Vivi Mandasari Thesis

Learning
Social Skills with
2D Animated Social Stories
for Children with
Autism Spectrum Disorders

Vivi Mandasari
A thesis submitted in fulfillment of the requirements for the degree of
Masters of Science (by Research)

Performed at
Swinburne University of Technology
2012

Abstract
Autism Spectrum Disorders (ASD) are a group of neuro‐developmental disorders caused by brain
abnormalities which results in impaired social skills. There are five variants of the spectrum:
Asperger Syndrome, Pervasive Developmental Disorder – Not Otherwise Specified, Autistic
Disorders, Rett’s Syndrome and Childhood Disintegrative Disorders. These broad variants produce a
wide variety of symptoms among children with ASD, where each child with ASD will have his own
pattern of autism; however, all children with ASD will share the same deficits in the areas of social
skills which include social interaction, verbal and non‐verbal communication and unusual
behavior/interest.
Research on treatment in helping children with ASD to improve social skills is growing as the cases
of children diagnosed with ASD are on the rise. Social Story™ is one of the proven methods of
treatment in helping children with ASD to learn social skills. However, the current presentation
format of Social Story™ has not been attractive and it requires intensive teacher‐student
interaction for the full benefit of social skills acquisition.
Numerous studies have proved that children with ASD are motivated and have a better
understanding from reading or visual illustration learning rather than learning through spoken
instructions. Results from studies have also discovered that the computer is attractive and
engaging for children with ASD, as it offers much benefit to them.
It has been said that learning is most effectual when motivated, thus, the purpose of this study is to
discover a learning tool that children with ASD will be motivated to use on their own, and it is
achievable by combining elements that they are interested in.
This research focuses on the combination of Social Story™, 2D animation, and the computer as a
medium of presentation to present an interactive pedagogical tool for children with ASD to learn
social skills. This combination is anticipated to be an effective tool in teaching social skills to
children with ASD, as they are naturally drawn to computers and visual cues, combined with the
fact that Social Story™ has been effective in changing the social behavior of children with ASD.
The prototype titled ‘I‐Learn Social Story’ has been developed and evaluated on thirty children with
ASD in a special school located in Kuching, Sarawak. A preliminary study has been conducted on
three children with ASD prior to this final evaluation to ensure that the final prototype functions
are properly based on the children’s needs. The method used in the evaluation study is the
quantitative method, specifically single subject design, which is one type of experimental design.
Results of the experimental study reveal that the prototype is effective in changing the
participants’ social behavior and in improving their social skills. There are significant improvements
in the appropriate social behavior, decrease in the inappropriate social behavior, and increase in
the number of social interactions made by the participants.
Thus, this study has contributed to the emergent research of treatment for children with ASD in
social skills learning. The result of this study is important as we have discovered a novel method of
treatment that can be used effectively in assisting children with ASD to improve their main deficit,
social skills.

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Acknowledgement
For the completion of this thesis, I would like to thank everyone who had provided me with
their assistance throughout this research. In particular, I would like to express my gratitude to
the following people:
 My supervisor, Dr. Lau Bee Theng for her support, guidance and most of all,
encouragement throughout the years of the Master’s journey.
 My co‐supervisor, Associate Professor Henry Lee Seldon for his constructive comments,
knowledge and most importantly, for his kind heart.
 Dr. Margaret A. Seldon, for her generosity in advice and effort on the thesis proof reading.
 Principal, teachers, and class helpers from the Perkata Special School. Thank you all for
being so enthusiastic in assisting me conducting the study. Without your support, this
study will not have been a success.
 My lab and academic mates, Nia Valeria, Ong Chin Ann, Lau Tiu Chung, Jofry Hadi Sutanto,
Shane Wee, and Serena Sim. Thanks for the academic help, discussion, and most of all our
precious friendships.
 My brothers and sisters from Hope Church, I am really thankful for all the support and
love. With you, I found my home in Kuching.
 My best buddies since the time I landed in Kuching: Steph, Pam, Carol, Sally and Amanda,
thank you all for the fun and memorable moments together. I enjoy a lot to be with you.
 And most of all, I will always be grateful to God and Jesus Christ, who are always with me
and have never failed to love me. Also for providing me with a wonderful family, the
people who matter the most in my life.

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Declaration of originality

This thesis contains no material which has been accepted for the award of any other degree or
diploma in any university, and to the best of my knowledge contains no material previously
published or written by another person, except where due reference is made in the text of the
thesis. Work based on joint research or publications in this thesis fully acknowledges the
relative contributions of the respective authors or workers.
Candidate’s name : Vivi Mandasari
Candidate’s signature : _____________
Date : _____________

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Table of contents
ABSTRACT ........................................................................................................................................... I
ACKNOWLEDGEMENT ......................................................................................................................... II
DECLARATION OF ORIGINALITY .......................................................................................................... III
TABLE OF CONTENTS .......................................................................................................................... IV
LIST OF ILLUSTRATIONS ..................................................................................................................... VII
LIST OF TABLES .................................................................................................................................. IX
CHAPTER 1: INTRODUCTION............................................................................................................... 1
1.1 SCOPE OF RESEARCH ......................................................................................................................... 1
1.2 RESEARCH BACKGROUND ................................................................................................................... 1
1.3 RESEARCH AIM ................................................................................................................................. 3
1.4 RESEARCH CONTEXT AND PARTICIPANTS ................................................................................................ 4
1.5 RESEARCH TIMELINE .......................................................................................................................... 4
1.6 OVERVIEW OF THE THESIS .................................................................................................................. 5
CHAPTER 2: LITERATURE REVIEW ........................................................................................................ 6
2.1 INTRODUCTION ................................................................................................................................ 6
2.2 AUTISM SPECTRUM DISORDERS (ASD) ................................................................................................. 6
2.2.1 The causes and treatment of Autism Spectrum Disorders ...................................................... 7
2.2.2 The spectrum of the Autism Disorders .................................................................................... 9
2.2.3 Deficits in Autism Spectrum Disorders ..................................................................................14
2.3 SOCIAL SKILLS ACQUISITION ..............................................................................................................20
2.3.1 Behavioral Modification Treatments ....................................................................................21
2.3.2 Augmentative and Alternative Communication (AAC)..........................................................28
2.3.3 Robot therapy .......................................................................................................................31
2.3.4 Music therapy .......................................................................................................................33
2.3.5 Computer assisted learning ..................................................................................................34
2.3.6 Animation .............................................................................................................................35
2.3.7 Video modeling (VM) ............................................................................................................38
2.3.8 Interactive computer software .............................................................................................39
2.3.9 Virtual reality (VR) ................................................................................................................43
2.3.10 Social Story™ ....................................................................................................................47
2.4 CRITICAL REVIEW ...........................................................................................................................56
CHAPTER 3: CONCEPTUAL DESIGN AND MODELING ........................................................................... 58
3.1 INTRODUCTION ..............................................................................................................................58
3.2 RESEARCH PROBLEM .......................................................................................................................58
3.3 PROPOSED SOLUTION ......................................................................................................................59
3.4 HYPOTHESIS ..................................................................................................................................60
3.5 RESEARCH METHODOLOGY ...............................................................................................................61
3.6 RESEARCH PROCEDURES ..................................................................................................................65
3.7 CONCEPTUAL DESIGN ......................................................................................................................68
3.7.1 Requirements and specifications ..........................................................................................68
3.7.2 Design rationale ....................................................................................................................71
3.8 PRELIMINARY STUDY .......................................................................................................................74
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3.8.1 Methodology ........................................................................................................................ 75
3.8.2 Findings ................................................................................................................................ 77
3.9 IMPROVED CONCEPTUAL DESIGN ....................................................................................................... 78
3.9.1 Final design ........................................................................................................................... 79
3.9.2 Changes and rationale.......................................................................................................... 80
3.10 SUMMARY .................................................................................................................................... 82
CHAPTER 4: I‐LEARN SOCIAL STORY DESIGN AND DEVELOPMENT ...................................................... 83
4.1 INTRODUCTION ............................................................................................................................. 83
4.2 METHOD IN DEVELOPING I‐LEARN SOCIAL STORY ................................................................................. 83
4.3 SOCIAL STORY DEVELOPMENT ........................................................................................................... 84
4.3.1 Targeted social skills ............................................................................................................. 84
4.3.2 Social story selection/writing ............................................................................................... 84
4.4 USER INTERFACE DEVELOPMENT ....................................................................................................... 89
4.4.1 The introductory screen ........................................................................................................ 90
4.4.2 How to greet someone at school .......................................................................................... 91
4.4.3 Play and sing with friends ..................................................................................................... 93
4.4.4 Snack time ............................................................................................................................ 95
4.4.5 Walking in the hallway ......................................................................................................... 97
4.4.6 Washing hands ..................................................................................................................... 99
4.5 DEVELOPMENT TOOLS................................................................................................................... 102
4.5.1 Adobe Flash CS3 and ActionScript 3.0 ................................................................................ 102
4.5.2 Windows Sound Recorder and external microphone ......................................................... 102
4.5.3 Audacity .............................................................................................................................. 103
4.6 SUMMARY .................................................................................................................................. 103
CHAPTER 5: PROTOTYPE TESTING AND EVALUATION ...................................................................... 104
5.1 INTRODUCTION ........................................................................................................................... 104
5.2 PROCEDURE/PREPARATION ............................................................................................................ 104
5.2.1 Participant selection ........................................................................................................... 106
5.2.2 Participants’ profiles ........................................................................................................... 107
5.2.3 Dependent measures in data collection ............................................................................. 109
5.2.4 Data collection .................................................................................................................... 110
5.2.5 Data processing and analysis ............................................................................................. 113
5.2.6 Ethical considerations ......................................................................................................... 114
5.3 SETTINGS ................................................................................................................................... 115
5.3.1 Classrooms ......................................................................................................................... 115
5.3.2 School multi‐purpose hall ................................................................................................... 116
5.3.3 Kitchen ................................................................................................................................ 116
5.3.4 Outdoor field ...................................................................................................................... 116
5.4 MATERIAL AND EQUIPMENT ........................................................................................................... 116
5.4.1 Data collection sheet .......................................................................................................... 116
5.4.2 I‐Learn Social Story presented in a set of notebook ........................................................... 116
5.5 RESULT AND ANALYSIS .................................................................................................................. 117
5.5.1 Individual results ................................................................................................................ 117
5.5.2 Results collected for individual social story ........................................................................ 208
5.5.3 Overall results ..................................................................................................................... 220
5.6 FINDINGS AND DISCUSSION ............................................................................................................ 225
5.6.1 Statistical significance ........................................................................................................ 225
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5.6.2 Effectiveness of our proposed intervention .........................................................................227
5.6.3 Social skills acquisition/behavioral changes .......................................................................228
5.6.4 Treatment integrity .............................................................................................................229
5.6.5 Social validity and acceptability ..........................................................................................229
5.6.6 Inter observational agreement ...............................................................................................230
5.7 SUMMARY ..................................................................................................................................231
CHAPTER 6: CONCLUSION ............................................................................................................... 233
6.1 MAIN CONTRIBUTIONS ..................................................................................................................233
6.2 LIMITATIONS AND DIRECTIONS FOR FUTURE WORKS .............................................................................235
6.3 FINAL CONCLUSION .......................................................................................................................237
REFERENCES & BIBLIOGRAPHY ........................................................................................................ 239
GLOSSARY OF TERMS ...................................................................................................................... 269
APPENDIX A: ETHICAL CLEARANCE APPROVAL .................................................................................................270
APPENDIX B: INFORMED CONSENT ...............................................................................................................271
APPENDIX C: DATA COLLECTION SHEET .........................................................................................................273
APPENDIX D: STUDENT ASSENT FORM ..........................................................................................................274
APPENDIX E: TREATMENT INTEGRITY .............................................................................................................275
APPENDIX F: SOCIAL VALIDITY .....................................................................................................................276
APPENDIX G: RESEARCH TIMELINE ................................................................................................................277

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List of Illustrations

FIGURE 1 RESEARCH PROCEDURES ...................................................................................................................... 66
FIGURE 2 OPERATION FLOW OF THE FIRST PROTOTYPE ............................................................................................ 71
FIGURE 3 USER INTERFACE OF THE FIRST PROTOTYPE .............................................................................................. 72
FIGURE 4 SCREENSHOT OF ‘SNACK TIME’ (FIRST PROTOTYPE) ................................................................................... 76
FIGURE 5 OPERATION FLOW OF THE FINAL PROTOTYPE ........................................................................................... 79
FIGURE 6 CONCEPTUAL DESIGN OF THE FINAL PROTOTYPE ....................................................................................... 80
FIGURE 7 STEPS IN DEVELOPING I‐LEARN SOCIAL STORY .......................................................................................... 83
FIGURE 8 THE INTRODUCTION SCENE ................................................................................................................... 90
FIGURE 9 THE STORY LIST .................................................................................................................................. 90
FIGURE 10 STORY LIST WITH ‘HOW TO GREET SOMEONE AT SCHOOL’ HIGHLIGHTED ...................................................... 91
FIGURE 11 THE TARGET BEHAVIOR OF ‘HOW TO GREET SOMEONE AT SCHOOL’ ............................................................ 91
FIGURE 12 SCREENSHOOT OF ‘HOW TO GREET SOMEONE AT SCHOOL’ ANIMATION (PART 1 OF 2) ................................... 91
FIGURE 13 SCREENSHOOT OF ‘HOW TO GREET SOMEONE AT SCHOOL’ ANIMATION (PART 2 OF 2) ................................... 92
FIGURE 14 STORY LIST WITH ‘PLAY AND SING WITH FRIENDS’ HIGHLIGHTED ................................................................ 93
FIGURE 15 THE TARGET BEHAVIOR OF ‘PLAY AND SING WITH FRIENDS’ ....................................................................... 93
FIGURE 16 SCREENSHOOT OF ‘PLAY AND SING WITH FRIENDS’ 2D ANIMATION (PART 1 OF 1) ........................................ 94
FIGURE 17 STORY LIST WITH ‘SNACK TIME’ HIGHLIGHTED ........................................................................................ 95
FIGURE 18 THE TARGET BEHAVIOR OF ‘SNACK TIME’ .............................................................................................. 95
FIGURE 19 SCREENSHOOTS OF ‘SNACK TIME’ ANIMATION (PART 1 OF 3) .................................................................... 95
FIGURE 22 STORY LIST WITH WALLKING IN THE HALLWAY HIGHLIGHTED ..................................................................... 97
FIGURE 23 THE TARGET BEHAVIOR OF ‘WALKING IN THE HALLWAY’ ........................................................................... 98
FIGURE 24 SCREENSHOOT OF ‘WALKING IN THE HALLWAY’ ANIMATION (PART 1 OF 2) .................................................. 98
FIGURE 25 SCREENSHOOT OF ‘WALKING IN THE HALLWAY’ ANIMATION (PART 2 OF 2) .................................................. 99
FIGURE 26 STORY LIST WITH ‘WASHING HANDS’ HIGHLIGHTED ............................................................................... 100
FIGURE 27 THE TARGET BEHAVIOR OF ‘WASHING HANDS’ ..................................................................................... 100
FIGURE 28 SCREENSHOOT OF ‘WASHING HANDS’ ANIMATION (PART 1 OF 2) ............................................................ 100
FIGURE 29 SCREENSHOOT OF ‘WASHING HANDS’ ANIMATION (PART 2 OF 2) ............................................................ 101
FIGURE 30 STEPS IN THE EXPERIMENTAL STUDY ................................................................................................... 105
FIGURE 31 PARTICIPANT 1’S BEHAVIORAL CHANGES ............................................................................................. 118
FIGURE 40 PARTICIPANT 10’S BEHAVIORAL CHANGES ........................................................................................... 145
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FIGURE 47 PARTICIPANT 17’S BEHAVIORAL CHANGES ...........................................................................................166
FIGURE 61 OVERALL CHANGES IN APPROPRIATE, INAPPROPRIATE AND NO INTERACTION BEHAVIOR ...............................224

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List of Tables
TABLE 1 RESEARCH TIMELINE ............................................................................................................................... 5
TABLE 2 STORYLINE AND SENTENCE COMBINATION OF ‘HOW TO GREET SOMEONE AT SCHOOL’ ....................................... 85
TABLE 3 STORYLINE AND SENTENCE COMBINATION OF ‘PLAY AND SING WITH FRIENDS’ ................................................. 86
TABLE 4 STORYLINE AND SENTENCE COMBINATION OF ‘SNACK TIME’ ......................................................................... 87
TABLE 5 STORYLINE AND SENTENCE COMBINATION OF ‘WALKING IN THE HALLWAY’ ..................................................... 88
TABLE 6 STORYLINE AND SENTENCE COMBINATION OF ‘WASHING HANDS’ .................................................................. 89
TABLE 7 SUMMARY OF PARTICIPANTS’ PROFILE ................................................................................................... 108
TABLE 8 SOCIAL BEHAVIOR DEFINITION AS ADOPTED FROM THIEMANN & GOLDSTEIN (2001) ...................................... 109
TABLE 9 BASELINE DATA COLLECTION PROCEDURE ............................................................................................... 110
TABLE 10 INTERVENTION DATA COLLECTION PROCEDURE ...................................................................................... 111
TABLE 11 REVERSAL BASELINE DATA COLLECTION PROCEDURE ................................................................................ 112
TABLE 12 FOLLOW‐UP DATA COLLECTION PROCEDURE .......................................................................................... 113
TABLE 13 CLASSROOMS PROFILE SUMMARY ....................................................................................................... 115
TABLE 14 BEHAVIORAL CHANGES OBSERVED IN LOW COGNITIVE FUNCTIONING GROUP FOR ‘HOW TO GREET SOMEONE AT
SCHOOL’ ............................................................................................................................................. 208
TABLE 15 BEHAVIORAL CHANGES OBSERVED IN HIGH COGNITIVE FUNCTIONING GROUP FOR ‘HOW TO GREET SOMEONE AT
SCHOOL’ ............................................................................................................................................. 209
TABLE 16 BEHAVIORAL CHANGES OBSERVED IN ALL PARTICIPANTS FOR ‘HOW TO GREET SOMEONE AT SCHOOL’ ................ 210
TABLE 17 BEHAVIORAL CHANGES OBSERVED IN LOW COGNITIVE FUNCTIONING GROUP FOR ‘PLAY AND SING WITH FRIENDS’211
TABLE 18 BEHAVIORAL CHANGES OBSERVED IN HIGH COGNITIVE FUNCTIONING GROUP FOR ‘PLAY AND SING WITH FRIENDS’
......................................................................................................................................................... 211
TABLE 19 BEHAVIORAL CHANGES OBSERVED IN ALL PARTICIPANTS FOR ‘PLAY AND SING WITH FRIENDS’ .......................... 212
TABLE 20 BEHAVIORAL CHANGES OBSERVED IN LOW COGNITIVE FUNCTIONING GROUP FOR ‘SNACK TIME’ ....................... 213
TABLE 21 BEHAVIORAL CHANGES OBSERVED IN HIGH COGNITIVE FUNCTIONING GROUP FOR ‘SNACK TIME’ ...................... 214
TABLE 22 BEHAVIORAL CHANGES OBSERVED IN ALL PARTICIPANTS FOR ‘SNACK TIME’ .................................................. 215
TABLE 23 BEHAVIORAL CHANGES OBSERVED IN LOW COGNITIVE FUNCTIONING GROUP FOR WALKING IN THE HALLWAY’ .... 216
TABLE 24 BEHAVIORAL CHANGES OBSERVED IN HIGH COGNITIVE FUNCTIONING GROUP FOR ‘WALKING IN THE HALLWAY’ .. 216
TABLE 25 BEHAVIORAL CHANGES OBSERVED IN ALL PARTICIPANTS FOR ‘WALKING IN THE HALLWAY’ .............................. 217
TABLE 26 BEHAVIORAL CHANGES OBSERVED IN LOW COGNITIVE FUNCTIONING GROUP FOR ‘WASHING HANDS’ ............... 218
TABLE 27 BEHAVIORAL CHANGES OBSERVED IN HIGH COGNITIVE FUNCTIONING GROUP FOR ‘WASHING HANDS’ ............... 219
TABLE 28 BEHAVIORAL CHANGES OBSERVED IN ALL PARTICIPANTS FOR ‘WASHING HANDS’ .......................................... 220
TABLE 29 THE OVERALL RESULT OBTAINED FROM ALL OF THE SOCIAL STORIES ON LOW COGNITIVE FUNCTIONING PARTICIPANTS
......................................................................................................................................................... 221
TABLE 30 THE OVERALL RESULT OBTAINED FROM ALL OF THE SOCIAL STORIES ON HIGH COGNITVE FUNCTIONING PARTICIPANTS
......................................................................................................................................................... 221
TABLE 31 THE OVERALL RESULT OBTAINED FROM ALL OF THE SOCIAL STORIES ON ALL PARTICIPANTS .............................. 222
TABLE 32 SUMMARY OF PREVIOUS SOCIAL STORY STUDIES ..................................................................................... 226

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Chapter 1: Introduction

The first chapter of the thesis illustrates the scope of the research, the background of the
research, the aim of the research achieved through several objectives, the targeted audience
of the research, the timeline of the research process, and an overview of how this thesis is
organized.
1.1 Scope of research
This research was performed at Swinburne University of Technology (Sarawak Campus) and
the subjects of the study were students at Perkata Special School, a school for special children
located in Kuching.
The study of this thesis is based on a quantitative research method that utilizes an
experimental design of the single subject design in evaluating the usability and efficacy of the
proposed prototype, entitled I‐Learn Social Story in assisting children with ASD to learn social
skills. This study attempts to introduce a new approach in helping children with ASD to learn
social skills.
The prototype is titled I‐Learn Social Story and throughout this thesis it will also be referred to
as ‘2D Animated Social Story’, illustrating the main feature which is Social Story™ in 2D
animation form.
This thesis covers the background of the study including the essential elements such as the
research objectives and audience, intensive and detailed literature review on related topics,
conceptual design and modeling of the prototype which will include the methodology of the
study, the implementation process of the prototype, and the experimental design to evaluate
the effectiveness of the I‐Learn Social Story prototype.
1.2 Research background
Autism Spectrum Disorders (ASD) are conditions in children that causes them to have
difficulties in their social lives because of the lack of social skills. Social skill is an important art
in relating with others. Without social skills, an individual would find it difficult to live in
society, since humans are required to relate with others in their daily lives. Social skills are
essential for an individual to survive as a human being.
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There has been evidence of growing rates in cases of ASD in the past decade (Stillman 2009;
Bogdashina 2006; Fambonne 2003; Shattuck 2006; Kaufmann & Silverman 2010; Lewandowski,
2010; Williams & Williams 2011), yet there is still no exact knowledge of the cause and
treatment for children with ASD; thus these children are trapped in their social problems with
which they are born. Therefore it is important to help children with ASD to learn social skills in
order for them to have an independent life. With this concern in mind, research and studies on
the treatment and application to help children with ASD cope with their social skills, are
increasing rapidly.
However, from the current treatment and application used for children with ASD to learn
social skills, there are only a few that are proven to be effective, but with a high cost and a
lengthy treatment (Shattuck & Grosse 2007; Ganz 2008). Thus, in between those current
applications, there is a gap for improvement in the area of application for children with ASD to
improve their social skills. This study presents a novel way of assisting children with ASD to
learn social skills, by combining methods that have been evidently effective in teaching social
skills to children with ASD, with a medium that they are attracted to.
Social Story™ is one of the interventions used to help children with ASD to learn social skills,
created by Carol Gray in 1991. Social Story™ is a short story written from the children’s
perspective to help them understand a particular social situation. Included in Social Story™ are
the descriptions of the social situation, the people involved in the social situation and their
perspectives, as well as the suggested appropriate response for the child to perform in that
particular social situation. Social Story™ is thus one way of helping children with ASD to better
understand social situations from the perspectives of others and of themselves.
Social Story™ has been widely used with children with ASD with promising results (Adams et al.
2004; Bledsoe et al. 2003; Crozier & Tincani 2005; Crozier & Tincani 2007; Delano & Snell 2006;
Demiri 2004; Kuoch & Mirenda 2003; Ozdemir 2008; Sansosti & Powell‐Smith 2006, Sansosti &
Powell‐Smith 2008; Scattone et al. 2002; Scattone et al. 2006, Schneider & Goldstein 2009).
However, in spite of the apparent impact of Social Story™ to promote social behavioral
changes, this technique has a few drawbacks. Several authors have reported that the social
skills acquisition achieved from Social Story™ in children with ASD is minimal unless it is
followed with intensive treatment. For Social Story™ to be significant and effective in changing
the students’ behavior, it requires intensive one‐to‐one student‐teacher interaction, where the
teacher would read out the Social Story™ to the child and would then model the desired target
behavior with the student consistently, for an extensive period of time.
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Thus, the current usage of Social Story™ is resource and time consuming. It is crucial that there
is a discovery of a new and dynamic approach in the Social Story™ treatment. These resource
and time consuming problems can be overcome by a tool that can be used by the child
independently with minimal supervision from the teacher. To achieve this, it is necessary for
the tool to be appealing to the child so that he/she will be motivated to learn independently.
1.3 Research aim
The aim of this research study is to discover a supplementary treatment tool that can be used
effectively in teaching social skills to children with ASD, using methods that will motivate their
learning. This study examines whether the combination of the proposed model, Social Story™
and 2D animation on a computer, will have a significant role in changing the social behavior of
children with ASD. Its effectiveness, efficiency and satisfaction are evaluated in the present
study. Hence, this study has the following objectives:
 To observe and understand the social behavior of children with ASD
The study investigates the social behavior and the learning behavior of children with ASD. This
will supply the crucial information needed in order to develop the learning tool that will fulfill
their needs, based on their social behavior and learning style. This is important because
children with ASD are different from normal children, therefore specific information on their
behavior and learning styles is necessary. To achieve this objective, a field observation on
children with ASD and a literature review is conducted.
 To analyze the existing treatment tools for children with ASD
The literature review was conducted in order to reassess the existing treatment tools that help
children with ASD to learn social skills. This review highlights the benefits and the limitations of
the treatment tools that have been developed and distributed by various organizations. It is
important to find out the benefits and limitations of these available products, from which the
benefits can be integrated into our model, and improvements that can be made based on the
limitations of the current treatment tools.
 To investigate and analyze the technology and hardware requirement for the prototype
In developing the prototype, performing an investigation on the technology and hardware
requirement is an essential step. This step ensures that the hardware and technology used are
available to most general public users and are cost‐effective and can be implemented in the
user’s home.
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 To conduct a preliminary study for the initial prototype
A preliminary study ensures that the final model of the prototype is the refined model, based
on the results gathered from the pilot study. The pilot study is conducted on a smaller number
of participants to gather the necessary information on the prototype usability before
proceeding to a larger number of participants.
 To design and develop the improved prototype
The final prototype is developed based on the previous analysis of the children’s needs,
technology requirements and the results of the pilot testing/preliminary study.
 To evaluate the improved prototype to the targeted community
After the final prototype has been designed and implemented, an evaluation of its
effectiveness is conducted. Experiments are conducted to test the usability and effectiveness
of the prototype to children with ASD.
1.4 Research context and participants
This research targets children with ASD, especially those between the ages of 4 to 12 years.
This is the age range when children start to have social interactions with other people
independently. Also at this stage, children are more capable of coordinating and operating the
computer or other mobile applications.
As the sample target audience for the study, thirty students with ASD are selected from a
special school located in Kuching, Sarawak. Their participation in the study is completely
voluntary. To achieve a pertinent result, certain inclusion criteria are imposed.
1.5 Research timeline
Table 1 briefly presents the timeline of the research. As illustrated, the research took about 96
weeks from the inception of ideas to the development, evaluation and documentation stages.
The detailed research timeline is presented in Appendix G (Research Timeline).

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Tasks Proposed Duration
Proposal development 26 weeks
Preliminary study 14 weeks
Prototype implementation 10 weeks
Testing and evaluation 24 weeks
Result analysis 16 weeks
Dissertation writing 12 weeks
Table 1 Research timeline
1.6 Overview of the thesis
This thesis contains 6 chapters:
Chapter 1 (Introduction): the first chapter of the thesis begins with the introduction of the
research, which includes the background of the study, the purposes of the research, the
community of the targeted audience, schedule of the whole research, as well as the chapters
in the outline.
Chapter 2 (Literature Review): consists of the review of the literature on the subjects that are
related to the research, including a detailed review on ASD and their nature, the current
treatments and their limitations, Social Story™ and its application for children with ASD,
animation in computer with its benefits for children with ASD.
Chapter 3 (Conceptual Design and Modeling): presents the conceptual design and model of
the study. Included here are the research problems and our proposed solutions, the
methodology used in this study which covers the research design and the approach used in the
study. The preliminary study is presented as the basis of the final design and evaluation. The
conceptual design of the final prototype which is derived based on the preliminary study’s
result refinement and it includes the requirements and specifications of the final prototype
such as operation flow, requirements, as well as the conceptual design of the user interface.
Chapter 4 (Prototype Implementation): discusses the implementation of the prototype based
on the conceptual design. This chapter captures the screenshot of the developed prototype,
the development of social stories that have been integrated into the prototype, and tools used
in developing the prototype.
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Chapter 5 (Prototype Testing and Evaluation): contains the systematic experimental study of
the prototype that was evaluated on thirty students with ASD in a local school. The chapter
covers subjects that are related to the study, including methods of the experimental study,
such as procedures, participants, setting, and materials. The findings from the experimental
study are also discussed in this chapter.
Chapter 6 (Conclusion): gives the conclusion to the study by providing the thesis summary and
the specific contribution to the field of the study. The directions for future work are also
discussed in this chapter. And lastly, there is a final conclusion that summarizes the discussion
of the research project.
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Chapter 2: Literature Review
2.1 Introduction
This chapter reviews the related publications for this research. The discussions include a
detailed explanation on the two major areas that are related to the research. The first is
Autism Spectrum Disorders, its spectrum, characteristics and its social skill deficits. The second
is social skill acquisition in children with ASD, which includes various teaching and learning
applications available for children with ASD. And finally, a critical review is included as the
final part of the chapter.
2.2 Autism Spectrum Disorders (ASD)
The term Autism was introduced by Paul Bleuler in 1921; it is derived from the Greek word to
describe a condition of self‐state where individuals are engrossed in their own world (Dixon et
al. 2009). The formal discovery of ASD started when Leo Kanner in 1943 discovered eleven
cases of children who lacked the ability to relate to people and social situations (Kanner 1943).
Kanner used the term early infantile autism to describe children who exhibited poor social
skills, engaged in self‐abuse and showed repetitive patterns of behavior (Veague et al. 2009).
In 1944, Hans Asperger who was unaware of Kanner’s work, used the same term of autistic or
autism, derived from the Greek word autos (self), and coined by Swiss psychiatrist Eugen
Bleuler to describe his casework of four cases of children who found it difficult to fit in socially
(Frith 1991; Townsend & Westerfield 2010). Lorna Wing in 1981 introduced the term Asperger
Syndrome to refer to children who had a milder form of Autism as described by Asperger
(LeBlanc & Volkers 2007).
Since Kanner’s and Asperger’s discoveries, there have been many different views of the
disorders which are unique to each other (Feinstein 2010; Foster 2007). Therefore, the term of
Autism Spectrum Disorders is widely used to cover all autism related disorders (Autism Society
Canada 2005; Bregman 2005).
ASD is often referred to as Pervasive Developmental Disorders (PDD), as the disorder is
characterized by pervasive and usually severe impairment of reciprocal social interaction skills,
verbal and non‐verbal communication deviance, and restricted repetitive stereotypical
behavior or interest patterns (Videbeck 2010; Volkmar et al. 2005; LeBlanc & Volkers 2007;
Jelicic 2005; Wood et al. 2006). The term ‘pervasive’ means that delays in certain areas of

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development will impact, along with the line of growth, upon other areas of development,
compounding the deficits of function. Because ASD is a developmental disorder, its symptoms
inherited in particular personalities will appear different at different ages, some aspects fading
away with growth stages while others begin (Berger 2002).
There is no medical test that can be used to diagnose a child as having ASD. Any diagnosis of
ASD is based on observation of the characteristics of the children’s behavior (Sicile‐Kira 2004).
As said earlier, ASD is a wide spectrum disorder; therefore, there will be no children with ASD
that have exactly the same characteristics or symptoms and level of functioning. Different
children with ASD will experience different combinations of symptoms, where some children
will have mild symptoms while other children may have the severe combination of symptoms
(Siegel 1997).
Due to the characteristics of the disorder that is somehow seen by normal people as anti‐
social, children with ASD are often being excluded from social opportunities for various
reasons. They may be victimized by teasing or bullying, or even being considered as
troublemakers, where well‐meaning adults may isolate them in order to protect them from
social rejection (Loomis 2008; Attwood 2006). For children with ASD, this social isolation often
increases the loneliness and feelings of being different (Joan & Rich 1999; Bogdashina 2006).
Children with ASD have difficulties in dealing with their peers, therefore, they tend to spend
time interacting with objects, which has resulted in their brain’s visual portion becoming highly
developed (Kalb 2009; National Autistic Society 2008). This makes children with ASD have a
better understanding of what they see compared to what they hear, thus, visual strategies are
widely used to help children with ASD in communication learning.
Today, ASD is a neurodevelopmental disorder with high prevalence rates of 90 to 110 per
10000 children (Matson & Kozlowski 2011), affecting children all through the world (Stillman
2009; Bogdashina 2006; Fambonne 2003; Shattuck 2006; Kaufmann & Silverman 2010;
Lewandowski 2010; Williams & Williams 2011), regardless of their race, ethnic group, creed,
social and economic status (Veague et al. 2009).
2.2.1 The causes and treatment of Autism Spectrum Disorders
It is generally accepted that ASD is caused by atypical brain structure or function in the brain
regions that are primarily responsible for social, communicative and executive functions
(Sparks et al. 2002; Kaufmann & Silverman 2010; Muhle et al. 2004; Rutter & Bartak 1971;

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Bregman 2005; Boucher 2009), as brain scans show differences in the shapes and structures of
the brain in children with ASD compared to neuro‐typical children (Autism Society 2008).
Boucher (2009), Lathe (2006), Weiss et al. (2009) and Boria et al. (2009) in their studies
explained the relationship of the brain structure with the brain function that controls the social
areas of children with ASD in enormous detail.
There have been many controversies in identifying the causes of the brain abnormalities in
children with ASD, among which are environmental contributions (Landrigan 2010; Muhle et
al. 2004; Roullet & Crawley 2011; Lewandowski 2010; Bernier & Gerdts 2010), genetics
(Kaufmann & Silverman 2010; Muhle et al. 2004; Roullet & Crawley 2011; Bernier & Gerdts
2010), drug therapy/vaccine (Jick & Kaye 2003; Muhle et al. 2004; Lewandowski 2010; Bernier
& Gerdts 2010), onset in infancy (Szatmari 2003), onset in prenatal period (Lewandowski 2010)
or complications in pregnancy (Burstyn et al. 2011).
However, despite many literature reviews on the potential causes of ASD, as to date, there is
still no definite answer for the specific cause of atypical brain structure in autism (Bogdashina
2006; Crawley 2007; Bernier & Gerdts 2010; Glicken 2009; Magyar 2010; Williams & Williams
2011), as it is very clear that genes are not the only explanation for all types of autism, maybe
for the most distinctive types, as brain growth depends on more than just genes. ASD is
suspected to be caused by a combination of genes and other factors, such as the environment,
acting together that leads to the pattern of behavior in children with ASD (Lewandowski 2010;
Bernier & Gerdts 2010; LeBlanc & Volkers 2007).
As the case with the cause, there have been controversies in the search for an effective
treatment for children with ASD, which has branched into a wide variety of treatment
approaches (Bernier & Gerdts 2010; Williams & Williams 2011; Turkington & Anan 2007).
Scott & Baldwin (2005), Dodd (2005) and Robledo & Ham‐Kucharski (2005) compiled a partial
list of the possible treatment approaches that have been promoted to offer benefits to
children with ASD. Some of those approaches are: allergy therapies, anti‐yeast therapy,
applied behavioral analysis, auditory integration training, gluten free diet, cognitive
approaches, discrete trail training, dolphin therapy, drug therapy, Epsom salt baths, folic acid,
higashi, holding therapy, irlen lenses, lovaas method, magnet therapy, melatonin, music
therapy, natural language paradigm, occupational therapy, picture exchange communication
system, pivotal response training, play therapy, precision teaching, prism lenses, psychology
psychotherapy, psychodynamic therapy, reiki massage, secretin infusion, sensory integration

Page 8

therapy, social skills training, social stories, son‐rise program, speech‐language therapy, the
squeeze machine, TEACCH, tomatis method, therapy dogs, verbal behavior, vision integration
therapy, multiple subpial transections surgery, and martial arts therapy. From those
approaches available, Schreibman (2008) stated that most of them, such as higashi, irlen
lenses, melatonin, reiki massage or the squeeze machine, had not been rigorously evaluated,
which could lead to a false hope for the well‐being of the children with ASD.
Lack of knowledge in the specific causative factors of ASD is the reason behind the
controversies that surround the treatment for children with ASD (Bernier & Gerdts 2010;
Williams & Williams 2011). There are many treatments claimed to be effective for children
with ASD, but each child has his/her own unique profile. Therefore, a treatment that is suitable
for one child might not be suitable for another child (Ball 2008).
Research on the cause and treatment for children with ASD is expanding fast. It aims to
understand the underlying brain abnormalities of ASD and to improve the systems for
prevention, detection, diagnosis and treatment approaches for children with ASD (Fambonne
2003; Baird et al. 2000; Fillipek et al. 2000; Robins et al. 2001; Stone et al. 2000). With
improvements in these systems, and particularly in detection and diagnosis, treatment can be
effected as early as possible, which will eventually allow many children with ASD to be
appropriately identified and treated (Loomis 2008; Scott & Baldwin 2005).
Many researchers agree that children with ASD can experience a great improvement when the
treatment is carried out at the earliest possible time (Cipani 2008; Scott & Baldwin 2005;
Corsello 2005; Dawson et al. 2010). With the early treatment, children with ASD can gain
improved communication and social skills (Dawson et al. 2010; Holmes 2009). This suggestion
for early treatment has also been supported by experiments at the Mind Institute of the
University of California (Holmes 2009).
2.2.2 The spectrum of the Autism Disorders
As discussed above, there are many forms of Autism that are unique from each other. The
three main types of ASD that are most studied are: (1) Asperger Syndrome, (2) Pervasive
Developmental Disorders – Not Otherwise Specified, and (3) Autistic Disorder, and two rare,
severe autistic‐like conditions, are (4) Rett’s Syndrome and (5) Childhood Disintegrative
Disorders (Hirsch 2009; American Psychiatric Association 2000; Matson & Neal 2009; Bregman
2005; Dixon et al. 2009).

