자폐스팩트럼장애 유아의 친사회적 행동에 미치는 효과＊1)
Facilitating Positive Social Interactions Through English Activity Class for Kindergarteners with Autism Spectrum
Disorders
김 정 일**
Kim, Jeong il 요 약
< >
본 연구는 영어수업을 활용한 통합교육이 자폐스팩트럼장애 유아의 친사회적 행동과 방 해성 행동에 미치는 영향을 실험연구 하였다 본 연구의 참여자로서 세 명의 자폐스팩트럼. , 장애 유아들이 중재대상으로 참여하였으며 여섯 명의 일반발달또래 유아들이 통합교육수, 업 내에서의 또래지원자로 참여하였다 중재대상간 다중기초선설계를 사용하여 한 명의 중. , 재대상 유아와 여섯 명의 또래지원자들이 영어노래 부르기와 율동으로 구성된 영어수업에 참여하였다 연구결과 영어수업을 활용한 통합교육 프로그램은 세 명의 중재대상 유아들의. , 친사회적 행동의 증가와 방해성 행동의 감소를 나타냈다 또한 중재이후 일반발달또래들의. , 중재대상 유아에 대한 또래수용도가 중재이전에 비해 증진됨을 나타냈다.
핵심어 : 자폐스팩트럼 장애 친사회적 행동 방해성 행동 영어수업 통합교육 또래, , , , ,
. INTRODUCTION
Ⅰ
Individuals with autism spectrum disorders lack appropriate social skills, have a limited ability to take part in reciprocal conversation and do not seem to
understand many of the unwritten rules of communication and social conduct that their peers seem to naturally learn through observation.
These characteristics significantly impact their ability to demonstrate
이 논문은 년도 핵심과제에 의하여 연구되었음
* 2004 BK21 .
This work was supported by Brain Korea 21 Task Forced Project.
대구대학교 유아특수교육과 교수 교신저자
** ( : ashramguru@daegu.ac.kr)
Department of Early Childhood Special Education, Daegu University.
social and emotional competence, encompasses self-awareness, control of impulsivity, working cooperatively and caring about others (Elias et al., 1997, Ryan, & Patrick, 2001). Especially, prosocial behavior in a peer group is intimately related to the potential occurrence of various types of challenging behaviors at school that affect children's inclusion and overall life (Garfinkle & Schwartz, 2002). Deficit in social skill also can influence children's interpersonal skills, peer acceptance, social adjustment, and social competence.
Several researchers and educators have developed interventions for autism spectrum disorders to improve their prosocial behaviors. In the interventions, the effect of peer mediation has been supported by many researchers as being effective in teaching prosocial skills to children with special needs (Diamond, 2001; Lee, Kim, Lee, & Lee, 2002; Mervis, 1998). Also, peer mediation has been supported as being helpful for typically developing peers to understand individuals with different characteristics and their overall life situations (Dianmond, 2001; Diamond & Carpeter, 2000).
To improve prosocial behaviors in a child's naturalistic inclusive environment, peer-group programs in the general education and community have been facilitated by the educators (Farmer &
Cadwallader, 2000; Grubbs & Niemeyer, 2000; Kohler et al., 2001).
As one of effective programs to build prosocial behaviors of children with special needs, researchers have reported dancing and physical activity in an inclusive setting to be effective. It has been reported as effective in decreasing isolation, increasing communication skills, and increasing verbalization (Elliot, 1999; Lee, Kim, Lee, & Lee, 미 2002; Parish-Plass & Lufi, 1997; Schwartz, 1989). Several studies also reveal that involving peers in social skill training provides children with autism spectrum disorders the opportunity to observe, imitate and learn from the social behaviors of their typically developing peers (Kamps et al., 2002).
