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http://foa.sagepub.com Disabilities Focus on Autism and Other Developmental DOI: 10.1177/10883576050200030301 2005; 20; 150 Focus Autism Other Dev Disabl Shannon Crozier and Matthew J. Tincani Using a Modified Social Story to Decrease Disruptive Behavior of a Child With Autism http://foa.sagepub.com/cgi/content/abstract/20/3/150 The online version of this article can be found at: Published by: Hammill Institute on Disabilities and http://www.sagepublications.com can be found at: Focus on Autism and Other Developmental Disabilities Additional services and information for http://foa.sagepub.com/cgi/alerts Email Alerts: http://foa.sagepub.com/subscriptions Subscriptions: http://www.sagepub.com/journalsReprints.nav Reprints: http://www.sagepub.com/journalsPermissions.nav Permissions: by georgela taranu on April 17, 2009 http://foa.sagepub.com Downloaded from

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Disabilities Focus on Autism and Other Developmental

DOI: 10.1177/10883576050200030301 2005; 20; 150 Focus Autism Other Dev Disabl

Shannon Crozier and Matthew J. Tincani Using a Modified Social Story to Decrease Disruptive Behavior of a Child With Autism

http://foa.sagepub.com/cgi/content/abstract/20/3/150 The online version of this article can be found at:

Published by: Hammill Institute on Disabilities

and

http://www.sagepublications.com

can be found at:Focus on Autism and Other Developmental Disabilities Additional services and information for

http://foa.sagepub.com/cgi/alerts Email Alerts:

http://foa.sagepub.com/subscriptions Subscriptions:

http://www.sagepub.com/journalsReprints.navReprints:

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Despite the popularity of Social StoriesTM as an intervention fordisruptive behavior in children with autism, there have been fewinvestigations on the effectiveness of Social Stories. Scattone,Wilczynski, Edwards, and Rabian (2002) found that Social Sto-ries decreased challenging behaviors in children with autism,but they identified verbal prompts as a source of variability tobe examined in future study. The current study examined theeffects of a modified social story, with and without verbalprompts, on the disruptive behavior of a student with autism in his preschool classroom. A reversal design was used to com-pare the effectiveness of the modified social story with andwithout verbal prompts. The disruptive behavior decreased during both phases of the intervention but to a greater degreewhen the story was paired with prompting. Maintenance probesconducted 2 weeks after intervention revealed that the modi-fied social story had become a regular instructional routine forthe student. Results are discussed in relation to study limita-tions, applications, and directions for future research.

Autism is characterized by impairments in social inter-action and communication, as well as restricted reper-toires of behavior (American Psychiatric Association,

2000). In children with autism, these impairments commonlyresult in problem behaviors. Problem behaviors can negativelyaffect a person’s ability to participate in family and communitylife and to access educational opportunities (Dunlap & Fox,1999). Interventions that reduce problem behaviors can makesignificant improvements in the quality of life for people withchallenging behaviors and others in the community (Carr et al., 2002).

A Social Story™ is one positive behavior intervention forstudents with autism. A Social Story is a short, simple storywritten from the perspective of the child that delivers instruc-tion on appropriate social behaviors (Gray & Garand, 1993).Stories are carefully designed to be within the comprehensionlevel of the target child. Social Stories are potentially benefi-cial for several reasons. First, they capitalize on the visual learn-

ing strengths of students with autism (Quill, 1997). Second,the stories’ book format is unobtrusive in an educationalsetting and, therefore, less stigmatizing. Third, the stories pro-vide concrete instruction that students can easily reference re-peatedly until they master a skill. Finally, teachers and parentsfind the stories to be an effective, user-friendly tool (Ivey,Heflin, & Alberto, 2004; Smith, 2000).

Much anecdotal evidence supports the effectiveness of So-cial Stories (Gray & Garand, 1993; Simpson & Myles, 1998;Rowe, 1999). Students with autism tend to be strong visuallearners, and Social Stories provide instruction in a medium ofstrength without the complexity of interpersonal interaction(Scattone, Wilczynski, Edwards, & Rabian, 2002).