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2.2.2.1 Asperger Syndrome (AS)
Asperger syndrome was named after Hans Asperger by Lorna Wing, a psychiatrist and
physician in 1981 for Asperger’s discovery of the disorder many years earlier (Wing 1998; Wing
1981; Lyons & Fitzgerald 2005).
Asperger referred to the children with this syndrome as “little professors”, as they showed a
highly developed intellectual functioning despite their delay in social interaction, unusual
behavior and difficulties in non‐verbal communication and pragmatics of language (LeBlanc &
Volkers 2007; Lyons & Fitzgerald 2005). Since children with ASD perceive and think about the
world in a different way from other people, Attwood (2006) considered it as a personality
disorder rather than a mental illness such as Schizophrenia.
Contrary to children with classic forms of ASD, children with AS generally perform better in the
verbal and linguistic skills rather than in the visual and motor skills (LeBlanc & Volkers 2007;
Jelicic 2005). Often their grammar and vocabulary are relatively advanced (Stoddart 2005;
Patrick 2008). Also in contrast to children with the other types of disorders in the spectrum,
children with AS do not have any clinically significant general delay in cognitive development,
age‐appropriate self‐help skill, and adaptive behavior other than social interaction (Jelicic
2005).
Despite having normal speech development, there is a number of impairments in verbal and
non‐verbal communication in children with AS, especially in the conversational aspect of
language (LeBlanc & Volkers 2007; Matson & Neal 2009; Attwood 2006). This causes them to
have many difficulties in using language in an appropriate way, such as difficulty in
conversational exchanges, not knowing when and how to terminate a conversation
appropriately (Sigafoos et al. 2009). Apart from that, they have difficulties in using language to
convey meaning in a communicative context, which is important for initiating and sustaining
reciprocal social interaction (Tartaro & Cassell 2008), interpreting speeches of others
concretely (LeBlanc & Volkers 2007), conducting one sided communication and having clumsy
motor skills (Matson & Neal 2009; Attwood 2006), having difficulty in interpreting figurative
language (Patrick 2008), and having a lack of imagination as a result of difficulty in abstract
thinking (LeBlanc & Volkers 2007). According to Matson and Neal (2009) and Attwood (2006),
the language used by children with AS is pedantic; however, they are deeply absorbed with
extreme knowledge in the specific topic of their interest.

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Children with AS have delayed social reasoning and some aspects of their social abilities are
quite unusual at any stage of development. Therefore, it severely disables their capacity for
socialization despite their desire to establish social relationships (Jelicic 2005). They also do not
possess the social intuition or do not understand social cues such as, not knowing when and
how to terminate a conversation appropriately (Sigafoos et al. 2009). They have advanced
grammar and vocabulary, however, their conversation reveals their inability to conduct a
normal conversation.
Children with AS often have obsessive behavior such as in the area of their interest (LeBlanc &
Volkers 2007). They find changes in their routine upsetting which can lead them to be anxious
or distressed (LeBlanc & Volkers 2007). There are some AS children who have disorders like
depression (LeBlanc & Volkers 2007). Personal relationships and social situations are
challenging areas for them (Evans 2009). They are intellectually normal but have such an
unusual behavior that people often label them as odd or eccentric (LeBlanc & Volkers 2007).
In order to maintain an independent life, Bauminger (2002) suggests that children with AS
need help in understanding social norms/rules and in processing social information. Treatment
should focus on facilitating their capabilities in social understanding and social cues in different
social situations and improving their skills in making accurate social interpretations.
Mann & Myles (2008) incorporate the stories, writing and artwork from numerous children
with AS, to assist the communities to understand the complex exceptionality of children with
Asperger Syndrome. Temple Grandin, an American academic and world famous animal
scientist who authored various books about ASD was one of the children with AS who
managed to achieve a high academic performance and to live an independent life (Grandin
2006; Parsons et al. 2000).
2.2.2.2 Autistic Disorder
Autistic Disorder, also referred to as Classic Autism, is the most common condition in the
spectrum (Pierangelo & Giuliani 2008) which is more prevalent in boys than in girls (Videbeck
2010). Autistic Disorder is a developmental disorder; symptoms usually appear during the first
three years of childhood and continue throughout life (Turkington & Anan 2007). Jelicic (2005)
states that symptoms in Autistic Disorder are usually measurable by 18 months of age,
however, a formal diagnosis is usually made between the age of 2 to 3 years when there are
delays in language development.

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Jelicic (2005) and Turkington & Anan (2007) describe Autistic Disorder as a severe
developmental disorder that affects children’s ability to communicate, to form relationships
with others and to respond appropriately to the environment. Symptoms and characteristics
that appear in children with Autistic Disorder emerge in a wide variety of combinations, from
mild to severe. If children are left untreated, they may not learn to communicate or behave
properly (Turkington & Anan 2007).
Filipek et al. (1999) highlight the absolute indications that require an immediate further
evaluation for autistic disorder as (1) no babbling by 12 months, (2) no gesturing by 12 months,
(3) no single word by 16 months, (4) no two word spontaneous phrases by 24 months, and (5)
any loss of any language or social skill at any age. Some indications for Autistic Disorder can be
observed through communication (does not respond to name, language is delayed, does not
point or wave good‐bye), social interaction (does not smile socially, prefers to play alone, very
independent, poor eye contact, not interested in other children) and behavioral patterns
(tantrums, does not know how to play with toys, toe walks, unusual attachment to toys, lines
up things, odd movement patterns, oversensitive to certain texture or sound).
Children with Autistic Disorder may also have echolalia of words or phrases of others. Their
communications are mainly for instruments such as in requesting something rather than for
social communication or conversation (Sigafoos et al. 2009).
2.2.2.3 Pervasive Developmental Disorders – Not Otherwise Specified (PDD‐NOS)
PDD‐NOS has also been referred to as Atypical Autism, and although it is a relatively common
diagnosis in ASD, research in this specific area is still highly limited (LeBlanc & Volkers 2007).
PDD‐NOS diagnosis falls in the umbrella of Pervasive Developmental Disorder (PDD). The
designation of NOS in PDD as a diagnosis is applied when the disorder appears to fall within
the larger category of PDD, but does not meet the full criteria of any specific disorder within
the category in ASD (LeBlanc & Volkers 2007; Matson & Neal 2009).
PDD‐NOS is given as a diagnosis when there is a significant autistic symptom (such as deficits in
reciprocal social interaction, verbal and non‐verbal communication, stereotyped behavior,
interests and activities), but the full criteria are not met for a specific diagnosis in any other
ASD. This diagnosis is usually given to children whose symptoms are atypical or not as severe
as Autistic Disorder (Jelicic 2005).

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Children with PDD‐NOS are characterized by a significant impairment in social interaction,
communication, and/or stereotyped behavior pattern, but without all of the features defined
in other specific types of ASD (Turkington & Anan 2007; Yale School of Medicine 2008; Matson
& Neal 2009). Therefore, Turkington & Anan (2007) and Sigafoos et al. (2009) argue that
children with PDD‐NOS tend to function at a higher level of communication compared to
children with other types of ASD, including Asperger Syndrome. However, as described by
Sigafoos et al. (2009), communication in children with PDD‐NOS often focuses on a limited
range of idiosyncratic topics. They may appear to be anxious and awkward when they are
engaged in any social communication.
2.2.2.4 Rett’s Syndrome
Rett’s Syndrome was first identified by Andreas Rett in 1954 when he noticed two girls
engaged in the same repetitive hand‐writhing behavior (Matson & Neal 2009). The name of
Rett’s Syndrome was given by Berigt Hagberg in 1983, who observed the similar symptoms in
his young female patient (Turkington & Anan 2007).
Based on the Encyclopaedia of Autism Spectrum Disorders, Rett’s Syndrome is a rare
progressive disorder that occurs almost exclusively in girls, that is every 1 out of 10,000 to
15,000 girls (LeBlanc & Volkers 2007; Turkington & Anan 2007). However, recent studies
discovered that boys can also have Rett’s Syndrome (Turkington & Anan 2007; Kerr 2002,
Jelicic 2005).
Children with Rett’s Syndrome produce autistic like behavior, learning disabilities, poor muscle
tone, aimless hand wringing movements, difficulty in expressing feelings, poor eye contact,
seizures, slow brain and skull growth, shortened life expectancy and walking abnormalities;
therefore, it is easily confused with Cerebral Palsy (LeBlanc & Volkers 2007).
Children with Rett’s Syndrome appear to develop normally until the age of 6 to 18 months.
After that, autism‐like symptoms start to manifest in the child’s development. Their mental
and social development starts to regress followed by deceleration of head growth, loss of
purposeful hand movements, and appearance of stereotypical hand movements. In addition,
there is a loss of social engagement and severely impaired receptive and expressive language
development and cognitive skills (Jelicic 2005). They are no longer responding to parents and
they pull away from any social contact. They begin to stop verbal communication, to lose
control of their feet and to start wringing their hands (LeBlanc & Volkers 2007). There are also
psychomotor retardation and impairment of language development.

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2.2.2.5 Childhood Disintegrative Disorders (CDD)
CDD was first described by Heller in 1930 (Rapoport & Ismond 1996). Therefore, it is also
known as Heller’s Syndrome (LeBlanc & Volkers 2007). CDD is a well‐described disorder (Jelicic
2005). CDD occurs with a prevalence of less than 2 children per 100,000 children with ASD (Le
LeBlanc & Volkers 2007).
The differences of CDD from typical ASD are in the later onset of symptoms (usually between
26 to 48 months) in CDD (Turkington & Anan 2007). CDD is associated with seizures and is
more common in boys. Children with CDD cannot be specifically treated or cured and usually
require lifelong care (Turkington & Anan 2007). The cause of CDD is still unknown, but several
lines of evidence suggest that CDD is linked to neurological problems (Turkington & Anan
2007), generally in some form of the central nervous system pathology (LeBlanc & Volkers
2007).
Children with CDD appear to develop appropriate skills in communication and social
relationships for their age until the ages of three and four, where the symptoms typically
appear. After this normal development, a child with CDD rapidly loses multiple areas of
function, typically after serious illnesses such as the infection of the brain and/or nervous
system (Turkington & Anan 2007). Somewhere in the first five years of age, children with CDD
begin to “disintegrate” until their behavioral difficulties are basically the same as a child
diagnosed with autism or PDD‐NOS, or even more severe than in Classic Autism (LeBlanc &
Volkers 2007).
The disintegration typically includes a loss of previously learned language; a loss of desire for
significant amounts of social contact; a loss of desire to play; a loss in bowel and bladder
control; increasingly poor eye contact; occurrences of seizures and possessing a very low IQ;
impaired social interaction and communication associated with the onset of restrictive,
repetitive and stereotyped behavior that are typical of autism (LeBlanc & Volkers 2007; Jelicic
2005; Siegel 1997); and a loss in other forms of nonverbal communication such as pointing
(Siegel 1997). A more severe symptom includes mental retardation due to a profound loss of
cognitive skills (Jelicic 2005).
2.2.3 Deficits in Autism Spectrum Disorders
Social skill deficits in children with ASD lay the concepts of Theory of Mind and Triad of
Impairment, which both entered the literature around the same time (Doherty 2009). This
elicited Baron‐Cohen et al. (1985) to hypothesize that the two concepts might be related.

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2.2.3.1 Deficits in Theory of Mind
Theory of Mind (ToM) could be referred to as empathy in general. However, this term has been
popularly used to define the concept that is lacking in children with ASD and it explains the
social challenges they are having (Bogdashina 2006; Doherty 2009; Baron‐Cohen et al. 1985).
ToM, or empathy, is crucial for social awareness in a complex social environment.
ToM is defined as the ability to take and surmise perspectives such as belief, desire, emotion,
perception and intention of self and others to interpret behavior. This ability involves making a
distinction between the real world and the mental representation of the world. ToM can be
explained as the ability to understand other people as mindful beings who have their own
mental states that are different from self (Lantz 2002; Elzouki et al. 2007).
Normal children are said to have ToM because of their ability to explain and predict others’
behavior by attributing them to independent mental states (Gallagher & Frith 2003). In
contrast, children with ASD often rely on a backup system like intellectual reasoning and
experiences for their daily decision making and social interaction, which could lead a simple
social interaction into a complex social calculation for them (Hickson & Khemka 1999).
The development of ToM begins within the first year of life, such as by gaze following, joint
attention, drawing attention of others with pointing, ability to understand if an object is
animate or inanimate, and an awareness of others as intentional agents (Weiss et al. 2009).
The inability to impute mental states of self and others that underpins the essential human
ability to communicate and interact in a meaningful way (Parsons & Mitchell 2002) has caused
children with ASD to have a difficult time in understanding and interacting with other people.
They find it difficult to understand that other people have their own point of view of things
that is different from their own point of view. They also cannot understand that a comment
could embarrass or offend other people and that an apology would help to make a person feel
better (Sicile‐Kira & Grandin 2006).
These inabilities cause children with ASD to have problems in communication and social
relation as they may not be able to anticipate what other people will say or do in various
situations (Chen 2008). In addition, based on his personal experience as an individual with ASD,
Chen (2008) also states that people with ASD have no instinct to share their world and are
unconscious of the world around them.

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From a study of a first birthday party at home, children with ASD paid less attention to other
people, and to the faces of others, failed to respond when their names were called and did not
see the gaze of others to guide their actions (Osterling & Dawson 1994; Dawson et al. 1998).
This is an evidence that children with ASD often fail to develop the essential prerequisite of
ToM.
2.2.3.2 Triad of Impairment
The original concept of Triad of Impairment as defined by Wing & Gould (1979) is impairment
in the areas of (1) social interaction (impaired relationship); (2) social communication/language
(verbal and non‐verbal); and (3) imagination/rigidity of thought (Wing 1988; Wing & Wing
1976; Bowen & Plimley 2008; Macintyre 2009). However, imagination is now replaced in the
triad by behavior inflexibility that is characterized by restricted, repetitive, stereotyped and
narrow range of interests/behaviors and activities/actions (rigidity of thought/lack of
imagination) (Doherty 2009; Boucher 2009; Slater & Bremner 2003; Bregman 2005; Eyal 2010).
Triad of impairment translates the difficulty that children with ASD have in
understanding/conveying meaning, expressing/reading emotion, using non‐verbal behavior
and participating in interpersonal imaginative play (Tartaro & Casell 2008; Tartaro 2007; Cheng
et al. 2005). Social interaction and communication are the critical features in children with
ASD, as stated by many authors (Howlin 2003; Schreibman 2005; Tager‐Flusberg 1989;
Schopler & Mesibov 1985 & 1986; Kanner 1943). Language and communication pattern in
children with ASD reflect their failure to understand the nature of another person. Another
deficit includes restricted interest as identified by Howlin (2003) and Schreibman (2005).
The symptoms included in the Triad of Impairment differ among children with ASD; some
children with ASD would have a mild combination of symptoms while symptoms in other
children with ASD are more obvious (Sicile‐Kira 2004). Schreibman (2005) states that there are
heterogeneous nature and complexity in ASD; therefore, it is frustrating to identify the core
and primary deficit in ASD, as it is unlikely that a single core deficit would explain all features of
ASD. However, he identifies that the behavior problems featured in children with ASD are in
the areas related to social skills, communication and restrictive, repetitive and stereotype
behavior and interests.

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a. Social interaction impairment
As identified by Kanner (1943), the natural inability to form a normal social relationship is the
outstanding characteristic of children with ASD. Their inability to interact normally with other
individuals includes: no desire to make friends, lack of eye contact, showing the trait of
gullibility (LeBlanc & Volker 2007), less likely to develop peer relationships or personal
friendships, and lack of the urge to share interests or achievements. Added to that, they hardly
point out objects of interest, are lacking in cooperative play, they spend an unusual amount of
time unoccupied or in ritualistic activities, have lack of empathy, and lack of coordination of
social behavior to signify social intention (Schopler & Mesibov 1986).
They also possess abnormality in voice and speech intonation, impairment in non‐verbal
behavior such as eye gaze, facial expressions and gestures (Weiss et al. 2009). The lack in
social/emotional reciprocity (such as discrimination between parents and other adults or
repeating behavior that are laughed at) and their difficulty in initiating, maintaining and
terminating social interactions in an appropriate manner or failure to respond properly in
social situations are among the symptoms as well (Brassard & Boehm 2007).
Children with ASD are insensitive in responding to social stimuli such as name calling or play
group participation. They have circumscribed and obsessive interests in the physical aspect of
the social situation rather than in being engaged in the social experiences. For instance, in a
setting where two or more children are playing with toys, children with ASD will not be drawn
to join but will rather have a fixation on other physical elements such as on the toy itself.
Howlin (2003) refers to people with ASD as having social dyslexia, as they show direct
avoidance of social situations and do not actively seek out social interaction, often failing in
perceiving and appreciating others’ thoughts and feelings, failing in perceiving the impact of
someone’s behavior on others, and having difficulty in reading facial and body expressions of
other people.
Regardless of their inability to form normal social relationships, Bogdashina (2006) argues that
many children with ASD have a strong desire to be with others. They interact and form
relationships with others, but of a different nature. Thus, isolation from social situations will
increase their feelings of loneliness and of being different (Joan & Rich 1999).

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b. Social communication impairment
Social situations can be very confusing for children with ASD as they tend to pre dominantly

interpret language literally without interpreting the accompanied body language (Myles et al.
2004). This makes them very vulnerable and dysfunctional in certain situations (Bogdashina
2006).
Symptoms of social communication inability in children with ASD are: inability to sense people
who are not sincere, or when someone is lying (Bogdashina 2006), inability to grasp different
idiosyncrasies of language/signs, monotonous speech in intonation and volume, overly formal
speeches, taking phrases literally, and delayed responses to questions (LeBlanc & Volker 2007).
They face difficulties in understanding and using forms of communication (such as speech, sign
language, body language, tone of voice and vocalization), and difficulties with the
form/content/use of verbal language (Dodd 2005).
Some children with ASD, especially those with AS, may be extremely verbal with vast
vocabularies, however, their usage of words is not appropriate for social communication. They
speak in monotonous or pedantic style, lacking in melody and intonation. Other children with
ASD who are verbally delayed may have some typical language problems which are consistent
with a language disorder (Howlin 2003), such as delayed or lack of functional language,
impairment in initiating or sustaining conversations, repetitive use of language, lack of varied
and spontaneous make‐believe play, using idiosyncratic language, and a tendency to echo the
last few words heard (Brassard & Boehm 2007). Children at the lower functioning level may
throw tantrums, make noises or physical activities as the way infants do when they feel
discomfort, have a fixation on an object, or as an initiation of interaction (Schopler & Mesibov
1985), may listen selectively to familiar words, and may point and use gestures to get
something that they want (Brassard & Boehm 2007).
Social communication difficulties can trigger challenging behavior in children with ASD, such as
self‐injury, aggression and tantrums. There is evidence shown that when children with ASD are
taught functional communication skills, there is a reduction in these challenging behaviors
(Schreibman 2005).
Deficit in social communication results in a difficulty to learn through peer social interaction,
which normally provides many benefits of learning. They will not only miss the valuable
learning opportunities, but these deficits will affect their future especially in personal
relationships, education and employment opportunities (Tartaro & Cassell 2008).

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c. Behavioral inflexibility
Rigidity of thought and an impoverished imagination causes children with ASD to have narrow
and repetitive patterns of activities/behavior (Rosenberg 2000; Feinstein 2010; Macintyre
2009). This results from a lack of social imagination and creativity or a lack of novel,
imaginative behavior (Boucher 2009).
Behavioral inflexibility in children with ASD is also indicated by their inability to pretend and
hence they have a hard time trying to play games with peers. This shows their difficulties in
relating with others and in forming friendships (Rosenberg 2000). They find it hard to
transfer/generalize skills learnt from one situation to another similar situation (Bowen &
Plimley 2008).
Other typical behaviors of children with ASD include stereotype (known as self‐stimulatory
behavior, referring to repetitive movement of body or object); hypersensitivity to
environment; tunnel vision, which is strictly following rules and routines in highly specific
orders everyday as repetitive behavior; and finding it difficult to cope with a sudden change in
daily routine (Rosenberg 2000; Bowen & Plimley 2008). They seldom play spontaneously,
instead, they simply manipulate toys and do not engage with them in any meaningful way
(Slater & Bremmer 2003).
They are also preoccupied with a restricted pattern of interest, adhere to non‐functional
routines, engage in repetitive gestures and have a persistent preoccupation with parts of
objects. They also show stereotyped behavior such as body rocking, hand flapping, finger
flicking and object spinning and twirling with a lack of obvious purpose (Slater & Bremmer
2003). According to Schreibman (2005), this occurs up to 100% in children and adults with ASD.
Children with ASD are often fascinated with regular patterns of objects and may collect and
arrange objects they find in a systematic and repetitive way for no apparent reason and they
may be distressed when these arrangements are disturbed (Slater & Bremmer 2003). Their
interest is restricted and narrow, and most of them show affinity to one special interest that
can be all‐absorbing and dominating. This causes problems in social interaction especially
when they are with people who do not share the same interest (Howlin 2003; Bowen & Plimley
2008).

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2.3 Social skills acquisition
Compared to normal children, children with ASD have diminishing to low social intelligence
due to their impairment in ToM which is linked to social intelligence, causing social skills or the
lack of them as the main issue in children with ASD.
Social skills, as defined by Westwood (2007), are “the specific behavior an individual uses to
maintain effective interpersonal communication and interaction”, therefore, it is any learned
behavior that allow a child to elicit social reinforcement and to avoid social punishment
(Marton 2008). Social skills are needed in everyday life to interact with other people and when
they are used correctly and at the right time, they will help people get along with others and
make appropriate decisions in social situations (Burke et al. 2006).
According to Dautenhahn (1999), social skills are the individual’s capability to develop and
manage relationship between individuals, to build up shared social interactions which help to
integrate and manage the individual basic interest in relationship to the interest of the social
system at the next higher level.
Basic social skills are following instructions, accepting critics, accepting ‘no’ for an answer,
staying calm, disagreeing with others, asking for help, asking permission, getting along with
others, apologizing, having a conversation, giving and accepting compliments, listening to
others, being honest, showing sensitivity to others and introducing self (Burke et al. 2006).
As identified, social skills involve initiating social interaction, listening, taking turns in
conversation, giving and receiving compliments, expressing emotional upsets appropriately,
sharing and cooperating, following rules, resolving conflicts, assisting others and asking for
assistance appropriately (Gresham & Elliott 1990; Marton 2008). Basic components of social
initiation are greeting others, asking questions, commenting on others, negotiating needs and
asking to join on‐going activities. Social responses are responding to social overtures of others
such as in greetings, questions and in offering to join activities (Weiss et al. 2009; Bauminger
2002).
One research suggests that social skill training is one of the most effective treatments to help
children with ASD to learn skills to help them succeed in their personal and academic lives, as
the lack of social skills can lead a person to a lonely life and depression (Loomis 2008). Active
techniques in social skill training in structured home and classroom environment that focus on
the children’s strength and compensate on their deficits can produce a higher gain in the
development of children with ASD (Fambonne 2003).

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Children with ASD usually find it easier to practice social skills with adults or younger children
rather than with the same age peers, since peers often place a greater demand on verbal and
non‐verbal communication skills, and are less tolerant of poor social skills (Loomis 2008).
Generalization of learned social skills in children with ASD is difficult; their learning can be very
context‐based such that they only demonstrate the learned skills with the person who has
taught them or in the setting where they have learnt them (Loomis 2008; Bowen & Plimley
2008). Eventually, if they do not use these skills outside the learning context, the skills will be
forgotten and lost (Loomis 2008).
More than academic skills, development in peer social interaction skills and social
competencies will support the success and well‐being of these children with ASD and will
determine how independent the children with ASD will be as adults (Loomis 2008; Tartaro &
Cassell 2008).
There are many ways of intervention for children with ASD to learn social skills. According to
Sicile‐Kira (2004) the considerations involved when choosing an intervention are age, what the
child is like in terms of functionality, the child’s behavior, whether the child is a visual or an
auditory learner, what the child’s strengths and weaknesses are and what goal the child has.
The types of treatment that have been widely used for children with ASD are behavioral
modification treatment, augmentative and alternative communication, robot therapy, music
therapy, computer assisted, animation, video modeling, interactive computer software, virtual
reality and Social Story™.
2.3.1 Behavioral Modification Treatments
In the broadest sense, behavior modification treatment includes any system that is controlling
behavior by means of reward and punishment (Waltz 2003). Effective strategies for a perfect
behavioral modification program as identified by Ball (2008) are: repetition, shaping,
reinforcement, play, extinction, and rapport building/behavioral momentum.
There are various behavioral modification treatments available, and with the three most
popular treatments specifically designed for children with ASD are Applied Behavioral Analysis,
Developmental Individual‐Difference Relationship‐based/Floortime, and The Treatment and
Education of Autistic and related Communication‐handicapped Children.

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2.3.1.1 Applied Behavior Analysis (ABA)
ABA is a systematic process that examines behavior by observation, reproduction, testing and
objectivity to select change and evaluate human behavior (Ball 2008; Ringdahl et al. 2009). It
grew in popularity as a model to be used for children with ASD by the works of O. Ivar Lovaas,
who succeeded in changing behavior in a small group of children with ASD, using a highly
structured, intensive behavior modification program based on discrete trial teaching (Ball
2008).
ABA is the most widely researched treatment method for developmental disabilities,
communication disorders, special education and rehabilitation psychology (Ball 2008; Matson
& Neal 2009; Heilbroner & Castaneda 2006). ABA is taught through a number of discrete trials
in which correct responses are reinforced, and the new skills are shaped through prompting
(Dodd 2005). Children with ASD who use the ABA program are constantly re‐directed to
engage in appropriate behavior. In addition, the children’s responses in every ABA teaching
session are recorded. The recorded data is used to determine the effectiveness of the activities
and whether the program needs to be modified (Dodd 2005).
There are a variety of program models that are ABA based, ranging from the very intensive and
structured to the less intensive and more naturalistic programs (Ball 2008), with the most
popular ones as Discrete Trial Teaching, Pivotal Response Training and Lovaas Model (Sherman
2007).
a. Discrete Trial Teaching (DTT)
DTT also known as Discrete Trial Instruction, Discrete Trial Therapy or Discrete Trial Training
(Ernsperger 2003), is a form of ABA. It is a systematic instructional training for children with
ASD that breaks down specific target activity/skill into three distinct components (Sherman
2007; Ball 2008; Gerlach 2003). The specific target activity/skill has basic functional units, and
each of these functional units is taught in a systematic way (Ball 2008; Gerlach 2003). The
three components are: a cue (an instruction by teacher/therapist), a response/behavior (by
the student) and a reinforcer/consequence (Ball 2008; Sherman 2007). As part of its
methodology, DTT also uses prompts, consequences and measurement (Ball 2008).
The key principles of DTT are: (1) a high level of teacher‐student interaction, (2) active student
engagement, (3) employment of sequenced and structured materials and activities, (4)
breaking down of task or skill into small measurable steps by completing a task analysis, (5)
utilizing powerful motivation or reinforcement, (6) providing corrective and informational

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feedback, (7) giving the student many chances to learn a new skill through increased
repetition, (8) strong emphasis on data collection, (9) providing clear and concrete
instructions, and (10) maximizing student participation and learning outcomes (Ernsperger
2003).
DTT rely heavily on a direction or command from the teacher/therapist as a signal to begin the
discrete trial. The beginning lesson in DTT focuses around basic functions, such as children
learn to contain or control maladaptive behavior. At the same time, they are being taught
positive behavior. If the children respond appropriately after the instruction, they may be
given a simple reinforcer/reward such as a candy. As the program progresses, the reward can
be changed to a social reinforcer such as a hug or praise (Sherman 2007). In the DTT approach,
the targeted skill is repeated several times until the children reach a level of mastery (Ball
2008; Gerlach 2003), and as the program progresses, simple lessons are combined to teach
more complex tasks or skills (Sherman 2007).
b. Lovaas/UCLA Model
Lovaas was first developed at the University College of Los Angeles (UCLA) by Dr. Ivor Lovaas in
1987 (Lovaas 1987; Richer & Coates 2001). Many have considered the Lovaas method as DTT
such as Golden et al. (2010) and Siegel & Ficcaglia (2006), whereas there are others who
consider it as a separate method from DTT, such as Sherman (2007), Gerstein & Gerstein
(2004), Prelock et al. (2010). They consider the Lovaas model as only relying primarily on the
DTT model.
Lovaas is an intensive, home‐based intervention program for children with ASD that is run by
parents, family, friends and students who are trained in the method (Deiner 2009). The
intensive teaching is provided through a discrete trial format (Ringdahl et al. 2009; Gupta
2004). Lovaas uses a model of introduction, prompting and reinforcement of behavior, with a
curriculum that focuses on increasing language skills, social behavior (Ringdahl et al. 2009;
Deiner 2009), academic skills (Deiner 2009), imitation, play and self‐care skills and decreasing
disruptive behavior (Ringdahl et al. 2009). Generalization of skills learned is an important
component of the Lovaas’s treatment plan (Deider 2009).
c. Applied Verbal Behavior (AVB)
AVB is the function assessment of a language program that has an emphasis on verbal
behavior or language development (Ball 2008; Shore et al. 2006). In AVB, language is treated

Page 23

as a behavior that can be shaped and reinforced, while careful attention is paid not only to
what a child is saying but why he/she is using that language (Barbera & Rasmussen 2007).
AVB is an approach that emerges from the basic teaching of ABA (Boutot & Tincani 2009;
Barbera & Rasmussen 2007). However AVB differs from ABA, as it is less formal and structured.
The process of AVB occurs in a natural environment, where errors are minimized through
systematic prompting and fading (Shore et al. 2006). The rationale in ABA is that language is
the foundation for many other skills; it is easier to acquire other behavior or skills when a
language is mastered (Shore et al. 2006).
According to Ball (2008), AVB is viewed as a bridge builder that is used in conjunction with the
behavior modification technique to increase motivation and to provide a better understanding
of words and their meanings. AVB teaches children to imitate, follow instructions, match and
make requests not only through speech/spoken language, but also through all sorts of non‐
vocal forms of communication such as finger pointing, singing, writing, gesturing, signs, or
even tantrums (Barbera & Rasmussen 2007). AVB also supports the use of the augmentative
system for communication (Gupta 2004; Shore et al. 2006; Boutot & Tincani 2009).
AVB utilizes principles (such as reinforcement and extinction) and techniques (such as shaping,
prompting/motivation and generalization) to increase on‐task behavior, where the
teacher/therapist continually attempts to offset the value of escape during instructional time,
while every opportunity is viewed as a learning opportunity to maximize responding (Kates‐
McElrath & Axelrod 2006). In teaching children with ASD by using AVB, there is an initial
emphasis on establishing the teacher as a conditional reinforcement, which is accomplished
through pairing the teacher with a reinforcement (Kates‐McElrath & Axelrod 2006).
d. Pivotal Response Training (PRT)
PRT was developed by Pierce & Schreibman (1995) as a naturalistic intervention model that
combines ABA procedures and development approaches. It provides opportunities for children
with ASD to learn within a natural environment setting and includes components such as the
child’s choice and turn taking (Ringdahl et al. 2009; Sherman 2007; Ball 2008).
Rather than targeting on the individual behavior one at a time, PRT focuses on behaviors that
are pivotal in the acquisition of other behavior/pivotal areas of the child’s development such
as motivation (reinforcement), ability to respond to multiple cues (Ball 2008; Sherman 2007),
self‐management and social initiations (Sherman 2007). By targeting these pivotal areas, as

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argued by Sherman (2007), PRT can result in widespread collateral improvements in other
social, communicative and behavioral areas that are not specifically targeted.
PRT has been used to target the language skills, play skills and social behavior in children with
ASD (Ball 2008), to decrease disruptive or self‐stimulatory behavior, and to increase social
communication and academic skills (Sherman 2007).
Motivational strategies of PRT are incorporated into the intervention as often as possible.
These include: following the child’s lead/choice, using a child’s preferred items and activities,
teaching the child within the natural context, providing clear instructions, providing choices,
reinforcement/reward of attempts, varying and interspersing tasks, and using direct/natural
reinforcers (Ringdahl et al. 2009; Sherman 2007).
In PRT, children play a crucial role in determining activities and objects that will be used as the
exchange. Children’s intentful attempts at target behavior are rewarded with a natural
reinforcer, such as, if a child attempts to request a stuffed animal they will receive the animal,
not a piece of candy or other unrelated reinforcer (Sherman 2007).
2.3.1.2 DIR/Floortime
DIR (Developmental, Individual‐Difference, Relationship‐based) was developed by two child

psychiatrists, Dr. Stanley Greenspan and Serena Wieder in 1980. DIR is an interactive,
intensive, relationship based intervention program (Ball 2008; Sherman 2007) that emphasizes
improving the child’s ability to form relationships (Hendrickson 2009).
DIR focuses on the importance of emotion and relationship in learning development and it
systematically addresses the core issues in ASD through an array of family focused
intervention. It is designed to build the child’s capacity to relate, communicate, think
symbolically and process sensory information (Sherman 2007). To use the DIR approach, each
child’s unique strength, developmental capabilities and challenges must be identified (Metz et
al. 2005).
The goal of DIR is to connect the child’s emotion to the family and peers, to enable the child to
read and respond to social signals with empathy and self‐awareness, and to be involved in
creative and reflective thinking and complex problem solving (Sherman 2007). It places parents
as the central organizer of the child’s world and routine, who will eventually help the child to
develop a greater functional and emotional independence and capacity (Metz et al. 2005).

