The Use of Social Stories to

Promote Independent Behaviors

in Novel Events for Children
with PDD-NOS

Michelle L. Ivey, L. Juane Heflin, and Paul Alberto

This study investigated a previously undocumented use for Social Stories (Gray, 1994, ficulty due to inappropriate social behav-
2000): preparation for a novel event. Three children with pervasive developmental ior in these settings (Howlin, 1998). The
disorder—not otherwise specified (PDD-NOS) participated in novel activities within the reliance on routine and ritual may help
routine setting of their weekly speech–language therapy sessions. During intervention, the child with autism exercise some con-
Social Stories written for the novel activities were used to prepare the participants for trol in an environment that is generally
the upcoming events. Independent participation during the novel events was calcu-
overstimulating and unpredictable (Klin-
lated using event recording of the presence of five different skills within each session.
ger & Dawson, 1995; Quill, 1998; Schu-
The effectiveness of the strategy was documented through a withdrawal design with
counterbalanced presentation of novel events. Results indicated that the use of Social ler, 1995).
Stories produced a 15% to 30% increase in participation during novel events for all Children with ASD are a heteroge-
three participants. neous group. They show different
strengths and deficits, and each child has
different needs (Committee on Educa-
tional Interventions, 2001; Quill, 1998).

A
utism spectrum disorder (ASD) is
an umbrella term used to en-
compass pervasive developmen-
tal disorders (Waltz, 1999). The Diag-
nostic and Statistical Manual of Mental
Disorders (DSM-IV-TR; American Psy-
chiatric Association, 2000) defines per-
vasive developmental disorders as exist-
ing in five subcategories, all of which are
diagnosed through qualitative impair-
ments in reciprocal socialization, verbal
and nonverbal communication, and re-
stricted and repetitive behaviors.
Of interest in this study is the diag-
nostic category related to restrictive and
repetitive behaviors. Individuals with
ASD typically exhibit restricted patterns
of behavior (Wing, 2001), which are ev-
idenced by reliance on precise routines,
preoccupation with parts of objects, lim-
ited ranges of interests, and an insistence
on sameness (American Psychiatric Asso-
ciation, 2000). Individuals with ASD may
be observed to be rigid in expectations
for events; they may become anxious
when they are expected to incorporate
change into a routine, and those with
ASD may react negatively to even small
changes in their environment. Such neg-
ative reactions occur on a continuum. At
the mild end of the continuum, a child
with ASD may attempt to manipulate a
situation to fit into an anticipated routine
or show mild distress at having a change
in routine. Severe responses may involve
large-scale reactions that result in physi-
cal stress and aggressive behaviors (Amer-
ican Psychiatric Association, 2000, p. 71;
Howlin, 1998). A child’s resistance and
apprehension may lead to substantial prob-
lems in acquiring new skills that require
change in established routines and to dif-
Because there are a multitude of strate-
gies for addressing the needs of these
children, the following information in
this introduction will review what inves-
tigators currently know regarding affect-
ing change within routines and enhanc-
ing social skills in a variety of situations
for children with ASD. One particular
method, the use of Social Stories, as de-
scribed by Gray (1994, 2000) and Gray
and Garand (1993), will be proposed as
a means of developing flexibility within a
routine, while considering the language
and interactional needs of children with
ASD.
Researchers have considered reliance
on routine characteristic of children with
ASD. Ferrara and Hill (1980) observed
children with autism having more engage-
ment and play in predictable situations
and becoming increasingly withdrawn in

FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES

VOLUME 19, NUMBER 3, FALL 2004
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PAGES 164–176

