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The Effectiveness of Peer-Mediated Intervention for Young Children with Autism
Introduction
Children with autism often suffer from a lack of social integration and fail to engage meaningfully with their peers. Peer-mediated intervention is a prominent technique for developing social skills and fostering involvement in children suffering from autism. Such children usually have fewer social connections, especially in the school environment, which leads to detachment and further aggravation of disorder symptoms. Peer-mediated intervention (PMI) is reported to have a positive influence on social engagement, verbal and non-verbal communication in people with autism due to the availability of peers and the help with forming socially-accepted behaviors. Since PMI can help address these social difficulties of children, it is paramount to review scientific evidence to reveal the patterns for practical application. The present study undertakes the task of reviewing 18 studies connected with peer-mediated interventions aimed at young children with autism and assessing the effectiveness of this method.
Literature Review
Katz and Girolametto (2013) studied the effectiveness of PMIs in children with autism. The methodology presupposed 4 specialists to train 6 peers to interact with 3 children with autism spectrum disorder (ASD) aged 4 and 5. All three ASD subjects were subject to an 11-month intervention separately to create groups and assess the effectiveness of the measure. The results demonstrated an increase in frequency and quality of social engagement among subjects. Furthermore, participants with ASD retained their social skills after the test and demonstrated additional improvements.
Owen-DeSchryver, Carr, Cale, and Blakeley-Smith (2008) focused on assessing the effects of PMI in a sample of slightly older participants with ASD. Groups included two students from second grade and one from fourth grade. Psychologists trained certain peers to increase the quality of assessment. Peer training included three 30-45-minute-long sessions. The data collection period lasted 3 to 6 weeks. As a result, students with ASD started initiating social interactions more frequently in intervention groups. However, in groups with untrained peers, there were also signs of improvement.
The study by Oppenheim-Leaf, Leaf, Dozier, Sheldon and Sherman (2012) focused primarily on teaching normally developing peers to interact with ASD children. The authors selected three peers aged 4-6 taught by a single instructor to tutor and play with three children with autism. The teacher used role-play techniques to make peers aware of the needs of the children with ASD. The produced results indicated an increase in positive interactions between children and a decrease in negative ones. Among positive authors named invitation to play or initiating sharing. Negative was a refusal to play or share.
Another study was done by Harrell, Kamps, and Kravits (1997) prioritized investigating the impact of peer networks on the length of interaction and communication in students with ASD. The study selected three participants with ASD to interact with five of their peers to practice receiving and giving game instructions, complementing, and speaking activities. All peers received training in the amount of two 30-minute-long courses. As a result of the intervention, students with ASD demonstrated an increased length of interaction and increased the expressiveness of their speech.
Schmidt and Stichter (2012) investigated the use of PMIs to increase the generalization of social skills among adolescents in order to enhance life quality for their peers with autism and Aspergers syndrome. The study was conducted with participants aged 11 to 14. Two response and initiation training sessions were administered to normally developing students. The results showed that peer-mediated proximity and peer-mediated initiation both contributed to the development of the necessary social skills in peers.
Betz, Higbee, and Reagon (2008) aimed to assess the usefulness of joint activities for increasing the social engagement of children with and without autism. The sample included three children with autism and three normally developing ones divided into 3 pairs. Results showed that in all three pairs the length of joint activities and frequency of joint gaming sessions without additional prompting.
Harper, Symon, and Frea (2008) aimed to assess the significance of Pivotal Response Training on improving social skills and quality of interactions in children with autism. The sample was comprised of two schoolchildren (8 and 9 y/o) diagnosed with autism. Each student was engaging in gamified training with three peers. The results indicated that naturalistic PMIs were able to increase the social activeness of children with ASD and sustain the changes after the intervention.
Koegel et al. (2012) assessed the effect of creating opportunities for social engagement in the form of unstructured events on the development of social skills in children with autism. The study was conducted on three participants of 11, 13, and 14 years old. Social clubs in which the children with ASD learned to invite peers and communicate with them within 40 sessions showed positive results. The level of engagement rose by 80-100% in all three groups and the effect was retained with no intervention.
