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Conversation Skills For Socially Isolated Children
Conversation Skills For Socially Isolated Children
behaviour
had ceased and his washing. dressing and toilet behaviours
were within normal limits. His weekend
behaviour
followed a similar pattern and was within the normal range by the fourth treatment
weekend. The
patient also gradual11 increased his degree of social and other leisure activities during the weekends at home.
He was discharged
and returned to full-time employment
at the beginning of the seventh week. Follow-ups
at
3- and 6-months
indicated
that improvement
had been maintained
and that a further increase in social
activities had taken place. This patient was highly motivated to reduce his ritualistic behaviour
and attributed
his success to the importance
of receiving the reinforcement.
Thus. while a complete reversal design was not possible in this study. the results are quite suggestive and
support the use of response prevention.
as recommended
by Meyer PI ul. (1974). and the suggestions
made by
Rachman (1971 I concerning
the use of reinforcement
withdrawal
together with the use of comfort and reassurance as reinforcers contingent
upon desirable behaviour.
The motivation
and cooperation
of both patient and
his wife were significant factors in treatment
success. Finally. the concurrent
home and hospital treatment
was
probably instrumental
in preventing
a relapse
Arkrfowledgotletlts-The
co-operation
of Mrs Pam Hopkins and Mr John Cook is gratefully
carrymg-out
the ward programme
and communicating
the needs of the programme
to other
acknowledged
staff.
in
REFERENCES
CAUTELA .I. R. (1967) Covert sensitization.
Ps.~cho/. Rat. 20, 459-468.
A. and MCLEAN C. (1975) A comparison
of flooding and thought-stopping
in the
obsessional
neurosis. Behor. Res. Ther. 13, 263-269.
KENNY F. T.. SOLYOM L. and S~LYOM C. (1973) Faradic disruption
of obsessive ideation in the
obsessive neurosis. B&rr.
Thrr. 4. 448-457.
MEYER V.. LCVY R. and STHN~XER A. (1974) The behavioural
treatment
of obsessive-compulsive
Ohsrssionul Srms (Edited by H. R. BEECH). Methuen.
London.
RA(.HMAK S. (I 97 1I Obsessional
ruminations.
Behur. Res. Ther. 9, 229-235.
RA(.HMAN S. (1976) The modification
of obsessions. Be/m-. Res. Ther. 14, 437443.
ROPER G.. RA~HMAK S. and MARKS 1. (1975) Passive and participant
modeling
in exposure
obsessive-compulsive
neurotics. Brltur. Res. Ther. 13, 271-279.
STERY R. S. (1978) Obsessive thoughts:
The problem of therapy. Br. J. Psychiar. 132, 200-205.
HACKMANN
treatment
of
treatment
of
disorders.
In
treatment
of
0005.7%7180/0501-0217SO2.00/0
(Rewired
5 June
1979)
Summary-A
social skills training program consisting of instructions,
modeling, behavior rehearsal. performance
feedback. and programmed
generalization
set was used to teach conversational
behavior to four sociall) isolated children. Effects of training were assessed in a multiple-baseline
analysis across behavior. Subjects were selected on the basis of peer sociometric
ratings. a behavioral role-playing
task. naturalistic
observation.
and teacher ratings. All subjects demonstrated
noticeable Improvement
in the target behavior as well as in overall conversational
ability. How* This article is based on Mark Whitehills masters thesis, conducted
under the direction of the second and
third authors. and submitted to the Graduate
Faculty of Arts and Sciences, University of Pittsburgh,
in partial
fulfillment of the requirements
for the Master of Science degree. Reprints may be obtained from either Michel
Hersen. Department
of Psychiatry,
Western Psychiatric
Institute and Clinic, University of Pittsburgh
School of
Medicine. Pittsburgh.
PA 15261, U.S.A. or Alan S. Bellack. Clinical Psychology
Center. University
of Pittsburgh. Pittsburgh.
PA 15260. U.S.A.
IX
CA9
Suhjvcrs
Socially isolated children ranging m age from 8 to IOyr were recruited from the Falk Elementary
School of
the University of Pittsburgh
following a four-fold screening procedure.