unpredictable and novel situations. Mc-
Clannahan and Krantz (1999) suggested
building flexibility into a child’s daily rou-
tine by making small, systematic changes
to a detailed picture schedule. They sug-
gest that making changes in the schedule
may require effort at first, but may be-
come increasingly simpler as the child
learns to adapt to new activities within his
or her day.
The introduction of a novel event is
another situation that may alter a rou-
tine. However, no specific research has
been conducted in the area of novel
events in relation to children with ASD
or any disability. There is a small body of
literature investigating novel events for
typically developing children. The re-
search concludes that children’s expecta-
tions during novel events will rely on re-
call of the general information for similar
events and that memory for events is bet-
ter than memory for objects (Fivush,
Hudson, & Nelson, 1984; Jones, Swift,
& Johnson, 1988). Given that individu-
als with ASD have difficulty generalizing
information (Siegel, 1996), the research
conducted with typically developing chil-
dren has limited applicability.
Transitions are another possible form
of novel events. A transition between ac-
tivities is somewhat similar to a change in
routine, because a child has to stop an ac-
tivity and move on to doing something
different. Transitions, however, can be
routine or novel. For example, a routine
transition occurs when a class regularly
goes to music on Thursdays after atten-
dance is taken. A novel transition occurs
when, after attendance on a Thursday,
for example, the class goes into the room
across the hall to watch a video as a spe-
cial event. Several empirical studies re-
garding transitions for children with
ASD give insight into means of prepar-
ing children for novel events within their
routines. Schmit, Alper, Raschke, and
Ryndak (2000) concluded that a combi-
nation of visual and verbal cueing re-
duced the number of tantrums and in-
creased independence in the classroom,
an outcome that transferred to the stu-
dent’s home environment. Other re-
searchers have used picture schedules to
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VOLUME 19, NUMBER 3, FALL 2004
support children with ASD in transition-
ing from one activity to the next within
their environments (MacDuff, Krantz, &
McClannahan, 1993; Schopler, Mesibov,
& Hearsey, 1995). Dettmer, Simpson,
Myles, and Ganz (2000) used a variety of
visual cues, including picture schedules,
visual timers, and a finished box to de-
crease latency and increase independence
during transitions for children with ASD.
Quill (1997) identified several potential
means of supplementing language-based
instruction with visual supports to en-
hance treatment programs for children
with ASD. Furthermore, video priming
was used to prepare children for an up-
coming change in activities. Priming, a
procedure of previewing future events to
make them more predictable, was done
prior to each targeted transition. Results
indicated a decrease in disruptive behav-
ior and some generalization of successful
transitions into other settings (Schreib-
man, Whalen, & Stahmer, 2000).
Social Stories, as described by Gray
(1994, 2000) and Gray and Garand
(1993), have been researched as a visual
and auditory means for introducing en-
vironmental information in a format that
is understandable to an individual with
ASD. Social Stories explain social con-
cepts and situations, describe necessary
components, and suggest expected re-
sponses. The story can be used to answer
questions individuals with ASD do not
ask or do not ask correctly, thereby help-
ing them gain information. Social Stories
are not a form of social skill instruction;
rather, they are a medium for explaining
what is happening and expected within
environmental settings. A byproduct of
better understanding of the environment
is an increase in socially acceptable be-
havior from the individual with ASD.
Gray (1994, 2000) and Gray and
Garand (1993) described the content
and structure of Social Stories. Stories are
individually written to address the needs
of a particular student. Generally, they
are written in first person with present or
future tense verbs. Illustrations, particu-
larly for younger children, may be in-
cluded. However, for some children,
drawings are restrictive and may limit the
165
application of the social skill to only the
situation depicted, because children with
ASD have a tendency to be rigid in their
expectations of events. Some students
will respond to stories written on a single
page, while others may respond to book-
style stories with one concept and a very
general picture or icon on each page. The
story should be able to be generalized to
other similar situations for the targeted
skill or concept. Therefore, using terms
such as usually will allow for some flexi-
bility in the interpretation of the story.
Using words such as always or every may
lead to problems in a situation with an
unanticipated change or an irregular oc-
currence. The story should be as clear
and specific as possible, as in the follow-
ing example: “I sit at my desk until my
work is finished. I know that I am fin-
ished because I have answered all of the
questions on my page.” When writing a
Social Story, the author should not make
assumptions regarding the reader’s pref-
erences or opinions, but the author can
make statements regarding the reactions
and feelings of other people involved in
the story. Gray (1994) recommended
that individuals’ cognitive functioning
levels be at or above the level of moder-
ate intellectual disability when using So-
cial Story techniques. In addition, the
story should be written at an individual’s
comprehension level. Stories can be used
with individuals of a variety of ages.
Social Stories are generally short and
contain four main sentence types, used
most frequently, and two other sentence
types, used less frequently (Gray, 1994,
2000; Gray & Garand, 1993). Descrip-
tive sentences answer the wh questions:
when a situation will occur, what is hap-
pening, why it is happening, and who is
included in the situation. Perspective sen-
tences show the reaction and feelings of
others. Affirmative sentences describe
common associations with a particular
situation. These sentences highlight con-
cepts such as laws and rules, provide re-
assurance, and emphasize important
points. Cooperative sentences describe
the roles of others within a situation. Di-
