Assessing and Teaching Job-Related Social Skills to Adults with Autism Spectrum Disorder

Dorothea C. Lerman, Ph.D., BCBA-DCarolyn Grob, Natalie Villante, & Channing Langlinais

“My son was diagnosed with Asperger syndrome as a child. He has graduated from High School. He failed success at additional education and also at any job placement with the department of rehabilitative services. He can drive locally; now at age 27, he would like to do something with his life but has not found anywhere he can succeed. His days are filled with staying at home watching two dogs, tv and video games. Are there any resources to help him toward a more socially productive life?” – Comment posted on podcast website, People’s Pharmacy 10/2/15

My CollaboratorsoCarolyn GroboChanning LanglinaisoCourtney LaudontoTrena RouseoLoukia TsamioNatalie VillanteoBridgette WhiteoDan Wright

Employment of Individuals with Disabilities• Employment by disability (Shattuck, 2012)o 55% Autism Spectrum Disordero 68% Intellectual Disabilitieso 86% Speech Impairmento 93% Learning Disability

• Adults with ASD:o Earn less and work fewer hours (Burgess & Cimera, 2014)oRely on other adults for support

• Outcomes flat/declined across 10 yrs; access to services had minimal impact (Taylor & Mailick, 2014)

Types of Employment Services• Vocational Rehabilitative (VR) Serviceso Largest U.S. program to provide employment services o “State of the states report” (Burgess & Cimera, 2014)

o Texas Workforce Commission (TWC)

• Sheltered Employment “Train-then-place” approach “Negative ‘value-added’” service (Cimera, 2011)

• Supported Employment “Place-then-train” approach Individual / group

Why Vocational Difficulties?

• Verbal report of potential factors (Baldwin et al., 2014; Hurlbutt & Chalmers, 2004; Muller, Burton, & Yates, 2003)o Inadequate job trainingoDifficulty interacting with supervisors/co-workersoUnclear expectations

Potential Targets: What Should We Teach?• Securing Employmento Identifying desirable vocationso Completing applicationso Interviewing

• General Vocational Skillso Following instructionsoManaging timeoNavigating job site

• Job-Specific Skills• Job-Related Social Skills o Asking for assistanceoResponding appropriately to feedback

• Hygiene/Grooming

Potential Targets: What Do Employers Care About Most?

Surveys:o Follows instructionso Shares informationo Respects others / Offers to helpo Requests assistanceo Clarifies instructionso Responds appropriately to criticismo Is dependable/On timeo Shows personal integrity/honesty

(e.g., Foss & Peterson 1981; Ju et al. 2012; McConaughy et al 1989; Salzberg et al. 1986)

Potential Targets: What Do Employers Care About Most?

Reasons For Termination/Problems on the Job:▫ Disruptive/distractive/anti-social behavior▫ Lack of social awareness▫ Interactions w/ supervisors & co-workers

(e.g., Butterworth & Strauch, 1994; Cheney & Foss, 1984; Ford et al., 1984; Greenspan & Shoultz, 1981; Mueller, 1988)

Potential Targets: What Should We Teach?Some Examples

• Securing Employmento Identifying desirable vocationso Completing applicationso Interviewing

• General Vocational Skillso Following instructionsoManaging timeoNavigating job site

• Job-Specific Skills• Job-Related Social Skills o Asking for assistanceoResponding appropriately to feedback

• Hygiene/Grooming

Research on Vocational Interventions for Individuals with Autism

• Focus on those with more severe disabilities

• Few target “soft skills” related to job retention

Assessing Job-Related Social Skills

• Caregiver or Staff Interviews/Checklistso Scale of Job-Related Social Skill Performance (SSSP;Bullis et

al., 1993)

• Client Verbal Report (Self-report/Knowledge-based tests)

Test for Interpersonal Competence for Employment (TICE; Bullis& Foss, 1986); Scale of Job-Related Social Skill Knowledge (SSSK;Bullis et al., 1993)

Problems with Questionnaires and Tests

• May not correspond with actual performance

• Others’ knowledge may be limited

Barriers to Direct Assessment

• Limited access to job sites

• Restricted evocative situations

Assessing Job-Related Social Skills

• What About Analog???

Clinic-BasedVocational Social Skills Assessment

o Goal: Assess skills directly and efficiently

o Employee “workroom,” “supervisor’s office,” “break room”

o Supervisor absent; all sessions videotapedo “I will be in my office; let me know if you need anything”

o Two 3-hour visits (10- to 15-min work sessions)

Typical Tasks

o Folding shirtso Rolling/sorting silverwareo Sorting objectso Stuffing envelopeso Stapling paperso Alphabetizing books/folders/envelopeso Cleaning roomo Stocking shelveso Computer-related jobs (data entry, web searches,

word processing)

Response Measurement1:o Confirming statementso Requests for help - tasko Requests for help - materialso Notification of task completiono Response to corrective feedback o Eye contacto Inappropriate comments/behavioro On-Task/Task Accuracyo Monitoring time 1Drawn from Butterworth & Strauch (1994); Ju, Zhang, & Pacha (2012); Montague & Lund (2009); Partington & Mueller (2015) and others

