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313

Promoting Social Skills Generalization WithADHD-Diagnosed Children in a Sports Setting

Patrick M. O’Callaghan

Louisiana State University

David Reitman

Nova Southeastern University

John Northup

Louisiana State University

Stephen D. A. Hupp

Southern Illinois University Edwardsville

Molly A. Murphy

Louisiana State University

Efforts to promote social skills generalization among ADHD-diagnosed childrenhave had limited success. Despite evidence that attentiveness and social skills can beenhanced, the general absence of gains beyond the original treatment setting or ex-tended through time suggests a need for systematic generalization planning. In thepresent study, a combination of techniques described by Stokes and Baer (1977)were implemented to foster the transfer of target behaviors across settings. A multiple-baseline design across 4 participants was used to evaluate efforts to promote the gen-eralization of social skills in a sports context. Results suggested that a combinationof generalization procedures, including training sufficient exemplars, trainingloosely, indiscriminable contingencies, programming common stimuli, and trainingto generalize, was effective in producing generalization of social skills from individ-ual training sessions to a group kickball game. No arbitrary contingencies for ap-propriate social behavior were in effect during the kickball game and very littleevidence of generalization was observed in the absence of explicit programming ef-forts. Researchers should continue to refine techniques for programming generaliza-tion and more actively involving paraprofessionals in the treatment of ADHD-diagnosed children.

Address correspondence to David Reitman, Ph.D., Center for Psychological Studies, NovaSoutheastern University, Fort Lauderdale, FL 33314; e-mail: reitmand@nova.edu.

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o’callaghan et al.

Despite the high visibility of attention-deficit/hyperactivity disorder (ADHD)and a wealth of clinical research data bearing on the evaluation and treatmentof ADHD-diagnosed children, few are aware of its social consequences (Lan-dau & Moore, 1991). These social skills problems also negatively influencerelations with caretakers, as children who engage in disruptive behaviorsevoke less social support and elicit more stress and negative evaluations fromboth teachers and parents (Demaray & Elliot, 2001; DuPaul, McGoey, Eck-ert, & VanBrakle, 2001). Children diagnosed with ADHD may also strugglein sports and play settings with their peers (Pelham et al., 1990). In recogni-tion of the potential long-term consequences associated with social isolationand peer rejection (see Greene, Bierderman, Faraone, Sienna, & Garcia-Jetton,1997; Patterson, Reid, & Dishion, 1992), some researchers have begun todescribe ADHD as a “social disability” (Gentshel & McLaughlin, 2000).

Stimulant medication has been recognized as an effective means of reduc-ing hyperactivity and off-task behavior for ADHD-diagnosed children, butthe benefits of medication for ameliorating social skills problems have beenless certain. For example, Pelham et al. (1990) demonstrated that ADHDchildren were more attentive when receiving methylphenidate in athletic set-tings, but no improvement in the production of social skills (i.e., prosocial orsportsmanlike behavior) was observed. Although pharmacological agents donot appear to directly promote the acquisition of prosocial skills such as initi-ating and maintaining social interactions, turn-taking, cooperating, or sharing(Pelham, Wheeler, & Chronis, 1998), stimulant-mediated reduction of overlyaggressive and antisocial behavior may improve interpersonal relationshipsto some degree (Bagwell, Molina, Pelham, & Hoza, 2001). On the other hand,some research with humans and nonhumans suggests that stimulant medica-tions, particularly at higher doses, may inhibit social interaction (Baumeister &Hawkins, 2001; Northup, Gulley, Edwards, & Fountain, in press).

More recent, and arguably more successful, efforts to address social skillsproblems have been achieved with multidimensional approaches that includedprogrammatic instruction in social skills, the use of stimulant medication,training in the use of contingency management procedures (including responsecost), academic skills training, and self-monitoring (Frankel, Myatt, Cantwell,& Feinberg, 1997; Jensen et al., 2001; Landau, Milich, & Diener, 1998; Reit-man, Hupp, O’Callaghan, Gulley, & Northup, 2001; Stormont, 2001). Psy-chosocial interventions may also enhance social standing among young chil-dren and adolescents (see Gross & Johnson, 1984; Weiss & Duncan, 1992).Training social skills in sports settings can be justified in at least two ways.First, there are many parallels with social behavior outside of the sportsarena, such as rule-following requirements and demands for social reciproc-ity. Thus, sports settings provide the opportunity to train or “coach” childrenin a number of important social behaviors (Smith & Smoll, 1991). Second,motivation to participate in social skills programs may be enhanced byembedding them in pleasurable, nonstigmatizing social activities such assports (Anderson, Rush, Ayllon, & Kandel, 1987).

