A Research Review of the Use of Peer Mediated Strategies to Increase Language and Social Skills in Individuals with Autism Jennifer Cheselka Caldwell College Summer 2008

Discussion Components Search terms and strategies used to identify studies and books Defining “social behavior” Peer mediated strategies: mid-1970s to the present Intervention approaches of peer mediated strategies Perspective of peers Pertinent Study Contributions of peer mediated strategies Future research

Search terms and strategies used to identify studies and books PsycINFO searches- Peer reviewed journals “Peer mediated strategies” “Social skills” & “Autism (2) PsycINFO searches based on intervention approaches identified by DiSalvo & Oswald, 2002 “Integrated play groups”(1) “Peer buddy”(2) “Peer tutoring” (6) “Group oriented contingencies (2) “Peer networks” (1) “Pivotal response training”(5) “Peer initiation training”(1) “Target child initiation training(0) “Initiation training for target child and peers”(0)

Search terms and strategies used to identify studies and books (cont.) Various Google searches “Peer mediated strategies autism” “Peer mediated interventions autism” Author searches Journal article searches References from: Autism: Behavior Analytic Perspectives Peer-Mediated Interventions to Increase the Social Interaction of Children with Autism

Defining social behavior Almost all research papers pertaining to the subject of social behavior of young children point out the difficulty in defining behavior(s) of interest. It is often easy to see when it is not present, however a true conceptual definition has yet to be established. (Ghezzi, 1999)

Peer mediated strategies: mid-1970s to present Early attempts in changing social behavior used adults to manipulate antecedent and consequence events An early study demonstrated that prompting and reinforcement provided by adults to: 1) increase one target child’s social skills and 2) encourage social contact by members of the peer group, increased the behavior of all members included (Strain & Timm, 1974) A second study was conducted to analyze these “spillover” effects (Strain, Shores & Kerr, 1976) Although treatment gains were noted, early studies demonstrated that these social behaviors failed to maintain once treatment was terminated. Research conducted in the 1980’s suggested that adult manipulated intervention may have inadvertently limited the duration of social exchanges. Walker, Hops & Greenwood, 1981, demonstrated that longer interaction episodes could be sustained when a reinforcement contingency was applied. ( Strain & Kohler, 1999)

Peer mediated strategies: mid-1970s to present (cont.) Increases in generalization and maintenance for these early studies led to replication studies to demonstrate lasting effects (Strain, 1977) After it had been demonstrated that peer mediated strategies were effective at increasing social skills and increased the likelihood of generalization and maintenance of these behaviors, studies were conducted to establish which components of treatment were responsible for these behavior changes (Strain & Kohler, 1995) Attention has also been paid to the highly structured environment of early and studies and the limitations of activities as a result. Kohler, Strain & Goldstein conducted a pilot study in 1994 in which four pre- school teachers to were asked to observe a list of classroom activities, which they had initially compiled, to determine opportunities in which peer interactions could be facilitated. ( Strain & Kohler, 1999)

Intervention approaches of peer mediated strategies Integrated Play Groups Integrated Play Groups: A Model for Promoting Social and Cognitive Dimensions of Play in Children with Autism (Wolfberg & Schuler, 1993) Participants: three play groups containing: 2 peers with autism and three typically developing peers (ages 6- 8 years) Setting: classroom Design: Multiple baseline across participants IOA, generalization and social validity data were collected

Intervention approaches of peer mediated strategies (cont.) Peer Buddy and Peer Tutoring Approaches The Effects of Scripted Peer Tutoring and Programming Common Stimuli on Social Initiations of a Student with Autism Spectrum Disorders (Petursdottir, McComas, McMaster & Horner, 2007) Participants: A 5-year-old boy with autism spectrum disorder and 3 typically developing boys from his kindergarten class (5-years-old) Setting: Special education class when its 5 students were joined by 10 typical kindergartener Design: combined ABA withdrawn and multiple baseline across peer design IOA, generalization, social validity and treatment integrity were all assessed

Intervention approaches of peer mediated strategies (cont.) Peer Networks The Effects of Peer Networks on Social Communicative Behaviors for Students with Autism (Garrison-Harrell, Kamps & Kravitz, 1997) Participants: 3 target students with autism between 6 and 7 years old, 15 typically developing students from a first grade classroom Setting: library or conference room in the elementary school Design: Multiple baseline across target students IOA data were collected