Children with autism spectrum disorders may exhibit behavioral challenges that interfere with learning and social interaction. These can take the form of disruptive behaviors or can be more serious as in the case of aggression. Disruptive behavior can interfere with the
education of both the child creating the disruption and other children who share the class. It may also interfere with the social interactions of the child disrupting the class because this child is often identified as "troublesome" (Harris et al., 1992). Especially, given the recent trend toward inclusion in general education, there is an increased number of children with special needs, including autism spectrum disorders, in the general education environment (Koegel, Koegel, Frea, & Fredeen, 2001). As a consequence, considerable attention has been dedicated to promoting effective intervention techniques to enhance appropriate behaviors in a peer group activity in inclusive settings. Therefore, teaching social skills is an integral element of a comprehensive behavioral program for children with autism spectrum disorders (Scattone, Wilczynski, Edwards, & Rabian, 2002; Taylor, 2001).
A variety of teaching programs and strategies to build prosocial behaviors for children with autism spectrum disorders have been studied and examined in naturalistic environments. However, few of the studies considered the importance of providing typically developing members with naturalistic curriculum. Most of intervention even in inclusive program was structured on a therapeutic basis to meet the needs of children with disabilities. To pursuit the education programs in an equal opportunity base and to facilitate more successful collaboration among children with different needs, teaching programs for all the children with different characteristics need to consider the mutual benefits.
This study examined the effect of an English-mediated inclusive program for both the children with autism spectrum disorders and their typically developing peers. This study had the following purposes. First, it was to see whether English activity program increased prosocial behaviors for children with autism spectrum disorders. Second, it was to see whether the program decreased disruptive behaviors of children with autism spectrum disorders.
Third, it was to see if the program changed the level of peer acceptance from the classmates for the children with autism spectrum disorders.
. METHOD
Ⅱ
1. Participants
Three kindergarten boys with autism spectrum disorders participated in the study. To be selected as subjects in the study, prospective participants must have met all the following criteria: (1) been diagnosed autism spectrum disorders within the last year; (2) be in the range of age 5.5 and 6; (3) been attending regular education classes; (4) possess a history of disruptive behaviors and social skill deficit; (5) been currently reported by his teacher as showing disruptive behaviors and social skill deficit; (6) have no medication history relating to behavioral problems within the last year; (7) offered consent from both the child and the parents.
Six of typically developing kindergarteners, three boys and three girls in the range of age 5.5 and 6, volunteered as peer members in the study. The peers were selected based on the teacher's report that they had no history of maladaptive behaviors at school and indicated social competence and school adjustment index within the top five percent of class scores. The characteristics of the subjects were described in <Table 2-1>.
<Table 2-1> Summary of Participants
Child CA PEP VAS PLS DC Inappropriate behaviors
A 5.9 3.7 SA 3.3
SQ 38 2.8 AD
out-of-seat and running around; smelling/
chewing others' hair; scrawling on the floor;
tamper tantrum; stereotypic vocalization;
reluctant to be with a peer and leaving away the place; playing alone
B 6.0 4.0 SA 3.9
SQ 40 3.3 HF A
out-of-seat and running around; table-banging in changing conversation, withdrawn and anxious of peers' approaching and leaving away the place; playing alone
C 5.8 5.1 SA 5.0
SQ 57 3.7 AS
climbing the desk in class, stereotypic vocalization in class, out-of-seat and lingering;
preoccupied to blue color; keeping talking in class; anxious of boys' approaching but getting along well with girls; playing alone
Note: CA=chronological age; PEP=psychoeducatinal profile; VAS=Vineland Adaptive Scale;
PLS=Preschool Language Scale; SA=social age; SQ=social quotient; DC=Diagnosed Condition;
AD=Autistic Disorder; AS=Asperger Syndrome; HFA=High Functioning Autism
2. Settings
The settings included two adjacent rooms: the English program room (13m x 13m) and the free-play room (5m x 6m). Video cameras were installed in both rooms and a TV monitor was installed in a separate monitoring room. Children did not know that all their activities in both settings were monitored on video. Audio systems for providing the participants with English songs were set in the room. Each 25 minute interval was announced by ringing a bell to inform them the transition to free play from the English program.
