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© Springer International Publishing AG 2017
J.B. Leaf (ed.), Handbook of Social Skills and Autism Spectrum Disorder, Autism and Child
Psychopathology Series, DOI 10.1007/978-3-319-62995-7_18
Using the Teaching Interaction
Procedure to Teach Social Skills
for Individuals Diagnosed
with Autism Spectrum Disorder
Joseph H. Cihon, Sara M. Weinkauf,
and Mitchell Taubman
J.H. Cihon (*)
Autism Partnership Foundation,
Seal Beach, CA, USA
Endicott College, Beverly, MA, USA
e-mail: jcihon@autismpartnership.com
S.M. Weinkauf
JBA Institute, Torrance, CA, USA
M. Taubman
Autism Partnership Foundation,
Seal Beach, CA, USA
18
18.1 Introduction
Autism spectrum disorder (ASD) is marked by
qualitative impairments with social skills, com-
munication, and restricted and/or repetitive
behavior (American Psychiatric Association,
2013). Interventions based on the science of
applied behavior analysis (ABA) have been des-
ignated as the only empirically supported inter-
ventions to address these areas of need (Smith,
2012). With respect to the development of social
repertoires, one evidence-based intervention is
the teaching interaction procedure (TIP; Leaf
et al., 2015b; Phillips et al., 1968), which consists
of a multistep, systematic teaching procedure.
This chapter will provide an in-depth description
of the TIP, a historical context, a summary of
recent research as it applies to ASD and social
skills, and a discussion of future directions and
implications.
18.2 What Is the Teaching
Interaction Procedure?
The term teaching interaction first appeared in
print when Phillips and colleagues (1968)
described the procedure in The Teaching Family
Handbook. The TIP, specifically, was originally
developed as a component of the Teaching
Family Model (Phillips, 1968), which was
designed as an ABA-based intervention
approach to improve the lives and reduce the
recidivism of pre-delinquent and delinquent
youth. Lonnie and Elaine Phillips, who were the
original Teaching Parents in the first Teaching
Family Home (Kirigin, Braukmann, Atwater, &
Wolf, 1982; Phillips, 1968; Wolf et al. 1976),
furnished skill instruction to the program’s
court-adjudicated residents. Through videotape
analyses, it was determined that the couple
described and demonstrated necessary skills,
provided reasons that the skills were important
to the young residents’ future success, and had
the youth practice the skills while specific feed-
back was provided. Thus, the TIP was born and
research into its effectiveness followed. Minkin
et al. (1976) provided an early experimental
analysis of using the TIP to teach social skills to
pre-delinquent and delinquent girls (12–14
years of age). The girls who volunteered for the
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study demonstrated deficits in social communi-
cation skills with others. The researchers tar-
geted asking appropriate conversational
questions and providing positive conversational
feedback. The results showed that the TIP was
effective at increasing the use of the targeted
conversational skills for all four girls.
Following the first description, coining of
the term, and early research, the TIP was
brought to the Young Autism Project at UCLA
(Lovaas, 1987) by the third author (i.e.,
Mitchell Taubman) and implemented with
individuals diagnosed with ASD, including
those in residential facilities (Smith, Parker,
Taubman, & Lovaas, 1992). Subsequently, the
TIP has been included in curriculum books,
such as Crafting Connections (Taubman, Leaf,
& McEachin, 2011), and training manuals,
such as Effective Skills for Child- care Workers:
A Training Manual from Boys Town (Dowd,
Czyz, O’Kane, & Elofson. 1994), and The
ASSET Manual (Hazel, Schumaker, Sherman,
& Sheldon-Wildgen, 1983). Although the steps
of the TIP typically occur in the same order in
these publications, as well as in practice, the
order should be viewed as a guideline and the
interventionist should remain flexible and
modify as needed. What follows is a descrip-
tion of the common order found within the lit-
erature and curriculum guides as well as a
visual representation of the common sequence
outlined in Fig. 18.1.
18.2.1 Label and Identify
In the first step, the interventionist labels/identi-
fies the skill that will be the target of the teaching
interaction. The end of this step is typically
marked by the learner repeating the skill to the
interventionist. This step is used to ensure attend-
ing and that the learner can label the skill to be
learned. As such, the interventionist should
ensure that the label is clear and concise. The lan-
guage used and length of the label (i.e., number
of words or syllables used) should be appropriate
for the learner’s age and skill level.
