Affectively-Align & Culturally Aware ABA Notebook

(Subject: Measurement and Experimental Design – assignment #7)

1. Literature Review 

Research and Summarize: 

The leading behavior in focus is social inferencing— the ability to interpret nonverbal cues (tones, facial expressions, body language) to understand the implicit meaning in social interactions. This is a core challenge for individuals with autism spectrum disorder, often persisting into adulthood and impacting friendships and employment. 

Key Studies: 

• Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” Test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 242-251.  

Summary: This seminal study developed an objective measure of social inferencing by asking participants to identify complex mental states from photographs of just the eye region. Adults with Asperger’s or high-functioning autism scored significantly lower than neurotypical controls, proving robust evidence for a deficit in this specific skill. 

• Golan, O., & Baron-Cohen, S. (2006). Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology, 18(2), 591-617. 

Summary: This study tested an intervention using interactive multimedia to teach emotion recognition. The treatment group showed significant improvements in recognizing complex emotions in both trained and untrained stimuli, demonstrating that social inferencing skills are malleable and can be taught through structured, systematic instruction. 

• Laugeson, E.A., Frankel, F., Gantman, A., Dillon, A.R., & Mogil, C. (2012). Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program. Journal of Autism and Developmental Disorders, 42(6), 1025-1036. 

Summary: While focused on adolescents, the PEERS program is highly relevant. It uses didactic instruction, role-playing, and homework assignments to teach ecologically valid social skills, including interpreting social cues. Its demonstrated success provides a strong rationale for adapting its principles (like scripted responses and in-vivo practice) for an adult population. 

Current Understanding and Gaps: 

The current understanding is that deficits in social inferencing are a hallmark of ASD but are amenable to intervention. Effective interventions often involve: 

• Explicit Instruction: Breaking down abstract social concepts into concrete rules. 

• Structured Practice: Using role-play and scripts to rehearse responses. 

• Technology: Utilizing multimedia for engaging repeatable practice. 

Gaps in The Literature: 

1. Focus on Adults: Much of the research like PEERS focuses on children and adolescents, creating a gap in validated interventions for adults with ASD. 

2. Generalization: Many studies show improvement on trained tasks but fail to demonstrate robust generalization of skills to novel, naturalistic setting. 

3. Individualization: There is a need for more research on individualized interventions that can be tailored to specific workplace or social contexts for adults. 

2. Proposed Intervention 

Intervention Description: 

I propose the Contextualized Script Training for Inferential Reasoning (C-STIR) intervention. C-STIR involves creating individualized scripts for common, challenging social scenarios to teach appropriate inferential responses. It combines direct instruction, video modelling, and in-vivo practice with feedback. 

Rationale: 

This intervention directly addresses the gaps in the literature. It is designed for adults, and uses scripting, a technique supported by the success of programs like PEERS and Golan & Baron-Cohen’s multimedia approach (addressing gap 1 & 3).  

The focus on practicing in naturalistic contexts with feedback is specifically included to promote generalization (addressing gap 2). 

Implementation: 

1. Phase 1: Assessment & Script Development: Interview the participant (e.g., Rosenthal the hypothetical participant in my module 2 assignment) to identify 3-5 frequently misinterpreted scenarios (e.g., When one of his friends sighs during a conversation). Collaboratively write a script for each scenario, including: 

• The Cue: (e.g., Friend crosses arms and look away) 

• The Inference: (e.g., This might mean they are bored or disagree.) 

• The Scripted Response: (e.g., I notice you crossed your arm. Should I change the topic?) 

2. Phase 2: Direct Training & Rehearsal: Use video models to demonstrate both incorrect and correct examples. The participant rehearses the scripts through role-play with a clinician until they achieve 100% accuracy across two consecutive sessions. 

3. Phase 3: In-vivo Practice and Generalization: The participant is instructed to attempt the scripts in real-life interactions. A support person (e.g., friend, job coach) provides immediate, subtle feedback after the interaction using a predetermined signal. 

3. Experimental Plan 

Experimental Design Choice: A multiple baseline design across behaviors is the most appropriate choice. 

• Why: It allows for demonstration of experimental control without requiring withdrawal of treatment (which would be unethical and impractical for a learned skill.) We can implement the C-STIR intervention on one social scenario (e.g., responding to sarcasm) while keeping others in baseline, then stagger the introduction to the other scenarios. 

Participants: 

• Sample size: 3 adults with ASD (single-subject design emphasizes depth over breadth). 

• Selection Criteria: 1. Formal ASD diagnosis (Level 1), 2. IQ >70, 3. self-reported difficulty with social inferencing, 4. expressed motivation to improve social relationships. 

Procedure: 

• Baseline (A Phase): For 3-5 sessions, data is collected on all three targeted social behaviors (e.g., Response to sarcasm, response to disinterest, response to Nonverbal Cues) using the 5-min. Partial interval recording system from the previous plan. 

