Social initiations by autistic children to adults and other children

Social initiations made by autistic and verbal-matched retarded children were recorded in two naturalistic situations. Frequencies of initiation to adults did not differ between groups, but the retarded children initiated much more frequently to peers. Most interactions for both groups were positive, but the autistic children engaged in more ritualized, and the retarded children more playful, initiations. The autistic children monitored the social environment more when forced into proximity with peers, whereas the retarded children initiated more in the unstructured situation. Autistic initiation to peers was unrelated to severity of autism, but was related to cognitive skills, including vocabulary and comprehension of affect, whereas retarded children's initiations were unrelated to cognitive level. Results are discussed in terms of the differences between adults and children as social stimuli, prerequisite skills for initiation to peers, and the relationship between social cognition and social behavior. It is suggested that autistic and retarded children differ in the quantity of their initiations to peers, and the quality of their initiations to adults, and that initiations to peers may be a particularly useful index of social development in autistic children. Results confirm the need of autistic children for highly structured social environments, and suggest an important role for the remediation of specific cognitive skills such as comprehension of others' affects.This project was supported by National Institute of Mental Health Grant RO 1 40162 to Drs. Fein, Waterhouse, and Feinstein, and by NINDS 20489 to Autism and Language Disorders Collaborative Project Preschool Study Group. We are very grateful to the staff, students, and parents at participating schools.     

A systematic review of peer-mediated interventions for children with autism spectrum disorder

BackgroundPeer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.MethodThe current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.ResultsFour of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.ConclusionPMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.     

Using Peer-Mediated LEGO® Play Intervention to Improve Social Interactions for Chinese Children with Autism in an Inclusive Setting

The purpose of this study was to examine the effects of a peer-mediated LEGO® play intervention on improving social skills for children with ASD in an inclusive preschool in China. Three boys with ASD and 13 typically developing children participated in this study. A multiple-probe across participants design was used. The intervention consisted of LEGO® construction activities incorporated with peer-mediated strategies for one child with ASD and two typically developing peers. The intervention sessions were conducted two sessions per week with a total of 28–31 sessions for each participant. Results indicated that all three children with ASD increased their social initiations and responses following the completion of the intervention. Social validity was also obtained.     

Concept Mastery Routines to Teach Social Skills to Elementary Children with High Functioning Autism

Children with autism are included in general education classrooms for exposure to appropriate social models; however, simply placing children with autism with typical peers is insufficient for promoting desired gains in social skills. A multiple baseline design was used to explore the effects of concept mastery routines (CMR) on social skills for four elementary-age boys with high functioning autism. Visual and non-parametric analyses support the conclusion that small group instruction with typical peers via the CMR was effective for increasing responses, initiations, and recognition of emotional states. The skills taught in small groups generalized when the visual strategy of the completed concept diagram was taken to another setting. Most importantly, the four boys experienced improved social status following intervention.     

Recess is Time-in: Using Peers to Improve Social Skills of Children with Autism

Children with autism face enormous struggles when attempting to interact with their typically developing peers. More children are educated in integrated settings; however, play skills usually need to be explicitly taught, and play environments must be carefully prepared to support effective social interactions. This study incorporated the motivational techniques of Pivotal Response Training through peer-mediated practice to improve social interactions for children with autism during recess activities. A multiple baseline design across subjects was used to assess social skills gains in two elementary school children. The results demonstrated an increase in important social skills, namely social initiations and turn taking, during recess.     

Establishing response and stimulus classes for initiating joint attention in children with autism

The absence of the fundamental skill of initiating joint attention reflects the social-communicative impairment characterizing autism. Initiating joint attention is related to social and communication development as well as intervention outcomes for children with autism. A behaviorally based intervention was used to teach an expanded class of responses for initiating joint attention consisting of combinations of nonverbal and verbal forms. The class of stimuli was also expanded to include routine activities involving a diverse array of events that occasion joint attention initiations during interactions with both adults and peers. The importance of addressing sophisticated forms of initiating joint attention within the context of a variety of stimuli ensuring children with autism possess skills similar to their typically developing peers is discussed.     

Depressive symptoms from kindergarten to early school age: longitudinal associations with social skills deficits and peer victimization

Background  

Depressive symptoms in children are associated with social skills deficits and problems with peers. We propose a model which suggests different mechanisms for the impact of deficits in self-oriented social skills (assertiveness and social participation) and other-oriented social skills (pro-social, cooperative and non-aggressive behaviors) on children's depressive symptoms. We hypothesized that deficits in self-oriented social skills have a direct impact on children's depressive symptoms because these children have non-rewarding interactions with peers, whereas the impact of deficits in other-oriented social skills on depressive symptoms is mediated through negative reactions from peers such as peer victimization.     