18.2.2 Meaningful Rationales
The second step involves discussing meaningful
rationales for why the skill is important. These
rationales are meaningful in that they are impor-
tant to the learner and are informed by the learn-
er’s experiences. For example, if talking to peers
about superheroes is a preferred topic for the
learner, but s/he does not maintain appropriate
distance during the interaction which results in
peers walking away, then learning this skill so
peers stay close and talk about superheroes would
potentially be meaningful for the learner.
Furthermore, rationales should be comprised of
potentially natural consequences for the behavior
being taught. For instance, a rationale should not
be “You should stay an arm’s length away from
your friends, so you don’t get in trouble with
your teacher,” but, rather, “You should stay an
arm’s length away from your friends because it
could make more friends want to stay by you and
talk to you about superheroes.” Therefore, ratio-
nales should not include external or artificial con-
sequences (e.g., awarding of tokens) or potentially
unrealistic outcomes (e.g., you will become the
quarterback of your favorite NFL team). They are
intended to introduce the student to salient, sup-
portive consequences that will likely occur once
the student learns and employs the skill being tar-
geted. During the first session with the TIP, the
interventionist may take a more active role in
providing rationales and can then gradually fade
so that the learner is providing the meaningful
rationales in future TIPs (Braukmann, Ramp,
Braukmann, Willner, & Wolf, 1983).
18.2.3 Description
Third, the interventionist breaks the skill down
into its components or steps. These steps should
be defined in a way that is clear to the learner. A
description of the skill could be broken down into
smaller steps similar to a task analysis or as a
component of a larger social skill. No matter how
the skill is broken down, it should be done prior
to the teaching interaction so that the interven-
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tionist is prepared. Breaking down a complex
social skill in vivo can be extremely difficult even
for highly skilled and practiced interventionists.
In addition, given the complex nature of social
skills, the steps should include all relevant infor-
mation. This often includes not only what to do
but also how to do it (e.g., posture, tone, and
gaze). This step is complete once the learner
repeats or states the components or steps in the
skill.
18.2.4 Demonstration
Following the description, or sometimes done
concurrently, the interventionist models the skill
for the learner. This is the fourth step of the
TIP. The demonstration includes models of the
correct and incorrect way to engage in the skill.
This also sets the occasion for the learner to label
if and why the demonstration was correct or
incorrect. Modeling provides the interventionist
with an opportunity to show the learner the exem-
plar performance and nonexemplar performance,
ranging from more obvious examples to less
obvious examples as the learner progresses.
Furthermore, the interventionist can use the dem-
onstration of the incorrect performance (some-
times referred to as “not-cool;” Leaf et al., 2016)
to model the current way the learner responds in
the social situation so that the learner can begin
to identify that response as incorrect.
Demonstrations can occur in vivo, written or pic-
torial, or via a recording, and should be selected
based on what will be most beneficial for the
learner. Regardless of the modality of the demon-
stration, the demonstration paired with the
description should provide the learner with a
complete representation of the targeted skill.
18.2.5 Practice
In the fifth, and perhaps most important, step, the
learner practices/role-plays the skill with the
interventionist or a peer. Practice takes the TIP
beyond simply describing and demonstrating the
skill for the learner and is an essential part of
learning. In general, behavior must occur for it to
be altered by consequences and practice provides
this opportunity for the learner. The learner
should have ample time to practice what has been
modeled by the interventionist. Practice should
be designed in a way that increases the likelihood
Label & Identify
• What is being taught?
Meaning ful Rationale
• Why is this skill important
to the learner?
Description
• When should the learner use
the skill?
• What are the signals/cues?
Task Analysis
• What are the important
steps?
• Break it down to the level of
the learner
Demonstration
• Correct, omitted, and/or
incorrect steps
• Base model on the learner's
responding
Practice
• It's the learner's turn!
Feedback
• Reinforcement and
corrective feedback as
needed
• Relate back to the rationale
Repeat as necessary
Fig. 18.1 A flowchart depicting the typical sequence for conducting a teaching interaction procedure (TIP). It should
be noted this flowchart is provided as a guideline and should not be taken as the only way to conduct a TIP
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that the learner will be successful. Over time,
practice scenarios should be expanded to increase
complexity, difficulty, and independence. Thus,
practice begins to resemble the terminal environ-
ment in an effort to promote generalization
(Stokes & Baer, 1977).
