Interventions that facilitate socialization in children with autism

The Impact of a Computer-Based Activity Program on the Social Functioning of Children with Autistic Spectrum Disorder

BACKGROUND

Problems with social functioning are a major area of difficulty for children with autism. Such problems have the potential to exert a negative influence on several aspects of the children's functioning, including their ability to access education. This study looked to examine if a computer-based activity program could improve the social functioning of these children.

MATERIALS AND METHODS

Using a pooled subject design, 100 children with autistic spectrum disorder were randomly allocated, controlling where possible for age and gender, to either an intervention or a control group. The children in the intervention group were encouraged to use the Nintendo (Kyoto, Japan) Wii™ and the software package "Mario & Sonic at the Olympics" in addition to their routine school physical education classes over a 9-month period. The control group attended only the routine physical education classes.

RESULTS

After 1 year, analysis of the changes in the scores of teacher-completed measures of social functioning showed that boys in the intervention group had made statistically significant improvement in their functioning when compared with controls. The number of girls in the study was too small for any change to reach statistical significance.

CONCLUSIONS

This type of intervention appears to have potential as a mechanism to produce improvement in the social functioning, at least of boys, as part of a physical education program.

Peers as clinicians: Examining the impact of Stay Play Talk on social communication in young preschoolers with autism

BACKGROUND

Peer Mediated Interventions (PMIs) can be incorporated into integrated early childhood and preschool settings to address socialization impairments observed in children with ASD (Katz & Girolametto, 2013). However, research examining specific PMI strategies with young preschoolers remains limited.

OBJECTIVE

The current study examines the efficacy of the Stay, Play, Talk PMI (English, Shafer, Goldstein, & Kaczmerek, 1997) on the social communication skills of young preschool children diagnosed with an Autism Spectrum Disorder (ASD).

METHOD

Each of 3 typically developing children (ages 3-5 years) was paired with a child with an ASD (ages 3-4 years). Typically developing peers were taught to Stay with their friend, Play with their friend, and Talk to their friend. The child dyads played together during two, 20-min weekly sessions for 6-8 weeks. A multiple baseline design across participants was implemented to measure the impact of the Stay Play Talk strategies on social initiations and responses characterized by non-coordinated gestures, gestures, and words. Simulation Modeling Analysis was also conducted to confirm visual analysis.

RESULTS

All 3 typical peer buddies and all 3 target children with ASD demonstrated increases in the frequency of their responses, reaching levels that greatly exceeded baseline levels. Further, social reciprocations increased among each dyad above baseline. Social initiations remained variable across dyads. Gains were not maintained two months post intervention.

CONCLUSION

Results of this study corroborated previous findings that support the usefulness of PMIs to improve social communication of young children with ASD (Chan et al., 2009) and suggest an economical, naturally occurring approach to improve social communication during early childhood.

LEARNING OUTCOMES

Readers will gain knowledge regarding the social communication profile of children with ASD and how this profile can negatively impact language development and peer relationships. In addition, readers will be able to identify the basic components of the Stay Play Talk intervention. Finally, this paper will explain the impacts of the Stay Play Talk intervention on the social communication skills of young children with ASD.

Peer-mediated intervention for pre-schoolers with ASD: Effects on responses and initiations

PURPOSE

This study investigates the effects of peer-mediated intervention on the responses and initiations of pre-schoolers (aged 4;2-5;1) with Autism Spectrum Disorder (ASD).

METHOD

A speech-language pathologist and three early childhood educators trained typically-developing peers to facilitate responses and initiations from three pre-schoolers with ASD during playtime. A multiple baseline design across subjects was used to determine the effects of the intervention. Play sessions between the children with ASD and their typically-developing peers were videotaped. Videotapes were analysed using an interval coding system in order to collect information regarding responses and initiations.

RESULT

All three target children demonstrated improvements in their responses and initiations to their peers during intervention. Moreover, they maintained these gains 4 weeks later and generalized their response and initiation skills to an untrained peer. Social validity data, obtained using unbiased, independent, lay, observers to rate the children's performance provided external validation of an observable treatment effect (i.e. increased responses and initiations) following intervention.