3. Data Collecting
1) Direct Observation and Data Reliability
Two classes of behaviors were selected as dependant variables in the study. One group was "disruptive behavior." The other dependent variable was "prosocial behavior." Specifically, disruptive behavior included out-of-seat and running/walking around, smelling others' hair, shouting, table-banging, temper tantrum, climbing the desk, and stereotypic vocalization. Prosocial behavior in the study included giggles, laughs, smiles, questions, comments, praise, pats, hugs, talking-turns, saying sorry/thanks, answering yes/no appropriately, and sharing toys when asked, which are directed towards a peer or received from a peer. Definition and topography of the target behaviors are described in <Table 2-2>. Observations of each subject during group activities in both the English class and free play were conducted using a 10-second partial interval recording system.
An interaction was coded as having been received only when the initiative and/or received interaction that preceded it are separated by 3 or more seconds. Social interactions that are initiative/received must be separated by 3 or more seconds to be coded as multiple
interactions.
<Table 2-2> Definitions and Specific Topography of Target Behaviors Target
Behavior
s Definition Topography
Disruptiv e Behavior
Behavior that significantly interrupts the learning climate of the class or endanger the well- being of others. It includes offensive language, repeated failure to complete assignments, failure to obey instructions, loitering in study areas in the class when asked not to, and/or other acts of misconduct that are disruptive but which do not create a potential safety hazard of himself and others.
out-of-seat and running around, smelling others' hair, scrawling on the floor, shouting, table- banging and/or temper tantrum for getting what he wants, climbing the desk in class, stereotypic vocalization in class, jumping with stereotypic vocalization, keeping talking in class, playing alone
Prosocial Behavior
Behavior that responds to and/or initiates interaction towards a peer.
Receptive prosocial behaviors that a child is touched, gestured to, given direction or questioned by peer.
Initiative prosocial behaviors that a child actively seeks positive contact with a peer. Contacts must have been specifically directed toward children.
Accidental touches within the course/context of an activity are not coded as having received an interaction.
giggles, laughs, smiles, questions, comments, praise, pats, hugs, talking-turns, saying sorry/thanks, answering yes/no appropriately, and sharing toys when asked, which are directed towards a peer or received from a peer, by touching peer, gesturing to, vocalizing to, or talking to peer.
(modified from Schleien, Mustonen, & Rynders, 1995)
All the activities during free play were recorded on a videotape, and it was reviewed for data collection in three conditions: baseline, intervention program, and maintenance. A 25-minute observations were recorded on the video tapes and used for data recording.
An average of interobserver agreement for occurrence / nonoccurrence of disruptive behavior and prosocial behavior was 92%
and 90%(range of 89 94%) respectively in the intervention.～
2) Peer Ratings
Peer ratings were modeled after those of Gresham(1993) to assess the peers' acceptance intention from each subject's classmates. The classmates were asked to look at each child in the picture (for whom parental consent was obtained) and rate him or her on how much they liked to play with the child using a Likert scale with a 3=smiling face, 2 = neutral face, 1 = a sad face, and a neutral face with a question mark to indicate “Don't know.”Children were given practice using the Likert scale with unrelated statements (i. e.,"I like to play with the teddy bear”) before actually assessing their friendship responses to ensure they understood the procedure.
3) Social Validity
To check its social validity, teacher acceptability and satisfaction with the intervention by the peer members were assessed using a scale based on Witt and Martens'(1983) recommendations. Information on the intervention procedures was outlined and explained to each subject's regular education teacher when data collecting in the maintenance condition was completed. The teachers rated, on a Likert-type scale (1=strongly disagree to 5=strongly agree), 9 statements that described each treatment component.
A brief self-report index modeled after Bray and Kehle(1996) was used to determine the peer members' satisfaction with the program.
The scale consisted of 10 items rated on a 5-point Likert-type scale with 1= Never liked/lost time and 5=Definitely liked/got benefits. The 10 statements included 'becoming more interested in English than
before the participation' and 'being more proud of myself as I am more confident in doing well with other language'. To rate the peers' satisfaction, The teacher read each statement twice and asked him to answer. If the peers did not respond to the teacher twice, it was scored as blank.
4. Experimental Design and Intervention Procedures
A multiple baseline design across subjects was used to examine the effects of the English activity class to improve prosocial skills for children with autism spectrum disorders. A description of each condition is described below.