Despite the rich anecdotal evidence, few studies have ex-amined the use of Social Stories for behavior change (Sansosti,Powell-Smith, & Kincaid, 2004). Existing studies fall intothree categories: case studies, studies that pair Social Storieswith other interventions, and Social Story–only interventionswith an experimental design. In one case study, Swaggart andGagnon (1995) reported a decrease in the problem behaviorsof all three of their participants after the introduction of So-cial Stories. They, however, did not use a formal experimentaldesign to organize their study, reporting instead on informallygathered information. Furthermore, they paired the use of So-cial Stories with a behavioral social-skills training program,making it impossible to determine which intervention pro-duced the desired behavior change.

Two single-participant studies, Kuttler, Myles, and Carl-son (1998) and Norris and Dattilo (1999), were the first touse an experimental design and to report data. Kuttler et al.(1998) used an ABAB design, thereby addressing some of themethodological difficulties of the Swaggart and Gagnon(1995) study. Results indicated a significant reduction in prob-lem behaviors during the intervention. Because the partici-pant’s functioning level was lower than initially recommendedby Gray and Garand (1993), the success of the interventionsuggests that Social Stories may be useful for children with

FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIESVOLUME 20, NUMBER 3, FALL 2005

PAGES 150–157

Using a Modified Social Story toDecrease Disruptive Behavior ofa Child With Autism

Shannon Crozier and Matthew J. Tincani

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lower cognitive skills. Norris and Dattilo’s (1999) study ex-amined the effects of Social Stories on the inappropriate be-haviors of an 8-year-old girl with autism in an inclusiveclassroom. The results were highly variable and inconclusive.Their findings were limited by the AB design of the experi-ment and by external variables at home and school that the au-thors acknowledged were beyond their control.

The first study to use multimedia Social Stories targetedhandwashing or on-task behaviors in three boys with autism(Hagiwara & Myles, 1999). Hagiwara and Myles found noconsistent results in their multiple-baseline experiment. Giventhe variable results of the effectiveness of Social Stories re-ported thus far, it is not possible to determine whether the lackof effect in this study was due to the use of Social Stories, themultimedia medium, or other confounding variables.

In another case study, Smith (2000) conducted two 1-dayworkshops for parents, teachers, and assistants on making andusing Social Stories. Workshop participants created Social Sto-ries in groups, and some participants implemented the storiesoutside of the workshop. Participants completed an evaluationof their perceptions of the efficacy of the stories and their im-pressions of using them. Although no behavior change datawere included in Smith’s paper, the feedback from participantsindicating satisfaction with the Social Story intervention sup-ports the social validity findings of other researchers.

Rogers and Myles (2001) reported on a case study of a 14-year-old boy with autism and his responses to Social Storiesand Comic Strip Conversations™. In their brief report, Rogersand Myles described the positive behavioral changes of theirparticipant; however, the lack of baseline data and the lack ofmethodological information make it difficult to understandexactly how the behavioral changes came about.

Thiemann and Goldstein (2001) included Social Stories ina multicomponent intervention for five students with autismand social deficits. A systematic intervention program consist-ing of Social Stories, cue cards, role-play, and video feedbackwas introduced to participants across a multiple-baseline design.The combined treatment was effective in increasing specific so-cial skills, and results were replicated across four different be-haviors. Once again, the combination of Social Stories withother interventions prohibits conclusions being drawn on theeffectiveness of Social Stories individually.

Two recent dissertations have used group experiment de-signs to assess Social Stories. Feinberg (2001) found signifi-cantly higher levels of social skills in the treatment group atposttest. Limitations regarding the delivery, the short dura-tion, and the clinical setting make it difficult, however, totransfer these findings to the natural environment. Romano(2002) also found that Social Stories reduced the problem be-haviors in the treatment group, although there also was somereduction of problem behaviors in the control group. Herfindings are limited by the fact that treatment and controlgroups were part of the same classroom, making it difficult tocontrol for contamination. Furthermore, although Romano’s

results at posttest were promising, neither the treatment northe control group maintained the behavior after the interven-tion.

Scattone et al. (2002) targeted the problem behavior ofthree participants with autism using a Social Story–only inter-vention in a multiple-baseline design. Problem behaviors de-creased across all participants. The authors identified verbalprompting of the Social Story content by teachers as a possi-ble source of variability and recommended further study to as-sess its influence.

