Integrated play groups: a model for promoting the social and cognitive dimensions of play in children with autism

Peer mediation in play settings for minimally verbal students with autism Spectrum disorder

Background and aims

Peer-mediated interventions (PMIs) are effective strategies to foster socialization of children with autism spectrum disorder (ASD) in natural settings. However, research examining the efficacy of peer mediation for students with ASD who have the greatest cognitive and language impairments remains limited. Additionally, previous studies essentially targeted communicative abilities of participants. To address this gap, the present study evaluated the effects of a play-based PMI on three socio-communicative skills (play, social engagement and imitation) of minimally verbal students with ASD who also have a comorbidity of intellectual disability (ID).

Methods

Seven children with ASD attending ordinary school settings and 14 typically developing (TD) preschoolers participated. Seven single-sex groups were formed, and children played together during two 30 min weekly sessions. TD children were trained according to the principles of the integrated play group model. We used a multiple-baseline design across participants to measure the effects of the intervention on play skills, social engagement and motor imitation of students with ASD.

Results

Outcomes revealed an intervention effect for most of the participants, despite some variations across children. After the peer training, four children increased their duration of functional/symbolic play, six children improved their duration of interactive play and five children increased their rates of motor imitation. Concerning maintenance gains, inter-individual differences are also important.

Conclusions and implications

These findings suggest that a play-based PMI may be a feasible option for targeting inclusive education and improving socio-communicative skills of some minimally verbal students with ASD who also have an ID. However, variations across children invite further research to clarify how individual factors can moderate the effects of PMIs in children with ASD who are the most impaired.

Mothers' Perspectives on the Inclusion of Young Autistic Children in Kuwait

There is a lack of information on early childhood inclusive education and the parental perspectives towards the inclusion of autistic children in Kuwait. The aim of this study was to explore the perspectives and experiences amongst mothers of young autistic children regarding the inclusion of their children in general education kindergarten settings. Focus group and individual semi-structured interviews were conducted with (n = 34) Kuwaiti mothers of children with (ASD). The study participants were of the opinion that the behaviours unique to (ASD) can only be managed in highly structured special education settings. The themes that emerged from the interviews demonstrate that the general view amongst the study participants is that the inclusive educational model will not meet the autistic children's needs.

The use of augmented toys to facilitate play in school-aged children with visual impairments

BACKGROUND

Children with visual impairments (VIs) face challenges in social play activities, which limits their opportunities to practice social skills.

AIMS

We investigated whether augmented toys were effective to facilitate play in 52 children with VIs who attended special schools for students with visual impairments and blindness.

METHODS AND PROCEDURES

52 children with VIs (mean age: 9.22 years, SD = 2.07) played three times with both an augmented and a non-augmented toy. A Playmobil® knight's castle was augmented with Radio Frequency Identification (RFID) technology, such that each play figure produced audio feedback during play. The RFID-technology could be activated and deactivated. Social and cognitive aspects of play were coded from video and data were analyzed using multilevel logistics.

OUTCOMES AND RESULTS

Children showed less disengagement and more parallel play, but less cooperative play when they used the augmented versus the non-augmented castle. This pattern persisted after repeated play sessions with both toys.

CONCLUSIONS

The addition of sounds to physical toys increased shared attention between children with VIs during the exploration of play materials, yet it interfered with social interaction during peer play.

An Introduction to Play and the Preschool Child with Autistic Spectrum Disorder

As the main occupation of childhood, play is considered by occupational therapists as an important vehicle for the assessment and treatment of preschool children. For the child with autistic spectrum disorder (ASD), play not only offers a mechanism whereby the severity of the disorder can be ascertained but also enables interventions to be implemented and monitored.

This paper aims to summarise the current literature as it relates to the play of children with ASD. By doing so, it alerts the reader to the complexity of the issue of play as a means of assessment and intervention and highlights areas of continuing clinical and research concern.

