You are on page 1of 15

Journal of Applied Behavior Analysis 2020, 53, 1404–1418 NUMBER 3 (SUMMER)

Effects of textual prompts and feedback on social niceties of


adolescents with autism spectrum disorder in a simulated
workplace
SHINYA YAMAMOTO AND SHINZO ISAWA
HYOGO UNIVERSITY OF TEACHER EDUCATION

Previous research demonstrates the efficacy of behavioral skills training with a textual prompt to
establish greetings and conversational skills. This study examined the efficacy of a brief interven-
tion of textual prompts with performance feedback for increasing social niceties of adolescents
and young adults with autism spectrum disorder in a simulated workplace. Target social niceties
included “Do you have a minute?” when a participant initiated an interaction and “Thank you
for your time” when a participant ended the interaction. Results revealed this intervention was
effective for 7 of 9 participants. This study expands upon previous studies by showing the effi-
cacy of a resource-efficient training on acquisition and generalization of social niceties by people
with autism spectrum disorder.
Key words: autism spectrum disorder, performance feedback, simulated workplace, social
skills, textual prompt

Past research demonstrates that Autism Spec- Greetings and interstaff casual communication
trum Disorder (ASD) is associated with difficulties are essential to employment success (Snell &
finding and continuing employment due to unique Brown, 2011). However, people with ASD may
behavior patterns (Hendricks, 2010) and difficulty have difficulty acquiring these skills. For example,
responding to social cues (Hillier, Fish, Cloppert, & previous studies suggest that some people with
Beversdorf, 2007). Many people with ASD do not ASD struggle to master the appropriate use of
have jobs (Shattuck et al., 2012). However, people phrases such as “excuse me, please” (Matson,
with ASD may become successful in employment Sevin, Box, Francis, & Sevin, 1993; Morgan &
by acquiring additional social skills (Benz, Salzberg, 1992), “thank you,” and “you’re wel-
Yovanoff, & Doren, 1997; Burt, Fuller, & Lewis, come” (Matson, Sevin, Fridley, & Love, 1990;
1991; Park & Gaylord-Ross, 1989; Schall, Stowitschek, McConaughy, Peatross, Salzberg, &
Wehman, & McDonough, 2012; Wehman et al., Lignugaris/Kraft, 1988). They may also struggle
2014). Previous studies have described efficacious to master complimenting others and offering assis-
social skills training for adolescents and young tance (Hwang & Hughes, 2000; Ruble &
adults with ASD that could be extended to the Dalrymple, 1996). Morgan and Salzberg (1992)
workplace (Gantman, Kapp, Orenski, & Laugeson, referred to these behaviors as “social amenities,”
2012; Hillier et al., 2007; Mesibov, 1984). though “social niceties” may be a more conven-
tional phrase to denote responses that have a
polite effect within certain verbal communities.
Shinya Yamamoto is now at Department of Advanced Social niceties can be conceptualized as
Professional Development in School Education, Hyogo autoclitics (Skinner, 1957) because they are
University of Teacher Education.
Address correspondence to: Shinya Yamamoto, Depart- verbal behavior that accompanies other verbal
ment of Advanced Professional Development in School operants (e.g., mands) and they function to
Education, Hyogo University of Teacher Education, modify the effect of the speaker’s behavior on
942-1, Shimokume, Kato-shi, Hyogo, Japan. Email:
eight.days.a.week1118@gmail.com the listener. Previous researchers have investi-
doi: 10.1002/jaba.667 gated methods of teaching social niceties to
© 2019 Society for the Experimental Analysis of Behavior
1404
ASD Simulated Workplace 1405

individuals with ASD, including the use of tex- behavioral skills training followed by in vivo train-
tual prompts (e.g., Sarokoff, Taylor, & ing with delayed feedback to teach conversational
Poulson, 2001; Thiemann & Goldstein, 2004). skills including greetings and closing statements.
For example, Matson et al. (1993) taught Hood, Luczynski, and Mitteer (2017) taught indi-
“excuse me” and “thank you” to children with viduals with ASD greeting and conversational skills
ASD by providing textual prompts. Teaching using behavioral skills training with textual pro-
social niceties may help young adults with ASD mpts and performance feedback. All participants
to communicate smoothly in the workplace. in these studies acquired the target greetings.
The workplace presents challenges for job Hood et al. (2017), in particular, described a
coaches to reinforce social niceties without inter- training package with promise for teaching social
rupting participants’ interactions. For example, a skills in a work setting because participants
trainer teaching his client with ASD to ask, “Do acquired greeting skills immediately when the
you have a minute?” before consulting on a work textual prompt was introduced. Moreover,
task cannot provide immediate feedback on the Hood et al. conducted only one session per week
appropriate initiation without disrupting the con- for 1.5 or 2 hours with two participants and two
versation between the person with ASD and his sessions per week for 30 min with one partici-
colleague. Delayed performance feedback may be pant. Grob, Lerman, Langlinais, and Villante
helpful in this circumstance. Performance feed- (2019) also taught job-related social skills and
back provides descriptive information to people social niceties, such as responding appropriately
about their past performance (Balcazar, Hop- to feedback and knocking on a door, by using
kins, & Suarez, 1985) and it may produce behavioral skills training with a stimulus prompt
behavior change when delivered after a series of which consisted of a sheet of paper with sample
targeted behaviors (Laugeson, Frankel, Gantman, responses. Furthermore, they examined the gen-
Dillon, & Mogil, 2012; Leblanc, Ricciardi, & eralization of social skills and social niceties to a
Luiselli, 2005; Reinke, Lewis-Palmer, & Martin, different simulated workplace. Because these
2007). For example, Leblanc et al. (2005) used textual prompts may serve a similar function to
performance feedback to teach 10 discrete-trial instructions and modeling for the vocal behavior
instructional skills to three teachers. Investigators of participants who can read, the combination
provided the performance feedback after a session of textual prompts with delayed feedback may
was over rather than after the participant emitted be a resource-efficient and promising technique
each targeted skill. In spite of this delay in feed- for teaching people with ASD social niceties in
back, all participants acquired the target skills. the workplace, and it may be effective to general-
Delayed performance feedback is a promising ize to different settings.
technique for job coaches to increase participants’ Some previous studies have used simulated
use of social niceties without interrupting their work environments as the context for training
social interactions. young adults and adolescents with ASD
Researchers have also utilized behavioral skills (e.g., Lattimore, Parsons, & Reid, 2006; Latti-
training to teach social niceties to people with more, Parsons, & Reid, 2008). Simulated work
ASD. For example, Nuernberger, Ringdahl, environments may promote generalization of skills
Vargo, Crumpecker, and Gunnarsson (2013) tau- from the training setting to naturalistic work set-
ght vocal and nonvocal social skills including greet- tings by embedding stimuli, people, and other ele-
ing skills to young adults with ASD using ments that are also present in a typical workplace.
behavioral skills training with textual prompts and Stokes and Baer (1977) refer to this method for
performance feedback. Kornacki, Ringdahl, promoting generalization as “programming com-
Sjostrom, and Nuernberger (2013) used mon stimuli.” Furthermore, Stokes and Baer
1406 Shinya Yamamoto and Shinzo Isawa