Timeliness; knock; wait; statement

Evocative Situations (min. three times per assessment):o Clear Instructions

o Complete instruction + demonstrationo Vague Instructions

o “Sort this;” “Stock these shelves;” “alphabetize”o Task component not in repertoire

o Computer log-in; computer taskso Materials missing/broken, equipment malfunctions

o Missing vacuum; run out of staples/napkins; shredder jamso Supervisor corrects work

o Clear, vague, conflictingo Not enough work for time allocatedo Break

Recent Additions (Problem Solving)o Task interruptiono Supervisor unavailableo Materials in supply cabinet

Additional Situations:o Multiple tasks (w/ & w/0 written list)o Supervisor/peer present vs absento Time pressure o Reinforcement for task completiono Brief behavioral skills training

8 Participants • 7 male, 1 female• aged 16 – 32 years• ASD (3 with ID)• 2 – college coursework • none employed• 5 w/ previous volunteer or work experience

Lerman, White, Grob, & Laudont (2017). A clinic-based assessment for evaluating job-related social skills in adolescents and adults with autism. Behavior Analysis in Practice.

• General Findings for 8 Initial Participants:

▫ Inconsistently used confirming statements▫ More likely to ask for help w/ materials than tasks▫ Notified supervisor when finished▫ Inconsistently corrected errors▫ On-task for majority of intervals▫ Engaged in little inappropriate behavior

ConsiderationsHow to provide effective intervention if▫ Individual not currently employed▫ Limited/no access to job site▫ Employer’s cooperation needed

Ideal interventions▫ Efficient, low-cost, nonintrusive ▫ Transfer from therapy setting to job site▫ On-site supervisors willing to implement

Current Intervention ApproachGrob, Lerman, Langlinais, & Villante (under review)

• Brief Behavioral Skills Training (BST)• Stimulus (Text) Prompts

Sequential introduction of additional components; require increasing amount of “buy in” from supervisor

• Antecedent (Vocal) Prompts• Feedback• Tangible reinforcement

Brief BST + Stimulus Prompts• ComponentsoWritten/Spoken Instructiono Examples / Modelingo Practice (Role Play)o Feedback

• Text/pictures to cue participant (“help sheets”)

I understand. I got it.That makes sense.

I can do that. I will do that.Consider it done.

Stimulus (Text) Prompts

Can you show me how?

Could you demonstrate it?

I need a model.

How do I do it?

Stimulus (Text) Prompts

Have I done this task before?

Did the supervisor give an example ?

Stimulus (Text) PromptsProblem Solving

• Performance criterion (6 consecutive)

• “Test” in relevant assessment situation(s)

• Stimulus prompts present in tests

Brief BST + Stimulus Prompts

BST “Booster”

• Return to BST if performance criterion not met

• Continue “tests” once BST performance criterion met

Additional Components

• Verbal prompt immediately prior to work session

• Immediate feedback▫ Descriptive Praise▫ Correction

• Immediate feedback + tang Sr:▫ Tangible (e.g., $) + Descriptive Praise▫ Correction

Experimental Design

• Concurrent multiple baseline across skills/evocative situations

• Assess generalization across some skills and to separate location/supervisor

• Participants

▫ Arthur: age 19; ASD; high school degree; volunteer experience

▫ Jerry: age 27, ASD, A.A in Criminology & A.A.S. in Information Technology Security; no experience

▫ Vanessa: age 19, ASD, ADHD; high school degree; volunteer experience

Assessment Results

C l e a r

I n s t r u c t i o n s

V a g u e

I n s t r u c t i o n s

0

2 0

4 0

6 0

8 0

1 0 0

M a k e C o n f i r m i n g S t a t e m e n t

( I n i t i a l T a s k I n s t r u c t i o n s )

C l e a r

I n s t r u c t i o n s

V a g u e

I n s t r u c t i o n s

0

2 0

4 0

6 0

8 0

1 0 0

M a k e C o n f i r m i n g S t a t e m e n t

( I n i t i a l T a s k I n s t r u c t i o n s )

C l e a r

I n s t r u c t i o n s

V a g u e

I n s t r u c t i o n s

0

2 5

5 0

7 5

1 0 0

M a k e C o n f i r m i n g S t a t e m e n t

( I n i t i a l T a s k I n s t r u c t i o n s )

Pe

rce

nta

ge

of

Op

po

rtu

nit

ies

(Co

rre

ct)

A r t h u r J e r r y V a n e s s a

P a r t i a l

Jerry

V a g u eIn s tru c tio n s

M is s in g /B ro k e nM a te r ia ls

T a s k C o m p le te d

0

2 0

4 0

6 0

8 0

1 0 0

A s k F o r H e lp

V a g u e In s tru c tio n s

T a s k N o t In R e p e r to ire

M is s in g /B ro k e nM a te r ia ls

T a s k C o m p le te d

0

2 0

4 0

6 0

8 0

1 0 0 T im e ly

H e lp S ta te m e n t

" W h at's N ex t?"

