Peer-Based Interventions for Children and Youth With Autism Spectrum Disorder: History and Effects

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.

Strengths, weaknesses, opportunities and threats of peer support among disadvantaged groups: A rapid scoping review

Objective

To explore the current state of knowledge and evidence about peer support for various disadvantaged groups; to identify the strengths, weaknesses, opportunities, and threats of peer support to critically reflect on peer support within health and social services.

Methods

A rapid scoping review was conducted according to Arksey and O'Malley's framework, aiming to identify eligible studies in PubMed, APA PsychInfo, Education Resources Information Center, Cochrane Library, Academic Search Premier, ScienceDirect, Directory of Open Access Journals, ResearchGate, WorldCat, and Google Scholar. According to Rodgers' concept analysis steps and the SWOT model, data was reported using thematic synthesis.

Results

Forty-five studies were included, describing a variety of peer support initiatives among groups of young migrants and unsupervised minors, young adults with autism, people with (mental) health problems, foster/shelter families, vulnerable pregnant women, people outside the labour force, older adults, and homeless people. The strength of peer support is its positive effect on the quality of life among vulnerable people. The weakness is represented by peers both being too involved and focused on personal interest or by peers lacking expertise and knowledge. Opportunities for peer support are mutual learning, the anticipated long-term effects, and the potential to facilitate social inclusion. Culture, language barriers, drop-out rates, securing sustainability, and peers' lack of time and commitment are regarded as threats to peer support.

Conclusion

Although peer support offers good outcomes for various groups of vulnerable people, the weaknesses and threats need to be considered to provide and proliferate peer support.

A peer support training and supervision program for Veterans and families: Development and preliminary results

LAY SUMMARY

Behavioural health peer support connects individuals to needed professional services (e.g., counselling) and provides benefits in groups of people that might face more challenges, like military Veterans. Different training exists for peer supporters, but not a lot of information is available to demonstrate if these trainings, or checking in with trained peers, is helpful. This study took a peer support training program used in fire service and updated it to fit the needs of Veterans and Veteran family members (V/VFM) in Texas, United States. Texas has a lot of Veterans and lacks enough mental health providers (e.g., psychologists). In this study, V/VFM were trained in peer support skills and had six months of peer check-in calls after the training. The trainees completed a test before training asking about their engagement and confidence with helping others, as well as a test after training asking these questions again and assessing satisfaction with training. Results show training was appropriate and acceptable. V/VFM appreciated the check ins and showed increases in confidence in their ability to help others. They tried to help more peers and were more successful when they did reach out. This study describes one way peer support can improve mental health access.

Communication and Social Interaction Experiences of Youths With Congenital Motor Speech Disorders

PURPOSE

The purpose of this study was to explore the communication and social interaction experiences of adolescents with congenital motor speech disorders due to cerebral palsy or Down syndrome, with the aim of identifying clinical and research needs to support the development and implementation of speech-language interventions.

METHOD

Five male youths (ages 14-18 years) with congenital motor speech disorders and one of their parents participated in face-to-face, semistructured interviews designed to understand communication and social experiences in daily life. Interviews were audio-recorded and orthographically transcribed offline. Content was coded according to topic areas emerging in the data. Themes were developed to illustrate the most salient and representative aspects of participants' experiences according to the phenomenological tradition that recognizes that participants are experts in their "lived experience."

RESULTS

Participants described the youths' day-to-day communication experiences, including facilitators and barriers to successful social interactions. Thematic analysis revealed three main themes: (a) strong core relationships amidst sparse, superficial interactions in daily life; (b) the complicated picture of why; and (c) how speech-language pathologists can help.

CONCLUSIONS

Participants reported that the impact of congenital motor speech disorders on social interactions and experiences became more apparent in adolescence than in earlier childhood. Addressing communication challenges to meet the unique social demands of this period requires tailored interventions that target multiple contributing factors beyond speech impairment, such as social communication skills, negative communication partner attitudes, and participation opportunities. Shifting practice toward a life participation approach to communication intervention stands to substantially improve the long-term social outcomes of adolescents with motor speech disorders.

