Improving Eye Contact through Video Modeling and Role-Play ......The Autistic Brain: Thinking Across the Spectrum (2013). She references The Journal of Autism and Developmental Disorders

Running head: IMPROVING EYE CONTACT

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Improving Eye Contact through Video Modeling and Role-Play

Sarah Naumann

Texas Christian University

IMPROVING EYE CONTACT

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Abstract

Eye contact is an important social skill for students to develop in order to succeed in

academic and social settings. This skill does not always come naturally to students with

disabilities such as Autism. Difficulties arise as students are frequently required to

communicate with peers and teachers in the school setting. The current study investigates

the effect of a video modeling and role-play intervention on the amount of eye contact

with students with Autism and similar conditions that indicate social skill deficits. Whole

interval time samples were collected every five seconds for 5 minutes at a time. A single

subject multiple-probe design was used. A functional relationship was found in one out of

three of the students’ data. The combination of video modeling and role-playing was a

limited intervention in this setting and should be replicated in other settings in order to

confirm findings.


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Improving Eye Contact through Video Modeling and Role-Play

Social skills help us achieve social, academic, and professional proficiency in

society. However natural or unnatural these skills may be for a person, they are important

to acquire. Social skills help us accomplish daily activities such as holding conversations,

making and maintaining friends, interpreting verbal and nonverbal messages, asking for

help, interviewing for jobs, and fulfilling job requirements. Thus, social skills are

required for activities all throughout life.

Piaget (1951) describes egocentrism as an early stage of human cognitive

development where the person cannot differentiate between self and others. In order to

make connections with other people in society, one must outgrow the egocentric mindset

he or she was born with and learn to see things from others’ perspective. This social skill

is called empathy. According to Goldstein and Winner (2012), “social cognitive skills

such as empathy (matching the emotional state of another)…are crucial for everyday

interactions, cooperation, and cultural learning” (p. 20). Non-verbal expressions were

claimed by Mehrabian and Ferris to account for, “approximately one and one-half times

as much variability in the judgment of a message of a message as does the vocal channel”

(Mehrabian & Ferris, 1967, as cited by Haase & Tepper, 1972).

For some, however, the concept of empathy is too abstract to understand and learn,

so researchers have identified observable indicators of this social skill. Some of these

indicators include making appropriate comments, nodding the head, smiling, and

maintaining eye contact (Ganz, Earles-Vollrath, & Cook, 2011).

Eye Contact as a Norm and a Deficit


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Dr. Temple Grandin explains the neuroscience behind eye contact in her book,

The Autistic Brain: Thinking Across the Spectrum (2013). She references The Journal of

Autism and Developmental Disorders to explain that the brains of high-functioning

people with Autism respond to eye contact in the opposite fashion of those with typically

developing brains. A neurotypical brain’s temporoparetal junction (TPJ) actively

responds to eye contact while an Autistic brain’s reaction is to avert eye contact (Pitskel

et al., 2011, as cited by Grandin & Panek).

According to Arnold, Semple, Beale, and Fletcher Flinn (2000), eye contact is

used to “infer another person’s thoughts, desires, or intentions.” Researchers believe

“there is a widespread belief that training appropriate eye gaze behaviours will enhance

the social skills of children with developmental disabilities” (Arnold et al., 2000). Upon

the conclusion of a study that questioned what normal social behavior is exactly, Arnold

et al. (2000) suggest that future interventionists strive to increase eye contact in an

interaction beyond 20% of the interaction time. They continue to state maintained eye

contact for 50% to 100% of interaction time would be an inappropriate amount of social

behavior.

Challenges with Social Skills and Eye Contact for People With Autism

Deficits in social cognitive skills such as empathy are often manifested in people

with Autism (Goldstein & Winner, 2012). Among the many types of social skills, eye

contact is one skill in which many people with Autism especially need explicit instruction.

While eye contact may be a fairly natural skill for some, it is not the case for all. Travis,

Sigman, and Ruskin (2001) characterize Autism “by deficits in social understanding and

social behavior” (p. 119). Tuononen, Laitila, & Kärnä (2014) state, “the difficulty in


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seeking or maintaining eye contact seems as the most striking feature of ASD because it

violates our everyday understanding of the way social encounters are realized” (p. 2). The

academic and social success for individuals with Autism relies heavily on the

development of early social-communication skills (McDuffie et al. 2006; Sigman &

McGovern 2005, as cited in Wilson, 2012). It is important to ensure students with Autism

master social skills early in life in order to function appropriately in society.

