BEHAVIORTHERAPY18, 17--32 (1987)

Behavioral Small Group Training to Improve the Social

Skills of Emotionally-Disordered Adolescents
ANTHONY J. PLIENIS

DAVID J. HANSEN

FELICIA FORD

STEVE SMITH, JR.

LORI J. STARK

JEFFREY A. KELLY
University of Mississippi Medical Center

Adolescents with a history of disorders such as autism and schizophrenia often

exhibit severe social skill deficits which interfere with the ability to establish
relationships. In the current study, three students attending special education for
emotionally-handicappedteenagers received small-group training at their school.
Treatment consisted of training in conversationalskill and social problem solving,
in multiple baseline fashion and replicated across all three students. Treatment
resulted in: (1) more effective performance during unstructured practice conver-
sations, including conversations with persons the teenagers never met before; (2)
more effective performance when presented with scenarios of social problems; (3)
improved ratings of adjustment made by their teacher; (4) increased quality and
rating of social interaction during informal class parties for two of the subjects;
and (5) generally improved scores on self-report measures of depression, self-
esteem, and loneliness. Implications for the use of social skill enhancement tech-
niques for this population are discussed.

A p p r o x i m a t e l y eight m i l l i o n c h i l d r e n a n d a d o l e s c e n t s i n t h e U n i t e d
States h a v e s e r i o u s e m o t i o n a l d i s o r d e r s i n c l u d i n g s c h i z o p h r e n i a , a u t i s m ,
affective d i s o r d e r s , a n d c o n d u c t d i s o r d e r s ( J o i n t C o m m i s s i o n o n M e n t a l

The authors extend appreciation to Mary Berry for her assistance. David Hansen is now
at West Virginia Universityand Lori Stark is now at Brown University. Requests for reprints
should be sent to either Anthony J. Plienis, Department of Psychiatry, Marshall University
Medical School, Huntington, WV 25701 or to Jeffrey A. Kelly, Department of Psychiatry
and Human Behavior, Universityof Mississippi Medical Center, Jackson, MS 39216. Copies
of all problem-solvingscene vignettes and the teacher rating scale can be obtained from the
authors.

17 0005-7894/87/0017-003251.00/0
Copyright 1987 by Association for Advancement of Behavior Therapy
All rights of reproduction in any form reserved.
18 PLIENIS ET AL.

Health in Children, 1970). While young people with these disorders can
exhibit behavioral excesses and deficits in many areas, social skill inad-
equacies are frequently present (American Psychiatric Association, 1980).
Behavioral interventions have been employed to promote adaptive com-
petencies and reduce inappropriate behavior with emotionally-disordered
youth, but efforts to improve social relationship skills with this population
are still rare.
Effective social skills enable an individual to develop friendships, form
social supports, and gain acceptance by peers; patterns of positive or
negative self-appraisal are also likely to be influenced by one's history of
success in relationships with others (de Armas & Kelly, in press; Jones,
1981; Kelly, 1982). Adolescents lacking peer-valued social skills can find
it difficult to establish gratifying relationships and to participate fully in
developmentally important social activities with peers. Teenagers with
serious emotional disorders are at particular social disadvantage because
they often stand out as "different" to their peers and to others in the
community. As long as emotionally-disordered adolescents lack neces-
sary, peer-valued social skills, their ability to function effectively in "non-
special" educational, community, and work social settings is limited.
Several recent investigations have explored the nature of social skill
deficits among emotionally-disordered teenagers. Hansen, St. Lawrence,
and Christoff (1984) found that adolescents in a short-term residential
treatment program exhibited conversational skill deficits relative to
matched "normal" teenagers. Studies with juvenile delinquents (Ollen-
dick & Hersen, 1979) and aggressive adolescent psychiatric patients (El-
der, Edelstein, & Narick, 1979) have established the presence of poor
assertion skills, have demonstrated that social skills training can improve
performance in role plays of situations requiring assertiveness, and have
found some evidence of general conduct improvement following training.
Other investigators have established that emotionally-disordered ad-
olescents lack social problem-solving skills relative to their nondisordered
peers. In a relatively early study, Platt, Spivack, Altman, Altman, and
Peizer (1974) found that when hospitalized adolescents were presented
with scenario descriptions of social problems, they verbalized less effective
and less elaborated solution strategies than matched "normal" peers.
Social problem-solving deficits among emotionally or socially-malad-
justed adolescents have since been replicated in several other studies
(Christoff et al., 1985; Tisdelle, 1984; Sarason & Sarason, 1981). Thus,
in addition to conversational skill deficits, adolescents exhibiting poor
emotional adjustment may lack the cognitive skills needed to plan meth-
ods to resolve problems with peers and increase their own participation
in peer-group activities.
The purpose of the present study was to evaluate the effectiveness of a
behavioral intervention for improving the social interaction skills of emo-
tionally-disordered teenagers. In contrast to past studies, the current proj-
ect examined the effectiveness of training "everyday" conversational be-
 G R O U P SKILLS T R A I N I N G 19

