Research in Autism Spectrum Disorders 1 (2007) 28–37

http://ees.elsevier.com/RASD/default.asp

A critical review of assessment targets and

methods for social skills excesses and deficits
for children with autism spectrum disorders
Johnny L. Matson *, Jonathan Wilkins
Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States

Abstract

A substantial research literature is beginning to develop regarding social skills excesses and
deficits for children with autism spectrum disorders. These developments are likely to continue given
the increasing recognition that these behaviors are among the most critical core symptoms of these
disorders. A review is provided of developments in the field with respect to the social excesses and
deficits that are most critical for this population of children. A discussion of direct observation and
scaling methods used to do these evaluations along with a discussion of strengths and weaknesses of
these methods is provided. A discussion of the current status and potential future developments of the
area is also covered.
# 2006 Elsevier Ltd. All rights reserved.

Keywords: Social skills; Autism spectrum disorders; Assessment

1. Introduction

At the core of autism spectrum disorders (ASD) are deficits or abnormal social
behaviors (Constantino et al., 2003). In study after study authors emphasize the importance
of such behaviors in the development of further difficulties, in what could be described as a
domino effect (Weiss & Harris, 2001). Others have conceptualized core problems such as
this as ‘‘behavioral cusps’’. Rosales-Ruiz and Baer (1997) describe this term as behavior

* Corresponding author. Tel.: +1 225 388 4104; fax: +1 225 388 4125.
E-mail address: Johnmatson@aol.com (J.L. Matson).

1750-9467/$ – see front matter # 2006 Elsevier Ltd. All rights reserved.
doi:10.1016/j.rasd.2006.07.003
 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37 29

which has consequences beyond the behavior change itself. For example, increased social
skill may make a child more popular with others and/or increase the number of social
interactions other initiate with the ASD child. Bosch and Fuqua (2001) note that behaviors
of significance must be assessed and rank-ordered based on how likely training on them
will lead to access to new reinforcers, how socially valid the skills to be trained are for the
child, how well the skill is likely to generalize, and how many people will the skill affect.
These criteria apply perhaps first and foremost to social skills with ASD children.
Unfortunately, the definitions used for social skills are almost as varied as the studies
conducted. Stella, Mundy, and Tuchman (1999) describe social behavior in the context of
orientation and communication; Wing, Leekam, Libby, Gould, and Larcombe (2002)
frame social skills in terms of interactions, play, and communication; Luteijn, Luteijn,
Jackson, Volkmar, and Minderaa (2000) identify social contact problems and social
insight; and Laushey and Heflin (2000) provide discrete operational definitions of social
skills such as asking for objects, getting the attention of another, and waiting for his/her
turn.
As a result of the interchangeable use of social skills for a variety of behaviors displayed
by children with ASD, the topic has become confusing for those who study the area.
Additionally, definitions of social skills in the ASD literature have presented
inconsistencies with how social skills are viewed and described for most childhood
conditions, where more consistent definitions are available. Thus, the first goal of this paper
will be to define social skills in the context of the ASD literature. Initially a brief historical
overview will be presented followed by a description of elements that might make up a
definition of social skills for children with ASD.

2. History

The treatment of social skills deficits and excesses has driven the development of
definitions and specific assessment procedures in the fields of mental health and education.
Having said that, the amount of research geared specifically at assessment versus treatment
has been meager. McFall and Marston (1970) describe one of the earliest studies labeled
social skills. Their paper dealt with assisting shy male college students to develop
‘‘appropriate assertiveness’’ as a means of getting dates. In short order these strategies were
adapted and expanded to clinical populations, particularly schizophrenic and depressed
adults (Hersen & Bellack, 1976). From these beginnings, the applications of social skills to
persons with intellectual disabilities (ID) soon followed (Matson, Kazdin, & Esveldt-
Dawson, 1980; Matson & Senatore, 1981), as did studies for people with visual
impairments (Matson, Heinze, Helsel, Kapperman, & Rotatori, 1986). The application of
social skills assessments and training to ASD children, conversely, is of fairly recent origin
and has been primarily with children diagnosed as autistic. For example, Matson, Sevin,
Box, Francis, and Sevin (1993), in one of the earliest studies of this type, trained autistic
children to increase self-initiated verbalizations.
In the childhood literature common definitions of social skills with children have been
available for some time (Matson & Ollendick, 1988), and have been applied to one group of
ASD children, those with autism (Matson & Swiezey, 1994). According to these persons
30 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37

and others in the fields of behavior therapy and applied behavior analysis, social skills are
seen as involving appropriate applications of motoric, cognitive, and affective behaviors in
amounts that would be viewed as neither excessive nor deficient to setting, individuals,
and/or situations (Hughes & Sullivan, 1988). Hops (1983) adds that social skills are
specific identifiable skills that result in socially competent behavior.

