Introduction
Today nearly all teens play video games, and over 4.5 billion people worldwide connect to the internet regularly (Internet World Stats, 2020). Players can select from a vast array of video games and play them on various screen-based media (e.g., home consoles, PC games, mobile games, touch-screen devices, online multi-player games, virtual reality, etc.). Most devices that support video games also access the internet and connect players around the world. A 2019 census estimated youth in the United States (ages 8-12) engaged in an average of 4.44 hours daily using screen-based media (not including time used for academic purposes), and 64% of children reported playing video games for 1.28 hours per day (Rideout & Robb, 2019). This evidence illustrates the major role video games play in the life of most teens.
Electronic media, including video games, is also extremely popular with youth diagnosed with autism spectrum disorder (ASD). Youth with ASD use electronic media even more frequently than neurotypical youth. For example, Mazurek and Wenstrop (2013) evaluated the amount youth with ASD (ages 8-18) used screen-based media in contrast to their neurotypical peers. The ASD group spent significant amount of their leisure time (62%) with electronic media than they did engaged in any other activity. They also spent significantly more time gaming and less time engaging in screen-free activities than the neurotypical group. Parents estimated youth with ASD spent 4.5 hours every day using electronic media, and played video games at least 2 hours per day, compared to neurotypical youth that spent 87% more time participating in other activities not involving a screen (Mazurek & Wenstrop, 2013). Likewise, teens with ASD visit websites that contain content related to video games more frequently than they visit websites with unrelated content (Kuo et al., 2014).
Video games are an important tool that teens, especially boys, use to socialize. According to Lenhart et al. (2015), most adolescents that play video games, play the games on the internet (75%), and many of these teens (52%) have played the games with strangers online. Additionally, 34% of all teen boys made a new friend while playing a video game online (Lenhart et al., 2015).
Despite the social benefits, youth may potentially be exposed to a variety of safety threats (e.g., cyberbullying, online enticement, sexual solicitation) in this virtual environment. McColgan and Giordano (2005) found the major threats youth face online include: a) exposure to material that is unsuitable or promotes risky behavior, b) harassing or demeaning conversation (i.e., cyberbullying), c) revealing of financial information or participating with activities that are illegal, and d) safety issues (e.g., online enticement and sexual solicitation). Internet predators will groom youth first by engaging in online communications to establish trust before planning to meet the child for a sexual encounter (Wolak et al., 2004). In 2010, 9% of teens (ages 10-17) that were surveyed recounted receiving unwanted sexual solicitations online (Jones et al., 2012).
Even more troubling, individuals with disabilities are universally more susceptible to being victimized. According to the Bureau of Justice Statistics (BJS, 2017), individuals with disabilities were victims of violent crime more than twice as much as the general population in 2015. Additionally, persons with an intellectual and developmental disability (IDD) were more prone to victimization. Variables that have been linked to the cyber-solicitation of youths (e.g., depression, loneliness, and social isolation) are generally found more often with youths with ASD than typically developing youth (Normand & Sallafranque, 2015).
Likewise, children with ASD may be coerced more easily by strangers than neurotypical children due to deficits in communication and social skills that are commonly associated with the disorder (Gunby et al., 2010). For example, one of the defining features of ASD, outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), are difficulties communicating and interacting socially across various settings and circumstances. This includes appropriately adjusting behavior and relationships to fit within different social contexts (American Psychiatric Association, 2013).
Effective training is sorely needed to teach safety responses to youth with ASD to use when safety threats are encountered while playing video games online. Jones et al. (2013) systematically reviewed youth prevention programs (e.g., drug abuse, sex abuse, youth violence) and identified the following key components of the most effective evidence-based strategies: a) the curriculum is structured so the materials presented are of high quality and delivered consistently, b) active learning strategies and skill-based learning objectives are utilized, and c) an “adequate dose” of training (i.e., lessons that build upon previous training) with extra learning opportunities is provided.
Jones et al. (2013) also identified and reviewed the well-established internet-safety programs that teach youth online-safety skills for use with threats encountered online (e.g., iKeepSafe, the i-SAFE prevention program, Netsmartz, and WebWiseKids). However, these popular programs are limited because they utilize an informational approach to safety training (i.e., educational messages are delivered, but learners are not given the opportunity to practice the skills that are taught). Similar safety programs for children that address other threats (e.g., discovering a firearm) have been found to be inferior to interventions that give learners opportunities to practice the skills that are being taught.
In-situ assessments have been used by many studies to evaluate the effectiveness of safety-training programs. During an in-situ assessment the experimenter contrives a situation in the subject’s natural environment for the purpose of simulating a specific safety threat (Miltenberger et al., 2013). These assessments consistently demonstrate that informational approaches (e.g., viewing a DVD) do not effectively teach safety skills.
