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Use of Positive Reframing to Reduce Negative Statements in Adolescents with ASD - 1 Year Follow up
Individuals with Autism Spectrum Disorder (ASD) often experience impaired social communication skills. With these difficulties, social isolation can occur which may lead to comorbid disorders such as depression and anxiety (Shtayermman, 2006; Ryden & Bejerot, 2008). Current research indicates that children with ASD are also susceptible to comorbid disorders such as depression and anxiety (Strang, J., F., Kenworthy, L., Daniolos, P., Case, L., Wills, M., C., Martin, A., & Wallace, G., L., 2012). Very few studies target these comorbid disorders in this younger population (Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., Baird, G., 2008). These increased levels of negative affect and commenting may create difficulties in social conversation and establishing meaningful relationships. Positive reframing is the ability to perceive something previously viewed as negative in a positive light (Lambert, Fincham, & Stillman, 2012). It is empirically validated as a beneficial treatment for a range of psychological conditions, including; Depression (Lambert, 2010), Anxiety disorders (Goldin et al., 2012), Depression/anxiety in parents of children with ASD (Benson, 2010).
Objectives:
To use positive reframing to effectively decrease the use of negative statements while reframing into neutral or positive statements during social conversations for adolescents with ASD. A second objective included if collateral improvements would be gained in affect/interest during social conversation.
Methods:
Participants included 3 adolescents, ages 9, 11, and 14, diagnosed with ASD. Selection criteria included making excessive negative comments to conversational partner during at least 20% of intervals in 10-minute conversational probes. A multiple baseline design was used along with partial interval recording. Behavioral measures included; negative/positive/neutral statements and affect. Self-report measures included: The beck depression inventory for youth, the beck anxiety inventory for youth, and social validity measures. For intervention, a combination treatment package was implemented. This included defining reframing, in-vivo prompting from a clinician and self-management of reframing.
Dependent Measures
Negative statements: utterances made by participant that reflected, sadness, anger, or anxiety (i.e., “I can’t wait for school to be over”). For each 30-second interval in social conversation, a plus (+) was recorded if there was a negative statement in the interval, and a minus (-) was recorded if there were no negative statements made. The percentage of intervals with negative statements for the 15-minute conversation probe was then calculated.
Positive statements: utterances made by participant that reflected happiness or excitement in the content of speech, independent of affect. Neutral statements were defined as utterances made by the participant that reflected an absence of negative or positive content of speech, independent of affect. Positive or neutral statements were merged into one variable for comparison to negative statement purposes.
Results: Findings indicate that it is possible for each adolescent with ASD to effectively decrease the use of negative statements while reframing during social conversation with peers (Ex. Participant 1 neg statements 24% with mod depression/severe anxiety decreased to 5% and increased pos from 0% to 14%). One year follow-up data was also collected and found generalization of new skills.