rective sentences tell the individual what
the desired responses is. Finally, a control
 FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
166
sentence, which is frequently written by
the individual, provides a strategy for re-
calling and using the information in the
Social Story. Because the purpose of the
story is to describe the target situation,
not to direct the child’s behavior (Gray,
1994, 2000), stories generally are written
with a ratio of zero or one directive or
control sentence to every two to five de-
scriptive, perspective, affirmative, or co-
operative sentences. The ratio ensures
the emphasis of the story is on descrip-
tive and assuring qualities, not on direct-
ing or controlling the individual.
Presentation of the story is systematic
and designed to minimize potentially
distracting interactions. The presenter
should sit beside and slightly behind the
student while reading the story. An au-
diocassette or even a video presentation
of the story further reduces person-to-
person interaction. Frequency of reading
and fading the story vary for each child
(Gray, 1994, 2000; Gray & Garand,
1993).
Social Stories are theorized to benefit
students with autism for a variety of rea-
sons. First, they provide access to infor-
mation regarding concepts and social be-
havior, which may be difficult for the
student to obtain otherwise. Second,
they clarify potentially confusing situa-
tions. Third, they have minimal teacher–
student interaction and can be used in-
dependently by students following an
introduction of the story (Gray, 1994;
Gray & Garand, 1993).
Social Stories may serve several pur-
poses within the child’s environment.
Gray (1994) suggested three distinct
purposes for Social Story use: (a) de-
scribing a situation and appropriate be-
haviors, (b) explaining simple, under-
standable steps for certain goals, and
(c) teaching new routines and anticipated
actions. Research has been conducted on
the first two purposes, but not the third.
The study results show at least an emer-
gence of the desired social behavior in
participants with autism or pervasive de-
velopmental disorder—not otherwise
specified (PDD-NOS).
Researchers have successfully used So-
cial Stories to decrease socially unaccept-
able behavior, including tantrums, inap-
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propriate sharing, poor eating manners,
and verbal assaults (Kuoch & Mirenda,
2003; Kuttler, Myles, & Carlson, 1998;
Lorimer, Simpson, Myles, & Ganz,
2002; Norris & Dattilo, 1999). Further-
more, Swaggart et al. (1995) and Rowe
(1999) observed a decrease in undesir-
able behavior, such as shouting and phys-
ical assault, and an increase in desirable
behavior, such as greetings and eating
lunch. Thiemann and Goldstein (2001)
used Social Stories as part of a treatment
package to increase social communica-
tion skills for children with ASD. Finally,
some researchers have used unique ap-
proaches in presentation of Social Stories
to children with autism. Individualized
stories have been presented via computer
program (Hagiwara & Myles, 1999) and
incorporated as lyrics in songs (M.
Brownell, 2002). The researchers found
some increase of skill level for the tar-
geted tasks. Despite considerable meth-
odological concerns, the current research
on Social Stories appears promising.
The research thus far about Social
Stories has focused on describing a situ-
ation and appropriate behaviors, and ex-
plaining simple, understandable steps for
certain goals. To date, none of the stud-
ies have addressed Gray’s (1994) other
suggested use for Social Stories: teaching
or preparing for a novel event. The chal-
lenge in conducting such research is that
once an event is experienced for baseline
purposes, it is no longer novel for inves-
tigation of the treatment. Previous re-
search on novel events with typically de-
veloping children (Fivush et al., 1994;
Jones et al., 1988) used analysis of sur-
vey responses following the novel events
to determine participants’ memory and
coding of events without application of
empirical designs. The current study
used a variety of novel events, grouped
into distinct categories. The categories
are repeated in the various phases. Due
to the characteristic difficulty with gen-
eralization exhibited by children with
ASD (Quill, 2000; Siegel, 1996), the
repetition of the category of event did
not necessarily prohibit novelty of each
individual activity. The purpose of this
study was to determine if the use of a So-
cial Story prior to a novel event within a
routine setting would lead to indepen-
dent behavior during the actual event for
children with ASD.
Method
Participants
Participants in the study were three boys
with a diagnosis of PDD-NOS. Diag-
noses were made by an independent psy-
chologist, developmental pediatrician, or
neurologist. According to Gray (1994),
individuals using Social Stories should
have intellectual abilities of moderate im-
pairment or better, as determined by IQ
scores greater than 55. Only one of the
participants had been given an IQ test.
Other test results, which were provided
by the parents or acquired by the first au-
thor, are presented here to help illustrate
the participants’ current levels of func-
tioning. The children’s ages ranged from
5 to 7 years old. The first author was fa-
miliar to the participants because she was
their speech–language pathologist, and
the children attended weekly therapy ses-
sions with her. These three participants
represent all of the children on the first
author’s caseload at the inception of the
study who were similar in language func-
tioning and had histories of difficulty
adapting to novel situations.
Ron. Ron, a Caucasian boy, was 7
years 5 months old at the initiation of the
study. He participated in partial integra-
tion and partial special education in his
public school program. His academic
work was based in a first-grade curricu-
lum. He was reading and spelling at age-
expected levels, but he disliked fine-
motor tasks such as writing. Ron had
difficulty with concepts such as relative
size and quantity, which led to difficulty
with mathematics. Ron was competent in
a variety of self-help skills, such as inde-
pendent dressing, toileting, and feeding.
He was able to participate in structured
and unstructured play.
Ron’s receptive and expressive vocab-
ularies were within normal limits for his
age. He used appropriate grammatical
structures. On the Test of Language

