Should I Stay or Should I Go?

By: Elizabeth Zeppernick, M.Ed., BCBA, LBA

One of the principal deficits which is central to the diagnostic criteria of Autism Spectrum Disorder (ASD) is an impairment in social interaction (American Psychiatric Association, 2013).  To this end, clinicians have an interest in assessing social interaction in order to improve social and play skills when working with individuals with ASD.  The core question is whether social interactions are reinforcing, neutral, or aversive for each individual.  

In their study titled Evaluating the Function of Social Interaction for Children with Autism, researchers Morris and Vollmer (2021) used a novel method of evaluating the function of social interaction in 21 children with ASD with an age range of 3-12 years old.

Structure of Study: 

In this study, researchers used a 12x12’ room divided into two halves with a line of tape on the floor.  Each half of the room contained identical furniture and age appropriate leisure items.  A therapist entered the space with the participant and indicated, “Go wherever you want.”  For the length of either an eight or ten minute session, the therapist switched sides of the room every two minutes.  The side that the therapist was located was considered the social side while the side they were not located on was considered the alone side.  The participant could cross to the other side of the room to enter into the alone side thus avoiding social interaction or could remain on the same social side as the therapist.  The therapist delivered social interactions on a fixed schedule of every ten seconds for the duration that the participant was on the social side.  Social interactions included vocal statements such as, “You’re playing with the blocks” and engaging the participant in play.  The therapists maintained neutral gaze (no eye contact), neutral body orientation (neither facing directly towards or away from the participant) and did not deliver social interactions when the participant was on the alone side of the room.  Therapists switched sides if the participant demanded or requested that the therapist come play with them or requested that the therapist go away.  

Outcome:

Researchers measured the percentage of session time the participant was located on the social side of the room.   A high percentage of time spent on the social side was an indication that social interactions were reinforcing or rewarding.  The data showed it was reinforcing for nine participants. A high percentage of time spent on the alone side indicated that social interactions were aversive.  The data showed it was aversive for five participants.  If they spent a relatively equal amount of time on either side then it suggested that social interaction was neutral.  The data showed it was neutral for seven participants.  

Why Does this Matter?

The structure of this assessment was efficient in assessing the function of social interactions.  On average, the duration of the assessment was only between 36 and 45 minutes.  The format yielded results that are relatively easy for clinicians to quantify and interpret so it is more likely to be adopted and put into practice.  An assessment of this type could be used at the onset of services to provide a baseline in appropriate reinforcement for social and play skills.  It is an assessment which could be implemented intermittently after services have commenced to assess the response to behavior analytic therapy as it relates to increasing social interactions.  

A secondary note of importance is that the diagnostic criteria for ASD (American Psychiatric Association, 2013) and some research (e.g., Candini et al., 2017; Humphrey & Symes, 2011; Klin et al., 2002; Ruta et al., 2017) indicate that social interaction is not likely to serve as a reinforcer for individuals with ASD.  In this study by Morris and Vollmer, nine out of the total of 21 participants demonstrated that social interaction was in fact reinforcing.  

Sources:

American Psychiatric Association (2013).  Diagnostic and statistical manual of mental disorders (5th ed.). APA Publishing. https://doi.org/10.1176/appi.books.9780890425596

Candini, M., Giuberti, V., Manattini, A., Grittani, S., di Pellegrino, G., & Frassinetti, F. (2017). Personal space regulation in childhood autism; Effects of social interaction and person’s perspective.  Autism Research 10(1), 144-154. https://doi.org/10.1002/aur.1637

Humphrey, N., & Symes, W. (2011). Peer interaction patterns among adolescents with autistic spectrum disorders (ASDs) in mainstream school settings. Autism,  15(4), 397-419. https://doi.org/10.1177/1362361310387804

Klin, A., Jones, W., Shultz, R., Volkmar, F., & Cohen, D. (2002). Visual fixation patterns during viewing of naturalistic social situations as predictors of social competence in individuals with autism.  Archives of General Psychiatry,  59(9), 809-816. https://doi.org/10.1001/archpsyc.59.9.809

Morris, S.L. and Vollmer, T.R. (2021), Evaluating the function of social interaction with children with autism. Journal of Applied Behavior Analysis. https://doi.org/10.1002/jaba.597

Ruta, L., Fama, F. I., Bernava, G. M., Leonardi, E., Tartarisco, G., Falzone, A., Pioggia, G., & Chakrabarti, B. (2017). Reduced preference for social rewards in a novel tablet based task in young children with Autism Spectrum Disorders. Scienti c Reports, 7, 3329. https://doi.org/10.1038/s41598-017-03615-x

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