CONCLUSION

The results suggest that training typically-developing peers to implement intervention strategies using the collaboration between a speech-language pathologist and early childhood educators may be an effective model of service delivery to enhance peer interaction skills of pre-schoolers with ASD.

More Than Words: Examining Communicative Competence Through a Preschool-Age Child With Autism

Using a social-ecological framework, this case study examined communicative competence through classroom interactions involving Aaron, a preschool-age child with autism who utilized an augmentative and alternative communication device (AAC). In addition to Aaron, participants included Aaron's father, the school director, classroom teachers, a paraprofessional, and 17 of Aaron's preschool classmates. The present analyses relied on ethnographic data collected by Russell and Valentino (2013)—specifically, five observations of classroom activities involving Aaron, one of which was video recorded, and six semistructured interviews of adult participants. Our extended analyses included a categorical analysis focused on communicative offers to and from Aaron as recorded in observational field notes and a new situated discourse analysis of the video-recorded small group activity. Together results revealed three key components of communicative competence: (a) presumed competence, (b) flexible multimodality, and (c) synchronized repetition. Implications focus on how to conceptualize and support communicative competence for children who use AAC from a social-ecological framework.

Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder

OBJECTIVE

We prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment.

METHOD

This group of children was assessed at age 6 years, 2 years after the intervention ended, across multiple domains of functioning by clinicians naive to previous intervention group status.

RESULTS

The ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, 2 years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The 2 groups were not significantly different in terms of intellectual functioning at age 6 years. Both groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period.

CONCLUSION

These results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time that the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism.

Gait deviations in children with autism spectrum disorders: a review

In recent years, it has become clear that children with autism spectrum disorders (ASDs) have difficulty with gross motor function and coordination, factors which influence gait. Knowledge of gait abnormalities may be useful for assessment and treatment planning. This paper reviews the literature assessing gait deviations in children with ASD. Five online databases were searched using keywords “gait” and “autism,” and 11 studies were found which examined gait in childhood ASD. Children with ASD tend to augment their walking stability with a reduced stride length, increased step width and therefore wider base of support, and increased time in the stance phase. Children with ASD have reduced range of motion at the ankle and knee during gait, with increased hip flexion. Decreased peak hip flexor and ankle plantar flexor moments in children with ASD may imply weakness around these joints, which is further exhibited by a reduction in ground reaction forces at toe-off in children with ASD. Children with ASD have altered gait patterns to healthy controls, widened base of support, and reduced range of motion. Several studies refer to cerebellar and basal ganglia involvement as the patterns described suggest alterations in those areas of the brain. Further research should compare children with ASD to other clinical groups to improve assessment and treatment planning.

Neural mechanisms of negative reinforcement in children and adolescents with autism spectrum disorders

Background

Previous research has found accumulating evidence for atypical reward processing in autism spectrum disorders (ASD), particularly in the context of social rewards. Yet, this line of research has focused largely on positive social reinforcement, while little is known about the processing of negative reinforcement in individuals with ASD.

Methods

The present study examined neural responses to social negative reinforcement (a face displaying negative affect) and non-social negative reinforcement (monetary loss) in children with ASD relative to typically developing children, using functional magnetic resonance imaging (fMRI).

Results

We found that children with ASD demonstrated hypoactivation of the right caudate nucleus while anticipating non-social negative reinforcement and hypoactivation of a network of frontostriatal regions (including the nucleus accumbens, caudate nucleus, and putamen) while anticipating social negative reinforcement. In addition, activation of the right caudate nucleus during non-social negative reinforcement was associated with individual differences in social motivation.

Conclusions

These results suggest that atypical responding to negative reinforcement in children with ASD may contribute to social motivational deficits in this population.

A tangled web: the challenges of implementing an evidence-based social engagement intervention for children with autism in urban public school settings

There is growing evidence that efficacious autism-related interventions rarely are adopted or successfully implemented in public schools, in part because of the lack of fit between the intervention and the needs and capacities of the school setting. There is little systematic information available regarding the barriers to implementation of complex interventions such as those addressing social engagement for children with autism.The present study used fieldnotes from an implementation trial to explore barriers that emerged during the training of school personnel and subsequent implementation of a social engagement intervention. A number of barriers at the individual (training) and school levels (policies surrounding recess, staffing, prioritization of competing demands, level of respect and support, and availability of resources) interfered with the continued use and sustainment of the intervention. We offer potential strategies to overcome these barriers and provide directions for future research in this critical area.