Development–Primary (Newcomer &
Hammill, 1997), Ron received a Spoken
Language Quotient of 91 (M = 100 ±
15). Ron had difficulty with figurative
language, making inferences, and consid-
ering multiple meanings of words. On the
Test of Language Competence–Expanded
Edition (Wiig & Secord, 1989), Ron’s
overall composite score was 75 (M = 100
± 15). On the Test of Auditory-Perceptual
Skills–Revised (Gardner, 1997), Ron re-
ceived an overall Auditory Processing
standard score of 80 (M = 100 ± 15).
Ron had poor conversational skills as ev-
idenced by inappropriate topic changes
and insertions, decreased elaboration,
and poor initiation. He used a visual
schedule within his speech–language
pathology sessions.
Ron lived in a two-parent, upper mid-
dle class home. Both of his parents had
earned bachelor’s degrees, and he had
two brothers, one older and one
younger. He was on a gluten- and casein-
free diet throughout the entire interven-
tion.
Adam. Adam, a Caucasian male, was
age 5 years, 1 month when the interven-
tion began. Adam attended a special
needs preschool program through the
public schools. He exhibited prereading
skills in the areas of letter and sound
recognition. He did not yet rhyme. On
the Wechsler Preschool Primary Scale of
Intelligence–Third Edition (Wechsler,
2002), he received a Verbal Score of 90,
Performance Score of 97, and a Full
Scale Score of 92 (M = 100 ± 15). How-
ever, on the Vineland Adaptive Behavior
Scales (Sparrow, Balla, & Cicchetti,
1985), he exhibited relatively lower
scores in adaptive living skills (Compos-
ite Score 68, M = 100 ± 15). He had
deficits in pragmatic communication,
toileting, shoe tying, interpersonal inter-
actions and awareness, and sensory inte-
gration, and had low muscle tone.
Adam presented with a mild receptive
language disorder. He had difficulties
understanding complex information and
inferring from contextual cues. Adam
had greater difficulty with expressive lan-
guage. He was able to answer questions
appropriately; however, he did not elab-
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VOLUME 19, NUMBER 3, FALL 2004
orate. He used limited spontaneous com-
ments. Adam would ask for permission
and for objects, but did not inquire
about the state or needs of others. He
was not able to tell a sequenced story. On
the Test of Early Language Development–
Third Edition (Hresko, Reid, & Ham-
mill, 1999), he received a Spoken Lan-
guage Quotient of 91 (M = 100 ± 15).
On the Bracken Basic Concept Scale–
Revised (Bracken, 1998), he received a
classification of Average in all areas ex-
cept Time/Sequence. On the Expressive
One-Word Picture Vocabulary Test (R.
Brownell, 2000), he received a standard
score of 103 (M = 100 ± 15).
Adam lived in a two-parent, upper
middle class family. His mother had com-
pleted two years of college; his father had
an advanced degree. He had one older
brother. Throughout the study, Adam
participated in the Samonas (Spectral Ac-
tivated Music of Optimal Natural Struc-
ture; Steinbach, 1994) listening program
under the supervision of an occupational
therapist.
Hal. Hal, an African American boy,
was 5 years 8 months old when the study
began. He participated in an integrated
kindergarten class with special education
supports throughout the week. Hal was
independent in self-help skills. He was
reading beginning sight words and en-
joyed writing and drawing. There were
no academic or psychological test results
available for Hal.
Hal had a mild to moderate language
disorder. His receptive language deficits
included difficulty processing complex
information and understanding temporal
concepts. He used delayed echolalia as a
way to express his thoughts or comment
on something familiar in his environ-
ment. Hal rarely elaborated on a topic
within a conversational setting, and
requested desired objects, but not infor-
mation, from others. Hal did not com-
plete the Clinical Evaluation of Lan-
guage Fundamentals–Preschool (Wiig,
Secord, & Semel, 1992) during an an-
nual assessment of his language. He re-
ceived scores within normal range on the
Basic Concepts and Formulating Labels
subtests. He had scores below normal
167
range on the Linguistic Concepts, Sen-
tence Structure, Recalling Sentences in
Context, and Word Structure subtests.
On the Expressive One-Word Picture Vo-
cabulary Test, he received a standard
score of 93. Finally, on the Test for Au-
ditory Comprehension of Language–
Third Edition (Carrow-Woolfolk, 1999),
he received a quotient of 85 (M = 100 ±
15).
Hal lived in a two-parent home in an
upper middle class area. His mother had
a bachelor’s degree; his father had an ad-
vanced degree. He did not have any sib-
lings. Hal responded well to structured
environmental supports such as visual
schedules and markers to indicate when
he completed an activity.
Prior to selection for the study, parents
were asked to rate their children on a
five-point scale on resistance to change
within routine events, the existence of
problems generated by the resistance,
and anticipated difficulty in their ability
to implement the procedure. Parents
confirmed that their children experi-
enced difficulty with change in routine
situations. On a scale of 1 (nonexistent)
to 5 ( frequent), two parents indicated
that their child’s level of resistance to
change was a 4. The third parent rated
her son at 5. When asked to rate the ex-
tent of problems that the resistance to
novelty created in daily functioning, two
parents said 5 and one said 4. Parents re-
ported observing difficulties such as
tantrums (including screaming, crying,
and hitting), resistance to going some-
where new (saying “No, no!,” not mov-
ing, or pulling away from the adult), anx-
ious or apprehensive body language, and
use of echolalic or rehearsed comfort
phrases.
Setting
Although settings varied across the dif-
ferent novel events targeted at a given
session, all activities occurred on the
campus of a children’s hospital in a met-
ropolitan area. Activities that did not in-
volve making a purchase or a novel set-
ting were conducted in the first author’s
treatment room in an outpatient speech–
language pathology clinic on the hospital
 FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
168
campus. This was the typical location for
the children’s therapy sessions. The chil-
dren were familiar with and comfortable
in this room. There were generally two
sessions per 1-hour therapy appointment.
Design
A reversal (ABAB) design (Alberto &
Troutman, 2003) was used to analyze
participants’ participation in the novel
events without Social Stories (baseline)
and with Social Stories (intervention).
Within each phase, four types of novel
events were targeted: setting changes,
novel toys presented by an unfamiliar
person, purchases, and novel activities
occurring within the session. These clas-
sifications of events were chosen because
they represent several skills that children
encounter as part of home, school, and
community life. The order of activities
within the events was counterbalanced
for each participant.
Some of the novel settings included
leaving the therapy room and going to a
fish pond on the hospital campus, and
going to the top floor of the parking deck
to see the view. The novel toys were all
recently purchased and had multiple
steps for assembly and use. The first au-
thor confirmed with the parents that
their child had not played with the toy
previously. The directions for using the
novel toys were presented by an unfamil-
iar person because the participants were
accustomed to listening to directions
from the first author. Examples of pur-
chase locations included a gift store and
a convenience store, both in the hospital
Examples of Target Skills for Each Novel Event Category
Skill Setting change
Example Memorial fountain
Attention Remain on task
Key Task 1 Comment
Key Task 2 Read a sign
Vocabulary Memorial
Request Directions
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complex. Finally, the novel activities con-
sisted of experiences within the therapy
sessions that were quite different from
typical events, including having a birth-
day celebration and making a video.
There were four different activities in
each event classification, for a total of 16
novel events.
The event categories and activities
were designed to be generally similar in
complexity, duration, and functionality
to allow for comparison of all sessions
and phases. Barlow and Hersen (1973)
supported similar phase lengths to ensure
that observed changes are due to the im-
plementation of a treatment variable.
The specific activities were counterbal-
anced across phases and participants. In-
dividuals with ASD frequently have dif-
ficulty with generalization (Quill, 2000;
Siegel, 1996). Therefore, the children
were not expected to have mastery of the
various skills that were repeated in all of
the novel contexts.
Data Collection
Five behaviors in four categories were
targeted for each of the novel routines.
Data on the occurrence or nonoccur-
rence of specific behaviors were collected
during all target sessions via event
recording on a checklist. The four be-
havior categories were chosen for the fol-
lowing reasons: (a) they represent what is
observed when a child is participating in
an event, (b) they are common deficits
for children with ASD, (c) they could be
observed in all of the activities, and
(d) they reflect skills frequently targeted
TABLE 1
Purchase
Fund-raiser purchase
Remain on task
Choose a snack
Give money
Delicious
Ask what adult wants
within a speech–language pathology ses-
sion. Table 1 contains a list of the specific
target skills by task classification and an
example for each task.
Five skills were targeted in each ses-
sion, resulting in a possibility of a child
receiving five points per session (one
point per skill). A child received credit for
using the skill if he completed it inde-
pendently or with one prompt. The ex-
ception to this criterion was the skill of
remaining on task. Due to the age of the
children, a child received credit for re-
maining on task if he received two or
fewer prompts to remain on task. All of
the necessary skills and vocabulary, with
the exception of remaining on task, were
addressed explicitly in Social Stories and
then reiterated in vivo within the ses-
sions.
On-task behavior was observed when
the child was engaged in an activity re-
lated to the task, a discussion regarding
the task, or a social discussion with an-
other person during extended transition
times such as walking to a location or
waiting for the next step. Individual
novel events lasted at least 10 minutes.
Data for on-task behavior were collected
during the first 10 minutes of the event
if it lasted longer than the targeted time.
Two prompts were allowed for on-task
because this was deemed typical accord-
ing to the children’s ages.
Two key tasks were identified for each
activity. They generally required using
necessary materials, following directions
to continue the activity, or following the
rules of a game. The child was requested
to do tasks by the adult leading the in-
Novel toy Novel event
Kerplunk Make a video
Remain on task Remain on task
Push sticks through tube Follow a script
Twist the tube Say, “cut”
Kerplunk Rehearsal
Marbles Ask how to turn camera on