havior; utilized realistically unstructured conversational simulations;

taught both social skills and problem-solving strategies related to their
implementation; and employed a range of assessment and generalization
measures.

METHOD
Subjects and Setting
The project was conducted in a high school classroom for adolescents
with emotional handicaps. Three students participated in training. The
adolescents were referred for training because, according to both school
reports and their own descriptions, they had great difficulty meeting oth-
ers, conversing with peers, and because they rarely participated in school
social activities even though they were "mainstreamed" into regular classes
for much of each school day.
Denise, a 20-year-old senior, had been in special classes for three years.
She had a longstanding history of emotional upsets, periods of crying and
depression, and suicide threats at home and school. Data from school
records and the student's own reports indicated that antecedents of these
episodes often involved Denise's perception that classmates did not like
her, made fun of her, and provided her little positive attention. During
interactions with peers and adults, Denise often exhibited overdramati-
zation and exaggerated affect while also dominating the interaction. She
attained average grades, but often missed school or left school early when
she was upset.
Tom, a 17-year-old junior, had been diagnosed in childhood as schizo-
phrenic. This diagnosis was reconfirmed by a clinical psychologist two
years before the study using standard mental status and interview-based
criteria. He had been in special classes for eight years. Tom socialized
with others, but had a very limited conversational repertoire and talked
almost exclusively about religion or sports; classmates reportedly became
bored talking with Tom and avoided him. Tom exhibited affective in-
appropriateness and often grinned, sought attention by giggling, and dis-
played other age-inappropriate social behavior. His intellectual function-
ing level was in the low average range.
Ann, a 19-year-old senior, was first diagnosed as autistic at age three.
This diagnosis was reconfirmed based on DSM-III criteria several months
before the present training began. During childhood, Ann exhibited such
autistic behaviors as extreme social withdrawal, frequent self-injurious
behavior, echolalic speech, and stereotyped motor activity. By adoles-
cence, Ann's intellectual functioning was within the normal range, she
was earning average to above-average grades in standard academic cours-
es, and she exhibited appropriate vocabulary. However, Ann was avoidant
of others and appeared highly anxious in conversations because she spoke
minimally, stammered, rarely made eye contact, fidgeted, and often ig-
nored others or ran away when they approached her.
20 PLIENIS ET AL.