Summer Treatment Program Improves Behavior of Children with High-Functioning Autism Spectrum Disorder

This study evaluated the effects of a behavioral summer treatment program for children with high-functioning autism spectrum disorder (HFASD). Twenty boys (M = 9.2 years) diagnosed with HFASD participated in the 6-week program across 6 years. Detailed daily behavioral data were collected on a variety of positive and negative social behaviors. Repeated measures ANOVAs of weekly behavior frequencies indicated substantial improvements in a number of behaviors over the 6 weeks of the program, including following activity rules, contributing to a group discussion, paying attention, and less complaining/whining. Overall, results highlight the potential efficacy of treating chronic functional impairments of HFASD and associated problem behaviors in the context of an intensive behavioral summer treatment program.

Using self-management to improve the reciprocal social conversation of children with autism spectrum disorder

Individuals with autism spectrum disorders often exhibit difficulties with reciprocal social conversation, engaging in limited verbal exchanges, even when language structures are intact. This study employed a multiple baseline design to examine the effectiveness of a self-management intervention targeting (1) on-topic responsiveness to a conversational partner; (2) expansion of the conversational topic; and (3) on-topic question asking. Results demonstrated improved reciprocal social conversation through elaborated responses and on-topic question asking, which generalized and maintained. Social validity measures by naïve observers indicated that the intervention led to meaningful improvements during conversation, including interest, naturalness, and desirability as a conversational partner.

Improving question-asking initiations in young children with autism using pivotal response treatment

Social initiations make up a core deficit for children with autism spectrum disorder (ASD). In particular, initiated questions during social interactions are often minimal or absent in this population. In the context of a multiple baseline design, the efficacy of using the motivational procedures of Pivotal Response Treatment to increase social question-asking for three young children with autism was assessed. Results indicated that participants initiated a greater number of targeted questions following intervention. Additionally, all children exhibited increases in initiation of untargeted questions during social interaction in novel settings. Furthermore, post intervention data revealed collateral gains in communication and adaptive behavior. Theoretical implications of incorporating motivational strategies into intervention to improve social initiations in young children with ASD are discussed.

Mental health services for individuals with high functioning autism spectrum disorder

Adolescents and adults with an autism spectrum disorder (ASD) who do not have an intellectual impairment or disability (ID), described here as individuals with high-functioning autism spectrum disorder (HFASD), represent a complex and underserved psychiatric population. While there is an emerging literature on the mental health needs of children with ASD with normal intelligence, we know less about these issues in adults. Of the few studies of adolescents and adults with HFASD completed to date, findings suggest that they face a multitude of cooccurring psychiatric (e.g., anxiety, depression), psychosocial, and functional issues, all of which occur in addition to their ASD symptomatology. Despite this, traditional mental health services and supports are falling short of meeting the needs of these adults. This review highlights the service needs and the corresponding gaps in care for this population. It also provides an overview of the literature on psychiatric risk factors, identifies areas requiring further study, and makes recommendations for how existing mental health services could include adults with HFASD.

'Look at me when I am talking to you': evidence and assessment of social pragmatics interventions for children with autism and social communication disorders

PURPOSE OF REVIEW

This article provides an analysis of the effectiveness of commonly used interventions for social pragmatic interventions for children with autism spectrum disorder (ASD) and social communication disorders.

RECENT FINDINGS

Several evidence-based social skills interventions are emerging, including peer mentoring, social skills groups, and video modeling. Social stories are effective as supports for improved interactions but generalization is limited. Research supports the need for multimodality and individualized treatment programs. Research validates that video and visual learning is highly effective with children with ASD when utilized with specific, appropriate targets. Multiple studies have shown that picture-based communication systems are effective at improving functional communication with moderate effects on social communication. Despite limitations in research, there is strong evidence in the existing literature for the role of alternative augmentative communication in improving both functional and social communication.

SUMMARY

Social pragmatic interventions when individualized are effective for improving language, adaptive behavior and social skills.