Intervention approaches of peer mediated strategies (cont.) Pivotal Response Training Increasing Complex Social Behavior in Children with Autism: Effects of Peer-Implemented Pivotal Response Training (Pierce & Schreibman, 1995) Participants: Two boys diagnosed with autism 8 and 10 years old, two typically developing boys both 10 years old Setting: Infrequently used classroom at the participants school Design: Multiple baseline across subjects IOA and generalization were assessed

Intervention approaches of peer mediated strategies (cont.) Peer Initiation Training Reducing Teacher Prompts in Peer-Mediated Interventions for Young Children with Autism (Odom & Watts, 1991) Participants: 3 target children with autism, 3 ½ to 5 years of age, 4 typically developing children (pre-school age) enrolled in the same integrated classroom as the target children Setting: structured play activities that were a part of a regular class schedule of an integrated classroom Design: multiple baseline with a multi-element component for the first two phases, correspondence training/visual feedback package was implemented for the 3 rd and last phase and a baseline condition was implemented in the fourth phase Social validity was assessed

Intervention approaches of peer mediated strategies (cont.) Target Child Initiation Training The Use of Multiple Exemplars to Enhance the Generalization of Play Skills to the Siblings of Children with Autism (Belchic and Harris, 1994)  Participants: 3 pre-school children with autism and 5 typically developing peers  Design: multiple baseline across children with multiple baseline across probes  Generalization data were collected (DiSalvo & Oswald, 2002)

Intervention approaches of peer mediated strategies (cont.) Initiation Training for Target Child and Peers Social Skills Training to Increase Interactions Between Children with Autism and their Typical Peer (Gonzalez- Lopez and Kamps, 1997) Participants: four children with autism (ages 5 and 7), 12 typically developing children (6 kindergarteners and 6 first graders) Setting: special education classroom with two groups running simultaneously, but independent of each other Design: a reversal design with two intervention conditions IOA data were collected

Perspective of Peers What do the Peer Think? Social Validity of Peer- Mediated Programs (Kamps, Kravitz, Gonzalez- Lopez, Kemmerer, Potucek & Harrell, 1998) 203 elementary students in multiple settings across five years were interviewed Interventions included: class-wide or small group tutoring sessions, cooperative learning groups, special class buddies, social (play) groups Measures included: social interaction data, peer interviews, consumer satisfaction surveys

Perspective of Peers (cont.) Program Effects: Social intervention can make increase active social participation in children with autism Peer are accepting of social activities with children with autism and are often excited in engage in them Based on data and interviews, only a few findings of negative comments directed toward children with autism were reported Limitations: Most of the information compiled was subjective information Focusing in “acceptance” and “participation variables alone may be misleading Not enough studies to identify “true interaction” activities Measures should be expanded to include: physical integration, social integration, relationships, preference and social networks

Pertinent Study An Experimental Analysis of “Spillover” Effects on the Social Interaction of Behaviorally Handicapped Preschool Children (Strain, Shores and Kerr, 1976) Journal: Journal of Applied Behavior Analysis Introduction: Purpose of Study: to determine whether desired behavior changes in non-reinforced peers during treatment of target peers can be applied to settings to maximize behavior change Importance: have yet to be conducted to determine these effects

Pertinent Study Method: Setting: a language classroom of an early education center for behaviorally handicapped pre-school children Participants: three behaviorally handicapped preschool children (all 4 years old), six peers with disabilities that ranged from mild language delay (with no other deficits) to severe language delay (with other behavioral deficits) Dependent Variable: Frequency of positive and negative behavior  Positive and negative behavior were defined in each of the following categories: motor-gestural and vocal-verbal  Teacher behavior (prompting and reinforcement) were also recorded

Pertinent Study (cont.) Intervention: a combination of verbal and physical prompts were used, as well as, verbal praise contingent upon appropriate social behaviors Experimental Design: a reversal and multiple baseline design across participants, five stages of reversals were used IOA: was assessed for 15 of the 70 sessions (21%), mean agreements ranged from 84%-98% Treatment integrity and social validity were not assessed Generalization and maintenance were not mentioned