General Design and Procedure Overview

Following a series o f baseline assessments, 22 group treatment sessions
were conducted on a twice weekly basis. The first 12 sessions focused on
improving conversational skill; the final 10 sessions focused on improving
social problem-solving competence. In this way, the experimental design
consisted o f a multiple baseline application o f the same group training
procedure to two aspects o f social skill (conversational skill and social
problem-solving) replicated simultaneously for each o f the three adoles-
cents (Kelly, 1980). Followup assessment was conducted six weeks fol-
lowing treatment.
Dependent Measures
Three categories o f assessment measures were e m p l o y e d to evaluate
the effectiveness o f training. During baseline, at the end o f each training
week, and at followup a conversational assessment was conducted. At the
same points, student social problem-solving skills were assessed. Addi-
tionally, a set o f generalizat!on and clinical validation measures was ad-
ministered at periodic probe points before, during, and following the
intervention period. No assessments were ever conducted on the same
day as a training session.
Conversational assessments. Prior to training, each adolescent engaged
in a series o f five 5-minute baseline conversations with one o f two ex-
perimental confederates. The confederates, one a male and the other a
female, had been trained to converse in a warm and n o n d o m i n a t i n g
manner, to respond to partner questions with responses not exceeding
three sentences, to reciprocate questions only, and to break conversational
silences only after 30 seconds had elapsed. In this way, responsibility for
maintaining conversational initiative remained with the subject.
At the start o f each conversational assessment, a student was r a n d o m l y
paired with one o f the confederates and was asked to talk with the con-
federate to "get to know him (her) better." N o other instructions were
provided. Conversations were staged in a r o o m at the school and were
audiotape recorded. The same conversational assessment procedure was
repeated at the end o f each training week.
T o evaluate the adolescents' performance in conversational assess-
ments, a n u m b e r o f verbal, nonverbal, and global effectiveness ratings
were made. A research assistant was trained prior to the project to rate
c o m p o n e n t behaviors o f social skill. The assistant listened to each con-
versation tape and tallied the total frequency, over the five-minute in-
teraction, o f the following verbal behaviors: conversational questions di-
rected to the confederate, speech acknowledgers, speech duration o f the
adolescent's contribution to the conversation, and appropriate disclosures
o f information about interests and activities. These verbal behaviors were
selected for assessment and training because they have been well-defined
in the literature, because empirical research has previously related t h e m
to ratings o f social likeability, or because they have been shown to dif-
 GROUP SKILLS TRAINING 21

ferentiate lonely f r o m nonlonely adolescents (Franco, Christoff, C r i m -

rains, & Kelly, 1983; Jones, H o b b , & H o c k e n b u r y , 1982; M i n k i n et al.,
1976).
A n i m p o r t a n t question relevant to social skill assessment with adoles-
cents that has received little previous attention involves identifying those
topics teenagers find interesting to talk a b o u t with one another. T o e m -
pirically d e t e r m i n e high interest conversational topics, 100 m a l e a n d 100
female students attending the s a m e high school as the three adolescents
in the study were presented with a list o f 24 topics. T h e n o r m a t i v e sample
rated each topic on a 5-point scale o f interest value. Topics receiving
m e a n ratings o v e r 3.5 (friends, music a n d musical groups, appearance,
future plans, m o v i e s , travel, sports, food, hobbies, a n d television pro-
grams) were designated as high interest topics to teenagers. T o assess
conversations on this variable, all statements m a d e b y the subjects in
these topic categories were labeled as high interest statements.
A rating o f overall conversational skill was m a d e b y a different trained
assistant w h o h a d no prior contact with the subjects or knowledge a b o u t
the intervention. This rater was presented with all baseline a n d training
phase tapes in r a n d o m order a n d was asked to imagine that she was
overhearing a c o n v e r s a t i o n between two teenagers. After listening to each
five-minute interaction, the assistant m a d e a rating (from 1 = extremely
unskilled to 7 = extremely skilled) to describe the b e h a v i o r o f the subject
in the conversation. Finally, to obtain a m e a s u r e o f n o n v e r b a l skill, the
confederates w h o interacted with the adolescents during the assessment
conversations m a d e a rating o f a p p r o p r i a t e affect using a 1 to 7 scale
i m m e d i a t e l y after each interaction t o o k place.
Social problem-solving assessments. T e n scenarios describing social
p r o b l e m s were constructed for assessment purposes. Each scenario de-
scribed a social difficulty identified during interviews with school staff
a n d with the adolescents. T h e scenarios i n v o l v e d situations where the
subject had an o p p o r t u n i t y to m e e t others, was i n v o l v e d in a conflict, or
was called on to m a k e a decision concerning social relationships. E x a m p l e s
o f two o f the scenes are:

"You've seen someone several times in the cafeteria that you would like to get
to know. As you come out of the lunch line, you see this person sitting alone"
and
"'A teacher calls on you to answer a question. You give an incorrect answer, and
some of the other kids in the class tease you with words like 'dumb' or 'stupid.'"

