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Rowan University Rowan University Rowan Digital Works Rowan Digital Works Theses and Dissertations 6-19-2015 The effects on physical exercises to improve social The effects on physical exercises to improve social communication skills of adolescents with autism communication skills of adolescents with autism Christopher Fox Follow this and additional works at: https://rdw.rowan.edu/etd Part of the Special Education and Teaching Commons Recommended Citation Recommended Citation Fox, Christopher, "The effects on physical exercises to improve social communication skills of adolescents with autism" (2015). Theses and Dissertations. 470. https://rdw.rowan.edu/etd/470 This Thesis is brought to you for free and open access by Rowan Digital Works. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Rowan Digital Works. For more information, please contact [email protected]  THE EFFECTS ON PHYSICAL EXERCISES TO IMPROVE SOCIAL COMMUNICATION SKILLS OF ADOLESCENTS WITH AUTISM by Christopher J. Fox A Thesis Submitted to the Department of Language, Literacy, and Special Education College of Education In partial fulfillment of the requirement For the degree of Master of Arts in Special Education at Rowan University May 2015 Thesis Chair: Joy Xin Ed.D  © 2015 Christopher J. Fox  Dedications I dedicate my thesis to my family and friends. A special feeling of gratitude to my loving parents, Barbara and Steven Fox whose words of encouragement and motivation ring in my ears daily. To my grandparents who were biggest supporters in all I do. A very exceptional feeling of gratitude to my girlfriend Rachel Kovlak for her persistent, devoted, loving support during this extensive trial. To Andrea Tyszka for configuring this program and her guidance throughout this study. To Robert Neitzel for his insight and motivation to allow me to see the best in myself and my academics. To Anthony Nicolino for sharing his wisdom and motivation throughout this study. To Cherry Hill Health and Racquet club for providing the setting for the study. To my friends for checking in on me throughout the length of this study to show support and care. I thank you all from the bottom of my heart for all the support and love you have demonstrated through this long lasting study.  Acknowledgement I would like to express my appreciation to Professor Joy Xin for her guidance and assistance throughout this research study and graduate process. It has been her strong commitment to my higher education learning that has motivated me to achieve as much as I have. It is with her enduring support that I have sought to further my education even more after the completion of this study. It is with a whole heart that I thank you for all you have provided and motivated me to achieve with my school career at Rowan University. iv  Abstract Christopher J. Fox THE EFFECTS ON PHYSICAL EXERCISES TO IMPROVE SOCIAL COMMUNICATION SKILLS OF ADOLESCENTS WITH AUTISM 2014-2015 Joy Xin, Ed.D Master of Arts in Special Education The purpose of this study was to examine the effects of fitness activities on communication skills of adolescents with Autism Spectrum Disorder (ASD). Over the course of 12 weeks, 3 middle school students with ASD participated in a wellness program focusing on learning social and conversational skills through practicing verbal language in a 1:1 situation, paired with peers, and whole group instruction. The initiation and maintenance of their conversation through reciprocal responses, and responses to questions and comments were evaluated. Participants gained social communication (e.g. requests, responses, and making comments), as well as conversational skills (e.g. reciprocity, listener knowledge, verbosity, topic management, discourse, and response language). The end survey also presented positive responses from parents. Having access to a fitness program seems to provide these adolescents with social experiences during their play and activities with others to create an avenue for learning social communication skills in an interesting, interactive, and healthy way. v  Table of Contents Abstract............................................................................................................................... v List of Figures.................................................................................................................... ix List of Tables ...................................................................................................................... x Chapter 1 :Introduction....................................................................................................... 1 Statement of Problem.............................................................................................................1 Significance of the Study.......................................................................................................6 Statement of Purposes............................................................................................................6 Research Questions ................................................................................................................6 Chapter 2: Review of the Literature ................................................................................... 8 Communication Problems of Students with ASD..............................................................8 Social Skills Training...........................................................................................................13 Peer Mediated Groups..........................................................................................................15 Using Social Stories .............................................................................................................18 Physical Exercises ................................................................................................................19 Physical Fitness........................................................................................................... 19 Reducing Behavior Problems. .................................................................................... 