Kuoch and Mirenda (2003) isolated Social Stories with three participants ages 3 to 6 years using a reversal design. In-tervention took place in home and school settings. For twoparticipants, a simple ABAB design was used to compare So-cial Stories to a baseline condition. For the third participant,an ACABA design was used to compare Social Stories with abaseline condition and a non–Social Story book plus adult at-tention condition. The C condition was included to determinewhether behavior change could be attributed to the individu-alized attention received during the Social Story intervention.Results indicated a significant decrease in problem behaviorsfor all participants in the Social Story condition and no de-crease in the non–Social Story book plus adult attention con-dition. There was no treatment reversal for any participant,suggesting irreversible learning as a result of intervention.

Most recently, Ivey et al. (2004) used a reversal design toexamine the effects of Social Stories on the independent be-havior of three participants during novel events. Target skillsfor each novel event were described in Social Stories, and in-terventionists verbally repeated cues during the sessions. Par-ticipants increased their independent behaviors 15% to 30%over the baseline in the Social Story conditions. The use of ver-bal reminders during each session appears to be a systematicversion of the informal verbal prompts observed in Scattone etal. (2002). Ivey et al. did not examine the differences betweenverbal reminders and no reminders. The researchers’ use of thereminders is interesting, however, because it deviates fromGray’s (2000) intervention guidelines and because of the men-tion of such prompts as a possible confound in an earlier study.

Although many of these studies show promising results,methodological limitations highlight the need for careful ex-perimental design and rigorous replication (Sansosti et al.,2004). The purpose of the current study was to extend the re-search base by examining the effectiveness of Social Stories inreducing the disruptive behavior of a student with autism inhis preschool environment. In particular, this study examinedthe effect of a modified Social Story, with and without verbalprompts. A standardized reading assessment was used to sys-tematically match the participant’s reading level with the text.The frequency of problem behavior during baseline and inter-vention was compared to determine effect.

A second purpose was to assess the effectiveness of a So-cial Story that deviated from Gray’s (2000) guidelines. Theseguidelines, though clear and specific, have yet to be systemat-

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ically verified. Moreover, Gray (1994) suggests that deviationsfrom the guidelines may be appropriate in some instances.Therefore, the goal was to determine whether a modified So-cial Story would be effective in reducing challenging behaviors.

Method

Participant

The participant in this study was an 8-year-old boy with autismwho had been diagnosed by his pediatrician. He was an onlychild of middle-class parents. Alex attended a private schoolfor students with challenging behaviors. His teachers nomi-nated Alex for the study because he was leaving the schoolsoon and they were concerned that his behavior would makethe transition difficult. The criteria for including the partici-pant in the study were (a) a diagnosis of autism, (b) the pres-ence of prerequisite skills, and (c) the classroom teacher’swillingness to use the intervention. Prerequisite skills includedemergent literacy skills and demonstrated ability to sit and reada book with adult support. At his parents’ request, Alex hadnot participated in any formal assessments. For the study,Alex’s reading skills were assessed using the Analytical Read-ing Inventory (ARI; Woods & Moe, 2003). The ARI is an in-formal reading inventory designed for use in classroom andclinical settings to provide information on how a reader pro-cesses text (Woods & Moe, 2003). Graded word lists, pas-sages, and comprehension questions were administered to theparticipant, one on one.

Alex’s score on the ARI showed that he had solid emerg-ing literacy skills. He knew all of his letters and correctly read90% of the preprimer word list and 40% of the primer wordlist. On the preprimer reading passage, Alex correctly read 85% of the words. He answered 75% of the comprehensionquestions correctly, including the interpretive question. Histeachers confirmed that Alex loved to read books and quicklymastered simple new sight words in books and the environment.

Setting

The setting for the intervention was a classroom in a privatepreschool for children with developmental disabilities and chal-lenging behavior in a major metropolitan area of the south-western United States. The intervention took place during astructured independent activity session in a classroom with 15to 19 students, depending on daily attendance. The expecta-tion for students’ behavior during this session was to workquietly and independently at a station on an activity of the stu-dents’ choice. There were three teachers and one volunteer as-sistant in the class.

During both the baseline and intervention phases, regularclassroom activity continued for the students who did not par-ticipate. The first author conducted the modified Social Storyintervention sessions and collected observation data. The vol-unteer assistant and one of the teachers assisted in collectinginterobserver agreement data.