Creating Socially Supportive Environments for Fully Included Students who Experience Multiple Disabilities

This investigation analyzed the effectiveness of an intervention designed to facilitate the social inclusion of three students who experienced significant physical and intellectual challenges and, for two students, dual sensory impairments. The children were full-time members of two first-grade and one fourth-grade classrooms. The individualized intervention package included three major components: (a) provision of ongoing information to classmates about the communication system, adaptive equipment, and educational activities of the students with disabilities in the context of naturally occurring interactions between the students and their classmates or during “club” meetings; (b) identification and utilization of various media that could serve as the basis for interactive exchanges between the focus students and others; and (c) ongoing facilitation by educational staff of social exchanges between students and their classmates through the establishment of a “buddy” system, arrangement of interactive activities across the day, and prompting and interpreting communicative exchanges when necessary. All aspects of intervention were implemented by educational staff including general education and inclusion support teachers, paraprofessionals, and related service personnel. An analysis of the interactive patterns between the focus students and others indicated that when the intervention was fully implemented, there were increases in (a) reciprocal interactions with peers, (b) focus student-initiated interactions, and (c) focus student-initiated interactions that were comments (with no increase in requests or protests). In addition, there were decreases in assistive interactions with paraprofessionals. The social validity of changes in interactive patterns between the focus students and their classmates was established through interviews with the students' friends and their teachers.

The Relationship between Stereotypic Behavior and Peer Social Interaction for Children with Severe Disabilities

The purpose of this study was to examine the collateral relationship between engagement in social interaction with peers and the occurrence of stereotypic behavior for two children with severe disabilities. Peers without disabilities were taught to make social initiations to two children with autism and other severe disabilities who engaged in high rates of stereotypic behavior. When the peers made social initiations and the children with disabilities increased their engagement in social interaction, collateral decreases occurred in their stereotypic behavior. Within an ABAB design, the functional relationship between these variables was demonstrated. Implications of these findings for designing interventions for promoting social integration and their possible effects on stereotypic behavior are noted.

Visually Cued Instruction for Children with Autism and Pervasive Developmental Disorders

Visually cued instruction involves the use of pictographic and written language as instructional supports in both structured and natural learning contexts. This article discusses the theoretical rationale for visually cued instruction, followed by examples of pictographic and written language cues that enhance children's organizational skills, general skill development, academic learning, communication, socialization, and selfcontrol.

Design, development, and clinical validation of therapeutic toys for autistic children

[Purpose] One of the characteristics of autistic children is social interaction difficulties. Although therapeutic toys can promote social interaction, however its related research remains insufficient. The aim of the present study was to build a set of cooperative play toys that are suitable for autistic children. [Subjects and Methods] This study used an innovative product design and development approach as the basis for the creation of cooperative play toys. [Results] The present study has successfully developed cooperative play toys. Compared to the traditional game therapy for autism, cooperative play toy therapy can significantly improve the interactions between autistic children and their peers. [Conclusion] The most critical design theme of cooperative play toys focuses on captivating the interest of autistic children. Based on the needs of the individual cases, the design of the therapeutic toy set was specifically tailored, i.e., by reinforcing the sound and light effects to improve the attractiveness of the toys. In the future, different play modes can be combined with this toy set to further enhance the degree of interaction of autistic children and improve their quality of life and social skills.

Using Video Modeling for Generalizing Toy Play in Children With Autism

The present study examined effects of video modeling on generalized independent toy play of two boys with autism. Appropriate and repetitive verbal and motor play were measured, and intermeasure relationships were examined. Two single-participant experiments with multiple baselines and withdrawals across toy play were used. One boy was presented with three physically unrelated toys, whereas the other was presented with three related toys. Video modeling produced increases in appropriate play and decreases in repetitive play, but generalized play was observed only with the related toys. Generalization may have resulted from variables including the toys' common physical characteristics and natural reinforcing properties and the increased correspondence between verbal and motor play.