Firsr. three sociometric
questionnaires
(positive peer nomination,
negative peer nomination.
and the roster and rating methods) were administered
to
all classes in the 8-l I yr age range (total IV = 95) in order to identify peer rated child isolates. Children who
received less than three positive nominations.
less than five negative nominations.
and a roster and ratmg
average of less than 3.0 were selected for further screening. Twenty-three
children qualified as isolated on the
sociometric
measures.
Second. the 23 sociometrically
identified tsolates were subjected to a behavioral
role-playmg
test m order to
assess conversational
skill. Of these 23. eight met the criteria of at least three deficient conversational
skills (e.g.
few or no open-ended
questions).
7hird. head teachers were asked to fill out an abbreviated
form of the Conners Teachers Questionnatre
for
16 children. Five of the eight children identified through the first two screening methods were rated by teachers
as experiencing
some difficulties in group activities.
Fourrlt. two classroom
observers rated the free-play activity of each of the eight children who qualified on
sociometric
and behavioral
measures. Of these eight, five were observed as spending a disproportionately
large
amount of time alone during free-play as compared
with non-isolated
children.
Final eligibility for the study was determined
by comparing
the naturalistic
classroom
data with teacher
ratings, Four of the five identified isolates on the classroom
measure were rated by teachers as experiencmg
difficulties in group activities. These four children were selected for the study; all received conversation
skills
training.
Joan was a IO-yr-old. white. female third grader whose teacher described her as aloof. impersonal
and overly
protective of personal belongings. She was described as snobbish and impulsive, and had few friends. Her IQ.
was I36 on the Stanford-Binet.
Jolni was an 8-yr-old. black, third grade male who was described as being extremely quiet. with few friends.
Additionally,
he was said to be cooperative
in his attitude toward authority,
and easily led in group activities.
His Stanford-Binet
IQ. score was 100.
Bvth was a 9-yr-old, white, female third grader who was described by her teacher as withdrawn
and isolated.
having few friends. She was also described as submissive in her attitude toward authority.
She obtained an IQ.
of I17 on the Stanford-Binet.
Grey was a 9-yr-old. white, male third grader who was described
by his teacher as neither accepted
nor
rejected by peers. He was also described
as overly sensitive and said to cry often and easily. and to be
quarrelsome.
His I.Q. was I I1 on the Stanford-Binet.
Experimental
.srttirly
Behavtoral assessments
and training sessions were conducted
in a videotape studio that included three chairs
arranged
in a triangle to accommodate
the subject and two role-models
(male and female undergraduate
(ASI
HIST0RII.S
219
Behavioral
assessment
The Conversation
Probe served as the major dependent
measure for the present study. It consists of four,
common
interpersonal
situations
which present the child with the possibility
to meet someone,
to begin
conversation,
and to maintain conversation
for a specified time period. Two of the scenes involve a same-sex
partner and two involve an opposite-sex
partner. An attempt was made to include situations
that subjects were
likely to encounter
with other children at school. Similarity between scenes and typical daily encounters
was
expected to facilitate the subjects ability to respond as they might in the natural environment.
Two of the
scenes were used as training items for all subjects. The remaining
comprised
the generalization
scenes. Listed
below are the four scenes of the Conversation
Probe.
Training
scenes
Male model:
You are asked by the teacher (childs name). to work on a puzzle with several of your
classmates.
none of whom you know well. As the kids are coming together, you realize
that you have never worked closely with any of them before, especially that one boy in the
back of the room who seems to be looking in your direction..
Female
model:
Generakatiotl
scenes
There is a new boy in your class (childs name), and this is his first day at school.
not know anyone and looks lonely. You wish he felt happier. He sits down near
looks at you
Male model:
Female
model
He does
you and
It is lunch time (childs name), and there are not many seats available in the cafeteria. You
finally find one next to the girl you have wanted to meet for several weeks. As you
approach
the one empty seat. she looks up at you..
to read a
you might
would like
be playing
until I tell
Now. I realize that Cindy and Doug are not really your classmates,
and that you are not really in the
situatton I will describe. However. I would like you to imagine yourself in the situation as closely as possible,
and imagine that Cindy and Doug really are your classmates.
Do you think you can do that?