Rationale and Benefits of the Study

The ability to operate in society with appropriate social skills is invaluable. “Since

many young children with autism spend the majority of their days in educational settings,

practical, efficient, and evidence-based classroom intervention tools are vital to

addressing the social-communication needs of these young students” (Bellini & Akullian

2007 as cited in Wilson, 2012, p. 1819). With the characteristics of Autism in mind,

“educational programs for children with ASD must be multi-faceted and address

communication and language development, social and affective development, life skills,

and academics” (Schmidt & Bonds-Raacke, 2013, p. 121).

Since non-verbal communication such as eye contact is so critical in determining the

“nature of communication” (Haase & Tepper, 1972), specific instruction is required.

Often, the best learning strategies for students with Autism require explicit, visual

demonstrations of targeted behaviors (Ganz et al., 2011). A prime example of this form

of demonstration is video modeling. The repetitive nature of video modeling leads to

retention of the targeted behavior. Studies have also found that video modeling fosters

motivation of students with Autism. (Corbett & Abdullah, 2005). The purpose of this


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study is to investigate the effects of video modeling and role-playing on changes in the

amount of eye contact demonstrated by students with Autism.

Video Modeling, Acting, and Other Interventions for Students with Autism

Video modeling is an intervention with strong validity due to ample

documentation in the behavioral sciences (Corbett & Abdulla, 2005). The visual

instruction and repetition of the intervention is especially beneficial to people with

Autism. According to Ganz et al. (2011), video modeling “promotes independent

functioning, and can be used to address numerous learner objectives, including

behavioral, self-help, communication, and social objectives” (p. 8). Educators and

students alike can benefit from the time- and cost-efficiency of video modeling (Wilson,

2012). Video modeling reduces the amount of unrelated stimuli and allows the student to

focus on the desired skill (Tetreault & Lerman, 2010). Researchers have used video

modeling to address a range of target behaviors including first aid skills (Ergenekon,

2012), on-task behavior, transitions (Schmidt & Bondes-Raack, 2013), game-learning

skills (Odluyurt, 2013), and conversation skills (Tetreault & Lerman, 2010).

Nikopoulou-Smyrni (2008) highlights other studies that have explored successful

interventions in addition to video modeling. These additional interventions have all

contributed positively to the social deficits displayed by children with Autism. Examples

of such interventions include guided story telling and role-playing (Hess, 2006), social

stories and peer-mediated stories (Amin & Oweini 2013), and acting activities (Goldstein

& Winner, 2012). Significant room for further research exists in the field of arts-

interventions, specifically acting.


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In light of the statement that “much of human learning occurs by watching and

imitating others (Corbett, Gunther, Comins, Price, Ryans, Simon, Schupp, & Rios, 2010),

theatre arts are a natural solution to this claim as both audience and actors alike are

involved in observing others’ behaviors on a stage. “Theatre, like modeling, may help

individuals identify key social cues (e.g., recognizing facial expressions)” (McAfee, 2002,

as cited by Corbett et al.). Acting in particular is a unique activity that requires one to

pretend to be someone else without the intention of deceiving. This activity is

theoretically and empirically supported as a means of potentially increasing empathy

(Goldstein & Winner, 2012). Results of Goldstein & Winner’s study showed that an arts

intervention, specifically acting activities, might lead to improvement in social cognitive

skills of empathy. Future research in this field is necessary.

Methods

Participants

The school director recommended three students to participate in the study who

made atypicoal amounts of eye contact compared to their peers. Student 1 is a 14-year-

old Caucasian male. He has an Autism diagnosis and struggles with a variety of social

skills, particularly conversation skills. Student 2 is a 12-year-old Caucasian female in 8th

grade with an Autism diagnosis that makes more than an appropriate amount of eye

contact. Student 3 is a 14-year-old Caucasian female who demonstrates Autistic

tendencies, however, does not have a diagnosis. Student 3 also demonstrates hearing

problems. Student 3 lives with both parents and Students 1 and 2 live in single-parent

households. None of the participants had experience with video modeling or role-play

activities prior to this study. Student 1 did mention that he enjoys acting for fun.


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Setting

The study took place in a non-profit, private school for students with disabilities

in North Texas. Before the study began, the researcher spoke with the school’s director to

designate pullout times that were least likely to disrupt classroom-learning time. The

students were escorted to the school’s library for approximately 10-15 minutes up to

three times weekly for intervention sessions. On some days the library was in use so the

sessions occurred in the school’s art room or auditorium.

