Children with ASD experience challenges in social reciprocity and communication that impede their ability to navigate social interactions, impacting the presence and quality of peer relationships. If left untreated, these social impairments exacerbate with age and continue through adulthood. Several interventions have been developed and tested to address this issue. Most recently, Kasari et al., (2012) conducted a randomized controlled school-based trial with 60 mainstreamed children with ASD from 56 classrooms in 30 schools. They found that peer-mediated interventions as facilitated by expert research personnel improved the social inclusion of children with ASD. However, at the 12-week follow-up, it was clear that the gains children with ASD made as a result of the intervention would not sustain without additional support. These data showed that addressing social impairments within the school context can produce meaningful changes in children’s social functioning, but also highlighted the challenges associated with schools’ adopting and implementing social skills interventions to support children with ASD.
Objectives:
The purpose of this study was to conduct a randomized pilot a modified version of the Kasari et al. intervention with school personnel. The intervention was modified to provide schools with a cost-effective, feasible, and sustainable program to improve the social interactions of elementary-school-aged children with ASD with their peers.
Methods:
A total of 10 children with ASD, 10 school staff members, and 100 typically developing peers participated. School personnel and children with ASD were randomized in pairs to immediate treatment (IT) or a waitlist (WL) control. School personnel were provided with hands-on training with the target student and his/her peers during the lunch period that included didactics, modeling, and in vivo coaching on strategies to facilitate opportunities for children with ASD to engage in activities and/or play games with peers in the cafeteria and on the playground. For both groups, quantitative (e.g. social network centrality, measures of playground engagement with peers, fidelity of implementation) and qualitative (e.g. interventionist and observer field notes) data were collected at baseline, exit, a 6-week follow-up and each week of intervention.
Results: Analyses are ongoing. Mixed methods will be used to develop a complete understanding of implementation of the modified intervention for children with ASD in schools. Preliminary analyses will be conducted comparing the IT and WL groups on pretreatment scores of social network centrality and playground engagement. Qualitative data will be coded using the principles of grounded theory to examine factors related to implementation and quotes or themes will be used to support or refute results derived from quantitative data.
Conclusions: While the results suggest the effectiveness of this model, we encountered a number of barriers that interfered with the continued use of the intervention and were unable to address the issue of sustainability. We will discuss potential strategies to overcome child, classroom, and organizational barriers to implementing social skills interventions in school settings.
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