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Through systematic observation in the child’s natural environment and their interactions with
family members, DIR identifies the children’s emotional development levels and intellectual
functioning, determines their individual ways of reacting to movement, sound, sight and other
sensations. Through it, methods are formulated for learning through relationships and
interactions at home, schools and in different settings (Sherman 2007).
The centrepiece of DIR is Floortime, where the child and family members get down on the
floor in a 20‐30 minute session, to engage the child in establishing a bond between the child
and family members (Ball 2008; Sherman 2007). Through Floortime, family members learn
how to draw the child into emotionally satisfying and meaningful interactions by appealing to
his/her natural interest/behavior. Floortime helps the child to be capable of establishing a
warm reciprocal relationship, spontaneous self‐expression, curiosity, flexibility and abstract
thinking (Sherman 2007). The environment in Floortime that is based on play and social
interactions make it a very natural way of teaching (Ball 2008).
However, there are also critics of the DIR/Floortime program. Hendrickson (2009) states that
the DIR/Floortime intervention does not contain any skill training. The effectiveness of
DIR/Floortime is also considered as unproven as it has not been researched or studied for its
effectiveness (Ball 2008; Hendrickson 2009). According to Metz et al. (2005), there is only one
study supporting the effectiveness of Floortime, which was done by Greenspan and Wieder
(1997) who presented a retrospective, 200‐casechart review of outcomes of children with ASD.
2.3.1.3 TEACCH
The Treatment and Education of Autistic and related Communication‐handicapped Children
(TEACCH) program was established in the early 1970s at the University of North Carolina by Dr
Eric Schopler. The long term‐goal of the TEACCH program is for students with Autism to fit into
society as adults through respecting the differences that Autism creates within them, and
working within their cultures to teach the skills needed to function in society (Feinstein 2010;
Ball 2008).
TEACCH is a broad and lifelong approach that addresses not just work skills and
communication skills, but also covers other skills such as social and leisure skills (Ball 2008). It
improves the welfare of children with ASD by understanding the nature of ASD and the
individuals, then developing an appropriate structured individualized program that capitalizes
on their skills and interests, promotes independent work skills, emphasizes strength/interest,
fosters communication, social, leisure interest and opportunities (Metz et al. 2005).

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TEACCH involves parents as co‐therapists. It uses behavioral strategies to enhance
communication and social interactions (Deiner 2009). TEACCH supports the use of visual
organizers and cues such as picture squares combined with words or symbols (Deiner 2009;
Sherman 2007).
The TEACCH program is very structured with separated areas for each different activity.
Materials used such as visual strategies, independent scheduling, individual work station and
labeled work boxes are modified to make them clearer and more meaningful (Sherman 2007).
This is the foundation of the everyday routine for children with ASD to promote maximum
independent life at home or in school (Ball 2008). The critic of TEACCH, Ball (2008) states that
it is not exactly clear how the TEACCH individual program strategies are taught.
2.3.1.4 Limitation of Behavioral Modification Treatments
ABA’s approaches rely on teacher’s directions, prompted responses and contrived forms of
reinforcement. ABA approaches have inherent weaknesses, they often lead to a passive style
of communication, in which children respond to prompts to communicate but do not initiate
communication or transfer the acquired behavior to situations outside the teaching context
(Paul & Sutherland 2005; Stokes & Baer 1977; Prelock et al. 2010).
In order to optimize the benefits of the behavioral modification treatment program,
intervention is very time intensive; it utilizes up to 40 hours per week for approximately 2
years (Dodd 2005). This approach has slow progress; it could take months or years to see
noticeable results in children with ASD (Bernier & Gerdts 2010).
Behavioral modification treatment is also an expensive approach, which has to be carried out
by a team of trained people including supervisors, therapists, parents and peers (Dodd 2005).
This limits the feasibility of behavioral modification intervention for many families (Bernier &
Gerdts 2010; Heilbroner & Castaneda 2006).
As identified by Heilbroner and Castaneda (2006), behavioral modification treatment does not
appear to help all children with ASD. There are also claims that ABA does not allow children to
establish relationship with others, skills are not generalized and these children appear to be
very robotic in their responses to others (Ball 2008).

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2.3.2 Augmentative and Alternative Communication (AAC)
AAC is another line of approach that was originally developed to help individuals with
significant motor‐speech problems (Volkmar & Wiesner 2009). AAC is widely used in enhancing
the social, communicational, behavioral, academic and vocational lives of children with ASD
(Mirenda 2003; Audet 2007; Charman & Stone 2006). In the AAC approach, children are helped
to communicate in various ways, such as using sign language, Picture Exchange
Communication System and Facilitated Communication. The AAC approach can also be
combined with other approaches in helping children with ASD to communicate (Volkmar &
Wiesner 2009).
2.3.2.1 Sign Language
There are two major forms of sign language, the American Sign Language (ASL) and the Exact
English, with the primary difference in the use of conceptual thinking. The motion and gestures
of ASL are created to say as much as possible quickly and economically where an entire phrase
is often represented with one single sign. On the other hand, Exact English uses one sign for
each word, which can be helpful for children with ASD as they learn about conceptual ideas
(Tilton 2004).
Sign language is the preferred language for people who have a lack of verbal communication
ability (Tilton 2004). In sign language, the child performs hand signs to request preferred items
or to perform other language functions (Boutot & Tincani 2009). It was first developed as a
means of communication for people with hearing impairment or developmental disabilities
(LeBlanc & Volkers 2007).
However, children with different levels of ASD can also be taught to use sign language in
communication (Turkington & Anan 2007). It has been useful in decreasing problem behavior
in children with ASD such as aggression, tantrums, self‐injury, anxiety and depression that are
often caused by frustration over their inability to communicate (Kurtz 2008; Turkington &
Anan 2007). Despite its effectiveness, the use of sign language is not as common as in previous
years, due to an increase in the use of the computerized communication system (LeBlanc &
Volkers 2007) and experts have suggested that it is better to use a picture system or a
computerized device to enable communication for those who do not understand the signs
(Turkington & Anan 2007).

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2.3.2.2 Picture Exchange Communication System (PECS)
PECS is an augmentative communication system designed to assist non‐verbal and verbal
children with ASD to communicate in a functional and effective way (Ball, 2008). It has been
recognized around the world for its focus on the initiation component of communication
(Turkington & Anan 2007). PECS was developed in 1985 by Andrews Bondy and Lori Frost, as a
training package to teach children with ASD to initiate communication (Ball 2008; Bondy 2001;
Kurtz 2008), as they observed many children with ASD having difficulty in acquiring
spontaneous communication skill via speech or sign language (Bondy 2001).
PECS teaches words by using a picture as an exchange for the desired object. Once the child
has the idea, the picture can be used as the basis for building more complex language,
including a full sentence. It is useful in both verbal and non‐verbal children, as a way of
producing spontaneous communication (Turkington & Anan 2007). The logic in PECS is that
most children with ASD prefer to learn through the visual media. Therefore the use of pictures
encourages their learning, where a picture of reward is one of the fundamental tools that
allow the child to let a person whom he is trying to talk to, know what he wants (Robledo &
Ham‐Kucharski 2005; Kurtz 2008).
The objective of PECS is to enable children with ASD, whose speech is unintelligible or non‐
existent, to spontaneously initiate communication with others, to understand the function of
communication and to help them develop communicative competency (Lin & Biggs 2006;
Cornwallis & Peacock 1998; Turkington & Anan 2007).
PECS emphasizes the differences between talking and communicating (Boushey 2004). Several
authors such as Robledo & Ham‐Kucharski (2005), Kurtz (2008) and Turkington & Anan (2007)
consider PECS as a part of ABA because the teacher/trainer must first identify the learning
motivation of a child, and then use that motivational object to reward the child.
PECS has many advantages for children with ASD; it is easy to understand and implement, it is
child‐initiated, it requests social contact, materials are readily available or it can be created by
the teacher to tailor to the child’s needs, it has universal appeal and can be implemented and
used everywhere because it is non‐verbal (Ball 2008). There are many ranges of the PECS
system, from cutting of magazines (Richman 2001) to the computerized system such as
Boardmaker (Ben‐Arieh & Miller 2009; Richman 2001; Lin & Biggs 2006). PECS is easy to be
incorporated into any existing program (Sicile‐Kira 2004). It does not require expensive

Page 29

materials (Sicile‐Kira 2004; Richman 2001). It has also been argued that PECS can help to get
language started (Turkington & Anan 2007; Sicile‐Kira 2004; Mirenda & Erickson 2000).
There are controversies that say the use of PECS inhibits the development of speech in
children with ASD (Glennen & DeCoste 1997; Volkmar & Wiesner 2009; Sicile‐Kira 2004). There
is an issue of when a child seeks to communicate something that is not yet in the picture
system (Mirenda & Erickson 2000). In addition, minimal training for PECS’s therapists could
lead to PECS being used inconsistently within the classroom (Boushey 2004).
2.3.2.3 Facilitated Communication (FC)
FC is a form of the AAC system that allows children with none or limited verbal ability to
communicate with a facilitator assisting them (Biklen 2007; Schreibman 2005; Bernier &
Gerdts 2010). It was initially developed for children with Cerebral Palsy by Rosemary Crossley.
It has then subsequently been widely used with children with ASD after Douglas Biklen
observed that children with ASD who used FC could engage in communication that was
conceptually sophisticated (Schreibman 2005; Bernier & Gerdts 2010).
In the FC program, a child with ASD will work with one or more trained ‘facilitators’, who
provide emotional and physical assistance as the child attempts to communicate by typing,
pointing to pictures or accessing to computer controls (Kurtz 2008).
There was much controversy in FC (Gilpin 1993), as there was no convincing evidence that FC
worked to help people with ASD (Weathington et al. 2010). When FC was put to scientific
testing, it failed miserably, as the studies found that it was not the student who was
communicating; it was in fact the facilitator who assisted the student (Schreibman 2005;
Bernier & Gerdts 2010), therefore FC could be considered to be harmful (Bernier & Gerdts
2010).
2.3.2.4 Limitations of Augmentative and Alternative Communication
Regardless of the advantages and its wide range of applications, AAC has limitations as a
means for children with ASD to learn social skills as identified by various authors.
Smith (2005) and Fossett & Mirenda (2009) suggest that more empirical studies are needed in
order to evaluate the effectiveness of AAC application to support the learning of children with
ASD. Professionals who wish to provide AAC services must be competent in the specified skills
of the AAC system (Glennen & DeCoste 1997). Therefore, it limits the service availability of

Page 30

AAC to public users. The AAC device is being abandoned by the users due to the mismatches
between skills, expectations and device’s capabilities (Glennen & DeCoste 1997; Spitko 2008).
Salminen & Petrie (1999) show that computerized AAC for disabled children is demanding,
slow, and highly context‐independent. In the same study, it is also found that users often lose
interest in the device after six months of application.
2.3.3 Robot therapy
The robot therapy has been researched as an aid for children with ASD to learn social skills, as
children with ASD tend to behave more pro‐socially when interacting with robots than with
humans (Ricks 2010; Khatib et al. 2009; Kozima et al. 2007; Dautenhahn 2008; Besio et al.
2007; Siciliano & Khatib 2008; Fujimoto et al. 2010; and Tsui 2008).
A robot has the potential to adapt to behavior and allow children to develop at their own rates
(Werry et al. 2001a, 2001b). The use of robot as a therapy partner for children with ASD can
lead to a stronger learning environment. The robot is able to function and communicate in the
designated ways, allowing children with ASD to focus on a few communication channels
without missing any details. The robot can also present the children with a safe and
comfortable environment and allow them to explore and learn about the interaction space
involved in social situations, where interaction can be controlled (Werry et al. 2001a, 2001b;
Besio et al. 2007).
Three robot applications are included in the review. The first and second ones are simple toy‐
based robots for children with ASD to learn emotions that are necessary for social skills. They
are the Affective Tigger and Keepon and the third robot is an advanced robot application,
named Aurora Project, which is specifically developed for children with ASD.
2.3.3.1 Keepon
Keepon is a simple yellow snowman‐like looking robot made of soft silicone rubber. Keepon
was created by Professor Hideki Kozima to help in the research of the development of children
with ASD, specifically to study their social development, by communicating with them.
Keepon’s behavior were designed with intention to help children with ASD to understand its
attentive and emotive actions (Kozima & Nakagawa 2007; Nakamoto 2011; Kozima et al. 2005;
Fujimoto et al. 2010).
Keepon is a minimally social robot that has four degrees of freedom (Tsui 2008). Keepon’s
minimal expressiveness helps children with ASD to understand socially meaningful

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information, which then activates their motivation to share interests and feelings with others
(Kozima et al. 2007). The purpose of Keepon is to study the social interaction of children with
ASD (Tsui 2008) through non‐verbal interactions.
2.3.3.2 The Affective Tigger
The objective of Affective Tigger is a toy that can serve as an affective mirror for the child’s
expression, showing a reflection of the affective qualities when the child is playing with it
(Picard 2000; MIT Media Lab 2009). A study conducted by MIT Media Lab shows that Affective
Tigger has successfully communicated some aspects of emotion and is able to prompt positive
behavior (MIT Media Lab 2009).
Tigger exhibits the expressive emotional behavior as responses to how a child plays with it, as
it has sensors that are capable of discriminating potentially abusive actions like poking of the
eyes to potentially playful actions like bouncing or light pulling in the tail (Picard 1999). When
Tigger’s emotional state is happy, such as when the child has postured Tigger upright and
bouncing it along the floor, the ears of Tigger will be moving upwards and it will be emitting a
happy facial expression.
2.3.3.3 Aurora Project
The Aurora Project was developed in 1998 by Dautenhahn et al. as the result of a study in the
possibility of using a robotic platform as a therapy aid for children with ASD (Dautenhahn
1999; Werry et al. 2001). The study covers the development of a mobile, autonomous, non‐
humanoid and social robot that can be used as a therapeutic tool for children with ASD, in an
environment in which children can explore and discover their interaction skills, instead of
being simply taught to them (Dautenhahn et al. 2002a, 2002b; Eliasz 2009).
The study was intended to discover how a mobile robot (Aurora Project) could become a toy
and a remedial tool for getting children with ASD into coordinated and synchronized
interactions with the environment (Dautenhahn 1999). Therefore, the aim of the Aurora
Project is to serve as both mediator and teaching aid for children with ASD in giving them an
opportunity to practice and explore their behavior in social situations, as well as to provide a
focus of interest and attention for them, in order to stimulate interpersonal relations and
interactions (Werry et al. 2001).
The long term goal of the Aurora Project is to develop a robotic platform that can be used in
schools by teachers to allow children with ASD to practice their social skills, learned in other

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classes (Werry et al. 2001), and eventually helping children with ASD make a bond with the
social world (Dautenhahn 1999).
The main limitation of the Aurora Project as identified by Dautenhahn & Billard (2002) is that
the robot used in the project can only offer a very small number of interactions with children
with ASD, i.e. the type of interaction that occurs is limited to the spatial approach/avoidance
turn‐taking games.
2.3.3.4 Limitation of robot therapy
Using robots in education and as an aid to the therapy for children with ASD poses many
challenges (Dautenhahn 2008). Issues in using a robot as a treatment aid for children with ASD
are: (1) the high cost of developing and building the humanoid robots (Eliasz 2009); (2) design
issues on the interactive environment for children with ASD, such as in the Aurora Project
(Dautenhahn 2000); (3) the nature of ASD poses particular requirements and constraints on
the robot and its behavioral capabilities, such as in safety and ethical issues, where it is vital to
provide a safe, enjoyable and relaxed environment for the child, as well as for any aspect of
the robot that might upset or scare the child (Dautenhahn & Billard 2002).
The use of robots can also inhibit children with ASD in building relationship with others if it is
not used with caution, as they might seek to have the exclusive relationship/interaction with
the robot and ignore other peers or adults who are present. Thus, there is a need to emphasize
that robot should become a social mediator that will encourage interaction with other people,
instead of reinforcing existing behavior of a social isolator (Besio et al. 2007).
2.3.4 Music therapy
Most children enjoy and respond positively to music, including children with ASD. Alvin (1978)
was the first to explore the use of music therapy as a treatment to children with ASD.
Subsequently, there have been many literature reports music to be used as one of the
interventions in helping children with ASD cope with social skills (Brunk 2004; Gerlach 2003;
Saville 2007; Howat 1995; Oldfield 2006).
Music therapy is the process of using music as a therapeutic tool or agent to address physical,
emotional and social needs of an individual. It focuses on achieving non‐musical goals such as
body and environmental awareness, motor control, social interaction and communication
(Shore et al. 2006). As suggested by Gerlach (2003), music therapy may include many activities
such as singing, body movement to music and playing musical instruments.

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The goal in music therapy is tailored to the needs of each individual, which may be to increase
nonverbal interactions (such as turn taking and eye contact), to explore and express feelings,
or to be creative and spontaneous (Sicile‐Kira 2004).
Recently, music therapy has been combined with other therapeutic approaches for specific
reasons. Social stories are musically adapted in Brownell’s research (2002) to help ASD children
to understand social situations or events, whilst Berger (2002) describes a collaborative
approach between music therapy and sensory integration theory with autism (Saville 2007).
However, as stated by Gerlach (2003), there are varying degrees of success in music therapy in
children with ASD. In line with Gerlach (2003), Brunk (2004) states that there are no studies
that have identified a particular music as being beneficial to all children with ASD. Berger
(2002) also highlights that music therapy requires an extensive amount of time to be effective
as a treatment for children with ASD.
2.3.5 Computer assisted learning
Direct face to face learning can be so overwhelmingly uncomfortable that children with ASD
resist or switch off their attention (Moor 2008). While avoiding social interactions, the interest
and attention of children with ASD are very much drawn to the computer, as proven in the
studies of Elzouki et al. (2007), Strickland (1997), Tartaro & Cassell (2008), who find that
children with ASD enjoy using the computer and are responding well to it. They find
technology attractive and are drawn to computers (Moor 2008).
Studies were conducted in comparing the traditional book learning (Williams et al. 2002) and
personal instruction (Chen & Bernard‐Opitz 1993) with computer assisted learning in children
with ASD. The first study found that children spent more time on task and reading materials in
computer assisted learning compared to book learning (Williams et al. 2002), whereas the
second study found that children showed better motivation and fewer behavioral problems in
computer learning conditions (Chen & Bernard‐Opitz 1993).
Stromer et al. (2006) suggest that integrating multimedia computers with an activity schedule
can be an effective way to teach children with ASD to manage their work, play and skill‐
building activities independently. The review illustrates how the activity schedule presented in
computers enforces new learning via videos, sounds, dialogues, images and words that are
employed as instructional stimuli.

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Due to this interest of children with ASD in computers that present visual cues (such as
pictures and animation), application of computer assisted and multimedia learning as learning
agents for children with ASD has been suggested and widely studied by various researchers,
such as Hardy et al. (2002), LeBlanc & Volkers (2007), Eliasz (2009), Hall (2010), Moore &
Calvert (2000). All of these studies found that the computer is beneficial as a treatment for
children with ASD, as these children find a special appeal and enthusiasm for computers,
therefore giving this method of using the computer a positive response (Hardy et al. 2002;
Bernard‐Opitz et al. 2001).
Children with ASD interact naturally with computer technology and they can use it creatively
(Eliasz 2009). The computer can also become a catalyst for social interaction, such as, while
using the computer, a child with ASD will converse naturally with the child next to him, such as
telling him which button to press and what to do (Hardy et al. 2002). Another reason that
supports computers to be used to help children with ASD to develop their interaction skills is
the fact that when using the computer, the child is actually in direct control of the computer,
meaning that the interaction may not be as intimidating as a face‐to‐face interaction with
others (LeBlanc & Volkers 2007).
Advantages of the computer assisted learning method for children with ASD, as identified by
Hall (2010) are: (1) it does not require interaction with other people; (2) it offers autonomy
and a safe environment; (3) it is non‐judgmental; (4) it provides a focal point to hold
concentration; (5) it is consistent and predictable; (6) it enables errors to be easily corrected;
(7) it provides instant feedback; (8) it creates an awareness of self; and (9) its simple computer‐
presented games promote communication with others.
2.3.6 Animation
Another method of presenting information to children with ASD is through animation. In
traditional terms, animation is the process of caricaturing life which could serve as a medium
to project a story, such as a film, comic or book used to illustrate a story, to its viewer. In
modern terms, animation refers to the rapid displays of still images in a sequence to create an
illusion of live motion. It can also be explained as the simulation of movements through the
sequence of still images that have objects with slightly different positions shown one after the
other very quickly so that the human eye and brain blend the image to produce the effect of
live motion (Itl Esl 2009). Animation is a powerful tool in communicating complex ideas (Itl Esl

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2009), as it is often much easier to show a person how things work than to try to explain how
things work.
Animation/cartoon is one type of visual support that children with ASD are attracted to, and
this technique has already been implemented for many years in helping children with ASD to
enhance their understanding of language (Myles et al. 2004). Animation figures can play an
integral role in a number of intervention techniques, such as pragmatism (Arwood & Brown
1999), mind reading (Howlin et al. 1999), and comic strip conversation (Gray 1995). Each of
these techniques promotes social understanding by using simple figures and other symbols.
The use of animation as a treatment approach for children with ASD has been widely
supported by various authors, such as Wells (1998), Bernard‐Opitz et al. (2001), Howlin et al.
(1999), Herskowitz (2009) and Baron‐Cohen et al. (2009). Children with ASD are capable of
learning a new language within a program that is centered on a computer‐animated agent,
multimedia, to encourage active participation. Compared to video modeling, the use of this
method shows that there is a transfer and use of language learned in a natural and untrained
environment, as suggested by Bosselar & Massaro (2003).
Visual cues enhance the ability of children with ASD to understand their environment (Gray
1995; Rogers & Myles 2001; Myles et al. 2004). Visual symbols found in animation/cartoon
often enhance the social understanding of children with ASD by turning an abstract and elusive
event into something tangible and static that a person can reflect upon (Dunn et al. 2002;
Hagiwara & Myles 1999; Kuttler et al. 1998; as noted by Myles et al. 2004).
A research by Bosselar & Massaro (2003) showed that children with ASD are capable of
learning vocabulary with the help of a computer‐animated agent. Positive results using
animation to teach children with ASD have also been shown by Baron‐Cohen et al. (2009),
whose research shows that an animated movie has improved the understanding and emotion
recognition in children with ASD. Using computerized animation, children with ASD are able to
learn problem solving techniques (Herskowitz 2009); animation has also been proven effective
in helping children with ASD to recognize human emotions (Golan et al. 2009; Baron‐Cohen et
al. 2009; Baron‐Cohen et al. 2007).
As noted by Herskowitz (2009), animation can be used for several purposes: Firstly, animation
can be used as a reinforcer, for example when a child performs a task correctly in the
computer program, an animated character will display and congratulate the child for the job
well done. The second function of the character animation is that it can be used as a prompt

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device. And thirdly, the use of animation as the actual characters in the program can increase
the child’s attention and focus on the task. There are two types of computerized animation,
which are the 2D animation and 3D animation.
a. 2D animation
In the traditional technique, 2D animation is created in two flat planes or dimensions by
making several sets of slightly different complete pictures and arranging them in a sequence to
create an illusion of movement as perceived by the human brain. This is normally done
manually by flipping a stack of notes or hand drawing pictures. In the modern technique, 2D
animation is developed in digital format through the use of a computer program.
2D animation is a very common type of animation; it is widely used in the media industry,
ranging from simple advertisements to movies, with great success (Itl Esl 2009).
Despite the fact that 2D animation has been widely used in many areas, there has not been
much scientific research conducted on the effects of 2D animation, particularly on children
with ASD, except for a few like Boraston et al. (2007) who studied the effect of 2D abstract
animation on children with ASD, in identifying simple emotions. However, there has been
much feedback from real‐life experiences from the families of children with ASD who claimed
that 2D animation was enjoyed by most of the children with ASD. Therefore, one of the study
aims is to conduct a scientific research on how children with ASD respond to a 2D animation
that is combined with a Social Story™.
b. 3D animation
3D animation is also one of the popular techniques in animation. According to Morrison
(2003), the 3D model is the mathematical representation of a physical object, thus this makes
3D graphics, especially animation, to be extremely complicated because it often requires the
heavy‐duty mathematical processing.
The difference of 3D animation and 2D animation is that in the 2D animation, the object
cannot be rotated to obtain views from different angles. This, however, can be achieved in the
object of 3D animation. However, according to Morrison (2003), 2D animation is a more
straightforward and efficient technique in animation compared to 3D animation. Therefore,
while 3D technology is more advanced than the 2D animation, the use of digital 2D animation
is more popular, where mostly cartoons on the televisions and movies are based. The 3D

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animation is mostly used in computer‐aided designs, such as in architectural building (Itl Esl
2009).
2.3.7 Video modeling (VM)
VM is the process of an individual, referred to as the model, being recorded in a video,
demonstrating a behavior that can be imitated by another person (Dood 2005). The process of
VM as a treatment for children with ASD often involves the child with ASD repeatedly watching
videotapes of positive examples of competent confederates (could be adults, peers, or
themselves) performing/engaging in a targeted behavior for improvement (Reichow &
Volkmar 2010; Delano 2007; McCallister 2010; Baker et al. 2009). In this case, the child is also
given an opportunity to perform the task in a real life setting (Reichow & Volkmar 2010;
Ferraioli & Harris 2010). VM has been an important tool for teaching imitation and socially
reciprocal behavior (Williams & Williams 2011); therefore, it is fit for social skill training in
children with ASD (Hollander & Anagnostou 2007; Nikopoulos & Keenan 2003).
There are two types of VM which differ in the use of the model in the video. The first type uses
competent confederates like peers, and the second type uses self‐model in performing the
targeted behavior, often referred to as video self‐modeling (VSM) (Shipley‐Benamou et al.
2002). Both types have proven effective as treatments for children with ASD in addressing
social‐communication skills, behavioral functioning, and functional skills (Bellini 2006).
VM has numerous benefits, including the demonstration of targeted skills in a relevant
context, the use of multiple stimulus and response exemplars, and the standardization of the
presentation of training, allowing for consistency (McCallister 2010). It is effective in
promoting skill acquisition and maintenance in post‐intervention (Shipley‐Benamou et al.
2002; Nikopoulus & Keenan 2004).
The first study on VSM, conducted by Buggey et al. (1999) suggests that VSM is effective in
increasing participants’ responses to questions during play situations. Therefore, it may
constitute a positive behavior change. A review of nineteen empirical studies from 1985‐2005
by Delano (2007) on the use of VM on children with ASD suggests that VM is effective in
teaching a variety of skills to those children. Study by Taylor et al. (1999) show that the use of
VM in teaching children with ASD to make play comments towards their siblings is effective.
MySchool Day is one of the commercial packages designed for use in VM activities (Prelock
2006). It is designed to facilitate learning by providing an option to pause and to discuss

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information, reply scenarios for greater recall and understanding, and to engage in exercises
that may help the learner to carry out the learned skills in everyday life. It is an interactive
computer program that incorporates real‐life video as a media of learning, to teach social skills
to children and adolescents. The video clips illustrate a typical school day to allow the user to
view the appropriate interactions and social behavior within the school environment. The user
will be asked to identify, explain and produce several social situations in response to the video
clips.
Setting up VM as an intervention for children with ASD requires a long process and needs at
least two people involved in the video production (Moor 2008). The effectiveness of VM is
subjective, depending on the child; VM can be more or less useful as an intervention
(McCallister 2010). A study by Charlop‐Christy & Daneshvar (2003) has found out that children
with ASD can perform a generalization of the skills learnt from the VM; however, unlike their
result, a study by LeBlanc et al. (2003) indicates that there is only a limited generalization in
the skills learnt from VM. Therefore, strategies need to be developed for enhancing the
generalization of the new skills learnt from VM.
2.3.8 Interactive computer software
The traditional method of teaching children with ASD is often monotonous, laborious and not
effective (Sharmin et al. 2011). Therefore, for this reason and concerning the natural interest
in computer of children with ASD, many developers have been led to produce interactive
software to assist their play and learning activities.
In learning vocabulary, the use of the educational interactive computer software is more
effective, where children are more attentive, motivated and can learn more vocabulary
compared to learning through the behavioral program (Moore & Calvert 2000). The interactive
computer software is also effective in increasing intelligibility in children with ASD (Sharmin et
al. 2011).
The result of a study by Hetzroni & Tannous (2004) in the use of interactive computer software
for enhancing communication functions of children with ASD indicates that after exposure to
the software simulations, children produce fewer sentences with delayed and irrelevant
speech, engage in fewer sentences involving echolalia and increase the number of
communication intentions and the amount of relevant speech. Children are also able to
transfer their skills learned from the software setting to the natural classroom environment.

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a. Mouse Trial
Mouse Trial is one of the software packages based on the method of discrete trial therapy
which is a major component of ABA and the related treatment programs.
There have not been many literature reviews on the Mouse Trial, however, Moor (2008) and
Hall (2010) have suggested for Mouse Trial to be used as one of the software packages for
children with ASD. Mouse Trial is utilized to develop vocabulary that can be used in
communication for children with ASD. This software is available at a very low cost and is easy
to be used by children with ASD, as long as the children are able to interact with computers.
However, the features in Mouse Trial are limited to object recognition.
b. MyYard
MyYard features an expressive animated dog called Buddy and a series of circus characters in
order to teach children to stay in their own yard while playing outside, to reinforce the
importance of staying in their yard. The software comes with five main features which are:
Stay in the yard; guard the yard; sing‐a‐long; color & get‐2‐free; and printables.
The learning of MyYard starts with a child making a connection with Buddy who will show him
how to do things. According to Nelson (2008), 80 percent of participants in a multiple study
groups using MyYard, had been able to transfer their new skills to the real world after 20‐30
minutes of using the software.
c. Gaining Face
Gaining Face is an interactive computer software which helps people with AS learn to
recognize facial expressions. It was developed in 1999 by Team Asperger, and has been studied
by professionals in order to help people with AS learn to recognize facial expressions and
associate them with moods and emotions (Hall 2010).
The software has four main features. The first feature Faces of Moods, allows the user to pick a
mood by name, and it will illustrate and explain the expression that accompanies it. The
second feature is Moods of Faces, where the user can select an expression from a pictorial
menu of thumbnail images. The software then illustrates the chosen expression and provides a
text narrative explaining the distinguishing features of the expression. The third feature is
Compare Expression where the user can choose pairs of facial expressions, one from each of
two side‐by‐side lists. The software then illustrates both expressions, side‐by‐side with a
descriptive text to help the user discern their differences and similarities. The last feature is

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Quiz, which consists of twenty questions, testing on the user’s skill at recognizing and
distinguishing various facial expressions.
d. Mind Reading
Mind Reading is a memorization software for children with ASD in learning to recognize the
expressions and emotions of others (Bryant 2004). The user can learn human emotion and the
meaning of facial expressions including the tone of voice, by providing a live‐action video
library of all human emotions from six actors that portray 412 video expressions of emotion.
These expressions are in the context of short stories that will provide appropriate information
about the emotion (Bryant 2004).
There are three main features in Mind Reading. First is the visual dictionary of emotion titled
Emotion Library, the second feature is the Learning Center, consisting of a variety of lessons
and quizzes to present emotion in a systematic way and a recognition test, the difficulty of
which can be adjusted to suit the ability of the user. Learning Center also features rich sets of
rewards to motivate the user. The last feature is the Games Zone, where a user can play games
to guess the feelings of others. It encourages informal learning of emotions in a fun and less
structured setting to reinforce learning.
e. Affective Social Quest (ASQ)
ASQ was developed by Blocher and Picard (2005) at MIT for children with ASD. ASQ aims to
help children with ASD learn to associate emotions with expressions and situations (Bryant
2004). The system plays videos of both the natural and animated situations giving rise to
emotions, and the child interacts with the system by picking up one or more stuffed dwarfs
that represent or are related to the set of emotions under study (video clips), and it is
wirelessly connected to the computer via infrared (Bryant 2004).
ASQ was built on the strength of the visual system of children with ASD through the use of the
video. This system has been tested and it has shown positive results, as a three‐year‐old
participant has an increased ability to identify a wider range of emotions after each session of
training with ASQ (Poon 2006).

