Social skills development and applications

Social Skills

Behavioral disorders among children are becoming increasingly prevalent among students in primary and elementary schools. These disorders are often, and usually, accompanied by disruptive behaviors, which affect not only the children themselves, but teachers, other students, and parents. It is important that strategies for reduction of these disruptive behaviors be investigated in order to improve functioning, learning, self-esteem, and overall quality of life for children who have behavioral disorders. Social skills training programs have received much attention, and research has demonstrated that different programs focusing on the development of social skills are effective in behavioral improvements among children with behavioral disorders.

One of the most common behavioral disorders among children is Attention Deficit Hyperactivity Disorder (ADHD). This disorder affects 3% to 6% of children that are school-aged (Gonzalez & Sellers, 2002). The behavioral disruptions exhibited by children with ADHD involve hyperactivity, inattention, and impulsivity, which cause these children to have conflicts with those in their environment. This disruptive behavior necessitates intervention by parents, teachers, and clinicians (Gonzalez & Sellers, 2002).

Management of this disorder may effectively involve the implementation of stress management programs to target reduction of disruptive behaviors. Stress management programs would involve a focus on the development of appropriate social and coping skills (Gonzalez & Sellers, 2002). Gonzalez and Sellers (2002) investigated the effects of a stress-management program on the reduction of troublesome symptoms associated with ADHD. A framework of coping and stress was used to develop the program. According to this framework, coping is the process of continually changing cognitive perceptions or behaviors in response to conditions in the environment. In other words, coping involves continually adjusting one's perceptions and behaviors in order to effectively control, lessen, or endure external and internal conditions (Gonzalez & Sellers, 2002). The purposes of coping are problem-focused, which involve managing the situation causing stress, and emotion-focused, which involve the emotional reaction to stress (Gonzalez & Sellers, 2002). Desirable outcomes of stress-management programs include the development of accurate control beliefs and positive self-concept (Gonzalez & Sellers, 2002). Social-skills training is an integral component to the achievement of these desirable outcomes.

Past research has demonstrated that children with ADHD have significantly more intense feelings of discomfort and isolation, less social involvement, avoid decision making, and are more dependent than children without the disorder (Gonzalez & Sellers, 2002). Furthermore, children with ADHD experience a significantly higher level of internal psychological distress. Therefore, programs need to be identified that can help children with ADHD more appropriately manage chronic discomfort and distress. This could be initiated by reducing the intensity of negative and pessimistic beliefs surrounding themselves and their interactions with the environment (Gonzalez & Sellers, 2002). Training in social skills would empower children with ADHD by providing them with tools to better interact with their environment, further promoting an improved self-concept.

A couple of examples of effective interventions are social problem solving and stress-inoculation training. These are two cognitive-behavioral interventions that have been used to improve social actions between children with ADHD and their peers (Gonzalez & Sellers, 2002). Hinshaw et al., as cited by Gonzalez and Sellers (2002) utilized these interventions to improve the children's ability to control anger responses when provoked by peers. Findings indicated that stress-inoculation training resulted in a greater sense of self-control and a better use of effective strategies for coping. This type of program in combination with a stress-management program could improve self-esteem among children with ADHD, improve their social interactions, and furthermore reduce the occurrence of disruptive behavior.

The purpose of the study conducted by Gonzalez and Sellers (2002) was to investigate the effectiveness of stress-management programs to improve self-concept, locus of control, and acquisition of appropriate coping strategies among children with ADHD. Results indicated that in order for the stress-management program to be effective, both parents and teachers needed to be involved in application of the intervention. In other words, if only the parents were applying the program, improved social interactions were not apparent in the school environment, and if only the teachers were applying the intervention, the results would not be transferred to the home environment. Therefore it may be concluded programs aimed at the development of social skills among children with ADHD requires consistency across all environments the child is involved in.

Interventions aimed at the improvement of behavior among children with behavioral disorders usually require sustained effort on the part of parents in order to facilitate change. Some programs are specifically aimed at educating the parents on how to effectively manage the behavior of their children. An example of this is a program called the "Triple P - Positive Parenting Program." Bor, Sanders, and Dadds (2002) investigated the effectiveness of this program on pre-school children with comorbid disruptive behavior and attentional/hyperactive difficulties.

Children that present with disruptive behaviors, such as oppositional defiant disorder or conduct disorder, in conjunction with ADHD have several difficulties in social environments (Bor et al., 2002). These children tent to experience increased severity of symptoms, more rejection from peers, increased deficiency in social information processing, and greater risk for antisocial behaviors later on in life (Bor et al., 2002). Furthermore, parent so of children affected by this comorbidity are more likely to experience increased levels of psychosocial adversity as well as psychopathology (Bor et al., 2002). Research has indicated that parents of children with behavioral disorders report coercive family interactions and concerns regarding discipline (Bor et al., 2002). Parents of children with these disorders have been shown to be more negative in interactions with the child and demonstrated more stress than parents of children without behavioral disorders (Bor et al., 2002). Since family and parenting variables play such an important part in the development of children with behavioral disorders, parental interventions are regarded as essential for early intervention programs with these children (Bor et al., 2002).

