A Review of Social Communication Interventions for Students with Autism Spectrum Disorder in School Settings: Contributions from Single-Subject Research

Background: Poor social communication skills are one of the many barriers that hinder the ability of students with ASD to learn and interact with peers in school settings. Studies evaluating the efficacy of interventions that promote the acquisition and the development of different social communication skills for children with ASD have been reported in the literature and reviews for such a literature have been conducted. However, none of the previously conducted reviews explicitly evaluated single-subject research targeting social communication skills for students with ASD in school settings.

Objectives: The purpose of this study to systematically review peer-reviewed publications that utilized single-subject experimental design to evaluate interventions targeting social communication skills for students with ASD (3 to 21 year old) in school settings.

Methods: Sixty-nine studies, located in ERIC, PschINFO, and MEDLINE and published from 1995 to 2014, met the inclusion criteria. These study were sorted by: 1) the number and the characteristics of participants, 2) settings, 3) targeted outcome(s), 4) intervention practice used, 5) type of single-subject design, 6) documentation of generalization and maintenance, 7) the person delivering the intervention, 8) the rigor of the study (Reichow et al., 2008), and 9) effect size using non-overlap indices Tau-U score (Parker et al., 2011). Inter-rater reliability for coding was 97.91%.

Results: One hundred and ninety two students (150 male, majority of them were between 3-6 years old and elementary school age) with ASD diagnoses were exposed to intervention and intervention packages (mostly based on behavioral principles) targeting social communication skills that were delivered by teachers, researchers, peers in 29, 36 and 8 studies, respectively. The targeted social communication skills were categorized in two ways: 1) based on the function, type, domains of skills, and 2) based on the form and/or the modality of the outcomes. Requesting, joint attention, conversation-related skills, greeting, and commenting were targeted in 39, seven, seven, four , and 12 studies respectively. Ten studies targeted skills were not part of the above-mentioned categories. With respect to the form or modality of skills targeted, verbal responses were targeted in 44 studies and nonverbal responses (e.g., gestures such as pointing, reaching, showing, eye contact, or eye gaze, etc.) were targeted in 20 studies, manual signs were targeted in two studies, picture exchange were targeted in 14 studies, the use of speech-generated devices (SGD) was targeted in 15 studies. In terms of the rigor of the study, only seven studies were rated as strong, 39 were as adequate, and the remaining 23 as weak. The mean Tau-U across all the studies was 0.76 (range from 0.00 to 1.00).

Conclusions: Findings from this review suggest the availability of a wide range of specific interventions (and intervention packages) to improve different social communication skills for students with ASD in school settings.