Peer-Mediated Interventions to Increase the Social Interaction of Children with Autism

Kids Interacting

Research on Autism Spectrum Disorders (ASDs) has given significant attention to helping children with ASDs develop better socials skills. Treatments such as Applied Behavior Analysis, and therapies that fall within that category such as, Pivotal Response Training (PRT) have been shown to be very effective in teaching children with ASDs new social skills. Adult-mediated interventions (i.e., children practicing social skills with an adult) have been used successfully to teach children with ASDs the new skills necessary for successful social interaction; however, children often have difficulty generalizing their new social skills to peers of their same age.

In the article, Peer-Mediated Interventions to Increase the Social Interaction of Children with Autism, (2002), Carla A. DiSalvo and Donald P.Oswald reviewed the various types of peer-mediated interventions that have been shown by the literature to help improve the social functioning of children with ASDs. They also reviewed the studies which have investigated the use of these peer-mediated techniques. A summary of the techniques and studies, as described by DiSalvo and Oswald, are reviewed below.

Research has demonstrated that changing the social environment is useful for helping children with ASDs increase interactions with typically developing peers. Some techniques involve manipulating the classroom situation or putting contingencies in place that promote more interaction. Integrated play groups are an example of this approach. In an integrated play group an adult facilitates participation between children with Autism and typical peers. Rather than using adult direction, the adult maximizes the interactions between the children with Autism and their peers by prompting both the peers and the children with Autism to interact directly with each other. Wolfberg and Schuler (1993) examined integrated play groups and found that the groups produced significant increases in the amount of interaction with peers, decreases in repetitive play, and increases in functional play. These gains did not continue, however, after treatment ended.

The peer buddy system, in which a typical peer is matched with a child with Autism, has also been shown to help children interact more. The peer buddy stays with the child with Autism, talks with him, and plays with him. Laushey and Heflin (2000) investigated this approach with two 7 year old boys with Autism and found that the two boys increased their social interactions between 36% and 38% during the treatment phase of the study. Group oriented contingency is a useful technique, as well. The contingency requires that all children in a group or classroom work toward a common goal by engaging in a specific behavior. The studies that have used this approach also provided social skills training to the group of children prior to the implementation of the contingency. In these group contingencies, the children are taught to be supportive of each other and prompt each other to engage in the target behavior. In one of these studies (Kohler, Strain, Hoyson, Davis, Donna & Rapp, 1995), the amount of time that children with Autism interacted with their peers increased from 28% to 65% and supportive peer prompts increased from 2.6 to 7.6 times per session.

Another group of interventions focuses on teaching typical peers how to promote interaction with children with Autism. For example, peer networks attempt to promote peer understanding of, and interest in, children with special needs. The typically developing peers form a social network to provide support for the children with Autism. Garrison-Harrell, Kamps & Kravitz (1997) used fifteen typical first-grade students to create three peer networks of five peers per child with Autism. Peers were taught how to use each child's augmentative communication system, encourage social skills, initiate conversation, respond to conversations, give compliments, share, provide instruction, and maintain conversations. The children spent 20 minutes with their peer group across three different settings. After the intervention, the peers reported higher acceptance of the children with Autism and the student with Autism increased the frequency and duration of his or her interactions across all settings.

Pivotal Response Training has been used as a role-playing technique to teach peers how to interact with children with Autism in a productive manner. Peers are taught how to provide social reinforcement, including paying attention, letting the child choose, varying toys, modeling appropriate social behavior, reinforcing attempts, encouraging conversations, taking turns, providing narration during play activities and teaching responsivity to multiple cues. In one study (Pierce & Schreibman, 1995), after several weeks of intervention, the children with Autism began to initiate play and social conversation with the trained peers and these gains were maintained during a follow-up period.

Another group of interventions provides instruction to the child with Autism to promote interaction with their typical or regular education peers. The idea behind this strategy is that if the children with Autism increase the frequency of initiation, their peers will change their expectations and make more of an effort to interact as well. In child initiation training, for example, the children with Autism are prompted to initiate with a typical peer. The peer is instructed to respond but not initiate. The children with Autism are then reinforced by their peers via a social response.

DiSalvo and Oswald express that the above mentioned techniques have been shown to be very effective for increasing interactions between children with Autism and their peers. They caution, however, that more research is needed on these various techniques. Though many of the studies showed an improvement in social interactions, the results were often varied and generalization to new settings and peers was limited. The authors did note that many studies showed that these interactions were also effective in changing the expectations the typical peers had for the children with Autism. Peck, Donaldson, and Pezzoli (1990) found that high school students who had interacted with students with special needs reported improved self-concept, reduced fear of human differences, increased tolerance of others, the development of personal principles, and more relaxed and accepting friendships. It is clear that these techniques helped the peers as well as the children with Autism. DiSalvo and Oswald propose that examining the peer expectations of students with Autism will play a key role in developing more effective interventions for social interactions in the future. They argue that this particular area has not been sufficiently studied yet.

It is clear that providing opportunities for your children to interact with peers is critical to the development of his social skills. In addition to play dates, there are opportunities for teachers and schools to provide these structured, interactive environments for their students with Autism.