described the potential importance of “training Table 1


sufficient exemplars” when programming for gen- Participant Demographic Information
eralization. Training sufficient exemplars requires
Name Male/female Age Status
trainers to incorporate various people, activities,
Masaru Male 21 Employed full time
and materials throughout training. For example, Shingo Male 21 Student
Marzullo-Kerth, Reeve, Reeve, & Townsend Naohiko Male 18 Student
(2011) used various stimuli to teach sharing Tomohiko Male 16 Student
Yoshifumi Male 18 Student
responses such as “would you like to try this?” to Kazufumi Male 19 Unemployed
children with ASD, and the participants general- Kayoko Female 18 Student
Toshihide Male 17 Student
ized acquired sharing responses to stimuli not used Tetsuro Male 15 Student
in training. It may be especially important for
investigators to program for generalization of
workplace social skills so that people with ASD
can develop a repertoire of social niceties well Second, they had to be at least 15 years old.
before they secure their first paid job. Third, their parents had to report a history of
The purpose of this study was to examine reciprocal conversational skills. Finally, parents
the efficacy of textual prompts and delayed per- had to report participants’ readiness to perform
formance feedback on acquisition of social nice- simple work such as assembling envelopes or
ties by adolescents and adults with ASD. binding a document for more than 30 min.
Furthermore, we assessed the effects of training Informed consent was obtained from individual
on generalization of social niceties across vari- participants included in the study.
ous coworkers and bosses in the simulated According to caregivers’ reports, all the par-
work environment. ticipants who met the four inclusion criteria
could speak more than three sentences and
could take turns speaking for at least a 10-min
METHOD
conversation. They could emit mands as well as
Participants and Setting a variety of tacts of common items such as ani-
Nine Japanese adolescents and young adults mals, vehicles, foods, cartoons, and clothes.
with ASD participated in this study. All partici- Participants did not comment on things such
pants lived in Japan and their primary language as politics and emotions. All participants could
was Japanese. Table 1 displays background infor- answer simple social questions (e.g., What is
mation for each participant. Of the nine partici- your name? What is your favorite food?). It was
pants, eight were males and one was female. important for the participants to acquire these
Their ages ranged from 15 to 21 years, and the verbal behaviors because the intervention in
average age was 18 years old. All the participants this study was conducted in interactions with
had been diagnosed with ASD by a doctor who others. According to reports from parents, all
did not participate in the study. According to the participants started conversations without a for-
caregivers’ reports, none of the participants was mal initiation such as saying, “excuse me” or
diagnosed with a cognitive impairment. To “hi.” Furthermore, they departed from conver-
recruit participants, authors advertised their sations without saying “thank you” or politely
research on workplace social skills on the website ending the conversation in some other way.
of a nonprofit organization run by parents of Although all words are translated into English
people with ASD. Participants were required to for this publication, all participants always
satisfy the following four conditions: First, they spoke Japanese and all sessions and interactions
were required to have a diagnosis of ASD. were in Japanese.
ASD Simulated Workplace 1407

All the sessions in this study were conducted workplace interactions which are particularly
in a 16 m × 7.5 m private room in a public necessary to work in cooperation with others in
facility. Only participants, actors, and trainers Japanese culture. The first social nicety was say-
were present in the room. Each session lasted ing “Do you have a minute?” to initiate the
15 min. Two to three sessions were conducted interaction before making additional requests.
per visit and visits took place on 1-2 days every The response had to occur within 5 s after the
other week. The simulated workplace included participant approached an actor within about
four long desks that faced each other. Each 1.5 m, but before the participant made addi-
desk had two to three chairs. Investigators tional statements or requests. If the participant
placed one desk away from the other desks to emitted the response after 5 s passed or from
serve as the boss’ desk. On each desk for too great a distance, the response was incorrect.
workers was a packet of unassembled envelopes, If the participant did not approach or did not
a manual that explained how to assemble an emit the vocal initiation at all, data collectors
envelope, glue, a pencil, an eraser, a pair of scis- recorded an incorrect response. Furthermore, if
sors, and a memo pad. We selected the work of the participant made his or her additional
assembling an envelope because teachers and work-related statements or requests before the
caregivers of each participant predicted they boss or the colleague responded to the social
could engage in the task for at least 30 min. nicety, data collectors recorded an incorrect
response. The second social nicety was saying,
“Thank you for your time” to end the interac-
Materials
tion. The data collector scored a correct
Table 1 displays an example of the textual
response when the participant responded before
prompt sheet employed in this study translated
departing from the interaction (i.e., within 5 s
into English (see the Supplemental Materials
after the actor responded to the participant’s
document for the original Japanese). We devel-
request but still standing within about 1.5 m).
oped three textual prompt sheets, one for each
Responses with a similar function to the cor-
scenario that required social niceties: consulting
rect responses above were also recorded as cor-
with others, delivering information to others,
rect responses. For example, “Do you have a
and borrowing tools to use for work. Each tex-
sec?” and “Is this a good time for you to talk?”
tual prompt included descriptions of discrimi-
were considered to have similar effects as “Do
native stimuli and responses scheduled for
you have a minute?” In addition, “Thank you
reinforcement, including two social niceties per
for the help” and “I’m sorry I interrupted you”
scenario (i.e., an initiation and a closing
are examples that were considered functionally
statement). In addition, the sheet included a
equivalent to “Thank you for your time.”
blank square next to notations of each response
Impolite initiations or closing statements such
in the scenario. The size of the paper was
as knocking on the desk or stating, “Stop your
15 cm × 21 cm, and a 12-point Gothic font
business and listen!” were recorded as incorrect
was used.
responses.
The trainers recorded a circle for correct
Data Collection and Interobserver Agreement responses or a triangle for incorrect responses
The dependent variable was the percentage on their own copy of the textual prompt that
of social niceties (i.e., initiating and closing the was out of view from participants. The reason
interaction) correctly emitted in one session for using geometric shapes such as a circle and
(i.e., three work scenarios). We defined correct a triangle was because a circle means positive
responses according to parameters of respectful and a triangle means negative in Japan; this
1408 Shinya Yamamoto and Shinzo Isawa

