The purpose of this study was to (1) examine changes in social competence from baseline to intervention phases of a sensory-based social skills program and to (2) depict individualized changes, considering autism spectrum disorder (ASD) severity in five categories of social participation.

According to the Centers for Disease Control and Prevention, approximately 1 in 68 children is diagnosed with ASD. A pervasive symptom is the inability to engage in goal-directed social behaviors with peers. Research has demonstrated that social participation intervention in a socially embedded context improves child-initiated social behaviors and results in more frequent prosocial behaviors. Sensory integrative dysfunction may also impair a child’s occupational performance through the inability to cope with stress, respond to the interactions of others, and independently initiate appropriate behaviors.

Although social participation and sensory integration interventions are respectably researched, there is a paucity of literature on how these two frames of reference, when combined, improve social competence. Children with ASD have highly individualized behaviors and responses to intervention, and thus single-subject designs are helpful in highlighting both progress and variability. In addition, observational checklists can be an effective means of outcomes assessment for this unique population.

A quasi-experimental AB single-subject design was used. Daily summary scores from the Social Participation Inventory (SPI) were plotted to create line graphs for visual analysis in each of the following five categories: initiating behaviors, responding behaviors, temperament and self-regulation, emotional regulation, and peer interaction.

Five participants, all with a high probability of ASD symptomatology per the GARS–3, and between 6 and 10 yr old, took part in the study.

Data were collected with the SPI, an observational checklist developed by Dr. Charney, based on social participation principles. This tool was developed because standardized assessments for this population had previously not been responsive to discrete changes over relatively short periods of time.

Daily summary scores for each of the five categories of social participation as well as total composite scores on the SPI were computed and graphed. Nonparametric statistical analysis was used to evaluate mean differences from baseline to intervention phases. Visual analysis was used to consider individual changes in social competence categories across participants and level of ASD severity. The mean composite score for the SPI was 39.5 at baseline and 61.5 during the intervention phase of the program, demonstrating a significant difference (t = –17.8, p = .000). Visual analysis of the social competence categories illustrated that the greatest improvement was seen in children with Level I ASD severity, and in the social skill areas of responding behaviors and peer interaction.

A 1-mo program of structured social skills and sensory–motor protocols showed significant improvement of social skills, with most responsiveness noted in the areas of responding behaviors and peer interactions. Those with mild ASD showed the greatest levels of improvement. Therapists should consider how daily recording of specific participation behaviors can be measured, facilitated, and reinforced in small-group settings. Individualized interventions can be designed to document progress in discrete social behaviors over the short term. It is essential to integrate these outcome assessment strategies into daily practice to both validate what we do and provide important data to guide changes in interventions.