21 Engaging in Social Interactions..........................................................................................23 vi  Table of Contents (Continued) Summary................................................................................................................................25 Chapter 3: Methodology................................................................................................... 27 Setting ....................................................................................................................................27 Participants ............................................................................................................................27 Teacher...................................................................................................................................29 Materials ................................................................................................................................29 Instructional Materials. ............................................................................................... 29 Measurement Materials........................................................................................................30 Observation Checklist 1.............................................................................................. 30 Observation Checklist 2.............................................................................................. 30 Parent Survey.............................................................................................................. 30 Procedure ...............................................................................................................................31 Instructional Procedures.............................................................................................. 31 Measurement Procedures.....................................................................................................35 Observations. .............................................................................................................. 35 Survey. ........................................................................................................................ 35 Research Design ...................................................................................................................35 Data Analysis ........................................................................................................................36 vii  Table of Contents (Continued) Chapter 4: Results............................................................................................................. 37 Chapter 5: Discussion ....................................................................................................... 42 Request........................................................................................................................ 42 Response to Questions................................................................................................ 43 Making Comments...................................................................................................... 44 Conversations.............................................................................................................. 45 Listener Knowledge.................................................................................................... 45 Verbosity..................................................................................................................... 46 Topic Management. .................................................................................................... 46 Discourse..................................................................................................................... 47 Response Language. ................................................................................................... 48 Limitations.............................................................................................................................49 Recommendations ................................................................................................................49 Conclusion.............................................................................................................................50 References......................................................................................................................... 51 Appendix A: Lesson Plan ................................................................................................. 58 Appendix B: Parent Survey .............................................................................................. 60 Appendix C: Observation Checklists................................................................................ 61 viii  List of Figures Figure Page Figure 1. Presents Participants’ Communication scores across phases……………. 39 Figure 2. Participants’ Mean Scores of Conversation Skills………………………. 40 ix  List of Tables Table Page Table 1. General Information of Participants……………………………………… 28 Table 2. Instructional Procedures…………………………………………………...34 Table 3. Means and Standard deviations of Social Communication Skills Across Phases………………………………………………………………………..37 Table 4. Means and Standard Deviations of Conversational skills across Phases………………………………………………………………………..38 Table 5. Parent Survey Responses………………………………………………… 41 x  1 Chapter 1 Introduction Statement of Problem According to the Center for Disease Control (2014), Autism Spectrum Disorder (ASD) is considered as a developmental disability that significantly affects children’s verbal and nonverbal communication and social interactions before age three. Individuals with ASD lack social communication skills which make them to be easily isolated but hard to be accepted by their peers (Muller & Schuler, 2008). These individuals often demonstrate limited abilities to a) initiate a conversation, b) request for their wants and needs c) listen and respond to questions and comments, and d) interact with others (Sansosti & Powell-Smith, 2008). These problems become serious at the secondary level, when a conversation with teachers and peers is the primary medium for social interaction and expectation of appropriate communication to gain social acceptance is raised (Hughes, 2011). These youngsters have difficulties in communication, such as, inferring information, taking another’s perspective and even maintaining a conversation (Flynn, Lorna, Healy & Olive, 2011). They have limited skills to interact effectively with teachers and peers, and display difficulty in responding appropriately to social stimuli (Hendricks & Wehman, 2009). According to the Center for Disease Control (2014), more than 3.5 million Americans have ASD. The prevalence in children in the United States was 1 in 100 in 2000, 1 in 88 in 2010, and 1 in 68 in 2014. It assumes that the number of children with ASD will continue to increase (Center for Disease Control, 2014). While the prevalence of ASD is on the incline, socialization is what makes this prevalence critical.  