Research Design

This study was a multiple-probe design. All students began on baseline for a

minimum of three sessions, which simply consisted of a conversation between the

participant and the researcher on a topic of the student’s choice. The design supported

internal validity through the use of the video camera (for a second observer’s scoring)

and the minimized conversation regarding the intervention outside of sessions. Social

validity was strengthened by the relevance of the intervention to other students with

Autism outside of this study. The intervention is also easy to replicate and requires

minimal materials.

The dependent variable was the student’s amount of eye contact. Eye contact was

operationally defined as looking the conversant in the eye while talking and listening

during any conversation and role-play activity for whole intervals of 5-seconds. If the

student looked away, even briefly, the interval was not counted. The independent variable

was the video modeling and role-play intervention, which involved the student viewing,

discussing, and re-enacting video clips with the researcher.

Materials and Procedures


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The materials used to collect data include a smart phone to keep time, a video

camera to record the student’s behavior, and a laptop to play the video clips. The

researcher selected a variety of video clips from the films Frozen, Up, and Shrek and

showed them on a laptop. The researcher selected video clips from each movie based on

the average amount of eye contact exemplified by the characters. Each video clip only

had two characters in the scene in order to make the role-playing activity easy to replicate

with the student and researcher. A new video clip was randomly presented for each

intervention session. No video clip was used more than once for any particular student.

The researcher selected two NIH-certified peers to serve as inter-observers. The

inter-observers cumulatively viewed 20% of the sessions’ video recordings and recorded

data using whole interval recording.

Training and Reliability

The researcher trained both observers by operationally defining eye contact,

including examples and non-examples. The researcher initially watched a sample video

with the observers to discuss exactly when to start the timer and how to record data using

the correct marks. The researcher scored data separately and then compared to the inter-

observers. The researcher assigned 20% of the data to the inter-observers to score and

then calculated inter-observer agreement (IOA). IOA was calculated by dividing

agreements by agreements plus disagreements and then multiplied by 100 to find the

point of agreement. An agreement only occurred with corresponding intervals. For

instance, if the researcher gave the second interval a plus but the inter-observer gave the

second interval a minus, then it would count a disagreement. The same number of plus’s

and minus’ between all data collection was not enough- the intervals all had to align.


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Baseline

Each baseline session consisted of a 5-minute conversation between the

researcher and the student. The researcher said, “let’s begin” to initiate the conversation

with the student, which cued the observer to start recording data when later viewing the

video recording of the session. Data were recorded every 5 seconds. The researcher said,

“time” at the end of the 5 minutes to cue cut off for recording. The student was permitted

to complete a thought if he/she wanted to avoid feeling cut off, however, eye contact after

the stopping point was not recorded. After each session, the researcher reviewed the

video recording in order to record data.

Intervention

The intervention sessions began when the students’ graphed baseline data showed

a consistent trend in the amount of student’s eye contact. The intervention began with a

1-3 minute introduction to the video. The researcher said, “As we watch this video clip, I

want you to pay close attention to where the character’s (i.e., Elsa) eyes are looking. Are

they looking at the other character (i.e. Anna), at their shoes, or at the wall? After we

finish watching the clip we will talk about it.”

After the clip ended, the researcher asked the student what he/she noticed about

the character’s eyes. If the student did not recognize that the character’s eyes were

looking at his/her friend, then the researcher prompted the student to come to this

realization by asking, “Did you notice the character looking at the other character in the

eyes?”

Then, the researcher told the student they were going to pretend to be the two

characters from the clip they just watched. Once roles were assigned, the researcher


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played the clip one more time so the student could pay close attention to his/her

character’s lines. If the student struggled getting into the scene, the researcher set the

example by reminding the student of the first few things the character said. Then the

researcher prompted the student to help her remember what happened next and act it out.

The researcher implemented two phase changes beginning on the 8th session.

Besides the initial conversation about the importance of making eye, the researcher felt

verbal prompting would benefit students as well. If the student did not look at the

researcher for a significant amount of time in the conversation, she would redirect by

saying, “Where are your eyes looking?” This verbal prompt was particularly necessary

for Student 3. The researcher also felt students were running out of things to say and

losing focus, so she adjusted the conversation time to 2.5 minutes.

Measures

The researcher used the whole interval method to score data. The conversations in

which data were collected were five minutes long for the first 8 sessions, then 2.5

minutes for the remaining sessions, with 5-second intervals. By watching the sessions’

video recordings, the researcher and interobservers could carefully track whether the

student maintained eye contact for the full 5-second interval. If he or she did, then a plus

sign was recorded for that interval. If he or she did not, then a minus sign was recorded.