Target Behavior

Teacher interviews were conducted to identify Alex’s disrup-tive behaviors and the settings in which the behaviors weremost likely to occur. One target behavior, talking out, wasidentified by the teachers in response to the question “Whatsingle behavior most interferes with this student’s ability tosucceed at school?” Once talking out was identified as the tar-get behavior, classroom staff were further interviewed to de-termine when, where, and with whom the behavior was mostlikely to occur. Alex’s classroom teacher was also asked whatpurpose she thought the talking-out behavior served. Theteacher’s intuition was supported by analysis of her responsesto the Motivational Assessment Scale (MAS; Durand & Crim-mins, 1992). After the interviews, the first author conducteda classroom observation. This information gathering was con-ducted to ensure that the modified Social Story would accu-rately address the target behavior.

The information that was gathered revealed that Alex wasmost likely to talk out during independent work times whenhe did not have the direct attention of one of the staff mem-bers. He sought the attention of all staff without discrimina-tion. Alex’s talking out did not appear to increase or decreaseaccording to his location in the classroom. When Alex suc-ceeded in gaining a staff member’s attention, he would talkuntil he was directed to work quietly again. After this redirec-tion, Alex would return to his task without complaint andwould work quietly for a couple of minutes before talking outagain.

Response Definitions and Recording Procedures

Event recording was used to measure the target behavior, andeach occurrence was recorded as one event during the 30-minute observation session. The target behavior for Alex wastalking out. Talking out was defined as talking to teachers orother adults without raising his hand or being called on tospeak. Examples of talking out include asking questions, mak-ing comments, and requesting assistance. Nonexamples in-clude self-talk during play, responding to a teacher, and sayinggood morning when a teacher or student arrived at school.One incident of talking out was counted for each utterance.An utterance was considered to be anything from a single wordto a group of sentences. A new incident was recorded whenAlex had stopped speaking for more than 5 seconds or changedthe person to whom he was speaking.

Materials

Modified Social Story. Based on the information gath-ered from the classroom staff, the first author wrote a modi-fied Social Story for Alex that targeted his disruptive behaviorand described functionally similar replacement behavior. Al-though the story contained descriptive, perspective, and di-rective sentences, as well as illustrations that reflected Alex’s

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interests, it deviated from Gray’s (2000) guidelines in somekey ways. First, the ratio of directive to perspective and de-scriptive sentences recommended by Gray is 1:2–5. Alex’s storyhad a ratio of 3:5. Second, the story did not include suchwords as sometimes or usually. These types of words are typi-cally used to protect against the literal expectations of studentswith autism. The decision to write a story that deviated fromGray’s guidelines was made to accommodate Alex’s academiclevel. The intention was to write a story that Alex would even-tually be able to use independently, thus reducing the amountof teacher–student instruction. To achieve this goal, the storywas shorter than many of the example stories in the literature.Additionally, more complex and abstract words (e.g., usually)were eliminated, as Alex had not yet demonstrated the literacyskills for reading such words independently.

The story followed the guidelines for emergent readertexts recommended in the Fountas/Pinnell Book Gradient Sys-tem (Fountas & Pinnell, 1996). Specifically, the story vocabu-lary included known words as much as possible, key wordswere repeated throughout the story, the print appeared at thesame place on each page and was clearly separated from thepictures, and words were clearly separated for easy pointing.

The modified Social Story was seven pages long. Story textwas printed in 14-point Helvetica, with a maximum of twosentences per page. Each page included a line drawing illus-trating the main point. Stories were printed on white 81⁄2 × 11paper and stapled at the top, middle, and bottom of the leftside of the page. Story text is included in Figure 1.

Data Collection Form. The data collection form usedduring observation sessions was an 81⁄2 × 11 tally sheet withthe target behavior across the top and date and time slots alongthe left side of the page. The observer held the sheets on a clip-board and sat 5 to 8 feet away from the participant during ob-servations.

Experiment Design

This study used an ABAC reversal design (Barlow & Hersen,1984). In the baseline phase (A), Alex was observed for 30minutes in his regular classroom setting to assess the rates ofthe target behavior. In the first intervention phase (B), themodified Social Story was read immediately before the obser-vation period. After six sessions of Phase B, the Social Storyintervention was withdrawn to baseline conditions. In thesecond intervention phase (C), the Social Story interventionresumed with the addition of verbal prompts. During mainte-nance probes, when the Social Story procedures had beentransferred to the classroom staff who incorporated it intotheir routine, Alex was observed without receiving any inter-vention from the first author.