teraction, who was either an unfamiliar
person (novel toy sessions) or the first au-
thor (all other sessions). For example,
when looking at a fountain in the novel
setting situation, the child was asked to
“read” a sign for important information.
In the cafeteria for the purchase situa-
tion, the child was instructed to give
money to the cashier. A child was given
credit for using the targeted key skill if it
was performed independently or with
minimal assistance. Minimal assistance
was defined as cueing by gesture, model-
ing the behavior, or indirectly referenc-
ing the necessary behavior. A key task was
scored as not occurring if partial or full
physical assistance was needed, or if the
child had the target skill done for him.
The target vocabulary word for each
session was modeled at least five times in
the natural context of the event for all
baseline and intervention phases. The
target word was also used and defined in
each of the Social Stories. To receive
credit for the vocabulary skill, the child
had to use the target word appropriately
in the context of the event. Immediate
echolalia, without regard to context, did
not count as using the target word.
Finally, during each session necessary
information or a necessary item was
withheld from the child to determine if
he would make a request. The child was
cued that an item or information was
necessary, but was not explicitly told to
request it. For example, in the cafeteria,
the adult said that she was hungry for a
snack. The child was expected to request
information to learn what she wanted to
eat. During the novel games, essential
pieces from the toys were withheld. The
child was expected to inquire about the
missing pieces. When making a video,
the child was told to turn on the camera,
but not told how to do so. Strategies for
successfully completing the requests
were provided in the Social Stories. The
stories contained phrasing that suggested
the children could ask for help if they
needed information or assistance. To be
scored as occurring, the child was ex-
pected to request the item or informa-
tion to continue the event. A child was
given credit for requesting materials or
assistance if he made the request inde-
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VOLUME 19, NUMBER 3, FALL 2004
pendently or with minimal assistance.
Minimal assistance was defined as one
rephrasing of the stimulus cue that an
item or material was necessary.
As dependent variables, the five be-
haviors were clearly defined and objec-
tively observed. Therefore, it was appro-
priate for the first author to collect the
data, although she was not blind to the
purpose of the study.
Interobserver Reliability
The second author collected interob-
server reliability data on the five behav-
iors for 20% of the sessions across all
phases. These sessions were videotaped
and the second observer was able to view
them independently. The video camera
was placed in an inconspicuous place
within the treatment room of the first au-
thor or in an observation room with a
speaker behind one-way glass. Partici-
pants were not aware of the video process
although parents had provided consent
for the taping. The videotapes were
erased following the interobserver relia-
bility procedure. The second observer
was trained in the operational definitions
and use of the data collection form. In-
terobserver reliability was determined by
calculating the scores for each target ses-
sion and counting the number of agree-
ments between the two observers divided
by the number of agreements plus dis-
agreements multiplied by 100. Mean in-
terobserver reliability across all phases
was 89%.
Materials
Following Gray (1994) and Gray and
Garand’s (1993) criteria, the first author
wrote a Social Story for each of the novel
routines used in the study. The first and
second author collaborated on the revi-
sions for the final stories. In addition, a
third person, also familiar with Social
Stories, read 11 of the 16 of the stories
(69%) before they were used in the in-
tervention. The third reader agreed that
the stories adequately explained the
novel events, were written with a reas-
suring quality, and contained the proper
sentence-type ratio. Therefore, the re-
169
sulting stories met the requirements of
face validity.
The actual storybooks were made on
black 81⁄2" × 11" construction paper,
folded in half horizontally. The text was
printed on white paper in 16-point Arial
and mounted on the upper half of the
page. Digital photographs of key infor-
mation and black-and-white line draw-
ings, using the Boardmaker software
(King, 1995), of general information were
placed on the lower half of each page.
For example, there were photos of the
toys and their pieces, the various settings,
such as the gift shop, and the pillows
where the children were asked to sit to
watch their videos. Icons were used in-
stead of pictures for any illustrations in
which the person or purchase item could
change (such as a cashier). Icons were
also used instead of pictures for nonspe-
cific concepts such as filthy and sorting.
Generally there was one picture per page,
but some pages had more than one illus-
tration to help clarify the text. The sto-
ries were laminated then folded together
and secured with pipe cleaners running
through the middle of the book. All
three children used the same set of
books. As an example, the text of the
story for the birthday party is presented
in Figure 1.
Procedure
Approximately 1 week prior to the actual
event, the first author met individually
with one parent of each child for train-
ing. Parent training included an intro-
duction or review of Social Story theory
and instructions on presenting the Social
Story. The parents had varying degrees of
prior knowledge of Social Stories; there-
fore, the content of the introduction was
controlled with a training checklist. The
use of the checklist assured that all of the
necessary information was reviewed with
each parent. A copy of the checklist is in-
cluded as Appendix A. The parents were
provided with phone numbers to contact
the first author with any questions re-
garding presentation of the Social Sto-
ries.
During intervention phases, each
week parents were given two Social Story
 FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
170

