed relations

Case Study - Contributions

• Practical Utility

• Value of a fluency-based approach and SCC measurement system

• Utility of time-series analysis

References• Azrin, R.D., Hayes, S.C. (1984). The Discrimination of Interest Within a Heterosexual

Interaction: Training, Generalization, and Effects of Social Skills. Behavior Therapy, 15, 173-184.

• Gore, J.N., Barnes-Holmes, Y., Murphy, G. (2010). The relationship between intellectual functioning and relational perspective-taking. International Journal of Psychology and Psychological Therapy, 10-1, 1-17.

• Barnes-Holmes Y., McHugh, L., & Barnes-Holmes, D. (2004). Perspective-taking and theory of mind: A relational frame account. The Behavior Analyst Today, 5, 15-25.

• Haas, J. R., Hayes, S. C. (2006). When knowing you are doing well hinders performance: Exploring the interaction between rules and feedback. Journal of Organizational Behavior Management, 26 (1,2), pp. 91-111.

• Hayes, S.C., Brownstein, A.J., Haas, J.R. & Greenway, D.E. (1986). Instructions, multiple schedules, and extinction: Distinguishing rule-governed from schedule-controlled behavior. Journal of the Experimental Analysis of Behavior, 46(2): 137-147.

• Hayes, S.C, Strosal, K.D., Wilson, K.G. (1999). Acceptance and Commitment Therapy. The Guilford Press, New York, NY.

• Johnson, K.R., Layng, T.V. (1992). Breaking the structuralist barrier, literacy and numeracy with fluency. American Psychologist, 47(11), 1475-1490.

References• McHugh, L., Barnes-Holmes, Y. & Barnes-Holmes, D. (2004). Perspective-taking as

relational responding: A developmental profile. The Psychological Record, 54, 115-144. • Rehfeldt, R.A., Dillen, J.E., Ziomek, M.M. & Kowalchuk, R.K. (2007). Assessing relational

learning deficits in perspective-taking with high functioning autism spectrum disorder. The Psychological Record, 57, 23-47.

• Rosenfarb, I.S., Hayes, S.C., Linehan, M.M. (1989). Instructions and experiential feedback in the treatment of social skills deficits in adults. Psychotherapy, 26(2), 242-251.

• Skinner, B.F. (1957). Verbal Behavior. Copley Publishing Group. Acton, Massachusetts.• Villatte, M., Monestes, J., McHuch, L., Baque, E.F., Loas, G. (2008). Assessing deictic

relational responding in social anhedonia: A functional approach to the development of theory of mind impairments. International Journal of Behavioral Consultation and Therapy, 4-4, 360-373.

• Villatte, M., Monestes, J., McHuch, L., Baque, E.F., Loas, G. (2010). Adopting the perspective of another in belief attribution: The contribution of relational frame theory to the understanding of impairments in schizophrenia. Journal of Behavior Therapy and Experimental Psychiatry, 41, 125-134.

• Weil, T. M. & Hayes, S. C. (Under Review) Impact of training deictic frames on Theory of Mind in Children. Psychological Record.