An example of a safety-training program that utilizes an informational approach is the National Rifle Association’s (NRA) Eddie Eagle Gun-Safe program. Children are played a DVD that instructs the appropriate safety responses to use when a firearm is encountered. The Eddie Eagle program was demonstrated to be an ineffective procedure for training firearm-safety skills because most participants failed to perform the safety responses accurately during in-situ assessments (Gatheridge et al., 2004; Himle, et al., 2004). Likewise, the Safe Side DVD that teaches children abduction-prevention skills, when evaluated using in-situ assessments, also showed the participants failed to demonstrate the correct abductionprevention responses (Beck & Miltenberger, 2009).
Active learning interventions for risk prevention are characterized by learners practicing the skills until they are performed independently. Active learning approaches have reliably outperformed informational approaches in behavioral assessments of safety skills (e.g., Gatheridge et al., 2004; Himle et al., 2004; Kelso et al., 2007). Behavioral skills training (BST) is an active learning strategy that blends instruction (i.e., description of safety threat and explanation of appropriate responses), modeling (i.e., demonstration of safety skills), rehearsal (i.e., skills practice), and feedback (i.e., corrective feedback and praise for correct responding). To increase the likelihood responding will be controlled by the safety threat, the threat is simulated numerous times. This is done for the purpose of affording the learner multiple occasions to practice the safety responses in its presence. Consequently, the safety threat will function in the future as a discriminative stimulus that will evoke the appropriate safety response in its presence (Miltenberger & Valbuena, 2015).
Numerous studies have found BST is an effective way to teach safety skills. For example, it was employed to train abduction prevention responses (e.g., Marchand-Martella et al., 1996; Poche et al., 1981), abuse prevention responses (e.g., Egemo-Helm et al., 2007), fire safety skills (e.g., Houvouras & Harvey, 2014), firearm safety skills (e.g., Gatheridge et al., 2004; Hanratty et al., 2016; Himle et al., 2004; Jostad et al., 2008; Lee et al., 2019), helpseeking responses (e.g., Pan-Skadden et al., 2009), pedestrian safety skills (e.g., Harriage et al., 2016), and poison prevention responses (e.g., Dancho et al., 2008).
One of the initial BST studies, conducted by Poche et al. (1981), used an intervention comprised of modeling, rehearsal, and positive reinforcement to train safety responses for abduction lures presented to preschool children. Every child showed significant increases in safety-rating scores (e.g., scores of 0 in baseline increased to the maximum of 6) following BST. One child maintained the safety responses three months after training, while the remaining two children required additional sessions to improve long-term maintenance (Poche et al., 1981). Marchand-Martella et al. (1996) also examined the effectiveness of BST to teach abduction safety responses to preschool age children for multiple abduction lures (e.g., simple, authority, and incentive). All participants displayed increased levels of responding during BST and posttest follow ups (Marchand-Martella et al., 1996).
Giannakakos et al. (2020) completed a comprehensive search of the literature and identified 82 studies of safety-response training methodologies for a variety of potential threats (e.g., abduction prevention, fire safety, gun safety, poison prevention, etc.). The authors concluded BST, especially when combined with in-situ training (IST), is the “most well researched and effective training method for teaching safety responses” (Giannakakos et al., 2020, p. 114).
The relevant research also confirms BST is an efficacious methodology to teach abduction prevention skills to individuals with ASD and other IDD (e.g., Bergstrom et al., 2014; Gunby et al., 2010; Gunby & Rapp, 2014; and Ledbetter-Cho, 2016).
For example, Gunby et al. (2010) employed BST to teach three boys with ASD to give the following responses: a) say “no”, b) leave to a safe area, and c) report the incident immediately, when exposed to different abduction lures. All participants in the study responded correctly during BST and posttest assessments following a month of treatment (Gunby et al., 2010).
Gunby and Rapp (2014) expanded on this line of BST research by presenting abduction lures to children with ASD after “high-probability request sequences” (i.e., requests the children perform frequently and reliably). Safety scores increased for all children following the BST intervention in this study. It should be noted IST was required during post-training for participants to reach the performance criterion (Gunby & Rapp, 2014).
Therefore, the purpose of this study was to broaden the BST literature by extending this research into the domain of online safety. This was accomplished by using a BST procedure, similar to the methodology employed previously in abduction prevention studies, to teach safety skills to a youth with ASD for use in response to threats associated with encountering strangers on the internet. The mock threat presented during this study was an inappropriate request for personal information (IRPI) made by a previously unknown confederate to the participant while he played a video game online. The effects of BST to increase the safety scores of the participants were evaluated.