Supporting Children on the Autism Spectrum in Peer Play at Home and School

The article focuses on integrated play groups (IPGs) as a model to support children with ASD in play with typically developing peers/siblings, and its recent adoption with children in a home and school setting in Taiwan. The first part provides a brief overview of the IPG model and its essential features. The second part reports on a pilot investigation that combined quantitative and qualitative methods to examine the effects of participation in IPGs on the symbolic and social play of two early elementary-aged children with autism. Preliminary findings suggest that each child made notable gains in reciprocal social interaction and symbolic/pretend play while participating in play groups. Implications are discussed in terms of play’s role in enhancing socialization, imagination and peer cultural inclusion.

Beyond Echoplaylia

The article was written to support the use of play as a medium to extend and enrich the communicative exchanges and, more specifically, the symbolic language of children on the autistic spectrum. The first argument in support of such use of play lies within the features of autistic communication, and particularly the extreme challenges encountered in imaginative play and narrative thought. The second argument on behalf of play lies within the selection of specific inter- vention strategies, which are discussed subsequently. Finally, the article presents a case illustration of how adult facilitated dramatic peer play led to a breakthrough in a range of symbolic behaviours in a 9-year- old girl with autism, who up to that point had not progressed beyond a semi-communicative use of echolalia, best described as ‘situation association’.

Integrated play groups: promoting symbolic play and social engagement with typical peers in children with ASD across settings

Children with autism spectrum disorders (ASD) face pervasive challenges in symbolic and social play development. The Integrated Play Groups (IPG) model provides intensive guidance for children with ASD to participate with typical peers in mutually engaging experiences in natural settings. This study examined the effects of a 12-week IPG intervention on the symbolic and social play of 48 children with ASD using a repeated measures design. The findings revealed significant gains in symbolic and social play that generalized to unsupported play with unfamiliar peers. Consistent with prior studies, the outcomes provide robust and compelling evidence that further validate the efficacy of the IPG model. Theoretical and practical implications for maximizing children's developmental potential and social inclusion in play are discussed.

Uncovering the theoretical underpinnings of an interprofessional preschool intervention program: Tumbling Together

BACKGROUND

Intervention programs are rarely tailored for children with self-regulation and communication challenges. Therefore, clinicians develop their own programs as is the case with the preschool program Tumbling Together. This program combines occupational therapy, speech-language therapy, and gymnastics.

PURPOSE

The aim of this study was to take an in-depth look at the program to answer the following questions: (a) What are the fundamental concepts of the program? and (b) What is the underlying theoretical model that illustrates the relationships between concepts?

METHOD

The qualitative research method of grounded theorizing using situational analysis was employed.

FINDINGS

Fourteen main concepts of the program were identified and informed the development of a theoretical model.

IMPLICATIONS

A theoretical model incorporating Tumbling Togethers concepts is a first step in evaluating its efficacy. Although the concepts involved are not novel, their unique combination forms a promising intervention approach for this population.

The Use of Peer Networks to Increase Communicative Acts of First Grade Students with Autism Spectrum Disorders

Peer networks including social groups using typical peers, scripted instruction, visual text cues, and reinforcement were examined with students with autism spectrum disorders (ASD). A multiple baseline design across four participants was used to measure students’ use of communication acts with peers during free play following instruction. Peer Network groups occurred over a 3-month period for 30 min 3 times per week. Visual inspection of trends and TauU effect size calculations showed significant changes in total communication acts for all four participants during peer network sessions and increased initiations for three of the four participants. Generalization probes during classroom centers indicated increased communications following interventions for three of the four participants.

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.