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f. Emotion Expressor
Emotion Expressor is a project by Poon (2006), done with the aim of developing a prototype
system that allows children with AS to explore their feelings and to express their opinions on a
selected topic, and to enable them to express their feelings about the topic as easily as
possible.
The interface of the system was developed and refined, using a user‐centered design
approach. A picture set was used since children with ASD are visual learners. Emotion
Expressor focuses on the picture symbols that are the basis of communication, as these can be
easily selected and understood by children.
g. Emotional Social Intelligence Prothesis (ESP)
ESP/Self Cam was created in the MIT Affective Computing Group Media Lab in 2006 (Teeters et
al. 2006; MIT Media Lab 2009; Frames MIT Lab 2006) as a tool for children with ASD, and it
consists of a wearable camera aimed at the wearer’s face for facial expressions. The data of
the facial expression could be read and analyzed in real time by the system, i.e. the belt‐
mounted computer and real‐time mental‐state interface software that gives personal feedback
to the wearer. The information gathered would be communicated back to the wearer
immediately, allowing for dynamic reading of the effect in interpersonal situations with
assistance from technology.
ESP analyses the wearer’s facial expressions and head gestures in real time. It infers six
underlying affective cognitive‐state of mind: agreeing, disagreeing, interested, confused,
concentrating and thinking. The wearer of ESP can explore who they appear to be from other
people’s point of view. ESP could help children with ASD improve their empathy by observing
non‐verbal cues and behavior of others; they would attribute mental states to these and
respond accordingly (Teeters et al. 2006; MIT Media Lab 2009; Frames MIT Lab 2006).
h. Limitation of interactive computer software
According to Hall (2010), there is not much interactive software available for children with
ASD, except for the few focused on specific aspects. Therefore, the computer is only to be
used as an occasional support and not be a dominant part of their learning activities. More
research is also required to establish whether skills learned from computer instructions will be
generalized into non‐trained problem situations in the real life context (Bernard‐Opitz et al.
2001).

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2.3.9 Virtual reality (VR)
The potential for using VR in educational context for children with ASD has been recognized by
authors such as McComas et al. (1998), Vera et al. (2005), Parsons et al. (2005), Herrera et al.
(2006), Parsons et al. (2004), and Cobb & Sharkey (2007). There are two types of VR available,
Immersive Virtual Reality (IVR) and Non‐Immersive Virtual Reality (NVR).
In IVR, the user is required to wear a head‐mounted display (HMD) stereo to provide a full
visual immersion and special gloves that allow six‐degree‐of‐freedom input for directly
manipulating the environment (Robertson et al. 1993). The HMD devices are expensive and
heavy to use, and can cause symptoms of cyber‐sickness. Therefore, IVR may not be an
appropriate technology to use with children with ASD (Parsons et al. 2004).
NVR is also referred to as Desktop VR, and it represents an alternative approach to the IVR.
There are non‐internet‐based NVR and internet‐based NVR, which, according to Wadley &
Ducheneaut (2009) have become a popular form of 3D environment and are proposed for a
variety of workplace scenarios. In Desktop VR, the user experiences a 3D environment that can
be directly manipulated by a conventional graphic workstation using monitor, keyboard, and
mouse. The scene is displayed with the same 3D depth cues used in IVR: perspective view,
hidden‐surface elimination, color, texture, lighting, shading, and shadows (Robertson et al.
1993). Desktop VR is more affordable and accessible for educational use, and tends to be much
less susceptible to the symptoms of cyber‐sickness (Parsons et al. 2004).
a. Second Life/Brigadoon City
One example of a successful VR application is Second Life (SL), a computer generated 3D online
virtual world established in 2003. In this virtual world, objects such as houses and activities are
created by the residents, i.e. players of the SL.
An individual with ASD has difficulty in social interaction and is unable to feel a sense of
belonging in the real world. Therefore, the virtual world could serve as a therapeutic tool, an
ideal place for them to communicate and interact with people via their avatars (Lester 2005;
Shore & Zhou 2009; Weiss & Klinger 2009; Klinger & Weiss 2009; Bury 2008). Based on this
idea, John Lester in 2004 purchased a 16‐acre Private Island in SL and named it as Brigadoon
City (Ball & Pearce 2008; Lester 2005; Bury 2008; Shore & Zhou 2009).
Brigadoon brings individuals with AS together to relate and help each other in their similar
struggles. Lester attempts through Brigadoon City to enhance the lives of individuals with AS in

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developing their social intelligence and communicative skills (Lester 2005; Bignell 2007; Burke
2008). Brigadoon is a private enclave reserved specifically for a mixture of caregivers and
individuals with ASD as a medium to allow them to form social bonds in the virtual world,
while learning and growing through the support and experiences of others within a flexible and
safe environment (Lester 2005; Willems 2009; Shore & Zhou 2009). The residents of Brigadoon
City, who call themselves Dooner, have the same privileges as others in the more public sector
of SL. They are able to create their own avatars, build houses, and make friends through
socialization, which have been much harder in their real lives (Bury 2008).
Research shows that the Brigadoon environment has some beneficial features for individuals
with ASD (Sheehy 2008; Biever 2007). The controlled simulation environment is less fearful
because it does not involve local interactions (Weiss & Klinger 2009; Klinger & Weiss 2009).
However, Hansen (2009) reports that the residents in SL have lost their interests in their virtual
world (i.e. Second Life). Weiss & Klinger (2009) also state that the ability of the virtual world of
Brigadoon to teach social skills that are effective in real world situations still needs to be
evaluated.
b. iSocial
iSocial is a 3D virtual learning environment created by Laffey et al. (2009) to support social
competence development for adolescents with ASD and it is a Virtual Environment (VE) with
the same concept as SL, however, with a smaller scope enclave specifically for adolescents and
children with ASD.
Users and online guide of iSocial from different physical places could gather together in the
iSocial virtual place where their appearances are represented in 3D avatars that would allow
them to move around virtually and interact with the virtual world with the sense of other
presence in the VE. There are tasks in iSocial that would require the users to interact with each
other. There is a local teacher‐facilitator who is with the students physically during the
orientation. The user is expected to work with minimal supervision from the teacher. Upon
login to the iSocial system, the user is able to see other students who are online, and the
student will be greeted by an online guide, who is the trained teacher. The user could go into
his virtual room which holds trophies and awards from previous accomplishments in iSocial,
where a review of what has been achieved so far is also been provided.

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Field tests conducted on iSocial indicate that iSocial is easy to use and is enjoyable for most
users. Users are able to operate the system within the VE with minimal difficulty, engage in
instructions, follow directions and interact with others.
The challenge in iSocial lies in the coordination of activities by the online guide. The online
guide often has trouble in managing the instructions due to a lack of non‐verbal and
paralinguistic prompts. Communication with the teacher‐facilitator is limited as the teacher
can hear and see what is happening in the virtual world, but cannot communicate with the
online guide. The online guide also lacks effective tools to coordinate with the teacher‐
facilitator to ensure that the users focus their attention on the task physically and virtually
without getting distracted.
c. Sam, the virtual playmate
Sam is a gender ambiguous virtual peer developed to teach safety and social skills to children
with ASD by simulating behavior and conversations of the children (Tartaro 2007, Tartaro &
Cassell 2006a, Tartaro & Cassell 2006b). In order to boost motivation and to facilitate teaching,
the key feature of Sam is that the control of the interaction will be under the children as the
users (Trepagnier et al. 2006).
The image of Sam is displayed on a large drop‐down or plasma screen and is projected against
a background that matches the actual room, creating the illusion of shared space. Social
communication and interaction among children fall under the watchful eyes of Sam who can
track eye movement and has computational intelligence that allows Sam to respond to the
children’s behavior on its own.
Sam acts as a bridge between two worlds, the virtual world of Sam and the real world of the
child, and a wooden castle is used to bridge the two worlds. That miniature wooden castle
anchors the play session, with its front end in the real world and its back end appearing in
Sam’s virtual world. Sam would guide the child who interacts with him through the process of
toy sharing and storytelling.
In the system, the child can play with three figurines and Sam can track their eye movements.
When a child puts a figurine in the wooden castle’s so called magic attic, the figurine would
reappear virtually in Sam’s hand. This gives the impression that the real child and Sam, the
virtual peer, are sharing toys.

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A study was conducted on six children with ASD, aged 7 to 11 (McGlaun 2008). They were
engaged in a half‐hour play session with collaborative narratives with both a real human and
Sam. The findings suggest that contingent discourse increases over the course of interaction
with Sam and not with the human peer, thus children with ASD are significantly more likely to
respond to Sam’s invitation than to the real child’s. Furthermore, topic management such as
introducing a new topic or maintaining the current topic is more likely to occur between the
children with Sam rather than with the human peer. The story narratives are more interactive
in Sam’s company (Tartaro & Cassell 2008).
d. Virtual street
Virtual Street is a VR program in which the user is required to guide the avatar across the
divided crosswalk to a virtual Toys R Us store. The purpose of Virtual Street is to improve the
traffic safety skills of children with ASD. The pared‐down urban street scene in the program
has proven its worth in teaching moderately functioning children with ASD on how to safely
cross the street and to gain more independence in the process.
A study which was conducted suggested that the children, when presented with the program,
quickly and noticeably improved their scores. At the onset training, they scored 2.66/9 and
improved to 8.91/9. Likewise, their cumulative accident tallies decreased from 22 to 0. Three
of six children were able to transfer their skills learned from virtual street to park street
crossing (Nelson 2008).
e. Limitation of virtual reality approach
Children with ASD often interpret a situation literally; therefore an overly literal interpretation
of the environment in VR could limit its usefulness as a tool to learning social skills, as the users
of VR need to understand that what happens in the VR is not a literal representation of what
happens in real life.
VR is a simulation technology, so no matter how perfect the virtual world is designed, the
user’s activities in the virtual world are limited, compared to the real world (Zhao & Wang,
2008). In addition, in order to get engaged with the virtual world and their avatar, the user
needs to spend a lot of time in the VE (Zhao & Wang 2008).
According to Vera et al. (2005) and Brown (2009), due to the high cost and complexity in its

development, VR‐based educational software is extremely limited in the market, especially for
special education, making it not widely available for the general public yet.

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2.3.10 Social Story™
Social Story™ (SS) was first developed by Carol Gray in 1991 (Gray & Garand 1993) as an
intervention strategy that taught social skills to children with ASD. SS is a promising approach
and the effectiveness has been proven by numerous studies that have reported improvement
in children’s behavior after a systematic exposure to SS, such as Hagiwara & Myles (1999), Ivey
& Alberto (2004), Scurlock (2008), Bledsoe et al. (2003), and Rogers & Myles (2001).
SS is a brief, written story that explains a social situation that is causing difficulty in a person’s
life due to the lack of information or cognitive confusion (Scurlock 2008), and it is used to
provide concrete information to help improve social skills and appropriate behavior.
Therefore, the objective of SS is to describe rather than to direct, and it provides a child with
information through text and visual images. In each story it provides concise and accurate
information about what is happening in a specific social situation, what people do, why they
do it, and what the common responses (expected behavior) are to help children with ASD to
feel more relaxed and comfortable in social situations. The child’s improved understanding of
events and expectations from the story could lead to a more effective response (The Gray
Center 2010)
SS is a great tool for teaching skills through direct instructions, giving a better understanding of
other people’s thoughts, feelings and views, the areas where children with ASD are unable to
pick up naturally. Therefore, providing SS to children with ASD before an event could help
them predict actions, behavior and assumptions of others (Gabbert 2010). This could lead to a
decrease in a child’s anxiety, improve his/her behavior and help him/her understand an event
from the perspective of others (Heward 2006).
SS attempts to address the Theory of Mind impairment by helping children with ASD to be able
guess beliefs, thoughts, feelings, emotions and behaviors of others (Wallin 2009). This will help
strengthen their intuitive skill and instill in them a sense of ethics (Gabbert 2010). Therefore,
SS should inculcate concrete and clear information on the social situation, expected behavior
from characters involved, in order to improve their reactions and responses in the situation. It
should also explain simple steps for achieving certain goals or outcomes.
The main goal of SS is not to change behavior, rather to increase the understanding of social
situations and expectations in these situations, by describing the social situation in detail and
translating the goal of the social event into understandable steps including appropriate
responses. This would help the child to be more comfortable in the situation and could

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facilitate the opportunity to learn more effective responses to the social situation (Ball 2008;
Wallin 2009).
2.3.10.1 Guide for writing Social Story™
Gray & Garand (1993) describe four main types of sentences which can be used in writing SS:
descriptive sentences, perspective sentences, directive sentences and control sentences
(Attwood 2005; Batts 2004; Brownell 2002; Kuoch & Mirenda 2003; Lorimer et al. 2002).
However, according to various authors, there are currently six types of recognized sentences
including the original four that can be used in writing social stories (Matson 2009; Barry &
Burlew 2004; Crozier & Tincani 2007; Reynhout & Carter 2006; Kokina & Kern 2010; Sansosti et
al. 2004; Test et al. 2011). They are:
• Descriptive sentence is the type of sentence that objectively defines where a social situation
occurs, who is involved, what they are doing, and why they are doing that. It could also be
used to suggest to the learner the expected positive response to the situation or new concept,
and to provide sequential steps for completing the activity.
• Perspective sentence is the type of sentence that provides an insight into another’s internal
states by describing how others involved, feel in a social situation. This type of sentence is
mainly used to reflect other people’s perspectives especially on behavior, desire, emotion,
knowledge, thought, feeling, belief, opinion, motivation or physical condition in a social
situation; so the learner can learn how different people perceive differently in various
situations. This type of sentence attempts to address the Theory of Mind impairment in
children with ASD.
• Affirmative/control sentence is the type of sentence that is used to re‐assure the learner. The
control sentence uses analogies to explain a situation. It identifies personal strategies that the
learner will use to recall and to apply the information learned from the story, reassuring the
learner’s responses. Often written by the learner after reviewing the story, this sentence may
be eliminated from lower functioning or younger children with ASD.
• Directive sentence is the type of sentence that directly tells the learner what is the expected
behavior in response to a social situation. It often begins with “I will try to…” or “I can…” and it
answers the “wh” (who, what, when, where and why) questions.
• Cooperative sentence is the type of sentence that tells the learner who can assist him/her in
different situations.

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• Consequence sentence is the type of sentence that tells what will happen as a result of
certain actions.
Not every SS will contain all the six or even the four main types of sentences (Washburn 2006),
such as in the studies by Adams et al. (2004), Bledsoe et al. (2003) and Lorimer et al. (2002). In
contrast, it may also contain long and complicated sentences, like in Dodd et al. (2008). SS
primarily consists of descriptive and perspective sentences, since the primary goal is to provide
information rather than instructions (Brownell 2002). As cited by Brownell (2002) and Gray
(1994, 1997, and 1998) the most frequent mistake in SS is the utilization of too many directive
sentences that turn the story into a rigid set of rules for the children to follow; therefore,
phrases like “I will try to…” is preferred to “I will…” (Brownell 2002; Bledsoe et al. 2003).
According to Doyle & Iland (2004), SS should contain components of: (1) descriptions of what
will happen; when, where and who will be present in the event, (2) descriptions of positive
emotion or feeling that the learner may experience, positive thoughts the learner may have,
and descriptions of expected behavior of the learner, (3) descriptions of what others may be
thinking or feeling, (4) list of action steps for the learner, and (5) descriptions of any reward
that may follow.
2.3.10.2 Application of Social Story™
SS was first developed for children with the higher functioning form of ASD. However, in the
development, researchers found that the SS approach has also been successful with children,
adolescents, and adults with ASD and other social and communication delays and differences,
as well as young children who are developing normally (Gray 1994). SS for adults and
adolescents must be written in a more age‐appropriate level and format.
SS works especially well for children with ASD because of their inability to see social situations
from the perspective of others and their dislike of surprises. Bauminger (2002) suggests that
intervention should focus on facilitating the child’s social understanding, teaching them the
ability to read social cues in different social situations; enhancing the capacity for making
accurate social interpretation, and expanding the child’s repertoire of behavioral alternatives
for different social tasks.
In terms of skill teaching, SS was initially developed to teach social skills. However, in the
development, it expands beyond the scope of teaching social skills. It has also been used to
teach a number of social and behavioral concepts in any environment/setting that children

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with ASD are having difficulty in, including self‐awareness, self‐calming, and self‐management
skills. SS is also used to teach new routines, how to tolerate changes of routines, and to teach
things that the child values or is interested in.
According to The National Autistic Society (UK) website, SS has a huge range of applications,
including: (1) to develop self‐care skills (such as how to wash hands or get dressed), social skills
(such as sharing, asking for help, saying thank you) and academic abilities; (2) to assist the
learner to cope with changes in routine, and unexpected or distressing events such as absence
of teacher, moving house or a thunderstorm; (3) to provide positive feedback to the learner
regarding his/her area of strength or achievement in order to develop self‐esteem; (4) to
develop behavioral strategy, such as what to do when angry or coping with obsessions.
SS has been found effective in increasing appropriate greetings and compliments (Swaggart et
al. 1995; Dodd et al. 2008), and increasing verbal interaction (Crozier & Tincani 2007). It also
decreases inappropriate social interaction (Norris & Datillo 1999), increases initiation of
comments and requests with generalization and maintenance across social behaviors (Delano
& Snell 2006; Scattone et al. 2006; Thienmann & Goldstein 2001), decreases echolalia and
excessive voice volume (Brownell 2002), and decreases tantrums and ineffective
communication (Lorimer et al. 2002). Apart from that, it increases appropriate use of words
(Adams et al. 2004), capacity in labeling and explaining emotions (Bernad‐Ripoll 2007), and
increases conversational abilities (Sansosti & Powell‐Smith 2006, 2008).
2.3.10.3 Presentation of Social Story™
The original SS format as introduced by Gray from 1991‐1995 is a plain paper‐based format,
where the text was printed on paper without any use of pictures or visual cues. Since children
with ASD are visual learners, researchers found that incorporating visual cues such as
pictures/drawings, or even real objects to each page of the story could increase the child’s
understanding, thus, adding to the effectiveness of SS for children with ASD (Wallin 2009;
Heward 2006; Gabbert 2010).
Hagiwara & Myles (1999) were the first to conduct a study to use the multimedia approach
combining SS, visual symbols and computer‐based instructions. Roger & Myles (2001)
combined SS with comic strip conversations; Thiemann & Goldstein (2001) combined SS with a
multi‐component intervention which included SS, cue cards, role‐play and video feedback.

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The use of SS in combination with other methods of presentation has been widely studied, not
only in combination with visual cues in paper text, but also in combination with music, power‐
point or video modeling, as discussed in the following section.
a. Paper‐text
There are a few variations of paper‐text based SS that include plain paper text with cues and
with partnership with a teacher.
Paper‐text
Scurlock (2008) presented a study of SS to a 10 year old boy with AS in her thesis. The purpose
was to examine the effect of individualized SS intervention on sportsmanship social behavior.
To address the boy’s problematic behavior, SS was typed on white paper mounted on black
construction paper and was compiled into a book‐like format that was spiral bound at the top.
One or two sentences were placed on each page. The story was not combined with other
interventions, including illustrations.
The overall result suggested that the introduction of SS had a positive effect on the participant.
However, this study was a single subject design with a single participant, therefore,
generalization of the findings to other students or behaviors was not proven.
Paper‐text with visual cues
Schneider & Goldstein (2009) investigated the effect of SS on three children with ASD. There
were two phases of the study, the first phase used plain text SS but the result was only fair and
therefore, in the second phase, visual schedules were added to SS replacing the reading of SS.
The visual schedule used pictures and shorter phrases adapted from the SS at the first phase
and it was placed on a 6 by 9 inch black foam board.
The results of the study indicated that SS is effective in improving appropriate behaviors of the
participants, and the visual schedule in SS holds promise for children with ASD. After the
intervention, participants were able to respond more appropriately and were able to manage
their behaviors, indicating that SS could facilitate the development of self‐management.

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Paper‐text with partnership
Agosta et al. (2004) collaborated with a classroom teacher and a team of university
researchers to address the problem behavior of a child with ASD. The classroom teacher had
tried several techniques to decrease these behaviors, however, none was successful. For the
study, SS was developed to be used in two different approaches. The first approach was with
tangible reinforcement of the reward system (candy), and the second approach was done with
a minor variation that was the removal of the tangible reinforcement (candy). SS was
presented in a 5‐page booklet, with one sentence and accompanying pictorial icons from
Boardmaker on each page.
The result collected from the study revealed that the SS presented by the classroom teacher
successfully helped to solve challenging behavior of the participant in the classroom. However,
this approach requires the classroom teacher to become a central member of the research
team throughout the study, and to be exceptionally faithful in reading the story and providing
positive reinforcement. This method is time and effort consuming, especially in a large
classroom context where a teacher has to cater to quite a number of students and will not be
able to focus on a single student.
b. Comic strip conversation (CSC)
CSC is a type of SS, adapted for younger children or those with limited verbal communication
skills, that utilizes simple symbols, stick figures and colors to identify key elements of social
interaction (Glaeser et al. 2003). It is used as a positive behavioral support strategy to improve
the social skills of children with ASD (Pierson & Glaeser 2005). CSC is based on beliefs that
visualization and visual support is useful in structuring the learning of children with ASD and to
improve their understanding and comprehension of conversations (Gray 1994, cited by Fouse
& Wheeler 1997). It provides additional support to individuals who struggle to understand the
quick exchange of information which occurs in conversation, by providing visual
representations of the conversation to enhance understanding and comprehension (Dood
2005; Gray 1994).
The illustration in CSC usually consists of stick figures and bubbles where the figures’ words
and thoughts are written. It focuses on what people in a situation may be thinking and assists
them in understanding the situation or another person’s perspective (Dodd 2005). This
technique involves drawing an event on a story board with stick figures to represent each
participant and using speech and thought bubbles to represent the participants’ words and

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thoughts, allowing children with ASD to analyze and understand the range of the message and
meaning that are a natural part of a conversation or play (Attwood 2004).
Fouse & Wheeler (1997) suggest CSC to be used with children with ASD who enjoy drawing.
CSC is most useful in conveying information or in teaching social skills (Dood 2005). It helps
children with ASD discover the thoughts, beliefs, knowledge and intentions of the participants
in a social situation (Attwood 2004). According to Attwood (2000), CSC is particularly useful for
clinicians in analyzing a child’s motives when a specific incident has caused considerable
distress, as well as in illustrating alternative responses that a child could make.
There are few studies published on the use of CSC to present SS to children with ASD. A study
by Rogers & Myles (2001) revealed that SS presented in CSC had successfully changed the
behavior of a 14 year old child with AS, and the child enjoyed using the CSC and had requested
to use it for other settings. A study by Pierson & Glaeser (2005) on four students with
problems in social behavior showed that all of the four participants improved their perception
of the social situation, exhibited appropriate social growth and began to generate their own
solution to difficult social situations, and demonstrated decrease in target behavior. Glaeser et
al. (2003) describe three steps to implementing CSC with illustrated examples for a child with
mild ASD and an aggressive child. However, the CSC technique has not been examined by
independent empirical research (Attwood 2000).
c. Music integrated into the SS
Brownell (2002) was the only author investigating the effect of musical presentation of SS on
the behavior of children with ASD, in his Masters’ study. The participants of the study were
four children with ASD. To address the behavioral goals, two versions of a unique SS were
created. One version was the original SS with only text, and the subsequent version of original
music was composed using the text of the SS as lyrics.
The independent variable was one of three treatment conditions: baseline (a); reading the
story (b); and singing the story (c). The result from all four cases indicated that both the
reading condition (b) and the singing condition (c) were significantly more effective in reducing
the target behavior than the no‐contact control condition (a). The singing condition was
significantly more effective than the reading condition in case study 3. For the remaining case,
the mean frequency of the target behavior was smaller during the singing condition but not
significantly so. These results suggest that the use of musically adapted version of SS is an
effective and viable treatment option for modifying behavior in children with ASD.

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d. Computers and SS
As a majority of children with ASD show a great interest in computers, researchers have
adapted the computer as a presentation format of SS, such as in Power‐Point and VM. SS in
computerized format was first implemented by Hagiwara and Myles in 1999, using PowerPoint
instead of paper in presenting pages of the story. Following them, there were a few more
computerized SS for children with ASD studies, such as by Sansosti & Powell‐Smith in 2008.
More (2008), suggests presenting SS by using a slideshow program. These studies show that
the combination of SS and visual image on computer is effective in helping children with ASD
learn social skills.
Benefits of the computer to children with ASD include: children enjoy and respond well to the
computer’s structure, explicit, consistent expectations and challenges (Strickland 1997; Tartaro
& Cassell 2008). The computer offers a conducive environment to children with ASD, as it
provides a safer learning situation by individualized tutoring where instructions could be
repeated without tedium and potentially counter‐productive human intervention (Elzouki et
al. 2007; Strickland 1997). The computer environment can also be made progressively complex
until it becomes a realistic scenario, to help children function safely and comfortably in the real
world (Elzouki et al. 2007; Strickland 1997; Vera et al. 2005). Computers are predictable and do
not demand social skills required by humans, such as not having to look them in the eyes, not
having to talk to them and read their emotions (Tartaro & Cassell 2008).
Mancil et al. (2009) conducted a study that compared two different formats of SS to three
children with ASD. For this study, a SS that addressed all of the three children’s needs was
developed. The story was seven sentences long, one written in paper format with pictures of
peers performing the targeted behavior and another in a computerized format in the form of
an interactive power‐point presentation. The latter format was referred to as Computer
Assisted Social Skills Training (CASST), which presented the story with a black background using
the same pictures and text used in the paper format. Compared to the paper format, the text
used in the power‐point version was interactive; when a space bar was pressed, the text would
slowly change colors to serve as a visual cue to read the text. The overall results showed that
the CASST format was slightly better than the paper format, as all participants preferred the
CASST format to the paper format and they could maintain the use of the CASST format
without teacher prompting. Teachers also reported that they liked the CASST format better
than the paper format because the students seemed to enjoy the CASST format more. Each
teacher noted a change in the participants’ behavior by the end of the study. After the last

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intervention session, participants were asked to choose whether to continue using the SS. Each
participant chose to continue using the CASST format and had been using it during the two
week interval following the final phase, without assistance from adults.
Studies by Mancil et al. (2009), Sansosti & Powell‐Smith (2008) and Hagiwara & Myles (1999)
also find that computerized SS is as effective as SS in the original paper‐text, or even slightly
more effective.
e. Video
According to Scattone (2008), Video Modeling (VM) has been found effective in enhancing
conversational skills for children with ASD; therefore, Scattone (2008) combined SS and VM in
an effort to examine the impact on conversation skills of a 9 year old boy with AS who had
poor eye contact and had often engaged in one sided conversations. Attempts by his mother
and teacher to teach him appropriate social behavior had failed.
Three different SS for three different target skills (eye contact, smiling and initiation) were
developed. Each story was compiled into a booklet of 6, 7 and 10 pages respectively. The
wording on each page was shown in the video narrated by an adult. After the story had been
narrated, the adults modeled the target skill during 5 minutes of video‐taped conversations.
When the treatment was introduced, the participant immediately demonstrated an
improvement in eye contact, however, smiling was difficult for him to master, and the results
indicated that no appreciable improvement had occurred. As reported by his mother, it was
difficult to maintain the participant’s interest in viewing the video towards the conclusion of
the study, especially after he had mastered the skills. This study shows that SS combined with
VM may be an effective intervention for some children with ASD in certain skills. However, the
exact role VM plays in conjunction with SS is uncertain and needs further exploration; it is
impossible to determine how individual components contribute to the effectiveness of SS.
Another study on SS and VM was conducted by Litras et al. (2010), who investigated the
effectiveness of SS combined with VSM in teaching social skills to a 3 year old child with ASD.
His study showed that this combined intervention was effective in improving targeted
behaviors.
One drawback of video modeling is the process involved in the video production which
requires extensive planning, is time consuming and is resource intensive, especially in video
self‐modeling where the video will only suit a specific child (Litras et al. 2010).

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2.3.10.4 Limitations of Social Story™
There has not been much limitation of SS reported. However, Prelock (2006) states that the
maintenance of skills learned from SS is somehow inconsistent, therefore more research is
needed to demonstrate generalization and maintenance effect of the skills learned from SS
across social context.
The paper‐text based SS presented by teachers to use as a classroom lesson had received
positive responses. However, to use it as a classroom lesson in a consistent manner is time
consuming for the teacher especially when handling a large group of students with ASD
(Crozier & Tincani 2007). The inconsistency in the SS deployment decreases its effectiveness as
a tool in remedial behavior. Therefore, a more appropriate approach is needed, such as an
approach where the children can read the SS on their own.
2.4 Critical Review
ASD is a wide disorder with causes that are still unknown. Available treatments cannot fit
every child. There are many areas of deficit that children with ASD experience, as explained by
the Triad of Impairment. The main deficits that all children with ASD have, is in the area of
social skills, which is mainly caused by an impairment in the ToM, which medical researchers
suspect to be caused by brain abnormalities affecting the areas that involve social behavior.
Because of this impairment, children with ASD have difficulties in social interaction compared
to normal children. Fortunately, children with ASD can improve their social communication
and social skills with early detection and treatment.
As the cases of ASD are on the rise, there have been many applications that are mainly
targeted at children with ASD in teaching, learning, communication and social skills, ranging
from the simple PECS to the high‐end system, such as immersive virtual reality.
SS is also one method of treatment for children with ASD to learn social skills. It has been used
widely and effectively in teaching social skills to children with ASD, with many supports from
various publications to use SS to improve the social skills of the affected children. The most
common presentation type of SS is in the original paper‐text based with or without the use of
pictures as visual cues but there are also computerized SS in Power‐Point presentation format.
For the SS approach to be effective, it requires an intensive teacher‐student interaction with a
long period of treatment. The presentation format of the current SS is also somehow dull and
not interactive, even in the Power‐Point format. The presentation of SS can still be improved

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to catch the attention of children with ASD, thus they could learn on their own without
intensive support from the teacher.
To achieve this goal, the presentation of SS needs to be something that a child with ASD is
attracted to, thus they would be motivated to learn independently. Studies have also proved
that children with ASD are naturally interested in computers and visual cues. Animation, which
is a type of visual cue, has also been used effectively in teaching children with ASD, as
illustrated in the review.
Thus, the intention of this study is to combine SS with the computer and 2D animation as a
pedagogical tool for children with ASD to learn social skills. SS is presented as 2D animation
with the computer as the medium. We can anticipate that this method of presenting SS should
be effective in assisting children with ASD to learn social skills, as the review has highlighted
that SS has been used effectively and 2D animation has engaged the attention of children with
ASD.

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Chapter 3: Conceptual Design and Modelling

Chapter 3: Conceptual Design and Modeling
3.1 Introduction
After grasping the idea of the nature of ASD, the current treatment tools and their limitations
from the Literature Review, this chapter lays out the essential information to design the
prototype to suit the needs of the targeted audience. It includes the research problems and
proposed solutions, followed by the research methodology and procedures, the conceptual
design and its rationale, the preliminary study conducted and finally the improved conceptual
design based on the results of the preliminary study.
3.2 Research problem
The literature review highlighted crucial information that relates to the research. It started
with the growing rates of diagnosis of ASD (Stillman 2009; Bogdashina 2006; Fambonne 2003;
Shattuck 2006; Kaufmann & Silverman 2010; Lewandowski 2010; Williams & Williams 2011).
Children who have been diagnosed with ASD have problems in the area of social skills, which
include verbal and non‐verbal communications, behavioral inflexibility and impaired social
interaction, as explained by the deficit in Theory of Mind and Triad of Impairment (Sicile‐Kira
2004; Bogdashina 2006). These were explained as being caused by brain abnormalities,
however, there is still no exact known cause for these brain abnormalities. Thus, treatment for
them to cope with their social skill impairment is needed and crucial, to help them manage
their social lives; this is a fundamental step to help them lead independent lives.
There are many ways to learn social skills. SS, computer and visual cues including 2D
animation, play an important role as treatment tools for children with ASD. Each of these
approaches has been used positively with children with ASD, whether used individually or in
combination with others. It is also evident that SS is more effective when it is used in
combination with visual schedules, as they enhance learning and understanding of children
with ASD (Schneider & Goldstein 2009).
The use of visualization and visual support, such as pictures and animation has been found
useful in structuring the learning of children with ASD, in improving their understanding and
comprehension of conversations (Gray 1995; Odom & Watts 1991; Twachtman 1992; Quill
1995; Quill 1997), as well as in reducing teacher prompts (Odom & Watts 1991).

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SS in combination with visual schedules has also been incorporated into computerized format,
where the power‐point presentation program is used to display SS together with the visual
cues. Studies have suggested that these increase the propensity of children with ASD towards
their learning, thus producing more positive results compared to the normal paper‐test based
SS (Hagiwara & Myles 1999; Mancil et al. 2009; Heimann et al. 1995; Sansosti & Powell‐Smith
2008).
However, the use of static pictures as shown in the previous studies often fail to portray the
non‐literal components in communication, such as body language, facial expression and
gestures. Another problem of the current SS method is that it requires intensive teacher‐
assistance or supervision. For the SS to be effective, it requires a teacher to be a part of the
program during the student’s learning time, to read out the SS to the student intensively and
personally for a period of time.
Children with ASD eventually need to learn social skills more effectively to help them cope with
everyday life. The following specific research questions are raised to address the issues above.
1. How effective is the combination of SS and 2D animation in computer presented
format as an intervention tool in assisting children with ASD learn social skills in the
school setting?
2. How is the user’s (child with ASD) response to this new approach of intervention?
3.3 Proposed solution
Looking at the limitations of the current treatment, researchers are trying to discover new
interactive and dynamic approaches in helping children with ASD to learn social skills
effectively. The issue in the use of static pictures could be altered with the use of moving
pictures, i.e. animation.
The matter concerning the intensive student‐teacher time required by the current method
could be overcome by a tool that can be used by the children independently. To develop such
an independent learning tool, there is a need first to develop the children’s natural interest in
the learning tool. To achieve this, the tool must be appealing to children with ASD so that they
would be motivated to learn and their willingness to learn would be formed naturally; thus it
will require less supervision time by the teacher and will lead to independent and effective
learning.

