This issue of NASET’s Autism Spectrum Disorder series focuses on social skills and ASD (written by Melanie Tempest). Social skills are a core deficiency of Autism Spectrum Disorder (ASD), characterized by delay or lack of joint attention, social communication, social-emotional reciprocity and play. Many studies have researched the effectiveness of social skills training in early intervention, school and clinical settings, focusing on using one interventionist mediator agent either parent, peer or teacher. The results of these studies have shown that social skills training can be effective. However, the studies have not looked at generalizing and maintaining these behaviors across environments and social partners. The objective of this literature review is to examine the effectiveness of the interventions from the perspective of the mediator agent; parent, peer or teacher and the effect of that intervention on generalization of acquired social skills. Results indicate that further research is warranted on combining the three approaches; parent, peer, teacher intervention so that acquired social skills can be generalized across multiple environments.
Effect of the Method of Training on Generalization of Social Skills in Children with Autism Spectrum Disorder
By
Melanie L. Tempest
Abstract
Social skills are a core deficiency of Autism Spectrum Disorder (ASD), characterized by delay or lack of joint attention, social communication, social-emotional reciprocity and play. Many studies have researched the effectiveness of social skills training in early intervention, school and clinical settings, focusing on using one interventionist mediator agent either parent, peer or teacher. The results of these studies have shown that social skills training can be effective. However, the studies have not looked at generalizing and maintaining these behaviors across environments and social partners. The objective of this literature review is to examine the effectiveness of the interventions from the perspective of the mediator agent; parent, peer or teacher and the effect of that intervention on generalization of acquired social skills. Results indicate that further research is warranted on combining the three approaches; parent, peer, teacher intervention so that acquired social skills can be generalized across multiple environments.
Keywords: social skills, Autism, preschool, parent, teacher, peer
Effect of the Method of Training on Generalization of Social Skills in Children with Autism Spectrum Disorder
A core feature of Autism Spectrum Disorder (ASD) is the impairment of social skills. For young children with ASD this can impact many aspects of their development; communication, play skills and their ability to learn. Developmentally appropriate practices emphasize that the focus of early childhood education programs focus on social play interaction as the foundation for learning (National Association for the Education of Young Children, [NAEYC], 2021). Most early childhood curriculum models are based on social play interaction as the catalyst for learning pre-academic skills. Therefore, a primary goal of early intervention for ASD is to address this social deficit through social skills training. The necessity to impact this area has far reaching implications for a child with ASD, social skills training has an influence on the child’s immediate growth and development through increased language acquisition and peer interaction and in addition has long term benefits for future learning, self-esteem and employment. Many studies since the 2000’s have looked at the implications of social skills training for children with ASD (Park et al., 2022). However, the studies have been primarily in clinical settings and/or only addressed one environment, the classroom or the home. Moreover, these consisted of only one entity delivering instruction on the acquisition of social skills but not on generalizing to multiple environments and social partners. The objective of this literature review is to look at social skills training across environments and intervention partners: teacher, parent, peer and the effect of the social skills training on generalization to community, home and classroom.
Peer Mediated Interventions
Peer mediated social skills interventions can be very effective in early child settings due to the typical structure and activities that take place in these settings “Peer-mediated intervention is an effective and socially valid means to intervene on the core deficits of ASD, such as play and social communication” (Wong et al., 2015; Whalon, Conroy, Martinez, & Werch, 2015, as cited in Hensen et al., 2019, p. 97). As stated in Hensen et al. (2019) peers are a logical choice as interventionists on social communication skills and may provide increased opportunities for intervention similarly Hume at al. (2019) states that peer mediated interventions may be a better strategy than adult mediated interventions for promoting social interactions. Social interactions naturally take place for preschool children in inclusive settings during play, small group activities, recess and mealtimes. During these times peers are the primary communication partners and logically would be best suited to facilitating social interactions with their ASD peers. However, “placement in inclusive settings alone will not improve the social skills of children with ASD” (Guiterrezet al.,2007, Koegel et al.,2001 as cited in Hume et al., 2019) Successful implementation of peer mediated interventions needs to take place in a high-quality pre-school setting with training of staff and peers in evidence-based practices and strategies. The Hume et al. (2019) study took place in a LEAP classroom where teachers are trained to facilitate social interaction and the Hensen et al. (2019) study used an interventionist to train the peer through social narratives on how to elicit joint attention from the ASD peer. Without intensive instruction for teachers and peers, generalization of social skills to other settings may be limited.