Competência social, inclusão escolar e autismo: um estudo de caso comparativo

A presente pesquisa analisou o perfil de competência social (CS) de uma criança pré-escolar com autismo, na escola comum comparado a uma criança com desenvolvimento típico e investigou a influência do ambiente escolar (sala de aula ou pátio) no perfil de CS de ambas. As interações sociais com seus pares foram filmadas, na escola, e a codificação dos vídeos foi realizada por um avaliador independente. Utilizou-se como instrumento a versão adaptada da Escala Q-sort de CS. Os resultados demonstraram que enquanto o perfil de competência social da criança com desenvolvimento típico pouco variou entre os contextos, a criança com autismo demonstrou maior frequência de comportamentos de cooperação e asserção social e menor frequência de agressão e desorganização do self, no pátio.

Co-learning facilitates memory in mice: a new avenue in social neuroscience

Social context affects brain function but our understanding of its neurobiology is at an early stage. The mere presence of one individual can alter the cognitive capacities of another and social learning has been demonstrated in many species, including the mouse. We asked several questions: 1. How can active engagement of two familiar mice in the same learning activity (co-learning) alter their memory? 2. Under which environmental conditions (aversive vs non-aversive) can we expect the memory to be enhanced, impaired, or not affected? 3. Can a genetic factor modify the co-learning effect on memory? More specifically, can co-learning correct memory deficits in autistic-like BTBR inbred mice with deficient sociability? We demonstrated that pairs of familiar inbred mice of the same or different genotypes (C57BL/6J and BTBR) that were habituated to new objects and their spatial location, had enhanced episodic memory in the spatial object recognition test, whereas individually-trained animals failed to solve this task. Notably, the co-learning effect was genotype-dependent. BTBR mice paired with BTBR cage-mates in the habituation session modestly ameliorated their performance in the object recognition test but co-learning with a familiar C57BL/6J mouse completely normalized episodic memory deficit. Next, we explored the co-learning effect on fear memory in these inbred strains. Interestingly, mice of both genotypes displayed significantly enhanced contextual fear memory once they had been conditioned together with BTBR animals. The same influence of BTBR presence was observed on cued fear memory in C57BL/6J mice, whereas a modest co-learning effect was found on cued fear conditioning in the BTBR strain. Taken together, we demonstrated for the first time the co-learning effect on cognitive capacities in mice, which can be modified by genetic background and environmental conditions. The possible implications of this methodological approach in social neuroscience are discussed. This article is part of a Special Issue entitled 'Cognitive Enhancers'.

Play, behaviour, language and social skills: the comparison of a play and a non-play intervention within a specialist school setting

The aim of the present study was to investigate the play, behaviour, language and social skills of children aged 5-8 years participating in a play intervention (based on the 'Learn to Play' program) compared to a group of children participating in traditional classroom activities within a specialist school over a six month period. Thirty-five children participated in the study, 19 participated in the play intervention group and 16 participated in the comparison group. Fourteen staff members at the special school were involved. A quasi-experimental design was used with pre and post data collection. Children in the play intervention and the comparison group were assessed using the Child-Initiated Pretend Play Assessment (play), Goal Attainment Scaling (behaviour), the Preschool Language Scale (language) and the Penn Interactive Peer Play Scale (social skills) at baseline and at follow up. Findings revealed that children participating in the play intervention showed a significant decrease in play deficits, became less socially disruptive and more socially connected with their peers. Both groups improved in their overall language skills and significantly improved in their goal attainment. This study supports the use of a play intervention in improving a child's play, behaviour, language and social skills.

Social involvement of children with autism spectrum disorders in elementary school classrooms

BACKGROUND

Children with autism spectrum disorders (ASD) are increasingly included in general education classrooms in an effort to improve their social involvement.

METHODS

Seventy-nine children with ASD and 79 randomly selected, gender-matched peers (88.6% male) in 75 early (K-1), middle (2nd-3rd), and late (4th-5th) elementary classrooms across 30 schools completed social network surveys examining each child's reciprocal friendships, peer rejection, acceptance, and social involvement.