AU

: Up

dat

e?

social skills generalization and adhd

315

Although long-term outcome data are needed, existing studies suggest thatsocial skills interventions in sports settings are beneficial. For example, sev-eral studies have effectively used token economies and medication to improveathletic skills and/or sportsmanlike behavior (Hupp & Reitman, 1999; Hupp,Reitman, Northup, O’Callaghan, & LeBlanc, 2002; Reitman et al., 2001;Sharpe, Brown, & Crider, 1995). Even if such interventions failed to producesocial skills gains outside of sports settings, they might still prove valuable ifthey promoted the retention of children in team sports (e.g., Little Leaguebaseball) and friendship formation, rather than peer rejection and the con-comitant loss of socialization opportunities. However rationalized, interven-tions designed to take advantage of the sports context as a means of promotingsocial acceptance have proliferated in recent years (see Hupp et al., 2002;Pelham et al., 1990; Sharpe et al., 1995).

To date, most interventions addressing social skills with ADHD-diagnosedchildren have yielded only short-term improvements, with treatment gainsfailing to generalize to nontraining settings (Pelham et al., 1998). Some of themost promising efforts to enhance the treatment of social skills problems forADHD-diagnosed youth have utilized parents to facilitate the generalizationand maintenance of social skills training (Cousins & Weiss, 1993; Frankel etal., 1997; Pfiffner, Calzada, & McBurnett, 2000; Pfiffner & McBurnett, 1997).However, efforts to promote social skills generalization through parent partici-pation have not met with unqualified success. For example, a well-coordinatedstudy by Sheridan, Dee, Morgan, McCormick, and Walker (1996) producedlittle evidence of generalization of social skills to natural settings (such aspeer interactions at school). By contrast, Frankel et al. (1997) demonstratedgeneralization from a parent-mediated social skills program to blind teacherratings of child likeability and aggression. While intriguing, replications ofsuch effects are necessary. One possible explanation for the overall lacklustergeneralization results observed in many studies may be a failure to incorpo-rate generalization programming into existing social skills interventions.

Based on their review of the research literature in the late 1970s, Stokesand Baer (1977) were able to identify nine techniques for facilitating general-ization. Two techniques, “train and hope” and “sequential modification,” describetypical efforts to systematically produce generalization or promote directtraining in the generalization setting, respectively. Stokes and Baer consid-ered the procedures most likely to produce systematic behavioral change out-side of the training settings to be the introduction of natural maintainingcontingencies, training sufficient exemplars, training loosely, the use of indis-criminable contingencies, programming common stimuli, mediated generali-zation, and training to generalize. Descriptions of each generalization strat-egy and the manner in which many were implemented in this study are shownin Table 1.

The purpose of this study was to replicate a program for increasing sports-manlike and attentive behaviors in ADHD-diagnosed children and to demon-strate generalization of these behaviors to a nontraining setting. In the present

316

o’callaghan et al.

TA

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Gen

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izat

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mor

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sing

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ting

Occ

asio

nally

use

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ter (

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trai

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odel

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se s

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setti

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ld),

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)M

edia

ted

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arni

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that

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kely

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as

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in to

gen

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Part

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per

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beh

avio

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an

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tting

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ms

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icip

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aref

ully

to

live

gam

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tion

(8)

social skills generalization and adhd

317

study, combinations of these generalization programming techniques wereimplemented to foster the transfer of target behaviors across settings for fourchildren previously diagnosed with ADHD. The effectiveness of the interven-tion was evaluated using a multiple-baseline-across-participants design. Ide-ally, the transfer of sportsmanlike and attentive behaviors may enable chil-dren to be successful in a multitude of settings with limited adult supervisionand therefore may have high clinical utility (Hersen & Bellack, 1977).

