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.