1) Baseline
Prior to the implementation of the intervention, baseline data was recorded for the three subjects in the setting. In the baseline condition, free play environment was given to the subject and the six peers in a group, but neither feedback nor trained peers' mediation was provided in this condition. Also, there was no teachers' presence in the environment. The free play situation was set in a small group play therapy room including a variety of toys and kids' music instruments.
2) English Activity Program
After a baseline condition English activity class was implemented to the participants. The activity class focused on singing, dancing, and touching peers to the words of English songs, which consisted of simple rhythmical movement of their body parts with a song. The words of each song were modified to facilitate and model prosocial behaviors (see Table 2-3). In the English activity room, the music was song in turns by the teachers with simple topography of singing,
dancing, movement, and then the children imitated the teacher's modeling . The two songs (The Hokey Pokey and Where is Daddy?)involved touching and other gestures, which was designed mainly to teach young children a body image, self and other awareness, and socialization. The English activity program was followed by free-play time in an enriched naturalistic environment to give children opportunities of generalization. The song were taught in the class to give all participants equality in verbal communication and to attempt to prevent withdrawal by some children who experienced communication difficulties (Holzberger, 2001; Lee, Kim, Lee, & Kim, 2002).
After 25 minutes of the English activity program, all the participants in the group were asked to move to a free-play room for 25 minutes. In the free-play room, children played with toys and encouraged not to leave the free-play room by the closing second of the intervention.
<Table 2-3> Components of the English activity Program
Song Words Application
The Hokey Pokey
You put your right foot in, you put your right foot out, your put your right foot in, and your shake it all about, And then you do the hokey poky, and you turn yourself about. That's what it's all about. You do the hokey pokey, you do the hokey pokey, you do the hokey pokey, that's what it's all about!
Getting together in
a group and
touching others
Where is Daddy?
Where is OOO? Where is OOO? Here I am, here I am.
How are you today, OOO?
Very well I thank you, run away, run away.
Getting to know each other and recognizing a peer's name in a group
3) Maintenance
Upon completion of the study, the two observers recorded data every five days for a month. No reinforcement or feedback was delivered to the subjects in this condition. The peers were advised not to mediate in any of situation during this condition. Except for the items
of toys, efforts were made to ensure that there was no novel source of variability that could influence the occurrence/ nonoccurrence of target behaviors in this condition.
. RESULTS
Ⅲ
1. Direct Observation
Figure 1 represents the percentage of target behaviors, disruptive behavior and prosocial behavior, that each child occurred in each session in the program room. Figure 2 does the scores on the peer rating by the classmates.
In <Figure 3-1>, baseline data for Child A showed that he exhibited remarkable levels of disruptive behavior with an average of 45%
(range 35-50%). Following the English activity class, a decrease in its percentage of disruptive behaviors to below the first baseline level was observed. From the 10th session of the intervention, he showed a distinctive decrease in the
0 10 20 30 40 50 60 70 80 90 100
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33
disruptive prosocial
0 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0 9 0 1 0 0
1 3 5 7 9 1 1 1 3 1 5 1 7 1 9 2 1 2 3 2 5 2 7 2 9 3 1 3 3 3 5 3 7 3 9
0 10 20 30 40 50 60 70 80 90 100
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
Baseline Intervention Maintenance
Child A
Child B
Child C
Sessions
Percentage of Target
<Figure 3-1> Percentage of Target Behaviors
disruptive behavior and showed an average of 27.65%(range 10-65%).
This behavior change maintained the percentage of his reduced disruptive behaviors after the withdrawal of the English activity class.
His prosocial behaviors were also measured. He did not display
prosocial behaviors in the baseline as results were in the level of zero. However, after the English activity program was introduced, his behavior changed prosocial behaviors from the 6th session. The average of prosocial behavior was 10%(range 0-30%) occurrence during the intervention. The behavior change maintained the percentage of his increased prosocial behaviors when the program was withdrawn.
In all, disruptive behavior alone averaged 45% occurrences at baseline, 27.65% during the intervention sessions, and 8.33% across the maintenance session, while prosocial behavior alone averaged 0%
at baseline and 10% during the intervention sessions, and 33% across all of the maintenance sessions.