scoring system was the appropriate way to show “Do you have a minute?” was 97%, and percent-
performance feedback to participants during age agreement for each observer was 94%, 97%,
training. Trainers scored correct and incorrect and 100%. The mean IOA results for each partic-
responses throughout each session for purposes ipant were: for Masaru, 97% (range, 92-100%);
of delivering feedback. However, data in for Shingo, 92% (range, 85-100%); for Naohiko,
Figure 1 were independently scored from video 100%; for Tomohiko, 100%; for Yoshifumi,
footage by a trained data collector. Although 100%; for Kazufumi, 97% (range, 92-100%); for
most data scored from video by trained Kayoko, 94% (range, 92-100%); for Toshihide,
observers and data scored in situ by trainers 97% (range, 92-100%); for Tetsuro, 94% (range,
were consistent, there were two exceptions. 92-100%). The mean IOA for “Thank you for
During the sixth session for Kayoko and the your time” was 94%, and percentage agreement
seventh session for Cesar, the trainer recorded a for each observer was 84%, 98%, and 100%.
response in one trial as an incorrect response The mean IOA results for each participant were:
for the social initiation (“Do you have a for Masaru, 100%; for Shingo, 92% (range,
minute?”) and provided corrective feedback, 78-100%); for Naohiko, 95% (range, 85-100%);
although the observer who reviewed the video for Tomohiko, 92% (range, 85-100%); for
footage scored correct responses for those Yoshifumi, 92% (range, 78-100%); for Kazufumi,
opportunities. Specifically, the trainer scored 92% (range, 78-100%); for Kayoko, 95% (range,
performance in the affected sessions as 50% 85-100%); for Toshihide, 97% (range,
correct and the observer scored the same per- 92-100%); for Tetsuro, 90% (range, 78-100%).
formance 75% correct.
Interobserver agreement (IOA) was collected
from video footage by three trained observers. Procedure
Secondary observers independently scored the Design. This study employed a multiple
dependent variables during a subset of response baseline design across participants to examine
opportunities from 50% of sessions in each the efficacy of textual prompts and delayed per-
phase of the study. For each of the sessions formance feedback on acquisition of social nice-
sampled for IOA, we randomly selected two ties in a simulated workplace. The total
opportunities to score one initiation and its number of sessions in this study was deter-
closing response per participant. Nine people mined before commencing data collection.
with ASD participated in this study, thus, the Therefore, the criterion for the transition from
total number of opportunities assessed for IOA one phase to next phase was predetermined for
was 18 per session. The number of opportuni- each group of three participants. To illustrate,
ties for each social nicety was the same in each Masaru, Shingo, and Naohiko were assigned to
session, thus, data were collected on 252 oppor- move from the baseline to training after three
tunities sampled from 50% of all sessions. In sessions. They were assigned to move to post-
brief, IOA was scored for 25% of opportunities training after the ninth session for Masaru, the
per participant for half of all sessions distrib- 10th session for Shingo, and the 11th session
uted across each phase of the study. An agree- for Naohiko.
ment was defined as all three observers General procedure. All interactions between
independently scoring the same performance the participants and the trainer and the actor
on the same opportunity. We calculated IOA were conducted in Japanese throughout all ses-
by dividing the total number of agreements by sions. In addition, all sessions were conducted
the number of agreements plus disagreements in Japan. All participants attended this study in
and multiplying by 100. The mean IOA for the same room simultaneously. Each of the
ASD Simulated Workplace 1409

Baseline Textual Prompt + Feedback Posttraining


100 Do you have
75 a minute? * * Masaru
50
*
25
*
0

100 Thank you


75 for your * * Shingo
50 time
25
*
0

100
75 Naohiko
50
25
0

100
75
* Tomohiko
50
25
Percentage correct response

100
75 Yoshifumi
50
25
0

100
* * Kazufumi
75
*
50
25
0

100
75
* Kayoko
50
25
*
0

100
Toshihide
75
50
25
*
0

100
* Tetsuro
75
50
25
* *
0

1 2 3 4 5 6 7 8 9 10 11 12 13 14
sessions

Figure 1. Percentage correct responses of each social nicety. The asterisk denotes sessions in which the experimenter
interrupted a participant’s attempt to prompt the social niceties of another participant or to provide feedback on the per-
formance of another participant.
1410 Shinya Yamamoto and Shinzo Isawa

nine participants was required to sit in a chair. usually stood out of sight of the participant so
Before each session started, an experimenter that he or she could not watch the trainer score
read the following script (translated to English performance. However, the trainers moved to a
here, see Supplemental Materials for the origi- visible position when they presented the textual
nal Japanese) to participants: Please imagine that prompt or performance feedback to a
you are here at a real workplace. Also, please look participant.
over the desk. There is a packet of unassembled Social niceties were assessed in three different
envelopes, a manual, glue, a pencil, an eraser, a work scenarios in this study. Each work sce-
pair of scissors, and a memo pad. If something is nario included one or two opportunities to
missing, please tell me. From now on, you will emit each of the social niceties. The work sce-
assemble the envelopes using these materials. Please narios were: consult with others, deliver infor-
read the manual to find out how to assemble mation about the task to others, and borrow
them. If you do not understand the content of the tools to use for work. Materials for each work
manual, please ask the trainer nearby. This work scenario differed per session, but all materials
will continue for about 15 minutes. When the and scenarios that we assessed during baseline
work is over, I will tell you “the work is over!” were also assessed at posttraining. Each work
This work also involves some actors, not just you. scenario occurred once per session and authors
The actors play as your boss or your colleagues. measured performance of initiating and closing
They occasionally ask you to do some work. When responses on four occasions, respectively, over
you are asked to perform a job, please perform to the course of three scenarios. The consult-with-
the best of your ability. Finally, if you become others scenario included two trials of initiating
tired or experience any discomfort, please tell the interactions and two trials of closing statements
trainer nearby. You can rest at any time. The to exit the interaction. The deliver-informa-
explanation is over. Now, please start working. tion-to-others scenario included one trial of ini-
The participants and three actors who played tiating an interaction and one trial of a closing
the role of colleagues sat face-to-face at the four statement to exit the interaction. The borrow-
long desks. The actor who played the role of tools-to-use-for-work scenario included one
the boss sat at the long desk positioned away trial of initiating an interaction and one trial of
from the other desks. The actor who played the a closing response.
role of the boss and the actors who played col- In the consult-with-others scenario, the boss
leagues differed between sessions. All partici- handed the participant a list or set of materials
pants and colleagues assembled the envelopes and instructed him or her to consult a specific
by applying paste to the designated section of colleague about which one to choose. The desig-
the paper and then folding it into an envelope nated colleague was always an actor as opposed
shape. If a participant stopped assembling enve- to another participant. In the delivering-
lopes for 1 min, a trainer standing nearby information scenario, a colleague asked the par-
vocally prompted the participant to resume ticipant to deliver information (e.g., a change in
their work. scheduled meeting time, a decrease in inventory)
Three trainers were present in the simulated to the boss. In the borrowing-tools scenario, the
workplace to measure participants’ responses boss asked the participant to work with a specific
and to provide prompts and feedback. Each tool that was not currently available on the table
trainer was assigned to observe and to interact (e.g., cutting out illustrations with a pair of scis-
with three of nine participants. The trainer sors, stapling documents with a stapler). The
assignments varied from session to session. boss also told the participant the name of a col-
During assessment or training trials, the trainer league who had the tool and that the participant
ASD Simulated Workplace 1411