The next time I go to see Michelle, it will be a very special day. It will be Michelle’s birthday. Everyone has a birthday one time a year.
Usually people like to have a party to celebrate. We will have a party for Michelle’s birthday.

To get ready for the party, we will decorate the room. We will tape streamers on the table. Streamers are long papers that have pretty
colors and hang down toward the floor. We might have a balloon at Michelle’s party. We can tape the balloon to the table by the long
streamers.

Next we will decorate Michelle’s cake. The cake will already be made. We’ll decorate it using frosting and sprinkles. We can use the
frosting to write her name, initials, or just “happy birthday” on the cake. We can use sprinkles to put pretty colors on the cake.

Next we need to set the table for eating the cake and drinking juice. We will need a plate, cup, and napkin for each person at the
party. There will be only two people at Michelle’s party, Michelle and me. I can put a plate, cup, and napkin on the table for each of us.

After the table is set, it will be time for the party. Michelle will sing “Happy Birthday.” Then Michelle will cut the cake, and we can eat
and drink. We can talk about the party while we’re eating and drinking.

We will have fun until the party is over. I will take the long streamers off of the table and put them in a bag. Then we will clean up
everything else. It will be time to do something else.

FIGURE 1. Full text of the birthday party Social Story, separated by pages. Key tasks included setting plates on the table and
decorating the cake. The vocabulary word was streamers. The boys needed to request tape.

books for the following week’s target ac-
tivities. Parents were instructed to intro-
duce the stories and read them to their
child one time per day for 5 days prior to
the events. Parents were responsible for
choosing a time of day when the child
was calm and receptive to listening to a
story. None of the children had sufficient
skills for independent story reading. The
parents were instructed to answer any
questions the children asked sponta-
neously. Parents were provided with a
record form to document the reading
times, questions, and responses. Parents
were asked to keep the stories available to
the child throughout the day. Finally,
parents read the Social Stories to their
child just prior to going to therapy.
On the days of the sessions, the par-
ticipants worked on specific speech–
language pathology activities as always;
however, there were one or two novel
events in the therapy time. There was a
period of familiar activity between two
target activities, allowing the child to
relax, if necessary. During target activi-
ties, the first author used event-recording
data collection based on a predetermined
checklist of target behaviors. Start times
and specific target skills that had been
previously operationally defined were on
the data recording page. Skills were
scored as 0 (if not demonstrated) or 1 (if
demonstrated according to criteria).
The investigation lasted for 12 weeks
for Adam and Hal and 11 weeks for Ron,
due to absences. The only change in the
procedure occurred during the cafeteria
trip for Ron. The cafeteria was closed at
the time of the session; therefore, mak-
ing a purchase was not possible. A vend-
ing machine area was substituted for the
cafeteria. Ron spontaneously used the
target vocabulary word, cashier, when he
asked, “Will there be a cashier at the
vending machine?” Inserting money into
the machine was substituted for giving it
to a cashier; the rest of the activity was
completed as designed.
Treatment Fidelity
Treatment fidelity was maintained
throughout the intervention. All of the
target skills were predetermined and
maintained on a list. This list was used as
a reference prior to each session and tar-
get skills were transferred to the data col-
lection form. Operational definitions for
each skill were created and reviewed fre-
quently to determine occurrence or non-
occurrence of a given skill. For consis-
tency, the examiner modeled the target
vocabulary word at least five times per ac-
tivity for sessions with and without Social
Stories. This was tallied on the data col-
lection form. Start times were also noted
on the data collection form so that tim-
ing for attention was consistently main-
tained for 10 minutes. Finally, parents
were provided with a daily checklist to
use at home to document when they read
the stories to their child. There was space
on the parent form for writing questions
or comments that they or the child had
during the reading.
Results
Figure 2 depicts the boys’ participation
in the various novel events introduced
during the routine speech–language
therapy sessions. Each phase consisted of
four sessions, which are represented on
the horizontal axis. Below the session
number is a letter indicating the type of
novel event. The vertical axis indicates
the number of participation skills the
boys used within each activity. The max-
imum number of participation skills for
each session was five.
During the initial baseline phase, Ron
exhibited a mean of 2.75 points out of
a possible 5.0 points (55%). In the first
Social Story intervention phase, Ron’s
mean number of observed participation
skills increased to 4.25 (85%), a 30% in-
crease in the number of skills observed
with Social Story preparation. In the with-
drawal (second baseline) phase, Ron’s
mean number of skills returned to the

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 171

FIGURE 2. Number of targeted skills observed during therapy activities without and with
Social Story preparation. The type of activity is coded as follows: S = setting change, P =
purchase activity, T = novel toy, E = novel event.