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As a solution to the research problems stated above, this study proposes to combine SS, 2D
animation, and the computer as the medium of presentation, to develop an interactive and
dynamic pedagogical tool for children with ASD to learn SS in order to improve their social
skills. We anticipate that this combination of methods would have many advantages over the
current available methods, as it would engage and motivate children with ASD to learn by
providing an attractive and enjoyable learning environment, thus boosting the effectiveness of
social skill inception in the children with ASD, with minimum supervision from the teacher. The
proposed solution is also intended to break the monotony of a typical SS format and to capture
and engage the children’s attention by using visual effects and vibrant colors.
Multimedia has also been said to offer children more control of the learning experience, which
will then lead to increased motivation, engagement and positive attitude (Yildirim et al. 2001).
The use of computer and 2D animation helps to increase the usability of SS through the
application of currently available technology as a means to enhance and enrich the social skill
learning process of children with ASD. This combination enhances the currently available
presentation format of SS.
The animation of the SS is made as simple as possible, as it is noted by Brownell (2002), and
stated by Gray (1994) that using illustrations with excessive details may cause more difficulties
to some children with ASD who may interpret information literally, or they may be unable to
generalize the situation beyond the environment or setting represented in the visual cues.
As part of the research problem and solution to verify that this method is effective, a scientific
study was conducted to evaluate the effectiveness and usability of the proposed model in
assisting children with ASD in their social skill learning.
3.4 Hypothesis
There are null hypothesis and alternative hypothesis formulated for the research problems,
detailed as below:
Null hypothesis (H0): The combination of SS and 2D animation in computer presented format is
not effective as an intervention in assisting children with ASD to learn social skills in the school
setting.
Alternative hypothesis (H1): The combination of SS and 2D animation in computer presented
format is effective as an intervention in assisting children with ASD to learn social skills in the
school setting.

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The effectiveness of the proposed model is determined by whether there is a change in the
behavior of children with ASD after the intervention. If there is a positive change in their
behavior, the intervention is said to be effective, if there is no change or negative change of
the behavior of children with ASD after the intervention, then the intervention is said to be not
effective. A statistical test was performed to prove these hypotheses, presented in Chapter 5.
3.5 Research methodology
A research method is conventionally divided into two categories: the qualitative research
method and the quantitative research method. Each of these methods differs in approaches,
tools and techniques, form, focus and emphasis of the study, thus they serve the research
purpose and will produce different results (Lee 1992). The combination of qualitative and
quantitative methods is known as the mixed‐method research design.
For this research, the quantitative method is adopted. This method is well suited for
quantitative descriptions and comparisons. It is used to determine the relationship between
one thing (independent variable) and another thing (dependent/outcome variable) in a way
that can be expressed numerically (Lakshman et al. 2000). The foundation of the quantitative
research is that the objective truth can be measured and explained scientifically, valid and
reliable (Cassell & Symon 1994; Matveev 2002).
Unlike the qualitative method, the quantitative method follows firmly the original set of goals
and arrives at a more objective conclusion and determines the issues of causality. The focus in
the quantitative method is the collection and analysis of numerical data and statistics that
involve counting and measuring events, and performing statistical analysis of numerical data,
rather than relying on interviews or case studies (Smith 1988).
When designed properly, the quantitative method can produce results that are highly reliable
and can be seen as real and unbiased (Martyn 2008) due to the use of controlled experiments
(Balsley 1970) and the elimination/minimizing of biases of researchers’ subjectivity (Kealey &
Protheroe 1996; Ting‐Toomey 1984). Therefore, it is arguable that this method can arrive at a
more conclusive result, supported by statistical proof (Gergen 2010; Moutinho & Hutcheson
2011; White 2002), especially to provide evidence concerning whether a particular
intervention is effective (Barlow et al. 2004).

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a. Descriptive Study
Descriptive study is also called observational study or survey study, as this study only includes
observation on subjects without intervening. In this approach, subjects are usually only
measured once, thus it is said that researchers measure things as they are. The main purpose
of the descriptive study is to only establish association between variables and the causality
(Hopkins 2000). The techniques included in the descriptive study are: case, case study, cross‐
sectional, cohort/perspective/longitudinal, and case‐control/retrospective. For an accurate
estimation of relationship between variables, a descriptive study needs samples of hundreds
to thousands of subjects.
b. Experimental Design
Experimental design is often referred to as true science as it has a standard format across
scientific discipline with a minor‐interdisciplinary difference in proving or disproving
hypothesis by mathematical and statistical means (Martyn 2008). Experimental study is also
referred to as intervention, as it involves more than just observation of the subjects (Hopkins
2000). The main purpose of the experimental design is to demonstrate how manipulating one
set of variable (independent) can produce a systematic change in another set of variable
(dependent/outcome).
In this method, the subject is measured before and after intervention to see what the effect of
the intervention is. Compared to the descriptive study, this approach may only need ten
subjects as study samples (Hopkins 2000). However, ideally the experiment should be
constructed in a manner that allows others to repeat the same experiment and obtain similar
results (Martyn 2008).
The simplest form of the experimental design is time series, where one or more measurement
is taken on all the subjects before and after treatment, thus known as repeated‐measure
study. A special case of time series is called a single‐subject design where measurement is
taken repeatedly before and after intervention on one or a few subjects where the same
participant serves as both the experiment and control sample (Hopkins 2000; Carolan 2000 as
cited by Kapitan 2010).
i. Single subject design (SSD)
SSD is based on B. F. Skinner’s study of using treatment on the subject and measuring the
outcome at various points in time, thus this design is often considered when performing

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behavioral modification or measuring behavioral changes (Heffner 2004). The basis of SSD is to
study behavioral changes that an individual exhibits as a result of some form of treatment (Gay
& Airasian 2003; Wasson 2005). It looks at the cause effect or functional relationship by
comparing each individual’s behavior on the pre‐ and post‐intervention processes (Horner et
al. 2005).
SSD is used extensively in experimental analysis of behavior as it is effective in measuring
behavioral changes when performing behavioral modification to an individual. Thus, this
design has been widely used by the SS researchers in measuring the effectiveness of SS in
modifying social behavior of children with ASD. It is also approved by Horner et al. (2005) that
this design is a rigorous scientific method to define behavior with features that are particularly
appropriate in the field of special education research.
SSD may only involve one participant, but typically it involves multiple participants that are
considered as one group. Each participant or group serves as their own control rather than
using another participant or group as control. It relies on the comparison of their
performances prior to treatment to during treatment and/or after the treatment. The
performance is generated in a single score per measurement period (e.g. 20 minutes) (Heffner
2004; Wasson 2005).
It is argued by Seale & Barnard (1998) that SSD is better and should be used in preference to
case study, which is essentially loose and limited in terms of empirical validity and difficult to
generalize results from another individual to others, who may differ in a number of ways. Gill
et al. (1992) state that SSD closes the gap between experimental research and practice, as they
provide realistic representation of participant‐treatment effects. The characteristics of SSD are:
reliable and repeated measure of behavior, diligent description of all conditions of target
behavior, consistency and stability of baseline/treatment, focus on changing one variable at a
time, and clear specification of treatment goal (Wasson 2005; McMillan 2004; Vacc & Loesch
2000). There are several types of SSD, as discussed below.
In SSD, the basic order of behavior measurement is: determine behavior (A/Baseline),
introduce treatment (B/C/Intervention) and remove treatment (A/Reversal Baseline). In the
first A (Baseline), behavior are observed and recorded with no treatment in place, this is a
crucial phase as it is impossible to determine if changes have occurred without this pre‐test
data (Heffner 2004). In B/C (Intervention), treatment is introduced and behavior is observed
and recorded. In the second A (Reversal Baseline), treatment is removed and behavior is

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observed and recorded (Seale & Barnard 1998). The duration of each phase should be long
enough (usually 5‐20 measurements, according to Seale & Barnard (1998)) to achieve stability
and consistency in the behavior before moving to the next phase (Heffner 2004).
The combination of these phases differs in each design, thus producing several types of SSD.
There are three common types of SSD: ABA withdrawal/reversal design, multiple baseline
design and alternating treatment design (Wasson 2005; Gliner & Morgan 2009).
 Withdrawal/reversal design

A common variant of withdrawal or reversal design includes AB, ABA, and ABAB design. AB
design is the simplest and most common yet the least interpretable variant of SSD (Houser
2007); it is used to quickly access the effects of a treatment. If there is a change in the behavior
after the treatment, then it is assumed that the changes are the direct results of the
treatment. However, in AB design, it is difficult to be certain that this assumption is accurate or
valid as there are only two phases in the design (Vacc & Loesch 2000). This weakness can be
strengthened substantially by adding to the withdraw/reversal phase, designs such as ABA or
ABAB (Monette et al. 2007; Bennett & Weissman 2004). The complexity of combinations
depends on the original intention of the study and the feasibility. ABA design would be used to
determine the effect of treatment and the degree of extinction only; complex ABABABAB
would be used to determine if any additional treatment would change the ultimate results.

ABA is also known as reversal/withdrawal design (Seale & Barnard 1998); this design is simply
an extension of AB design where another control phase is added after the end of the
treatment phase to allow for more reliable assessment of treatment effects. According to
Kazdin (1982) and noted in Wikipedia (2011), this reversal design is the most powerful single
subject design as it presents a strong reversal from baseline to treatment and back again to
baseline.

ABA design allows for strong interference if the target behavior returns to baseline after the
treatment is terminated (Vacc & Loesch 2000). However, there are certain situations when
condition is irreversible and the outcome is not expected to return to baseline, such as when a
treatment targeting on social skills or reading is withdrawn; one cannot unlearn these skills
and there are also ethical issues in the activities that involve self‐injurious behavior (Sparrow
1992; Janosky et al. 2009), or terminating the study after baseline would deny the subject to
the full benefit of treatment (Janosky et al. 2009; Vacc & Loesch 2000).

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ABAB design could overcome the ethical problem in ABA design by ending the experiment with
treatment; therefore ABAB design is basically the extension of ABA design where an additional
treatment phase is added at the end of the ABA design. Concerns with ABAB design include
training time and problems with internal validity.

 Multiple baseline design

In multiple baseline design, a varying time schedule is used to determine if a treatment is truly
influencing behavioral changes, thus there are two or three variables included in the
experiment: behavior/participant/setting. A common variant of multiple baseline design
includes the performance of several participants on the same behavior and the same setting,
the performance of one participant on several behaviors in one setting, and the performance
of one participant in one behavior in several settings. This design could strengthen the
competing hypothesis in AB design.

Multiple baseline design would require considerable time and resources and verification must
be inferred from the lack of changes in other behavior, thus making it weaker than the reversal
design at demonstrating experimental control.

 Alternating treatment design

Alternating treatment design is useful for evaluating the effects of several types of treatments
(B and C) on the same individual. After baseline (A) data is collected, the participant would be
given one of the two treatments (B or C) which is randomly chosen. After the first treatment,
the two other treatments are altered in rapid succession and the results from both treatments
are compared to figure out the most effective treatment.
3.6 Research procedures
As indicated earlier, in investigating the effectiveness of I‐Learn Social Story, this study
employed a single subject experimental design, specifically the ABA withdrawal/reversal
design, which is a research approach from the quantitative research method. According to
Sidman (1960), the single subject design is the best design used in proving the effectiveness of
an intervention and in measuring behavioral changes in an individual, and it is argued to be as
much more statistically powerful (Gergen 2010; Moutinho & Hutcheson 2011; White 2002),
especially to provide evidence concerning whether a particular intervention is effective
(Barlow et al. 2004). Therefore it has been widely used in the SS research to determine

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changes in behavior by researchers, such as Kuttler et al. (1998), Adams et al. (2004), Marr et
al. (2007), Kuoch & Mirenda (2003), Swaggart et al. (1995), Norris & Datillo (1999), Haggerty et
al. (2005), Bledsoe et al. (2002), Lorimer et al. (2002), Brownell (2002), Ivey & Alberto (2004)
and many more.
For reasons described above, a single subject design, specifically the reversal design, was used
in this study to solicit the information gathered from testing. This included the development of
the intervention tool used to change the social behavior of children with ASD.
Research
procedure
Identify the specific
Develop the Testing and
problem and solution in
prototype Evaluation
the study theme of the
study (Experimental study)
Identify the cumpolsory
elements to be included
Literature Review Field observation testing to the
targeted participants
Develop the first
prototype
analyse the testing
results
Preliminary
study/pilot testing
Develop the refined
model of the prototype

Figure 1 Research procedures
As illustrated in Figure 1, this study started by identifying the specific problem and solution by
collecting information related to the topic of research and to come up with preliminary ideas
to solve the research problem. After the literature of the related topic was collected, a
thorough deep review was conducted to understand issues that were related to ASD,
animation and SS, as well as to how the combination of animation and SS could be useful in
assisting the teaching of social skills to children with ASD.
The observation on children with ASD was useful to understand their behavior and how they
think and feel. The observation was essential to model a prototype that would be suitable for
their needs. Apart from the observation, interviews were conducted on the children and their
teachers to collect information in order to grasp a deeper understanding of the children’s

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needs. From the information collected from the observation and interview, an analysis was
carried out to determine the needs of children with ASD.
After the children’s needs and a potential solution were identified, the next step was
prototype development. This included a survey and an investigation on the available software
for children with ASD in the market, by examining the benefits and limitations of each product.
This survey helped to build a prototype with improved features, compared to the existing
products.
Hardware affordability and availability that supported the development of the model was also
investigated. The system required hardware that was fast yet at reasonable cost to ensure that
it was affordable for general public users.
Research on SS and animation was conducted to understand the effect of the current
application of SS and animation on children with ASD; how they could be effective to help
children with ASD in social skill acquisition. The review of the current applications and studies
of SS and animation ‐ to investigate their advantages and limitations ‐ would be valuable for
the design of the prototype.
After understanding the limitations of current applications, the developmental stage started by
conceptually modeling the prototype; analysis from the literature review and field observation
helped in identifying the requirements of the model. It also identified and anticipated any risks
that might arise. Thus, the first model of the prototype was developed.
A pilot test was conducted as part of the conceptual model to ensure that the final model
would satisfy the needs of the targeted community. The pilot test was conducted using the
first developed model of the prototype. The purpose was to discover the usability and features
that were necessary to be included before developing the final prototype. The result of the
pilot testing refined the conceptual model design of the final prototype.
Based on the refined conceptual model, the final prototype was developed with Adobe Flash.
By using Adobe Flash, the content was interactive and portable as it could be used on a PC,
notebook PC or mobile phone.
Once the final prototype was developed, an evaluation of the prototype was performed to
determine whether it was useful and appropriately suited to the children’s needs, and how it
assisted them in social skill learning. The evaluation was done by collecting and comparing the
behavior data of the participants before and after the intervention to identify the prototype’s

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effectiveness and usability. Feedback on the prototype was collected as well, from the
participants’ teachers.
As the final step of the study, the results of the evaluation, including the literature review,
conceptual model, prototype implementation and the methodology used in the experimental
study were compiled.
3.7 Conceptual design
This section illustrates the conceptual design of the prototype, which includes a discussion of
the requirements and specifications and the design rationale.
3.7.1 Requirements and specifications
The main methods used in the requirement gathering for the conceptual model were field
observation and prototyping (pilot study).
Children in a local school were observed during their daily school activities to understand their
social behavior. They were observed while they were performing their learning and social
activities in the natural setting of the school compound, mainly in the classroom. This was
done to understand their learning style and social behavior, and to define the target behavior
that they had to acquire. The data collected during the observation was essential before
moving to any developmental stage.

Prototyping was done as part of the pilot study. Prototyping is one of the modern techniques
in gathering requirements. Using this technique, preliminary requirements were gathered and
used to build an initial version of the prototype, i.e. the functional prototype used in the
preliminary testing for the pilot study. Based on the results generated from the pilot test,
additional requirements for the final prototype were discovered.
3.7.1.1 User characteristics
Most of the participants in the school were novice computer users who had a small amount of
knowledge about the computer system. In the school, they were currently using the computer
at specific allocated times of the week and they were not familiar with the overall structure of
the computer, thus, they would require an easy‐to‐use navigation menu.
a. End user/direct user: student with ASD

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The end users of I‐Learn Social Story were students with ASD. They would use the prototype to
learn social skills from the animated social story. For children who were familiar with the
computer, they would be able to operate 2D Animated Social Story (I‐Learn Social Story) by
themselves, where the others might need someone (such as other students or teacher) to
assist them to use the prototype presented in the computer.
b. Expert users: teacher, parent, caretaker
Teachers, parents or caretakers would assist the children who were not able to operate the 2D
Animated Social Story (I‐Learn Social Story) by themselves. As the expert users, a short training
would be provided for them. They would be required to assist and guide children in using the
program. They would give support to the user, until the end user was fully competent in using
I‐Learn Social Story independently.
3.7.1.2 Target behavior identifications
To implement an effective behavioral change, identification of specific target behavior was
essential before implementing the SS. This allowed the measurement of behavioral changes
from baseline to intervention, from intervention to reversal baseline, or from baseline to the
reversal baseline. It would also help to keep track of the specific behavior.
The initial data gathering for the identification of target behavior occurred after the first few
visits to the school through direct observation of the participants in their natural setting, along
with unstructured conversations with the school principal, teachers, class helpers and students
themselves. From the visitation to the school, the important behavioral traits that the
participants needed help in were observed and identified.
This process took place in the students’ classroom by observing their social behavior towards
their classmates, teachers, class helpers, other peers, or others who were interacting with
them. During the process, since teachers and class helpers were willing to discuss students’
behavior, they were verbally asked for their comments and input regarding the behavior of the
participants that they would like to see changes in.
Once all of the participants’ target behavior were identified, they were cross‐referenced with
the help of teachers, to determine the desired target behavior that were shared by all of the
participants, as in Buggey et al. (1999). Social stories were then created to address these
selected target behavior shared by all of the participants, as presented in Chapter 4.

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3.7.1.3 Quality requirements
Quality requirements are global constraints or quality attributes of the prototype to ensure the
prototype is concrete and stable, included here are the following:
a. Performance requirement
I‐Learn Social Story must respond to the user’s inputs with no perceptible delays.
b. Usability requirement
I‐Learn Social Story must be easy to use/operate, easy to handle and easy to navigate in the
most expected way.
c. Affordability requirement
I‐Learn Social Story must be affordable and available at a reasonable cost to most of the users.
d. Controllability requirement
I‐Learn Social Story must be easy to be controlled by the users.
e. Simplicity/understandability requirement
I‐Learn Social Story must use a simple interface and easy operation to ensure
understandability.
f. Reusability requirement
I‐Learn Social Story must be able to be used effectively by different users.

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3.7.2 Design rationale
The prototype was developed to ensure that it is easy to operate, with the use of simple
sentences. Figure 2 illustrates the operation flow of the first prototype. Once started, the
prototype showed a simple introduction animation for 8 seconds before the program
displayed a list of stories to choose from. Once the selection of one of the stories had been
made, the respective animation and video instructions of the SS content were displayed. To go
to the next page of the story, the user was required to click on the ‘next’ button available on
every page. There was also a ‘prev’ button, if the user needed to return to the previous page of
the SS animation. Quizzes would appear at the end of each SS. The participant was required to
answer one multiple‐choice question that was related to the story by selecting only one of the
choices given. Unlimited attempts were given in answering the question and if the participant
had selected the correct answer, hand clapping animation would be shown and then it would
lead back to the SS list.
Figure 2 Operation flow of the first prototype
Figure 3 illustrates the user interface of the first prototype design with listed features, which
contained a learning screen, a teacher video narration, a user face display, ‘next’ and ’prev’
buttons, and a quiz section. Other elements like font and colors, interaction style and interface
graphic elements and duration were discussed as part of the design rationale.

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Figure 3 User interface of the first prototype
The user interface design and rationale of each feature is discussed in the following sub‐
sections.
3.7.2.1 Learning screen
The learning screen was the main feature of the prototype. This screen presented the SS texts
that had been implemented into 2D animation form.
3.7.2.2 Teacher video narration
Audio narration was incorporated into the model with the intention of helping the children
with ASD to learn to read, thus this prototype could be used to gear the children towards self‐
learning with minor supervision. This was a shift from the “teacher‐centered approach”, where
a student was a passive learner by listening and reciting what had been taught to them by
teachers to “learning through experience”, where children could relate what they saw in the
learning content to the real life objects within their environment. The narration was presented
through a pre‐recorded video of an instructor reading out the story. It was displayed through a
small window at the right corner of the screen. This was to manifest the presence of the
instructor to extend personalized attention and verbal prompts while the participant was using
the prototype.
3.7.2.3 Display of user’s face
The user face display feature was used to display the user’s face in real time. This feature
allowed the user to look at his/her facial expressions during the learning. As suggested by
Loveland et al. (1994), producing elicited affective expression is difficult for children with ASD,
therefore, the user’s face was displayed in the expectation that children with ASD could
imitate the expressions from the animation, as suggested by Field et al. (2001); imitation could

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help children with ASD display more social and affective behavior. Study by Gena et al. (1996)
showed that affective display could promote generalization and social interaction.
3.7.2.4 ‘Next’ and ‘Prev’ button
The ‘next’ and ‘prev’ buttons were used to navigate around the pages of the story. The ‘next’
button was used to go forward one page and the ‘prev’ button was used to go backward one
page from the current page. These buttons allowed the children to learn at their own pace.
3.7.2.5 Quizzes
A one question quiz was presented at the end of the SS. The question would be related to the
SS played. The purpose of the quiz was to examine if the child understood what had been
taught in the SS.
3.7.2.6 Font and colors
Font type, the size of the font, spacing lines, contrast of print and paper (background) will
influence legibility (Thiessen & Dyson 2009). Study by Hughes & Wilkins (2000) found that
children benefited from a larger font size and spacing. Children materials were often
Inappropriate in the print size and words used (King et al. 2003).
In the prototype, the font used would be large with a variation of colors on each story, as it
was noted by Bernard‐Opitz & Hauber (2011) and Stahmer et al. (2011) that a variation of
colors helped in the learning of children with ASD.
The font type used was the sans‐serif type, as it was easier for children to read (Sanchez et al.
2004; Satterfield 2009). Sans‐serif font should be simple and big with clear messages and a
good contrast with the background (Sanchez et al. 2004). Vivid colors and details were
avoided, as it could confuse children with ASD (Moor 2008).
3.7.2.7 Interface and interaction style
The interface of the prototype was designed to display in full‐screen mode once started, to
avoid any distraction from the desktop background during learning, thus the user could focus
on the SS screen alone.
The graphic element of the SS was in 2D animation with simple graphics, as excessive use of
images with many details could confuse children with ASD in their understanding (Moor 2008).
The interaction style used was made as simple as possible with one sentence on one page, as it

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was noted by Herskowitz (2009) that too much animation on the screen might scare and
distract children with ASD, or they might become over‐stimulated by the animation.
There were reasons for choosing 2D animation over 3D animation or real‐human video, as
described below:
‐ Children with ASD have more interest in 2D animation compared to real‐life video (Rosset
et al. 2008; van der Geest et al. 2002; and Grelotti et al. 2005).
‐ 3D animation is complicated and costly.
‐ As stated earlier, animation should be made as simple as possible (Brownell 2002; Gray
1994), which is achievable by 2D animation.
3.7.2.8 Duration
The duration of each SS depended on the number of sentences ‐ about 5 to 8 in each SS. With
this number of sentences, the duration of the animation was less than 5 minutes on each
story.
3.8 Preliminary study
As described by Hopkins (2000), a pilot test or preliminary study is performed to develop,
adapt or check the feasibility of techniques to determine the reliability of measures. In this
study, a pilot test, as part of an experimental design, had been conducted to confirm that
components of the prototype, as being the critical characteristics of the final prototype, would
function pertinently on targeted users. The main purpose was to examine the features and
functions of the prototype, as well as to test the procedure. This ensured that the final
prototype would fulfill all the requirements needed by the users when running this program so
that it could be used effectively in their social skill learning.
For the preliminary testing, an initial prototype was designed and implemented. This prototype
was tested on three participants, and from the testing an evaluation was made. From the
observation of the effectiveness of the initial prototype, such as how the participants
interacted with it, the final model of the prototype would be refined, based on the results of
the pilot testing. The final prototype and testing would then be confirmed as an improved
version from the first version of the prototype developed for the preliminary study.

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3.8.1 Methodology
This section discusses the setup of the pilot study in the aspects of participants, materials,
settings and procedures followed. Prior to the pilot testing, consent forms were sent to the
school, from which consent was obtained from parents through the school principal who
informed participants’ parents and teachers.
3.8.1.1 Participants
Three children with ASD participated in the pilot study. The participants were invited through
the principal of the school.
Participant 1 was a 10 year old boy. He had very decent drawing and coloring skills. He was the
most advanced student among his classmates. He was good in mathematics and had shown
some creativity in building Lego blocks. However, he had difficulties in expressing his emotions
while communicating with his teachers or friends. He hardly initiated conversation and
interaction with his peers. However, he showed an ability in following directions, taking turns
and staying on the task.
Participant 2 was an 11 year old boy. He was experiencing difficulties in communicating with
peers, but he could respond well to the teacher’s instructions. His teacher often asked him to
help out in the class daily task, such as cleaning. He suffered from echolalia, an involuntary
tendency to repeat words or sentences spoken by others. He had difficulties in taking turns. He
demonstrated a higher social skill than the other two participants.
Participant 3 was a 10 year old boy. He had difficulties in following directions, transitioning,
and staying on the task. During class, he often got bored and restless. He liked playing the
computer. He hardly communicated with his teachers or with his friends. He did not have a
sense of ownership with regards to people’s belongings. When he wanted something he would
just get it without asking for permission, or would guide someone’s hand to reach for the
things that were unreachable to him. Because the classroom teacher often scolded him for
turning on the computer, he had the tendency to lead his classmate’s hands to press on the
computer’s switch.
3.8.1.2 Materials
The material used in the study was a notebook PC with an integrated camera that presented
2D Animated Social Story. Observation notes were used to record the significant behavior of
the participants and how they interacted with the prototype, including the features that they

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liked and features that distracted them. The content of the SS was titled Snack time. English

was the only language implemented in the first prototype.
Snack time was adapted from the paper of Crozier and Tincani published in 2007, “Effects of
Social Stories on Pro‐social Behavior of Preschool Children with Autism Spectrum Disorders”.
They had tested this story on three children with ASD. This story was selected as it was
applicable to the situation in the local school, where they had Snack time at their classroom
daily. The interface for Snack time 2D Animated Social Story is illustrated in Figure 4.
Figure 4 Screenshot of ‘Snack time’ (first prototype)

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3.8.1.3 Setting
The pilot testing was conducted in Perkata Special School, a school for mentally retarded
children located in Kuching, Sarawak. There were two special classes for students with Cerebral
Palsy and seven classes for children with other disabilities. The students in the mixed‐class
came from various intellectually disabled groups: Downs Syndrome, ASD and various types of
brain damage related problems with additional problems such as physical handicaps, hearing
or speech impairments and other behavioral problems. Each class had one teacher and one to
two helpers with a maximum of 17 students.
The pilot test took place in the respective participant’s classroom at the same time and
location each day. All of the three participants were in the classroom with about 10 to 15
students, depending on the class’s daily attendance. There were a teacher and a class helper in
each class during testing.
3.8.1.4 Procedure
During the testing, the participants went through the first version of the prototype. The testing
lasted for one week, with 2 to 3 sessions each day for each participant. Each session took
about 10‐15 minutes.
The participants were not videotaped during the intervention, and at all time, as this was the
request from the parents and the school principal, to protect the children’s privacy. As a
substitution for the video recording, observation notes were taken down during the
intervention period to note essential information.
3.8.2 Findings
The preliminary study results are discussed in the following sections based on observations of
the participants. The results were analyzed according to each participant’s response to the I‐
Learn Social Story prototype.
3.8.2.1 Prototype’s Features/User Interface
From the pilot test, it was found that there were features in the user interface design that had
to be amended. ‘Teacher video narration’ and ‘user face display’ were found to distract the
user’s attention from focusing on the learning screen. Participant 1 and 2 were distracted by
the teacher video narration because they wanted to listen to the narration carefully, thus

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switching their focuses between the main animation and the narrated video, and participant 3
was distracted by his own face display.
The quiz section would be removed as it was found that participant 2, and especially
participant 3 were clicking the answers aimlessly, so it was found that the quiz section was not
effective, especially for children with a lower cognitive skill.
There were features that were to be added, as will be explained in section 3.9.2
3.8.2.2 Testing Procedure
In the pilot study, the testing was conducted by presenting the prototype to the participants,
together with the other students, in their main learning area. This was quite disturbing for the
other students and the participants themselves. Thus, in the final testing, it was advisable to
present the prototype to one student at a time in a corner of the classroom and with the use
of earphones.
3.8.2.3 Overall participation
Although the purpose of the pilot study was not to capture the effectiveness of the SS, it was
found that all of the participants were engaged in the SS intervention. They would immediately
apply the story they had learnt right after the learning. Participant 1, right after the SS reading,
could immediately apply or generalize what he had learnt from the prototype into the real life
setting. He was playing with a matching pair puzzle, and once he finished with one pair, he
would say “next”, imitating the prototype, and after he had completed all the pairs, he would
say “well done” and clapped his hands. The teacher was amazed by this.
3.9 Improved conceptual design
This section discusses the conceptual design of the final prototype, which is the refined model
from the first prototype that had been used in the pilot testing. 2D Animated Social Story (I‐
Learn Social Story) is an independent and self‐contained prototype that consists of a set of
social stories for children with ASD. The main goal is to teach social skills to children with ASD
in a medium that they are interested in, which is 2D animation in the computer presented
form. Each SS has its targeted behavior to be achieved.
This design is thus an improved one from the first design used in the pilot study. It was
implemented based on the requirements gathered from the observation and interviews, as

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well as the additional requirements gathered from the preliminary testing, such as the addition
of automated play and the Bahasa Malaysia option, as discussed in the following sections.
3.9.1 Final design
The operation flow of the final prototype is illustrated in Figure 5. To start the program, the
user needs to double‐click on the ‘I Learn Social Story’ icon, then the program will start and the
user will be shown a 5‐second introduction animation. The user will then go to the SS list that
contains 5 social stories (5 in English and 5 in Bahasa Malaysia). The user is required to choose
one of the social stories from the list. Once a SS is chosen, the target behavior of the SS will be
shown for 5 seconds then the respective animation of the SS will be played. At the end of the
SS animation there will be one button; if the user clicks it, the program will return to the SS list.
To stop the program, the user needs to minimize the full‐screen and use the default exit to
close.
Figure 5 Operation flow of the final prototype
Figure 6 illustrates a screenshot of the final model of the prototype that was built based upon
the pilot testing result; some features had been added and some features that were not
beneficial to the users had been discarded, thus making it a simpler, yet an enhanced version.

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Figure 6 Conceptual design of the final prototype
3.9.2 Changes and rationale
The following are the amendments made from the first prototype design to the final prototype
design.
a. Learning screen
The learning screen which contains the SS animation interface and was the main focus of the
prototype remained in the final design with improved graphics and animation of the SS. The
learning screen mainly contained SS in 2D animation form. The animations used were similar
to the cartoonish look of Sam, which had been preferred to by children with ASD compared to
a real peer, as discussed in 2.3.9 Virtual Reality.
b. Automated play to replace the ‘next’/’prev’ button
Automated play was added as the replacement for the ‘next’/’prev’ button. It was added for
easier control and smoother story flow. This was useful for children who were not computer
literate, thus the teacher needed to only play the SS and the story would run continuously as in
a video, without using the mouse control to move to the next scene. From the pilot testing it
was also found that the user did not use the go back to the previous page button and the
buttons were only used mainly for moving to the next page of the story, so they had been
replaced with an automated flow for easy navigation.
c. Add‐on Bahasa Malaysia option
The mother tongue or first language is the language that an individual has learned from birth
from their parents. There are different definitions of mother tongue as defined in Kecskes and
Papp (2000). Edwards (2010) recorded that UNESCO (1953:11) dictum encourages the use of

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the mother tongue as the best medium in teaching a child. Murphy (2011) also stated that the
academic benefits of the mother tongue program are well documented.
In contrast with the dialect variation of the mother tongue, this suggestion may be for the
standard form of mother tongue instead of the non‐standard dialectic variant of the students
in their heterogeneous setting, such as Mandarin for the Chinese instead of other dialects.
However, this suggestion is not unanimously accepted, especially in a multi‐language setting.
And in the students with ASD setting, a study by Kremer‐Sadlik (2005) revealed that clinicians
have recommended the use of English only for children with ASD and their families, even to
parents whose native language is other than English. This is to ensure that the child is exposed
to the same language inside and outside the home.
In the current study, there were three major mother tongues spoken by the participants,
English for students with English educated parents, Bahasa Malaysia for most of the Bumiputra
(native Malaysian), and Mandarin for the Chinese. In the school setting, instructions used were
in both Bahasa Malaysia (official) and English. Thus, in the final prototype it was proposed to
add Bahasa Malaysia as a language option. This option would enable the children to choose
the language that they were more familiar with. Mandarin or other dialect options, such as the
Sarawak dialects could be expanded in future work.
d. User face display discarded
The user’s face display was discarded in the final design as the finding from the pilot test
discovered that some users often got distracted by this feature, thus they could not
concentrate on the learning screen.
e. Audio narration to replace the teacher video narration
Audio narration was added as a replacement for the teacher video narration. Similar to the
case with the user’s face display feature, the video narration was distracting the user from the
social story (learning screen). Thus, the video narration was replaced with an audio narration
instead.
f. Quiz section discarded
The quiz section was discarded due to the inability of many children to use the quiz feature.
Some of the participants were just playing around with this feature instead of using it
appropriately. Apart from that, children with ASD have different functional and intelligence

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levels. Many children could not attempt the quiz. Therefore, the quiz feature did not serve its
intended purpose.
3.10 Summary
This chapter has discussed the requirements in designing the conceptual model of the
program, 2D Animated Social Story (I‐Learn Social Story). This chapter covered the introduction
to the available research design and the design that had been chosen to be used in the study,
the discussion on the preliminary study and the results, and a detailed conceptual model of
the final prototype. The next chapter discusses the implementation of the prototype based on
the conceptual design that has been discussed in this chapter.

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Chapter 4: Prototype Implementation

Chapter 4: I‐Learn Social Story design and development
4.1 Introduction
As the title indicates, this chapter reviews the implementation of the final prototype based on
the conceptual design that has been outlined in the previous chapter. The first section
discusses the method used in developing the prototype, including the developed/selected SS
and the user interface. The tools/software used in the development of the prototype is
discussed in the section on developmental tools.
4.2 Method in developing I‐Learn Social Story
Steps in developing I‐Learn Social
Story (after the preliminary study)
Identify target write/select appropriate
record narration develop animation
behaviour social story scripts
From record using Adobe Flash to

Information based on
literature field previously narration develope the animation
from Gray's
review observation published based on based on the social
teacher guideline
study social story script
story
script
Add in the
narration
recorded
narration
editing
Completed
prototype
Figure 7 Steps in developing I‐Learn Social Story
Swaggart et al. (1995) outlined ten steps in producing, implementing and evaluating paper‐
based SS that are consistent with the recommendations made by Gray (1994). They are: (1)
identifying the target behavior of the problem situation for SS intervention; (2) define the
target behavior for data collection; (3) collect the baseline data on the target behavior; (4)
write a short SS using descriptive, perspective and control sentences; (5) place one to three
sentences on each page; (6) use photographs, hand‐drawn pictures or pictorial icons; (7) read
the story to the students and model the desired behavior; (8) collect intervention data; (9)
review intervention data; and (10) review the findings and related SS procedures.