could find that colleague by looking at his or her Because all participants were involved con-
name tag. The order of work tasks for each par- currently, it was plausible that participants
ticipant was predetermined by the first author. would provide prompts and feedback to each
Throughout this study, the boss and col- other. When this occurred (e.g., a participant
leagues provided the same scripted responses to pointed, called another participant’s name, or
participants’ correct and incorrect responses stood up and approached the participant who
(e.g., delivering the requested items, acknowl- was interacting with an actor or the trainer),
edging receipt of information, and so forth). the trainer said, “Please go on with your work.”
The boss and colleagues did not stop the inter- Trainers gave this order before the participant
action with the participant if he or she made an provided prompts or feedback in almost every
incorrect response. The actors received instruc- case. The mean number of trainer prompts was
tions for each scenario before the session 1.1 per session (range, 0-3). Asterisks in
started. Actor instructions for the borrow-tools Figure 1 denote the sessions in which trainers
scenario were as follows. This actor instruction had to interrupt at least one participant attempt
is translated to English here. See the Supple- to provide prompts or feedback.
mental Materials document for the original Jap- Baseline. The experimenter started each ses-
anese instructions. sion by reading the general instructions that
1. Please say, “Please come here, (the partici- were previously described. After general instruc-
pant’s name).” tions, actors presented the three work scenarios
2. When the participant comes, please ask the to each participant. The trainer for each group
participant to work with a specific tool. The work of three participants surreptitiously recorded
is to cut out illustrations with a pair of scissors or performance and withheld the textual prompts
stapling documents with a stapler. When you ask and feedback throughout baseline. Each partici-
a participant to work, do not pass the scissor or pant experienced the same order of work sce-
the stapler. Instead, please inform the participant narios with the same materials. However, the
of the name of a colleague who has the tool. If the order of work scenarios varied between partici-
participant asks you to borrow the tool, please say, pants. For example, the order of work scenarios
“I do not have the tool.” If the participant asks for Masaru was to consult with others, to
the name of a colleague who had the tool, please deliver information, and to borrow tools. The
inform the participant again. order of work scenarios for Shingo was to
3. When the participant says, “I am going to deliver information, to borrow tools, and to
work,” “I am going now,” or “Thank you for consult with others.
trusting me with this work,” please say, “Ok” Training. Instructions to start the training
without smiling. session were similar to the instructions in base-
If a participant walked away before complet- line, but the following sentence was added:
ing the assigned task or if a participant did not “When you have finished a work scenario, the
respond to the assigned task at all, the boss and trainer may hand you a sheet. On the sheet, the
colleagues withheld further prompts and the quality of your work is written. If a circle is writ-
trainers presented feedback immediately while ten, your work is excellent. If a triangle is written,
the participant stood and received the feedback. improvement is necessary for that scenario. When
Although there were a few situations in which you receive the sheet, please look at the sheet
a participant stopped interaction before com- closely.” Unlike baseline, the order of work sce-
pleting the work task, participants in this study narios per participant and the specific materials
always completed some of the steps in the or instructions per scenario varied between ses-
assigned task. sions. Table 2 illustrates how training scenarios
1412 Shinya Yamamoto and Shinzo Isawa

Table 2 prompt”). If the participant demonstrated


The Textual Prompt Sheet for Consulting with Others incorrect responses, the trainer provided correc-
“Consulting with others” tive feedback while referring to the textual
1. When you are asked to come to your boss, please go to
prompt and explaining how to perform the tar-
your boss. get social nicety. The trainer-scored textual
2. When you are left with some job to consult with the prompt sheet and descriptive performance feed-
colleague, please say, “OK.”
3. When you go to the colleague, please say, “Do you have back were presented within 10 s after the par-
a minute?” ticipant finished his interaction with the actor.
4. Please consult about the job entrusted by your boss.
5. When the consultation is over and you leave the Posttraining. Posttraining procedures were
colleague, please say, “Thank you for your time.” identical to baseline procedures, including a fixed
6. Please go to your boss to tell the result of consultation.
7. When you speak to your boss, please say, “Do you have
order of work scenarios, absence of the textual
a minute?” prompt sheets, and withholding of performance
8. Please tell your boss the result of consultation. feedback. Table 3 shows work scenario tasks and
9. When you leave the boss, please say, “Thank you for
your time.” materials per condition throughout this study.