Teacher Mediated Interventions
Most children with ASD access early intervention services through public schools, therefore teachers are the most probable to address their social skills deficits. Teachers are uniquely qualified to apply evidence-based interventions that address the core deficits of ASD in particular social communication, joint attention and peer interaction. Currently a “research to practice gap” exists although many studies have been conducted on the benefits and feasibility of evidence-based practices to address the social skill deficits of children with ASD in the classroom, wide scale use in the preschool education setting has yet to be realized (Engelstad et al., 2020, Panganiban et al., 2022). These studies have shown success using systematic approaches to teacher training and embedding interventions into the existing classroom curriculum. Engelstad et al. (2020) and Panganiban et al. (2022) used two different interventions Early Achievements for Educational Settings (EA-ES) and Joint Attention, Symbolic Play, Engagement and Regulation (JASPER) respectively with similar outcome gains in social skills. Panqaniban’s study embedded the JASPER strategies into small group instruction where the teacher could easily facilitate peer interaction whereas Engelstad’s study embedded EA-ES into shared reading activities with a focus on joint attention and peer to peer engagement. Incorporating these strategies into the existing curriculum “reduced the amount of new learning required of teachers” (Engelstad et al., 2020, p. 595) in addition “Training teachers to embed strategies in their curriculum can be a more sustainable way of addressing these needs in the naturalistic classroom setting.” (Panganiban, et al 2022 p. 2176). These studies highlight the need for in depth, focused social skills training for special education teachers in early intervention. Especially considering that most special education preschool classrooms use a curriculum that is developed for neurotypical students (Engelstad et al., 2020, Panganiban et al., 2022) that do not address the needs of children with ASD. “Targeting these core impairments of ASD within existing classroom routines facilitates acquisition and generalization of skills needed for a successful transition to school” (Marsh et al., 2017 as cited in Engelstad et al., 2022, p.595). Early intervention teachers, when trained in evidence based social skills interventions can have a significant impact on the social skills acquisition for ASD students in classroom interactions.
Parent Mediated Interventions
Parents are fundamental to a child’s development and education, the partnership between schools and parents is essential for all childreneven more so for children with ASD. Training for parents is a crucial component of social skills generalization for children with ASD. Parents are a constant presence through childhood and into adulthood they are particularly influential on skill acquisition and maintenance, Park et al. (2022) emphasizes “Parents may contribute to more successful learning opportunities, better overall treatment gains, and stronger durability of treatment gains over time (DeRosier et al., 2011; Kaat & Lecavalier, 2014; Reichow & Volkmar, 2010 as cited in Park et al., 2022 p. 2). In Park et al. (2022) and Siller et al. (2022) parent coaching is shown to be a viable option for social skills improvement in children with ASD, in both studies, parents reported advancement in their child’s social skills; specifically, social communication, social motivation and social responsiveness (Park et al., 2022 & Siller et al., 2022) In the Park et al. (2022) study the intervention took place in a clinical setting using the Program for the Education and Enrichment of Relational Skills (PEERS) intervention and the parents were trained by licensed clinical psychologists. In contrast the Siller et al. (2022) study was done in an early childhood classroom setting with ECE teachers training the parents using the Focused Playtime Intervention-Preschool, (FPI-I) intervention. The settings of the studies are significant in that the clinical intervention does not easily replicate to real world practice whereas the school-based setting has the possibility of further impact for families and children. In the school paradigm parents and teachers can develop a shared understanding by collaborating and planning together to support children’s social communication development; this provides a unique learning opportunity across home and school (Siller et al. 2022). Equipping parents to coach their children in social skills acquisition can have a beneficial effect on generalization to environments beyond the classroom.