Pertinent Study (cont.) Results and Discussion: The analysis of the data were appropriate, this study found that positive social interactions increased and negative social interactions decreased for non- targeted peers One theory of this effect was simply imitation of behavior that produced positive consequences Another theory for this “spillover” effect may be that reinforcement served as the S D for appropriate behavior of non-targeted children, thinking that their behavior will also be rewarded (Kazdin, 1973) This study greatly contributed to the idea that children with disabilities are able to learn from environments in which appropriate behavior interventions are not directly facilitated by adults

Analysis of Articles Discussed Peer-mediated strategies may be used with children of various age groups Peer-mediated strategies are effective at increasing social interactions in children with autism based on an abundance of peer- reviewed literature Treatment integrity was rarely assessed and social validity was not assessed that often

Contributions of Peer-Mediated Strategies Children with autism may not need teacher directed interventions to achieve good social outcomes Exposure only to peers with limited social skills limits opportunity for interactions Typical peers my receive multiple benefits from involvement in intervention (Strain & Kohler, 1999)

Future Research Lack of generalization in some studies requires future research Social validity also needs to be included in more research Without intervention, typically developing peers tend to interact with each other ( DiSalvo & Oswald, 2007)

References Belchic, J. K., (1994). The use of multiple peer exemplars to enhance the generalization of play skills to the siblings of children with autism. Child & Family Behavior Therapy, 16, DiSalvo, C. A., & Oswald, D. P. (2002). Peer-mediated interventions to increase the social interactions of children with autism: Considerations of peer expectancies. Focus on Autism and Other Developmental Disabilities, 17, Garrison-Harrell, L., Kamps, D., & Kravitz, T. (1997). The effects of peer networks on social-communicative behaviors for students with autism. Focus on Autism and Other Developmental Disabilities, 12, Ghezzi, P. M. (1999). Toward a definition of social behavior. In P. M. Ghezzi, W. L. Williams & J. E. Carr (Eds.), Autism: behavior analytic perspectives. (pp ) Reno, NV: Context Press. Gonzalez-Lopez, A., & Kamps, D. M. (1997). Social skills to increase social interactions between children with autism and their typical peers. Focus on Autism and Other Developmental Disabilities, 12, Kamps, D. M., Kravitz, T., Gonzalez-Lopez, A., Kemmerer, K., Potucek, J., & Harrell, L. G. (1998). What do peers think? Social validity of peer-mediated programs. Education and Treatment of Children, 21, Kazdin, A. E. (1973). The effect of vicarious reinforcement an attentive behavior in the classroom. Journal of Applied Behavior Analysis, 6, Odom, S. L., & Watts, E. (1991). Reducing teacher prompts in peer-mediated interventions for young children with autism. The Journal of Special Education, 25,

References (cont.) Petursdottir, A. L., McCommas, J., McMaster, K., & Horner, K. (2007). The effects of scripted peer tutoring and programming common stimuli on social interactions of a student with autism spectrum disorder. Journal of Applied Behavior Analysis, 40, Pierce, k. & Schreibman, L. (1995). Increasing complex social behaviors in children with autism: Effects of peer-implemented pivotal response training. Journal of Applied Behavior Analysis, 28, Strain, P. S. (1977). Training and generalization effects of peer social initiations on withdrawn preschool children. Journal of Abnormal Child Psychology, 5, Strain, P. S., & Kohler, F. (1995). Analyzing predictors of daily social skill performance. Behavioral Disorders, 21, Strain, P. S., & Kohler, F. (1999). Peer-mediated intervention for young children with autism: a 20-year retrospective. In P. M. Ghezzi, W. L. Williams & J. E. Carr (Eds.), Autism: behavior analytic perspectives. (pp ) Reno, NV: Context Press. Strain, P. S., Shores, R. E., & Kerr, M. M. (1976). An experimental analysis of “spillover” effects on the social interaction of behaviorally handicapped preschool children. Journal of Applied Behavior Analysis, 9, Strain, P. S., & Timm, M. A. (1974). An experimental analysis of social interaction between a behaviorally disordered preschool child and her classroom peers. Journal of Applied Behavior Analysis, 7, Wolfberg, P. J. & Schuler, A. L. (1993) Integrated play groups: a model for promoting the social and cognitive dimensions of play in children with autism. Journal of Autism and Developmental Disorders, 23,