During each p r o b l e m - s o l v i n g assessment, a research assistant m e t in-

dividually with each adolescent a n d verbally presented six scenarios; the
others were used to assess generalization. After every scenario narrative,
the adolescent was told to "tell m e all the things y o u could do in this
situation a n d tell m e which o f t h e m you would d o . " T h e assistant p r o v i d e d
no feedback and responses were tape recorded.
22 PLIENIS ET A L .

Investigators of social problem-solving (D'Zurilla & Goldfried, 1971;

Platt et al., 1974; Spivack & Shure, 1974) have identified components o f
problem-solving effectiveness including: (1) specification of why the sit-
uation is a problem, (2) explicit identification of a goal, (3) generation of
potential solutions, and the (4) evaluation and (5) selection of a solution.
Each scenario response was rated to determine how many of these com-
ponents were included, yielding a score of 0 to 5. In addition, because
problem-solving effectiveness is related to the ability to identify multiple
potential courses of action (D'Zurilla & Goldfried, 197 I), the number o f
different solutions verbalized in each total response was tallied. Finally,
the assistant made a 5-point rating of the overall effectiveness of the
solution that the adolescent said s/he would actually employ in the sit-
uation.
Generalization and clinical validation measures. Several other mea-
sures were administered as probes at baseline, at the time the conversa-
tional skills phase of treatment ended, at the time the social problem-
solving phase ended, and at followup. To obtain a measure of conversation
skills generalization to people other than the two confederates, each ad-
olescent engaged in an interaction with a different novel partner at each
of these probe points. To assess generalization of social problem-solving
skills, four o f the ten scenarios originally constructed were never practiced
but were administered only at the periodic generalization probes.
If training were successful, one would expect to find evidence of be-
havior change during informal social gatherings. To assess this, 40-minute
classroom parties were held at baseline, at the conclusion of conversational
skills training, and at followup. Each classroom party included taped
music, soft drinks, and snack foods; no instructions were given, other
than that the students should relax and enjoy themselves. During each
party, two observers sat in the room and unobstrusively rated each ad-
olescent's behavior using 10-second observe, 10-second record intervals
rotated sequentially across all three adolescents for a total of 15 obser-
vations per student. The behaviors coded on an occurrence/nonoccurrence
basis during each observation interval were: proximity (the observed ad-
olescent was within three feet of another adolescent during the interval),
social initiation (verbal behavior directed towards another person with
whom there was no previous interaction), response to initiation (respond-
ing to the initiation of another), talking (verbal behavior directed to
another person), and no interaction.
To further validate the intervention's impact, a teacher rating form was
completed by the adolescents' primary teacher at each probe point. The
form included 14 social skill behaviors, each rated on a 5-point scale.
The scale assessed extent of socialization with peers, ease and comfort in
interactions, appropriate resolution of peer conflicts, and appropriateness
o f emotional behavior. The scale was scored by summing the weight of
all item endorsements. Finally, three self-report inventories of adjustment
were administered at all probe points. These scales were the Coopersmith
 GROUP SKILLS TRAINING 23