Improving socialization for high school students with ASD by using their preferred interests

There has been a paucity of research on effective social interventions for adolescents with autism spectrum disorders (ASD) in inclusive high school settings. The literature, however, suggests that incorporating the student with ASD's special interests into activities may help improve their socialization with typical peers. Within the context of a multiple baseline across participants design, we implemented lunchtime activities incorporating the adolescent with ASD's preferred interests that were similar to ongoing activities already available at the schools. Results showed this increased both level of engagement and their rate of initiations made to typical peers. Social validation measures suggest that both adolescents with ASD and typical peers enjoyed participating in these activities and that the results generalized to other similar activities.

Peer Mediation to Increase Communication and Interaction at Recess for Students with Autism Spectrum Disorders

Recess plays an integral role in the social and emotional development of children given the time provided to engage in interactions with others and practice important social skills. Students with ASD, however, typically fail to achieve even minimal benefit from recess due to social and communication impairments as well as a tendency to withdraw. Implementation of evidence-based interventions such as peer-mediated social skills groups, are necessary to ensure recess is an advantageous learning environment for students with ASD. A multiple-baseline design across participants was used to determine if a functional relationship exists between a social skills instructional program combined with peer networks with school staff as implementers and increases in level of communicative acts for participants with ASD at recess. Results indicate all participants demonstrated an immediate increase in the number of communicative acts with the introduction of the intervention. Implications for practice are discussed.

Personality and self-insight in individuals with autism spectrum disorder

Autism spectrum disorder (ASD) involves widespread difficulties in social interaction, communication, and behavioral flexibility. Consequently, individuals with ASD are believed to exhibit a number of unique personality tendencies, including a lack of insight into those tendencies. However, surprisingly little research has examined these issues. Study 1 compared self-reports of Big Five personality traits in adults with ASD (n = 37) to those of typically developing (TD) adults (n = 42). Study 2 examined whether any observed personality differences replicated in children/adolescents with ASD (n = 50) and TD controls (n = 50) according to self- and parent reports of personality. Study 2 also assessed level of self-insight in individuals with ASD relative to TD individuals by examining the degree to which self-reports converged with parent reports in terms of self-other agreement and self-enhancement (vs. self-diminishment) biases. Individuals with ASD were more Neurotic and less Extraverted, Agreeable, Conscientious, and Open to Experience. These personality differences replicated for (a) children, adolescents, and adults; (b) self- and parent reports; and (c) males and females. However, personality traits were far from perfect predictors of ASD vs. TD group membership, did not predict within-group variability in ASD symptom severity, and had differential links to maladjustment in the ASD and TD groups, suggesting that ASD represents more than just an extreme standing on trait dimensions. Finally, individuals with ASD had a tendency to self-enhance and TD individuals, to self-diminish, but both groups showed comparable self-other agreement. Thus, individuals with ASD exhibit distinct personalities relative to TD individuals but may have a similar level of insight into them.

Advancing psychotherapy and evidence-based psychological interventions

Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state-of-the-art in psychotherapy treatment research, "component analyses" aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large-scale public health strategies and treatments that can be applied to more patients in a simpler and cost-effective way. Increased research on efficacy and moderators of Internet-based treatments and e-mental health tools (e.g. to support "real time" clinical decision-making to prevent treatment failure or relapse) might be one promising way forward.

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

OBJECTIVE

To determine the relationship of motor skills and the core behaviors of young children with autism, social affective skills and repetitive behaviors, as indicated through the calibrated autism severity scores.

DESIGN

The univariate GLM tested the relationship of gross and fine motor skills measured by the gross motor scale and the fine motor scale of the MSEL with autism symptomology as measured by calibrated autism severity scores.

SETTING

Majority of the data collected took place in an autism clinic.

PARTICIPANTS

A cohort of 159 young children with ASD (n=110), PDD-NOS (n=26) and non-ASD (developmental delay, n=23) between the ages of 12-33 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The primary outcome measures in this study were calibrated autism severity scores.

RESULTS

Fine motor skills and gross motor skills significantly predicted calibrated autism severity (p < 0.01). Children with weaker motor skills displayed higher levels of calibrated autism severity.

CONCLUSIONS

The fine and gross motor skills are significantly related to autism symptomology. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion.

