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Social Stories

A Social Story can be a written or visual guide describing various social interactions, situations, behaviours, skills or concepts and were first described by Gray and Garand in 1993. They are proposed to work for children with autism due to “theory of mind” and/or “weak central coherence”.

UPDATED:
December 8th, 2022
BY THE TEAM
“Social stories were developed in order to support individuals with autism to better cope with social situations." - Ali and Frederickson (2006, p. 355)

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What is a Social Story?

A Social Story can be a written or visual guide describing various social interactions, situations, behaviours, skills or concepts and were introduced and described by Gray and Garand (1993).

According to Gray (2010) ‘a Social Story describes a situation, skill, or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format. The goal of a Social Story is to share accurate social information in a patient and reassuring manner that is easily understood by its audience.’

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Although they are a very common intervention option for children, there remains a call for more research into the effectiveness of social stories (Reynhout & Carter, 2009).

This is because authors who have reviewed the evidence base have generally come to the same conclusions, that there remains a lack of clear evidence attesting to the specific factors leading to the success or failure of social story interventions (Reynhout & Carter, 2006; Kokina & Kern, 2010).

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Why Might Social Stories Work?

Social Stories and Theory of Mind

Social stories may help children with autism because of the hypothesis that individuals with autism lack a “theory of mind” (Baron-Cohen, Leslie, & Frith, 1985; Frith & Frith, 2003). It is proposed that having a theory of mind allows us to understand another person’s perspectives, desires and beliefs.

Having a theory of mind is a bit like being able to say you're able to “put yourself in another person’s shoes”. A test called the Sally Anne Test has been used to investigate this with children with autism.

According to Tager-Flusberg (2007, p. 311) ‘daily social life depends on the ability to evaluate the behaviour of other people on the basis of their mental states, such as their goals, emotions, and beliefs [which] is accomplished by dedicated cognitive systems, collectively referred to as theory of mind.’

Through lacking a theory of mind, social interaction for individuals with autism may be difficult, confusing and unpredictable. A Social Story might then be used to explain social situations in terms of what another person might be thinking and/or why they may behave in certain ways; thus reducing or removing the confusion and unpredictability (Ali & Frederickson, 2006).

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Social Stories and Weak Central Coherence

Another reason social stories may work for children with autism is the proposed theory that individuals with autism have a “Weak Central Coherence” (Happe, 2005). A “strong” or “typical” central coherence ‘refers to the tendency to integrate information in context for higher level meaning’ (Booth & Happé, 2010, p. 378).

In other words, we typically take information in as a whole without focusing on each and every specific detail. For example, when we look at a car we tend to take in the fact that it is a car first before even considering any specific details about it (e.g. model/make, alloys, tinted windows, badge etc.).

Having a “weak” central coherence suggests that instead of understanding the “whole” children with ASD focus on the details and have more difficulty processing the whole. Relating this to social situations ‘some individuals with ASD may pay attention to irrelevant details and fail to understand the meaning of those situations’ (Kokina & Kern, 2010, p. 813).

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Creating Social Stories: Sentence Types

Ali and Frederickson (2006, p. 358) describe four basic sentences that are used within Social Story construction. These include:

  • Descriptive Sentences: these are truthful, opinion-and-assumption-free statements of fact…e.g. “most children go to the park to play”.
  • Perspective Sentences: these are statements that refer to or describe an individual’s internal state, their thoughts, feelings, beliefs, or physical condition…e.g. “my teacher likes maths”.
  • Directive Sentences: these describe desired responses to social situations.
  • Affirmative Sentences: these often express a commonly shared value or opinion within a given culture…e.g. “I will try to keep my seatbelt on (this is very important)”.
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Reynhout and Carter (2011, p. 368) also describe two other sentences used for creating a Social Story:

  • Cooperative Sentences: identify "who" can assist the individual in a situation.
  • Control Sentences: use analogies to explain situations.
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According to Kuoch and Mirenda (2003, p.220), 'control sentences, which are unique in that they are written by the focus individual with assistance as needed), identify strategies that the person can use to recall the social story at an appropriate time and place'.

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Are the Guidelines being Followed?

According to Ali and Frederickson (2006) there have been considerable changes to the guidelines for social story creation first put forward by Gray and Garand (1993). Reynhout and Carter (2009, p. 248) state these changes ‘occurred with very little, if any, theoretical rationale or research-based evidence driving [them], and this may be [a] source of confusion for practitioners’.

Originally, advice was given against the use of illustrations because they may lead the child to interpret them incorrectly (Gray & Garand, 1993). However, this advice has since been reversed and it is now recommended that illustrations are used with written text (Reynhout & Carter, 2009).

Reynhout and Carter (2009) found that when comparing the social stories created by teachers to the guidelines put forward by Gray (2000), only one-in-five could be classed as a ‘‘basic’’ Social Story and not one could be classed as a ‘‘complete’’ Social Story.

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Although they did not meet Gray’s criteria, the teachers rated 51% of the stories as “very effective”, 47% as “somewhat effective” and just 3% as “ineffective”. It should be noted that only half of these teachers actually recorded any data before, during or after the interventions and therefore their ratings of effectiveness are subjective.

This lack of adherence to Gray’s guidelines was also found in an earlier review by Reynhout and Carter (2006), with the authors suggesting that the changes in the Social Story construction guidelines may be leading those implementing the stories to create them as they see fit.

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Teacher's Ratings of Social Story Effectiveness from Reynhout and Carter's 2009 study.
Teacher's Ratings of Social Story Effectiveness.

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Social Stories and Supplementary Tactics

Social stories are frequently used with other tactics; for example, imitation, prompting, priming and positive reinforcement. These tactics are often used to "supplement" the story and increase its effectiveness.

As an example, Chan and O’Reilly (2008) implemented a Social Story intervention for two boys with autism in an inclusive classroom. For simplicity we will use the information from just one boy, Matt, who was 6 years old. During “circle-time” in school Matt would:

  • sit in a way that would cause his peers to have to lean or move away from him.
  • not raise his hand when the class were asked questions.
  • make inappropriate noises and comments.

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One social story was created for each of the three behaviours and each was read by Matt in the mornings just before school .

They used three steps:

  • allow Matt to read each story
  • get Matt to answer questions on them
  • act out the behaviours through role plays

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Matt would read the story out loud and would then answer questions such as “What can I try to do when my teacher asks questions?” The questions were pre-written but the instructor could come up with new ones on the spot. If Matt couldn’t answer the question he was prompted to read the section related to the answer again.

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For the role plays, the instructor would play the teacher’s role by reading a passage from a book and asking questions about it. Another adult would sometimes act as a student and sit listening to the teacher (research instructor) and only raise their hand when a question was asked (modelling tactic). If Matt had any difficulty, verbal prompts were used and he was given praise whenever he got any step correct.

The intervention lasted for 5 weeks and included 13 sessions in total. Each of these sessions occurred prior to the start of the school day and lasted between 10-20 minutes.

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The authors concluded their study stating that ‘for Matt, introduction of the Social Stories intervention package resulted in (a) an immediate decrease in inappropriate social interaction behaviour, (b) a progressive increase in hand raising, and (c) a reduction of his inappropriate vocalisations’ (Chan & O’Reilly, 2008, p. 407).

Note that this study implemented a social story “package” and not social stories in isolation. The questions and modelling through role play may have contributed to the effectiveness of this intervention.

Due to copyright restrictions we cannot reproduce the graphs used to display the data recorded on Matt’s progress, however the graphs can be viewed freely in the published article itself at the Journal of Applied Behaviour Analysis online article access via PubMed Central (click here to read Chan & O’Reilly’s article).

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References

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