Staff training effective in increasing learning opportunities for school-aged children with autism spectrum disorders

Objective: This study examined the effectiveness of instruction and video feedback on staff's ABA skills during one-to-one play situations and initiations of children with autism spectrum disorder (ASD).

Methods: Data were collected within a multiple baseline design across 5 dyads. A continuous 20?s interval recording system was used to record motivation, creating opportunities, prompting and reinforcement of staff and child initiations. Training included instruction, consisting of instructions, video examples and role-plays. After this, a 4-h delayed video feedback condition started.

Results: Three staff members created significantly more learning opportunities during post-instruction and a significant increase occurred during video feedback for one staff member. Initiatives increased significantly in two children during post-instruction. During follow-up, three children showed unprompted initiatives. The mean percentage of spontaneous initiations increased during follow-up.

Conclusion: The findings provide support for training staff in a clinical setting to create learning opportunities, which also may result in concomittant improvement in child initiations.     

School-based social skills training for young people with autism spectrum disorders

ABSTRACT

Background: The Secret Agent Society (SAS) Program, an intervention to enhance social–emotional skills, was provided by schools for children with autism spectrum disorder (ASD). The program was assessed to determine if it improved social skills at school and home, and whether improvements were maintained.

Methods: Eighty-four students participated. Key outcomes were parent and teacher ratings of emotion regulation, social skills, and direct child social problem-solving measures. The standard school curriculum served as the control condition. Phase 1 was a two-group waitlist-control comparison of SAS versus the standard curriculum. Phase 2 was a follow up of all participants before and after the intervention and at 12-months post-intervention.

Results: Parent and child measures improved after the intervention but not in the waitlist condition. Improvements in parent, child, and teacher measures were apparent at 12 months.

Conclusions: The SAS Program warrants further research as a potential program for schools that serve children with ASD.     

Parent-child predictors of social competence with peers in children with and without autism

The current study investigated the relations among parent-child joint engagement, dyadic interactive behaviors, and children's subsequent social competence with peers. Participants were 40 children (20 children with autism, and 20 developmentally-matched typical children) between the ages of 2.75 and 6.5 years. Observational coding was conducted to assess children's joint engagement initiations, global interactive behaviors with parents, and parents’ responsiveness, behavior regulation, and attention regulation. Children's social competence with peers was measured approximately one year later. Group differences were observed in child-initiated joint engagement, children's interactive behaviors in the parent-child context, and individual aspects of social competence. Child-initiated joint engagement with parents was positively related to social competence with peers overall, and with less exclusion by peers and hyperactive-distractible behaviors with peers, in particular. In addition, parent attention regulation emerged as the most salient predictor of children's behaviors within the parent-child context. Findings are discussed with respect to implications for future research and intervention.     

The effect of peer- and sibling-assisted aquatic program on interaction behaviors and aquatic skills of children with autism spectrum disorders and their peers/siblings

The purpose of this study was to assess the effect of peer- and sibling-assisted learning on interaction behaviors and aquatic skills in children with autism spectrum disorders (ASD). Outcome measures were also examined in their typically developing (TD) peers/siblings. Twenty-one children with ASD and 21 TD children were assigned in three groups: peer-assisted (PG), sibling-assisted (SG), and control (CG). All participated in 16-week aquatic settings under three instructional conditions (teacher-directed, peer/sibling-assisted, and voluntary support). The main findings were that (a) PG and SG of children with ASD showed significantly more improvement on physical and social interactions with their TD peers/siblings during peer/sibling-assisted condition as compared to CG (p < 0.01), (b) PG and SG of children with ASD showed significantly more improvement on physical interactions with their TD peers/siblings (p < 0.01) and social interactions with their teachers and other children with ASD (p < 0.01) during voluntary support condition as compared to CG, and (c) all children with ASD and their TD peers/siblings significantly increased their aquatic skills after the program. The benefit for children with ASD as well as TD peers/siblings makes the use of TD peer/sibling assisted learning an even more desirable instructional strategy.     

A peer-mediated intervention to improve the conversational skills of high school students with Autism Spectrum Disorder

BackgroundSocial-communication deficits of adolescents with Autism Spectrum Disorder (ASD) can significantly interfere with their participation in high school activities, where conversation is the primary mode of social interaction. The purpose of this study was to extend the social-communication research in high school settings by the evaluating use of a peer-mediated intervention (PMI) during lunch on the conversational skills of three adolescents with ASD who were observed to be passive or reluctant conversationalists.MethodA multiple-baseline design across participants was used to assess the effects of teaching typical peers strategies for facilitating conversation with the focal students. Peers served as the primary interventionists, but as in other PMI research, we also incorporated the use of written text cues and direct instruction for the focal students, with the aim of using text cues flexibly for a more natural conversation.ResultsResults indicated improvements in focal students’ conversational skills including an increased number of conversational acts, initiations, and follow-up questions, and longer conversational episodes with peers. Overall assertive acts (i.e., responses not contingent upon peer requests) also increased, suggesting that the once passive conversationalists were becoming more assertive. Social validity outcome measures attested to the acceptability of the PMI and the quality of conversation between focal students and peers.ConclusionsThe results of this study provide preliminary evidence that PMI can produce substantial and socially-validated conversational outcomes for high school students with ASD.     