Method

Participants and Setting

Four children (2 boys, 2 girls) were selected from a pool of 10 childrenwho attended a 6-week summer camp designed to evaluate pharmacologicaland behavioral treatments for children diagnosed with ADHD. The partici-pants were chosen based on the following criteria: (a) a psychiatrist’s diagno-sis of ADHD using a structured interview based on the American PsychiatricAssociation’s

Diagnostic and Statistical Manual of Mental Disorders

(

DSM-IV

; 1994), (b) a

T

-score of at least 65 on the ADHD Index subscale of the Con-ners’ Parent Rating Scale–Revised (CPRS-R; Conners, 1997), (c) a

T

-score ofat least 60 on the Social Skills Scale on the Social Skills Rating System(SSRS; Gresham & Elliot, 1990), and (d) sportsmanlike and attentive behav-ior were observed in fewer than 30% of the game baseline intervals. Psycho-educational testing completed prior to the start of the camp demonstrated thatall participants were in the average range of intellectual functioning.

Medication status did not influence participant selection and only one ofthe four children selected to participate was receiving medication at the timeof the study. That participant, James, was involved in a double blind, placebo-controlled study of stimulant medication concurrent with our project. Both thechild and program staff were blind to medication status. Although medicationeffects was not the focus of this study, our previous research has suggested thatpharmacological treatment may not significantly influence the expression ofprosocial behavior, at least among younger children involved in athletic activity(Reitman et al., 2001). Consistent with these earlier research findings,James’s behavior did not appear to be influenced by stimulant medication.

Measurement

Sportsmanlike behavior

was defined as praising another player, giving“high-fives,” cheering or applauding, and other forms of verbal encourage-ment of other players (e.g., “good kick!”).

Attentive behavior

was defined asthe child being in the “ready position.” The ready position was defined as (a)standing within 10 feet of the base, (b) head and eyes facing toward home plate,and (c) both hands on knees or thighs (see Pelham et al., 1990). Also noted(but not presented here) were disruptive behaviors that diverted attention awayfrom the training or game, including negative statements (e.g., complaining,teasing), leaving one’s position, noncompliance, inappropriately playing with

318

o’callaghan et al.

objects (e.g., grass, leaves, clothing, and bases), aggression, and horseplay.Consistent with earlier studies where contingencies for prosocial behaviorwere in effect, levels of disruptive behaviors were generally low (see Hupp etal., 2002; Reitman et al., 2001).

Sportsmanlike and attentive behaviors were coded using an interval record-ing procedure. Before each at-bat the pitcher announced, “Here comes thepitch,” signaling the beginning of an interval. The interval terminated withthe call for the next pitch. Target behaviors were coded if they occurred at anypoint during the interval. Ten intervals were combined to yield one data point.

Reliability

Interobserver agreement was assessed for 47% of the intervals. The reli-ability of attentive and sportsmanlike behavior was calculated using Cohen’skappa for each target behavior to account for chance agreement. Interrateragreement for attentive and sportsmanlike behaviors was assessed separatelyand found to be .95 and .93, respectively (range across participants and set-tings

�

.92 to .98).

General Procedures

All training sessions were conducted on the campus of a large public uni-versity in the south-central United States. Two open areas, shaded by trees,served as the training and game settings. In the training setting, a kickballdiamond was set up consisting of four bases placed 10 feet apart. A 6-by-4-foot “dugout” area marked by cones was also constructed using plastic cones.A single experimenter and a research assistant served as coaches for eachparticipant. Training sessions generally consisted of modeling appropriatesocial skills followed by feedback and reinforcement for performing thebehaviors. The study was conducted each day (Monday through Friday) for a6-week period. Training data were obtained during sessions that occurred atvarious times of the morning during the camp day (anywhere from 15 min-utes to 90 minutes prior to the game). Regular game data were collected at aseparate location during a scheduled “recess” time near the end of the campday. The regular kickball game included all children in the summer program.

During the regular kickball games, camp staff who served as “teammates”were instructed to play the game but not to perform or prompt target behav-iors. Each kickball game consisted of two 20-pitch innings. Attentive behav-ior was observed when players took defensive positions in the field. Sports-manlike behavior was recorded for the offensive or “kicking” team while inthe dugout or on the bases. The pitcher verbally prompted the ready positionand sportsmanlike behavior on the 3rd and 13th pitch of each inning. Duringthis regular kickball game (i.e., the nontraining setting), no feedback, praise,or rewards were systematically provided for target behaviors. These gamescontinued for the duration of the study and served as the context in whichgeneralization was assessed.