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 FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
172
preintervention level of 2.75 (55%), a
30% decline. The second introduction of
Social Stories again increased his use of
targeted skills. His mean score was 4.25
out of 5.0 points (85%), again a 30% in-
crease with Social Stories.
Adam initially had a mean of 2.75
points out of 5.0 possible points (55%).
His scores increased 30% to 4.25 (85%)
with the addition of Social Stories.
Adam’s mean score decreased by 35% to
2.5 (50%) when the stories were re-
moved. With the reintroduction, his
mean increased to 4.0 (80%), a gain of
30% with the Social Stories.
During the initial baseline phase, Hal
exhibited a mean of 2.25 points of the
possible 5.0 points (45%). His perfor-
mance increased to 3.0 (60%) with the
introduction of Social Stories, a 15% im-
provement. Hal’s participation decreased
10% to 2.0 (40%), when the stories were
withdrawn. Finally, Hal had a mean of
3.5 points (70%) during the second in-
tervention phase, a 20% increase from
the withdrawal condition.
All three boys evidenced an improve-
ment in the percentage of participation
skills observed from the baseline through
the initial Social Story phase. The range
of increase was from 15% to 30%. Subse-
quently, all three evidenced a decrease in
the percentage of skills observed when
the Social Story intervention was discon-
tinued. The range of decrease was be-
tween 10% and 35%. Finally, all three
participants evidenced an increase in the
mean percentage of skills observed with
the reintroduction of Social Story prepa-
ration. These data demonstrate a func-
tional relationship between use of Social
Stories and subsequent increases in par-
ticipation for novel situations in a famil-
iar environment.
Social Validity
Harris (1994) explained that “people
with autism need to learn to tolerate
change if they are to function effectively
in the world, and learning to manage the
stress of change is therefore an important
lesson in childhood” (p. 84). Prizant,
Wetherby, and Rydell (2000) stated,
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Of primary importance is teaching the
child with ASD how and when to use their
communication and interaction skills by
reading and understanding social rules and
conventions, as well as by following the
rules of social communication and play
schemes inherent in play interactions.
(p. 215)
The use of Social Stories to assist in es-
tablishing new routines and changes in
routine addresses both of these areas.
The technique provided support for un-
derstanding, accepting, and working in a
changed environment.
Following the intervention, parents
were asked to complete a social validity
instrument (Appendix B). Results were
used to establish information regarding
ease of presentation of the Social Stories,
likeliness of using the intervention in
novel routines, and parents’ perceived ef-
ficacy of the intervention. Two of the
parents indicated that they felt the Social
Stories were highly effective and applica-
ble to a variety of situations. They also
agreed that the stories would have lasting
improvements in their children’s func-
tioning. These two parents reported that
they were already using the stories in
other situations. Both parents sponta-
neously commented that they noticed
that their sons exhibited decreased anxi-
ety and disruptive behaviors with the use
of Social Stories. The other parent felt
the stories were quite effective and highly
useful in a variety of situations. She be-
lieved, however, that there would be only
a fair amount of lasting change and that
the strategy might not be as effective in
the home. This third parent did not at-
tempt to use Social Stories indepen-
dently. The presence of two enthusiastic
parents and one more reticent parent is
substantiated by Smith (2001), who re-
ported that a majority of people who im-
plemented Social Stories with children
and adolescents with ASD and other dis-
abilities found the stories to be beneficial,
easy to use, and pleasurable.
After the study concluded, each child
was asked if he liked reading the books,
if the books helped him to play the games
and do activities, and if he would like to
read the stories again. Ron indicated that
he liked the books and would read them
again. He also said they did help him play
games. When asked to tell the evaluator
about the books, he reported, “They
were great. I want some more books.”
Ron’s mother reported that Ron asked
for stories to help with other recent so-
cial situations at home.
Adam gave an emphatic “yes” when
asked if he liked the books. He agreed
that they helped him play games and do
activities, and that he would like to read
them again sometime. He did not have
any further comments regarding Social
Stories.
Hal also agreed that he liked the books
and would like to read them again some-
day. He did not respond to the question
about whether the books helped him
play games. Hal’s mother observed that
he attended to these books more than
regular books, possibly because they per-
tained directly to him. Hal’s mother also
observed an increase in Hal’s anticipa-
tion and excitement when he was getting
ready for therapy sessions.
Discussion
The purpose of this study was to investi-
gate the extent to which participation in
novel situations within familiar routines
increased with the use of Social Stories
for three boys with ASD. All three boys
evidenced an increase in targeted partic-
ipation skills when they were prepared
for the novel events with Social Stories.
The range of the increase was between
15% and 30% from baseline measures.
The results of this study confirm the
benefit of using Social Stories with chil-
dren with ASD as reported by others
(Dettmer et al., 2000; Hagiwara & Myles,
1999; Kuoch & Mirenda, 2003; Kuttler
et al., 1998; Norris & Dattilo, 1999; Rowe,
1999; Swaggart et al., 1995). In addi-
tion, these results extend current knowl-
edge because they confirm the benefit of
including Social Stories in preparation
for a novel event. This study also differed
from many of the previous studies in that
photographs of the specific aspects of
each event were included in the stories.
This was done to help make the novel as-
pects of each event more familiar.