One more thing. In all cases you are to have a conversation
with either Cindy or Doug, but nor with both qf
them. And please remember
to contmue the conversation
until I tell you to stop. OK?
Lets try this practice
scene:
You are havmg difficulty with math these days (childs name), and would like to ask one of your classmates
for help. One day. while m line for lunch. you notice that you are standing in front of Sally. the class math
whiz.
Following the practice scene. probe sessions were conducted
as follows: (I) the narrator
read a description
of
a conversation:
(2) the subject began conversation
with one of the role-models;
(3) the role-model
responded
in
a way to facilitate a conversation:
(4) after 1 min the conversation
was stopped. Subjects responses to all four
Conversation
Probe scenes were videotaped three times per week for 3 weeks. Retrospective
ratings were made
for three components
of conversational
skill. two accessory components,
and for overall conversational
ability.
Srlection
hehauors
A behavioral
analysis of the SUbJCCtS responses was conducted
to establish which components
of behavior
appeared at a disproportionately
low frequency. To be considered
deficient, a behavior had to be consistently
rated as low across all three pre-treatment
admmistrations
of the Conversation
Probe. By the conclusion
of the
assessment phase. three deficient behavior targets had been identified for each subject. The definitions of target
behavior selected for modification.
are listed.
srarements. Any bit of information
that the subject conveys about himself or his environment.
Each bit IS considered
one piece of information
if it does not serve to qualify (or explain) a previous bit.
More than one bit may be observed in a given sentence. A subjects mean number of informative
statements
per scene is the numerical
average of the number of bits counted in both scenes (for both training and
generalization
scenes).
It!formarire
20
CASt
HISTORIES
ASV
SH0RTl.R
COMMLY\i,C,AT,ONS
Opewrrtded
yuesrrons. A question is considered
open-ended
if: (I) it can not be answered
does not have a single answer (e.g. Whats your name?); (3) it allows the respondent
answers. Open-minded
questions are scored as are informative
statements.
Requesrs,fbr shared actiaity. A request refers to the subject either explicitly asking for or Implying a desire for
some degree of cooperative
activity between him and the role-model.
These are readily countable
and are
scored as are the aforementioned
behaviors.
In addition
characteristics.
to the targeted
behavior
listed above.
concurrent
data
were collected
on two additional
speech
cotlversariotral
speaks
throughout
the conversation.
abilir)
awkward
Bornstein
sounding.
unnatural.
and
et al.s (1977) use of overall
5 indicating
assertiveness
judges unfamiliar
with purposes of the study. rated the
A subjective
5-point scale was used. with I indicating
very fluent. These global judgments
were adapted
from
judgments.
Classroort~ obserrarim.
Two undergraduate
research assistants observed free-play activity of selected children
prior to training,
at each weekly training
interval (between behavior).
and at 4- and R-week follow-ups.
Approximately
50min of observation
data per child were gathered
during each observation
period. which
usually extended over 2-3 days due to the limited amount of free-play activity per day.
Several types of interactional
behavior
were rated on a dichotomous
occurrencenonoccurrence
basis for
each 30-set interval; only time spent alone was calculated
as a dependent
measure. (Other types of behavior
were Included to keep the observers blind as to the target behavior of interest.)
Sociorwrric
admirtistrarion.
In addition
to serving as a means of subject selection. the three sociometric
and the roster and ratmg method)
were
measures
(positive peer nomination.
negative
peer nomination.
readmimstered
to the subjects classes subsequent
to tramrng, and at 4- and 8-week follow-up periods. This was
done to determine whether skills training influenced subjects peer status in the classroom.
At each administration. the following measures
were calculated:
(I) number of positive nominations
received: (2) number
of
negative nominations
received; and (3) roster and rating average (average peer rating received. with I indicating
does not like to play or work with given child. and 5 indicating likes very much to play or work with given
child).
Teacher ratirlgs. Classroom
teachers were asked to re-rate each child at the completion
of trainmg. and at 4and S-week follow-up intervals. Of the 39 behavior categories
the teachers were asked to rate (on a four-point
scale ranging from 1 = not at all to 4 = very much). only three were considered
relevant to the present study:
Isolates himself from others. Appears to be easily led. and Appears to be unaccepted
by group. Again. the
presence of additional
behavioral
categories
was arranged
to keep teachers as blind as possible to the target
behavior of interest.