Token economy.

During the training sessions only, a token economy was

social skills generalization and adhd

319

introduced to facilitate the acquisition of social skills in the game setting (seealso Hupp et al., 2002; Reitman et al., 2001). Based on previous experienceand a reinforcer survey, backup reinforcers were paired with tokens of differ-ent colors. For example, white tokens earned the least desirable items (e.g.,pencils, erasers, stickers, etc.), blue tokens were exchanged for more desirabletangibles (e.g., coloring and activity books, toy cars, etc.), and red tokens wereexchanged for the most highly valued rewards (e.g., stuffed animals, balls,candy bars, games, etc.). Since a total of 20 tokens could be earned perinning, the child began by earning white tokens (15), then blue (3), and,finally, red (2). The first demonstration of a target behavior per intervalearned the participant a single white token, the 16th, a blue token, and the18th, a red token. A single token earned for any color allowed the child theprivilege of selecting an incentive from a “goody box” of the same color.Thus, a child who earned 16 tokens would have an opportunity to select fromboth the white and blue goody box. At the end of the two innings, tokenswere exchanged for rewards. Finally, if the child earned tokens of all threecolors, they selected 1 item from each of the three colored boxes for eachinning (a maximum of 6 items).

Training Procedures

Pretraining.

During the first 2 days of the camp, kickball rules, athleticskills, and sportsmanlike behavior were explained, modeled, and practicedwithout data collection. Mastery of the skills was confirmed at the end of thesecond day, when all children were asked to demonstrate the ready positionand sportsmanlike behavior. Five consecutive demonstrations constitutedmastery.

Game baseline.

Initial baseline data were collected only in the regularkickball game setting on days 3 through 5. Before each game, the pitcherbriefly reviewed the target behaviors and requested that the children demon-strate the ready position and sportsmanlike behavior (e.g., ready position andcheering). Observers began recording baseline occurrences of attentive andsportsmanlike behaviors during recess kickball games. During this time, childreneither met or were excluded from the study based upon direct observation of theirbehavior (see Criterion D, Method/Participants). Four children were assignedrandomly to teams each day with camp staff not affiliated with the trainingsessions filling in as teammates (i.e., kicking and playing the outfield).

Training baseline.

Beginning on the 6th day, a “coach” and “teammate”(staff member, or later in training, a peer) began conducting individual train-ing sessions with the first participant. The rules for attentive behavior and theimportance of sportsmanlike behavior and basic sports skills were reviewedby the coach and practiced by the child. The coach functioned as the pitcherand followed the same protocol as the regular game kickball pitcher (i.e., 20pitches for each inning). Attentive behavior was assessed while the childassumed a fielding position and sportsmanlike behavior was noted while thechild kicked and ran the bases. Observers now collected baseline data on

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o’callaghan et al.

the rates of sportsmanlike, attentive, and disruptive behaviors during both thetraining and kickball game conditions. The coach, observers, and teammatesfrom the training session did not initially participate in the group kickballgames. Baseline conditions were continued until attentive and sportsmanlikebehavior became asymptotic.

Training sessions.

A token economy was systematically introduced toeach participant upon entering the training condition. Before each trainingsession, the coach told the child, “You will earn tokens for every time youcheer and when you are in the ready position for the pitch.” If the child was inthe ready position during the pitch the child was verbally praised (e.g., “Youget a chip for cheering” or “Good ready position”) and a token was depositedinto a container attached to the observer’s clipboard (see Reitman et al.,2001). Tokens were earned for sportsmanlike behaviors while “at-bat.” If thechild demonstrated sportsmanlike behavior at any point during the interval,token administration and praise were delivered as stated above. Before train-ing began, the child was informed that tokens earned during the session couldbe exchanged for an opportunity to select from the goody box.

Generalization sessions.

The generalization procedures were based onthose recommended by Stokes and Baer (1977) and appear in Table 1. Toincrease the likelihood of the attentive and sportsmanlike behavior generaliz-ing from the training sessions to the group game, programming techniqueswere indiscriminately introduced and withdrawn in the training setting. Thisstrategy, deemed

training loosely

, is defined as the deliberate reduction ofexperimental control and variation of training conditions to promote general-ization (Stokes & Osnes, 1988).