differed from the work scenarios assessed dur- RESULTS


ing baseline and posttraining. Figure 1 displays the percentage of correct
After instructions, but before the actor called responses of greeting and closing social niceties
the participant to complete a specific work sce- for all participants. During baseline, participants
nario, the trainer showed the participant the tex- rarely or never performed the social niceties. The
tual prompt sheet. The trainer told the mean percentage of correct response for “Do you
participant to silently read the textual prompt have a minute?” was 18% for Tomohiko and
sheet. For instance, the sheet displayed the fol- Yoshifumi, 16% for Masaru, 12% for Kayoko,
lowing written instruction: “When you report and 0% for Shingo, Naohiko, Kazufumi,
something to the boss, please say, ‘Do you have Toshihide, and Tetsuro. The mean percentage of
a minute?’” After the participant was done read- correct response for “Thank you for your help”
ing, the trainer instructed the participant to take was 18% for Tomohiko and Yoshifumi, 16% for
the textual prompt sheet and to follow it during Shingo, 8% for Naohiko, and 0% for Masaru,
the next work scenario. The trainer then Kazufumi, Kayoko, Toshihide, and Tetsuro.
refrained from further interaction as the partici- During training, seven of nine participants
pant completed the next work scenario with the demonstrated an immediate increase in use of
boss or the colleague. Trainers surreptitiously social niceties while the two remaining partici-
recorded the participant’s performance in blank pants either demonstrated a delayed or variable
spaces provided beside each social nicety on their change in performance. The percentage of cor-
own copy of the textual prompt. rect responses for both social niceties for
After the work scenario was complete or the Naohiko, Tomohiko, Yoshifumi, Toshihide,
participant stopped responding, the trainer gave and Tetsuro increased to 100% immediately,
the scored prompt sheet to the participant and and performance maintained at 100% through-
said, “Please take a good look.” Next, the out posttraining. The percentage of correct
trainer described the performance feedback. If responses for Masaru and Kayoko gradually
the participant demonstrated correct social increased and stabilized at 100% during train-
niceties, the trainer briefly praised the partici- ing, with Kayoko’s performance of “Do you
pant’s behavior (e.g., “You are really doing a have a minute?” decreasing in posttraining.
good job, you nicely followed the textual Although the percentage of correct “Do you
ASD Simulated Workplace 1413

Table 3
Work Scenario Tasks and Materials per Condition

Baseline / Posttraining Training


Consulting with others 1. Consulting about which person to hire 1. Consulting about which box to use for
while looking at two resumes with a product packaging while looking an
photo actual product
2. Consulting about where to entertain 2. Consulting about when to set the date for
foreign customers while looking at a list the farewell party for retirees while
of restaurants looking at their schedule
3. Consulting about which mascot character 3. Consulting about which air conditioner
to use while looking at character’s photos to install at the workplace while looking
at a catalog of air conditioners
Delivering information 1. Delivering the information that there was 1. Delivering the information that the
a call from a customer at 10 AM visitor is expected to arrive at 14 PM
2. Delivering the information that the water 2. Delivering the information that the
pipe repair is confirmed form meeting date was set for Friday afternoon
November 10 3. Delivering the information that the
3. Delivering the information that the order location of the next meeting is conference
for products required for the work was room 2
complete
Borrowing tools 1. Borrowing a punching tool to form holes 1. Borrowing scissors to cut out illustrations
in documents from paper
2. Borrowing a stapler for binding 2. Borrowing tape to mount a label on an
documents envelope
3. Borrowing a pencil sharpener to sharpen 3. Borrowing a red pen to mark
many pencils typographical error of a paper

have a minute?” for Kazufumi gradually training scenarios, the absence of textual pro-
increased during training, his percentage of cor- mpts, and the absence of trainer feedback.
rect “Thank you for your help” varied from Kayoko was the only participant who performed
50% to 100% correct during training and sub- above baseline, but below training levels of accu-
mastery performance persisted through post- racy on one social nicety during posttraining,
training. The percentage of correct responses “Do you have a minute?” (62% correct).
for both social niceties for Shingo increased to
100% immediately, but the percentage of cor-
rect “Do you have a minute?” temporarily DISCUSSION
decreased to 25% in the sixth session of train- In the present study, we examined the effi-
ing. In this session, Shingo made the mistake cacy of textual prompts and performance feed-
of gluing many envelopes in the wrong place back on acquisition and generalization of two
and he had to redo the work. After that, he social niceties by adolescents and young adults
said, “I have to hurry” and assembled envelopes with ASD. Nine participants acquired the social
faster than usual. When confederates presented niceties “Do you have a minute?” and “Thank
opportunities for social niceties, he responded you for your time,” though training produced
by speaking fast and moving quickly. The need variable performance for Kazufumi’s initiations
for Tetsuro to redo his table work in session six and less robust posttraining maintenance for
might have competed with his attending or Kayoko’s closing responses. A previous study
other responses to the training trials. showed that the number of sessions for acquir-
In posttraining, all participants showed correct ing a social nicety can be greater than the num-
responses despite task materials that varied from ber of sessions for acquiring other skills
1414 Shinya Yamamoto and Shinzo Isawa

(Morgan & Salzberg, 1992). However, the cur- behavior changes before contacting conse-
rent study demonstrated that people with ASD quences (Cooper, Heron, & Heward, 2007).
acquired social niceties relatively quickly by There are previous studies in which participants
employing the presentation of the textual pro- with ASD acquired target behavior without
mpts and performance feedback. Participants in reinforcement, immediately after the rule was
this study acquired social niceties at a relatively introduced (Campbell & Tincani, 2011;
low training intensity of 30-min sessions once Miguel, Yang, Finn, & Ahearn, 2009; Persicke,
every 2 weeks. Tarbox, Ranick, & Clair, 2013). Other studies
The results of Hood et al. (2017) are similar demonstrate that behavior change may occur
to our findings. Hood and colleagues used tex- faster after employing a rule than after
tual prompts to teach greeting skills such as employing contingencies (Lang et al., 2009;
handshaking and a salutation. They showed Tiger & Hanley, 2004). To examine the role
that individuals with ASD acquired greeting of rule governance in the efficacy of the treat-
skills immediately when the textual prompt was ment package under study, future researchers
introduced. Results of the current study dem- should consider conducting direct assessments
onstrate a functional relation between the treat- of participants’ rule-governed behavior prior to
ment package of textual prompts plus intervention as well as measure behavior change
performance feedback and participants’ use of in the presence of the textual prompt without
social niceties. Although it was possible that performance feedback.
baseline responses by the boss and colleagues Although most participants’ performance
may have functioned as reinforcement or pun- maintained in posttraining, Kayoko’s percent-
ishment, this seems unlikely because the per- age correct for “Do you have a minute?”
centage of correct responses remained low decreased to 50% correct in the final sessions.
among participants who emitted some correct The reason for this decline may be because we
responses prior to training. It was also possible removed performance feedback for “Do you
that participants acquired social niceties by have a minute?” in posttraining and because
observing other participants’ responses because bosses or colleagues nondifferentially assisted
all participants simultaneously attended this participants with their requests throughout the
study in the same room. Observational learning study. The mean percentage of correct
may have influenced the effects of this study. responses for “Thank you for your time” did
However, we consider that the possibility was not decrease in the posttraining. We cannot
low because the percentage of correct clarify the difference between the two social
responding remained low for untrained groups niceties, but one possible reason is the delay in
during baseline. task completion due to emitting “Do you have
The percentage of correct responses of a minute?” Kayoko, in particular, worked hast-
Tomohiko, Toshihide, and Tetsuro increased ily to finish consulting with others as soon as
immediately to 100% when the textual prompt possible. Saying “Do you have a minute?”
was presented in training, and these partici- slightly delayed her completion of the assigned
pants’ social niceties maintained when the work. In contrast, because the assigned work
intervention was removed. It is possible that had already been finished when she was
Tomohiko, Toshihide, and Tetsuro acquired required to say “Thank you for your time,” the
social niceties as rule-governed behaviors. social nicety did not delay the work. The pres-
Behavior is rule-governed when the rule is in ence or absence of the delay in the assigned
place (e.g., “When you speak to your boss, work may have resulted in a difference in main-
please say ‘Do you have a minute?’”) and tenance for Kayoko. To encourage emitting
ASD Simulated Workplace 1415