For Child B, the baseline data showed that he exhibited high levels of disruptive behavior with an average of 59.23%(range 55-65%).
Following the English activity class, a decrease in its percentage of disruptive behaviors to below the first baseline level was observed.
From the 8th session of the intervention, he showed a decrease in the disruptive behavior and showed an average of 36.76%(range 15-65%). This behavior change maintained the percentage of his reduced disruptive behaviors after the withdrawal of the English activity class.
His prosocial behaviors were also measured. He did not display prosocial behaviors in the baseline as results were in the level of zero to 3. However, after the English activity program was introduced, his behavior changed prosocial behaviors from the 5th session. The average of prosocial behavior was 20%(range 0-40%) occurrence during the intervention. The behavior change maintained the percentage of his increased prosocial behaviors when the program was withdrawn.
In all, disruptive behavior alone averaged 59.23% occurrences at baseline, 36.76% during the intervention sessions, and 11.67% across the maintenance session, while prosocial behavior alone averaged 0.92% at baseline and 20% during the intervention sessions, and
40% across all of the maintenance sessions.
Baseline data for Child C showed that he exhibited high levels of disruptive behavior with an average of 57.5%(range 60-55%).
Following the English activity class, a decrease in its percentage of disruptive behaviors to below the first baseline level was observed.
From the 5th session of the intervention, he showed a decrease in the disruptive behavior and showed an average of 41.82%(range 15-70%). This behavior change maintained the percentage of his reduced disruptive behaviors after the withdrawal of the English activity class.
His prosocial behaviors were also measured. He displayed prosocial behaviors in the baseline as results were in an average of 3.50%.
Since the English activity program was introduced, his prosocial behaviors displayed slight increase from the 5th session to the level of 10%. The average of prosocial behavior was 9.09%(range 0-20%) occurrence during the intervention. The behavior change maintained the percentage of his increased prosocial behaviors when the program was withdrawn.
In all, disruptive behavior alone averaged 57.50% occurrences at baseline, 41.82% during the intervention sessions, and 11.67% across the maintenance session, while prosocial behavior alone averaged 3.5% at baseline and 9.09% during the intervention sessions, and 23.33% across all of the maintenance sessions.
The figure shows that the intervention resulted in a reduction in disruptive behaviors while doing play activities with all the two children, and a increase in prosocial behavior. The changed level in both the target behaviors was remained in all the three children when the intervention was withdrawn.
2. Peer ratings
Two analyses were completed to obtain a better understanding of the peer's rating from the classmates in general education class in the baseline and the maintenance. The number of times each student
gave a “smiling face” rating(rating of 3 or the highest rating) to the subject was summed. Then, the summed number was divided by the number of classmates involved in the rating and a total score was calculated. Results of this analysis found that children rated, on average 31.6%(SD = 19.8).
또래 평가
0 20 40 60 80 100 1
2 3
4
5
6
7
8
9 10 12
13 14 15 16
17 18
19
20 Post
Pre
0 20 40 60 80 100 1
2 3
4
5
6
7
8
9 10 11 1 2 1 3 1 4 1 5 16
1 7 1 8
1 9 2 0
0 20 40 60 80 100 1
2 3
4
5
6
7
8
9 1 0 11 1 2 13 1 4 15 16
17 1 8
19 2 0
Child A Child B Child C
<Figure 3-2> Peer Rating Scores
Peer acceptance ratings for Child A increased from the pretest 28.74 to the posttest 72.26, suggesting that peers may have been more accepting of subjects following the intervention. Peer acceptance ratings for Child B increased from baseline 29.63 to post-treatment 66.32, suggesting that peers may have been more accepting of subjects following the intervention. For Child C, there was improvement of peer acceptance level from the pretest 28.53 to the posttest 68.37, suggesting that peers may have been more accepting of subjects following the intervention. Although this change was slight, it was in the preferred direction and is thus notable.
3. Social Validity
The teachers strongly agreed on each factor for the intervention as a classroom behavior management strategy. The teacher's mean rating was 96.3%(95 for Teacher A, 97 for Teacher B, and 97 for Teacher
C), indicative of strong satisfaction with the intervention.