Once target behaviors occurred during at least 75% of the training intervalsfor 6 consecutive data points, generalization programming techniques wereintroduced in the training setting to facilitate the transfer of prosocial behav-ior to the kickball games. The program techniques appear in Table 1 andinclude programming indiscriminable contingencies, promoting contact withnatural contingencies, programming common stimuli, and verbally instruct-ing the individual. All raters were blind to the generalization strategiesemployed across training sessions. Descriptions of the specific actions takento promote generalization in this study are numbered 1 through 9 and appearin the far right column of Table 1.

To render training contingencies

indiscriminable

, the schedule of tokenreinforcement was faded using an intermittent schedule. Specifically, on thefirst 2 days of the generalization condition, tokens were awarded by adminis-tering one reinforcer

1

for every two correct expressions of the target behav-iors. The schedule was thinned again by requiring three correct expressionsfor each token earned. To accommodate these changes, the total number of

1 We use the term reinforcer rather than the less formal terms, incentive or reward, becausein both this and previous studies the presentation of tokens exchangeable for items in the“goody box” reliably increased the likelihood of attention and sportsmanlike behavior.

social skills generalization and adhd

321

available tokens per color for each inning was altered (e.g., when the sched-ule was thinned to 2:1 a total of 10 tokens could be earned, 7 white, 2 blue,and 1 red). Ratios continued to increase using an intermittent, variable sched-ule until tokens were faded completely, though verbal instructions and praiseremained stable regardless of the schedule of token reinforcement. In addi-tion, the role of the coach or trainer was changed by rotating different staffmembers into the training sessions to perform these duties at least once aweek. To promote

contact with natural contingencies

of reinforcement forbehaving prosocially, continuous but progressively more intermittent contin-gent praise was given with the occurrence of target behaviors and continuedindependent of modifications to the token economy.

A variety of techniques were used to incorporate the concept of

program-ming common stimuli.

The pitcher from the kickball game functioned as thetraining coach 1 day per week for each child. The training session locationwas changed to different settings to include as many varied conditions as pos-sible. Several times per week, training was held in the same location as thekickball game with the same physical stimuli present as in the game (i.e.,bases, dugout, etc.). In addition, observers from the individual training ses-sions continued to fulfill the role of observers in the group game each day.Peers were added to training sessions and rewarded in the same fashion asparticipants for modeling and prompting attentive and sportsmanlike behaviors.This procedure also ensured a greater number of opportunities for observa-tion of the target behavior by models similar to the children (

sufficient exem-plars

). Finally, participants were verbally instructed to perform the trainedbehaviors immediately prior to the start of the group kickball game (

trainingto generalize

). Importantly, no direct reinforcement for sportsmanlike behav-ior was available during regular kickball games.

Design.

This study employed a concurrent multiple-baseline-across-participants design to assess the generalization of attentive and sportsmanlikebehavior during a regular kickball game occurring in the context of a summercamp for ADHD children. The dependent variables, attentive and sportsman-like behavior, were subjected to visual analysis and plotted across three levelsof the independent variable (baseline, training, and generalization) in two set-tings (training or game). To assess the effect of generalization training proce-dures on the target behaviors, behavior in the “training” and “game” settingsafter the introduction of the token and generalization procedures is displayedconcurrently for each child in Figure 1 (attentive behavior) and Figure 2(sportsmanlike behavior).

Results

Ready Position/Attentive Behavior

Figure 1 presents data for “on-task” behavior for all four participants in themultiple-baseline-across-participants design. The same data are summarizedin Table 2, showing the percent of intervals in which the children were observed

322

o’callaghan et al.

Fig

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e A

cros

s-Pa

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for

Atte

ntiv

e B

ehav

ior

(num

bers

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ific

gene

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atio

n pr

oced

ures

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the

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e of

firs

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in the ready position across baseline, training, and generalization conditionsin both training and game settings. Treatment generalization is best observedby comparing the “training treatment” column to the “game treatment” col-umn. As can be seen, while all the children responded powerfully to the inter-vention in the training setting (mean

�

88%), practically no transfer of gainswas observed in the game setting (mean

�

7%). Transfer of treatment effectswas far superior after generalization programming (game setting mean

