Using a group-oriented contingency to increase social interactions between children with autism and their peers. A preliminary analysis of corollary supportive behaviors

Stakeholder Perceptions of the Acceptability of Peer-Mediated Intervention for Minimally Speaking Preschoolers on the Autism Spectrum

Peer mediated intervention (PMI) is an evidence-based approach to supporting social and communication development for children on the autism spectrum. For PMI to be integrated into everyday practice, it needs to be acceptable to stakeholders. This article engaged with autistic individuals, early childhood educators, parents, and speech and language pathologists on the prospective acceptability of implementing PMI with minimally speaking preschoolers in inclusive preschool settings. Focus groups and semi-structured interviews were conducted. The transcriptions were analyzed qualitatively using reflexive thematic analysis. Stakeholders described PMI as an acceptable intervention approach for this population and provided valuable insights to inform the development and implementation of PMIs. Attention needs to be paid to how to support preschools to adopt a PMI-friendly philosophy.

Feasible Peer-Mediated Intervention for Autistic Children Using Minimal Speech: A Qualitative Intervention Development Process

PURPOSE

Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings.

METHOD

A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings.

RESULTS

While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation.

CONCLUSION

To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/setting), and micro (individual).

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25155770.

Consistency in Single-Case ABAB Phase Designs: A Systematic Review

The current article presents a systematic review of consistency in single-case ABAB phase designs. We applied the CONsistency of DAta Patterns (CONDAP) measure to a sample of 460 data sets retrieved from 119 applied studies published over the past 50 years. The main purpose was to (a) identify typical CONDAP values found in published ABAB designs and (b) develop interpretational guidelines for CONDAP to be used for future studies to assess the consistency of data patterns from similar phases. The overall distribution of CONDAP values is right-skewed with several extreme values to the right of the center of the distribution. The B-phase CONDAP values fall within a narrower range than the A-phase CONDAP values. Based on the cumulative distribution of CONDAP values, we offer the following interpretational guidelines in terms of consistency: very high, 0 ≤ CONDAP ≤ 0.5; high, 0.5 < CONDAP ≤ 1; medium, 1 < CONDAP < 1.5; low, 1.5 < CONDAP ≤ 2; very low, CONDAP > 2. We give examples of combining CONDAP benchmarks with visual analysis of single-case ABAB phase designs and conclude that the majority of data patterns (41.2%) in published ABAB phase designs is medium consistent.

Could You Give Me the Blue Brick? LEGO®-Based Therapy as a Social Development Program for Children with Autism Spectrum Disorder: A Systematic Review

LEGO®-based therapy is a social skills development program aimed at children with autism spectrum disorder (ASD). A systematic review of the literature was conducted using PRISMA guidelines. PubMed, Scopus and Web of Science bibliographic databases were searched from their date of inception to August 2020. The review included 19 studies. Studies were classified according to experimental designs (e.g., Randomized Control Trial, Non-Randomized Studies of Interventions and case report and series) and a narrative synthesis of each was provided, along with a critical discussion of the strengths and weaknesses of the available literature on the topic. Although LEGO®-based therapy appears a promising treatment for social interaction in ASD, the findings of LEGO®-based therapy studies should be interpreted and generalized with caution, due to the low quality of the studies and the small sample sizes.

Group Contingency Interventions With Children—1980-2010

The present study sought to evaluate the efficacy of group contingency procedures via meta-analysis. A total of 182 studies published between 1980 and 2010 were identified via PsychInfo that included group contingency as a keyword. Studies that met inclusion criteria (e.g., single-subject design, school-aged children; N = 50), were coded and effect sizes were calculated. Results strongly support the efficacy of group contingencies with an overall effect size of 3.41. Types of group contingencies were also evaluated for dependent group contingencies (ES = 3.75, n = 11), independent group contingencies (ES = 3.27, n = 8), and interdependent group contingencies (ES = 2.88, n = 35). These results clearly establish all varieties of group contingencies as efficacious for a wide range of target behaviors with school-aged children. Results are discussed with regard to practical implications.

Effective Behavioural Strategies for the Defining Characteristics of Autism

The following review paper describes the outcomes of data-based behavioural intervention strategies for the defining characteristics of autistic disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). The results of relevant evaluations of behaviour analytic procedures are reviewed for each of the four potential areas of difficulty under each of the main criteria for autistic disorder, which are: (a) impairment in social interaction, (b) impairment in communication, and (c) restrictive, repetitive, and stereotyped patterns of behaviour, interests, and activities (DSM-IV). The current areas of research activity as well as those domains that have received comparatively little attention by behavioural researchers are identified, and suggestions for future research are discussed.

