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«The Effects of Creative Drama-Based Intervention for Children with Deficits in Social Perception Committee: Margaret Semrud-Clikeman, Supervisor ...»

-- [ Page 1 ] --

Copyright

by

Laura Ann Guli

2004

The Dissertation Committee for Laura Ann Guli

certifies that this is the approved version of the following dissertation:

The Effects of Creative Drama-Based Intervention

for Children with Deficits in Social Perception

Committee:

________________________________

Margaret Semrud-Clikeman, Supervisor

________________________________

Cindy I. Carlson

________________________________

Gary Borich ________________________________

Sharon Grady ________________________________

Frank Richardson The Effects of Creative Drama-Based Intervention for Children with Deficits in Social Perception by Laura Ann Guli, B.A., M.A.

Dissertation Presented to the Faculty of the Graduate School of The University of Texas at Austin in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy The University of Texas at Austin December, 2004 Dedication This is dedicated to my parents Diana Mercedes Martinez Guli and Salvatore Dominick Guli With eloquent example, you taught me that in our lives it’s not speed, or skill, that matters.

It’s determination.

Acknowledgements I would like to express great thanks to my supervisor, Dr. Margaret Semrud- Clikeman, for all of her encouragement, teaching and support over the last seven years.

Peg, I will miss learning from you, laughing with you and cornering you in your office at unexpected moments with questions (i.e., where is the picture of my brain?) I would also like to express my thanks to my committee members, Dr. Cindy Carlson, Dr. Gary Borich, Dr. Sharon Grady and Dr. Frank Richardson, for contributing their time, expertise and support to this process.

I also thank my fellow graduate students, particularly Jenifer Walkoviak, Alison Wilkinson and Kimberly Glass, for their major contributions to this project. Great thanks also to all the group leaders and observers who helped run the program and collect data, including Aimee Gerrard, Mike Graves, Alexandra Kutz, Cress Suess, Elizabeth Portman, Reshma Naidoo, Sarah Schloeneban and Bill Jarrold. Thanks also to Teresa, for her endless help and patience in scheduling rooms necessary for the project and helping dealing with crowd control in the School Psychology suite.

Thanks, Mom and Dad, for providing the encouragement and financial support to get this degree completed. Special thanks also to my honey Brit, who lived with not only me but the dissertation through our many growing periods. Brit, you have been a continually loving and supportive influence throughout this process (even when I made you turn off the video games!) I would also like to thank Delane, Jim and Ken, my internship supervisors at Salesmanship Club Youth and Family Centers, for giving me the impetus to get this project done. My experience at Salesmanship Club inspired me to get out into the field again with children as soon as possible.

Finally, I thank the parents and children who volunteered many afternoons and precious Saturdays to participate in this project. Without question, you are the reason for increased knowledge and progress in this field. I will long remember your faith in the project, your tenacity in the face of difficulty, and your unique gifts.

–  –  –

This study explored the effects of the Social Competence Intervention Program, a unique intervention based on creative drama. Unlike traditional social skills interventions, this program specifically addressed the needs of children with social perception deficits. The sample included children with diagnoses of Nonverbal Learning Disabilities (NVLD), Asperger Syndrome, high functioning autism (HFA) and Attention Deficit Hyperactivity Disorder (ADHD). Participants were compared to nonparticipants on various measures of social perception and social competence, including the Diagnostic Analysis of Nonverbal Accuracy (DANVA2) child faces and paralanguage subtests, the BASC parent questionnaire withdrawal and social skills scales, and behavioral observations. Qualitative data were also collected through child interview, parent interview and group leader journals. Quantitative results approached significance at the p.05 level for DANVA2 child faces subtest and behavioral observations. Post-intervention, the treatment group was observed to have significantly less solitary behaviors and significantly more positive interactions than the clinical control group. According to parent and child participant interviews, 75% of participants reported one or more positive effect in social competence as a result of participation. In addition, results suggested that the intervention was less successful for children who had a diagnosis of ADHD alone. Parent and participant suggestions for improvement include increased parent participation, more structured behavioral management and lengthening the program. Recommendations for future research include the replication vi of this or similar studies with greater sample size and/or the use of single-participant design, the collection of follow-up data and additional exploration into the nature of social perception deficits for these populations. Implications for school psychology theory, research and practice are discussed.

vii Table of Contents





List of Tables……………………………………………………………………….xi List of Figures……………………………………………………………………...xii Chapter 1: Introduction……………………………………………………………...1 Chapter 2: Literature Review………………………………………………………..4 Social Competence and Social Perception……………………………………….4 Models of Social Perception…………………………………………………..6 Neuropsychological Basis of Social Perception………………………………7 Development of Social Perception……………………………………………8 Assessment of Social Competence and Social Perception…………………..10 Populations with Social Perception Deficits……………………………………11 Nonverbal Learning Disabilities (NVLD)…………………………………...11 Assessment and Diagnosis of NVLD…………………………………….14 Neuropsychological Model of NVLD……………………………………14 Autistic Spectrum Disorders……………………………………

