Stories in Motion: A Pilot Study of a Social Visualization and Progress Monitoring Program for Elementary School Students with High Functioning Autism

Background: Effective treatments for children with high functioning ASD (HFA) are needed to address the significant social impairments that interfere with their social and peer interactions. Visualization tools such as social stories are frequently used, widely accepted, and theoretically well grounded, but have shown inconsistent empirical support. Computer-based platforms can address this issue by standardizing implementation and enhancing treatment effectiveness. However, most computer-based visualization programs targeted to individuals with ASD have not attempted to establish an evidence-base.

Objectives: To develop and test an interactive social visualization and progress monitoring program for elementary students with HFA. With easy integration into classroom environments, Stories in Motion (SiM) has been developed to enhance social skills in students with HFA and document progress toward measurable social goals.

Methods: A pilot study was conducted to examine feasibility of SiM implementation, usability in its intended educational setting, and to gather preliminary efficacy data. Participants included 31 triads of students with HFA, service providers, and general education teachers, randomly assigned to participate in either SiM (n=17) or Services as Usual (SAU; n=14). Based on provider rankings of 12 social target areas, students and providers in both conditions completed the 6 target area topics most relevant for the given student. SiM students engaged with the software to create a personalized story (including animated video, comic strip, and highlights card) to be reviewed throughout the week. Data sources included pre/post measures of student global social functioning/behavior, topic knowledge, provider/student ratings of student confidence and frequency of skill performance.

Results: Pre-, post-, and follow-up knowledge quizzes for each target area were examined (McNemar’s test, test for the equality of two proportions). SiM students showed significant pre-/post knowledge gains for coping, impulse control, and transitioning (improvement = .68, .85, .80, p < .05), and long term gains (pre- to follow-up) for anxiety, coping, non-verbal communication, and transitioning (improvement = .76, .78, .9, .73, p < .05). SiM students showed significant pre-/post knowledge change for impulse control (Improvement = .83, p < .05), and long term gains in conversation, non-verbal communication, sportsmanship, and impulse control topic areas (improvement = .77, .8, .88, .79, p < .05). SiM and SAU were significantly different for the bullying and transition topics, during the pretest-posttest interval (p < .05). Pretest-follow-up interval results for coping suggest SiM is more effective at increasing knowledge in the long term than SAU (.78 vs .56 improvement, p = .061).

Pre/post provider ratings on the Social Responsiveness Scale (SRS, Constantino & Gruber, 2005) showed a reduction in social cognition problems for both groups (b = -2.85, p < .05). The SiM condition was effective in reducing problems in social motivation, while the SAU was not (b= -5.308, p < 0.05).

Conclusions: These data provide preliminary evidence for the effectiveness of SiM for increasing student social skill knowledge. These findings are particularly strong given our small sample size and the briefness of the intervention period.  Additionally, provider and student usability data support utility of the program in educational settings.