RESULTS

Across grade levels, peers less frequently reciprocated friendships with children with ASD than students in the matched sample. While children with ASD were not more likely to be rejected by peers, they were less accepted and had fewer reciprocal friendships than matched peers at each grade level. Although 48.1% of children with ASD were involved in the social networks of their classrooms, children with ASD were more likely to be isolated or peripheral to social relationships within the classroom across all grade levels, and this difference is even more dramatic in later elementary grades.

CONCLUSIONS

In inclusive classrooms, children with ASD are only involved in peers' social relationships about half of the time, and appear to be even less connected with increasing grade level. Promoting children with ASD's skills in popular activities to share with peers in early childhood may be a key preventive intervention to protect social relationships in late elementary school grades.

Social peers rescue autism-relevant sociability deficits in adolescent mice

Behavioral therapies are currently the most effective interventions for treating the diagnostic symptoms of autism. We employed a mouse model of autism to evaluate components of behavioral interventions that improve sociability in mice. BTBR T+tf/J (BTBR) is an inbred mouse strain that exhibits prominent behavioral phenotypes with face validity to all three diagnostic symptom categories of autism, including robust and well-replicated deficits in social approach and reciprocal social interactions. To investigate the role of peer interactions in the development of sociability, BTBR juvenile mice were reared in the same home cage with juvenile mice of a highly social inbred strain, C57BL/6J (B6). Subject mice were tested as young adults for sociability and repetitive behaviors. B6 controls reared with B6 showed their strain-typical high sociability. BTBR controls reared with BTBR showed their strain-typical lack of sociability. In contrast, BTBR reared with B6 as juveniles showed significant sociability as young adults. A 20-day intervention was as effective as a 40-day intervention for improving social approach behavior. High levels of repetitive self-grooming in BTBR were not rescued by peer-rearing with B6, indicating specificity of the intervention to the social domain. These results from a robust mouse model of autism support the interpretation that social enrichment with juvenile peers is a beneficial intervention for improving adult outcome in the social domain. This novel paradigm may prove useful for discovering factors that are essential for effective behavioral treatments, and biological mechanisms underlying effective behavioral interventions.

A randomized controlled study of parent-assisted Children's Friendship Training with children having autism spectrum disorders

This study evaluated Children’s Friendship Training (CFT), a manualized parent-assisted intervention to improve social skills among second to fifth grade children with autism spectrum disorders. Comparison was made with a delayed treatment control group (DTC). Targeted skills included conversational skills, peer entry skills, developing friendship networks, good sportsmanship, good host behavior during play dates, and handling teasing. At post-testing, the CFT group was superior to the DTC group on parent measures of social skill and play date behavior, and child measures of popularity and loneliness, At 3-month follow-up, parent measures showed significant improvement from baseline. Post-hoc analysis indicated more than 87% of children receiving CFT showed reliable change on at least one measure at post-test and 66.7% after 3 months follow-up.

Social benefits of a tangible user interface for children with Autistic Spectrum Conditions

Tangible user interfaces (TUIs) embed computer technology in graspable objects. This study assessed the potential of Topobo, a construction toy with programmable movement, to support social interaction in children with Autistic Spectrum Conditions (ASC). Groups of either typically developing (TD) children or those with ASC had group play sessions with Topobo and with LEGOTM. We recorded the extent and sequence of different categories of play during these sessions. For both participant groups, there were more social forms of play with Topobo than with LEGOTM. More solitary play occurred for LEGOTM and more parallel play occurred with Topobo. Topobo was also associated with more time in onlooker and cooperative play in TD. Finally, we observed differences in play sequences between TD and ASC children, and discuss how different play materials might produce specific patterns of play in these two groups.