Trembath, Balandin, Togher, and Stancliffe (2009) aimed to assess the effectiveness of peer-mediated naturalistic teaching for preschool students with ASD. Within the study scope, three groups of students (each child with ASD engaged with 2 peers) were participating in gaming activities. All groups utilized speech-generating devices for communication. As a result of PMIs which lasted for 30 sessions, social skills and engagement levels increased in all 3 students, yet only one of them maintained the result.
Garfinkle and Schwartz (2002) designed their study to measure social interaction in children with autism after the participation of the latter in inclusive classrooms. Four participants with autism were divided into four groups where they communicated with equal-age children and engaged in joint activities with no structure. As a result of the intervention, the researchers recorded an increase in the number of interactions and proximity to peers.
Banda and Hart (2010) aimed to investigate the effectiveness of direct instructions on peer-to-peer participation and engagement. In the course of study two elementary students with autism engaged in free-form activities with trained peers. The training lasted 5 minutes in 4 sessions. As a result of the intervention, the two participants demonstrated an increased frequency of initiations, sharing, and responses. The said variables were not assessed post-intervention.
Petursdottir, McComas, McMaster, and Horner (2007) aimed to study the effectiveness of scripted peer-mediated reading activities on preschool children with ASD in a free-play environment. The study collected data from free-play sessions with one participant and three same-aged peers who were previously instructed to engage with the participant. The measuring tool was a Likert-scale test administered to teachers who were in the same room during sessions. The results showed that no change in social skills or engagement was observed in the behavior of a child with autism by the results of the test.
Laushey and Heflin (2000) aimed to research the effect of peer tutoring on the development of social skills in preschool students. Two students with ASD were playing in pairs with normally developed peers. The latter were instructed to share, engage and communicate with the mentally-challenged partners. The results captured the increased frequency and length of interactions. The increase constituted up to 100%. The follow-up study indicated post-kindergarten retention of the trends.
Thiemann and Goldstein (2004) researched the effects of two PMIs such as training, and written text treatment on the demonstration and development of social skills in children with ASD and Pervasive developmental disorder. The sample was comprised of five mentally-challenged school-aged children. Each of the five children was interacting with two peers who were previously trained by oral instructions or written text. Engagement included educational and leisure activities. Four sample students out of 5 demonstrated better involvement in discussion, more frequent responses, and retained the skills after the sessions.
Trottier, Kamp, and Mirenda (2011) aimed to study Peer-mediated use of speech-generating devices (SGD) in order to enhance social skills in students with autism. Each of the two participants with ASD was grouped with three peers and measured during their game activities with the support of SGDs. The peers were previously taught to instruct the rules of games and either engage or not engage in conversations first. Each of the students with autism demonstrated an in the number of initiated communicative acts.
Johnson (2016) aimed to analyze the experiences of the peer tutors aged 13-18 who worked with students suffering from mental disabilities. The study analyzed the other side of the peer-disabled student relationships. The results indicated that most of the students (50-80%) gained certain benefits in the form of engaging with others, helping others. The study also identified that the benefits of the tutee can be extended to the tutor.
Kamps, Dugan, Potucek, and Collins (1999) examined how peer networks affect the ability of the students with disabilities in higher grades to become tutors for students with disabilities in the first grade. The target students were taught to teach words, interact, share, etc. As a result of multiple baseline-intervention shifts, the researchers were able to document social engagement and academic performance in all groups increased.
DiSalvo & Oswald (2002) researched different peer-mediation techniques including networking and situation manipulation, integrated environment, etc. in relation to their effect on children with autism. The researchers have found that all of the PMIs result in some form of improvement of social skills or engagement. In addition, most of the techniques resulted in post-intervention retention of the social skills.
Conclusion
The review included 18 articles on Peer-mediated interventions for young children with autism. The data of all studies except one suggested that such interventions help children of the majority of age groups from 4-14 develop and implement social skills, increase the frequency of initiated engagements, quality and quantity of responses, and other characteristics. Moreover, many studies indicated that children with autism tend to retain their skills after the sessions. The present literature review revealed that most of the studies utilized one to five students with ASD to measure the effectiveness of PMIs. This might be the gap that needs to be addressed in further studies that can include larger samples. In addition, certain studies used controlled environments where teachers were present in the classroom. This also might have undermined the accuracy of the data.