social niceties that lead to work delays, it may prompt and the stimulus prompt differ
be effective to change the consequences that between nonverbal and verbal responses.
follow. For example, Kayoko’s performance Closely related, social niceties in the work-
might have maintained without prompts and place are influenced by more factors than social
feedback if the boss replied only when she said, niceties in the simulation setting. For example,
“Do you have a minute?” the boss or colleague was always available to
This study has at least three limitations. The interact with the participants in this study.
first limitation was that we did not conduct a Workplace social skills, by contrast, must even-
rigorous evaluation of generalizations across set- tually occur under convergent multiple control
tings. This study showed the efficacy of train- corresponding to multiple schedules of rein-
ing sufficient exemplars and programming forcement. Convergent multiple control is the
common stimuli to support generalization control of a single response by more than one
across people and task materials. Future variable such as nonverbal stimuli in the form
researchers should investigate the effects of of a potential listener’s body posture, other
additional task variations not presented in this audience variables, current motivating opera-
study on generalization of social niceties to a tions affecting the speaker, nonverbal contex-
wide variety of work activities. For example, tual stimuli, emotional private events, verbal
future participants might be trained to use stimuli emitted by the other person, and so on
social niceties while sorting documents in a (Michael, Palmer, & Sundberg, 2011). In brief,
warehouse, entering data into a computer saying “Do you have a minute?” is appropriate
spreadsheet in an office, and taking inventory if the boss is not busy, but it may not be inap-
in a supermarket. Most notably, we did not propriate if the boss is very busy. Rodriguez,
measure generalization to a naturalistic work Levesque, Cohrs, and Niemeier (2017) asserted
setting. Future researchers should measure the importance of teaching people with ASD
effects of training in the simulated work envi- both when to engage in the skill and when to
ronment on participants’ work and social out- not engage.
comes under natural conditions. For example, Future studies should consider the social
Grob et al. (2019) provided stimulus prompts nicety as behavior controlled by multiple
(e.g., a problem-solving prompt to help partici- stimuli and program training trials on which
pants assess whether they required a model to that response is not scheduled for reinforce-
perform the assigned task) when the participant ment. Investigators could also program
was required to emit targeted social skills and abolishing operation trials on which the natu-
social niceties in a simulated workplace, to ral reinforcer for using a social nicety is not
facilitate generalization of workplace social skills valuable. An example of an unreinforced
to a second simulated workplace environment. (s-delta) trial may involve a busy boss who is
In their study, participants showed the generali- engaged in a phone call when the participant
zation. The stimulus prompt with written arrives. An example of abolishing operation
responses of each targeted social skill (Grob trial is the boss instructing the participant to
et al. 2019) is similar to the textual prompt in borrow materials from a coworker that are
our study. However, while the social niceties in already on the participant’s desk.
their study were nonverbal responses such as A second limitation was that we did not con-
knocking on a door and waiting for an invita- duct pre-experimental assessments to determine
tion, the social niceties in our study were verbal which social niceties to target. One way to
responses. It is an important issue to examine more systematically select such social niceties is
whether generalization effect by the textual to observe participants’ behavior in their daily
1416 Shinya Yamamoto and Shinzo Isawa

life (Beaulieu, Hanley, & Santiago, 2013; highly if you emit the statement” in the textual
Peters & Thompson, 2015). As another prompt when a participant does not acquire a
method, Grob et al. (2019) assessed whether social nicety. Refining wording of the textual
participants emitted job-related social skills in a prompt may contribute the development of
series of work sessions (e.g., stocking items on resource-efficient training.
shelves, filing papers, and sorting objects) In this study, we introduced textual prompts
before selecting target behaviors. and the performance feedback to teach and to
Because Japan is a high context culture facilitate generalization of two social niceties for
(i.e., most of the information is inferred from individuals with ASD. In particular, we showed
the context of a message; Mukherjee & Ramos- this procedure was efficient because some of
Salazar, 2014), individuals in Japan prefer a participants could acquire social niceties imme-
relatively ambiguous or soft and polite commu- diately after the training started. Although we
nication style. Social niceties such as, “Do you selected two social niceties related to employ-
have a minute?” and “Thank you for your ment as dependent variables, future researchers
time” are essential to the Japanese workplace. should extend the procedure in this study to
Examples of other social niceties or etiquette to other social niceties to promote smooth inter-
target in future studies on workplace social personal relationships for people with ASD in
skills in Japanese culture may include bowing various social settings.
during initial greetings, avoiding too much
direct eye contact with others (Mukherjee &
Ramos-Salazar, 2014), exchanging business REFERENCES
cards (Polleri, 2017), and using Japanese polite- Balcazar, F., Hopkins, B. L., & Suarez, Y. (1985). A criti-
ness language (e.g., saying the word “desu” or cal, objective review of performance feedback. Journal
“masu” at the end of sentences to elders, chang- of Organizational Behavior Management, 7(3-4),
65–89. http://doi.org/10.1300/J075v07n03_05.
ing a verb to special honorific words when Jap-
Beaulieu, L., Hanley, G. P., & Santiago, J. L. (2013).
anese people are talking to someone older than Improving the conversation skills of a college student
them; Takeda, 2016). with peer-mediated behavior skills training. The Anal-
After selecting assessment-informed work- ysis of Verbal Behavior, 30, 48–52. http://doi.org/10.
1007/s40616-013-0001-8.
place social skills, future research should collect
Benz, M. R., Yovanoff, P., & Doren, B. (1997). School-
data on the social acceptability and validity of to-work components that predict postschool success
the targeted behaviors. To evaluate social for students with and without disabilities. Exceptional
acceptability and validity, participants’ behaviors Children, 63, 151–165. http://doi.org/10.1177/
may be assessed by presenting video samples of 001440299706300201.
performance before and after the intervention Buffington, D. M., Krantz, P. J., McClannahan, L. E., &
Poulson, C. L. (1998). Procedures for teaching
(Buffington, Krantz, McClannahan, & Poulson, appropriate gestural communication skills to children
1998) and collecting questionnaires from the with autism. Journal of Autism and Developmental
teacher or parents (Crozier & Tincani, 2007). Disorders, 28, 535–545. http://doi.org/10.1023/A:
1026056229214.
Researchers should measure the social accept-
Burt, D. B., Fuller, S. P., & Lewis, K. R. (1991). Brief
ability of various goals, procedures, and out- report: Competitive employment of adults with
comes related to teaching social niceties. autism. Journal of Autism and Developmental Disor-
Future studies should evaluate modifications ders, 21, 237–242. http://doi.org/10.1007/
BF02284763.
to this treatment package for participants whose
Campbell, A., & Tincani, M. (2011). The power card
performance does not maintain, similar to strategy: Strength-based intervention to increase
Kayoko. For example, it may be effective to direction following of children with autism spectrum
include the description of “You will be rated disorder. Journal of Positive Behavior Interventions, 13,
ASD Simulated Workplace 1417