Improving social skills in adolescents and adults with autism and severe to profound intellectual disability: a review of the literature

Social skills are important treatment targets for individuals with autism spectrum disorders (ASD) across the lifespan. However, few treatments are available for adolescents and adults with ASD who also have severe to profound intellectual disability (S/PID). Several social skill interventions have been described that may improve social skills in this population, including video modeling, developmental, peer-mediated, behavioral, and structured teaching interventions. However, significant challenges in research design and methodology exist across these studies. This paper reviews research examining social skill interventions for youth and adults with ASD and S/PID and points out weaknesses and challenges in this literature. We propose a developmental framework of adapting early childhood interventions for use with youth and adults with ASD and S/PID as one starting point for intervention development.

Social intervention for adolescents with autism and significant intellectual disability: initial efficacy of reciprocal imitation training

Individuals with autism have difficulty with social skills across the lifespan. Few social interventions have been examined for older individuals with autism who also have significant intellectual disabilities (ID). Previous research suggests that reciprocal imitation training (RIT) improves imitation and social engagement in young children with autism. This study used a multiple-baseline design to examine whether RIT could improve social behaviors in four adolescents with autism and significant ID. All adolescents improved their spontaneous imitation and two improved their joint engagement. In addition, two adolescents decreased their rate of self-stimulatory behaviors over the course of treatment. Overall, these results suggest that RIT may be effective at improving social interaction and decreasing self-stimulatory behavior in adolescents with autism and significant ID.

Mechanisms of change in psychosocial interventions for autism spectrum disorders

Research into psychosocial interventions (particularly cognitive-behavior therapies and social skills training) for social-communication deficits among individuals with autism spectrum disorder (ASD) has proliferated over the past decade. While this research has provided some empirical support for the efficacy of these interventions, little work has begun to elucidate therapeutic mechanisms-the when, why, how, for whom, and under what conditions an intervention may produce change, identification of mechanisms underlying these effects should help advance ASD intervention research. This article describes methods for assessing such mechanisms (ie, mediators and moderators) and presents promising candidates for common mechanisms impacting treatment response: behavior modification, therapeutic relationship, social knowledge, social motivation, social information processing, executive functioning, and internalizing comorbidities. Finally, future directions are discussed as a program of psychosocial intervention research designed to identify predictors of individual differences in treatment response (including biomarkers), isolate active therapeutic ingredients, and promote dissemination of optimized interventions.

Increasing social engagement in children with high-functioning autism spectrum disorder using collaborative technologies in the school environment

This study examined the effectiveness of a school-based, collaborative technology intervention combined with cognitive behavioral therapy to teach the concepts of social collaboration and social conversation to children with high-functioning autism spectrum disorders (n = 22) as well as to enhance their actual social engagement behaviors (collaboration and social conversation) with peers. Two computer programs were included in the intervention: "Join-In" to teach collaboration and "No-Problem" to teach conversation. Assessment in the socio-cognitive area included concept perception measures, problem solving, Theory of Mind, and a dyadic drawing collaborative task to examine change in children's social engagement. Results demonstrated improvement in the socio-cognitive area with children providing more active social solutions to social problems and revealing more appropriate understanding of collaboration and social conversation after intervention, with some improvement in Theory of Mind. Improvement in actual social engagement was more scattered.

Competência social e autismo: o papel do contexto da brincadeira com pares

Observa-se o esforço dos pesquisadores em delinear e avaliar intervenções para facilitar o desenvolvimento da interação social em crianças com autismo e seus pares, em situações de inclusão escolar. Entre os resultados controversos dos estudos estão os que se referem ao papel do contexto das brincadeiras, isto é, se livre ou dirigida, na promoção da competência social dessas crianças. O objetivo deste estudo foi revisar criticamente a literatura sobre o tema, buscando-se evidências sobre que tipo de contexto de brincadeira tende a promover as interações entre pares, examinando-se as questões metodológicas que cercam esse debate. A conclusão foi de que ambos os contextos promovem o desenvolvimento da competência social, mas o livre tende a ser mais duradouro e espontâneo.

Teaching play skills to young children with autism

BACKGROUND

Play is critical for the development of young children and is an important part of their daily routine. However, children with autism often exhibit deficits in play skills and engage in stereotypic behaviour. We reviewed studies to identify effective instructional strategies for teaching play skills to young children with autism.