Meta-analysis of social skills interventions of single-case research for individuals with autism spectrum disorders: results from three-level HLM

This meta-analysis used hierarchical linear modeling to examine 115 single-case studies with 343 participants that examined the effectiveness of social skills interventions for individuals with autism spectrum disorder (ASD). The average effect size of the included studies was 1.40 (SD = 0.43, 95% CL = 1.32-1.48, N = 115). In the further, several common predictors including intervention length, age and gender of the participants, and study quality indicators (provision of sufficient, in-depth, and replicable information of participants, settings/materials, independent variables, and dependent variables) were not found to mediate the intervention effectiveness. Only research design that the study employed was found to impact the intervention effectiveness; the studies using multiple baseline or reversal design had larger effect sizes than studies using other designs. Implications of the results and limitations of this study are discussed.

Effects of Peer-Mediated Implementation of Visual Scripts in Middle School

Although research has investigated the impact of peer-mediated interventions and visual scripts on social and communication skills in children with autism spectrum disorders, no studies to date have investigated peer-mediated implementation of scripts. This study investigated the effects of peer-implemented scripts on a middle school student with autism, intellectual impairments, and speech-language impairment via a multiple baseline single-case research design across behaviors. The target student demonstrated improvements in three communicative behaviors when implemented by a trained peer; however, behaviors did not generalize to use with an untrained typically developing peer.

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.

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.

Peer-mediated social skills training program for young children with high-functioning autism

One of the most prevailing characteristics of children with autism is their deficit in social communication skills. The purpose of this study was to evaluate the effectiveness of a peer-mediated social skills training (SST) program combined with video feedback, positive reinforcement and token system in increasing social communication skills in young children with high-functioning autism. Four boys with high-functioning autism, ages 6-7 years, participated in the study. The social skills training, lasting 12 weeks, targeted six communication skills, selected after parent interviews and behavioral observation during a pre-training assessment period. One SST session was conducted each week, each session lasted 90min and had six structured activities. The training effectiveness was evaluated through direct observation of a structured interaction period, using an observational coding system. Improvement was observed in three out of four children, although individual differences among children were seen for changes in two global scales as well as subscales. These results suggest that the social skills training was effective in improving social communication skills for some children with high-functioning autism. Clinical and research implications and future directions for social skills training as well as this study's limitations are discussed.

Establishing a generalized repertoire of helping behavior in children with autism

The present study used a multiple baseline across participants design to assess whether 4 children with autism could learn a generalized repertoire of helping adults with different tasks through the use of a multicomponent teaching package. Different helping responses were taught in the presence of multiple exemplars of discriminative stimuli drawn from experimenter-defined categories of helping behavior (e.g., locating objects, putting away items, setting up an activity). During the training condition, video models, prompting, and reinforcement were used. The results showed that all 4 children learned to emit appropriate helping responses in the presence of discriminative stimuli from the helping categories used during training. Generalization of helping responses was observed in the presence of untrained discriminative stimuli during additional probe conditions. Additional pre- and postintervention generalization trials showed that the frequency of helping responses also increased in the presence of novel stimuli, in a novel setting, and with a novel instructor.

Interventions to facilitate social interaction for young children with autism: review of available research and recommendations for educational intervention and future research

The purpose of this paper is to review the knowledge available from aggregated research (primarily through 2000) on the characteristics of social interactions and social relationships among young children with autism, with special attention to strategies and tactics that promote competence or improved performance in this area. In its commissioning letter for the initial version of this paper, the Committee on Educational Interventions for Children with Autism of the National Research Council requested "a critical, scholarly review of the empirical research on interventions to facilitate the social interactions of children with autism, considering adult-child interactions (where information is available) as well as child-child interactions, and including treatment of [one specific question]: What is the empirical evidence that social irregularities of children with autism are amenable to remediation?" To do this, the paper (a) reviews the extent and quality of empirical literature on social interaction for young children with autism; (b) reviews existing descriptive and experimental research that may inform us of relations between autism and characteristics that support social development, and efforts to promote improved social outcomes (including claims for effectiveness for several specific types of intervention); (c) highlights some possible directions for future research; and (d) summarizes recommendations for educational practices that can be drawn from this research.

Including children with autism in general education classrooms. A review of effective strategies

Children with autism can benefit from participation in inclusive classroom environments, and many experts assert that inclusion is a civil right and is responsible for nurturing appropriate social development. However, most children with autism require specialized supports to experience success in these educational contexts. This article provides a review of the empirical research that has addressed procedures for promoting successful inclusion of students with autism. Strategies reviewed include antecedent manipulations, delayed contingencies, self-management, peer-mediated interventions, and other approaches that have been demonstrated in the literature to be useful. The article concludes with a discussion of future research needs.