Peers' satisfaction rating data revealed that peer satisfaction with the intervention was well above average with a mean of 4.90 on the 5-point Likert-type scale(4.7 mean rating was indicative of strong satisfaction with the intervention, Bray & Kehle, 1996). All the participants showed a high degree of satisfaction with and benefaction from the intervention, 5.0 for Peer A, 5.0 for Peer B, and 4.71 for Peer C.
. DISCUSSION
Ⅳ
This study examined the effects of the English activity program in an inclusive setting for helping children with autism spectrum disorders improve their prosocial behavior and decrease disruptive behavior. As the program was implemented, all the children showed behavior change in both prosocial behavior and disruptive behavior, though the level of change was different in each child(see Figure 3-1). Also, the peer rating was also improved in the level of acceptance and likeness by the general education classmates.
The findings suggest that such a procedure would be a valuable adjunct to prosocial skill training program for children with autism spectrum disorders in a general education environment. Such a program may be a cost-effective way to encourage social skills and widen the range of activities for children in any of inclusive educational settings.
Although the English activity program in an inclusive setting seems to have been successful in increasing prosocial behavior and reducing disruptive behavior in an inclusive setting, we need to address several limitations. First, observations did not rule out the possibility that the positive behavior changes may have resulted simply from learning to work with others in a group, not necessarily from the peer-group English activity program. The second limitation was that it is not clear which aspect of the program was responsible for changes of the subjects in the program. Several factors may be
responsible for the change. Natural reinforcement during free play after the structured English activity group may also have influenced the children's behavior. The toys in the fee-play room may have been an influential factor and helped to lessen the percentage of disruptive behavior and increase prosocial behavior. The other limitation was that data of benefits from participating in the study for the typically developing peers was not collected. There may have possibility that typically developing peers would acquire several social cognitive skills by interacting with children with autism spectrum disorders. Also, typically developing children may benefit from the English activity program in terms of improvement in leadership, interpersonal skills, and problem solving skills. Therefore, it will need to examine the benefits from the participation on the basis of systematically checked data such as peers' academic performance in English or other language, social cognition, their self-esteem, and so forth in order to verify its mutual benefit.
The inclusive English activity class may be an invaluable resource for school children who have deficit in social skills with peers in a general education class. It may be particularly useful when teachers need the voluntary participation of classmates to be peers for children with autism spectrum disorders. Considering the lack of opportunity for children with autism spectrum disorders to be fully included in the peer group at school, this approach may be promising as a way to provide socialization for children, not only in school but in other community-based programs like after-school and/or weekend program for young children.
This study raises several issues for further research. First, the study suggests a way to promote a school-based natural peer-group activity or any other cooperative programs in classroom both for children with special needs and for typically developing peers should be studied to develop a more concrete social acceptance program and curriculum. Second, it suggests invaluable procedures to enhance generalized effects across mutually benefited group programs warrant more attention. Third, it suggests that studies should be conducted on
the effects on peers as they participate in a peer-group activities or cooperative tasks for both children with special needs and typically developing children, such as effects on academic achievement, self-esteem, and attitude toward peers with deficit in social and communication skills. Fourth, it suggests that studies are needed on the participating children's emotional development for expanding a positive recognition of inclusion on the part of typically developing children.
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<Abstract>
Facilitating Positive Social Interactions through English Activity Class for Kindergarteners with
Autism Spectrum Disorders
Kim, Jeong il
This study examined the effect of the English activity program in an inclusive class to increase prosocial behaviors and to decrease maladaptive behaviors for kindergarteners with autism spectrum disorders. Three kindergarteners with autism spectrum disorders as subjects and six of typically developing peers as peer members participated in the study. A multiple baseline design across subjects was used. The intervention program consisted of a structured inclusive English class mediated by singing and dancing in English.
The results of the study showed that there was an increase in prosocial behavior and a decrease in maladaptive behavior with all the subjects. The level of peer acceptance by the classmates was also improved with all the subjects.
Key words: autism spectrum disorder, social sill, disruptive behavior, English class, inclusion, peer