Student 1 was the only student who attempted a 5-minute scene for his first two

interventions, and all others were 2.5 minutes. In order to maintain consistency in

graphing, the researcher converted all data using a ratio of 1:2 so that the number of

intervals was still 60 (representing a total of 5 minutes).


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If the student maintained eye contact with the researcher for the entire 5 seconds,

a plus sign was marked for that interval. If the student did not maintain eye contact with

the researcher for the entire interval, then a minus sign was recorded. Reliability of the

study was strengthened because all sessions were video-recorded and scored at a later

time (with a percentage of recordings scored by a two inter-observers). Internal validity

was strengthened because the researcher was able to deliver the intervention without

having to record data simultaneously.

Data Analysis

The researcher recorded the data on three separate graphs, one per student, and

analyzed data measuring the amount of each student’s eye contact to determine if it was

improving. Once the first student had three stable data points (with either a decelerating

or zerocelerating trend) in baseline, the intervention was introduced to the second student.

This process continued for the third student as well. The researcher analyzed the change

in level between the last data point of baseline and the first data point of the intervention

to find absolute level change. If the difference was positive then an immediate change

due to intervention was evident.

The researcher calculated the relative level change to look for change within

condition. Relative level change is computed by finding the average value of the first

condition, then the average value of the second condition, and finally subtracting the

smallest value from the largest, noting any difference.

The researcher also calculated the percentage of non-overlapping data point

values (PND) for each student’s graph to determine any change across conditions. She

did this by first determining the range of data point values in each student’s baseline


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condition. Then, she counted how many data point values from the intervention condition

fell within the previously determined range from baseline, and divided that number by the

total number of data point values in the intervention. Finally, she multiplied that value by

100 to reach a percentage. The ability to compute the PND between the baseline and

intervention conditions allowed the researcher to analyze the impact the intervention had

on the target behavior.

Results

Data representing students’ amount of eye contact across the baseline and

intervention conditions are presented in Figure 1. Students 1 and 2 indicated absolute

level changes of 2 and 6 intervals, respectively. Students 1 and 2 also demonstrated

increases in relative level change of 7 and 6, respectively. Student 3 did not show any

improvement in these areas.

The researcher’s calculations for PND indicated improvement for Student 1, as

85.7% of his data points during intervention fell outside of the range of data points during

baseline. This calculation indicates a strong student response to the intervention. Students

2 and 3’s data contained 0% non-overlapping data, which indicated that no data points

within the intervention phase fell beyond the range of data points collected during

baseline for these students. The accuracy of all data collection is confirmed by the inter-

observer agreement, which was 76.6%.


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Figure 1. Students’ amount of eye contact measured in whole time intervals across

baseline and intervention conditions.


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Baseline

Baseline data were stable for Students 1 and 3 based on visual analysis. Student 2

displayed variable amounts of eye contact with a slightly increasing trend. After working

with all students within the first three sessions, the researcher chose to implement

intervention with Student 1 first. Since baseline simply consisted of an individual

conversation between the student and the researcher, it was not necessary to meet with

every student every day. The researcher did not want to exasperate the students or pull

them away from excessive class time before the intervention began.

Intervention

Positive results followed the implementation of the video modeling and role-

playing intervention for Student 1. He responded very well during the initial instruction

and came to call the intervention “the glare.” The researcher consistently reminded the

student that the point of looking someone in the eyes during a conversation is simply to

let that person know you are listening, not to intimidate. Student 2 did show an

accelerating trend, however, the percentage of non-overlapping data was much lower

than Student 1. Student 3’s data indicate she did not make any progress, however,

qualitative notes reveal otherwise. During baseline, Student 3 angled her face down and

away from the researcher during conversation and often gave the answer, “I don’t know,”

to most questions. During the intervention, however, Student 3 angled her face towards

the researcher and had plenty to say. Although she never maintained eye contact for a

whole interval, she did glance at the researcher more often and kept her face lifted during

intervention sessions. She responded the most when she got to play her favorite character,

Olaf, from Frozen.


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Discussion

The results of this study demonstrate limited effectiveness of video modeling and

role-play in improving eye contact of students with Autism and similar conditions. This

information is relevant to the students, family members, and educators as the

development of social skills is an ongoing process. Since the intervention proved very

successful for one out of three participants, recommendations for continued use of this

intervention are as follows: Student 1 should begin working to generalize the target

behavior. Students 2 and 3 should continue interventions for social skills with some

modifications such as more prompting and more opportunities for practice.