240–249. http://doi.org/10.1177/109830071140 Applied Behavior Analysis, 39, 91–102. http://doi.org/


0608. 10.1901/jaba.2006.154-04.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Lattimore, L. P., Parsons, M. B., & Reid, D. H. (2008).
Applied behavior analysis (2nd ed.). Upper Saddle Simulation training of community job skills for adults
River, NJ: Prentice Hall. with autism: A further analysis. Behavior Analysis in
Crozier, S., & Tincani, M. (2007). Effects of social stories Practice, 1, 24–29. http://doi.org/10.1007/
on prosocial behavior of preschool children with BF03391717.
autism spectrum disorders. Journal of Autism and Laugeson, E. A., Frankel, F., Gantman, A.,
Developmental Disorders, 37, 1803–1814. http://doi. Dillon, A. R., & Mogil, C. (2012). Evidence-based
org/10.1007/s10803-006-0315-7. social skills training for adolescents with autism spec-
Gantman, A., Kapp, S. K., Orenski, K., & trum disorders: The UCLA PEERS program. Journal
Laugeson, E. A. (2012). Social skills training for of Autism and Developmental Disorders, 42,
young adults with high-functioning autism spectrum 1025–1036. http://doi.org/10.1007/s10803-011-
disorders: A randomized controlled pilot study. Jour- 1339-1.
nal of Autism and Developmental Disorders, 42, Leblanc, M. P., Ricciardi, J. N., & Luiselli, J. K. (2005).
1094–1103. http://doi.org/10.1007/s10803-011- Improving discrete trial instruction by paraprofes-
1350-6. sional staff through an abbreviated performance feed-
Grob, C. M., Lerman, D. C., Langlinais, C. A., & back intervention. Education and Treatment of
Villante, N. K. (2019). Assessing and teaching job- Children, 28(1), 76–82. Retrieved from. http://www.
related social skills to adults with autism spectrum jstor.org/stable/42899829.
disorder. Journal of Applied Behavior Analysis, 52, Marzullo-Kerth, D., Reeve, S. A., Reeve, K. F., &
150–172. http://doi.org/10.1002/jaba.503. Townsend, D. B. (2011). Using multiple-exemplar
Hendricks, D. (2010). Employment and adults with training to teach a generalized repertoire of sharing to
autism spectrum disorders: Challenges and strategies children with autism. Journal of Applied Behavior
for success. Journal of Vocational Rehabilitation, 32, Analysis, 44(2), 279–294. https://doi.org/10.1901/
125–134. http://doi.org/10.3233/JVR-2010-0502. jaba.2011.44-279.
Hillier, A., Fish, T., Cloppert, P., & Beversdorf, D. Q. Matson, J. L., Sevin, J. A., Box, M. L., Francis, K. L., &
(2007). Outcomes of a social and vocational skills Sevin, B. M. (1993). An evaluation of two methods
support group for adolescents and young adults on for increasing self-initiated verbalizations in autistic
the autism spectrum. Focus on Autism and Other children. Journal of Applied Behavior Analysis, 26,
Developmental Disabilities, 22, 107–115. http://doi. 389–398. http://doi.org/10.1901/jaba.1993.26-389.
org/10.1177/10883576070220020201.
Matson, J. L., Sevin, J. A., Fridley, D., & Love, S. R.
Hood, S. A., Luczynski, K. C., & Mitteer, D. R. (2017).
(1990). Increasing spontaneous language in three
Toward meaningful outcomes in teaching conversa-
autistic children. Journal of Applied Behavior Analysis,
tion and greeting skills with individuals with autism
23, 227–233. http://doi.org/10.1901/jaba.1990.
spectrum disorder. Journal of Applied Behavior Analy-
23-227.
sis, 50, 459–486. http://doi.org/10.1002/jaba.388.
Hwang, B., & Hughes, C. (2000). The effects of social Mesibov, G. B. (1984). Social skills training with verbal
interactive training on early social communicative autistic adolescents and adults: A program model.
skills of children with autism. Journal of Autism and Journal of Autism and Developmental Disorders, 14,
Developmental Disorders, 30, 331–343. http://doi.org/ 395–404. http://doi.org/10.1007/BF02409830.
10.1023/A:1005579317085. Michael, J., Palmer, D. C., & Sundberg, M. L. (2011).
Kornacki, L. T., Ringdahl, J. E., Sjostrom, A., & The multiple control of verbal behavior. The Analysis
Nuernberger, J. E. (2013). A component analysis of a of Verbal Behavior, 27, 3–22. https://doi.org/10.
behavioral skills training package used to teach con- 1007/BF03393089.
versation skills to young adults with autism spectrum Miguel, C. F., Yang, H. G., Finn, H. E., &
and other developmental disorders. Research in Autism Ahearn, W. H. (2009). Establishing derived textual
Spectrum Disorders, 7, 1370–1376. http://doi.org/10. control in activity schedules with children with
1016/j.rasd.2013.07.012. autism. Journal of Applied Behavior Analysis, 42,
Lang, R., Shogren, K. A., Machalicek, W., Rispoli, M., 703–709. http://doi.org/10.1901/jaba.2009.42-703.
O’Reilly, M., Baker, S., & Regester, A. (2009). Morgan, R. L., & Salzberg, C. L. (1992). Effects of
Video self-modeling to teach classroom rules to two video-assisted training on employment-related social
students with Asperger’s. Research in Autism Spectrum skills of adults with severe mental retardation. Journal
Disorders, 3, 483–488. http://doi.org/10.1016/j.rasd. of Applied Behavior Analysis, 25, 365–383. http://doi.
2008.10.001. org/10.1901/jaba.1992.25-365.
Lattimore, L. P., Parsons, M. B., & Reid, D. H. (2006). Mukherjee, S., & Ramos-Salazar, L. (2014). "Excuse us,
Enhancing job-site training of supported workers your manners are missing!" The role of business eti-
with autism: A reemphasis on simulation. Journal of quette in today’s era of cross-cultural communication.
1418 Shinya Yamamoto and Shinzo Isawa