�

56%). Visual analysis of the data also showed very limited evidence of gener-alization of on-task behavior with the introduction of training and token rein-forcement, with no evidence of generalization to the game setting. Thoughchanges within the training condition are quite dramatic and obvious, onlysystematic efforts to promote generalization of on-task behavior were effec-tive in producing cross-setting generalization of on-task behavior. The numbersappearing above the data for training and generalization settings in Figure 1 (#1through #9) are linked to generalization-promoting procedures identified in thefar right column of Table 1 and represent the day of first introduction of thespecific generalization procedure. As can be seen, no single generalization pro-cedure seemed to be consistently effective for any of the participants. Overall, aslow but steady increase in attentiveness was observed for each child. By theend of the study, game performances over the last 4 data points generallyapproximated those observed in training (i.e., within 10% to 20%).

Sportsmanlike Behavior

Figure 2 presents the data for sportsmanlike behavior. These data are alsosummarized in Table 2. Both visual analysis and mean treatment response

TABLE 2

Percent of Intervals in Which Attentive and Sportsmanlike Behavior Were Observed Across Settings and Conditions

Behavior, ChildTrainingBaseline

TrainingTreatment

TrainingGeneralization

GameBaseline

GameTreatment

GameGeneralization

Attentive BehaviorElizabeth 30 80 94 23 14 45Susie 27 85 95 6 2 58James 6 96 94 0 13 56Thomas 5 90 100 0 0 63

Total 17 88 96 7 7 56

SportsmanlikeBehavior

Elizabeth 6 68 93 3 1 21Susie 7 68 92 6 15 49James 6 26 93 .4 22 62Thomas 7 77 79 2 0 25

Total

7

60

89

3

10

40

social skills generalization and adhd

325

data are consistent with those presented for on-task behavior. Again, all thechildren responded powerfully to the intervention in the training setting(mean

�

60% vs. a baseline performance of 7%), yet practically no transferof gains was observed in the game setting (mean

�

10%). Transfer of treat-ment effects was also superior after generalization programming (game set-ting mean

�

40%). Generalization was again achieved through somewhatslow and steady increases in sportsmanlike behavior. Only James showed evi-dence of rapid generalization of sportsmanlike behavior to the game setting.By the end of the generalization phase, however, all children in the game set-ting showed improvement in sportsmanlike behaviors relative to the baselineand training conditions.

Discussion

Past research shows that the inattentive, impulsive, and inappropriatesocial behavior (e.g., bossy, uncooperative) displayed by ADHD children isassociated with negative peer relations in many settings (Campbell & Paulas-kas, 1979; Johnson & Rosen, 2000; Pelham & Bender, 1982). Unfortunately,these problems are also among the most resistant to treatments such as medi-cation and traditional behavioral interventions (Johnson & Rosen; Pelham &Bender). The relative unpopularity of ADHD children with their peers (Bark-ley, 1998) and the effects of social rejection on later adjustment (Greene etal., 1997; Greene et al., 1999) suggest a need for additional research examin-ing the participation of ADHD-diagnosed children in sports.

This study represents another in a series of studies intended to improve theacquisition, maintenance, and generalization of prosocial behaviors forADHD-diagnosed children in sports settings (Anderson et al., 1987; Guevre-mont & Dumas, 1994; Hupp & Reitman, 1999; Hupp et al., 2002; Pelham etal., 1990; Reitman et al., 2001). In the training setting, the results clearlydemonstrated a marked increase (nearly 80%) in attentive and sportsmanlikebehavior with the incorporation of a token system, replicating the potenteffects that token systems can exert on the social behavior of ADHD-diagnosed children (Hupp et al.; Reitman et al.). Interestingly, increased ratesof socially skilled behavior in the training sessions were maintained even asreinforcement schedules were thinned and faded completely (Dunlap & Plie-nis, 1988).

More importantly, gains in prosocial behavior observed in the training set-ting did not greatly influence the rate of target behaviors in the generalizationsetting (i.e., the kickball game). Although some increases in prosocial behav-ior in the nontraining environment were observed for both James and Susie,these appeared minimal and sporadic. Stokes and Baer (1977) deemed simi-lar effects evidence of “train and hope” generalization, referring to the spreadof treatment gains without systematic planning. Since most behavioral andpsychopharmacological interventions fail to demonstrate either maintenanceor generalization of social skills after the removal of treatment (Pelham et al.,

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1998; Sheridan et al., 1996), this study reinforces the view that generalizationof social skills for ADHD-diagnosed children is unlikely to occur in the absenceof explicitly programming for such generalization.

