One of the most difficult mental developmental disorders in children is autism spectrum disorders (ASD), which represent a whole spectrum of developmental disorders characterized by various manifestations of the uniqueness of the emotional, volitional and cognitive spheres. According to most authors (Brain, Mirenda, Chang, Locke, Southall, Campbell, Sreckovic, Hume, Able, et al.), one of the primary impairments that hinder the successful adaptation of children with ASD is a lack of communication skills, manifested in the form of lag or absence spoken language, inability to initiate or maintain a conversation, and stereotyped statements.
The difficulties of autistic children in the arbitrary organization of themselves in space and time, the problem of active dialogue with the world, the inability to feel confident in a situation whose development is unpredictable actualizes the particular work on organizing their life at school (Watkins et al., 2015). Fujiki and Brinton (2009) suggest that since pragmatics in these children lags behind other areas of language development such as syntax, there is good reason to focus directly on pragmatic behavior. The general principle is to support changes in pragmatic behavior that will enhance socially beneficial communication (Fujiki and Brinton, 2009).
The entry of an autistic child into the rather tricky social conditions of the school, into the environment of ordinary children, is a new opportunity for the development of such a child. The undoubted advantages of inclusive education for children with ASD include the possibility of adequate socialization, communication skills, and expansion of social experience (Rodríguez-Medina et al., 2016). Since it is the violation of social adaptation that primarily prevents the development of a child with ASD, education in an inclusive environment has a correctional and developmental potential and leads to the correction of developmental disorders, as well as to the general development of a child with ASD.
Many studies (Kasari et al., 2021; Ezzamel and Bond, 2017; Platos and Wojaczek, 2018) show the efficiency of peer-mediated interventions (PMI) in expanding bonds with students with ASD, building communication, developing social skills, and making new friendships. These positive effects influence all students participating in the activity, as usually developing peers better understand disability and become effective in different interaction styles (Kasari et al., 2021).
Implementing PMI in an inclusive environment can be done for young children as these strategies can be readily incorporated into the natural setting of day-to-day activities and classroom routines (Chang and Locke, 2016; Watkins et al., 2015). The presence of students with different degree of social competence in an inclusive setting implies many various social partners with whom pupils can practice recently obtained social skills (Chang and Locke, 2016; Watkins et al., 2015). Moreover, the authors of both reviews concluded that PMI is a proceeding intervention for encouraging social interaction among students with ASD and their peers and called for continued research, especially with different samples (Chang and Locke, 2016). They noted that PMI could help generalize skills among peers in different settings (Watkins et al., 2015). Most of the practicing students with ASD and usually developing peers who took part in the PMI survey reported high grade of satisfaction with the intervention (Watkins et al., 2015).
Ezzamel and Bond’s (2017) research indicates promising network PMI results at the student, peer, and school levels. The data show positive changes in social skills, initiative and response, and greater enjoyment of work in the group of children with ASD to whom the PMI was applied. The study also reported an increased ability to regulate one’s emotions with peer support and an increased sense of empathy. These results are compatible with preceding research (Watkins et al., 2015; Chang & Locke, 2016), showing positive results for the target learner’s ability to initiate and respond more effectively to peers.
Strategies of Peer-Mediated Interventions
Kasari et al. (2021) note that children with autism show significant diversity in their social skills and, therefore, their needs for school intervention are variable. No single intervention will meet the needs of all children with autism (Kasari et al., 2021). Thus, it is necessary to understand how best to combine, structure, and individualize social skills interventions to meet the diverse needs of these children. Adaptive Interventions (AI) are predefined sequences of decision rules used by schools to combine, rationalize, and individualize social skills interventions. Kasari et al. (2021) identified AI as environmental (break, class support) and individual interventions (parent and peer-mediated).
Watkins et al. (2015) identified 14 evidence-based intervention strategies, including behavioral approaches, visual approaches (visual support and video modeling), social skills training, and peer-mediated interventions. Of particular interest to this study is previous empirical support for peer-mediated interventions for teaching verbal initiation and responsive behavior (Watkins et al., 2015). Evidence suggests that highly functional children with autism react well to interventions that integrate visual support with technology, possibly due to their strong imaging skills (Southall & Campbell, 2015).
Discrete Trial Training
Radley et al. (2015) assess the feasibility and effectiveness of a school-based peer-mediated discrete trial training (DTT) protocol for students with autism spectrum disorders (ASD). Peers can implement basic DTT protocols with a high degree of integrity, delivering measurable improvements in the academic skills of children with ASD (Radley et al., 2015). The current results expand on previous research by providing proof of the efficiency of peer-mediated DTT in a school context. Although the 30-minute once-a-week DTT sessions used in this study were much less stringent than some of the DTT programs described by other researchers (for instance, Young et al. 2016), current results indicate that these relatively infrequent sessions were sufficient. In turn, more frequent sessions, such as daily sessions, could enable children with ASD to learn related skills in a shorter period of time (Radley et al., 2015). Therefore, peer-mediated DTT can significantly improve both academic skills and peer integration (Young et al., 2016).
Interaction during Lunch Breaks
Brain and Mirenda (2019) made a particular contribution to the study of the impact of peer-mediated social interaction interventions for students with autism who studied PMI during lunch breaks. The researchers provided evidence for a functional link between the PMI and both engagement and CAs, with three manifestations of the effect on participants. The results showed that children with ASD who were socially isolated during breaks began interacting with peers during lunch breaks. The mutual pleasure was evident to all participants, and social significance ratings were high for both classmates and class teachers. Thus, this study complements that of Chang and Locke (2016) and Watkins et al. (2015) and expands them to include middle school students and students with various intellectual and social communication abilities during their lunch breaks in vivo.