Self-Esteem Inventory (Coopersmith, 1975), the UCLA Loneliness Scale

(Russell, Replau, & Cutrona, 1980), and the Child Depression Inventory
(Kovacs, 1983).
Reliability assessments. All taped conversation problem-solving re-
sponses were rated by a primary rater; twenty-five percent of each were
randomly selected from all intervention phases and were independently
rated by a second assistant.
Reliability was assessed with Pearson product-moment correlations
between raters. Correlational values for conversational skill verbal be-
haviors averaged .93 (range = .78 to .99). The interrater correlation for
overall skill ratings was .81. The scoring of problem-solving scenarios
resulted in Pearson's r = .98 for problem-solving steps and r = .86 for
overall effectiveness. During the school parties, two different observers
overlapped on I00 percent of all observations. Interjudge reliabilities for
coded behaviors ranged from 80 to 100 percent (X = 95 percent) based
on agreements divided by agreements plus disagreements x 100.
Group Training Procedures
Group training sessions were led by two therapists; the therapists were
clinical psychology residents. Each session in both the conversational and
social problem-solving phases made use of the same skill instruction,
modeling, behavior rehearsal, feedback, and shaping procedures.
Sessions began with the therapists identifying the skill aspect that was
to receive attention in that day's group and instructing the adolescents in
its use and rationale. During the conversational skills phase, these aspects
included asking appropriate questions in conversations; conveying verbal
and nonverbal interest and attention to a partner; disclosing appropriate
information about one's own interests, hobbies, and background; talking
about topics likely to be of interest to peers; and pacing one's style or
flow of conversation in an appropriate manner. During the social problem-
solving phase, the adolescents were taught a model for decision-making
that included defining why a situation was problematic; determining what
one wants to see happen in the problem situation; "brainstorming" po-
tential solutions to the problem; evaluating those solutions; and selecting
a solution as most workable after the evaluation.
Following brief instruction in that day's skill aspect, the therapists
modeled the skill. For example, in a session focusing on conversational
skills, the therapists might role play a short interaction while the adoles-
cents watched and noted when the therapists exhibited the targeted skill.
At that point in the session, the adolescents rehearsed the same behavior,
by verbalizing examples of it or by role playing with a therapist or with
one another. The therapists and group members offered feedback, sug-
gestions, and reinforcement following this in-session rehearsal. Sessions
lasted approximately 45 minutes.
Toward the end of the intervention, and when the adolescents had
become proficient in correctly exhibiting the skills, efforts were made to
24 PLIENIS ET AL.

DENISE

i
BABELINE I CONVERSATIONSKILL FOLLOW--UP BASELINE ICONVERSATIONSKILL FOLLOW--UP
I TRAINING TRAINING

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FIG. 1. Results of conversational and social problem-solving training for Denise. Note
that the right-hand panels represent a continuation of the left-hand panels in Figures 1, 2,
a n d 3.

foster in v i v o skill use. Each student was prompted to identify situations

in the class, school, and c o m m u n i t y when s/he could converse with other
people. Reports o f successful skill use were reinforced, and reports of
difficulties applying the skills in v i v o were discussed in the group. In
addition, the group members were encouraged to raise actual life problems
 G R O U P SKILLS T R A I N I N G 25

TOM

BASELINE CONVERSATION SKILL FOLLOW-- BASELINE CONVERSATION SKILL FOLLOW--

TSAINING UP TRAINING UP

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0 1. 2T 3, 4, 5"I1 6. . .?. . .8. . .5.1. 0 1 1 1 2 1 2 1 4 1 5 1 5
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FIG. 2. Results o f conversational and social problem-solving training for Tom.

that each had encountered and were taught to apply their newly-acquired
problem-solving skills to those difficulties.
RESULTS
The effects of the conversational skills and social problem-solving train-
ing are illustrated in Figures 1 through 3 for Denise, Tom, and Ann,
26 PLIENIS ET AL.

ANN

BASELINE CONVERSATION FOLLOW--UP

SKILL TRAINING BASELINE CONVERSATION FOLLOW--UP
SKILL TRAINING

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SOLVING TRAINING UP
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FIG. 3. Results of conversational and social problem-solving training for A n n .

respectively. Because baseline measures reflect different patterns of ex-

cesses and deficits in conversational and problem-solving skills, these
results are presented individually by subject.
Denise. The baseline measures for conversational skills for Denise show
that she typically dominated the conversational exchange, but exhibited
low rates of effective conversational skills and typically discussed somatic
problems or difficulties getting along with her family and peers. Her poor
 GROUP SKILLS TRAINING 27

DENISE TOM ANN

Cony. Follow Cony. Follow Cony. Follow
Baseline Training up Baseline Training up Baseline Training up