Conclusion
Addressing the social skills deficit in Autism is an essential component of improving the developmental trajectories of children with ASD. Considering that social skills have a significant impact across many developmental domains and environments it is crucial that programs and service providers are trained in evidence-based practices that address this core deficit. Moreover, social interactions do not only take place in classrooms and clinics, social skills need to be transferable across all settings where children are interacting with others including home and community. The studies reviewed all showed improvement to varying degrees within certain environments and with specific social partners. Peer mediated interventions demonstrated improvement in play skills and joint attention in highly controlled environments however these studies took place in inclusive classroom settings and would be difficult to replicate in self-contained settings. Teacher mediated interventions also indicated increases in social skills such as joint attention and turn taking however adult directed activities may decrease peer to peer interactions, as children are more likely to continue an interaction with an adult rather than initiate a new interaction (Harper & McClusky, 2003; Kishida & Kemp, 2009, as cited in Hume et al. 2019). Classroom interventions alone may not lead to generalization due the many supports and routines in place for successful academic instruction. Parent mediated interventions additionally showed promise in attainment of social skills for children with ASD in specific settings. All studies involved intensive training and coaching of intervention mediators: peers, teachers and parents in the instruction of social skills evidence-based practices. Although gains in social skills competence were documented in all studies, the generalization and maintenance of those skills across varied contexts and environments were not evidenced. Further research is needed to determine the effects on the generalization of the social skills attained. Perhaps combining the teacher, peer and parent interventions into a three-pronged approach would better address the needs of children with ASD and lead to generalization across settings. Social skills training models that can be implemented in the school setting by a trained special education teacher who can coach peers and parents may enable wide scale implementation and cost effectiveness. Targeting social skills deficits in this manner would address all contexts and environments for better maintenance and generalization of skills.
References
Engelstad, A.M., Holingue, C., Landa, R. J. (2020). Early achievements for education settings: An embedded teacher implemented social communication intervention for preschoolers with autism spectrum disorder. Perspectives of ASHA special interest Groups, 5, 582-601. doi.org/10.1044/2020_PERSP-19-00155
Hensen, S., Raulston, T.J., Machalicek, W., Frantz, R., Drew, C., Erturk, B., & Squires, J., (2019). Peer-mediated joint attention intervention in the preschool classroom. The Journal of Special Education, 53(2), 96-107. doi.org/10.1177/0022466918807464
Hume, K., Sam, A., Mokrova, I., Reszka, S., & Boyd, B., (2019). Facilitating social interactions with peers in specialized early childhood settings for young children with ASD. School Psychology Review, 48(2), 123-132. 10.17105/SPR-2017-0134.V48-2
National Association for the Education of Young Children (2021), Developmentally Appropriate Practice NAEYC
Panganiban, J., Shire, S., Williams, J., & Kasari, C., (2022). Supporting peer engagement for low-income preschool students with autism spectrum disorder during academic instruction: A pilot randomized trial. Autism, 26(8), 2175-2187. doi.org/10.1177/13623613221085339
Park, M. N., Moulton, E. E., & Laugeson, E. E., (2022). Parent-assisted social skills training for children with autism spectrum disorder: PEERS for preschoolers. Focus on Autism and Other Developmental Disabilities. doi.org/10.1177/10883576221110158
Siller, M., Pickard, K., Fuhrmeister, S., Kushner, E., Rudrabhatla, A., & Morgan, L., (2022). Teacher-implemented parent coaching in inclusive preschool settings for children with autism. Journal of Early Intervention, 44(2), 211-231. 10.1177/1053815122108355
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