3. Current confusion on definitions

Much of the early assessment and treatment research on social skills across the range of
child and adult groups came from a learning based model. Because most of the studies were
being produced by like-minded professionals, they were reading each others research and
largely adhering to a similar conceptualization toward definition and assessment. However,
ASD researchers have been a much more heterogeneous group. Developmental
psychology, special education, and biological psychiatry have been as influential as
behaviorally based clinical and school psychologists and psychiatrists. Because of different
academic and research traditions, different notions have emerged regarding the definition
of social skills and consequentially methods of assessment. Based on these data the
definition of social skills in ASD children may be grouped into Sections 3.1 and 3.2.

3.1. Learning theory

This model conceptualizes social skills as discrete, observable responses that are
essential for a child to adapt to and cope with his/her environment. Typically the most
frequently posited rationale for the child with ASD to fail to perform these skills is a deficit
in knowledge about social behaviors the person should possess and display. As a result,
emphasis is placed on identifying the excesses and deficits in social skills and then
remediating them, typically via operant and/or social learning procedures (Matson &
Ollendick, 1988).
A second source of social skill problems as conceptualized in the learning model is the
lack of initiative or motivation to perform the skill. If a child is stealing food for example,
the motivation for doing so, may in the child’s eyes, outweigh the benefits of not engaging
in the behavior. In this instance, the focus of assessment is to better delineate motivating
variables and to establish conditions that will result in the child performing more versus
less appropriate social behavior.

3.2. Developmental

ASD is recognized as a neurodevelopmental disorder. Because of the biological

component inherent in the condition there are inescapable issues of temperament which are
pervasive across all domains of behavior, including social skills (Volkmar, Klin, Marans, &
Cohen, 1996). Additionally, ASD and the most frequently occurring specific disorders in
this broader group, which include autism and PDD-NOS, have a great degree of overlap
with intellectual disability (ID). Additionally, the most severe levels of ID are associated
with the highest comorbid rates of ASD (Ghaziuddin, 2000; Scott, 1994). This relationship
 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37 31

is particularly noteworthy since communication and social skills are considered core
deficits of autism and PDD-NOS (Matson, Nebel-Schwalm, & Matson, in press; Sevin,
Matson, Coe, Fee, & Sevin, 1991; Wing et al., 2002). Compounding this problem is the
recognition that individuals with ID are also deficient across a broad range of social skills,
leading to the conclusion that social excesses and deficits are defining characteristics of ID
(Matson & Hammer, 1996; Matson, LeBlanc, Weinheimer, & Cherry, 1999). Given that a
great deal of overlap exists between ID and ASD, many children are faced with a
compounding effect from both disorders on social skills problems. This ‘‘predisposition’’
to social skill difficulties further complicates the skill building approach noted in the
learning theory model.

3.3. Defining social skills

Perhaps the best method of determining what constitutes social skills in ASD children is to
look at scales and the items they include. The Matson evaluation of social skills in youngsters
(MESSY) (Matson, Rotatori, & Helsel, 1983), which will be reviewed later, is specific to
social skills and has been employed with autistic children. Some social skills items they
identified as particularly problematic in a sample of autistic children were smiles at people
(s)he knows, says thank you when appropriate, initiates social conversation, calls people by
their name, and exhibits eye contact (Matson, Stabinsky-Compton, & Sevin, 1991). More
recently Wing et al. (2002) developed a diagnostic scale with a substantial subset of social
skills. Some of their items include absence of speech, irrelevant speech, odd tone of voice,
facial expression that is absent or odd, does not produce a natural smile on request, poor eye
contact, does not greet other people, and makes one-sided social approaches. A good deal of
consistency for many of the social items is evident across these and other measures, as well as
for the behaviors selected for treatment studies across a range of populations using role-play
scenes (see next section) and in vivo prompted social interactions (Laushey & Heflin, 2000).
Common themes for all these definitions are a set of overt, observable behaviors broken down
into two general categories of verbal and nonverbal communication. The specific behaviors
noted above typify these definitions.