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In this study, social stories were developed after target behaviors/skills were identified from
literature review, observation and interview with classroom teachers and class helpers. Each
SS was first drafted in paper before implemented into 2D animation. The SS was developed or
taken from a previous study that adhered to Gray’s guidelines. When the SS script was ready,
audio narration was recorded and edited based on the story script. The narration was to be
used together with the animation that was implemented later. The next step was to construct
the SS script into 2D animation using Adobe Flash CS3. These steps of I‐Learn Social Story
development are illustrated in Figure 7.
4.3 Social story development
This section describes the development of the SS as the main content of the prototype. The
social stories were individualized in the sense that they were designed around specific
situations that were causing difficulties. In order to develop a SS that would be effective for
children with ASD, the guidelines and types of sentences from the SS author, Carol Gray, were
followed (refer to 2.3.6.3 Guide/criteria in writing social story). Titles of the social stories,
developed to suit the children’s common needs were: How to greet someone at school, Play
and sing with friends, Snack time, Walking in the hallway, and Washing hands.
4.3.1 Targeted social skills
The SS was formed based on the targeted social skills/behaviors of the children that had been
gathered from the earlier stage. Below is a list of the essential social skills/behaviors to be
acquired by the participants in the local school, after the observation requirement gathering
and information obtained from the teacher and class helpers.
1. Appropriate social behavior, such as how to relate and respond appropriately to others in
a social situation,
2. Friendship building through socialization which included initiating and responding to
conversation with friends,
3. Self‐management and healthy lifestyle, and,
4. Patience and self‐control
4.3.2 Social story selection/writing
The social stories to be adopted for 2D animation essentially have the targeted behaviors as
listed in the section above. Apart from the original writing, the social stories were to be taken
from websites or published papers, which where ever necessary, would be modified to suit the

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setting of the children with ASD in Perkata Special School. All of the five SS scripts were created
from the perspective of students, using familiar and simple vocabulary. The following section
discusses the selected social stories incorporated into the final prototype.
4.3.2.1 How to greet someone at school
How to greet someone at school was taken from http://www.child‐autism‐parent‐
cafe.com/How‐To‐Greet‐Someone‐At‐School.html and it was not modified as the story suited
the school context. It taught the students skills like initiating or responding to greetings
verbally or non‐verbally. The general targeted social skills were types 1 and 2 (refer to 4.3.1
Targeted social skills). This SS aimed to help the students learn to respond verbally to greetings
with “hello” and “good‐bye”, and to help them learn how to acknowledge their teachers and
classmates in non‐verbal ways. Table 2 presents the storyline and sentence combination of
How to greet someone at school.
Appropriate behavior included students could initiate and/or respond to greetings verbally,
physically or through gesture. Inappropriate behavior included students who initiated and/or
responded to greetings in inappropriate ways such as pushing and yelling. No Interaction
included students had no response to social greetings.
English version Bahasa Malaysia version
Type of sentence
(How to greet someone at school) (Menyapa seseorang di sekolah)
There are many ways to greet someone at Ada banyak cara untuk menyapa seseorang Descriptive
school di sekolah
When I see someone I know, I will try to Apabila saya berjumpa seseorang yang saya Descriptive
smile and say ‘hi’ or ‘hello’ kenal. Saya akan cuba senyum dan berkata
‘hi’ atau ‘helo’
They may say ‘hi’ or ‘hello’ back to me Mereka juga pasti akan menjawab ‘hi’ atau Descriptive
‘helo’
I can ask someone ‘how are you today?’ Saya boleh bertanya kepada seseorang, ‘apa Directive
they may stop to talk with me khabarmu hari ini?’ Mereka mungkin
berhenti untuk bercakap dengan saya
In the morning, I will try to say ‘good Pada waktu pagi, saya akan cuba menyapa Directive
morning’ to someone ‘selamat pagi’ kepada seseorang.
At dismissal time, I will try to say Selepas habis waktu, saya akan Directive
‘good‐bye’ or ‘see you tomorrow’ cuba mengucapkan ‘selamat tinggal’ atau
‘semoga berjumpa lagi’
Table 2 Storyline and sentence combination of ‘How to greet someone at school’

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4.3.2.2 Play and sing with friends
The general targeted social skills for Play and sing with friends were type 2 (refer to 4.3.1
Targeted social skills). The Appropriate behaviors included students could play, sing or had
other social interactions with their peers, such as sharing stationery and/or asking/responding
to help in appropriate ways. Inappropriate behaviors included students refused to play or
share their toy/stationery with their peers in an inappropriate way, students refused to sing
together with peers, students refused to lend or help their peers in an inappropriate way. No
Interaction included students had no response to social invitation by their peers.
This SS aimed to teach students in building friendship through class activities. Table 3 presents
the storyline and sentence combination of Play and sing with friends.
Type of sentence
(Play and sing with friends) (Bermain and bernyanyi bersama kawan)
At school, I can do a lot of things Di sekolah, saya boleh melakukan banyak Descriptive
perkara
I can work, I can play and I can sing too Saya boleh bekerja, saya boleh bermain, Descriptive
dan saya boleh menyanyi
I can play with my friends and we can sing Saya juga boleh bermain dengan rakan‐ Descriptive
together too rakan saya dan bernyanyi bersama
Playing and singing with friends is a fun Bermain and bernyanyi bersama kawan Descriptive
thing to do sangatlah menyeronokkan
My friend and I will be happy when we are Kawan‐kawan dan saya seronok apabila Consequence
having fun playing or singing together bermain atau bernyanyi bersama
Table 3 Storyline and sentence combination of ‘Play and sing with friends’
4.3.2.3 Snack time
Snack time was adapted from the paper of Crozier and Tincani published in 2007. They had
tested this story on three children with ASD. This story was selected as it was applicable to the
setting of the students in the local school, where they had their Snack time in their classroom
daily. This SS aimed to encourage students to talk with their friends during snack time at
school, and to encourage students to share their snacks with their friends during snack time.
Table 4 presents the storyline and sentence combination of Snack time.
The targeted social skills for Snack time were types 1 and 2 (refer to 4.3.1 Targeted social
skills). This story was used to encourage students to interact with others during snack time at
school, or to hold a decent conversation by asking for more snacks or drinks. The Appropriate

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behaviors included students could initiate or respond to others verbally, physically or
gesturally during snack time, students could share their snacks with others, students could ask
for snacks from others, students refused to share snacks in an appropriate way. Inappropriate
behaviors included students taking other’s snacks without permission, students refused to
share their snacks in an improper way, such as pushing. No Interaction behavior included
students had no response when being offered snacks, students had no response on being
invited to participate in social interaction during snack time.
Type of sentence
(Snack time) (Waktu rehat)
We have snack time at school Kita ada waktu rehat di sekolah Descriptive
Friends talk and share at snack time Rakan‐rakan berbual dan berkongsi semasa Descriptive
waktu rehat
Some friends greet me ‘hi..’ Beberapa kawan yang menyapa’hi’ Descriptive
Some friends ask for drink Beberapa kawan ingin minum Descriptive
Some friends ask for more snacks Beberapa kawan meminta makanan ringan Descriptive
lebih
I can say ‘hi..” to my friend Saya boleh menyapa ‘hi’ kepada kawan saya Directive
I can ask for more snacks Saya boleh meminta makanan ringan lebih Directive
banyak lagi
Friends are happy when we talk at snack Rakan‐rakan gembira apabila kami berbual‐ Consequence
time bual pada waktu rehat
Table 4 Storyline and sentence combination of ‘Snack time’
4.3.2.4 Walking in the hallway
The targeted social skills of Walking in the hallway were types 1, 2 and 4 (refer to 4.3.1
Targeted social skills). Appropriate behaviors included students could initiate/respond to social
interaction while walking in the hallway, such as holding hands or talking softly, students
walked slowly and did not make noises while walking in the hallway. Inappropriate behavior
included students initiated/responded to social interaction in an inappropriate manner,
students ran or made noises while walking in the hallway. No Interaction included students
had no response when being invited into social interaction during their walk in the hallway.
This story aimed to teach students to walk appropriately in the hallway and to encourage
students to socialize while walking in the hallway. Table 5 presents the storyline and sentence
combination of Walking in the hallway.

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Type of sentence
(Walking in the hallway) (Berjalan di koridor)
At school, we need to walk in the hallway Di sekolah, kita perlu berjalan di koridor Descriptive
While my classmates are walking in the Semasa rakan kelas saya sedang berjalan di Descriptive
hallway, other students are working in their koridor, pelajar yang lain masih membuat
classroom kerja di kelas mereka
So, I must keep quiet while walking in the Jadi, saya harus berjalan dengan senyap di Directive
hallway koridor
I will stay in line and walk slowly Saya akan beratur dan berjalan perlahan‐ Directive
lahan
I also can hold my friend’s hand and we can Saya juga boleh memegang tangan kawan Directive
walk together saya dan berjalan bersama‐sama
My teacher will be proud and other classes Guru saya berbangga manakala kelas yang Consequence
will be able to work when I walk slowly in lain boleh belajar semasa saya berjalan
the hallway perlahan‐lahan di koridor
Table 5 Storyline and sentence combination of ‘Walking in the hallway’
4.3.2.5 Washing hands
The general targeted social skills for this SS were types 2 and 3 (refer to 4.3.1 Targeted social
skills). This story aimed to encourage students to socialize while doing activities, i.e. washing
hands, and to promote hygienic lifestyle by washing hands before meals. Table 6 presents the
storyline and sentence combination of Washing hands.
Appropriate behaviors included students were able to ask their peers to go to wash their
hands, brush their teeth or to the washroom together, students were able to accept/reject in
an appropriate way at their peer’s request to go to wash their hands, brush their teeth, or to
go to the washroom together, without promptings, students were able to go to wash their
hands before meals or after activities. Inappropriate behaviors included students rejecting
their friend’s request to wash their hands, brush their teeth or to go to the washroom together
in an inappropriate way, such as pushing or shouting, students went to wash their hands only
after a few promptings from the teacher/class helper. No Interaction was defined as students
did not respond to the teacher, class helper or friend’s request to go to wash their hands,
brush teeth or to go to the washroom together.

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Type of sentence
(Washing hands) (Mencuci tangan)
My hands often get dirty when I do things Tangan saya senang kotor ketika mewarna Descriptive
such as coloring
Dirt and germs on dirty hands can make Habuk and kuman di tangan yang kotor Descriptive
people sick boleh membuatkan orang sakit
I will wash my hands when they are dirty Saya pasti mencuci tangan apabila ianya Directive
kotor
I need to wash my hands before I eat to Sebelum makan saya perlu mencuci tangan Descriptive
stay healthy supaya lebih sihat
Washing my hands keep them clean again Untuk lebih bersih lagi, saya mencuci tangan Descriptive
saya
I can also ask my friend to go to wash hands Saya selalu bertanya kawan‐kawan saya Directive
together untuk pergi mencuci tangan bersama‐sama
We will stay happy if we are healthy Jika kita sihat, kita pasti gembira Consequence
Table 6 Storyline and sentence combination of ‘Washing hands’
4.4 User interface development
This section presents screen captures of the user interface of the I‐Learn Social Story that has
been implemented into 2D animation forms, in English and Bahasa Malaysia. The rationale of
font, colors, interaction style, interface and graphic element used has been discussed in
Chapter 3.
The prototype was designed to display in full‐screen to avoid any distraction from the
background display while children were using the prototype. Figure 8 illustrates the
introduction animation of I‐Learn Social Story; it is a simple animation for 8 seconds before the
program displays the list of the social stories to choose from in Figure 9, where the five social
stories reside, with English and Bahasa Malaysia as options to choose from. Figure 10, Figure
14, Figure 17, Figure 22 and Figure 26 illustrate the social story list with each social story
highlighted in turn.
Once the user has made the selection of a story, the respective target behavior will be
displayed for 10‐20 seconds; there is also a “skip” button, where the user can press to skip this
target behavior scene (Figure 11, Figure 15, Figure 18, Figure 23 and Figure 27).
And finally, after the target behavior scene, the animation for the respective SS that has been
chosen will be played. Figure 12, Figure 13, Figure 16, Figure 19, Figure 20, Figure 21, Figure
24, Figure 25, Figure 28 and Figure 29 show the screenshots of some social stories animation.

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At the end of each story, there will be “Another story” button to bring the user back to the
social story list as in Figure 9.
4.4.1 The introductory screen
Figure 8 The introduction scene
Figure 9 The story list

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4.4.2 How to greet someone at school
Figure 10 presents the screenshot of the SS list with How to greet someone at school
highlighted. The screenshot of the target behaviors is displayed in Figure 11. Figure 12 and
Figure 13 present the animation screenshot of How to greet someone at school. All of the
figures are presented with the original two versions; on the left is the English version and on
the right is the Bahasa Malaysia version.
Figure 10 Story list with ‘How to greet someone at school’ highlighted
Figure 11 The target behavior of ‘How to greet someone at school’
Figure 12 Screenshoot of ‘How to greet someone at school’ animation (part 1 of 2)

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Figure 13 Screenshoot of ‘How to greet someone at school’ animation (part 2 of 2)

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4.4.3 Play and sing with friends
Figure 14 presents the screenshot of the SS list with Play and sing with friends highlighted. The
screenshot of the target behaviors is displayed in Figure 15. Figure 16 present the animation
screenshot of Play and sing with friends. All of the figures are presented with the original two
versions; on the left is the English version and on the right is the Bahasa Malaysia version.
Figure 14 Story list with ‘Play and sing with friends’ highlighted
Figure 15 The target behavior of ‘Play and sing with friends’

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Figure 16 Screenshoot of ‘Play and sing with friends’ 2D animation (part 1 of 1)

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4.4.4 Snack time
Figure 17 presents the screenshot of the SS list with Snack time highlighted. The screenshot of
the target behaviors is displayed in Figure 18. Figure 19, Figure 20 and Figure 21 present the
animation screenshot of Snack time. All of the figures are presented with the original two
versions; on the left is the English version and on the right is the Bahasa Malaysia version.

Figure 17 Story list with ‘Snack time’ highlighted
Figure 18 The target behavior of ‘Snack time’
Figure 19 Screenshoots of ‘Snack time’ animation (part 1 of 3)

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4.4.5 Walking in the hallway
Figure 22 presents the screenshot of the SS list with Walking in the hallway highlighted. The
screenshot of the target behaviors is displayed in Figure 23. Figure 24 and Figure 25 present
the animation screenshot of Walking in the hallway. All of the figures are presented with the
original two versions; on the left is the English version and on the right is the Bahasa Malaysia
version.

Figure 22 Story list with Wallking in the hallway highlighted

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Figure 23 The target behavior of ‘Walking in the hallway’

Figure 24 Screenshoot of ‘Walking in the hallway’ animation (part 1 of 2)

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Figure 25 Screenshoot of ‘Walking in the hallway’ animation (part 2 of 2)
4.4.6 Washing hands
Figure 26 presents the screenshot of the SS list with Washing hands highlighted. The
screenshot of the target behaviors is displayed in Figure 27. Figure 28 and Figure 29 present
the animation screenshot of Washing hands. All of the figures are presented with the original
two versions; on the left is the English version and on the right is the Bahasa Malaysia version.

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Figure 26 Story list with ‘Washing hands’ highlighted
Figure 27 The target behavior of ‘Washing hands’

Figure 28 Screenshoot of ‘Washing hands’ animation (part 1 of 2)

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Figure 29 Screenshoot of ‘Washing hands’ animation (part 2 of 2)

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4.5 Development tools
The tools that had been used in developing the prototype were: Adobe Flash CS3 with
ActionScript 3.0 for developing animation, Microsoft Windows sound recorder and external
microphone for the narration recording, and Audacity for narration editing.
4.5.1 Adobe Flash CS3 and ActionScript 3.0
In developing the prototypes, used in both the preliminary testing and the final evaluation, the
main tools used were Adobe Flash CS3 together with its programming language, ActionScript
3.0. Flash and ActionScript have evolved together since Flash was originally released in 1996
(Florio et al. 2008). Flash CS3 is the first version of Flash to incorporate ActionScript 3.0 (Florio
et al. 2008).
Adobe Flash was formerly known as Macromedia Flash; it is an authoring application that uses
vector graphics, and it allows the designer to create an interactive content with the use of
ActionScript and simple frame‐based animation (Reimers & Stewart 2007). Adobe Flash has
been used in research to deliver interactive content, such as Reimers & Stewart (2007), who
used Adobe Flash to run complex psychological experiments over the web.
Without ActionScript, Flash is “just” a powerful animation tool. ActionScript is the tool that
makes the Flash content interactive; it is a well‐organized and mature language that shares
much of its syntax and methodologies with other object oriented programming languages
(Braunstein 2009). ActionScript is crucial for a content that is highly dynamic, responsive,
reusable and customizable (Braunstein 2009). The combination of these two offers the most
powerful, most versatile and most popular development environment available (Florio et al.
2008).
Flash is especially used for creating animations, games, splash screens or advertisements.
There are millions of Flash‐created contents as indexed by Google (Reimers & Stewart 2007).
4.5.2 Windows Sound Recorder and external microphone
All audio narration that had been incorporated into the prototype was recorded using
Windows Sound Recorder with an external microphone attached to the computer. Windows
Sound Recorder is a simple sound recorder program that has been included in Windows since
its earliest days (Cowart & Knittel 2008).

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In recording sound with Windows Sound Recorder, a microphone was plugged into the Mic
port on the sound card (Wempen 2004). The recorded sound was saved as the waveform
(WAV) format, which was then being edited using Audacity.
4.5.3 Audacity
Audacity is an open source software that is used in editing the recorded sound. It was
developed by a team of students, software developers, musicians, recording engineers and
others, freely in their spare time (http://web.audacityteam.org/sponsor.php).
In the prototype, Audacity was used to divide the recorded sound files into smaller sound files
for each line of the SS narration.
4.6 Summary
I‐Learn Social Story, the prototype used in the experimental design was developed by
incorporating five selected social stories that were written following the guidelines from Carol
Gray. The five stories were Snack time, Walking in the hallway, Play and sing with friends,
Washing hands, and How to greet someone at school. The English and Bahasa Malaysia
versions were implemented as presented in this chapter. The major tool that was used in
developing the prototype was Adobe Flash CS3 together with its programming language,
ActionScript3.0 to create animation and to add interactivity. Other tools that were used in
developing the prototype were Windows Sound Recorder with an external microphone and
Audacity, which had been used to handle the sound recording and editing. The next chapter
discusses the testing of the prototype that had been implemented on thirty students with ASD
in Perkata Special School.

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Chapter 5: Prototype Testing and Evaluation

5.1 Introduction
As discussed in Chapter 3, out of the three research design methods (qualitative method,
quantitative method and mixed‐method), this study employed the quantitative research
design as it is the most suitable design to be used in this type of study.
It has been said in Chapter 3 that the single subject design from the quantitative method is
effective in measuring behavioral changes. According to Horner et al. (2005), the single subject
design is a rigorous scientific methodology used to define behavior and it offers many features
that are particularly appropriate for use in the field of special education research.
The objective of a single subject design is to establish the effects of an intervention on a single
individual, thus the essence in this design is that the individual participants will be in control.
Since the participants are in control, each will benefit from the intervention (Washburn 2006).
In this study, the reversal (ABA) design, which is a type of a single subject design, was used to
measure the effectiveness of I‐Learn Social Story to children with ASD.
5.2 Procedure/preparation
Figure 30 illustrates the procedure used in the experimental study. In selecting participants,
inclusion criteria were set (refer to 5.2.1 Participant selection for details of inclusion criteria).
In gathering participants, the author met with the school principal and consulted her
concerning the potential participants who could satisfy the inclusion criteria set. The school
principal then selected the students who met those criteria and sent the consent forms to
their parents. Once consent was given, the principal then informed and passed the approved
participants to the author. The school principal also informed the classroom teachers about
the study and requested for their help and assistance in aiding the author to access the
participants’ daily classroom activities.
Once the participants were confirmed, intervention started with observation for the collection
of baseline data using the data collection sheet (Appendix C). It was done in the participants’
respective classrooms, during their daily school activities. After the baseline data had been
collected for 2 weeks, the treatment took place in the participants’ respective classrooms
during their free time, before the targeted activity.

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The treatment was done by showing and assisting participants to use I‐Learn Social Story. In
the treatment session, student behaviors were recorded in the data collection sheet
immediately after each treatment. After the treatment, which was conducted for a minimum
of 16 sessions, the reversal phase began, where the participants were no longer using I‐Learn
Social Story. In the reversal phase, the data collection sheet was again used to gather
information on the behavior of the participants, which was also done in the participants’
respective classrooms during their daily school activities.
The analysis of the data began by compiling all the data collected in all phases into the Excel
spread sheet and graphed for visual analysis. The analysis was done by comparing the baseline
data with the data from intervention and reversal baseline. The conclusion was drawn on
whether the intervention was effective on the participants based on the analysis of data
collected.
Steps in the experimental
study
Selecting participants Intervention Result analysis
Set inclusion criteria Collect baseline data gather all colelcted data
Obtain participants from
Treatment with I‐Learn graphed the data for analysis
School Principal based on
inclusion criteria Social Story and collect
data
analyse the data
School Principal send consent
letter to parents Collect reversal data
draw conclusion from the data
Approved consent

Figure 30 Steps in the experimental study
The following subsections discusses the procedures on participant selection, participant
profile, dependent measures in data collection, data collection in all phases, data processing
and analysis, and ethical consideration.

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5.2.1 Participant selection

The participants of the study were students from Perkata Special School, a special school for
disabled children located in Kuching, Sarawak. In order to ensure the validity of the
experimental study, there were a number of criteria imposed when selecting the participants,
as listed below:
1. He/she had a diagnosis of Autism Spectrum Disorders, which includes Asperger Syndrome,
Autistic Disorders, Pervasive Developmental Disorders – Not Otherwise Specified, Rett’s
Syndrome or Childhood Disintegrative Disorders, whether identified by a psychological
assessment or a psychiatric diagnosis. They were obtained from their medical records as
documented in the school database,
2. His/her age had to be between 4 to 17 years old,
3. He/she was currently a student of the school,
4. He/she demonstrated behavioral problem and/or had impaired verbal/social
communication on the targeted social skills (listed in section 4.3.1 Targeted social skills),
5. He/she was able to look at a computer screen, without the necessity of knowing how to
operate the computer, and
6. He/she was willing to participate in the study.
The participants were recruited through the principal of the Perkata Special School by perusing
the school record for students who met these inclusion criteria provided by the author.
Parents of selected participants were contacted directly by the principal for their consent for
the child’s participation in the study (see Appendix B). Once consent was given, the principal
passed the students’ names to the author. The principal then informed the classroom teachers
regarding the study and asked for their help and cooperation in assisting the author in the
study with the selected participants. Prior to the study, permission was obtained from the
participants and the Student Assent Forms (Appendix D) were distributed to them.

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5.2.2 Participants’ profiles

There were thirty participants selected to participate in the study. Table 7 shows the summary
of the participants’ profile, including their gender, age, diagnosis, basic communication skills,
cognitive functioning, home‐class, mother tongue and special notes if any.
It had been anticipated that the number of male participants would be significantly more than
the female participants, as statistic has shown that the diagnosis of ASD is more prominent in
males (Fambonne 2003). In this study, there were 4 female participants and 26 male
participants. The average age of the participants was 9.8 years old. There was only one
participant with a diagnosis of Rett’s Syndrome, three participants with Asperger Syndrome,
eleven participants with Pervasive Developmental Disorders – Not Otherwise Specified, fifteen
participants with Autistic Disorders and none with Childhood Disintegrative Disorders.
Basic communication skill was defined from the ability of the students to communicate in an
appropriate way using verbal or non‐verbal languages (such as gestures). Students without
basic communication skills were the ones who often did not respond to others verbally or
gesturally in an appropriate way.
Cognitive functioning was defined from the students’ competency to understand the materials
taught by the teacher and be able to join in the teaching activities. Students afflicted with this
problem would not also participate in the teaching activities, and were thus often excluded
from the teaching sessions.

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Basic
Cognitive
commu
ID Gender Age Diagnosis functionin Class Mother tongue Notes
nication
g
skill
1 F 4 Rett’s Syndrome - √ 1 English
2 F 5 Asperger Syndrome - √ 1 Mandarin
Mandarin/
3 M 5 PDD/NOS - √ 2
English
Interest in drawing and
4 M 6 Asperger Syndrome - √ 1 English
computer
5 M 6 PDD/NOS √ √ 2 English
6 M 6 PDD/NOS √ √ 1 BM
7 M 7 Autistic Disorder √ √ 1 English
8 M 7 Autistic Disorder - √ 2 BM Severe type

Mandarin/
9 M 8 PDD/NOS √ √ 2 Hyperactive
English
10 M 8 PDD/NOS √ √ 3 Mandarin
11 M 9 Autistic Disorder - - 2 BM
12 M 9 Autistic Disorder - √ 3 Mandarin
13 F 9 Autistic Disorder √ √ 3 English
14 M 9 PDD/NOS √ √ 3 English
Interest in computer and

15 M 10 Asperger Syndrome √ √ 4 BM/English
math
16 M 10 PDD/NOS √ √ 4 Mandarin Special interest in computer
17 M 10 Autistic Disorder - - 2 BM Severe type
18 M 10 PDD/NOS - √ 3 Mandarin/ BM
19 M 10 Autistic Disorder - √ 3 BM Hyperactive
20 M 11 Autistic Disorder - - 4 English Severe type
21 M 11 PDD/NOS - √ 4 English
Interest in phones and

22 M 11 PDD/NOS √ √ 4 BM
computer
23 M 11 Autistic Disorder - √ 4 BM/English
24 M 11 Autistic Disorder - - 4 Mandarin
25 M 12 Autistic Disorder - - 5 BM
26 M 13 Autistic Disorder - - 5 BM Severe type
27 F 15 PDD/NOS √ √ 5 Mandarin
28 M 16 Autistic Disorder √ √ 5 BM
29 M 17 Autistic Disorder - - 5 English Severe type
Mandarin/
30 M 17 Autistic Disorder √ √ 6
BM
Table 7 Summary of participants’ profile

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5.2.3 Dependent measures in data collection

The dependent measure in the data collection was set based on Thiemann & Goldstein (2001)
that categorized social behavior as Appropriate and Inappropriate. The dependent measure
had to be set to measure the behavioral changes of the participants.
In this study, apart from the Appropriate and Inappropriate responses to measure the
behavior, No Interaction will also be used as one of the dependent measures. Table 8
illustrates the definition of Appropriate, Inappropriate and No Interaction social behavior
measures, as adopted from Thiemann & Goldstein (2001).
Social Skills Description
Contingent Coded if the focus child’s utterance is contingent on a peer’s immediate prior utterance, within a 2‐s
response (CR) interval following the peer’s utterance, through (a) acknowledging (e.g. “hmm”) or direct or partial
repetition of the utterance, (b) agreeing (e.g. head nod, “yeah”), (c) answering peer’s question, (d)
responding with a related comment about observable objects or events within the on‐going activity,
(e) confirming or clarifying a question or comment from the peer (e.g. “What did you say?”).
Securing Coded if the focus child (a) request attention or acknowledgement from peers (e.g. “Hey” “See
attention (SA) this?” or “Look”), (b) call the peer’s name to gain attention, or (c) uses gestures or vocalization to
Appropriate
establish joint attention with the peer (e.g. taps on shoulder, holds an object up to show peers).
Initiating Descriptive comments that are related to the on‐going topic or event, but not contingent on a peer’s
comments (IC) prior utterance and not used to request information, and the focus child (a) provides a comment
following a 3‐s interval after a peer’s last utterance, (b) initiates a new idea or topic that relates to
the on‐going joint activity or topic but is not a request, (c) compliment the peer (e.g. “You did it!”) or
himself, (d) reinforces the peer for winning, (e) expresses enjoyment to the peer regarding their
interaction together (e.g. “This is fun!”). The child’s utterance is coded as IC if met with the criteria
of (b) to (e) within the 3‐s interval.
Initiating Coded if focus child’s utterance is related to the on‐going topic or event, but not contingent on a
requests (IR) peer’s prior utterance and not used to clarify something the peer said (would be CR), and the focus
child requests information or actions following a 3‐s interval after a peer’s last utterance.
Topic change Coded with or without a change in materials or games if the focus child (a) interrupts (definite
(TC) overlap of words) a peer to introduce a new topic that has not been discussed previously or to
reintroduce a previous topic, (b) changes the topic to something unrelated to and non‐contingent on
the peer’s prior utterance, (c) comments tangential to some aspect of the peer’s previous utterance
Inappropriate
but there is an ambiguous semantic referent not immediately recognizable. Verbal turns that follow
a TC are coded as CR, IC, IR, or SA if the conversation follows the changes or shifted topic.
Unintelligible Utterances that are not interpretable or are unintelligible to the coder after listening to the
(UN) audiotape a minimum of three times.
Other (OT) Any (a) animal noises or other vocalizations, (b) stereotypic or perseverative utterance (considered
perseverative on the third utterance; if another child speaks or the child continues the perseveration
at a later time, start over and code the first two utterance as they are defined), (c) delayed echolalia
that is non‐interactive.
No response Child does not respond verbally or non‐verbally within 3‐s to (a) a peer’s request for information,
No response
(NR) requests for actions, or protests; (b) if the child is performing an action requested by the peer that
takes longer than 3‐s, wait to see if he completes the task and give him credit if he does, or (c) if the
peer asks the same question again within the 3‐s interval, the utterance is not coded, and the time
frame starts at 0 after the peer’s second question. If the child does not respond after the peer
repeats himself two or more times, code as NR.
Table 8 Social behavior definition as adopted from Thiemann & Goldstein (2001)

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5.2.4 Data collection

There were three phases in the data collection: baseline, intervention and reversal baseline. To
conceal the children’s privacy, the data collection process was not recorded, instead, a Data
Collection Sheet that was prepared specifically for the data collection was used (Appendix C)
The Data Collection Sheet (Appendix C) was prepared by the author following Norris & Datillo
(1999) with the response definition of Appropriate, Inappropriate and No Interaction (see
Table 8 for definition).
Data for each category was collected during the session as soon as it occurred, using the
traditional tally method by marking with “I” in the appropriate column of the Data Collection
Sheet for each occurrence. The duration of each session of data collection was set to 10
minutes. In a regular one day class, there would be 2 to 8 sessions of data collection.
Phase Baseline
Pre‐condition Consent letter approved by parents
Participants had behavioral problems as listed in the targeted social skills (Section
4.3.1).
Setting/Environment Participants’ respective classrooms/kitchen/multi‐purpose hall/outdoor, including
the participants, teacher, classroom helper, other students of the class and the
author, as the observer.
Duration/No of sessions 10 days. 1 day = 2 sessions, total 12‐20 sessions
Materials Data Collection Sheet
Data collection procedures Author informs the classroom teacher about the observation
Participants were observed in their daily class activities, they were not informed
about the observation so that they could behave naturally, if any of the targeted
behaviors occurred, notes would be taken on the Data Collection Sheet by
marking with ‘I’ for each behavior.
Table 9 Baseline data collection procedure
In the baseline phase, the initial conditions of the participants were observed. They were
observed while engaging in their daily school activities from a close distance or through direct
interaction. There was no intervention, inappropriate behaviors were not corrected and
correct behaviors were not cued in this phase. Each participant engaged in 10‐mins of social
activities per session. The social activities were based on the current classroom curricular
topic, familiar routines and the child’s preference whenever possible.

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Each participant in total was observed for 12 to 20 sessions in the baseline, depending on their
attendance and the stability of the baseline data. An Appropriate, Inappropriate and No
Interaction behaviors were noted in the Data Collection Sheet when they occurred. The data
was then processed, and was graphed for visual analysis within twenty‐four hours of the
occurrence. Once the data collected was consistent, or twenty sessions had been completed,
the intervention phase began. Table 9 describes the baseline data collection procedure.
Phase Intervention
Pre‐condition Participants’ baseline data had been collected for at least 10 sessions and the
data was stable
Setting/Environment A corner in the classroom, provided with table and chairs. Other students of the
class, teacher, and class helper were presents as well.
Duration/No of sessions 5 days. 1 day = 4 sessions, total 12‐20 sessions.
Materials I‐Learn Social Story presented in a notebook
Data Collection Sheet
Data collection procedures Classroom teacher informed the author if the participants were available for the
testing
The author brought participants to a corner of the classroom that was provided
with table and chairs
Author briefed the participants on the testing
Author started up I‐Learn Social Story from a notebook
Participants who were able to operate the prototype were allowed to operate the
program on their own; otherwise the author would assist the participants in
operating the program
At the end of each social story, the author would ask if the participants
understood or wanted to repeat the story before moving on to the next story
At the end of the testing session, the author brought the participants back to their
seats and the observation sessions began (procedure as in the baseline/reversal
baseline)
Table 10 Intervention data collection procedure
In the intervention phase, the author showed I‐Learn Social Story to the participants during
their free time prior to the activity of interest, and that was after the classroom teacher told
the author when the participant was available for testing. The intervention phase continued
daily for a week. During the first session of the intervention, the author explained to the
participant that the purpose of the SS intervention was for them to learn social skills.

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During testing, the participant and the author sat side by side at a table with chairs and the
author assisted the participant in using the I‐Learn Social Story for 10‐20 minutes. Immediately
after the testing was done, the participant was brought back to his/her regular school activities
and the observation for the intervention phase began. There were 10 to 16 sessions of data
collection in the intervention phase, depending on the participant’s attendance.
In order to ensure that the SS was understood by the participant, the author would ask some
comprehension questions to ascertain that the participant understood the SS and behavior
recommended, such as what the SS was referring to, what other people expected you to do,
and what you need to do in the situation. Then the SS was repeated to them for additional one
or two times. Table 10 describes the intervention data collection procedure.
Phase Reversal Baseline
Pre‐condition Participants completed the intervention phase
Duration/No of sessions 5 days. 1 day = 7 sessions, total 32 sessions.
Materials Data Collection Sheet
Data collection procedures Participants were observed in their daily class activities, they were not informed
behaviors occurred, notes would be taken on the Data Collection Sheet.
Table 11 Reversal baseline data collection procedure
Once intervention data had become stable or 16 sessions of intervention had been completed,
I‐Learn Social Story intervention was completely withdrawn from the participants, and reversal
baseline phase began for 16 to 32 sessions (depending on the participants’ attendance and the
stability of the data), right after the intervention phase ended.
The procedure used in the reversal baseline was the same procedure used in the baseline. The
purpose of the reversal baseline phase was to access the short‐term skill maintenance of the
participants after they had learnt the SS. This phase could also be called as the post‐
intervention phase. Table 11 describes the reversal baseline data collection procedure.