• Intervention (B Phase- Staggered): 

• C-STIR is implemented for Behavior 1 (sarcasm). Behavior 2 and 3 stays in baseline. 

• Once Behavior 1 shows a stable, accelerating trend for 3 sessions, C-STIR is implemented for Behavior 2 (disinterest). 

• Once Behavior 2 shows a similar trend, C-STIR is implemented for Behavior 3 (nonverbal cues). 

• Data Collection: A naive observer collects data during unstructured social gatherings 3 times per week. 

Data Analysis:  

The primary BCBA supervisor for the study will be responsible for all data analysis. This will ensure consistency in the interpretation of data. 

Data will be analyzed through visual analysis of the graphed data across phases. 

• Primary Variables: Level, trend, and variability within and across phases. 

• Demonstration of Effect: A functional relationship is demonstrated if each behavior only changes when (and only when) the intervention is applied to it, and not while it is still in baseline. 

• Effect size: Percentages of Non-overlapping Data can be calculated for each behavior to supplement visual analysis. 

Ethical Considerations: 

• Informed Consent: The process will be tailored for adults with ASD, using clear, concrete language to ensure full understanding of their role, the potential risks (frustration, anxiety), and benefits. 

• Confidentiality: All data will be anonymised. Videos used for training will be stored on encrypted devices and destroyed after the study. 

• Beneficence: The intervention includes a built-in support system to minimize distress. Participants will be reminded that withdrawal is possible at any time without penalty. 

• Social Validity: At the end of the study, participants and their peers will complete a questionnaire to assess whether the changes in behavior were meaningful and improved their social quality of life. 

Conclusion: 

This proposal outlines a comprehensive and ethically sound plan to address a critical gap in the applied literature: The development of effective social inferencing interventions for adults with ASD. By integrating evidence-based practices—such as scripting (Laugeson et., 2012; Wong et al., 2015) and video modeling (Golan & Baron-Cohen, 2006) into the novel Contextualized Script Training for Inferential Reasoning (C-STIR) protocol, this study prioritizes not only skill acquisition but also generalization to naturalistic settings. 

The Experimental design, a multiple baseline across behaviors, provides a rigorous methodological framework for evaluating the intervention’s efficacy while adhering to ethical best practices by avoiding treatment withdrawal. The proposed data analysis plan, overseen by a BCBA supervisor, will allow for a clear, visual determination of functional relationship between the intervention and changes in target behaviors. 

If effective, the C-STIR intervention would represent a meaningful contribution to the fields of ABA and OBM, offering a practical, person-centered tool for supporting neurodivergent adults in navigating the complex social demands of workplace and community integration. Future research could focus on implementing C-STIR within actual organizational settings and measuring its impact on broader outcomes such as employment retention and quality of life.  

Here’s an answer to the feedback I receive from my Professor:

For measuring—Instead of PIR, I could use a trial-by-trial method and track the “percentage of correct responses”? So, say for each of 10 short videos scenarios, I’d record if participant’s answer was right or wrong, and then just calculate a percentage at the end. And event recording to count frequency of participant correctly uses a social inference during a conversation. Yes, this would work. 

Before starting, I’d do a quick check to see if it’s a ‘can’t do’ (skill deficit) or a ‘won’t do’ (performance deficit) problem. For example, If I give him a hint and he suddenly gets it right, it’s probably more about motivation. If he still doesn’t get, it’s a skill issue. Correct. 

For motivation I could include a simple reward system, like tokens for correct answers that he could trade for something he likes (one game of D & D). Could this help create that ‘contrived motivation” to get him started? You would contrive the motivation by depriving the student of a preferred item/reinforcer and then capture that motivation by using that to evoke the behavior you want to see. )

References: 

Baron-Cohen S, Wheelwright S, Hill J, Raste Y, Plumb I. The “Reading the Mind in the Eyes” Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. J Child Psychol Psychiatry. 2001 Feb;42(2):241-51. PMID: 11280420. 

GOLAN O, BARON-COHEN S. Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology. 2006;18(2):591-617. doi:10.1017/S0954579406060305 

Laugeson, E.A., Frankel, F., Gantman, A. et al. Evidence-Based Social Skills Training for Adolescents with Autism Spectrum Disorders: The UCLA PEERS Program. J Autism Dev Disord 42, 1025–1036 (2012). https://doi.org/10.1007/s10803-011-1339-1 

Wong, C., Odom, S.L., Hume, K.A. et al. Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review. J Autism Dev Disord 45, 1951–1966 (2015). https://doi.org/10.1007/s10803-014-2351-z 

Spain D, Blainey SH. Group social skills interventions for adults with high-functioning autism spectrum disorders: A systematic review. Autism. 2015 Oct;19(7):874-86. doi: 10.1177/1362361315587659. Epub 2015 Jun 4. PMID: 26045543.