Effects of Adaptive Prompts in Virtual Reality-Based Social Skills Training for Children with Autism

The purpose of this single-case experimental design (SCED) study is to investigate how adaptive prompts in virtual reality (VR)-based social skills training affect the social skills performance of autistic children. Adaptive prompts are driven by autistic children's emotional states. To integrate adaptive prompts in VR-based training, we conducted speech data mining and endorsed micro-adaptivity design. We recruited four autistic children (12-13 years) for the SCED study. We carried out alternating treatments design to evaluate the impacts of adaptive and non-adaptive prompting conditions throughout a series of VR-based social skills training sessions. Using mixed-method data collection and analyses, we found that adaptive prompts can foster autistic children's desirable social skills performance in VR-based training. Based on the study findings, we also describe design implications and limitations for future research.

Educational Interventions for Children and Youth with Autism: A 40-Year Perspective

Commemorating the 40 th anniversary of the Diagnostic and Statistical Manual (DSM) III, the purpose of this commentary is to describe school-based and school-relevant interventions and instructional approaches for children and youth with autism that have been developed and employed during that time period. The commentary begins with a brief description of foundational research that provides an historical context. Research themes shaped by science, ethics, social policy, and the changes in the DSM provide an organization for describing the evolution of intervention and instructional practices over the four previous decades. The commentary concludes with a discussion of school-contextual variables that influence implementation and the promise of the "iSciences" for closing the research to practice gap in the future.

Guidelines for Integrating Young Children with Visual Impairments in General Educational Settings

To achieve success in educating visually impaired children in general educational settings, best-practice initiatives should be established before implementation occurs. This article examines the literature on early childhood special education and education of children with visual impairments to suggest practical guidelines for integrating youngsters who are blind or visually impaired with their age-appropriate peers.

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

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

Units of Analysis of Social Interaction Outcomes in Supported Education

In spite of increased advocacy efforts, demonstrations, and consumer demand for supported education, there is a paucity of empirical research that investigates the predicted outcomes of this model. The rationale for supported education is based largely on increasing social participation, acceptance, and friendships between students with severe disabilities and nondisabled students. This article discusses several issues that underlie the development of measurement systems to evaluate the social effects of supported education. We believe that it is essential to measure the outcomes of supported education (i.e., increased acceptance, social participation, and levels of friendships) as well as the process variables (e.g., specific social interaction skills) that are pivotal in creating the outcomes. An assessment model for outcome and process variables is described. Within this model, social interaction skills, organizational support characteristics, and contextual features are viewed as pivotal events in attaining valued outcomes.

Children's Perception of Fairness in Classroom and Interpersonal Situations Involving Peers with Severe Disabilities

Elementary-aged children (kindergarten, first grade, and second grade), attending classrooms that fully included peers with severe disabilities, judged a series of scenarios comprising common teacher-related and social situations. The scenarios contained different degrees of ambiguity regarding equitable treatment of the protagonists; some stories involved only typical children, and some involved children with disabilities. Participants were asked to judge the fairness of the outcome, why it was fair or unfair, how the characters might feel, and what could have been done to make the situation more fair. In general the children were very sophisticated in their judgments, using consistent principles of social justice, regardless of disability. Few age-related differences emerged, although there was a slight tendency for older children to make excuses for children with disabilities. Even young students demonstrated appropriate empathy for the feelings arising from being left out or being wrongly blamed. Suggested solutions tended to be short-term but based largely on equality of opportunity, and at least some of the children were able to recommend equitable policy changes in classroom and social practices.

Learning within the Context of Play: Providing Typical Early Childhood Experiences for Children with Severe Disabilities

Early childhood educators regard child-initiated, child-directed, teacher-supported play as the primary context in which young children learn, whereas special educators have relied more heavily on teacher-directed activities that are focused on specific skill development. The purpose of this manuscript is to suggest that a play-based environment is the most natural instructional context for young children with severe disabilities. The application of a play-based curriculum requires neither an abandonment of effective instructional special education practice nor a violation of early childhood education best practice. Adopting such an approach, however, does represent a conceptual step away from existing practice. Further, allowing play activities to form the foundation on which effective instruction and classroom organization are built requires the utilization of best practice in the fields of early childhood education and early childhood special education in conjunction with effective practices for educating students with severe disabilities.

How Teachers Use Peer Interactions to Include Students with Moderate and Severe Disabilities in Elementary General Education Classes

This study investigated the way teachers in five elementary classrooms used peer interactions to facilitate the inclusion of a student with moderate or severe disabilities. Four themes describing the strategies used to encourage and shape interactions between students with and without disabilities were identified: new rules about helping, “just another student,” age appropriateness, and “backing off.” The discussion focuses on the complexity of facilitating peer helping roles without encroaching on the social reciprocity found in friendships. The development of inclusion practices based on cooperation and mutual assistance for all students, rather than only for students with identified disabilities, is recommended.