18.2.6 Feedback
Following practice/role-plays, the interventionist
engages in the final step of the TIP, feedback.
Practice in the absence of feedback will have a
limited impact. If practice sets the occasion for
the learner to engage in behavior, feedback is the
set of consequences that will shape that behavior.
Feedback should be specific and descriptive.
Feedback can take the form of a potentially rein-
forcing event when the learner engages in the tar-
geted step(s) of the skill correctly (e.g., verbal
praise, access to a preferred event, a token). If the
learner displays some or all of the steps incor-
rectly, feedback can take the form of corrective or
instructive feedback (Werts, Wolery, &
Holcombe, 1991). Role-plays and feedback con-
tinue until the learner meets a predetermined cri-
terion for mastery selected by the interventionist
(e.g., 100% of steps completed correctly across
three consecutive role-plays).
18.3 Teaching Interaction
Procedure and Behavioral
Skills Training
Many teaching procedures based upon the prin-
ciples of ABA have components of the TIP
embedded into the procedures. The procedure
that associates most closely with the TIP is
behavioral skills training (BST; see Chap. 19).
These two procedures sharing many common
features have led to author commentaries dis-
cussing the similarities and differences of the two
procedures (e.g., Leaf et al., 2015b). These com-
mentaries have identified two primary features of
the TIP that distinguish it from BST.
First, the TIP includes the provision of ratio-
nales. When developing and evaluating the TIP, the
use of rationales was viewed as a critical component
(Leaf et al., 2015b). It was hypothesized that mean-
ingful rationales could result in faster fading of
supplemental reinforcement (e.g., tokens). As
noted previously, rationales typically include the
description of naturally occurring contingencies.
For example, losing graciously can result in your
peers asking you to play more frequently, whereas
being a “sore loser” can result in your peers asking
you to play less often. Furthermore, it is speculated
that the use of rationales can aide in developing the
learner’s understanding of cause and effect, as
demonstrated by the learner providing potential
outcomes based on the presentation of precipitat-
ing situations and desired choice making. In con-
trast, BST does not include meaningful rationales
as a core component but, instead, focuses solely on
the use of instructions, modeling, rehearsal, and
feedback (Miltenberger, 2008) to achieve the
desired change in behavior.
The second distinguishing feature is that the
TIP includes a demonstration of the correct and
incorrect way to engage in the targeted skill.
Demonstrations of the incorrect response are
often catered to the learner. That is, the interven-
tionist models the features of the learner’s current
responding with respect to the targeted skill. This
is done in an attempt to teach the learner the dis-
crimination between her/his current performance
and the desired performance. Conversely, dem-
onstrations during BST include only the correct
way to engage in the targeted skill.
18.4 The TIP, ASD, and Social Skills
Thirty-five years after the procedure first appeared
in print and was initially used in treatment for per-
sons diagnosed with autism, Leaf et al. (2009)
provided the first empirical evaluation of the TIP
with individuals diagnosed with ASD. Prior to
this, Harchik et al. included the TIP in their 1992
study; however, the participants were adults diag-
nosed with mental retardation and not autism.
Since Leaf et al., several other studies have also
evaluated the effectiveness of the TIP for teaching
individuals diagnosed with an ASD; many of
which have targeted social skills. The focus of the
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remainder of this chapter is to provide a summary
of the research exploring the effectiveness of the
TIP to teach social skills to individuals diagnosed
with ASD (for a full review of the use of the TIP,
see Leaf et al., 2015b).
