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Developing Self-Reflection: A Novel Social Skills Intervention Using First-Person Video Recording Eyeglasses
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by profound and lifelong impairments in social relationships and communication. Social-communication deficits are important targets for intervention because proficiency is critical for successful functioning within society.
Objectives:
This study takes a novel approach to social skills development by improving participants’ ability to self-reflect. In this context, self-reflection is the capacity to think about one’s own behavior during social interactions and consider whether it was appropriate. Using first-person-perspective video recordings as a tool, participants with autism learned to reflect upon their conversational behavior, learn from their mistakes and successes, and improve future social interactions.
Methods:
Participants: Four adolescent males with autism (diagnosis confirmed by ADOS-2), ages 12-16 years-old, with average IQs (as measured by WISC-V) and fluent spoken language, participated in this study.
Study design: Single-case design; multiple-baseline across participants, replicated across four individuals.
Measures: The following measures were administered to all participants and/or their parent. ADOS-2, WISC-V, Autism Social Skills Profile (ASSP-II), Social Responsiveness Scale (SRS-2), Social Skills Improvement System (SSIS), Self Reflection and Insight Scale (SRIS), a social validity questionnaire.
Intervention approach: Each session consisted of a 10-minute, unstructured, naturalistic conversation between the participant with ASD and an interventionist (i.e. a trained school psychology doctoral student or a principal investigator). Both members wore first-person, video capture eyeglasses that recorded the conversation from their viewpoint. Baseline sessions involved a 10-minute conversation (nothing else). Intervention sessions involved a conversation and then the participant was asked to, “Think back about how the conversation went.” Video clips were viewed so the participant could see himself from the outside (e.g. the expression on his face, the gaze of his eyes, the topics he brought up) and the interventionist (e.g. to see the puzzled look or smile on her face). Sometimes, clips showed the table or floor because the participant had looked down during much of the conversation. Participants identified moments of conversational strength and imperfection.
Videos of the participants were coded for behavioral changes by trained graduate students. A randomization procedure was used to reorder videos before coding began so coders were blind to treatment condition. IOA was completed for 30% of videos to an average level of 93%.
Results:
Each participant engaged in 14-23 conversational sessions (this number varied due to the multiple-baseline study design), and two generalization sessions six weeks later. Participants improved in at least one conversational measure. These target skills were individualized, as some participants developed their eye contact, while others talked less about restrictive-interests and asked more questions. Participants and parents completed a feedback survey; learned new skills, recommended the study to others. Effect sizes and visual analyses will be presented.
Conclusions:
First-person video recording eyeglasses can be used as a tool to improve some conversational behaviors for adolescents with ASD. Nonverbal communication skills (like eye contact, facial affect, and physical orientation) were easy for participants to self-identify from videos. Conversational skills, like perseverating on restrictive interests or initiating new topics, were more difficult for participants to recognize independently.