TSM Business Review, 2(1), 18–28. http://doi.org/10. youth with an autism spectrum disorder. Pediatrics,
23837/tbr/2014/v2/n1/112854. 129, 1042–1049. http://doi.org/10.1542/peds.2011-
Nuernberger, J. E., Ringdahl, J. E., Vargo, K. K., 2864.
Crumpecker, A. C., & Gunnarsson, K. F. (2013). Skinner, B. F. (1957). Verbal behavior. Englewood Cliffs,
Using a behavioral skills training package to teach NJ: Prentice Hall.
conversation skills to young adults with autism spec- Snell, M., & Brown, F. (2011). Instruction of students with
trum disorders. Research in Autism Spectrum Disorders, severe disabilities (7th ed.). Upper Saddle River, NJ:
7, 411–417. http://doi.org/10.1016/j.rasd.2012. Pearson.
09.004. Stokes, T. F., & Baer, D. M. (1977). An implicit technol-
Park, H. S., & Gaylord-Ross, R. (1989). A problem- ogy of generalization. Journal of Applied Behavior
solving approach to social skills training in employ- Analysis, 10, 349–367. http://doi.org/10.1901/jaba.
ment settings with mentally retarded youth. Journal 1977.10-349.
of Applied Behavior Analysis, 22, 373–380. http://doi.
org/10.1901/jaba.1989.22-373. Stowitschek, J. J., McConaughy, E. K., Peatross, D.,
Salzberg, C. L., & Lignugaris/Kraft, B. (1988).
Persicke, A., Tarbox, J., Ranick, J., & Clair, M. S.
(2013). Teaching children with autism to detect and Effects of group incidental training on the use of
social amenities by adults with mental retardation in
respond to sarcasm. Research in Autism Spectrum Dis-
orders, 7, 193–198. http://doi.org/10.1016/j.rasd. work settings. Education and Training in Mental
2012.08.005. Retardation, 23, 202-212. Retrieved from http://
www.jstor.org/stable/23878503
Peters, L. C., & Thompson, R. H. (2015). Teaching chil-
dren with autism to respond to conversation partners’ Takeda, I. (2016). Report: Project-based learning with
interests. Journal of Applied Behavior Analysis, 48, 21st century skills for the Japanese language class-
544–562. http://doi.org/10.1002/jaba.235. room. Journal of Integrated Creative Studies, 2, 1-7.
Polleri, M. (2017). Exchange business cards in Japan: Oh! https://doi.org/10.14989/225153
So you are an …. Anthropology Today, 33(3), 23–24. Thiemann, K. S., & Goldstein, H. (2004). Effects of peer
http://doi.org/10.1111/1467-8322.12351. training and written text cueing on social communi-
Reinke, W. M., Lewis-Palmer, T., & Martin, E. (2007). cation of school-age children with pervasive develop-
The effect of visual performance feedback on teacher mental disorder. Journal of Speech, Language, and
use of behavior-specific praise. Behavior Modification, Hearing Research, 47(1), 126–144. https://doi.org/10.
31, 247–263. http://doi.org/10.1177/ 1044/1092-4388(2004/012.
0145445506288967. Tiger, J. H., & Hanley, G. P. (2004). Developing stimu-
Rodriguez, N. M., Levesque, M. A., Cohrs, V. L., & lus control of preschooler mands: An analysis of
Niemeier, J. J. (2017). Teaching children with autism schedule-correlated and contingency-specifying stim-
to request help with difficult tasks. Journal of Applied uli. Journal of Applied Behavior Analysis, 37,
Behavior Analysis, 50, 717–732. http://doi.org/10. 517–521. http://doi.org/10.1901/jaba.2004.37-517.
1002/jaba.420. Wehman, P. H., Schall, C. M., McDonough, J.,
Ruble, L. A., & Dalrymple, N. J. (1996). An alternative Kregel, J., Brooke, V., Molinelli, A., … Thiss, W.
view of outcome in autism. Focus on Autism and (2014). Competitive employment for youth with
Other Developmental Disabilities, 11, 3–14. http:// autism spectrum disorders: Early results from a ran-
doi.org/10.1177/108835769601100102. domized clinical trial. Journal of Autism and Develop-
Sarokoff, R. A., Taylor, B. A., & Poulson, C. L. (2001). mental Disorders, 44, 487–500. http://doi.org/10.
Teaching children with autism to engage in conversa- 1007/s10803-013-1892-x.
tional exchanges: Script fading with embedded textual
stimuli. Journal of Applied Behavior Analysis, 34, Received August 23, 2017
81–84. http://doi.org/10.1901/jaba.2001.34-81. Final acceptance September 15, 2019
Schall, C., Wehman, P., & McDonough, J. L. (2012). Action Editor, Amanda Karsten
Transition from school to work for students with
autism spectrum disorders: Understanding the pro-
cess and achieving better outcomes. Pediatric Clinics
of North America, 59, 189–202. http://doi.org/10. SUPPORTING INFORMATION
1016/j.pcl.2011.10.009. Additional Supporting Information may be
Shattuck, P. T., Narendorf, S. C., Cooper, B.,
Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). found in the online version of this article at the
Postsecondary education and employment among publisher’s website.

You might also like