The current study combined a number of generalization procedures(Stokes & Baer, 1977; Stokes & Osnes, 1988) in an attempt to maximize thelikelihood of successful transfer of behavior change. The implementation andorder of generalization procedures were deliberately varied to maintain a“loose” training environment. The generalization programming proceduresproduced significant gains in the game setting for all children, providing evi-dence of generalization. However, there was some variability in response andno one generalization programming technique yielded consistent results forall children. Although programming common stimuli (i.e., intermittently insert-ing the trainer into game situations), instructed generalization, and a massedor “kitchen sink” approach to promoting generalization appeared consistentlyassociated with successful generalization (see Figures 1 and 2), the design ofthis study does not permit conclusions about the relative efficacy of specificgeneralization strategies. Nevertheless, it seems encouraging that efforts tosystematically program for social skills generalization resulted in increasesof 40% to 50% without the introduction of arbitrary contingencies for theirperformance in the generalization setting.

There are a few notable limitations to this study. First, the small number ofparticipants makes it difficult to generalize these results to larger groups ofchildren. Second, as noted above, the generalization programming techniqueswere not systematically introduced, making it difficult to determine a specificprocedure’s efficacy in the transfer of social skills. Third, the effects shownhere demonstrate generalization but not maintenance of effects. The long-term sustainability of treatment gains in sports settings will require furtherelaboration via longitudinal and follow-up studies. Fourth, and related, theexternal and social validity of these kinds of interventions will also requirefurther study. The large number of staff required to complete the study, as wellas weather and space considerations, may make its “effectiveness” (Seligman,1995; Weisz & Jensen, 2001) questionable. Finally, while this study wasstrengthened by the direct observation of social skills, such observationscould be biased by the observer’s knowledge of the status of the participants(i.e., ADHD-diagnosed children involved in a treatment study).

Sportsmanlike and attentive behaviors may be naturally reinforcing insports settings and improvements in these settings could translate into agreater likelihood of acceptance by teammates and supervising adults andmore lasting results than observed with more didactic social skills training(Browne & Francis, 1993; Cousins & Weiss, 1993; Gross & Johnson, 1984;Weiss & Duncan, 1992). However, this kind of speculation is in need ofempirical validation. Future studies should therefore carefully evaluate theexternal validity of social skills interventions for ADHD children. Particu-larly valuable would be studies examining both changes in social skills per-formance and sociometric ratings. As part of such a line of research, one

social skills generalization and adhd

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might also more systematically evaluate the effect of specific generalizationprocedures and endeavor to create a generalization protocol (although researchmay yet determine that the specific generalization techniques required in anyone case may be quite idiosyncratic).

The performance of Elizabeth, in particular, may prove instructive in futureintervention efforts. Elizabeth was observed to be quite socially withdrawnand shy. She rarely spoke to peers in the group game; however, during indi-vidual training sessions she easily initiated social interactions with staff andperformed target behaviors. After a peer was added to her training sessions tomodel the appropriate behaviors, the peer began to spontaneously prompt tar-get behaviors during game play. This prompting was continued in the groupcontext and may explain her improved performance. Peer-based interventionssuch as this may also be more easily exportable to parents and teachers (Frankel,1996). The coach “training to generalize” may have also influenced Eliza-beth’s performance (Stokes & Baer, 1977). In this instance, the coachinstructed Elizabeth to exhibit sportsmanlike behaviors in the group game.This procedure was not introduced to her until late in the study and is repre-sented in Figure 2 by a sharp increase in the occurrence of this behavior.Taken together, these data suggest that interventions such as instructed gener-alization, correspondence training, and efforts to promote the solicitation ofpeer support may all be worthy of additional research. Procedures similar tothose described here could also be used by adults in the child’s natural envi-ronment, such as parents and teachers, to facilitate social interaction andthereby increase the external validity of social skills training efforts (Ander-son et al., 1987; Milich & Landau, 1982). Certainly, there is a strong need foradditional research evaluating the influence of paraprofessionals on behaviorproblems in general and social behavior in particular. Finally, the results ofthis study support the view that social skills generalization is unlikely tooccur in the absence of active efforts to promote generalization.

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Received: May 23, 2003Accepted: February 11, 2003