Empirisch überprüfte Frühfördermethoden bei autistischen Störungen

Autistische Störungen (AS) zeichnen sich durch Einschränkungen in den drei Bereichen soziale Interaktion, Kommunikation und Sprache sowie durch stereotypes Verhalten und Sonderinteressen aus. Im Rahmen der Frühförderung bei AS geht es um eine umfassende Förderung der gemeinsamen Aufmerksamkeit, des Spielverhaltens, der Sprachentwicklung sowie insbesondere der sozialen Interaktion und Kommunikation. Es existieren unterschiedliche, empirisch relativ gut überprüfte, verhaltenstherapeutische Ansätze und Therapieprogramme, die in diesem Artikel zusammengefasst sind. Dabei wird besonderer Wert auf die wissenschaftliche Evidenz der jeweiligen Ansätze gelegt.

Effects of the use of visual strategies in play groups for children with autism spectrum disorders and their peers

The purpose of this study was to investigate the impact of visual strategies with preschool children with autism spectrum disorders (ASD) and their peers during play group sessions. A changing-criterion design was implemented with three preschool-aged children with ASD while they participated in play groups with four typically-developing peers. Results indicated improvements in the use of script phrases, context-related comments, and intervals in which speech occurred for all three participants. Results regarding unscripted phrases, responses, and use of prompts were variable and are discussed.

Social challenges and supports from the perspective of individuals with Asperger syndrome and other autism spectrum disabilities

The study describes the perspectives of individuals with Asperger syndrome and other autism spectrum disabilities (ASDs) regarding social challenges and supports. Eighteen adults with ASDs were individually interviewed. They were asked to describe their experiences navigating their social worlds, and recommend effective social supports and strategies for improving social connectedness. Qualitative analyses of the interview transcripts revealed a number of common experiences including a profound sense of isolation, difficulty initiating social interactions, challenges relating to communication, longing for greater intimacy, desire to contribute to one's community, and effort to develop greater social/self-awareness. Commonly recommended social supports included external supports (e.g. activities based on shared interests, highly structured or scripted social activities, and small groups or dyads); communication supports (e.g. alternative modes of communication, explicit communication, and instruction in interpreting and using social cues); and self-initiated strategies for handling social anxiety (e.g. creative/improvisational outlets, physical activity, spiritual practice/organized religion, and time spent alone).

Parent-assisted friendship training for children with autism spectrum disorders: effects of psychotropic medication

Twenty-five 6 to 13-year-old children with autism spectrum disorders, who were high functioning, were given 12 weeks of parent-assisted children's friendship training. Thirteen were prescribed various psychotropic medications by physicians in the community prior to treatment (medicated) while 12 were not (unmedicated). Two parent-rated and three teacher-rated social measures served as outcome variables. Results revealed that unmedicated subjects had greater positive change on three of these five measures when compared to children in the medicated group. It was hypothesized that being prescribed psychotropic medication was a marker for refractory psychosocial treatment response by children with autism spectrum disorders.

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.

Effects of peer training and written text cueing on social communication of school-age children with pervasive developmental disorder

This study consecutively examined the effects of 2 social interventions-- peer training and written text treatment--on the social communication of 5 elementary students with pervasive developmental disorder. Each child with autism was paired with 2 peers without disabilities to form 5 triads. In Intervention 1 (peer training), peers were taught to use 5 facilitative social skills over 5 days. After peer training, 4 children with autism increased or used more stable rates of initiations and contingent responses overall. However, all children continued to demonstrate deficits in specific social-communication skills. Once Intervention 2 (direct instruction using written text cues) was implemented, increased use of 3 different communication skills was observed across all 5 participants. In addition, social validity outcomes revealed improved quality of child-peer interactions, 2 teacher reports of improved social skill development, and improved acceptance and friendship ratings for the children with autism. Results support the use of written text cues to improve children's social communication with peers, and suggest that combining approaches may be necessary to improve the quality of children's relationships.

Measures in intervention research with young children who have autism

In this paper, the outcome measures used in intervention research with young children with autism were analyzed. Two types of literature were reviewed: reports evaluating specific intervention practices and reports of complete intervention programs. A description of the types of measures used in each literature source and measurement practices reported were analyzed and described. In addition, the intervention program literature was reviewed to determine whether factors that may mediate outcomes were measured. Finally, the literature was reviewed to identify instances in which multiple risk and opportunity factors were analyzed to account for variations in outcomes.