References
Banda, D. R., & Hart, S. L. (2010). Increasing peertopeer social skills through direct instruction of two elementary school girls with autism. Journal of Research in Special Educational Needs, 10(2), 124-132.
Betz, A., Higbee, T. S., & Reagon, K. A. (2008). Using joint activity schedules to promote peer engagement in preschoolers with autism. Journal of Applied Behavior analysis, 41(2), 237-241.
DiSalvo, C. A., & Oswald, D. P. (2002). Peer-mediated interventions to increase the social interaction of children with autism: Consideration of peer expectancies. Focus on Autism and Other Developmental Disabilities, 17(4), 198-207.
Garfinkle, A. N., & Schwartz, I. S. (2002). Peer imitation: Increasing social interactions in children with autism and other developmental disabilities in inclusive preschool classrooms. Topics in Early Childhood Special Education, 22(1), 26-38.
Harper, C. B., Symon, J. B., & Frea, W. D. (2008). Recess is time-in: Using peers to improve social skills of children with autism. Journal of Autism and Developmental Disorders, 38(5), 815-826.
Harrell, L. G., Kamps, D., & Kravits, T. (1997). The effects of peer networks on socialCommunicative behaviors for students with autism. Focus on Autism and Other Developmental Disabilities, 12(4), 241-256.
Johnson, K. L. (2016). Benefits of peer tutoring students with disabilities in a secondary school setting. Web.
Kamps, D. M., Dugan, E., Potucek, J., & Collins, A. (1999). Effects of cross-age peer tutoring networks among students with autism and general education students. Journal of Behavioral Education, 9(2), 97-115.
Katz, E., & Girolametto, L. (2013). Peer-mediated intervention for preschoolers with ASD implemented in early childhood education settings. Topics in Early Childhood Special Education, 33(3), 133-143.
Koegel, R. L., Fredeen, R., Kim, S., Danial, J., Rubinstein, D., & Koegel, L. (2012). Using perseverative interests to improve interactions between adolescents with autism and their typical peers in school settings. Journal of Positive Behavior Interventions, 14(3), 133-141.
Laushey, K. M., & Heflin, L. J. (2000). Enhancing social skills of kindergarten children with autism through the training of multiple peers as tutors. Journal of Autism and Developmental Disorders, 30(3), 183-193.
Oppenheim-Leaf, M. L., Leaf, J. B., Dozier, C., Sheldon, J. B., & Sherman, J. A. (2012). Teaching typically developing children to promote social play with their siblings with autism. Research in Autism Spectrum Disorders, 6(2), 777-791.
Owen-DeSchryver, J. S., Carr, E. G., Cale, S. I., & Blakeley-Smith, A. (2008). Promoting social interactions between students with autism spectrum disorders and their peers in inclusive school settings. Focus on Autism and other Developmental Disabilities, 23(1), 15-28.
Petursdottir, A. L., McComas, 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(2), 353-357.
Schmidt, C., & Stichter, J. P. (2012). The use of peer-mediated interventions to promote the generalization of social competence for adolescents with high-functioning autism and Aspergers Syndrome. Exceptionality, 20(2), 94-113.
Thiemann, K. S., & Goldstein, H. (2004). Effects of peer training and written text cueing on social communication of school-age children with pervasive developmental disorder. Journal of Speech, Language, and Hearing Research, 47(1), 126-144.
Trembath, D., Balandin, S., Togher, L., & Stancliffe, R. J. (2009). Peer-mediated teaching and augmentative and alternative communication for preschool-aged children with autism. Journal of Intellectual and Developmental Disability, 34(2), 173-186.
Trottier, N., Kamp, L., & Mirenda, P. (2011). Effects of peer-mediated instruction to teach use of speech-generating devices to students with autism in social game routines. Augmentative and Alternative Communication, 27(1), 26-39.
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