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Phase Follow‐up
Pre‐condition Participants had completed the study for one month
Duration/No of sessions 1‐2 visits, each visit = 30 minutes
Materials Data Collection Sheet or notepad
Data collection procedures Participants were observed in their daily class activities, they were not informed
behaviors occurred, notes would be taken on the Data Collection Sheet.
Table 12 Follow‐up data collection procedure
The purpose of the follow up session was to assess the long‐term skill maintenance, conducted
three to five weeks after the completion of the study, in one or two visits, with each visit
lasting for 30 minutes. Table 12 describes the follow‐up data collection procedure.

The procedure used in the follow‐up session was the same as the procedure used in the
baseline/reversal baseline session, where the Data Collection Sheet was used to record the
participant’s behaviors. I‐Learn Social Story was not shown to the participant prior to the
follow‐up visit. Teacher and class helpers were asked for their comments on the participant’s
post study behaviors, whether he had maintained the social skills learned. These data collected
during the follow‐up was not presented in the data analysis, instead it is discussed in section
5.4 under Findings and Discussions.
5.2.5 Data processing and analysis

Data collected from the Data Collection Sheet (Appendix C) were recorded manually, and data
processing analyses were done in Microsoft Excel 2010. Microsoft Excel has been widely used
in data analysis for single subject design study, ever since Carr & Burkholder (1998). Data
collected from the sheet was converted within 24 hours of the data collection from
shorthand/keywords into sentences or descriptive narratives.
In Microsoft Excel, data collected during all of the phases in the study was combined and
tabulated to generate the average value of behavioral change of Appropriate, Inappropriate
and No Interactions for each participant. This yielded the number of interaction in average per

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session (10 minutes). The results/rates of the behavioral changes were then graphed, using
Microsoft Excel 2010 for visual analysis. The overall data of behavioral changes were also
tabulated and graphed by combining all the data generated from all of the participants.
In the best studies in experimental design, the blind analysis technique was performed on the
data, to prevent conscious or unconscious fudging or prejudiced interpretation (Hopkins 2000).
Thus, in this study, the data was analyzed without using the name of the participant, instead, a
number ID was given to each participant, and their collected data were analyzed using the ID
without revealing the real name.
Along with the preliminary data collected from the Data Collection Sheet during intervention,
secondary data from published papers, literature, and interview with teachers were analyzed
in order to support the intervention results and to generate social validity and teacher
satisfaction on the prototype, as discussed in section 5.4 under Findings and Discussions.
5.2.6 Ethical considerations

As this study required human participation, particularly children with ASD, certain ethical
issues of sensitivity needed to be addressed. The consideration of these ethical issues was for
the purpose of ensuring the privacy and safety of all the participants.
Among the significant ethical issues that were to be considered in the study process were the
consent from parents and teachers, as well as ensuring the confidentiality of the information
obtained in the study. In order to secure the consent of the selected participants, all important
details of the study, including its aim and purpose were relayed. The participants were also
advised that they could withdraw from the study if they wished to, even during the process,
without any penalty. With this, the participants were not made to feel forced to participate in
the research study.
The confidentiality of the participants was ensured by not disclosing their real names or any
other personal information in any presentation or publications related to the research, as well
as not being photographed or recorded throughout the study in order to conceal their privacy.
The data collected from the observation and interviews for the analysis was locked and
destroyed after the analysis of the data was done.

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5.3 Settings
The experimental study was held in Perkata Special School in a few specific locations of the
school area, such as the different classrooms, school kitchen, multi‐purpose meeting hall, and
the open area of the school.
5.3.1 Classrooms
There were 6 classrooms used as the setting for the study. Each classroom held a maximum of
17 students of mixed mental disabilities. Each class was managed by one classroom teacher
and one or two teacher’s assistants. Table 13 describes the classrooms and a short description
of the classes’ main activities.
No of
Short
Class participant Class main activities
description
from the class
Class 1 5 (Participant First range Playing with toys Learning alphabet
1, 2, 4, 6, 7) class; class for Watching kids’ movies Coloring
the youngest Singing Introduction to numbers
students Learning simple vocabulary
Class 2 6 (Participant Second range Playing with toys Learning alphabets
3, 5, 8, 9, 11, class Watching kids’ movies Drawing/coloring
17) Singing Introduction to numbers
Matching object pictures
Class 3 6 (Participant Third range Singing Drawing/coloring
10, 12, 13, 14, class Matching object pictures Simple math
18, 19) Cooking Spelling
Exercise Puzzle solving
Computer
Class 4 7 (Participant Fourth range Singing Math
15, 16, 20, 21, class Matching object pictures Spelling
22, 23, 24) Cooking Puzzle solving/logic learning
Exercise Reading/writing
Computer Art/craft
Drawing/coloring
Class 5 5 (Participant Fifth range class Singing Puzzle solving/logic learning
25, 26, 27, 28, Cooking Reading/writing
29) Exercise Art/craft
Computer Gardening
Drawing/coloring Life skills (cleaning, planting)
Math
Class 6 1 (Participant Seventh range Singing Puzzle solving/logic learning
30) class; the last Cooking Reading/writing
year students Exercise Art/craft
Computer Gardening
Drawing/coloring Life skills (cleaning, planting)
Math
Table 13 Classrooms profile summary

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5.3.2 School multi‐purpose hall

In Perkata Special School, there is one multi‐purpose hall which is normally used for singing
sessions, where there will be two classes combined for the session; teachers and class helpers
from both classrooms will lead the students in the singing. Other than that, it is also used to
hold special activities, such as visit from outside, class competition or any other purposes.
5.3.3 Kitchen
There is a kitchen in the school where cooking activities are held daily by different classes.
While the teacher and class helper are cooking, the students will be sitting down at the kitchen
table. Some of the more capable students will be asked to help the teacher out in various
activities, like washing the plates and spoons, distributing the utensils to their classmates, or
helping in peeling the vegetables.
5.3.4 Outdoor field

In Perkata Special School, there is an outdoor field where outdoor activities are carried out,
such as exercising or gardening. Thus, the outdoor field was one of the settings where the
observation was taking place.
5.4 Material and equipment

5.4.1 Data collection sheet
Data collection sheet (Appendix C) was mainly used for the data collection in all of the phases.
This sheet was prepared specifically for the data collection, as in Norris & Datillo (1999) with
columns for the response definition of Appropriate, Inappropriate and No Interaction as
defined in Table 8.
5.4.2 I‐Learn Social Story presented in a set of notebook

A notebook PC was used to present the I‐Learn Social Story to the participants. In the study,
the notebook used was Lenovo IdeaPad 10.1”. However, I‐Learn Social Story can be presented
in any computer and mobile phone that supports Adobe Flash Player.

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5.5 Result and analysis

The effectiveness of I‐Learn Social Story in changing the social behavior of the participants was
identified by comparing the average (mean) number of occurrences for the social behavior
(Appropriate, Inappropriate and No Interaction) on each of the phases (baseline, intervention
and reversal baseline) for each participant.
The average (mean) number of social behavior occurrences was obtained by summing‐up the
number of occurrences for the phase and dividing it by the number of sessions in the phase, as
each participant had a different number of sessions on each phase.
The unit used to measure the behavioral change in the results was by the number of
behavioral change within 10 minutes. Figure 28 to Figure 57 illustrate the graph for behavioral
changes for individual participants, Table 18 to Table 22 illustrate the changes based on each
SS. And after the result of the entire SS was tabled, the overall behavioral change results were
compiled into the overall results (Table 23), which revealed that the intervention of I‐Learn
Social Story was effective in changing the behavior of children with ASD.
5.5.1 Individual results
This section discusses the results of each individual participant following Figure 31 to Figure
60. Each figure displays the graphs of the individual participant’s result on each SS that the
participant went through. Included in each graph is the number of social interactions made on
each phase of the intervention. There were three phases of data collection (Baseline,
Intervention and Reversal Baseline, as discussed in section 5.2.1.4 Data collection). The
average value of each phase was calculated by adding the numbers of social behavior and
dividing it with the number of sessions in the phase. The value for overall behavioral changes
of each phase was obtained from the average behavioral changes value of all social stories in
each phase divided by the number of social stories that the participant went through. All
values were stated in number of times (occurrences) per 10 minutes session.

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I. Participant 1
Figure 31 illustrates the comparison graphs of Participant 1’s Appropriate, Inappropriate and
No Interaction behavior during baseline (A), intervention (B) and reversal baseline (A) for each
of the social stories that the participant went through, as discussed below:
Figure 31 Participant 1’s behavioral changes

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a. Result of How to greet someone at school
During the baseline phase, Participant 1 achieved an average of 0.1 occurrence of Appropriate
behavior; 1.6 occurrences of Inappropriate behavior; and 2.4 occurrences of No Interaction in
the observation. During the intervention phase, Participant 1 achieved 0.6 occurrence of
Appropriate behavior; 0.6 occurrence of Inappropriate behavior; and 0.8 occurrence of No
Interaction during the observation. During the withdrawal (reversal baseline) phase, the data
collected for Appropriate behavior was 0.5 occurrence, Inappropriate behavior was 0.5
occurrence and No Interaction was 0.8 occurrence. From the findings of the observation in the
three phases, Participant 1 had improved in Appropriate behavior by 0.45 occurrence.
Inappropriate behavior was reduced by 1.05 occurrences and the number of interactions
increased by 1.6 occurrences.
b. Result of Play and sing with friends
the observation. During the intervention phase, Participant 1 achieved 2.3 occurrences of
Appropriate behavior; 0.4 occurrence of Inappropriate behavior; and 1.2 occurrences of No
collected for Appropriate behavior was 2.1 occurrences, Inappropriate behavior was 0.5
occurrence and No Interaction was 0.9 occurrence. From the findings of the observation in
these three phases, Participant 1 had improved in Appropriate behavior by 1.9 occurrences.
Inappropriate behavior was reduced by 0.85 occurrence and the number of interactions
c. Result of Snack time
occurrence and No Interaction was 1.2 occurrences. From the findings of the observation in
the three phases, Participant 1 had improved in Appropriate behavior by 1.15 occurrences.

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d. Result of Washing hands
Overall, the results suggested that introduction of SS presented in I‐Learn Social Story had a
considerable and beneficial effect on Participant 1 in increasing the number of Appropriate
behaviors, decreasing the number of Inappropriate behaviors as well as increasing the number
of social interactions made.

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II. Participant 2

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three phases, Participant 2 had improved in Appropriate behavior by 1.1 occurrences.

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Overall, the results for Participant 2 suggested that the introduction of SS presented in I‐Learn
Social Story had a sizeable role in increasing the number of Appropriate behaviors and
decreasing the number of Inappropriate behaviors, as well as increasing the number of social
interactions made.

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III. Participant 3

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Appropriate behavior; 1.2 occurrences of Inappropriate behavior; and 1.1 occurrences of No
occurrences and No Interaction was 1.5 occurrences. From the findings of the observation in
Inappropriate behavior reduced by 0.1 occurrence and the number of interactions increased
by 1.6 occurrences.
occurrence and No Interaction was 1.3 occurrences. From the findings of the observation in
occurrences and No Interaction was 2.0 occurrences. From the findings of the observation in
Inappropriate behavior was reduced by 0.25 occurrence and number of interactions increased
by 1.90 occurrences.

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collected for Appropriate behavior was 0.8 occurrence, Inappropriate behavior was 1.0
three phases, Participant 3 had improved in Appropriate behavior by 0.60 occurrence.
Overall, the result for Participant 3 suggested that the introduction of SS presented in I‐Learn
Social Story had a substantial effect in increasing the Appropriate behaviors and the number of
social interactions made, as well as having little effect in decreasing Inappropriate behaviors.

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IV. Participant 4

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Social Story had a great positive effect in changing the social behaviors of the participant.

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V. Participant 5

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Appropriate behavior; 1.1 occurrences of Inappropriate behavior; and 0.8 occurrence of No
occurrence and No Interaction was 0.8 occurrence.
From the findings of the observation in the three phases, Participant 5 had improved in
Appropriate behavior by 1.75 occurrences. Inappropriate behavior was reduced by 1.35
occurrences and the number of interactions increased by 2.10 occurrences.
occurrence and No Interaction was 1.3 occurrences.
occurrence and No Interaction was 1.0 occurrence.

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occurrence and the number of interactions increased by 1.35 occurrences.
occurrences and No Interaction was 2.3 occurrences.
e. Result of Walking in the hallway
During the baseline phase, Participant 5 achieved an average of 0.60 occurrence of
Interaction in the observation. During the intervention phase, Participant 5 achieved 1.80
occurrences of Appropriate behavior; 1.10 occurrences of Inappropriate behavior; and 0.80
occurrence of No Interaction during the observation. During the withdrawal (reversal baseline)
phase, the data collected for Appropriate behavior was 1.70 occurrences, Inappropriate
behavior was 1.40 occurrences and No Interaction was 1.10 occurrences.
Overall, the results of Participant 5 suggested that the introduction of SS presented in I‐Learn
Social Story had a considerable effect on the participant in changing his social behaviors.

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VI. Participant 6

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During the baseline phase, Participant 6 achieved an average of 1.3 occurrences of Appropriate
occurrences and No Interaction was 0.60 occurrence. From the findings of the observation in
increased by 0.70 occurrence.
During the baseline phase, Participant 6 achieved an average of 2.30 occurrences of
occurrences of Appropriate behavior; 0.80 occurrence of Inappropriate behavior; and 0.50
behavior was 0.90 occurrence and No Interaction was 0.90 occurrence. From the findings of
the observation in the three phases, Participant 6 had improved in Appropriate behavior by
1.10 occurrences. Inappropriate behavior was reduced by 1.45 occurrences and the number of
interactions increased by 1.20 occurrences.
0.75 occurrence. Inappropriate behavior was reduced by 1.00 occurrence and the number of

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1.00 occurrences. Inappropriate behavior was reduced by 0.40 occurrence and the number of
Overall, the results collected suggested that the introduction of SS presented in I‐Learn Social
Story had a considerable and beneficial effect in changing Participant 6’s social behaviors.

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VII. Participant 7

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0.95 occurrence. Inappropriate behavior was reduced by 0.25 occurrence and the number of
behavior was 1.00 occurrence and No Interaction was 1.20 occurrences. From the findings of
the observation in the three phases, Participant 7 has improved in Appropriate behavior by 1.9
occurrences. Inappropriate behavior was reduced by 0.95 occurrence and number of
interactions increased by 0.90 occurrence.
behavior was 1.20 occurrences and No Interaction was 0.80 occurrence. From the findings of
1.60 occurrences. Inappropriate behavior was reduced by 1.25 occurrences and number of

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behavior was 1.10 occurrences and No Interaction was 1.10 occurrences. From the findings of
the observation in the three phases, Participant 7 has improved in Appropriate behavior by
0.90 occurrence. Inappropriate behavior was reduced by 0.65 occurrence and number of
Social Story had a beneficial effect in changing his social behaviors.

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VIII. Participant 8


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behavior; 2.80 occurrences of Inappropriate behavior; and 2.00 occurrences of No Interaction
in the observation. During the intervention phase, Participant 8 achieved 1.60 occurrences of
occurrences and No Interaction was 1.00.
behavior was 1.20 occurrences and No Interaction was 0.40 occurrence.
occurrences and the number of interactions increased by 0.75 occurrence.

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occurrences and the number of interaction increased by 0.65 occurrence.
occurrence and the number of interactions increased by 0.45 occurrence.
behavior was 2.10 occurrences and No Interaction was 1.20 occurrences.
Social Story had a considerable and beneficial effect in changing the participant’s Appropriate
behaviors and Inappropriate behaviors, as well as increasing the number of social interactions
made by the participant.

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IX. Participant 9


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behavior was 0.30 occurrence and No Interaction was 0.30 occurrence.
Appropriate behavior by 0.45 occurrence. Inappropriate behavior was reduced by 0.50
occurrences and the number of interactions remained the same.

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occurrences and the number of interactions remained the same.
occurrence and the number of interactions decreased by 0.05 occurrence.
Social Story had not substantially increased social interactions made by the participant, but it
noticeably increased the number of Appropriate behaviors and decreased the number of
Inappropriate behaviors made.

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X. Participant 10


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d. Result of Walking in the hallway
occurrences of No Interaction during the observation. During the withdrawal (reversal
baseline) phase, the data collected for Appropriate behavior was 3.10 occurrences,
Inappropriate behavior was 0.10 occurrence and No Interaction was 0.80 occurrence.
e. Result of Washing hands
Overall, the results for participant 10 suggested that the introduction of SS presented in I‐
Learn Social Story sizably increased the number of social interactions and Appropriate
behaviors, as well as reducing the number of Inappropriate behaviors made by the participant.

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XI. Participant 11


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Inappropriate behavior was 2.30 occurrences and No Interaction was 1.30 occurrences.
occurrence of Appropriate behavior; 2.30 occurrences of Inappropriate behavior; and 1.70
baseline) phase, the data collected for Appropriate behavior was 0.90 occurrence,

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occurrences and the number of interactions decreased by 0.65 occurrence.
Learn Social Story had a small effect in changing the participant’s social behaviors. It had a
slight, noticeable effect in increasing Appropriate behaviors and decreasing Inappropriate
behaviors, however it had slightly reduced the number of social interactions made by the
participant.

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XII. Participant 12


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Social Story had slightly increased the number of Appropriate behaviors and decreasing the
number of Inappropriate behaviors, and had considerably increased the number of social
interactions made by the participant.

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XIII. Participant 13


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During the baseline phase, Participant 13 achieved average an average of 0.90 occurrence of

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From the findings of the observation in the three phases, Participant 13 has improved in
Overall, the results for Participant 13 suggested that the introduction of SS presented in I‐
Learn Social Story had substantially influenced the increased number of Appropriate behaviors
and the decreased number of Inappropriate behaviors, as well as the increased number of
social interactions made by the participant.

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XIV. Participant 14


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Learn Social Story had substantially increased the number of Appropriate behaviors and the
number of social interactions, as well as decreasing the number of Inappropriate behaviors

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XV. Participant 15


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Learn Social Story had a considerable effect in increasing the Appropriate behaviors and the
number of social interactions made, as well as substantially reducing the number of
Inappropriate behaviors made by the participant.

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XVI. Participant 16


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From the findings of the observation in three phases, Participant 16 had improved in

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Appropriate behavior by 2.00 occurrences. Inappropriate was behavior reduced by 2.00
occurrences and number of interactions increased by 0.65 occurrence.
Social Story had a sizeable effect in increasing Appropriate behaviors and decreasing
Inappropriate behaviors, as well as substantially increasing the number of social interactions

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XVII. Participant 17


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occurrence of Appropriate behavior; 0.60 occurrence of Inappropriate behavior; and 4.30
Inappropriate behavior was 0.70 occurrence and No Interaction was 4.80 occurrences.
Appropriate behavior by 0.05 occurrence. Inappropriate behavior increased by 0.05 occurrence
and the number of interactions increased by 0.05 occurrence.
From the findings of the observation in the three phases, Participant 17 had decreased in

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and the number of interactions made remained the same.
Learn Social Story had a small effect in changing the participant’s social behaviors.

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XVIII. Participant 18


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Learn Social Story had considerably increase the number of Appropriate behaviors and had
decreased the number of Inappropriate behaviors, as well as increasing the number of social
interactions made by the participant.

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XIX. Participant 19


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Social Story had a small effect in changing the participant’s Appropriate and Inappropriate
behaviors, as well as a noticeable effect in increasing the number of social interactions made
by the participant.

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XX. Participant 20


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From the findings of the observation in the three phases, Participant 20’s Appropriate behavior
and the number of interactions made remained the same, but his Inappropriate behavior was
reduced by 0.40 occurrence.
remained the same. His Inappropriate behavior increased by 0.25 occurrence and the number
of interactions decreased by 0.10 occurrence.

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Appropriate behavior by 0.05 occurrence. Inappropriate behavior was increased by 0.30
From the findings of the observation in the three phases, Participant 20’s Appropriate and
Inappropriate behavior remained the same, and the number of interactions was decreased by
0.05 occurrence.
Learn Social Story had no effect in changing the participant’s social behaviors.

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XXI. Participant 21


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phase, the data collected for Appropriate behavior was 0.90 occurrence, Inappropriate

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Inappropriate behavior was 1.30 occurrences and No Interaction was 0.90 occurrence.
behavior was 0.80 occurrence and No Interaction was 2.00 occurrences.
occurrences and number of interactions decreased by 2.00 occurrences.
Learn Social Story had a substantial effect in increasing Appropriate behaviors, decreasing
Inappropriate behaviors, and increasing the number of social interactions made by the
participant.

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XXII. Participant 22


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Learn Social Story had a substantial effect in changing the participant’s Appropriate behaviors
and Inappropriate behaviors, as well as increasing the number of social interactions made.

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XXIII. Participant 23


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occurrence and number of interactions increased by 0.60 occurrence.

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Learn Social Story had beneficial effects on the participant.

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XXIV. Participant 24


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remained the same. Inappropriate behavior increased by 0.10 occurrence and the number of

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Social Story had small effects on the participant’s social behaviors changes; there was a slight
degree of increment in the number of social interactions made, however, the Appropriate and
Inappropriate behaviors changes were slightly negative.

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XXV. Participant 25


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Learn Social Story had beneficially influenced the increase in the number of Appropriate
behaviors and the decrease in the number of Inappropriate behaviors, as well as increasing the
number of social interactions made by the participant.

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XXVI. Participant 26


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occurrence and the number of interactions has not change.
remained the same. His Inappropriate behavior was reduced by 0.10 occurrence and the
number of interactions decreased by 0.05 occurrence.
Learn Social Story had no effect in increasing Appropriate behaviors, the number of social
interactions made was slightly reduced, however, Inappropriate behaviors was also slightly
reduced.

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XXVII. Participant 27


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Social Story had a beneficial effect in increasing Appropriate behaviors and in decreasing
Inappropriate behaviors, as well as a sizeable increase in the number of social interactions

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XXVIII. Participant 28


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Learn Social Story produced a substantial effect in increasing Appropriate behaviors,
decreasing Inappropriate behaviors, as well as in increasing the number of social interactions

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XXIX. Participant 29


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Appropriate behavior by 0.05 occurrence. Inappropriate behavior remained the same and the
number of interactions was reduced by 0.10 occurrence.

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remained the same. His Inappropriate behavior was reduced by 0.15 occurrence and the
number of interactions increased by 0.20 occurrence.
and Inappropriate behavior remained the same and the number of interactions increased by
0.05 occurrence.
Learn Social Story had not influenced behavior changes in the participant; however, the
number of social interactions made by the participant was slightly increased.

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XXX. Participant 30


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Learn Social Story had considerably increased the number of Appropriate behaviors,
substantially decreased the number of Inappropriate behaviors, as well as sizably increasing
the number of social interactions made by the participant.

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5.5.2 Results collected for individual social story
This section discusses the behavioral changes (from Table 14 to Table 28 for five designated
social stories) in three groups of participants: the low cognitive functioning, the high cognitive
functioning and the combination of both (refer to section 5.2.1.2 Participants’ profiles for the
definition of the cognitive functioning). Each table contains two main sections: Section on the
left displays the average value of Appropriate, Inappropriate and No Interaction results for
each phase (Baseline, Intervention & Reversal Baseline); section on the right displays the
behavioral changes from baseline to intervention [Intervention – Baseline], from baseline to
reversal baseline [Reversal Baseline – Baseline], and the summary of the overall behavioral
changes for each of Appropriate, Inappropriate and No Interaction social behavior
[(Intervention + Reversal Baseline)/2)‐Baseline]. The occurrence of behavioral changes was
measured in every 10‐minute session. SD represents the standard deviations while p
represents the significance value of t‐test.
5.5.2.1 How to greet someone at school
Table 14 illustrates the behavioral changes of the low cognitive functioning participants’ for
the How to greet someone at school social story. In the baseline phase, the average occurrence
of the Appropriate behavior is 0.36, Inappropriate behavior is 2.14, and No Interaction is 3.59.
In the intervention phase, the average occurrence of the Appropriate behavior is 0.54,
Inappropriate behavior is 1.76 and No Interaction is 3.44. In the reversal baseline phase, the
average occurrence of the Appropriate behavior is 0.56, Inappropriate behavior is 1.71 and No
Interaction is 3.54. The overall behavioral changes: An increment in occurrence of Appropriate
behavior i.e. 0.19, a decrease in occurrence of Inappropriate behavior i.e. 0.41, and a decrease
in occurrence of No Interaction of 0.09.
Table 14 Behavioral changes observed in low cognitive functioning group for ‘How to greet someone at school’
Note: The figures in column 1 (a to b) is calculated from [Intervention – Baseline], the figures in column 2 (a to a) is
calculated from [Reversal Baseline – Baseline], and the figures in column 3 (Overall) is calculated from [Intervention
+ Reversal Baseline)/2) – Baseline].

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Table 15 illustrates the behavioral changes of the high cognitive functioning group. In the
baseline phase, the average occurrence of the Appropriate behavior is 0.91, Inappropriate
behavior is 1.91, and No Interaction is 1.97. In the intervention phase, the average occurrence
of Appropriate behavior is 2.11, Inappropriate behavior is 0.88 and No Interaction is 0.81. In
the reversal baseline phase, the average occurrence of Appropriate behavior is 1.90,
Inappropriate behavior is 0.87 and No Interaction is 0.86. The overall behavioral changes: An
increment in occurrence of Appropriate behavior i.e. 1.09, a decrease in occurrence of
Inappropriate behavior i.e. 1.03, and a decrease in occurrence of No Interaction i.e. 1.13.
Table 15 Behavioral changes observed in high cognitive functioning group for ‘How to greet someone at school’
Table 16 illustrates the behavioral changes observed in all participants. In the baseline phase,
all participants have 0.78 occurrences in Appropriate behavior, 1.96 occurrences for
Inappropriate behavior, and 2.35 occurrences of No Interaction. In the intervention phase, the
average occurrence of Appropriate behavior for all the participants is 1.74, the average
occurrence of Inappropriate behavior is 1.09 and No Interaction is 1.43. In the reversal baseline
phase, the average occurrence of Appropriate behavior for all of the participants is 1.59, the
average occurrence of Inappropriate behavior made by all of the participants is 1.07 and No
Interaction is 1.49. The overall behavioral changes: an increment in Appropriate behavior of

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0.88 occurrence, a decrease in Inappropriate behavior of 0.89 occurrence, and an increment in
social interaction of 0.89 occurrence.
Table 16 Behavioral changes observed in all participants for ‘How to greet someone at school’
The highest Appropriate behavioral change is obtained by Participant 15 with an increment in
Appropriate behavior of 2.20 occurrences. On the other hand, Participant 26 and Participant
29 have the lowest Appropriate behavioral change, where their Appropriate behaviors are
decreased by 0.05 occurrence. Participant 27 has the highest decrease in Inappropriate
behavior that is reduced by 1.95 occurrences. Participant 24 has the least change in the
Inappropriate behavior that is reduced by 0.10 occurrence. The highest number of social
interaction change is achieved by Participant 15 with an increment of 2.25 occurrences while
the lowest is Participant 11, whose number of No Interaction only reduced by 0.20 occurrence.
5.5.2.2 Play and sing with friends
the Play and sing with friends social story. In the baseline phase, the average occurrence of the

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Appropriate behavior is 0.37, Inappropriate behavior is 3.23, and No Interaction is 3.13. In the
intervention phase, the average occurrence of the Appropriate behavior is 0.63, Inappropriate
behavior is 2.97 and No Interaction is 3.10. In the reversal baseline phase, the average
occurrence of the Appropriate behavior is 0.53, Inappropriate behavior is 2.83 and No
in occurrence of ‘No Interaction’ of 0.04.
Table 17 Behavioral changes observed in low cognitive functioning group for ‘Play and sing with friends’
Table 18 Behavioral changes observed in high cognitive functioning group for ‘Play and sing with friends’

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Inappropriate behavior i.e. 1.14, and a decrease in occurrence of ‘No Interaction’ i.e. 1.16.
Table 19 Behavioral changes observed in all participants for ‘Play and sing with friends’
average of Appropriate behavior for all the participants is 2.01, the average of Inappropriate
occurrence of Appropriate behavior for all of the participants is 1.81, the average occurrence

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of Inappropriate behavior made by all of the participants is 1.35 and No Interaction is 1.48.
The overall behavioral changes: an increment in Appropriate behavior of 1.16 occurrences, a
decrease in Inappropriate behavior of 0.95 occurrence, and an increment in social interaction
of 0.90 occurrence.

Appropriate behavior of 2.35. On the other hand, Participant 24 has the lowest Appropriate
behavioral change, where his Appropriate behaviors is decreased by 0.10 occurrence.
Participant 9 has the highest decrease in Inappropriate behavior that is reduced by 3.20
occurrences. Participant 20 has the least change in the Inappropriate behavior that is increased
by 0.25 occurrence. The highest number of social interaction change is achieved by Participant
1 with an increment of 2.75 occurrences while the lowest is Participant 11, whose number of
No Interaction only reduced by 0.35 occurrence.
5.5.2.3 Snack time
the Snack time social story. In the baseline phase, the average occurrence of the Appropriate
behavior is 0.44, Inappropriate behavior is 2.60, and No Interaction is 2.87. In the intervention
phase, the average occurrence of the Appropriate behavior is 0.70, Inappropriate behavior is
2.34 and No Interaction is 2.71. In the reversal baseline phase, the average occurrence of the
Appropriate behavior is 0.64, Inappropriate behavior is 2.24 and No Interaction is 2.76. The
overall behavioral changes: An increment in occurrence of Appropriate behavior i.e. 0.23, a
decrease in occurrence of Inappropriate behavior i.e. 0.31, and a decrease in occurrence of ‘No
Interaction’ of 0.14.
Table 20 Behavioral changes observed in low cognitive functioning group for ‘Snack time’

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Table 21 Behavioral changes observed in high cognitive functioning group for ‘Snack time’
The overall behavioral changes: an increment in Appropriate behavior of 0.96 occurrence, a

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of 0.86 occurrence.
Table 22 Behavioral changes observed in all participants for ‘Snack time’
Appropriate behavior of 1.95. On the other hand, Participant 20, 24, 26 and 29 have the lowest
Appropriate behavioral change, where their Appropriate behaviors are decreased by 0.05
occurrence. Participant 16 has the highest decrease in Inappropriate behavior that is reduced
by 2.50 occurrences. Participant 17 has the least change in the Inappropriate behavior that is
increases by 0.10 occurrence. The highest number of social interaction change is achieved by
Participant 4 with an increment of 2.25 occurrences while the lowest is Participant 11, whose
number of No Interaction only reduced by 0.65 occurrence.
5.5.2.4 Walking in the hallway
the Walking in the hallway social story. In the baseline phase, the average occurrence of the

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Table 23 Behavioral changes observed in low cognitive functioning group for Walking in the hallway’
Table 24 Behavioral changes observed in high cognitive functioning group for ‘Walking in the hallway’

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Inappropriate behavior i.e. 0.76, and a decrease in occurrence of No Interaction i.e. 1.11.
Table 25 Behavioral changes observed in all participants for ‘Walking in the hallway’

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of 0.82 occurrence.
Appropriate behavior of 3.00 occurrences. On the other hand, Participant 24 has the lowest
Appropriate behavioral change, where their Appropriate behaviors are decreased by 0.10
occurrence. Participant 16 has the highest decrease in Inappropriate behavior that is reduced
by 2.00 occurrences. Participant 20 has the least change in the Inappropriate behavior that is
increased by 0.30 occurrence. The highest number of social interaction change is achieved by
Participant 15 with an increment of 2.95 occurrences while the lowest is Participant 26, whose
number of No Interaction only reduced by 0.15 occurrence.
5.5.2.5 Washing hands
the Washing hands social story. In the baseline phase, the average occurrence of the
Table 26 Behavioral changes observed in low cognitive functioning group for ‘Washing hands’

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Table 27 Behavioral changes observed in high cognitive functioning group for ‘Washing hands’

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of 0.71 occurrence.
Table 28 Behavioral changes observed in all participants for ‘Washing hands’

Appropriate behavior of 1.65. On the other hand, Participant 24 has the lowest Appropriate
behavioral change, where their Appropriate behaviors are decreased by 0.05 occurrence.
Participant 9 has the highest decrease in Inappropriate behavior that is reduced by 2.45
occurrences. Participant 24 has the least change in the Inappropriate behavior that is increased
by 0.25 occurrence. The highest number of social interaction change is achieved by Participant
1 with an increment of 2.70 occurrences while the lowest is Participant 21, whose number of
No Interaction reduced by 2.00 occurrences.
5.5.3 Overall results
The overall changes in the Appropriate, Inappropriate and No Interaction behaviors are
measured by averaging the occurrences (in every 10‐minute session) for all the social stories.