Baseline and Intervention Procedures

The baseline phase consisted of classroom staff conductingregular instruction and behavior management procedures.

These procedures had been ineffective in reducing Alex’s tar-get behavior. During observation sessions, the observers sat 5to 8 feet away from the participant. Every effort was made tomake it appear that observers were engaged in meaningful ac-tivities unrelated to the participant, such as marking papers.

The first day of intervention consisted of a training session.During the training session, the students who were not par-ticipating in the study continued with regular classroom activ-ities. The training session began with the author approachingAlex and saying, “I have a new story for you! Come sit withme and let’s read it together.” The author and the studentwent into the classroom next door and sat diagonally across atable from one another. The author showed the student thecover of the book and introduced the story (“This is a storyabout talking at school.”). The author instructed, “Let’s readthis story out loud. Then I’m going to ask you some ques-tions.” The author listened to Alex read the story aloud. IfAlex had difficulty with a word, the author read the word andthen asked him to repeat the sentence. After the first readingof the story, the author showed Alex four visual comprehen-sion questions and asked him to circle his answers. Then theauthor and Alex returned to the other classroom.

Two interventions were used: a modified Social Storywithout verbal prompts (Phase B) and a modified Social Storywith verbal prompts (Phase C). The first author conducted allintervention sessions. Phase B sessions began with the re-searcher saying to Alex, “It’s time to read your story!” and tak-ing Alex to the classroom next door to read the story. Alexwould then read the story aloud. At the end of all interven-tion sessions, the researcher asked, “What’s the rule for talk-ing in school?” as a comprehension check. After reading, Alexand the author immediately returned to the other classroom,and Alex resumed his structured play activity.

Phase C intervention sessions consisted of two parts. Thefirst part, the reading of the story, was identical to the proce-dure for Phase B. During the target activity immediately fol-lowing the story reading, however, verbal prompts were usedduring the observation period. Prompts were given on a vari-able interval schedule at an average of once every 6 minutes.The verbal prompt for Alex was “Remember to raise your handwhen you want to talk to a teacher.” The variable intervalschedule for prompt delivery was selected to ensure that

FIGURE 1. Alex’s Social Story Text.

Social Story Text: Talking at School

At school I play games and work.I like to talk to the teachers.When I want to talk to the teachers, I don't call out.I put up my hand.I look at the teacher.I wait quietly.When the teacher talks to me, then I can talk.Everyone is happy when I put up my hand and wait.

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prompts would be equally distributed across the observationsession independent of participant behavior. Additionally, be-cause it was determined that Alex’s talking out was reinforcedby teacher attention, it was important for the verbal cues tooccur independently of talking out. Otherwise, verbal promptscould inadvertently reinforce Alex’s inappropriate behavior.

Maintenance

Two maintenance probes were conducted 2 weeks after thefinal intervention session. After the final intervention session,the Social Story was left with preschool staff who had asked tocontinue to have Alex read the story each morning before heselected his first activity. Staff learned to use the modified So-cial Story by observing the first author and Alex read the story,receiving verbal directions from the first author on how to usethe story, and then reading the story with Alex with feedbackfrom the author. Staff reported that Alex read the social storymost, though not all, mornings and that he now required onlyinfrequent redirection. During the maintenance probes, theauthor arrived at the preschool 20 to 40 minutes after Alex ar-rived and observed him during independent work. Alex askedeach morning if he could read his story again with the author.He was directed back to his activity, and the observation ses-sion began.

Treatment Integrity

A checklist was used to assess treatment integrity for each ses-sion. On the checklist, the author indicated whether the par-ticipant had completed all the steps of reading the story andanswering the comprehension question each day. During 25%of the intervention sessions, a teacher from the preschool waspresent to complete a second checklist. Interobserver agree-ment was computed as a percentage by dividing the numberof agreements by the number of agreements plus disagree-ments and multiplying by 100. The author completed 100%of the checklist steps across both intervention phases. Inter-observer agreement for the treatment integrity checklists wasalso 100%.