The functional relationship between
Social Story preparation and increased
participation in novel activities may be
due to the decrease in the novelty of the
actual events. With prior preparation and
introduction to the activity, materials, vo-
cabulary, and expectations, the children
in the study were able to focus more on
participating in the event and less on
comprehending and processing new in-
formation. This directly relates to Gray’s
(1994) description of Social Stories as a
means for the individual to understand
social situations and expected responses.
In addition, the current results are simi-
lar to those of Ferrara and Hill (1980),
who found increases in engagement and
play within familiar environments.
Although the boys made substantial
gains in participation with the introduc-
tion of Social Stories, there were still er-
rors or omission of skills. During the
intervention phases, the most frequent
errors were decreased attention and a
failure to ask for information, particularly
failing to ask what the first author wanted
to eat in the purchase situation. Atten-
tion to task is generally a deficit area for
children with ASD (Quill, 2000). At-
tending to the activity was not explicitly
mentioned in the text of the stories as
other target skills were. Rather it was an
anticipated outcome of increased prepa-
ration. Although decreased attention was
a frequent error type, overall demonstra-
tion of the skill across participants was
better with than without Social Stories.
Overall, there was no credit given for the
key task of attention in only 6 of the total
sessions with Social Stories as compared
to 10 of the sessions without stories, a
40% increase in participant attention with
Social Stories. During purchasing ses-
sions, requesting information errors were
observed with all three children. During
many of the trials, the boys offered the
researcher something that they chose.
When this item was refused, the child got
another item and offered it. This was a
consistent strategy for all three partici-
pants. Therefore, requesting another’s
preference may be a skill that needs to be
taught with focused intervention tech-
niques, rather than indirectly in the So-
cial Story.
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VOLUME 19, NUMBER 3, FALL 2004
Reading Social Stories daily for 5 days
prior to introducing a novel event al-
lowed the children opportunities to com-
ment or ask questions regarding the
upcoming event. The parents recorded
several questions the children asked dur-
ing the readings, such as “Can I say,
‘Cut’?” and “What are streamers?” The
parents recorded their children’s com-
ments that they were excited about the
upcoming session (e.g., “Tomorrow I
can go to Michelle’s!”). They indicated
that they liked the stories (e.g., “That
was a good story.” “I want to read the
books, Mommy.”). They commented
about the content of the stories (e.g., “I
think the frogs are pretend.” “The stairs
won’t scare you.”). Finally, one partici-
pant encountered a story about an activ-
ity that he did not want to do. When
reading the story about previewing and
watching the video, Hal told his mother,
“I don’t love it. I don’t like a preview. I
want to play Mr. Potato Head.” Creating
this forum for interaction and discussion
between a child with ASD and his parent
is an important goal in communication
therapy. Discussing the concepts of fu-
ture events and time sequences in a func-
tional format is also beneficial. The va-
riety and extent of these child–parent
interactions are exciting byproducts of
this intervention.
The effectiveness of Social Story use in
novel routines for children with ASD is
beneficial for generalization to many
events and situations. This method could
be generalized to school field trips, test-
ing schedules, or fire drills. It could apply
at home to babysitters or weekend plans.
In the community, stories may help with
change from routine expectations. The
use of the stories allows the children with
ASD increased opportunity for participa-
tion, learning, enjoyment, and interac-
tions.
Limitations
There were limitations in this study that
should be addressed. First, as previously
mentioned, using novel events in re-
search created a dilemma in designing
this study. The events that were used were
novel to the speech–language pathology
173
session setting; they were not necessarily
novel to the individual child. Although
the activities were designed to be similar,
if a child had a prior experience with the
event, it may have affected his perfor-
mance. The creation of four activities per
category of novel event, the creation of
discrete expectations within the event,
and the use of a counterbalanced design
helped to control for prior experience.
When investigating a truly novel event,
such as an airplane ride or attending a
theater performance, there could be no
baseline data for comparison.
Another limitation was the predeter-
mined number of sessions per phase,
rather than allowing data to reach levels
of stability before moving to the next
phase. This was done for two reasons:
(a) because children with ASD frequently
have scattered performance, stability
could be difficult to obtain, and (b) the
arrangement allowed for representation
of each type of activity in each phase.
However, the limited number of sessions
may have restricted the natural path of
the results.
The next limitation is the small num-
ber of targeted skills available for analysis
in each session. To keep the various ses-
sions as homogenous as possible, a lim-
ited number of skills were targeted in
each. The children actually participated
in many more aspects of the activities
than were charted on the data forms.
Finally the use of an ABAB design
could have resulted in some carryover
effect as was observed in the work by
Kuoch and Mirenda (2003). To help
control for carryover, none of the actual
activities were repeated for any one par-
ticipant. Although there were only four
classifications of activities, there were
four distinctly different activities within
each classification. In addition, any carry-
over effect was not substantial, because
all three participants dropped to near-
baseline levels during the second baseline
phase.
Future Investigations
The benefits of Social Stories are becom-
ing increasingly evident. The addition of
this information regarding using Social
 FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
174
Stories in novel events within familiar set-
tings is the beginning of another path of
investigation. As previously mentioned,
further research could investigate the
benefits of Social Stories in truly novel
situations. In addition, reading the story
for 5 days before the event was an ar-
bitrary number. Reading the story just
prior to the event is customary. Further
investigation may consider the optimum
amount of time a Social Story is needed
prior to a novel experience. This study
was completed with only three partici-
pants. Replication with more participants
and participants with different skill levels
will be beneficial in understanding the
best use of Social Stories in novel events.
Finally, empirical research needs to be
done to explore whether preparation for
a specific novel event supports general-
ization to other novel events, similar and
dissimilar.
ABOUT THE AUTHORS
Michelle L. Ivey, MA, CCC-SLP, is a speech–
language pathologist and current doctoral stu-
dent in special education. Her interests include
improving language and social communica-
tion, especially for children with autism spec-
trum disorders. L. Juane Heflin, PhD, is an
associate professor who coordinates the personnel
preparation program at Georgia State Univer-
sity that emphasizes autism spectrum disorders.
Paul Alberto, PhD, is a professor of special ed-
ucation at Georgia State University. His cur-
rent interests include community intensive
instruction and literacy for students with mod-
erate and severe disabilities. Address: Michelle
L. Ivey, Georgia State University, Educational
Psychology and Special Education, MSC
6A0820, 33 Gilmer St., Atlanta, GA 30303-
3086.
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APPENDIX A
Parent Training Checklist

Parent Name Date

Theory
1. Social Stories help the child understand why.
2. Social Stories answer questions the children don’t ask or don’t ask well.
3. The purpose is to describe, not direct.
4. Suggested uses for Social Stories include describing expected behavior, preparing for a novel event, and preparing for a new
routine.
5. Goal of the project is to see an increase in participation in a novel routine when the child has the benefit of the Social Story.
Also hoping for a decrease in resistance to change.

Procedure
1. I will make the books for the study.
2. Parent to read the story starting in 2 days (________), so it begins 5 days before the next therapy session.
3. Read the story daily at a time when child is able to attend to a story.
4. Answer any questions the child asks and record the question on the record.
5. Check the record page each day after you read the story.
6. Read it one more time just before coming to therapy.
7. Return the record page to me at the next session.

Comments and questions:

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176

APPENDIX B
Social Validity Instrument

Please read each item carefully and circle the number that best describes your response. Use the following scale to determine
how each statement reflects your opinion.
1 2 3 4 5
Not at all Just a little Somewhat Quite a bit Exactly

1. I believe Social Stories are useful for my child.

1 2 3 4 5
2. This intervention would be appropriate for a variety of situations.
1 2 3 4 5
3. This intervention would produce a lasting improvement in my child’s functioning.
1 2 3 4 5
4. I am likely to use this intervention again.
1 2 3 4 5
5. I would suggest this intervention to others.
1 2 3 4 5

Please write any comments that you have on the use of Social Stories.

Thank you for your time and participation in this project.

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