Using Badges to Increase Initiations of Children with Severe Disabilities in a Play Setting

A study was conducted to investigate a training strategy that allowed children with severe disabilities to choose and initiate activities when playing with chronologically age-appropriate peers without disabilities. Prior to intervention, each student with severe disabilities was taught to use badges with photographs to indicate play activities. Pretraining involved role-playing with the teacher, teacher assistant, and a fourth grader without disabilities and not otherwise involved in the study. The intervention involved having students with disabilities take their badges into a free-play situation. A multiple-baseline, across-subjects design indicated a functional relationship between intervention and student use of play organizers, initiations, and shares. Results are discussed in terms of including students with severe disabilities in the training process when teaching social and play skills.

Increasing the Social Behavior of Young Children with Autism Using Their Obsessive Behaviors

This study systematically asked whether individual topics or themes on which children with autism perseverated across a variety of settings (often called obsessions) could be used to create the theme for a socially appropriate game. Data collected within the context of a multiple baseline design revealed very low levels of social interaction during play periods in the baseline condition. In contrast, when the children with autism were taught a socially appropriate game (e.g., one child who perseverated on maps was taught a tag game played on a giant outline of a US map), the percent of social interactions increased dramatically and continued to be high during follow-up measures. Generalization measures indicated that following intervention, the children also demonstrated increases in social interaction during other play activities. The results are discussed in terms of incorporating obsession themes into common games to create intrinsically reinforcing appropriate activities for increasing social interactions, and in relation to developing activities that capitalize on the child with autism's interests, so that the child is a valued member of the peer group.

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.

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.

Finding Kirk's Words: An Infant Mental Health Approach to Preschool Intervention

Three-year-old Kirk arrived for his 1st day of preschool in November. Initially reluctant to let his parents leave, Kirk suddenly accepted their goodbyes and assumed a space near the library area. Staring past everyone, Kirk's eyes appeared vacant and fixed straight ahead. Occasionally his gaze would shift in response to a loud noise or someone's sudden movement. However, Kirk maintained the same blank expression and a rigid posture. As these early days turned to weeks, Kirk sustained the same blank gaze, flat facial expression, and rigid posture throughout the 4-hour preschool day. When he was calm enough to engage in an activity, it was almost exclusively solitary play, and Kirk had begun to growl at children who approached him directly. In addition, none of the staff had heard Kirk speak. There were grunts and growls, pointing and gesturing, but never a word spoken to his classmates or teachers. Interestingly, early conversations with Kirk's parents revealed that unlike the preschool environment, home was a place where Kirk spoke freely.

A comparison of two group-delivered social skills programs for young children with autism

A social skills group intervention was developed and evaluated for young children with autism. Twenty-five 4- to 6-year-old (diagnosed) children were assigned to one of two kinds of social skills groups: the direct teaching group or the play activities group. The direct teaching group used a video-modeling format to teach play and social skills over the course of the intervention, while the play activities group engaged in unstructured play during the sessions. Groups met for 5 weeks, three times per week, 1 h each time. Data were derived and coded from videotapes of pre- and post-treatment unstructured play sessions. Findings indicated that while members of both groups increased prosocial behaviors, the direct teaching group made more gains in social skills.

Assessment and treatment of autism

Physicians are often the first health care professionals to encounter children that display symptoms associated with developmental disorders such as autism. Unfortunately, there is lack of information regarding what strategies physicians should adopt in treating these symptoms and where they should look to refer individuals who present with severe symptoms of autism. This paper provides some preliminary information regarding the current behavioral assessment and treatment strategies in order to help physicians identify and make appropriate recommendations for successful treatment when working with autistic children. The essential components of successful treatment for autism are outlined; some preliminary treatment methodologies that physicians can recommend parents or caregivers attempt are also highlighted. In addition, the current behavioral treatment strategies used for acquisition of social skills and language are covered as well as methodologies for the reduction of maladaptive behavior in children with autism.

Pivotal areas in intervention for autism

Discusses several core pivotal areas that appear to be influential in intervention for autism. Literature and outcome data are reviewed with respect to several core areas that appear to be particularly helpful in intervention for autism, including improving motivation, responsivity to multiple cues, self-management, and self-initiation of social interactions. A conceptual framework is described, and outcome data are reviewed suggesting that when children with autism are motivated to initiate complex social interactions, it may reverse a cycle of impairment, resulting in exceptionally favorable intervention outcomes for many children. Because the peripheral features of autism can be numerous and extensive, the concept of intervention for pivotal areas of functioning may be critical if children are to be habilitated in a time- and cost-efficient manner.