As previously mentioned, Leaf et al. (2009) pro-
vided the first empirical evaluation of the TIP with
individuals diagnosed with an ASD. The research-
ers evaluated the effectiveness of the TIP to teach
various social skills to children, ranging in age
from 5 to 7 years old. Targeted social skills included
following a peer, greeting a peer, including a peer
in an activity, choosing a peer partner, changing the
topic during a conversation, going with the flow of
a conversation or game, giving a compliment, shar-
ing, and making on-topic statements. The TIP was
implemented within a one- to- one instructional for-
mat, and the effects were measured through natu-
ralistic probes. These probes consisted of a
confederate peer setting the occasion for the par-
ticipant to engage in the targeted skill. For exam-
ple, if the target skill was giving a compliment, the
confederate peer would show the participant a
piece of artwork s/he had completed. The confeder-
ate peers were not present throughout the course of
intervention (i.e., while the skill was being taught
to the participant via the steps of the TIP). The
results of Leaf et al. (2009) demonstrated that the
TIP was effective for teaching all three individuals
the targeted social skills; however, no generaliza-
tion measures were collected and maintenance
measures were variable.
Leaf et al. (2010) examined the effectiveness
of the TIP within group instruction for five indi-
viduals, ages ranging from 4 to 6 years old, diag-
nosed with ASD. Target skills included showing
appreciation, giving a compliment, expressing or
displaying empathy, and changing the game. The
study took place over 5–7 months with sessions
occurring twice a week for 1.5 h. Two typically
developing peers served as models during teach-
ing sessions. The results of a multiple probe
design showed that the group TIP was effective
for teaching the targeted skills for all of the par-
ticipants. Furthermore, the skills maintained 8
weeks after intervention was completed, and
social validity measures indicated that the inter-
vention was satisfactory. In addition, generaliza-
tion measures indicated variable levels of
responding; however, these measures did not
include the participants’ typical learning or social
environments (e.g., school).
Dotson et al. (2010) extended the use of the
TIP within a group instructional format with five
adolescents, aged 13 to 18 years old, diagnosed
with ASD. The researchers used the TIP to teach
the participants conversational basics, providing
positive feedback to the speaker, and answering
open-ended questions. These skills were broken
down into smaller components, such as maintain-
ing eye contact, using a positive voice tone, and
listening from an appropriate distance. Four of
the five participants reached the mastery criteria;
however, the skills were maintained at variable
rates across the five participants.
Leaf et al. (2012) compared the relative effec-
tiveness of the TIP to Social Stories™ to teach
six individuals, ages 5 to 13 years old, with ASD,
social skills in a one-to-one instructional format.
Three social skills were randomly selected for
each condition (i.e., TIP and Social Stories™).
Skills included losing or winning graciously,
sportsmanship, giving compliments, cheering up
a friend, showing appreciation, reciprocal com-
pliments, maintaining an on-topic conversation,
and changing the conversation. The results indi-
cated that the TIP was more effective (i.e., par-
ticipants mastered all skills taught using the TIP)
than Social Stories™ (i.e., only four skills were
mastered across all of the participants using
Social Stories™). Furthermore, skills taught
using the TIP were more likely to generalize and
maintain after the intervention.
Oppenheim-Leaf et al. (2012a) used the TIP to
teach two children with ASD, ages 5 and 7 years
old, how to play three common games (Go Fish®,
Uno®, and Yahtzee Junior®). Each of the com-
ponents of the games was broken down into small
steps and taught via the TIP. Both children par-
ticipated in each TIP (i.e., a dyad instructional
format). The rationale portion of the TIP also
consisted of the purpose of the game. Both par-
ticipants learned all three games with high levels
of generalization.
Oppenheim-Leaf et al. (2012b) extended the
literature in regard to the application of the TIP
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by examining the procedure’s use in teaching
typically developing children skills to promote
social interactions with their siblings diagnosed
with ASD. Participants included three siblings,
ages 4 to 7 years old, who were taught within a
small group format. Targeted skills were inviting
a sibling to play, asking to share, providing play
instructions, and choosing an activity. Skill
acquisition was measured in three ways. The first
was during role-plays within each TIP conducted
with an adult. The second was during generaliza-
tion probes with the participants’ siblings (ages
4 to 5 years old) in which the researchers
prompted the siblings with ASD to engage in
behavior that would create an opportunity for the
participants to display the targeted skills. And,
finally, during free-play probes in which the par-
ticipants and their siblings with ASD were
instructed to “go play.” Results from teaching
and generalization probes indicated that the TIP
was effective at teaching all three children the tar-
geted skills; however, during free play probes,
only one dyad demonstrated an increase in social
interactions without additional support.
Kassardjian et al. (2013) examined the gener-
alization of social skills taught using the TIP to a
natural environment with four individuals diag-
nosed with ASD, ages ranging 4 to 13 years old.