4. Assessment methods

A variety of methods have been utilized to assess and in the process define social skills
excesses and deficits in children with ASD. The initial research focused on operant
methods which included the assessment of operationally defined target behaviors. A
second methodology, which could be viewed as complimentary to the first, involved the
development of specialized tests for social skills of children.

4.1. Role-play scenes and target behaviors

Beginning with McFall and Marston (1970), one commonly used assessment approach
for evaluating social skills has involved scripted social situations tailored to the person
receiving treatment (Matson & Ollendick, 1988). Typically, one or two adults present a
32 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37

brief narrative story or situation which is aimed at eliciting a response from the child
relative to how the situation could/should be handled. Typically, the child’s response would
be evaluated on four to six operationally defined target behaviors such as eye contact,
latency period before responding, verbal content, voice volume, and appropriateness of
verbalizations to the situation described (Kazdin, Esveldt-Dawson, & Matson, 1983;
Matson, Esveldt-Dawson, & Kazdin, 1983). The constellation of particular social
behaviors is much longer than four to six. However, the reliable observation of more target
behaviors than this is unlikely. Thus, only the most salient behaviors for a given child are
recorded. These methods of assessment dominated early social skills assessment research
and resulted in the development of tests which had a pool of predeveloped social situation
narratives (role-plays). Typical of a standardized measure was the Social Skills Test for
Children which consisted of 30 scenes with topics such as giving praise, giving help,
accepting praise, accepting help, and assertiveness (Williamson, Moody, Granberry,
Lethermon, & Blouin, 1983). These narratives would be presented and discrete target
behaviors, such at those noted above, would be observed and recorded.
Typical of the child social skills assessment research on role-playing and related
measures of social skills is a study by Kazdin, Matson, and Esveldt-Dawson (1984). They
tested 38 children from 7 to 13 years of age with severe psychiatric disorders which had
resulted in inpatient hospitalization. Four measures of social skills were administered in
week 2 or 3 of hospitalization including role-play scenes, a knowledge questionnaire,
direct observations, and a checklist, the Matson evaluation of social skills with youngsters
(Matson, Rotatori, et al., 1983). (The latter measure will be discussed later.) The role-play
scenes consisted of the child acting out 20 social situations geared toward offering help,
making requests of others, giving compliments, responding to negative provocation, or
refusing unreasonable requests. Scenes were described by a therapist. A second therapist
(prompter) played the part of a second child.
One scene went as follows: ‘‘The child would be on the floor pretending to play a game’’.
The first adult therapist would then say, ‘‘Imagine you are playing a game and another child
comes up and threatens to hit you’’. The second therapist, the prompter, would then walk over
to the child and say, ‘‘I’m going to punch you’’. How the child responded would then be
scored on a number of fine grained ‘‘target behaviors’’. For this and most studies, target
behaviors included eye contact, number of words spoken, speech intonation, facial
expressions, motor movements, and verbal content of the child’s answer. Each behavior was
operationally defined. Number of words spoken for example was a simple count of words in
the response while intonation consisted of evaluations of voice inflection associated with the
child’s response. Despite widespread use in the general child literature, there does not appear
to have been much use of this technology for ASD children. While the most severely ID
children may not benefit from these methods, older children with mild or no ID may benefit
markedly from such an approach. Given the substantial literature with ID and other children,
trying these methods would seem reasonable.
The study by Kazdin et al. (1984) is one of the very few in the child social skills
literature which used a knowledge questionnaire. This finding is unfortunate since as
previously noted, social deficiencies can be due to lack of information or lack of
motivation. Thus, determining which is the case will guide intervention toward a teaching
skill or reinforcement for motivation model. Almost all treatment research assumes, and
 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37 33