Social initiations by autistic children to adults and other children

Social initiations made by autistic and verbal-matched retarded children were recorded in two naturalistic situations. Frequencies of initiation to adults did not differ between groups, but the retarded children initiated much more frequently to peers. Most interactions for both groups were positive, but the autistic children engaged in more ritualized, and the retarded children more playful, initiations. The autistic children monitored the social environment more when forced into proximity with peers, whereas the retarded children initiated more in the unstructured situation. Autistic initiation to peers was unrelated to severity of autism, but was related to cognitive skills, including vocabulary and comprehension of affect, whereas retarded children's initiations were unrelated to cognitive level. Results are discussed in terms of the differences between adults and children as social stimuli, prerequisite skills for initiation to peers, and the relationship between social cognition and social behavior. It is suggested that autistic and retarded children differ in the quantity of their initiations to peers, and the quality of their initiations to adults, and that initiations to peers may be a particularly useful index of social development in autistic children. Results confirm the need of autistic children for highly structured social environments, and suggest an important role for the remediation of specific cognitive skills such as comprehension of others' affects.

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

This investigation provides a description of a multifaceted model to promote peer play, and an evaluation of its impact on the social and cognitive dimensions of play in three children with autism. A combination of quantitative and qualitative methodologies were used to evaluate the effectiveness of the model application. A multiple-probe design across participants demonstrated (a) decreases in isolate play and collateral gains in more social forms of play, and (b) decreases in stereotyped object play and collateral gains in functional object play. While no symbolic play was observed in any of the participants during baseline, two participants demonstrated symbolic play in the final condition. Generalization and social validation measures indicated (a) advances in play behaviors were not limited to the play groups but observed in other contexts, and (b) were accompanied by language gains. Implications are discussed in terms of preferred service delivery models as well as of the importance of social interaction for the development of play and language.

Teaching children with autism appropriate play in unsupervised environments using a self-management treatment package

The present study used a self-management treatment package to teach 3 children with autism, who exhibited inappropriate play behaviors, to play appropriately in the absence of a treatment provider. After self-management training, generalization and maintenance of the behavior change were assessed. Because of the detrimental effects of self-stimulation (arm flapping, spinning toys, twirling, etc.) on learning, the relationship between self-stimulatory behaviors and appropriate play was measured. Results indicated that the children learned to exhibit appropriate play skills in unsupervised settings, appropriate play skills generalized to new settings, and 2 of the children maintained their gains at 1-month follow-up. In addition, self-stimulatory behaviors decreased as appropriate play increased. Treatment implications of these findings are discussed.

A peer-mediated social network intervention to enhance the social integration of persons with moderate and severe disabilities

Increasingly, parents, teachers, and students with disabilities are advocating for interventions that go beyond skill training to provide support for participation in integrated environments and support for friendships. The present research demonstrated a social network intervention for youths with moderate and severe disabilities. Two groups of nondisabled peers were recruited to participate in weekly discussions with an adult integration facilitator to increase opportunities for social interaction for 2 students (1 with autism and 1 who was moderately mentally retarded). The groups met to discuss social interactions that had occurred with the students with disabilities and to talk about strategies to promote greater inclusion of the students into ongoing social interaction. The nondisabled students participated in the design and implementation of social skills interventions during transition times and lunch. The nondisabled students used self-monitoring data sheets to record the quantity and quality of interactions. The frequency of interaction, number of opportunities for interaction, and appropriateness of social interactions were analyzed with a multiple baseline design. Results indicated that the social network intervention was successful in increasing the quantity and quality of interactions and that the network strategy promoted the development of friendships. The results are discussed in terms of the need for additional research showing the relationships between increases in social competence, peer-mediated intervention, and the development and support of friendship.

Training social initiations to a high-functioning autistic child: assessment of collateral behavior change and generalization in a case study

The present case study used a multiple treatment design to assess the effects of two interventions--peer social initiations and target child initiations--on the social and disruptive behavior of a high-functioning autistic child. Intervention included initiation training and videotaped feedback highlighting successful and unsuccessful initiations. During Interventions 1 and 2, nonhandicapped peers were trained to initiate social interaction with the autistic child, resulting in an increase in social interaction which dramatically decreased in a reversal phase. Social interaction quickly increased again in Intervention 3 when the autistic child was trained to initiate interaction using the same procedures. During Interventions 1 and 2 no decrease in the autistic child's disruptive behaviors was observed; however during Intervention 3 these behaviors decreased to a low rate. Social validation, generalization, and maintenance of these behavior changes are discussed.