1. Increasing Social Interactions Through the Combined Use of Visual Supports and Peer Modelling
Susan S. Johnston, Ph.D., SLP
Department of Special Education, University of Utah
Introduction
Play and social interactions are essential components of healthy child development (e.g., Heidemann & Hewitt, 2010)
Through play, children practice numerous skills and roles needed for later life (e.g., Parham, 2008)
Engagement in play provides children with the opportunity to learn about human relationships, explore objects in the environment, learn to solve problems, make decisions, persevere, acquire pre-literacy skills, lead and follow others, and experience acceptance (e.g., Knox, 2010; Terpstra, Higgins, & Pierce, 2002)
One aspect of play where children with disabilities may encounter difficulty involves entering into exchanges with peers (e.g., Odom, McConnell, & McEvoy, 1992; Quill, 1995)
A series of related empirical investigations conducted by the authors has demonstrated that;
an intervention using visual supports can be used to teach children with disabilities to enter into exchanges with peers by requesting entry into playgroups in inclusive preschool classrooms
once the children with disabilities successfully entered playgroups, their engagement time and sophistication level of play increased
(Johnston, McDonnell, Nelson & Magnavito, 2003; Johnston, Nelson, Evans, Palazolo, 2003; Nelson, McDonnell, Johnston, Crompton, & Nelson, 2007)
Implementation of Intervention (cont.)
Step 3: Develop a Visual Support for Requesting Entrance into Play Groups
based upon the needs of the child and the communication partners
example: graphic symbol representing “Can I play?”
Step 4: Incorporate the Visual Support as a Class-Wide Strategy
provide instruction to entire class regarding the variety of ways that children can request entry into playgroups as well as instruction on the importance of allowing a peer to play with you when asked
provide all students in the class with the graphic symbol and encourage them to use the symbol to request entrance into playgroups
Step 5: Model the use of the Graphic Symbol and Verbal Language to Request Entrance Into Play Groups
when a child indicates interest in an activity, a peer or teacher models the use of the graphic symbol and verbal language to request entrance into playgroups
Step 6: Provide Specific Guidance to Teach the Target Behavior
identify and deliver prompts
example: least to most prompting hierarchy that progresses from an indirect verbal/gestural prompt, to a direct verbal/gestural prompt, to a partial physical prompt, to a full physical prompt
identify and utilize a prompt fading strategy
example: fade prompts by inserting a 5 second delay following the opportunity, the model, and between each prompt in the hierarchy
Step 7: Provide Natural Consequences Contingent on the Emission of the Target Behavior
the natural consequence is playing with the materials and/or peers in the group
teachers/paraeducators must ensure that the consequence is provided contingent on the child’s request to enter the playgroup
Step 8: Monitor Progress to Determine Effectiveness of Intervention
collect data on the child’s performance and the prompts that were provided
display data in a way that allows for analysis (e.g., in a graph)
Case Study: Allen*
-4 year old with ASD
-Attends an inclusive preschool classroom
-Uses a few words spontaneously but does not imitate verbal language
-Rarely engages in play with peers during free-choice
-Target Communication Skill: Request entrance into a playgroup using symbolic communication (graphic and/or verbal)
Visual Display of Data
Progress Monitoring
*this case study was drawn from several authentic situations experienced by the authors and put together as an aggregated scenario
References
-Heidemann, S., & Hewitt, D. (2010). Play: The pathway from theory to practice. St. Paul, MN: Redleaf Press.
-Johnston, S., McDonnell, A., Nelson, C., & Magnavito, A. (2003). Implementing augmentative and alternative communication intervention in inclusive preschool settings. Journal of Early Intervention, 25, 263–280.
-Johnston, S. S., Nelson, C., Evans, J., & Palazolo, K. (2003). The use of visual supports in teaching young children with autism spectrum disorder to initiate interaction. Augmentative and Alternative Communication, 19(2),
-Knox, S.H. (2010). Play. In J.C. Smith & J.C. O’Brien (Eds.), Occupational Therapy for Children (6th ed. pp ). Maryland Heights, MO: Mosby Elsevier.
-Nelson, C., McDonnell, A. P., Johnston, S.S., Crompton, A., & Nelson, A. (2007). Keys to play: A strategy to increase the social interactions of young children with autism and their typically developing peers. Education and Training in Developmental Disabilities 42 (2)
-Odom, S. L., McConnell, S. R., & McEvoy, M.A. (1992). Peer-related social competence and its significance for young children with disabilities. In M. A. McEvoy (Ed.), Social Competence of Young Children with Disabilities (pp. 3-36). Baltimore: Paul H. Brookes.
-Parham, L.D. (2008). Play and occupational therapy. In L.D. Parham & L.S. Fazio (Eds.), Play in Occupational Therapy for Children (2nd ed. pp. 3-39). St. Louis, MO: Mosby.
-Quill, K.A. (1995). Visually cued instruction for children with autism and pervasive developmental disorders. Focus on Autistic Behavior, 10(3),
-Terpstra, J.E., Higgins, K., & Pierce, T. (2002). Can I play? Classroom-based interventions for teaching play skills to children with autism. Focus on Autism and Other Developmental Disabilities, 17,
Implementation of Intervention
Step 1: Identify Opportunities to Request Entrance into Play Groups
when child indicates interest but does not initiate or engage in the activity
Step 2: Identify Communicative Behavior(s) for Requesting Entry into Play Groups
can be verbal/vocal (saying, “Can I play?”), gestural (signing “WANT” + “PLAY”), and/or graphic (pointing to a symbol representing “Can I play?”)
decisions regarding the most efficient and effective behavior should be based on the child’s skills/abilities as well as features of the communicative environment