METHOD

Empirical studies on teaching play skills to young children with autism published from 1990 to 2011 were located. These studies included single subject and group designs.

RESULTS

Twenty-six studies were reviewed. The majority of studies on teaching play skills used combined interventions. Children with autism improved their play skills, with direct intervention embedding their interests during play. Improvements in play skills increased positive social interactions and decreased inappropriate behaviour as collateral effects.

CONCLUSIONS

Further research is needed to develop more effective play skill interventions that assess the functional use of play and are implemented in the natural environment.

Brief Report: impaired Flexible Item Selection Task (FIST) in school-age children with autism spectrum disorders

Cognitive flexibility has been measured with inductive reasoning or explicit rule tasks in individuals with autism spectrum disorders (ASD). The Flexible Item Selection Task (FIST) differs from previous cognitive flexibility tasks in ASD research by giving children an abstract, ambiguous rule to switch. The ASD group (N = 22; Mean age = 8.28 years, SD = 1.52) achieved a lower shift percentage than the typically developing verbal mental-age control group (N = 22; Mean age = 6.26 years, SD = 0.82). There was a significant positive correlation between verbal mental age and shift percentage for children with ASD. Group differences on the FIST converge and extend prior evidence documenting an impaired ability to adapt rapidly to changes in task demands for individuals with ASD.

Incorporating Video Modeling Into a School-Based Intervention for Students With Autism Spectrum Disorders

Purpose

Video modeling is an intervention strategy that has been shown to be effective in improving the social and communication skills of students with autism spectrum disorders, or ASDs. The purpose of this tutorial is to outline empirically supported, step-by-step instructions for the use of video modeling by school-based speech-language pathologists (SLPs) serving students with ASDs.

Method

This tutorial draws from the many reviews and meta-analyses of the video modeling literature that have been conducted over the past decade, presenting empirically supported considerations for school-based SLPs who are planning to incorporate video modeling into their service delivery for students with ASD. The 5 overarching procedural phases presented in this tutorial are (a) preparation, (b) recording of the video model, (c) implementation of the video modeling intervention, (d) monitoring of the student’s response to the intervention, and (e) planning of the next steps.

Conclusion

Video modeling is not only a promising intervention strategy for students with ASD, but it is also a practical and efficient tool that is well-suited to the school setting. This tutorial will facilitate school-based SLPs' incorporation of this empirically supported intervention into their existing strategies for intervention for students with ASD.

Parent and family impact of autism spectrum disorders: a review and proposed model for intervention evaluation

Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.

Evaluation of a Sibling-Mediated Imitation Intervention for Young Children with Autism

Parents and peers have been successful at implementing interventions targeting social interactions in children with autism; however, few interventions have trained siblings as treatment providers. This study used a multiple-baseline design across six sibling dyads (four children with autism) to evaluate the efficacy of sibling-implemented reciprocal imitation training. All six typically developing siblings were able to learn and use contingent imitation, four of the six siblings were able to learn and use linguistic mapping, and all six siblings increased their use of at least one component of the imitation training procedure. Three of the four children with autism showed increases in overall imitation and all four showed evidence of increases in joint engagement. Parents and siblings reported high satisfaction with the intervention and ratings by naïve observers indicated significant changes from pre- to post-treatment. These results suggest that sibling-implemented reciprocal imitation training may be a promising intervention for young children with autism.

Improving Social Engagement and Initiations between Children with Autism Spectrum Disorder and Their Peers in Inclusive Settings

Children with Asperger's Disorder often have difficulty with peer relationships and socialization. The current study assessed whether peer social interactions would improve in school settings if an intervention was designed that incorporated the children with Asperger's interests. Three children who were fully-included in regular education classes but did not interact with peers prior to intervention participated in this research. Social lunch clubs, open to both the study participants and their typical peers, were implemented twice weekly during regular lunchtime periods. Results showed that all three children increased their time engaged with peers as a result of the clubs. While their initiations greatly improved over baseline levels and approximated their peers, they were often initiating below the level of most of their peers. Implications for improving peer social interactions for children with Asperger's Disorder are discussed.