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FXG.4. Socialbehavior during classroomparties at baseline, after conversationalskills
training, and at followup. The upper panels show the percent of intervals when social
interaction, response to interaction, or talking occurred (open circle); and when proximity
occurred (square). The lower panel for each subject indicatesthe percent of intervals when
no social interactionoccurred.

performance is also reflected in the low ratings of overall conversational

skill at baseline. Denise's conversations after training show clear and
consistent improvement in all areas including speech duration near 50%,
which reflects an equitable conversational exchange. The novel partner
assessment at the end of the conversational training phase indicates ex-
cellent generalization of these skills to interactions with unfamiliar people.
These treatment gains were maintained at followup.
The problem-solving assessments conducted during baseline and con-
versational skills training reflect stable and poor performance on the six
to-be-trained problem scenarios and on the four generalization problems.
Assessments conducted during the problem-solving treatment and at fol-
lowup indicate rapid improvement in skill use, problem-solving ratings,
and generalization.
Tom. Tom's baseline conversational performance reflected excessive
but monotonous domination of the conversational exchange with low
rates of appropriate conversational skills. None of Tom's pretraining con-
versations were highly rated for overall conversational effectiveness. Dur-
ing training, all measures reflected substantial improvement in conver-
28 PLIENIS ET AL.

sational skill behavior. These improvements generalized to novel partners

and were, for the most part, maintained at followup.
T o m exhibited poor performance on the baseline problem-solving as-
sessments. During treatment, he increased his use of problem-solving
steps and increased the number of alternative solutions generated. These
improvements were also found for the end-of-phase generalization probes.
His followup performance was generally consistent with problem-solving
skill shown during the intervention phase.
Ann. Ann's baseline conversational performance, poorest of the three
subjects, reflected perseverative, negative, and low interest statements
(e.g., fear of failing her tests and having to study all of the time). Her
pretraining speech duration was high but was accompanied by very low
rates o f effective conversational behaviors and very low conversational
skill ratings. During training, Ann exhibited substantial improvement
from baseline on all conversational measures. In the novel partner con-
versations, Ann exhibited varying degrees of generalized improvement
across skills and achieved a high overall effectiveness rating; these gains
were well-maintained throughout the intervention period. At followup,
while affect and overall skill ratings with the novel partners remained
high, other aspects of Ann's performance revealed considerable decre-
ments. At the time o f followup, Ann was in the midst o f final exams and
frequently worried about doing well on her tests. These worries may have
had an overriding effect on her more recently acquired skills.
During the social problem-solving training phase, Ann exhibited im-
provement on the trained and generalization problem scenarios. Some
performance decrements were evident at followup, although the mean
overall effectiveness ratings on the trained problems were at a level con-
sistent with her improved performance during the training phase. Per-
formance on the generalization scenarios exceeded baseline levels.
Party behavior. The results of the three Friday afternoon classroom
parties are presented in Figure 4. For each subject, the upper panels
provide data on proximity as well as percent of occurrence for the three
rated categories of interaction" social initiation, response to initiation, and
talking. The lower set of panels for each subject presents the percent of
intervals when no social interaction occurred. For Denise, training was
associated with improved social interaction in the peer party setting. The
results for T o m were similar to Denise, although some decrement was
observed during the followup party. Ann's party behavior failed to change.

Self-Report Measures
The self-report measure scores are presented in Figure 5. These graphs
also illustrate one standard deviation above and below the mean for

----4
Fie. 5. Scoreson self-reportinventoriesand teacherratings at baseline,aftereachtraining
phase, and at followup. Hatched lines on the self-reportinventory panels indicate l SD
above and l SD below the inventory mean for "normal" adolescents.
 GROUP SKILLS TRAINING 29

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Cony. Solving Follow
Baseline Training Training up

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: 40 -*
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m 30
0c
20 o
J:
o
eo
10
4)
~- 0

• Denise
. Tom
oAnn IIIII~IIIIISD 1 above & 1 below
30 PLIENIS ET AL.

normal reference populations on which the measures were standardized

(Coopersmith, 1975; Russell et al., 1980; Kovacs, 1983). The measures
of depression and loneliness for Denise and T o m remained in the normal
range over the four assessment points. Ann's CDI scores, which early i n
the study indicated significant depression, decreased to levels near the
normative mean and comparable to her peers. Results of the adminis-
trations of the SEI indicate considerable gains in self-esteem scores for
all three subjects, most notably T o m and Ann.
Teacher rating scale. The results of the teacher rating scale of social
behavior are also illustrated in Figure 5. This measure indicates positive
effects for both T o m (from 40 at baseline to 50 posttraining) and Ann
(from 17 to 30).