An effective intervention involving parents and families is the behavioral family intervention (BFI) (Bor et al., 2002). This intervention is based on social learning models, and has been demonstrated as an effective treatment for children with disruptive behavior disorders. This intervention involves instruction for parents on how to increase positive interactions with their children while facilitating a reduction in inconsistent and conflictual parenting practices (Bor et al., 2002). This intervention has been extensively used with behavior disordered pre-school-aged children (Bor et al., 2002). Past research has demonstrated that group parent training programs result in significant improvements regarding the compliance of children and parent-child interactions, and these improvements were maintained for months after application of the intervention. Overall, there is a body of research that supports the effectiveness of interventions involving parent training for the improvement of symptoms among children with behavioral disorders.

A study conducted by Bor et al. (2002) sought to compare the effectiveness of an intervention involving enhanced BFI (EBFI) with standard BFI (SBFI). The SBFI treatment consisted of Triple P-Positive Parenting Program, an intensive, validated, parent-training intervention. The EBFI was comprised of three elements: parent training, partner support training (PST), and coping skills training (CST). The parent training consisted of the SBFI, and PST and CST were adjunctive interventions focusing on the family risk factors of marital conflict and parental adjustment.

Results of the study indicated that both interventions were associated with positive outcomes for parents and children. The enhanced program was not demonstrated to be in any way superior to the standard program. An explanation of why the two interventions were so similarly effective is that SBFI is a strong intervention on its own, resulting in drastic changes in parental patterns of behavior and furthermore improving the children's behavior. These changes had the effect of improving marital relations among the parents as well as mood states of the family (Bor et al., 2002). By improving interactions within the family, children with behavior disorders are better equipped with effective social skills that may benefit them in interactions outside the home as well.

Interventions are necessary that are aimed at the prevention of disruptive behaviors among children with behavioral disorders. Past research has provided evidence for widespread effectiveness of multifaceted intervention programs aimed at improving behavior among children with behavior disorders. The importance in early intervention lies in the fact that children with behavioral disorders are at greater risk of developing antisocial behavior later on than are children without behavior disorders. August, Egan, Realmuto and Hektner (2003) investigated an intervention model called the Early Risers "Skills for Success" Program. This program is a prototype for a multifaceted intervention approach that targets risk and protective factors that are involved in the development of antisocial behavior. This intervention involves the deliverance if education and skills training to both children with behavior disorders and their parents, through an annual 6-week summer program as well as a bi-weekly family program. The education and skills training components were fixed. There was also a variable intervention, which delivered specially tailored treatment based on individual needs of children and their families (August et al., 2003).

Research has demonstrated that this program is effective for improvements among children with behavior disorders (August et al., 2003). After 2 years of continuous intervention, children in the program showed significant improvements in academic achievement and classroom behavior in comparison to children with behavior disorders who did not take part in the program. Also, severely disruptive children showed marked improvement in self-regulation following participation in the program. Furthermore, parents of children with behavior disorders that took part in the program reported reduced stress and improved parenting practices (August et al., 2003). Significant gains in adaptability and social skills were also apparent following participation in the program (August et al., 2003).

August et al. (2003) examined three outcomes that resulted from the Early Risers "Skills for Success" program. These three outcomes were: 1) children's aggressive behavior; 2) social competence; and 3) academic achievement. Results of the study indicate that the decisions parents make regarding placing their children in various aspects of prevention programs affects the success of the outcomes from the program. This occurs to the extent that participation in certain individual components of the program mediates particular outcomes. Specifically, attendance in the summer program resulted in gains in social competency for children at all severity levels of behavior disorder. This program provided training groups each day that were focused on instruction of prosocial behaviors and social problem solving skills, and activities that encouraged peer affiliation and friendship-building. On the other hand, participation in the family program did not result in any increases in social competence among the children with behavior disorders. However, this program was associated with decreased aggression among children with low-severity behavioral disorders (August et al., 2003).

Based on the findings of the study, the researchers suggested that prevention strategies need to include better tailored interventions (August et al., 2003). Needs assessment technologies must be developed that could generate personalized information about children with behavior disorders in order to design the most optimal intervention. This development of prevention programs would necessitate measurement tools that could be used to match intervention strategies with children's specific needs before and/or during treatment (August et al., 2003). In the Triple P-Parenting Program, children and parents are exposed to all intervention components, but the intensity of service is adjusted on an individual basis. Furthermore, instead of a single uniform program with only one level of involvement, this program presents a multilevel system of parent support on a multilevel continuum of increasing intensity. Therefore, all parents receive the same content of the intervention, but the intervention varies among individuals with regards to the intensity of skills training and practitioner support provided (August et al., 2003). This tailored approach is desirable because it provides a great amount of flexibility and allows the children and families to participate in the program to the extent that suits their needs (August et al., 2003). Ideally, tools for measurement could be developed that accurate track a child or parent's progress in relation to the expected path of their individually tailored program. Intervention intensity could therefore be adjusted on a continual basis according to this measured information (August et al., 2003).

Social-skills training has been demonstrated as an effective means of improving behavior among children with behavior disorders. Research has shown that training in social skills is increasingly becoming common as a means for the prevention of developmental crime among children. Beelmann & Lusel (2006) performed a meta-analysis of randomized evaluations of the effectiveness of social skills training for the promotion of social competence and the prevention of antisocial behavior. Results of the meta-analysis revealed a significant overall positive effect for social skills training post-intervention as well as at a 3-month follow-up. The effect sizes were demonstrated to be greater for improvements in social competence than for antisocial behavior. Furthermore, cognitive-behavioral programs demonstrated the most optimal results in terms of time and outcomes (Beelmann & Lusel, 2006).