Interobserver Agreement of the Dependent Variable

Interobserver agreement (IOA) data were collected on 25% ofthe observation sessions. IOA sessions were selected on thebasis of the availability of preschool staff. The volunteer whoconducted most of the IOA sessions worked part-time and wasnot available to assist if other staff members were absent. IOAwas collected for three baseline sessions and three social storysessions distributed across phases. IOA was calculated by di-viding agreements by agreements plus disagreements and mul-tiplying by 100. The mean for IOA was 90%, with a range of63% to 100%. Only one session had an IOA of 63%, due pri-marily to the volunteer assistant being interrupted during the

observation by another student’s behavior. Excluding that ses-sion, IOA ranged from 84% to 100%.

Results

Talk-Outs

Overall, Alex demonstrated a reduction in his disruptive be-havior of talking out as a result of the intervention (see Fig-ure 2). The number of behavior incidents during the firstbaseline phase averaged 11.2 talk-outs during a 30-minute ob-servation period. During the Social Story–only intervention,his talk-outs dropped to an average of 2.3 per 30-minute ob-servation session. In the second baseline phase, talk-outs roseto an average of 8 per 30-minute observation session. In thefinal intervention phase, Social Story plus verbal prompts, talk-outs dropped to an average of 0.2 per 30-minute observationsession. The rates of behavior were most stable during the finalintervention phase, with 5 days of consistent data.

During the two maintenance observation sessions, Alex’stalk-outs remained at zero. The teachers reported that Alexinitially read his story daily, but his reading became more in-consistent after several days. Although no data were recordedon how frequently he read the story at the time of the main-tenance observations, the teachers estimated his reading at anaverage of twice a week. Verbal prompting was not used con-sistently with Alex during the maintenance sessions, althoughthe teachers delivered occasional prompts to all students aspart of regular classroom management. Alex was promptedonce during the first maintenance session and not promptedat all during the second session.

Anecdotally, Alex appeared to enjoy the Social Story in-terventions. After the first training session and upon seeing thefirst author arrive at the school, he would say, “I’m ready toread my book now!” It was also noted that, throughout theday, Alex would raise his hand to tell a teacher, “I’m not al-lowed to call out.” After the study ended, when the first au-thor returned to the school, Alex would ask to read the SocialStory with her and would appear disappointed when this wasnot possible.

Social Validity

Teacher acceptance of the intervention was assessed before theintervention began and again after the final phase was com-pleted. The author interviewed teachers about whether theythought the modified Social Story was an appropriate inter-vention for their classroom and if they would be comfortablecontinuing to use a modified Social Story after the completionof the study.

Before the study began, the preschool staff had never useda modified Social Story before. They responded favorably tothe idea and said that they thought such a strategy would workwell within the preschool structure. After the completion ofthe study, the first author interviewed each teacher about her

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impressions of the intervention and the potential benefit ver-sus the effort of using the Social Story. All the teachers re-ported favorable impressions of the effect of the modifiedSocial Story and indicated that they would like to learn howto write other stories so they could continue to use them withthe participant and other students. One teacher committed tohaving Alex read his story each morning. Two teachers askedfor Social Stories for other students in the school.

Discussion

The results suggest that the modified Social Story was an ef-fective intervention for lowering the disruptive behavior of apreschool student with autism. Compared to the first baseline,significant reduction in talk-outs occurred with the introduc-tion of the modified Social Story. After a return to the base-line condition, an even greater reduction in challengingbehavior occurred with the reintroduction of the modified So-cial Story with verbal prompts. Maintenance probes conducted2 weeks after intervention indicated that low levels of problembehavior were maintained after the experiment ended and thatthe modified Social Story was incorporated into the student’sregular education routine.

As noted, treatment reversal was observed after 2 days inthe second baseline phase, but not during the maintenanceprobes. One possible explanation is that six sessions were in-sufficient for mastery of the new behavior. Another possibilityis that the story plus prompts was more effective in producinglasting behavior change. In the future, these possible explana-tions could be examined by (a) increasing the length of thefirst intervention phase to see how many additional sessions

would be required to achieve mastery or (b) using the SocialStory plus prompts condition first to determine whether thatintervention is more effective in producing mastery.