DISCUSSION
The present study represents one of the first controlled evaluations of
social skills training for adolescents with a history of severe disorders
such as childhood schizophrenia and autism. The three adolescents stud-
ied here differed from one another; Ann was primarily avoidant of others,
T o m was talkative hut age-inappropriate in his social behavior, and Den-
ise was emotionally volatile and sensitive to peer slights. However, base-
line evaluations of all three teenagers revealed poor conversational skill
and an inability to solve social problems. Treatment attention directed
sequentially at these two competencies produced improvement in each
o f them. Generalization probe assessments showed that the teenagers
could usually apply their newly acquired skills to conversations with
people they had never before met and to social problems different than
those practiced in training. While not all adolescents showed evidence of
change across all generalization, maintenance, and validation measures,
each improved in some area beyond the direct practice tasks.
The gains made by the adolescents during treatment are noteworthy
given their history and severely deficient baseline performance. This is
especially true for Ann, who was autistic, and Tom, who was a childhood
schizophrenic. In late adolescence and early adulthood, less than one half
o f autistic individuals of normal intelligence have been able to continue
their education or maintain employment (Lockyer and Rutter, 1970).
Lotter (1974) attributes such failures to a lack of social intelligence, and
Rutter (1983) speculates that the social ineptness of higher functioning
adult autistics reflects a fundamental deficit in social cognition. As a
function of a small group treatment format which emphasized social and
cognitive skills training, even Ann acquired and could generalize new skill
behavior; self-report measures of depression and self-esteem suggest that
Ann also evaluated herself more positively following treatment. It is un-
clear whether some o f Ann's performance decrements at followup were
situationally specific and involved apprehension about final exams and
graduation.
Because the project concluded at the end of a school year and two
 G R O U P SKILLS T R A I N I N G 31

subjects graduated, longer-term followup could not be conducted. H o w -

ever, anecdotal reports further confirmed the impact o f treatment. Ann,
for example, attended her senior prom, brought to school photographs o f
the evening, and attended j u n i o r college after graduation. School officials,
pleased with the o u t c o m e o f training, requested that the same program
be repeated for other emotionally-disordered students.
The present study extends past social skills treatment research in several
respects. The project e m p l o y e d a comprehensive range o f behavioral ob-
servation, self-report, and other-report assessment measures sensitive to
skill acquisition, skill generalization, and impact on broader measures o f
adjustment. The use o f unstructured, extended practice conversations
permitted social skill assessment under conditions m o r e realistic than
brief role plays, and the practice o f social problem situations known to
be difficult for these particular teenagers in the second training phase
helped to ensure treatment relevance. Validation issues were given further
attention b y empirically surveying a large n u m b e r o f adolescents in the
school and then teaching the skills-deficient students how to converse
about topics o f known established reinforcement-value to classmates from
the same school. Finally, the present study targeted conversational skill
behavior as one intervention c o m p o n e n t and followed it with attention
to social problem-solving, which entails decision-making about how to
apply those skills to meet others, to handle conflicts, and so on. One would
surmise that a social skill e n h a n c e m e n t intervention will have m a x i m u m
clinical impact i f it not only teaches clients new social skills, but also
teaches cognitively-based rules and strategies for using those skills in the
natural setting. While the n u m b e r o f adolescents treated here was modest,
and while larger-scale training applications are now needed, the results
indicate that social skill e n h a n c e m e n t interventions can prove useful in
helping even seriously-impaired adolescents interact with others more
successfully.
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RF.~rCED: January 21, 1986

FINAL ACCEPTANCE:May 12, 1986