The researchers included a fifth participant as a
control (i.e., no intervention). Targeted skills were
taught in a one-to-one instructional format and
consisted of expanding conversations, winning
graciously, social initiations, greeting a peer, and
joining on-going conversations. Unlike previous
studies, the researchers implementing the TIP did
not solely rely on predetermined mastery criterion
but, rather, made in-the-moment assessments to
modify the implementation of elements of the TIP
based on participants’ performance and progress
(e.g., determining how many role- plays were con-
ducted). Furthermore, the intervention was gradu-
ally faded out during stages of generalization.
These stages consisted of (1) priming and tangible
reinforcement, (2) tangible reinforcement without
priming, (3) social praise without priming, and (4)
no priming or programmed reinforcement. The
results of a multiple baseline across participants
design indicated that the flexible TIP was effec-
tive for teaching all four participants, the targeted
social skills. Also, the skills generalized into natu-
rally occurring settings, with additional peers,
without the inclusion of supplemental reinforce-
ment (Kassardjian et al., 2013).
Ferguson, Gillis, and Sevlever (2013) used the
TIP with video games to teach six children diag-
nosed with ASD, ages 7 to 11 years old, team
sportsmanship skills. These skills included giv-
ing compliments, taking turns, and making a
positive post-game comment (e.g., “Good
game!”). TIPs were conducted in a small group
instructional format (i.e., n < 6), and intervention
lasted 10 weeks. The results of the study showed
an increase in the number of sportsmanship skills
and a decrease in the number of negative com-
ments. Generalization probes occurred in other
settings or with other video games and indicated
that the skills generalized to other contexts.
Kassardjian et al. (2014) replicated and
extended Leaf et al. (2012). The extension con-
sisted of using a group rather than a one-to-one
instructional format, evaluating responding to
peers rather than adults and an analysis of partici-
pant responding during each intervention. Three
children, each 5 years old and diagnosed with
ASD, participated in the study. One social skill
was assigned to the TIP condition, the Social
Stories™ condition, and a control condition (i.e.,
three skills in all). Changing the game when a
friend is bored was selected as the target in the
TIP condition, explaining a prior event in the
Social Stories™ condition, and inviting a peer to
play in the control condition. The results, which
were similar to Leaf et al., indicated that the TIP
was the most effective intervention (i.e., none of
the participants reached the mastery criteria for
skills in the control condition or the Social
Stories™ condition). Data collected on respond-
ing during teaching indicated that both proce-
dures resulted in accurate responses to
comprehension questions, but this responding
did not result in an increase in the percentage of
correct steps displayed for the targeted skill.
Furthermore, all of the skills maintained for at
least 100 days following the TIP intervention.
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Ng, Schulze, Rudrud, and Leaf (2016) exam-
ined the effectiveness of a modified TIP to teach
social skills to four individuals, ages 9 to 15 years
old, diagnosed with ASD. At the time of the study,
each participant would have been considered
lower functioning (i.e., an IQ score less than 75).
Target ed s ki ll s in cl ud ed p ro vi di ng h el p, nego ti at -
ing, giving a compliment, passing the phone,
responding to offers of help, requesting without
grabbing, and responding to comments. The TIP
was utilized in a small group instructional format.
Modifications to the TIP included the use of dem-
onstrations of the rationales, picture prompts for
identifying situations in which to engage in the
skills, picture prompts to identify the steps of the
skills, and only providing demonstrations of the
correct way to engage in the targeted skill, as
opposed to correct and incorrect, with the ratio-
nale of the final modification being to avoid the
potential of imitating undesirable examples. The
results indicated that the modified TIP was effec-
tive in teaching the targeted skills for all four par-
ticipants; however, for one participant, a variable
and increasing trend in baseline for the third skill
limits the interpretation of the results with respect
to a functional relation for that participant.