From my perspective--perceived participation in mainstream schools in students with autism spectrum conditions

OBJECTIVES

To examine perceived participation in students with ASC and their classmates in mainstream schools and to investigate correlations between activities the students wanted to do and actually participated in.

METHODS

Twenty-two students with ASC and their 382 classmates responded to a 46-item questionnaire regarding perceived participation in mainstream schools.

RESULTS

On 57% of the items, students with ASC perceived lower participation than their classmates. These results emphasize the importance of knowledge about students' perceived participation. However, positive correlations between what the students wanted to do and actually did indicate that students with ASC may be participating to the extent that they wanted.

CONCLUSION

Students with ASC perceived lower overall participation in mainstream school than their classmates. The correlations between "I want to" and "I do" statements in students with ASC indicated that aspects of autonomy are important to incorporate when studying, and interpreting, self-rated participation in mainstream schools.

Measuring change in social interaction skills of young children with autism

Designing effective treatments for improving early social behaviors in autism has been identified as a critical research need. One barrier to drawing conclusions about optimal treatments for children with autism is the use of highly varied dependent measures in the treatment literature. Contributing to this is the absence of "gold standard" assessment batteries. This is particularly true for assessing changes in social interaction impairments in very young children with autism. This paper addresses this issue by reviewing variables important in the development and evaluation of assessment measures, discussing previous studies' choices of socially-related dependent measures, and the strengths, limitations, and research questions pertaining to them. It concludes with recommendations for measurement selection and future directions for research.

Using Perseverative Interests to Improve Interactions Between Adolescents with Autism and their Typical Peers in School Settings

The literature suggests that adolescents with ASD typically are not socially engaged during unstructured school activities and do not initiate social activities with typically developing peers. This study assessed whether implementing socialization opportunities in the form of lunch clubs based around aspects of the adolescents with ASD's perseverative interests would promote positive direct and generalized social interaction between the target adolescent and their typically developing peers. A repeated measures multiple baseline experimental design (with two reversals) was implemented across participants. During baseline measures, the participants did not show social engagement or initiations. During intervention, results showed large increases in both social engagement and initiations. Generalization measures also showed that the target adolescents improved their social engagements and initiations with typically developing peers throughout unstructured lunchtime activities. These results have implications for understanding variables related to social development in autism.

Looking through the Same Eyes? Do Teachers' Participation Ratings Match with Ratings of Students with Autism Spectrum Conditions in Mainstream Schools?

To create an inclusive classroom and act accordingly, teachers' understanding of the experiences of participation of students with autism spectrum conditions (ASCs) is crucial. This understanding may depend on the teachers' professional experiences, support and personal interests. The aim of the present questionnaire study was to investigate how well the teachers' ratings of their students with ASCs' perception of participation matched with the students' own ratings. Furthermore, possible correlations between the accuracy of teachers' ratings and the teachers' self-reported professional experience, support (including support-staff), and personal interest were investigated. Teachers' ratings were also used to examine how their understandings correlated with classroom actions. The agreements between teachers' and students' ratings were moderate to high, and the ability to attune to the students' perception of participation was not affected by the presence of a support-staff. The teachers' personal interest in teaching students with ASC correlated with their accuracy, suggesting that this is a factor to consider when planning for successful placements in mainstream schools. Teachers' understandings of the students with ASCs' perception of being bullied or unpopular correlated with implementation of activities to improve the attitudes of classmates, but not with actions to enhance social relations for the students with ASC.

Improving generalization of peer socialization gains in inclusive school settings using initiations training

Social engagement by children with autism spectrum disorder (ASD) in unstructured school settings generally occurs at very low levels, if at all. Although many interventions improve peer socialization, generalization and maintenance of such gains when interventions are faded are typically low. The present study employed a multiple baseline design across participants to target generalization in the absence of interventionists in elementary school children with ASD at recess. Teaching initiations has been suggested as one method to increase generalization. The results of the present study showed that when initiations were targeted during intervention for social play, the participants demonstrated generalized peer social engagement, increases in unprompted peer-directed initiations, and more positive affect during peer interactions. Results are discussed in terms of theoretical and applied implications of incorporating initiations training into social interventions.