Platos and Wojaczek (2018) emphasize the importance of PMI outside the classroom, including in extracurricular activities, for interaction and social communication to be successful. Platos and Wojaczek (2018) say that the intervention should be about friendship, community participation, and well-being, which is a holistic approach. Thus, the field of PMI should not be restricted to teaching social skills to children with autism in school (Platos & Wojaczek, 2018). While this strategy of PMI should be pursued and developed, the authors have provided arguments that it would be favorable to involve peers in supporting children and adolescents with ASD in various group communities and use friendship schemes to increase their social involvement and well-being. Moreover, the study by Sreckovic et al. (2017) confirmed that extracurricular activities are beneficial for students with autism spectrum disorder by helping them master communication skills.
Interaction during Recess
Because autism spectrum disorder (ASD) is distinguished by social and communication difficulties that occur in school, this is especially veritable in less formal setting such as recess (Rodríguez-Medina et al., 2016). Rodríguez-Medina et al. (2016) evaluated a recess intervention to develop the social interaction and communication skills of pupils with high functioning ASD mediated by their peers. This PMIs include various strategies to stimulate peers without ASD applying direct instruction, simulation, as well as social reinforcement during recess. After fourteen sessions, there was a change in initiation rate and response to interactions, as well as a negative tendency in the percentage of time the child kept weak-intensity interactions or was alone (Rodríguez-Medina et al., 2016). Teachers and family members reported improved social skills, greater peer admission, and increased frequence and continuance of social interactions (Rodríguez-Medina et al., 2016). Thus, PMI during recess is an essential factor in enhancing the social interaction of children with ASD with peers.
Peer networks are an intervention strategy that has proven effective in developing social skills in students with autism spectrum disorder (Schmidt et al., 2017). By dividing children with ASD into two groups, only one of which was included in the peer-mediated program, the researchers concluded that this helps teach social competence to students with ASD. Peer network intervention has also been shown to enhance social interaction between adolescents in secondary schools and reduce the tendency towards aggressive behavior among them (Sreckovic et al., 2017). Furthermore, according to Sreckovic et al. (2017), using peer networks is effective in reducing victimization due to bullying.
SENSE Theater is an intervention program developed to improve mutual social interaction among students with autism spectrum disorder (ASD) applying behavioral models and theatrical methods in a peer-mediated model (Corbett et al., 2014). According to Corbett et al. (2014), peer-to-peer theater program improves underlying social deficits in ASD. In turn, a study by Corbett et al. (2016) expands on previous results showing that theater interventions lead to development of social competence in students with ASD, which confirms improvements in behavioral and neural metrics. In particular, the SENSE theater contributed to the development of memorization of faces and skills of social communication. The present study supports the use of the social inclusion model as a multi-level way of recognizing, reflecting, treating, and measuring the complexity of social competence in autism spectrum disorder. The results highlight important components of therapy, including peer mediation, social inclusion, and the promise of theater approaches to developing and maintaining social competence in students with ASD.
Theory of Mind Programs
One of the main determinants of competence in social interactions is the ability to perceive the other person’s point of view (Southall and Campbell, 2015). Southall and Campbell (2015) note that a systematic review of varied Theory of Mind programs for students with ASD educed that most of them led to improved perspective-taking skills – abilities that allow you to look at things beyond perception and own point of view. Southall and Campbell (2015) found evidence that programs led to positive improvements in children with ASD, although it is often difficult to achieve positive results with social development interventions in this population.
Thus, ASD is a complex disorder that includes several deviations from normal development. Among them, the difficulty of communicating with adults and peers, stereotyped, monotonous behavior, some features of intellectual development can be distinguished. The above characteristics of students with ASD are the main obstacles in organizing their education using traditional approaches. Researchers consider disorders of communication skills with peers in children with ASD as a priority mental development disorder. For the successful socialization of such students, various methods are used, including peer-mediated social interaction interventions. Therefore, due to this literature review, it was possible to summarize the main points and results of studies that used peer interventions for pupils with autism spectrum disorder in school. The data was extracted from 15 studies published between 2009 and 2021. In general, the results of the studies reviewed show that peer-mediated interventions are effective in meeting the peer-related social competence needs of students with ASD. Moreover, the results of this literature review suggest that peer interventions may be effective in addressing other behavioral needs in young children with ASD, such as developing perspective-taking skills and memory and reducing aggression.
Brain, T. & Mirenda, P. (2019). Eﬀectiveness of a low-intensity peer-mediated intervention for middle school students with autism spectrum disorder. Research in Autism Spectrum Disorders, 62(2), 26-38.
Chang, Y. C. & Locke, J. (2016). A systematic review of peer-mediated interventions for children with autism spectrum disorder. Research in autism spectrum disorders, 27, 1–10.
Corbett, B.A., Key, A.P., Qualls, L.R., Fecteau, S., Newsom, C.R., Coke, C., & Yoder, P.J. (2016). Improvement in social competence using a randomized trial of a theatre intervention for children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46, 658-672.
Corbett, B. A., Swain, D. M., Coke, C., Simon, D., Newsom, C., Houchins-Juarez, N., Jenson, A., Wang, L., & Song, Y. (2014). Improvement in social deficits in autism spectrum disorders using a theatre-based, peer-mediated intervention. Autism research : official journal of the International Society for Autism Research, 7(1), 4–16.
Ezzamel, N., & Bond, C. (2017). The use of a peer mediated intervention for a pupil with autism spectrum disorder: pupil, peer and staff perceptions. Educational & Child Psychology, 34(2). 27-39.
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