High Functioning Autism (HFA)…………………………………………18 Asperger’s Syndrome……………………………………………………..20 Autistic Spectrum and Social Perception Deficits……………………….. 21 Convergence among Asperger’s, HFA and NVLD……………………….22 Neuropsychological Basis of Autistic Spectrum Disorders……………….24 Attention Deficit Hyperactivity Disorder (ADHD): Issue of Comorbidity…..25 Existing Social Skills Interventions……………………………………………...28 Generalized Interventions…………………………………………………….28 Targeted Interventions………………………………………………………..30 Drama as Educational Intervention…………………………………………….. 33 Drama-In-Education………………………………………………………….34 Creative Drama……………………………………………………………….34 viii Process Drama………………………………………………………………...35 Rationale for Drama Activities as Social Competence Intervention …………37 Empirical Support for Drama as Social Intervention…………………………38 Empirical Support for Drama with Children with Learning Difficulties……..40 Chapter 3: Research Study…………………………………………………………..42 Statement of Purpose…………………………………………………..................43 Quantitative Research Questions and Hypotheses……………………………….43 Qualitative Research Questions…………………………………………………..45 Chapter 4: Method…………………………………………………………………..46 Participants………………………………………………………………………..46 Measures………………………………………………………………………….50 Procedures………………………………………………………………………...58 Data Analysis……………………………………………………………………..66 Chapter 5: Quantitative Results……………………………………………………...70 Preliminary Analyses……………………………………………………………..70 Tests of Hypotheses………………………………………………………………72 Post-hoc Analyses of Homogeneity of Groups…………………………………...74 Experimental Questions…………………………………………………………..77 Chapter 6: Qualitative Results……………………………………………………….82 Qualitative Research Question 1…………………………………………………82 Qualitative Research Question 2…………………………………………………87 Qualitative Research Question 3…………………………………………………90 Chapter 7: Discussion……………………………………………………………….105 Implications for Theory, Research and Practice…………………………………108 Limitations……………………………………………………………………….113 Recommendations for Future Research………………………………………….116 Appendix A: Rourke’s (1995) model of NVLD…………………………………….119 Appendix B: DSM-IV criteria for Autism and Asperger Syndrome………………..120 ix Appendix C: Behavioral observation data form and guidelines…………………….122 Appendix D: UT IRB forms………………………………………………………....125 Appendix E: Parent and Child Interview Questions………………………………..133 Appendix F: Social Competence Intervention Program: Manual Outline………….135 Appendix G: Outline of Group Leader Training…………………………………….143 Appendix H: Individual Changes Noted in Parent Interview………………………..144 References…………………………………………………………………………....146 Vita…………………………………………………………………………………...174

x List of Tables

Table 1: Participant Demographic Data…………………………………………….49 Table 2: Subgroup Makeup after Attrition………………………………………….65 Table 3: Age and FSIQ by Group…………………………………………………...71 Table 4: T-test for Equality of Means: Age and FSIQ……………………………...71 Table 5: Chi-square Analyses of Categorical Variables…………………………….72 Table 6: Results of Repeated Measures ANOVA: DANVA2 Faces Subtest……….73 Table 7: Mean Scores on the CASP…………………………………………………75 Table 8: DANVA2 Mean Error Scores……………………………………………...76 Table 9: Mean Parent Ratings on the BASC………………………………………...77 Table 10: Mean Observed Positive Interactions and Solitary Behaviors……………78 Table 11: Results of Repeated Measures ANOVA for Solitary Behaviors………….78 Table 12: Results of Repeated Measures ANOVA for Positive Interactions………..79 Table 13: Effects Reported by Treatment Group Parents……………………………83 Table 14: Effects Reported by Treatment Group Participants……………………….86 Table 15: Suggestions for Improvement……………………………………………..98

xi List of Figures

Figure 1: Social Perception Model…………………………………………………..7 Figure 2: Proposed Convergence among Asperger’s Syndrome, High Functioning Autism & Nonverbal Learning Disabilities………………………………24 Figure 3: Change in Solitary Behaviors for Treatment and Control Groups……….80 Figure 4: Change in Positive Interactions for Treatment and Control Groups……..81

xii Chapter 1: INTRODUCTION

“Sometimes it is too hard to concentrate on listening and looking at the same time.

People are hard enough to understand (since) their words are so very cryptic, but when their faces are moving around, their eyebrows rising and falling and their eyes getting wider then squinting, I cannot fathom all that out in one go, so to be honest I don’t even try.”

--Luke Jackson, age 13

Freaks, Geeks & Asperger Syndrome:

A User Guide to Adolescence (2002) While much attention is paid to the cognitive and academic difficulties experienced by children with developmental and learning disabilities, less focus is placed on their social difficulties. Yet, many children with these disabilities remain isolated, teased, and confused about how to interact successfully with their peers. Often, they may try to fit in, fail, and not know why. Not all children have social difficulties for the same reasons. For some children, environmental factors, past failures, anxiety, or depression may play a role. For others, serious conduct issues prevent them from succeeding socially. However, recent research suggests that yet another subset of children may have social competence problems because they have difficulty accurately perceiving and integrating the nonverbal cues in social interaction, such as facial expression, voice intonation, and nonverbal gestures.

Children with nonverbal learning disabilities (NVLD) and autistic spectrum disorders such as Asperger’s Syndrome have difficulty perceiving, integrating and expressing information that is presented nonverbally, such as visual-spatial stimuli or nonverbal aspects of language (Klin, Volkmar & Sparrow, 2000; Rourke, 1989;

Semrud-Clikeman & Hynd, 1990). For example, they may have trouble interpreting a very subtle look of fear, or integrating a happy expression with an angry tone of voice.



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