Social skills training for children with autism

This article summarizes the current literature on social skills training for children and adolescents with autism spectrum disorders. The article describes several different methods of social skills training, along with a summary of research findings on effectiveness. Interventions described include social skills groups, peer mentoring/training, social stories, and video modeling. The article also describes information about accessing social skills training services, and concludes with future directions and recommendations for pediatricians.

Pleasure, Throwing Breaches, and Embodied Metaphors: Tracing Transformations-in-Participation for a Child with Autism to a Sensory Integration—Based Therapy Session

In occupational therapy practice, the rich interweaving of procedural and narrative reasoning results in healing transformations. However, a lack of research focus on transformational processes perpetuates a focus on observable and measurable behaviors. In line with the movement toward evidence-based implementation research, this article focuses on a case study drawn from an ethnography of therapist—child—family interactions in a sensory integration—based clinic to provide a thick description of the moments leading up to and following changes in bodily and social engagement for a child with autism. Using theoretical resources on acted narratives and aesthetics, this article provides a developing method and language to show how an occupational therapist and a child with autism throw breaches to jointly create embodied metaphors of what matters to the child in his or her everyday life. A microanalysis of therapist—child bodily and sensing interactions also reveals how narrative and procedural reasoning converge in moments of pleasure that ultimately lead to outcomes in participation outside the clinic and confound characterizations of autistic aloneness. Implications for research on sensory integration approaches in general and social interventions for children with autism are discussed.

The efficacy of a Social Skills Group Intervention for improving social behaviors in children with High Functioning Autism Spectrum disorders

This study tested the efficacy of a new social skills intervention, S ocial S kills GR oup IN tervention-High Functioning Autism (S.S.GRIN-HFA), designed to improve social behaviors in children with high functioning autism spectrum disorders. Fifty-five children were randomly assigned to S.S.GRIN-HFA treatment (n = 27) or control (i.e., traditional S.S.GRIN intervention; n = 28). Examination of the direction and magnitude of change in functioning revealed that children who participated in S.S.GRIN-HFA exhibited significantly greater mastery of social skill concepts compared to children in the control group. Parents of S.S.GRIN-HFA group participants reported an improved sense of social self-efficacy, whereas parents of control participants reported a decline. The advantages of a specialized intervention such as S.S.GRIN-HFA, designed specifically for children with high functioning autism spectrum disorders, are discussed.

Recent Advances in Early Identification and Treatment of Autism

Currently, autism spectrum disorders (ASD) can be reliably diagnosed between the ages of 2 and 3 years. Efforts to identify symptoms of ASD in younger children are underway. Recent evidence suggests that children with ASD show reduced rates of early nonverbal social-communication skills by about 12 months, although diagnosis before age 2 remains a challenge. These early social-communication skills can be improved with targeted intervention, and doing so may produce broader improvements in later-emerging skills. Research is beginning to explore the use of these interventions with toddlers, with some success. Despite these advances, much is still unknown about the early presentation of ASD or the best way to intervene.

The richness of social stimuli shapes developmental trajectories: Are laboratory mouse pups impoverished?

The early environment is crucial for brain and behavior development. In particular, social experiences involving the mother and the peers are critical in shaping the adult individual. Though animal models of psychiatric disorders have widely investigated the relevance of the mother-offspring interaction, the peer interaction has so far been rarely studied. The communal nest (CN) is an innovative experimental strategy that favors a more comprehensive investigation of the long-term effects of both components. CN is a rearing condition employed by up to 90% of mouse females in naturalistic settings and consists of a single nest where two or more mothers keep their pups together and share care-giving. In a CN, the developing pup is exposed to high levels of both maternal care and interaction with peers. At adulthood, these mice display relevant changes in bran function and behavior, including high levels of neural plasticity markers, such as BDNF, and elaborate adult social competences. Overall, on the one hand, CN is an experimental approach complementary to the ones currently used that allows to investigate how the early environment determines developmental trajectories. On the other, it may represent a strategy to improve the study of animal models of psychiatric disorders characterized by social dysfunction, such as major depression, autism and attention deficit hyperactivity disorder. Indeed, the more elaborate social competences shown by these mice at adulthood may allow to better characterize deficits in the social domain induced by genetic and/or environmental manipulations.