The results support previous studies (e.g., Kuttler et al.,1998) that found reductions in challenging behaviors throughthe use of Social Stories. The current study examined the ef-fects of a modified Social Story paired with an additional va-riable, verbal prompts, which were delivered on a variableinterval schedule. The data suggest that the verbal promptsserved as effective reminders for the participant to follow class-room rules and to refrain from disruptive responses. It is there-fore recommended that when Social Stories are used in typicalclassrooms, teachers provide regular prompts for students toengage in appropriate behaviors, at least initially. As observedduring the maintenance sessions, Alex was able to maintainlow rates of talking out with fewer prompts than during in-tervention. This may suggest that Alex benefited from theprompting while acquiring the new skill of handraising, butonce his proficiency increased, he did not require promptingto maintain that skill.

The data also suggest that using a standardized reading as-sessment, such as the ARI (Woods & Moe, 2003), is an ap-propriate method for identifying story vocabulary. For SocialStories to be effective in typical classrooms, they should be sys-tematically matched to each student’s reading level.

Another contribution of this study is the finding that teach-ers reported favorable opinions of the modified Social Storyand continued to use it after completion of the study. Thisfinding indicates that a modified Social Story is not only ef-fective in reducing problem behavior but also likely to be ac-cepted by teachers and incorporated into typical classroomroutines.

FIGURE 2. Number of Talk-Outs Across Phases.

MaintenanceSocial Storywith prompts

Num

ber

of T

alk-

outs

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Two factors may limit the generality of the findings toother students with autism and challenging behaviors. First,the ABAC design used in the study did not establish a func-tional relationship between the use of verbal prompts andfurther reductions in challenging behavior. Additional replica-tions (e.g., ABACBC) would be necessary to confirm that ver-bal prompts enhanced the effectiveness of Social Stories. Still,reductions in talk-outs with the use of verbal prompts in PhaseC suggest that the prompts were a useful addition to the So-cial Stories routine. A second limitation was the use of onlyone participant. Additional replications of the interventionwith two or more participants would strengthen conclusionsregarding the effectiveness of Social Stories, both with andwithout prompts. Another limitation was the use of an indirectassessment, the MAS (Durand & Crimmins, 1992), to deter-mine the function of Alex’s challenging behavior. A functionalanalysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1984)would have provided more conclusive evidence about thefunction of his behavior.

Finally, this study met its goal of assessing the effectivenessof a modified Social Story and demonstrates that a story thatdeviates from the parameters set by Gray (2000) was effectivein changing Alex’s behavior. This suggests that there may beflexibility within Gray’s parameters that still allow for a suc-cessful Social Story. Indeed, Gray (1994) indicated this in aSocial Story training tool that instructs the reader to “Keep inmind effective Social Stories have been written which deviatedfrom the guidelines” (p. 1). To date, the Social Story guide-lines have not been validated. The success of a modified SocialStory in changing the behavior of a child with autism suggeststhe need for future research to examine the guidelines for writ-ing Social Stories.

In future studies, researchers could examine the role ofgestural, written, or other prompts in addition to verbalprompts in combination with Social Stories. An alternatingtreatments design (Barlow & Hersen, 1984), which readily al-lows for comparisons between interventions, could be used toexamine the effects of Social Stories with and without varioustypes and levels of prompting. Futhermore, studies to extendthe investigation of Ivey et al. (2004) on the different applica-tions of Social Stories would broaden the support for wider ap-plication of this popular tool. Researchers also could examineprocedures for fading Social Stories and prompts from the in-structional setting to promote student independence. Finally,although some young children with autism possess emergentliteracy skills, other children may not have acquired readingskills sufficient to comprehend beginning-level text. Given thevisual learning strengths that characterize this population, fu-ture studies could examine the effects of Social Stories that relyexclusively on picture-based depictions of classrooms andother settings for children who lack basic literacy skills.

ABOUT THE AUTHORS

Shannon Crozier, MEd, is a doctoral student in special education atthe University of Nevada, Las Vegas. Her current interests include be-

havioral interventions for children with autism and school-wide positivebehavior support. Matthew J. Tincani, PhD, is an assistant professor atthe University of Nevada, Las Vegas. Address: Shannon Crozier, De-partment of Special Education, 4505 Maryland Parkway, Box 453014,Las Vegas, NV 89154-3014; e-mail: [email protected]

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