Reliahilit~~
o/ heharioral
measures
Inter-rater
agreement
was evaluated during all experimental
phases for all of the videotaped
probe sessions
and for one third of the classroom observation
intervals. Pearson product-moment
correlations
were calculated
for ratings of total speech duration
and overall conversational
ability. Percentage
of agreement
between raters
was established
for ratings of informative
statements. open-ended
questlons, requests for shared activity. pauses.
and time spent alone in the classroom (see following section). To obviate the possibility of an inflated estimate
of agreement
due to agreements
on the nonoccurrence
of the behavior. percentage
agreement
was also calculated for iristances where only occurrence
of the behavior
was recorded.
Percentage
agreement
was again
obtained by dividing total number of agreements
by total number of agreements
plus total number of dlsagreements multiplied by 100.
Procedure
Brharioral
trauliug.
Following
baseline assessment,
all subjects received three weeks of conversation
skills
training consisting
of three 2&30 min sessions per week. As in Bornstein
er cl/. (1977). training was applied
sequenttally
and cumulatively
to the three behavior targets over the 3-week period in a multiple baseline design
across behavior.
Specifically.
during the first week. Beth and Greg received training
in making informative
statements.
while Joan and John were taught how to ask open-ended
questions.
In the second week, Beth and
Greg were taught how to ask open-ended
questions,
while Joan and John were trained on informative
statements. In the third week. training for all subjects focused on increasing
the number of requests for shared
activity.
Throughout
treatment,
two of the items from the Conversation
Probe served as training scenes: the remaming two scenes were used to assess generalization
from trained to untrained
scenes (for all subjects). Conversation skills training specifically involved the followmg: (I) the therapist presented one of the situations
of the
Conversation
Probe, then the subject was instructed
to converse with the role-model;
(2) after 3Osec (i.e.
CASL HISTORIES
AND
SHORTER
221
COMMUNICATIONS
one-half of the alloted time), the therapist stopped the conversation and provided the subject with feedback on
his/her performance. with specific reference to the targeted behavior; (3) the therapist discussed the target
behavior with the subject, stressing its importance to satisfactory conversations; (4) the second role-model (who
was not involved in that particular conversation) enacted the part of the subject and engaged in the same
conversation with the first role-model. During this Ye-enactment, role-models, working from predetermined.
memorized scripts. engaged in conversation specifically illustrating the targeted behavior; (5) after the targeted
behavior had been modeled on three occasions, the therapist stopped the conversation and repeated instructions: (6) the subject then was asked to begin the same conversation to determine if the targeted behavior was
emitted at a higher rate; (7) rehearsal continued until the therapist felt the criterion for the targeted behavior
had been reached (two examples within a 30-see period). Training then advanced to the second half of the
conversation; as indicated above, models worked from memorized scripts and evidenced three additional
examples of the targeted behavior. The subject was asked to rehearse the second half of the conversation until
he/she evidenced at least two more examples of the target behavior; (9) once this criterion level was attained,
the therapist moved on to the next training scene.
At the end of each probe administration, the subject was given a specific instructional set in an attempt to
facilitate transfer of training to the classroom. The instructional set incorporated the following aspects: (I)
recapitulation-the
therapist summarized what was said earlier in the session concerning the importance of the
target behavior to rewarding conversations; (2) encouragement-positive
feedback was offered to the subject for
his/her performance; it was emphasized that the new behavior should be practiced whenever the subject
becomes involved in conversation; and (3) questioning-the
subject was asked whether there was any aspect of
the session that was unclear or poorly explained.
After completion of training, all subjects were followed-up at 4- and 8-week intervals.
RESULTS
Inter-rater reliability and percentage agreement for all dependent measures are presented in Table I. Examination of the table indicates that inter-rater reliability and percentage agreement are quite high. This is attributed to the precision of definitions and the extensive training given to the independent raters.
Conversation probe data for Joan and John (averages) are presented in Fig. 1. Data points represent averages
across all scenes for each probe session. The sequential introduction of treatment for open-ended questions,
informative statements, and requests for shared activity resulted in considerable increases over baseline levels
for both training and generalization scenes. The specific changes generally were obtained without corresponding changes in untreated baselines. Also, independent ratings of overall conversational ability improved as the
three behavior targets were treated in succession. Four and eight week follow-up probe sessions indicated
maintenance of treatment gains.