Peters, Tullis, and Gallagher (2016) extended
Leaf et al. (2010) by evaluating the effectiveness
of the TIP implemented in a group instructional
format to improve social skills for four individu-
als, ages 8 to 10 years old, diagnosed with
ASD. Peters et al. also assessed maintenance of
the social skills targeted during the intervention
(i.e., asking for help from an adult, ignoring
classmates when they are distracting, joining
activities that are already started, and responding
appropriately when a game is changed). All ses-
sions occurred in the individual’s classrooms,
and the TIP was conducted by the staff within
each classroom. The results of a multiple-probe
design indicated that the TIP was effective at
teaching the targeted social skills for all four par-
ticipants. Furthermore, maintenance checks
showed that the skills were maintained at or near
the mastery criterion level for all four partici-
pants, and social validity measures showed that
the participants’ parents were very satisfied with
the intervention.
18.5 Future Areas of Research
There are several commonalities within the liter-
ature that has examined the use of the TIP to
teach social skills to individuals diagnosed with
ASD. First, the TIP has been empirically demon-
strated to be an effective teaching procedure
across many settings, participants, and skills. It
has also been shown to be effective in both one-
to- one and group instructional formats. Many of
the studies have used a multiple baseline or mul-
tiple probe design to examine the effectiveness of
the TIP, with the exception of Leaf et al. 2012,
with skill acquisition commonly assessed through
probes during teaching or in a more naturalistic
setting. Another commonality found in the litera-
ture is that, for the majority of the studies to date,
many of the participants would commonly be
described as high functioning, with the exception
of Ng et al. (2016). Finally, social validity mea-
sures taken throughout the TIP literature are lim-
ited. So, while the TIP has a respectable, emerging
literature base for teaching social skills to indi-
viduals diagnosed with an ASD, there are still
areas of research that require more investigation.
Although the TIP is a systematic procedure
consisting of several components, no research to
date has conducted a component analysis of the
TIP; therefore, it remains unclear which compo-
nents are necessary to ensure skill acquisition. A
component analysis would allow researchers to
explore the critical variables of the TIP and
potentially improve efficiency if some compo-
nents were deemed unnecessary. Furthermore,
the two features that distinguish the TIP from
BST are the inclusion of rationales and teacher
modeling of correct and incorrect skill perfor-
mance; therefore, a component analysis would
allow for researchers to determine if these differ-
ing features result in specific short-term or long-
term changes in learning or behavior that make
the distinction necessary.
To date, the study by Ng et al. (2016) remains
the only study to examine the use of the TIP to
teach social skills to individuals with more severe
cognitive impairments. The researchers modified
some of the components of the TIP before teach-
ing so the extent to which these modifications
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were necessary for the TIP to be effective remains
unknown. Future research should continue to
examine the use of the TIP to teach social skills
to individuals diagnosed with ASD with a variety
of skill levels. This research could examine what
modifications or procedural components are nec-
essary for which learners, which skills should be
targeted with various populations, and what pre-
requisite skills are necessary for the TIP to be an
effective teaching tool with a variety of
populations.
Many studies have explored the use of the TIP
within a group or one-to-one instructional for-
mat. The benefits of group instruction when
teaching social skills has been well documented
(e.g., Leaf et al., 2010). Nonetheless, research
has yet to demonstrate the direct benefits of con-
ducting the TIP in a group versus a one-to-one
format. Some potential measures that could
extend the literature base with respect to the ben-
efits of conducting this procedure in a group for-
mat could include efficiency, observational
learning repertoires, maintenance, and general-
ization. In addition to examining the potential
benefits of conducting the TIP in a group format,
research could also help determine the necessary
prerequisite skills for a learner to benefit from a
group TIP. For example, investigating if learners
with less advanced observational learning reper-
toires would benefit as greatly from group TIPs
as peers with more advanced observational learn-
ing repertoires.
Oppenheim-Leaf et al. (2012b) provided an
innovative example of using the TIP to improve
the social skills of children diagnosed with an
ASD without direct intervention. The researchers
taught specific social skills to siblings to improve
their interactions with their brothers and sisters
diagnosed with ASD. By teaching the siblings,
these skills also resulted in improvements in the
social skills of the children diagnosed with
ASD. This research could be extended in several
ways. For example, exploring what skills to tar-
get that would result in the largest collateral
social improvements for their brothers and sisters
diagnosed with ASD. Another possible extension
could examine if similar skills, taught to parents,
would result in similar effects. In addition, it may
be beneficial to consider social validity measures
to measure the children’s satisfaction with the
intervention as well as improvements in their
overall relationship with their sibling with special
needs.