Positive changes in the students’ behavior could possibly be attributed the

students’ increasing level of comfort with the researcher. Many students perform better

when they are working in a comfortable atmosphere and this situation is no different. Not

only did students respond better to the treatment, but the researcher as well towards the

end of the study.

The fact that Student 1 was the most outgoing and talkative student could explain

why he responded most successfully to the intervention. Student 2, although very

interested, struggled generating dialogue at times when the scene began, which could

explain why her improvement over time was not as significant. Student 3 was the least

talkative student in general, which could have been the cause for some inhibitions. After

talking with the school director, the researcher also discovered that Student 3’s

significant hearing problems could have also contributed to her lack of response at times.

Her head angling, which was originally perceived by the researcher to be bashfulness,

could have in fact been a result of the student’s hearing difficulty.


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Relevance

The findings are relevant to a much broader range of relatives, therapists, and

teachers of students with disabilities. The intervention’s flexible nature makes replication

possible at home or in pullout sessions. If a family feels that the student could benefit

from practice on a number of other social skills (i.e., conversation skills, non-verbal cues,

etc.) they can find video models online or in carefully selected movies and follow up with

a similar role-playing activity. Replication can be as simple or advanced as the

implementer is able to make it.

Eye contact in particular is a necessary skill in countless settings, both in and

outside of school, which is why practicing in a variety of settings is beneficial as students

work towards generalizing the behavior. As students graduate from high school, many

desire jobs. As society becomes increasingly acceptable of people with disabilities, so

does the job market. Many people with Autism are fully capable of succeeding in the

workforce if they can successfully communicate with others. Good relationships with

coworkers, employers, and clients typically form on the basis of acceptable social skills.

Although these skills may not come naturally to people with Autism and similar

conditions, they can learn explicitly through intervention.

Limitations

The small sample size presents itself as this study’s greatest limitation. Only three

students, all from the same school and similar demographics, were selected as

participants for this seven-week study. The criteria had to be significantly adjusted due to

the limited amount of options for participants, resulting in the acceptance of Student 3,

who does not have an Autism diagnosis. A longer time period would have allotted the


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researcher a greater opportunity to implement the intervention in other schools and

increase the sample size while using stricter criteria. Even within the group of students

that demonstrates a difficulty with eye contact, no student is exactly the same.

Another limitation existed in the researcher’s decision to accept participants in

middle and secondary school. At this point in the students’ lives, they have already

received various forms of therapy and interventions. Students brought in varying amounts

of prior experience that could have affected their conception of this intervention.

Student absences and school holidays also limited the researcher’s ability to

collect as much data as she would have preferred. Student 2 had frequent therapy sessions

that required her to leave school early, and Student 3 had frequent absences due to illness.

Unexpected ice days also caused school delays and cancelations.

The researcher was not scored on implementation and procedural fidelity. This

means that although the researcher was systematic in her implementation of the

intervention, data collection, and scoring, there is potential for human error that was not

fully accounted for.

In regards to social skills, eye contact does not capture some of the most

important skills. For example, in some situations body language can say more than eye

contact. In some scenes used in the intervention, the characters turned away from each

other to indicate disappointment. If the researcher were to adjust this study, she would

extend her explanation to the appropriateness of eye contact in relation to body language.

There are times in which a lack of eye contact is socially acceptable.


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Finally, the limited amount of data weakened the internal validity of the study.

Due to the researcher’s quickly approaching deadline, the intervention condition lasted a

shorter amount of time than desired.

Future Research

The study’s results indicate a need for future investigation. The particularly

positive reaction from Student 1 to the intervention implies promising results for future

replications of this study. Under better conditions and with further practice, Students 2

and 3 may have done better. Future researchers should focus on using a video modeling

and role-playing intervention to address other social skills of students with Autism such

as verbal and non-verbal communication. The few studies that have explored the use of

role-playing or acting have yielded successful results. Unfortunately, these studies are

limited. Further replications would draw attention to this innovate approach to teaching

social skills in the fields of research, education, and art. The flexible nature of this

intervention presents parents, teachers, and researchers with the option to address a great

variety of target behaviors.


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Documents

Improving Eye Contact through Video Modeling and Role-Play ......The Autistic Brain: Thinking Across the Spectrum (2013). She references The Journal of Autism and Developmental Disorders