Quality of Educational Programs for Elementary School-Age Students With Autism

The purpose of this study was to assess the quality of educational programs for school-aged children with autism in the United States. Investigators completed the Autism Program Environment Quality Rating Systems-Preschool/Elementary (APERS-PE) in 60 elementary schools enrolling children with autism. The mean total rating scores were near the midpoint rating, indicating schools were providing educational program environments classified as adequate but not of high quality. Domains of the APERS-PE reflecting structural quality tended to be significantly above average and domains reflecting process quality tended to be significantly below average. With a few exceptions, inclusive and special education program did not differ significantly in total program quality ratings and reflected the same pattern of domain quality ratings.

From Someone Who May Cause Trouble to Someone You Can Play With: Stakeholders' Perspectives on Preschool Program Quality for Autistic Children

In Sweden, young autistic children typically attend community-based preschool programs, which may not be adapted to their needs. In the current study, stakeholders to autistic children receiving Early Intensive Behavioral Intervention were interviewed following a quasi-randomized study (#NCT03634761) aimed at improving the preschool program quality using the Swedish version of the Autism Program Environment Rating Scale (APERS). Stakeholders provided their perceptions and experiences concerning key factors for high quality preschool programs as well as well as their experiences of the abovementioned APERS study. Applying thematic analysis, stakeholder groups differed in what they emphasized, but all highlighted staff’s competence, children’s inclusion and participation, collaboration, and the learning environment as key program areas that had been positively influenced by the APERS-based intervention.

The Effect of Teaching Initiations on the Communication of Children with Autism Spectrum Disorder: A Randomized Clinical Trial

This study examined the effect of Pivotal response treatment (PRT) to improve verbal initiations in children with Autism Spectrum Disorder, age 6-12 years old, using a Randomized Clinical Trial design. Intervention was conducted three times a week for 2 months, for a total of 24 one-hour sessions. The PRT intervention taught a variety of questions and attention/assistance-seeking initiations. The treatment as usual (TAU) group received standard language intervention. Results showed that the PRT group made significant improvements in their number of verbal initiations as well as collateral gains in general communicative skills and mean length of utterance (MLU) compared to the TAU group. Theoretical implications of including motivational approaches to develop social initiations are reviewed.

Positive University Environment and Agreeableness as Protective Factors Against Antisocial Behavior in Mexican University Students

Violence in schools is a global issue. Approximately 32% of Mexican students have experienced some form of violence in the school setting in their lives. Previous research has tended to focus on the causes of violence and antisocial behaviors in offenders or adolescent samples and has found evidence to suggest the underlying role of environmental and personal factors. The present study investigates the effect of positive school environment and agreeableness as protective factors against antisocial behaviors in a sample of undergraduate and graduate students (n = 304) from northwestern Mexico. Our results demonstrate that a positive school environment has a negative effect on antisocial behaviors via mood and anxiety disorders as well as in interaction with agreeableness, suggesting an interplay between personality and environment. These findings can provide some basis for the development of university programs aimed at fostering positive environments that promote student mental health and protect against antisocial behaviors.

Peer Perspectives Within the Inclusive Postsecondary Education Movement: A Systematic Review

Peers play a central role in supporting college access for students with intellectual and developmental disabilities (IDD). This review examines available research addressing the perspectives of college student peers on the inclusive postsecondary education (IPSE) movement and their involvement in it. Approximately 2,670 peers-most of whom were female and undergraduates-participated in these 37 studies. We review findings addressing the views of peers on the following topics: (a) motivations for volunteering, (b) effectiveness as a peer support, (c) challenges they encountered, (d) impact of involvement on themselves, (e) impact of IPSE on their campus, (f) recommendations for IPSE programs, and (g) attitudes regarding disability. This research collectively highlights the multiple factors that draw peers to become involved, the experiences peers have within their campus' programs, the myriad ways in which they and their campus may benefit from this movement, and their views regarding inclusion and disability. We offer recommendations for research and practice aimed soliciting the views and involvement of peers within the inclusive postsecondary education movement.