The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: intervention outcomes

This study evaluated the effectiveness of a 7-month cognitive behavioral intervention for the facilitation of the social-emotional understanding and social interaction of 15 high-functioning children (8 to 17 years old) with autism. Intervention focused on teaching interpersonal problem solving, affective knowledge, and social interaction. Preintervention and postintervention measures included observations of social interaction, measures of problem solving and of emotion understanding, and teacher-rated social skills. Results demonstrated progress in three areas of intervention. Children were more likely to initiate positive social interaction with peers after treatment; in particular, they improved eye contact and their ability to share experiences with peers and to show interest in peers. In problem solving after treatment, children provided more relevant solutions and fewer nonsocial solutions to different social situations. In emotional knowledge, after treatment, children provided more examples of complex emotions, supplied more specific rather then general examples, and included an audience more often in the different emotions. Children also obtained higher teacher-rated social skills scores in assertion and cooperation after treatment. The implications of these findings are discussed in terms of the effectiveness of the current model of intervention for high-functioning children with autism.     

Examining the Effectiveness of an Outpatient Clinic–Based Social Skills Group for High-Functioning Children with Autism

Although social skills group interventions for children with autism are common in outpatient clinic settings, little research has been conducted to determine the efficacy of such treatments. This study examined the effectiveness of an outpatient clinic-based social skills group intervention with four high-functioning elementary-aged children with autism. The group was designed to teach specific social skills, including greeting, conversation, and play skills in a brief therapy format (eight sessions total). At the end of each skills-training session, children with autism were observed in play sessions with typical peers. Typical peers received peer education about ways to interact with children with autism. Results indicate that a social skills group implemented in an outpatient clinic setting was effective in improving greeting and play skills, with less clear improvements noted in conversation skills. In addition, children with autism reported increased feelings of social support from classmates at school following participation in the group. However, parent report data of greeting, conversation, and play skills outside of the clinic setting indicated significant improvements in only greeting skills. Thus, although the clinic-based intervention led to improvements in social skills, fewer changes were noted in the generalization to nonclinic settings.     

Teaching preschool age autistic children to make spontaneous initiations to peers using priming

Children with autism rarely initiate social interactions with their peers. Currently available interventions have not increased autistic children' spontaneous initiations in natural settings without extensive teacher involvement. A priming strategy consisting of a low demand, high reinforcement session prior to the regular school activity was used to increase the spontaneous social initiations of 2 preschool age autistic boys to typically developing peers in a regular preschool classroom. Peers were also trained to independently respond to initiations. Implications for developing practical ways to improve autistic children's social functioning in regular school settings are discussed.     

Nonverbal social interaction skills of children with learning disabilities

Many children with learning disabilities (LD) face problems in their nonverbal communication, which constitutes an important component of their social skills. This study explores the frequency of nonverbal initiations and responses of 36 children with LD and 36 children without LD matched for age and gender, who were observed for 40 min during the break. Younger and older children with and without LD did not differ significantly in their nonverbal responses, but there was a statistically significant difference in terms of younger children's nonverbal initiations. Younger children with LD exhibited significantly fewer nonverbal initiations than younger children without LD. Findings are discussed and suggestions are made for further research.     

Peer Interaction and Loneliness in High-Functioning Children with Autism

Social interaction with peers and the understanding and feelings of loneliness were examined in 18 high-functioning children with autism and 17 typically developing children matched for IQ, chronological age, gender, and maternal education. Observations were conducted on children's spontaneous social initiations and responses to their peers in natural settings such as recess and snack time, and children reported on their understanding and feelings of loneliness and social interaction. Overall, children with autism revealed a good understanding of both social interaction and loneliness, and they demonstrated a high level of social initiation. However, they spent only half the time in social interactions with peers compared with their matched counterparts, and they interacted more often with a typically developing child than with another special education child. Despite the intergroup differences in frequency of interaction, a similar distribution of interactions emerged for both groups, who presented mostly positive social behaviors, fewer low-level behaviors, and very infrequent negative behaviors. Children with autism reported higher degrees of loneliness than their typical age-mates, as well as a lower association between social interaction and loneliness, suggesting their poorer understanding of the relations between loneliness and social interaction. Research and practice implications of these findings are discussed.