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Table 29 presents the results of the low cognitive functioning participants whereby Table 30
shows high functioning participants and Table 31 shows all participants. On the left side of the
table is the overall changes in the Appropriate, Inappropriate and No Interaction behavior in
each SS. On the right side of the table is the overall changes in the Appropriate, Inappropriate
and No Interaction behavior in all the social stories.
Table 29 The overall result obtained from all of the social stories on low cognitive functioning participants
Table 30 The overall result obtained from all of the social stories on high cognitve functioning participants
As shown in Table 31, overall change in the Appropriate behavior has an increment of 0.95
(SD=0.59), while Inappropriate behavior has a decrease of 0.80 (SD=0.50) and No Interaction
has a decrease of 0.87 (SD=0.65). Figure 61 illustrates the overall results in graphs. At the top
is the overall change in the Appropriate behavior; in the middle is the overall change in the
Inappropriate behavior; and at the bottom is the overall change in No Interaction behavior. It

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shows that the intervention is effective for twenty three participants. There are two
participants (11 & 19) with only a slight improvement, and five participants (17, 20, 24, 26 and
29) with no improvement in social skills.
Table 31 The overall result obtained from all of the social stories on all participants
As shown in Table 31, the Appropriate behavior in How to greet someone at school has an
increment of 0.88 (SD=0.62), Inappropriate behavior is reduced by 0.89 (SD=0.64), and social
interaction made increases by 0.89 (SD=0.70) for all participants. For the low functioning group
(Table 14), the average of increment in Appropriate behavior is 0.19 (SD=0.49), decrement in
Inappropriate behavior is 0.41 (SD=0.60) and increment in social interaction made is 0.09
(SD=0.28). For the high functioning group (Table 15), the increment of Appropriate behavior is
1.09 (SD=0.49), decrement in Inappropriate behavior is 1.03 (SD=0.58) and increment in social
interaction made is 1.13 (SD=0.61).
As shown in Table 31, the Appropriate behavior in Play and sing with friends has an increment
of 1.16 (SD = 0.76), Inappropriate behavior is reduced by 0.95 (SD = 0.74) and No Interaction is
reduced by 0.90 (SD = 0.77) for all participants. For the low functioning group (Table 17), the
increment in Appropriate behavior is 0.21 (SD=0.41), decrement in Inappropriate behavior is

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0.33 (SD=0.59) and increment in social interaction made is 0.04 (SD=0.38). For the high
functioning group (Table 18), the increment of Appropriate behavior is 1.45 (SD=0.58),
decrement in Inappropriate behavior is 1.14 (SD=0.68) and increment in social interaction
made is 1.16 (SD=0.66).
As shown in Table 31, the Appropriate behavior in Snack time has an increment of 0.96 in a
ten‐minute session (SD = 0.64). Inappropriate behavior is on average reduced by 0.75 (SD =
0.56). The number of social interaction made is increased on average by 0.86 (SD = 0.70). For
the low functioning group (Table 20), the average of increment in Appropriate behavior is 0.23
(SD = 0.37), decrement in Inappropriate behavior is 0.31 (SD = 0.51) and increment in number
of social interactions made is 0.14 (SD = 0.55). For the high functioning group (Table 21), the
average of increment of Appropriate behavior is 1.18 (SD = 0.53), decrement in Inappropriate
behavior is 0.88 (SD = 0.52) and increment in number of social interaction made is 1.08 (SD =
0.59).
As shown in Table 31, the Appropriate behavior in Walking in the hallway has an increment of
0.85 (SD=0.74), Inappropriate behavior is reduced by 0.58 (SD=0.52) and social interaction is
increased by 0.82 (SD=0.75) for all the participants. Table 23 shows that the low functioning
group has improvement of 0.09 (SD=0.23) in Appropriate behavior, decrement in
Inappropriate behavior of 0.14 (SD=0.35) and increment in social interactions made of 0.13
(SD=0.19). Table 24 shows the high functioning group achieving an improvement in
Appropriate behavior of 1.17 (SD=0.64), decrement in Inappropriate behavior is 0.76 (SD =
0.47) and increment in number of social interaction made is 1.11 (SD = 0.71).
As shown in Table 31, the Appropriate behavior in Washing hands has increased by 0.81
(SD=0.52), while the Inappropriate behavior is reduced by 0.75 (SD=0.65) and the occurrence
of No Interaction is reduced by 0.71 (SD=0.83) for all the participants. For the low functioning
group alone (Table 26), the Appropriate behavior has improved by 0.16 (SD=0.36),
Inappropriate behavior is reduced by 0.12 (SD=0.29) and the social interaction has increased
by 0.18 (SD = 0.39). On the other hand, the high functioning group (Table 27) obtained an
improvement of 1.01 (SD=0.39) in Appropriate behavior, a decrease of 0.94 (SD=0.61) in
Inappropriate behavior and the occurrence of No Interaction is reduced by 0.87 (SD=0.86).

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Figure 61 Overall changes in Appropriate, Inappropriate and No Interaction behavior
The highest Appropriate behavior change was obtained by Participant 15 with an increment of
1.93 occurrences; and the lowest Appropriate behavior change was obtained by Participant 24
with a slight decrease of 0.04 occurrences (see Figure 61 for graph). The Appropriate behavior
changes made by all of the participants has an increment of 0.95 (SD=0.59). For the low
functioning group (Table 29), the Appropriate behavior has is an increment of 0.18 (SD=0.37).
For the high functioning group (Table 30), the Appropriate behavior has an increment of 1.19
(SD=0.42).
The highest Inappropriate behavior change was obtained by Participant 16 with a decrease of
Inappropriate behavior by 1.81 occurrences. On the other hand, the lowest Inappropriate
behavior change was obtained by Participant 24, whose Inappropriate behavior is increased by
0.04 occurrences (see Figure 61 for graph). The average Inappropriate behavioral changes for

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all participants have decreased by 0.80 (SD=0.50). For the low functioning group, on average
Inappropriate behavior reduced by 0.26 (SD=0.41). For the high functioning group,
Inappropriate behavior is reduced by 0.97 (SD=0.41).
The highest increase of interactions was scored by Participant 1, who increased the social
interaction by 2.24 and the lowest increment in social interactions was obtained by Participant
11, whose social interactions were reduced by 0.19 (see Figure 61 for graph). The average
increment of social interactions over all of the participants is 0.87 (SD= 0.65). In low
functioning group, social interaction increases by 0.11 (SD= 0.33). In high functioning group,
social interaction increases by 1.09 (SD=0.54).
5.6 Findings and discussion
This is the first study of SS to demonstrate its effectiveness as computer animation, and one of
only few studies to show clear, statistically significant effects. Numerous previous studies
proved the positive effect of SS intervention on children with ASD. However, most of the
studies on SS intervention were conducted with a small number of participants; with very few
studies report their results with any statistical significance tests. Table 32 briefly summarizes
these studies.
5.6.1 Statistical significance
Only two previous studies on SS have had a sufficiently large cohort for a statistical analysis
(Table 32). Pettigrew (1998) had the highest number of participants, she tested SS on 69
children with language impairment. She divided them into three groups: an experimental
group of 31 who used SS with scaffolding activities; a control group of 24 who read library
book with no social meaning; and a comparison group of 14 who read a library book and
participated in scaffolding activities. In this study, teachers were asked to complete the pre‐
and post‐test ratings of the students. Result showed that the experimental group had an
increase in social competence. However, it is statistically confusing and inconsistent. There
was disagreement between the data presented in the figures and the texts, as argued by
Washburn (2006). The numbers used for Chi‐square analysis were inconsistent with the
number in the text. Another suspect source of inconsistency is due to the fact that the
teachers, instead of the researcher, rated the behaviors. On the other hand, Feinberg (2001)
tested SS to a control group of 14 normally developed children and experimental group of 34
children with ASD. SS was read to the experimental group while regular story was read to the

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control group. Result show there is a significant change for the experimental group only in
certain behaviors (p<0.005).
Statistical
Study N Variation of SS Design Duration Result/Effectiveness
Significance
Agosta et al 1 Teacher as active ABCA >22 days Positive behavioral changes, counted in occurrences Not tested
(2004) researcher per session.
Brownell 4 Musical social ABAC >8 days Reading (B) and singing (C) phase were significantly t‐test
(2002) story each more effective than control phase (A) p<.05
Crozier & 1 Drawing ABAC Unknown Reduction in disruptive behavior, counted in Not tested
Tincani (2005) illustration occurrences per observation session.
Crozier & 3 Color icon ABAB Unknown Overall, there was a reduction in inappropriate Not tested
Tincani (2007) illustration ABACBC behavior and increase in appropriate behavior,
counted per session. However, SS alone insufficient
for one participant.
Delano & 3 Picture symbols Multiple Unknown Increase in the duration of social engagement, Not tested
Snell (2006) baseline counted duration (seconds) and frequency of social
engagement
Haggerty et al 1 Drawing AB 4 weeks Maladaptive behaviors decreased in frequency, Not tested
(2005) illustration duration and intensity
Hagiwara & 3 Visual symbol on Multiple 15‐24 Increased the skills level of some participants in Not tested
Myles (1999) computer baseline days certain settings, counted by percentage of
(multimedia) completion day‐by‐day
Ivey & Alberto 3 Digital ABAB 11 weeks Increase in participation during novel event, Not tested
(2004) photographs counted in number of targeted skills occurrences.
Kuttler et al 1 Prize reinforcer ABAB 19 days Behavior improve further after the second Not tested
(1998) intervention phase
Kuoch & 3 Cartoon pictures, ABA(2) Unknown Reduction in rate of problem behaviors, counted in Not tested
Mirenda Verbal reminder ACABA(1) number of behavior per minute
(2003)
Litras et al 1 Video self‐ Multiple Unknown Effective in improving target behaviors, counted in Not tested
(2010) modeling baseline frequency in percentage per session
Lorimer et al 1 Picture ABAB 24 days Behavior returned to baseline when intervention Not tested
(2002) illustration withdrawn
Norris & 1 Picture symbols AB 18 days Reduction in inappropriate behavior, however no Not tested
Dattilo (1999) effect in increasing appropriate behavior
Rowe (1999) 1 Support assistant Case 12 weeks Immediate response, however it is anecdotal, as it Not tested
Study is an extremely informal and brief case study
Roger & 1 Comic Strip Case 5 days CSC show greater effects than SS alone Not tested
Myles (2001) Conversation study/AB
Swaggert et al 3 Verbal AB 27‐28 Increase in appropriate behaviors Not tested
(1995) prompting days
Sansosti & 3 Computer and Multiple Unknown Effective in improving the rates of social Not tested
Powell‐Smith video modeling baseline communication, counted by percentage of intervals
(2008) of social communication.
Scattone et al 3 None Multiple 11 weeks SS alone may be effective for some children with Not tested
(2006) baseline ASD, counted in percentage of intervals during 10‐
min session.
Scattone 1 Video modeling Multiple 15 weeks Increase in 2 out of 3 targeted skills, counted in Not tested
(2008) baseline percentage of intervals per 5‐min session
Schneider & 3 Pictures Multiple Unknown Modest improvement in classroom on‐task Not tested
Goldstein illustration baseline behaviors, counted in percentage of intervals of
(2009) behaviors
Thiemann & 5 Card cues, video Multiple 15‐19 Increases in target social communication skills, Not tested
Goldstein feedback and baseline weeks counted in number of behaviors per 10‐min session
(2001) verbal prompting
Pettigrew 69 Scaffolding Experime Unknown Increase in social competence Chi‐square
(1998) activities nt design test
Feinberg 34 Verbal Pre‐ post‐ Unknown Significant change in certain behaviors t‐test
(2001) prompting test
Table 32 Summary of previous social story studies

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The current study showed statistically significant improvements, especially in the high
functioning group. The t‐test results shown in Table 15, Table 18, Table 21, Table 24 and Table
27 show that the results observed in participants with high cognitive functioning group are
significant with p<0.01. From these significance values, it is proven that the proposed
intervention using the prototype is effective in assisting the participants with high cognitive
functioning in improving their social skills.
For the low functioning group as shown in Table 14, Table 17, Table 20, Table 23 and Table 26,
the result of the t‐test were not significant, p>0.05. Thus, the effectiveness of SS for this group
is not proven. The lack of statistical significance may be due, at least in part, to the small
number of participants in this group.
In our study, a statistical test was performed, the t‐test result of behavior changes obtained
from the thirty participants were significant at the p<0.01 for overall comparisons, hence the
null hypothesis presented in chapter 3 is rejected. These results were consistent with majority
of the previous studies (presented in Table 32) which resulted with positive change in social
behaviors after the SS intervention.
5.6.2 Effectiveness of our proposed intervention
Previous authors tested the effectiveness of SS intervention mostly by observation and
descriptions (Table 32). In our study, the effectiveness of the intervention was measured
quantitatively and qualitatively by observation and statistical analysis.
Participants of the study showed their interest in the prototype, as they found it interactive
and they learned something from it. As illustrated in the graphs, I‐Learn Social Story has been
shown to be effective in changing the social behavior of the participants. The combinations of
SS and 2D animation in computer‐presented medium showed a clear beneficial effect in
increasing appropriate behaviors of children with ASD. The results also showed a significant
reduction in the inappropriate behavior as well as an increase in the number of social
interactions performed by the participants.
However, irrespective of the positive achievement in the average result of all of the social
stories, the number of behavioral changes varied across the participants in the present study.
This might be due to the individual’s cognitive functioning, as it was shown that participants
with high cognitive functioning obtained higher positive results compared with the participants
with low cognitive functioning, who showed a decrease in appropriate behavior after the

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intervention (Participant 24), an increment in inappropriate behavior (Participant 24), and a
decrease in social interaction (Participants 11, 26 and 17).
There were also participants whose positive behavior changes were not significant. This might
be due to their lack of interest in the computer and/or to their delayed cognitive skill, since the
method used, environmental stimuli and schedule for reviewing each social story were same
among all participants. The results showed that verbal abilities did not have much effect on the
positive result. Many of the participants who were without verbal skills were able to achieve
high positive results, maybe due to their interest in using the computer, and thus they could
learn from the I‐Learn Social Story during the intervention time. These students, after the first
few sessions of the intervention, were able to demonstrate the skills learnt from I‐Learn Social
Story and showed slightly increased levels of verbal communication and social interaction with
others.
It was also noted that some of the participants generalized the skills across to other settings,
such as holding a friend’s hand not only while walking in the hallway. And interestingly, the
average of positive behavior changes doubled from the baseline phase to the reversal baseline
phase for most of the participants.
Thus, the analysis of the results confirmed that most of the participants showed an increase in
appropriate behavior, a decrease in inappropriate behavior and an increment in the number of
social interactions made. In a few of the cases, changes in their social interaction were
detected soon after the intervention and remained relatively consistent.
5.6.3 Social skills acquisition/behavioral changes
Behavioral change has been described qualitatively by most previous authors (Table 32).
Thiemann & Goldstein (2001) measured the behavioral changes by the number of occurrence
per session for each child. Sansosti & Powell‐Smith (2008) measured the behavioral changes by
percentage of social communication intervals for each child. Our current study had both
qualitative and quantitative measures by measuring the behaviors change of an individual child
and also in groups (low functioning, high functioning and combination of both), as described in
the earlier sections.
There were different paces of development in the social skills acquisition across the
participants. Some participants showed fast skill acquisition and others were slower. Most of
the participants took around 3 to 4 sessions for the acquisition of skills, while some were rapid.

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Participant 15 could apply the social skills learned immediately after he had finished with the
first session of the intervention phase. After the intervention prior to the walking in the
hallway activity, Participant 15 held one of his friend’s hands and walked together quietly,
which he had not done before. He also showed some generalization of the skills across other
settings.
From the pilot testing, it was also found that participants could generalize the skills across
other settings, proving that this method was engaging for children with ASD. In one of the
participants for the pilot testing, after the intervention, while he was playing with some pair‐
up puzzle, every time he paired one, he would speak out “next” and would move to the next
puzzle. This would go on until he had finished with the last pair and he would say “well done”
and clapped his hands, as in the prototype. The researcher and teacher were much amazed by
this.
The social skills acquisition learned from I‐Learn Social Story is rather fast compared to the
other methods of SS learning from other studies, which in average would take 12 days to 12
weeks for individual participants, such as reported in Hanley‐Hochdorfer et al. (2010), Rowe
(1999), Lorimer et al. (2002) and Scattone et al. (2002).
5.6.4 Treatment integrity
Based on National Dissemination Center for Children with Disabilities

(http://nichcy.org/research/basics/researchterms), treatment integrity is also known as fidelity
of implementation is “the extent to which the administration of an intervention complies with
that intended original design”. In this study, the data for the treatment integrity for each
participant was collected everyday by the author, and the classroom teacher/class helper using
the checklist that detailed the steps of the experimental study (Appendix E). The number of
steps completed correctly was divided by the total number of steps, and then multiplied by
100. A score of 100% meant that the treatment integrity had been achieved. If the score was
less than 100%, the author would thus correct any deficiencies before the next session. The
100% treatment integrity was achieved on an average of the 3rd day of intervention for all of
the participants.
5.6.5 Social validity and acceptability
Social validity is a measure of whether objectives, procedures and outcomes of an intervention
are meaningful and appropriate for a child and his caretaker (Lloyd & Heubusch 1996; Wolfe

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1994). As suggested by Fawcett (1991) and Wolf (1978), it is important to consider social
validity in designing and evaluating any intervention program. Social validity is important for
an intervention program to be adopted widely. Sansosti & Powell‐Smith (2008) stated that
variables such as teacher’s time and motivation produce an important effect on the success or
failure of an intervention while working in the school setting, thus, teacher’s satisfaction is one
way to investigate the social validity of an intervention program.
Following the end of the study on each class, teachers and class helpers were asked for their
comments on and perception of the intervention of I‐Learn Social Story. Social validity
(Appendix F) questionnaire was used to assess the teacher’s and class helper’s satisfaction on
the intervention through I‐Learn Social Story. From the results and comments, generally it was
found that they were happy and satisfied with the intervention as they found the intervention
is useful for the students, and in fact, there was not a single teacher or class helper who gave
feedback below the adequate satisfaction of the intervention. They even commented that
there were noticeable behavioral changes of the participants after the intervention and would
likely to use the intervention again, which had provided further evidence of the social validity
of the intervention.
When the author introduced SS to the teachers, most of them were aware of the effectiveness
of this type of intervention, but did not use it in the school, as the traditional SS was too time
consuming to be implemented in a large classroom setting. However, I‐Learn Social Story
which was presented in computer‐based format demonstrated time effectiveness in learning
social skills from SS, thus it could be said to be highly accepted by the teachers as they could
easily play it in the classroom computer during the students’ free time, making I‐Learn Social
Story as an effective intervention that is readily accepted. The information gathered from the
informal interviews with the teachers and class helpers agree that they are satisfied with the
noticeable behavioral changes in most of the students after the intervention of I‐Learn Social
Story. The teachers at Perkata Special School were ready to adopt I‐Learn Social Story as the
easy‐to‐use classroom teaching materials, however, some consideration had to be made
concerning the time and skills required to implement 2D animation and the construction of SS
based on Gray’s guidelines, the solution of which will be discussed in Section 6.3.
5.6.6 Inter observational agreement

For the inter‐observational agreement, either the classroom teacher or classroom helper was
asked by the author to be a second observer to validate the target behaviors performed by

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participants. Prior to the data collection, the target behavior of each story was explained to
them.
The researcher, as the first observer, was responsible for the main data collection, using
traditional tally method count, by marking with an “I” on the appropriate column in the Data
Collection Sheet (Appendix C) for each of the target behavior performed by the participants.
Once data collection was completed for one session, the first observer would then ask the
second observer if he/she agreed to the data collected by the first observer.
The score for the inter‐observational agreement was calculated on a session‐by‐session basis
on target behavior occurrences in each session, with the first and the second observer
agreeing on the target behaviors occurred. The calculation was done by adding the number of
agreements, dividing it by the total number of agreements and disagreements, and multiplying
it by 100, as suggested by Kazdin (1982).
A minimum percentage of 80% is needed to support the inter observational agreement. If the
agreement was less than 80%, which was not the case in this study, the definition of
Appropriate, Inappropriate and No Interaction behaviors would have been reviewed by the
first observer with the second observer, and the inter‐observer calibration procedure would
have continued until the 80% mark has been reached.
5.7 Summary
This chapter discussed the testing and evaluation of I‐Learn Social Story in detail. It covered the
research design and procedures used in the testing, the analysis and result, as well as the
discussion of the findings.
As hypothesized earlier, the overall significant result generated from all the participants of the
study indicated that the combination of SS with 2D animation and computer‐presentation was
associated with improvements in the appropriate behaviors, a decrease in the inappropriate
social behavior, and an increase in the number of social interactions. In addition, most of the
participants were able to behave more appropriately in the school setting, and they were able
to manage these appropriate behaviors even after they were no longer using I‐Learn Social
Story. This indicated that I‐Learn Social Story was connected with the behavioral changes in the
participants after the intervention, thus, it can be used in facilitating social skills learning in
children with ASD.

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From the experimental design that was conducted, it was noted that the participants’
response to the prototype was positive; they showed their enthusiasm and were looking
forward to the testing session where they could use the prototype to learn social skills.
The research questions presented in section 3.2 have been answered in the discussions
throughout this chapter. The hypothesis presented in section 3.4 has also been tested
statistically by analyzing the significance of the results. In summary, the findings from this
current experimental study are consistent with previous studies that demonstrated the
positive effect of using SS (Adams et al. 2004; Bledsoe et al. 2003; Crozier & Tincani 2005;
Crozier & Tincani 2007; Delano & Snell 2006; Demiri 2004; Kuoch & Mirenda 2003; Ozdemir
2008; Sansosti & Powell‐Smith 2006, Sansosti & Powell‐Smith 2008; Scattone et al. 2002;
Scattone et al. 2006, Schneider & Goldstein 2009) and 2D animation in teaching and learning
for children (Bosselar & Massaro 2003; Baron‐Cohen et al. 2009; Rosset et al. 2008; van der
Geest et al. 2002; Grelotti et al. 2005; Mayer & Moreno 2002; Mayer 2003). It is proven that
this study is timely, relevant and needed.

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Chapter 6: Conclusion

The growing number of cases of ASD demands the creation of dynamic learning tools for social
skill learning. On the basis of this, the research presented in this thesis has six aims which have
been achieved, as presented in this thesis. The following sections present the main
contributions and limitations of the current study.
6.1 Main contributions
This thesis reflects the work in the design, development and evaluation of SS intervention
through the computer assisted learning application, I‐Learn Social Story. It presents the 2D
animated social stories with computers for the purpose of assisting children with ASD to learn
social skills.
It is arguable that the study presented in this thesis is important to the research on ASD and
can be used to support a larger population and program involving researchers from multiple
fields, such as in computing or special education. This could be the foundation step to establish
a larger study.
Furthermore, the prototype developed and the experimental study conducted are believed to
be beneficial to the field of the study and as a whole, as we developed a treatment method
that can be used effectively in helping children with ASD learn social skills. The specific
contribution of this master’s research includes:
 A preliminary study
It has been often suggested that a preliminary study is a crucial element of a good study
design, thus, in the current study, a preliminary study had been conducted on three children
with ASD. The main purpose of the preliminary study was not to collect data, but rather to
refine the prototype features and the testing procedures. This study was used to get a
complete description of the proposed solution by checking on its feasibility thus the final
decision on usability, feature, functionality, performance, cost and procedure could be made.
In the current study, this testing served as an initial exploration and a review of issues related
to the quality of the proposed prototype, identifying the key features to be addressed. A
preliminary study is potentially valuable; anything missing in the pilot test can be added to a
later prototype to improve the chances of clear outcomes.

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Pilot testing can greatly reduce a number of unanticipated problems as it gives an opportunity
to redesign parts of the prototype that are not effective, thus it rectifies the problems that
have been revealed in the pilot study. It improves the quality and efficiency of the revised
prototype. It can reveal deficiencies in the design or procedures, thus giving chances for early
correction.
The result of this study was necessary to ensure and to verify that the final model will cater

adequately to the needs of the targeted users. The final model was built based upon the result
gained from this study.
 The development of social stories
As a major part of the prototype, social stories in the final prototype had been developed or
were selected carefully. There were five social stories entitled How to greet someone at school,
Play and sing with friends, Snack time, Walking in the hallway and Washing hands, which had
been incorporated into the prototype, as discussed in Chapter 4.
How to greet someone at school was taken from a website; it was selected without
modification as it had fulfilled the requirements set by Carol Gray, and the story was more
suitable to be used for the setting in the current study. Snack time social story was taken from
one of the published papers by Crozier & Tincani (2007); this story as well followed Gray’s
guidelines in writing SS and had been tested on participants with ASD. The rest of the three
social stories were developed with consideration of the skills that generally needed to be
obtained by the participants, as reported in Chapter 4. It was also ensured that these stories
followed the guidelines set by Carol Gray, the author of SS.
 The development of I‐Learn Social Story
One of the research objectives was to develop a computer assisted learning application to be
used for children with ASD. In regard to this, the prototype, titled I‐Learn Social Story had been
constructed using the up‐to‐date ICT technology (Adobe Flash) that is powerful in creating
animation and portable contents (discussed in Chapter 4).
The development of the prototype was important as an instrument or tool that realized the
proposed idea of helping children with ASD learn social skills in a way that they were attracted
to. The prototype was developed based on the findings generated from the observation,
literature review, consultation with teachers, as well as data gathered from the preliminary
study.

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 The evaluation of I‐Learn Social Story
Testing and evaluation on the developed prototype are crucial for the verification and quality
checking of its effectiveness, and are important for drawing the appropriate conclusions. The
testing and evaluation on the current research had been done by involving thirty children with
ASD in a special school setting. This number had fulfilled the minimum requirements of
participants to ensure that the results of the experimental study are generalized across
individuals with ASD.
Testing and evaluation is useful in determining if the developed prototype has been designed
properly. Thus, it was found from the testing results from I‐Learn Social Story that it is an
effective tool that can be used to engage children with ASD in their social skill learning.
This testing and evaluation had also verified that the prototype is suitable, appropriate and
effective to children with ASD, as well as to analyze the limitations of the prototype, as
presented in the following section.
6.2 Limitations and directions for future works
In the light of the findings from the experimental study, the results which showed positive
changes in the participants’ social behavior after I‐Learn Social Story intervention proved that
this approach is an effective intervention technique. However, more empirical research should
be conducted to produce more rigorous results. The following are six points of the current
study’s limitation and suggested direction for future research endeavors:
 Experimental control
The author is aware that the current study was lacking in accurate experimental control.
During the testing of the prototype, although separated at quite a distance, the participants
were in the same classroom with their classmates, thus they were often distracted during the
intervention. For future work it is advisable for future researchers to conduct an experimental
study in a controlled environment during the testing process, to avoid distraction.
 Examine the critical target behavior for each individual
In the current study, social stories were presented based on the generic nature that met the
targeted behavior of every one of the thirty participants. This is an effective way to reduce the
development time of social stories for common social skills. As for exclusive social skill required

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by a child, it is more advisable to develop an individualized SS related to his/her personal
environment and interest.
 Additional language option
In order to fully comprehend the teaching material, language is an important factor, thus the
same goes for the I‐Learn Social Story intervention. The participants of the current study were
learning in an environment that was using a language different from the one spoken at home.
Thus, future work could feature different language options for social stories to cater to the
needs of participants in a multi‐lingual society, such as Mandarin, other Chinese dialects and
Sarawak Malay, and as stated by Murphy (2011) the academic benefits of a mother tongue
program are well documented.
 Creation of tools which provides ready‐made template
As suggested by Sansosti et al. (2004), the implementation of social stories on a continuous
basis is necessary to achieve the desired results. Teachers have suggested making 2D animated
social stories to be widely used in the school setting and to provide them with tools/2D
animation framework for social stories, to enable them to create 2D animated social stories
independently.
However, it is relatively difficult, time consuming and costly to create 2D animate social stories
as it requires expertise in technology, specifically from the multimedia stream. This resource
limitation affects the possibility of a continuous production of subsequent social stories,
especially when it is specifically tailored to specific needs of the children. To make this
deployment possible, further studies could emphasize the possibility of creating a tool or
application which provides ready‐made templates for creating 2D animation for social stories,
such as Tab Kids, a software for children to create simple animation, available at
http://www.tabkids.com/htm/product.htm
 Support and training for the expert users
In order to ensure the software is used consistently, teachers, parents or caregivers as the
expert users would need to master the use of the software. Thus, one of the future works
could be investigating ways to train the expert users to work with the software more
effectively. Professional development such as training to write SS based on Gray’s guidelines
could also be done. This support and training would eventually help to sustain the use of the
software with the children.

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6.3 Final conclusion
In view of the rising cases of ASD, remedial aid has to be developed to provide adequate
support for children diagnosed with ASD to learn social skills in order to provide them with the
opportunity to lead a normal social life within an inclusive environmental setting.
SS is an old, yet effective intervention in teaching social skills to children with ASD by
describing specific social situations in words in order to help them resolve related cognitive
confusion. To increase the effectiveness of SS, this study introduced computer‐presented SS in
the form of 2D animation; social stories enacted in computerized 2D animation are more
appealing and engaging especially for children as they are visual learners and this could in turn
accelerate their learning process and stimulate their curiosity in exploring exciting ideas.
In the study, this novel approach of intervention was developed and tested on the targeted
users. As expected, the results of the intervention produced positive outcomes, and teachers
were ready to accept I‐Learn Social Story as part of their teaching materials, especially when
dealing with students with ASD. However, there are still some problems for the prototype to
be acquainted in the classroom, such as the issues with implementation.
The results of the study suggest that the intervention developed through I‐Learn Social Story
offer a positive and relatively unobtrusive type of intervention for children with ASD. Certainly,
it offers several advantages over the traditional method used for children with ASD in social
skill learning. I‐Learn Social Story is technologically friendly and has the benefit of producing
results relatively quickly; the results are seemingly effective and generalizable across settings.
The social skill literacy level increases naturally when the participants successfully apply the
skills they have learnt into their daily activities. This positive generalization and quick
acquisition of social skills may be due to the result of stimulus control of animation and the use
of the computer, and as said earlier that learning is best when motivated. If they are motivated
to learn, they would pay attention and acquire the knowledge presented in the content, thus,
they would be able to present the skills learned in a real life situation when the behavior or
skill is called for.
In conclusion, this study has contributed to the emerging research on SS by supporting the
clinical recommendations of using SS in combination with other methods, in teaching social
skills to children with ASD (Attwood 2000; Rogers 2000; Gray 1998). This study has also made a
contribution to literature by the establishment of a novel intervention which combines SS with
2D animation and the computer to help children with ASD learn social skills.

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It is believed that the issues discussed in this thesis, and the development of I‐Learn Social
Story, have contributed to the overall goal of the development and evaluation of computer
assisted learning tools for children with ASD, and it is believed that this work enriches the
understanding and knowledge of the field.

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Glossary of Terms
Glossary of terms
2D animation : one type of visual cue, it is a rapid display of a sequence of
images in order to create an illusion of movement.
Autism Spectrum Disorders : a range of developmental disorders that are characterized by
problems in areas of social development, communication and
stereotypic behaviors.
Baseline phase : a phase of collecting information of a subject’s behavior
before the treatment/intervention.
Experimental design : research design to investigate cause‐and‐effect relationships
between interventions and outcomes.
Intervention phase : a phase where the subject is exposed to
treatment/intervention
Intervention : the act of intervening, treatment.
Reversal baseline phase : a phase of collecting information on a subject’s behavior
after the treatment/intervention.
Single‐subject design : a research design where the subject serves as his/her own
control, rather than using that of another individual/group.
Social behavior : behavior directed towards society.
Social skills : set of skills that is used to facilitate interaction and
communication with one another.
Social Story™ : short stories written for children with ASD with the purpose
of helping them to understand social situations and to behave
appropriately in such situations.
Visual cues : illustrations using visual objects such as images, graphics, or colors.

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Appendixes

Appendix A: Ethical Clearance Approval

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Appendixes

Appendix B: Informed Consent

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Appendixes

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Appendixes

Appendix C: Data Collection Sheet

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Appendixes

Appendix D: Student Assent Form

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Appendixes

Appendix E: Treatment Integrity

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Appendixes

Appendix F: Social Validity

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Appendixes

Appendix G: Research timeline

W W W W W W W W W W W W W W W W
W
2 2 3 3 3 4 4 5 5 5 6 6 7 7 7 8
1
5 7 1 4 8 1 4 1 W W 5 W W 9 W W 3 W W 7 W W 1 W W 5 9 3 W
‐
Parameters W
‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ 5 5 – 5 5 – 6 6 – 6 6 ‐ 6 7 ‐ 7 7 ‐ ‐ ‐ 9
W W W W W W W W 3 4 W 7 8 W 1 2 W 5 6 W 9 0 W 3 4 W W W 9
2
2 3 3 3 4 4 5 5 5 6 6 6 7 7 8 9
4
6 0 3 8 0 3 0 2 6 0 4 8 2 8 2 8
GENERAL
1. Research proposal 
a. Literature Review 
b. Visit to school (Initial visit) 
c. Problem identified and proposed solution 
2. Information and explanation gathered from the 
School Principal, teachers, and class assistants
3. Informed consent sent to parents by the School 
Principal
PRELIMINARY STUDY
1. Develop the sample prototype 
2. Intervention using the developed sample 
prototype to 3 students
3. Analyze the student’s response and important 
notes gathered (such as procedure, etc.) from the
intervention
4. Identify the general target behaviors for 30  
participants (observation and information from
teachers)
FINAL PROTOTYPE IMPLEMENTATION
1. Develop social story based on the general target 
behavior identified from the 30 participants
2. Develop the final prototype, which is the refined  
model based on the preliminary study results
TESTING & EVALUATION
1. Class 1 testing
a. Collect baseline data 
b. Intervention 

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Appendixes

c. Fading/Maintenance 
d. Follow up (2 visits) 
2. Class 2 testing
b. Intervention 
d. Follow up (2 visits)  
3. Class 3 testing
b. Intervention 
d. Follow up (1 visit) 
4. Class 4 testing
b. Intervention 
d. Follow up (3 visits)  
5. Class 5testing
b. Intervention 
d. Follow up ( 1 visit) 
6. Class 6 testing
b. Intervention 
RESULT ANALYSIS
1. Analyse individual result for behavioral changes 
2. Analyse the overall results 
3. Graph the results for visual analysis  
THESIS WRITING                     
END OF STUDY ‐‐ 

Page 278

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Learning

Masters of Science (by Research)

1.1 Scope of research

1.2 Research background

1.3 Research aim

1.4 Research context and participants

1.5 Research timeline

1.6 Overview of the thesis

Chapter 2: Literature Review

2.2 Autism Spectrum Disorders (ASD)

2.2.1 The causes and treatment of Autism Spectrum Disorders

2.2.2 The spectrum of the Autism Disorders

2.2.2.1 Asperger Syndrome (AS)

2.2.2.2 Autistic Disorder

2.2.2.3 Pervasive Developmental Disorders – Not Otherwise Specified (PDD‐NOS)

2.2.2.4 Rett’s Syndrome

2.2.2.5 Childhood Disintegrative Disorders (CDD)

2.2.3 Deficits in Autism Spectrum Disorders

2.2.3.1 Deficits in Theory of Mind

2.2.3.2 Triad of Impairment

Social situations can be very confusing for children with ASD as they tend to pre dominantly

2.3 Social skills acquisition

2.3.1 Behavioral Modification Treatments

2.3.1.1 Applied Behavior Analysis (ABA)

DIR (Developmental, Individual‐Difference, Relationship‐based) was developed by two child

2.3.1.4 Limitation of Behavioral Modification Treatments

2.3.2 Augmentative and Alternative Communication (AAC)

2.3.2.1 Sign Language

2.3.2.2 Picture Exchange Communication System (PECS)

2.3.2.3 Facilitated Communication (FC)

2.3.2.4 Limitations of Augmentative and Alternative Communication

2.3.3 Robot therapy

2.3.3.2 The Affective Tigger

2.3.3.3 Aurora Project

2.3.3.4 Limitation of robot therapy

2.3.4 Music therapy

2.3.5 Computer assisted learning

2.3.7 Video modeling (VM)

2.3.8 Interactive computer software

2.3.9 Virtual reality (VR)

According to Vera et al. (2005) and Brown (2009), due to the high cost and complexity in its

2.3.10 Social Story™

2.3.10.1 Guide for writing Social Story™

2.3.10.2 Application of Social Story™

2.3.10.3 Presentation of Social Story™

2.3.10.4 Limitations of Social Story™

2.4 Critical Review

Chapter 3: Conceptual Design and Modeling

3.2 Research problem

3.3 Proposed solution

3.5 Research methodology

3.6 Research procedures

3.7 Conceptual design

3.7.1 Requirements and specifications

3.7.1.1 User characteristics

3.7.1.2 Target behavior identifications

3.7.1.3 Quality requirements

3.7.2 Design rationale

3.7.2.1 Learning screen

3.7.2.2 Teacher video narration