A sk fo r H e lp

A rth u r

P a r t ia l

Perc

enta

ge o

f Opp

ortu

niti

es (C

orre

ct)

V a g u eIn s tru c tio n s

T a s k N o t InR e p e r to ire

M is s in g /B ro k e nM a te r ia ls

T a s k C o m p le te d0

2 0

4 0

6 0

8 0

1 0 0

A sk fo r H e lp

V an essa

P a r t ia l

T im e lyH e lp S ta te m e n t

" W h at's N ex t?"

Perc

enta

ge o

f Opp

ortu

niti

es (C

orre

ct)

A p o lo g iz e A s k fo r C le a r

F e e d b a c k

M a k eC o n f irm in g

S ta te m e n t

C o rre c t M is ta k e

0

2 5

5 0

7 5

1 0 0R e s p o n d to C o rre c t iv e F e e d b a c k

P a r t ia l

A r th u r

A p o lo g iz e A s k fo r C le a r

F e e d b a c k

M a k eC o n f irm in g

S ta te m e n t

C o rre c t M is ta k e

0

2 5

5 0

7 5

1 0 0 R e s p o n d to C o rre c t iv e F e e d b a c k

A p o lo g iz e A s k fo r C le a r

F e e d b a c k

M a k eC o n f irm in gS ta te m e n t

C o rre c t M is ta k e

0

2 5

5 0

7 5

1 0 0R e s p o n d to C o rre c t iv e F e e d b a c k

J e r r y

V a n e s s a

Perc

enta

ge o

f Opp

ortu

niti

es (C

orre

ct)

Res

pond

ing

Acr

oss

Opp

ortu

niti

esArthur

In c o r re c t

C o r r e c tBL

B o o s t

P S - P S S m a ll S P

A s k in g fo r aT a s k M o d e l

B S T

In c o r re c t

C o r r e c t

A s k in g fo r H e lpw ith M a te r ia l s

B L B ST

Arthur

C o r r e c t

In c o r re c tA p o lo g iz in g

B L B ST B o o s t

In c o r re c t

C o r r e c t

A s k in g fo rC le a r F e e d b a c k

B o o s tB L B ST S m a ll S PR

espo

ndin

g A

cros

s O

ppor

tuni

ties

B ST

In c o r re c t

C o r r e c t

M a k in g C o n f irm in gS ta te m e n ts

(C le a r In s t ru c t io n s )

S m a ll S PB L B o o s t

In c o r re c t

C o r r e c t

M a k in g C o n f irm in gS ta te m e n ts

(V a g u e In s tru c t io n s )

In c o r re c t

C o r r e c t

M a k in g C o n f irm in gS ta te m e n ts

(C le a r T a s k F e e d b a c k )

Arthur

Res

pond

ing

Acr

oss

Opp

ortu

niti

es

In c o r re c t

C o r r e c tB STB L -S P

S P

M E I

C o n f irm in gS ta te m e n ts

(C le a r In s t ru c t io n s )

M E I*

Jerry

C o r r e c t

In c o r re c t

S P

-S PS P

M E I A s k in g fo r aT a s k M o d e l

M E I*

B L B ST -S P

Res

pond

ing

Acr

oss

Opp

ortu

niti

es

Jerry

In c o r re c t

C o r r e c t

S P

M E I*

A p o lo g iz in gM E I

B STB a s e l in e -S PR

espo

ndin

g A

cros

s O

ppor

tuni

ties

In c o r re c t

C o r r e c t

S PC o n f irm in gS ta te m e n ts

(T a s k F e e d b a c k )

M E I

M E I*

B L B ST

S P

-S P

In c o r re c t

C o r r e c t

C o n f irm in gS ta te m e n ts

(V a g u e In s tru c t io n s )

Jerry

Res

pond

ing

Acr

oss

Opp

ortu

niti

es

In c o r re c t

C o r r e c tB L B o o s t

A PF B $ - $ -F B

C o n f irm in gS ta te m e n t

(C le a r In s t ru c t io n s )

B STVanessa

In c o r re c t

C o r r e c t

C o n f irm in gS ta te m e n t

(T a s k F e e d b a c k )

B L B ST B S T B o o s te r

Res

pond

ing

Acr

oss

Opp

ortu

niti

es

B o o s t

C o r r e c t

In c o r re c t

A s k in g fo r aT a s k M o d e l

B a s e l in eB ST

A PB o o s t F B

$ - $ -F B

Vanessa

In c o r re c t

C o r r e c tA P F B $

A p o lo g iz in g

- $ -F BB L B STB o o s t

Res

pond

ing

Acr

oss

Opp

ortu

niti

es

Vanessa

In c o r re c t

C o r r e c t

C o n f irm in g S ta te m e n t(V a g u e In s tru c t io n s )

B a s e l in e

Res

pond

ing

Acr

oss

Opp

ortu

niti

es

Conclusions

• Brief BST + stimulus prompts effective for 2 of 3 participants

• Stimulus prompts critical to generalization?

• Start early!

• Don’t forget about the “soft skills”

Assessing and Teaching Job-Related Social Skills to Adults with Autism Spectrum Disorder

Dorothea C. Lerman, Ph.D., BCBA-Dlerman@uhcl.edu