most likely at least partially incorrectly in most instances, that the social problem is always
a skill deficit. We endorse this method of teasing out the etiology of the problem as a first
step in social skills assessment.
The knowledge questionnaire consisted of 10 items. Each item corresponded to the
context of the role-play scenes described above. Items were presented along with three
possible answers for each. The child was to pick the best answer from the three questions.
Second, children completed a self-efficacy measure. This scale asked the children
questions regarding their own assessment of whether they could complete the social skills
scenes appropriately. Finally, the child report of the MESSY was used, where children rate
their own skills.
While this method of evaluation continues to be a viable method of assessing social
skills in children, it has not been used in exactly this form with ASD children. Often, rather
than using role-play scenes, a social play situation or socially oriented school activities,
such as arriving at school, ‘‘circle time’’, snack time, and story time, replace role-plays as a
medium for assessing operationally defined target behaviors (Strain & Hoyson, 2000). As
such, these methods can be seen as a more naturalistic/realistic extension of the role-played
scene. However, these role-plays in some modified form may be of value. It is
disappointing that after 20 years few attempts to employ them with ASD children have
occurred. However, where such methods have been employed, they have been successful
(Goldstein & Cisar, 1992).
A final measure was direct observation for 20 min periods of the children on two
occasions. These data were collected during week 1 in their living environment.
Observations were made during free play periods in a restricted area. Staff supervision to
insure that inappropriate behavior did not escalate was used, but staff did not initiate social
interactions. A rater remained in the periphery of the play area and scored the target child’s
social behaviors. There were 118 10 s intervals for each 20 min observation period rated as
either engaged in appropriate behavior, inappropriate behavior, or no interaction.
Appropriate behavior included conversing, cooperative play, sharing, showing affection, or
positive affect. Additionally, interactions were scored relative to whether they occurred
with a peer or a staff person.

4.2. Scaling methods

Researchers in the field frequently stress the central nature of social skills in autism in
particular and ASD in general (Wing et al., 2002). Despite this belief, little has been done to
develop scaling methods to evaluate social behavior in this group, compared to differential
diagnosis, for example (Matson et al., in press). Having said this, some research is
emerging. Notable in this regard is the social responsiveness scale (SRS) (Constantino
et al., 2003). Their measure has 65 items which in a previous revision was called the social
reciprocity scale. The authors report only minor wording changes despite the name change
for this parent or teacher Likert scale (0 = never true to 3 = almost always true). The
authors report that the scale measures social awareness, social information processing, and
capacity for reciprocal social responses. In the initial efforts to establish the psychometric
properties of the SRS, 1900 children between 4 and 15 years of age were assessed, and test-
retest reliability was established (Constantino, Przybeck, Friesen, & Todd, 2000;
34 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37