Conversation probe data for Beth and Greg (presented in Fig. 2) are similar to those presented in Fig. I.
However. treatment effects are a bit weaker. with some loss of durability seen in the 4- and 8-week follow-up
probes.
Concurrent data for untreated behavior (pauses, total speech duration) appear in Fig. 3 (averaged for all four
subjects). Examination of these data indicates marked improvements over baseline levels that were maintained
throughout both follow-up probes.
Classroom observation data are graphically portrayed in Fig. 4. These data show that during treatment the
percentage time alone during free play activities decreased substantially for the four subjects. However. there
was some loss of the treatment effect by the 8-week follow-up session.
Finally. sociometric and teacher ratings are presented in Table 2. There seems to be minimal change with
respect to the sociometric ratings. Similarly, minor improvement is indicated in the teacher ratings for categories 2 and 3.
DISCUSSION
The results of this multiple baseline analysis indicate that conversation skills training led to improvement in
component behavior and in overall conversational ability for all four subjects. Treatment effectively enhanced
I Inter-rarer
Table
reliability and percentage agreement lor dependent
measures durmg hascbne. tr?mmg hollow-ups for trainmg and gcnerahza.
t!on scenes 01 the convcrw~~on prohe. and ior Classroom ohservatlon
data.
suhwts
avcraee
ofall
PCXSOn
MCLiSUrCS
CPtCgOrlCS
Agreement
COWCrSilbOn
probe sccncs
In1 Stmt.
Op.
96 IO +
90D 10):
Xl.. t0 +
95:, 101
87. (0 +
93,, IO)
85 (0 +
91,101
Ed Qu
Requests
PWSCS
Classroom ohs
data
NV
N)
N)
NI
0.95
0.97
94, (0 + N)
93., 101
l Both rralnlne
and ~cneraluauon sccncs were analyzed together
+ IO + Nk relcrs to occ~rr~nccs plus nonoccurrences of hehawor
: (01 rckrs lo occurrcnccs ol hchawor
CASt HISTORIES
AND
SHORTER
COMMC
ClC4TIOYS
I
I
I
3
i&E
sEs9w
I
n
t
*-
WEEKS
P&8E-
1
7
1
9
aWEB
for tratning
Fig. 2. Probe sessions during baseline. conversation
skills traming. and follow-ups
and generalization
scenes averaged for Beth and Greg. A multiple baseline analysis of: inforniative statements.
open-ended
questions.
requests for shared acttvtty. and overall conversational
ability.
CA.51 HIST0KII.S
TRAINING
11
PROBE SESSIONS
Fig. 3. Probe
sessions
behaviors
GENERALIZATICW
SCBES
I
I
I
I
I
111
I 3 5
223
SCENES
I
I
I
,
I
I
0
4- aWEEKS
1 3
5
7
9
PROBE sEssioNs
4-
R-
WEEKS
performance
in the components
of conversational
skill that had been identified as deficient (i.e. open-ended
questions. informative
statements,
and requests for shared activity). Multiple-baseline
analyses indicated
that
the different types of targeted behavior were predominantly
independent.
and that changes from baseline levels
were observed only when training was directed to a specific behavior. Thus. the sequential
and cumulative
effects of treatment were documented.
Gains due to treatment generalized
to untrained
scenes. with changes in
both treated and untreated
conversations
persisting at the 4- and 8-week follow-up evaluations.
Concurrent
indicators
of subjects improved conversational
skills were evidenced by increased speech duration
and fewer
pauses per scene
CLASSROOM
OBSERVATION DATA
60
0
I
aroba
Fig. 4. Probe sessions
Sauions
4-
aWooks
224
(ASI-
HISTORII-S
ANI)
SH0RTI.R
COMMI
llC4TIOLS
B. WHITEHILL
MICHEL HERSEN
ALAN S. BELLACX
University o/~Pittshurgh
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PANEPINTO R. A. (1976) Social skills training for verbally aggressive children. Unpublished
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