2 Socialization is a common skill, important for students to interact with their peers and adults both in school and at home; however it is very difficult for students with ASD. The major problems they face are initiating their wants and needs, developing a conversation, and maintaining such a conversation (National Institute on Deafness and Other Communication Disorders, 2012). Conversational initiation refers to the action to start a conversation. These adolescents have difficulty with pragmatics. They tend to have monologue or tangential conversations, but lack of joint attention with other’s responses. Also, sharing achievements, enjoyment, and excitement with others is difficulty for these students (Carpenter, 2013). It is found that small group situation involving a preferred interest provides an opportunity for these students to initiate their needs based on a topic of interest (Koegel & Koegel, 2013). Communication is any act by which one person gives or receives information. People are able to communicate their needs, desires, perceptions, knowledge, or effective states. Communication may be intentional or unintentional involving conventional or unconventional signals, with linguistic or nonlinguistic forms, in spoken or written modes. Students with ASD have difficulty in communication by initiating and maintaining a conversation. Conversation maintenance requires social reciprocity (Williams, Koenig, and Scahill, 2006). Reciprocity refers to responding to a positive action to keep back and forth flow of social interaction. Social reciprocity involves partners working together on a common goal of successful interaction with adjustments made by both partners until success is achieved. The skills involved in social reciprocity in young children begin with showing interest in interacting with others and exchanging smiles. This builds to being able to share conventional meanings with words  3 and topics in conversation. Students with ASD display an impairment in social reciprocity without taking an active role in social games, preferring solitary activities, or using a person’s hand as a tool or as a mechanical object. This may lead to ignoring another person’s distress or lack of interest in the focus or topic of conversation (Wiseman, 2009). It is necessary to provide interventions to improve socialization of students with ASD (Brown, 2001 & Koegel, 2009). While effective socialization intervention programs have been described for children with ASD (Rogers, 2000; McConnell, 2002; Matson, 2007), such as peer support networks (e.g. Haring & Breen, 1992; Garrison-Harrell, 1997), circle of friends (e.g. Whitaker, 1998; Kalyva & Avram-idis, 2005; Barton, 2011), buddy systems (e.g. Laushey & Heflin, 2000), and lunch clubs (e.g. Baker, 1998; Koegel, 2012), relatively few intervention programs target high school students (Bellini, 2007; Tse, 2007). This may become a growing concern as more children with ASD reach their high school ages. Without systematic interventions, adolescents with ASD may exhibit limited or Non-existent initiations toward typically developing peers (Hughes, 2011), have difficulty maintaining engagement in interactive conversations (Humphrey & Symes, 2011), become socially isolated (Knott, 2006 & Stichter, 2007), with limited participation in social activities in school and communities (Orsmond, 2004). Furthermore, this lack of socialization has negative effects on their emotions. It is reported that adolescents with ASD present feelings of loneliness (Lasgaard, 2010; Locke, 2010) and express a desire to build friendships (Beresford, 2007). Physical activities and exercises have been shown to be a beneficial intervention for physical and psychological illnesses and to reduce the stereotypic behaviors of  4 individuals with ASD (Awamleh & Woll, 2014). For example, dancing, horseback riding, yoga, basketball, baseball, and soccer, all can lead to successful experiences and potentially help those students (Delaney & Madigan, 2009). These physical intervention programs are aimed to enrich social activities, and incorporate these students’ interests into exercises to motivate their participation in physical activities together with their age appropriate peers. However, it is found that students with ASD have fewer occasions to partake in physical activities and less active than their typically developing peers (Tyler, MacDonald & Menear, 2014). In the past years, some methods have been developed to improve the social skills of students with ASD (Bellini, Benner & Hopf, 2007). These include social stories, (e.g. Delano & Snell, 2006), video modeling, (e.g. Patterson & Arco, 2007) and peer interventions (e.g. Laushey & Heflin, 2000). While many of these techniques can be effective for individual students, systematic reviews of the outcomes of social skills interventions have found that they are minimally effective for students with ASD (Nikopoulos & Keenan, 2004, Shukla-Mehta, Miller, & Callahan, 2010). Many of these social skill intervention methods can also be difficult and time consuming to implement. There is an opportunity to provide physical exercises leading to positive social outcomes through interaction with peers in participation in team sports and partner activities that allow these students to learn how to recognize the social cues required for successful performance in the field or on the court (Biddle, 1998; Strauss, 2001; Pan & Frey, 2006). According to Bhojne and Chitnis (2002), individuals with ASD have vestibular system dysfunction. This obstruction is caused by ineffective sensory processing which manifests itself in “problems in attention, behavior, learning, speech development,