Constantino & Todd, 2003). Only one general social factor has emerged. To date the scale
appears to be primarily for diagnosis as evinced by one study where it was compared to the
ADI-R to identify ‘‘autistic traits’’. However, scales such as this may also have value in
identifying targets for intervention and for evaluating treatment outcome. In addition, this
scale does include a number of items that would be labeled as social skills.
Luteijn, Jackson, Volkmar, and Minderaa (1998) also describe the Children’s Social
Behavior Questionnaire (CSBQ), which emphasizes social skills as one of the primary
components of the scale. The CSBQ, which was designed to be filled out by parents and
other caregivers of children 4–18 years of age, contains items on communication, social
interaction, stereotypy, motor behaviors, affect, attention, sensory abnormalities, and
social cues. A second study was conducted to further refine the scale (Luteijn et al., 2000).
A sample of 240 children from the Netherlands classified as PDD-NOS on DSM-IV criteria
were assessed. A second group of 95 ‘‘high functioning’’ autistic children and a third group
of 181 children with ADHD were tested. Two additional groups, 400 kids with ‘‘other
psychiatric problems’’ and 234 normally developing controls, were also tested. Interrater
reliability and test-retest data were good. A factor analysis yielded five factors: social
contact problems, social-insight problems, acting-out, anxiety/rigidity, and stereotypies.
The two former factors include a substantial number of items that were social in nature.
Social contact in particular resulted in the greatest deficits for autism, followed by PDD-
NOS, relative to the other three groups. This scale had good psychometrics and a large
subject pool relative to most psychometric studies of ASD. While the scale is not
exclusively on social skills, it could serve as an important adjunct measure, getting at a
series of behavior problems commonly seen in ASD children and providing a lot of overlap
on social behavior with scales more specifically designed to address the latter issue.
Another scale to consider, which has a focus on some social behaviors but also presents a
broader array of ASD symptoms, is the Childhood Autism Rating Scale (CARS). Stella et al.
(1999) factor analyzed the 15 CARS items on 90 children with a diagnosis of PDD-NOS or
autism. While this N is a bit small for the proposed analysis, obtaining large samples of such
children is difficult. The authors report a five factor solution consisting of social
communication, social orienting, emotional reciprocity, odd sensory exploration, and
cognitive and behavioral consistency. They report that the CARS was particularly sensitive to
‘‘social disturbance’’. Furthermore, the authors noted that profiles of social disturbance may
differ between autistic and PDD-NOS children, and therefore may by diagnostic.
For diagnostic purposes, it may be necessary to develop social skills assessment specific
to autism and other autism spectrum disorders. However, the child and ID literature outside
the ASD area has well developed scales on social skills that have been available for a good
deal of time. If the goal is to enhance normative behavior in ASD children and to integrate
them into regular classrooms, it would seem prudent to employ social skills scales that also
have normative data for the general population. These measures might be particularly
valuable in identifying targets for intervention and evaluating treatment outcome.
There has been little effort at developing scales specific to social skills, particularly as
applied to ASD children; the exception is the Matson evaluation of social skills in
youngsters. This scale has been used in many studies and has been used in a range of
childhood populations in many countries. Languages the scale has been translated into
include, Japanese, Spanish, Turkish, Chinese, and Dutch. The scale consists of 64 items
 J.L. Matson, J. Wilkins / Research in Autism Spectrum Disorders 1 (2007) 28–37 35

rated from 1 = not at all to 5 = very much. Areas addressed include conversational skills,
social isolation, and making friends among others. Norms are available for teacher and
self-report forms.
The MESSY has well established norms on regular school children with good reliability
and validity (Matson, Rotatori, et al., 1983). The MESSY has been recommended for ADHD
children, as a means of identifying primary areas for treatment (Gentschel & McLaughlin,
2000), in normative samples in Spain (Mendez, Hidalgo, & Ingles, 2002), for inner-city
children in Spain (Torres, Cardelle-Elawar, Mena, & Sanchez, 2003), for deaf children
(Matson, Macklin, & Helsel, 1985), for visually impaired children (Sharma, Sigafoos, &
Carroll, 2000), and for seriously emotionally disturbed children (Marcenko & Delaney,
2005).
The scale has also been used with autistic children (Matson et al., 1991). In this latter
paper the authors assessed 17 autistic children (mean age 9 years 2 months) and 17
nonautistic controls matched on age, sex, and race with the MESSY. The 64 items on the
scale were read to the parents in an interview format. Items that proved to be particularly
problematic for the autistic children included saying thank you, initiating social
conversation, making eye contact, and smiling at people they know. These data
demonstrate the efficacy of the MESSY with autistic children, and by matching them with
normal same-age peers demonstrate social validation procedures for identifying target
behaviors that warrant intervention. However, as can be seen from this brief review of
checklists, the area has been largely neglected with respect to the ASD population.
Hopefully, these and other measures will warrant greater attention in the future.

5. Conclusions

One must enthusiastically support the development of individual procedures and group
programs to improve social skill deficits and excesses of children with ASD. Having said
that, the field has developed so rapidly and in such an uncoordinated fashion that definitions
of social skills are often quite different from one another. Similarly, while assessment
research is less glamorous than treatment research, it is perhaps more critical at this
juncture. Researchers and clinicians do not know what social skills are commonly most
problematic or which skills are likely to be of the greatest value in promoting ‘‘normal
development’’ and ‘‘normal integration’’ for the child. We would re-emphasize the notion
of behavioral cusps, particularly with respect to Bosch and Fuqua’s (2001) criteria for rank-
ordering the behaviors for intervention that may have the greatest impact on the child.
Obviously, these priorities can vary across age as the child develops, across settings,
situations, or persons with whom the ASD child interacts. All of these areas urgently
warrant further investigation.

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