A comparison of the effects of structured play and facilitated play approaches on preschoolers with autism. A case study

This study compared the effect of structured play (SP) and facilitated play (FP) in promoting spontaneity and responsiveness in communication and play behaviors in children with autism. SP is characterized by the use of mass practice trials under the instruction of the experimenter while FP incorporated incidental teaching with multiple exemplars. Eight preschoolers participated in a crossover design of both play conditions. Gains in appropriate communication and play were observed across both treatments. Respondent communicative acts occurred more frequently across all participants during SP compared with FP. The preliminary results indicate an interaction between the mental age of the child and the teaching paradigm used. The need to match treatment goals and specific methods of the play intervention to the skill profile of participants is discussed.

Increasing joint attention, play and language through peer supported play

The purpose of the present study was to examine the effects of participation in an integrated play group on the joint attention, symbolic play and language behavior of two young boys with autism. Two 6-year-old twin brothers participated in this study, along with three typically developing girls, ages 5, 9 and 11. A multiple baseline design was used with three phases: no intervention, intervention with adult coaching, and intervention without adult coaching. After being trained, the three typically developing children implemented the integrated play group techniques in 30 minute weekly play group sessions for over 16 weeks. Results indicate that participation in the integrated play group produced dramatic increases in shared attention to objects, symbolic play acts, and verbal utterances on the part of the participants with autism. These increases were maintained when adult support was withdrawn. Implications of these findings for inclusion of children with autism are discussed.

Teaching social skills to people with autism

The treatment of social skills deficits remains one of the most challenging areas in meeting the needs of people with autism. Difficulties in understanding social stimuli, in initiating and responding to social bids, and in appreciating the affect that is intrinsic to social interactions can be baffling for people with autism. Researchers and practitioners of applied behavior analysis have tried a variety of strategies for teaching social skills. This article examines a range of useful procedures for teaching social skills to people with autism, including skills that are adult mediated, peer mediated, and child-with-autism mediated. The authors also consider the potential of classwide interventions in inclusive settings, pivotal response training, and the use of scripts to teach social initiations.

Social stories, written text cues, and video feedback: effects on social communication of children with autism

This study investigated the effects of written text and pictorial cuing with supplemental video feedback on the social communication of 5 students with autism and social deficits. Two peers without disabilities participated as social partners with each child with autism to form five triads. Treatment was implemented twice per week and consisted of 10 min of systematic instruction using visual stimuli, 10 min of social interaction, and 10 min of self-evaluation using video feedback. Results showed increases in targeted social communication skills when the treatment was implemented. Some generalized treatment effects were observed across untrained social behaviors, and 1 participant generalized improvements within the classroom. In addition, naive judges reported perceived improvements in the quality of reciprocal interactions. These findings support recommendations for using visually cued instruction to guide the social language development of young children with autism as they interact with peers without disabilities.

Instructional considerations for young children with autism: the rationale for visually cued instruction

Instructional considerations for children with autism who continue to struggle with current treatment models are discussed. Specifically, the use of instructional strategies for children who may be characterized as visual learners are addressed. The discussion begins with a review of research that illuminates the learning style differences associated with autism. Next, the instructional strategies of both behavioral and incidental teaching methods are examined in light of the research. Finally, using a case study as the backdrop, the discussion concludes with a description of how visually cued instruction can be applied in various contexts.

Prognosis in autism: do specialist treatments affect long-term outcome?

Many different treatments have been claimed to have a dramatic impact on children with autism. This paper reviews what is known about the outcome in adult life and examines the limitations and advantages of a variety of intervention approaches. It concludes that there is little evidence of any "cure" for autism, but appropriately structured programmes for education and management in the early years can play a significant role in enhancing functioning in later life.