To that end, the existence of social validity
measures within the TIP literature is lacking,
which is similar within much behavior analytic
work in general (Carr, Austin, Britton, Kellum, &
Bailey, 1999; Schwartz & Baer, 1991). The TIP is
an effective tool to teach social skills; however, it
remains unclear to what extent the skills taught,
or the procedure itself, is socially acceptable or
preferred. Effectiveness is not the only significant
criterion when determining the appropriateness
of a procedure or intervention approach. The pro-
cedure also needs to be socially acceptable and
appropriate, with all stakeholders considered.
Future TIP research and more behavior analytic
work, in general, should include measures of
social validity. These measures can include
appropriateness of the procedure, skill selection,
participant preference, and acceptability of levels
of maintenance and generalization.
18.6 Recommendations
for Practice
Social skills are complex phenomena and are
often more difficult to teach than other skills typi-
cally targeted for individuals diagnosed with
ASD (Taubman et al., 2011). There are an
increasing number of procedures or techniques
available to the interventionist to help teach these
complex skills (the existence of this book is a
perfect example of this increase). These proce-
dures include but are not limited to, Social
Stories™ (Gray, 2004), social scripts (e.g.,
Loveland & Tunali, 1991), TIP (Phillips et al.,
1968), BST (Miltenberger, 2008), pivotal
response training (PRT; Koegel et al., 1989), and
video modeling (e.g., Charlop & Milstein, 1989).
With this increase, it behooves the practitioner to
evaluate the empirical literature base, or lack
thereof, as well as the learner’s current social rep-
ertoire and prerequisite skills before selecting the
most appropriate procedure to use.
J.H. Cihon et al.
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321
As discussed previously, the TIP has been
empirically demonstrated to be an effective
approach to developing meaningful social skills.
The practitioner can be assured that when select-
ing the TIP to teach social skills, s/he is selecting
a procedure with a strong evidence base.
Furthermore, the frequent use of comparative
designs when evaluating the TIP provides the
practitioner with a guide for selecting the most
efficacious procedure. For instance, if one is
deciding between the use of Social Stories™ or
the TIP, the current comparative evidence indi-
cates that the TIP is the more desirable of the two
procedures. Although there may be conditions
under which Social Stories™ are more effective,
the current literature base has yet to identify these
conditions (Leaf et al., 2015a).
However, the TIP may not be well suited for
all learners. Although the research is lacking in
identifying which component skills are necessary
for the TIP to be an effective teaching tool, some
component skills should most likely be devel-
oped prior to using the TIP. First, given the
exchanges that occur between the interventionist
and the learner(s), some basic and/or intermedi-
ate conversation skills (e.g., commenting,
responding to comments, answering open-ended
questions; Leaf, & McEachin, 1999) and interac-
tion skills (e.g., following the lead of another,
social problem solving; Taubman et al., 2011)
may be necessary. Second, even brief TIPs can
require the learner to attend for rather long dura-
tions, so sustained attending may also be a neces-
sary skill prior to using the TIP. Third, Taubman
et al. (2011) discussed the need for a basic under-
standing of cause and effect relationships (e.g.,
turn the light off/the room is dark, drop an egg/
the egg shell is broken; Leaf, & McEachin, 1999)
as a prerequisite for the TIP. This understanding
is demonstrated by the learner stating why an
outcome occurred (e.g., “The egg is broken
because it fell on the floor”) and may be neces-
sary for comprehending rationales as well as the
relationships between role-play, employment of
learned skills in everyday situations, and resul-
tant changes in outcomes; therefore, this reper-
toire is also likely to be an important prerequisite
before utilizing the TIP to teach social skills.
18.7 Conclusion
When addressing social skills deficits for indi-
viduals diagnosed with ASD, many procedures
and approaches are available. Although there are
still areas of research to investigate regarding dif-
ferent aspects of the TIP, it should be one of the
prominent procedures selected for teaching social
skills, especially over nonempirically based pro-
cedures, given its documented effectiveness,
emerging literature base (Leaf et al., 2015b), and
flexibility in teaching and targeted skills (Dotson
et al., 2013; Kassardjian et al., 2013; Ng et al.,
2016). Through continued research and investi-
gation into this effective procedure, further
improvements in the intervention strategies uti-
lized to teach social skills to individuals with
ASD can be achieved.
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