Peer-mediated Intervention Research Articles

A Meta-Analysis of Peer-Mediated Interventions for Young Children with or at Risk for Developmental Delays: Focused on Single-Case Experimental Design Studies

본 연구에서는 단일대상연구설계를 활용한 또래활용 중재연구들의 효과크기를 분석하고, 또래활용 중재가 발달지체 및 장애위험 유아들을 위한 증거기반교수로서 활용 가능한 지에 대해 탐색하였다. 이를 위해 2000년 이후부터 2019년 12월 31일까지 발표된 국내학술지 논문 중 포함 및 배제기준에 따라 선정된 총 12편의 연구를 대상으로 하였다. 무선효과모형을 통하여 전체 평균효과크기(Tau-U)를 산출하였으며, Meta-ANOVA와 Meta-회귀분석을 활용하여 하위그룹 및 조절변인들에 따른 효과크기를 살펴보았다. 분석 결과는 다음과 같이 요약될 수 있다. 첫째, 또래활용 중재는 사회적 기술, 상호작용, 언어기술, 활동참여를 증진시키는 데에 중간-높은 수준의 효과를 보이는 것으로 나타났다. 둘째, 중재유형들 중, 사회극놀이가 가장 빈번하게 사용되었으나, 협동놀이와 게임의 효과크기가 가장 높게 나타났다. 셋째, 중재환경의 경우, 놀이터에서 진행된 중재가 강한 효과를 보였으며, 교실과 치료실은 상대적으로 낮은 효과크기를 나타냈다. 넷째, 유아의 연령, 성별, 중재의 시간과 횟수 변인들은 효과크기에 유의한 조절변인들로 작용하지 않았다. 이상의 결과들을 바탕으로, 또래활용중재의 효과적인 적용 방향과 향후 연구 과제에 대해 논의하였다.This study aimed to provide information about the effectiveness and research evidence on peer-mediated interventions based on a metal analytic approach as a way to evaluate whether those interventions can be established as evidenced-based and have the potential for classroom use. Among the peer-reviewed journals published from 2000 through 2019, an extensive search process with inclusion and exclusion criteria yielded a total of 12 single case experimental design studies to be included in the current study. Effect sizes(ES) were calculated using a Tau-U formula and a random effect model was employed to estimate the significant ESs. Meta-ANOVA and Meta-Regression were applied to calculate the ESs for sub-groups and mediators. Results can be summarized as below: First, peer-mediated interventions were effective in improving social skills, interactions, communication skills, and activity participation. Second, the social play was most frequently used as an intervention type, but the ESs were higher in collaborative play and games. Third, interventions provided in playgrounds showed the highest ES, and interventions delivered in classrooms and clinical rooms showed relatively low in ESs. Finally, variables such as age, gender, time, and session frequency didn’t impact on the significance of ESs. Based on the results, practical implications and directions for future research were discussed.

Systematic Review of Peer-Mediated Intervention for Children with Autism Who Are Minimally Verbal

In peer-mediated intervention (PMI), peers act as agents of intervention. Previous reviews in this area have not addressed the effectiveness of using PMI with children with autism who are minimally verbal. Following a systematic search, we reviewed 25 studies where PMI was used to increase communication in minimally verbal participants. The majority of these (n = 23) were single-case experimental design studies in settings that included preschools, elementary schools, and high schools. PMIs varied in the amounts of training offered to peers and the types of activities in which children engaged. Social communication increased across studies, with alternative and augmentative communication and spoken language measured in seven studies, respectively. We offer recommendations for future research in this area.

Effects of Nonreciprocal Peer Tutoring With Preschool Students.

We investigated the effectiveness of nonreciprocal peer tutoring, a type of peer-mediated instructional intervention, with preschoolers. We used a multiple-probe design across 2 dyads with participants with and without disabilities. The dependent variables were the number of correct tact responses to the untaught stimuli for the tutor and the number of correct tact responses to taught stimuli for tutees. Results demonstrated that nonreciprocal peer tutoring was effective in the acquisition of untaught tacts for the tutors and directly taught tacts for the tutees.

The Effectiveness Of Peer-Mediated Sandplay to Promote Social interactions among children with Autism

This study aimed at assessing whether playing with typically developing peers increased numbers of Social interactions in children with Autism Disorder (ASD). A version of a sandplay intervention previously investigated by Lu, Petersen, Lacroix, and Rousseau (2010), and modified to include peer-mediated play was used. The intervention explored the effects of sandplay with typically developing peers on engagement in social interactions by children with ASD. A multiple-case intervention design was used with three children with ASD with varying degrees of severity in functioning. While the number of social interactions among the children did increase from baseline with the introduction of the peer-mediated sandplay intervention. While the results of the intervention are inconclusive, these results necessitate further investigation into this method of intervention for children with autism disorder, specifically with regard to ASD severity. Theoretical and treatment implications are offered, as well as directions for future research

Can We Play Together? A Closer Look at the Peers of a Peer-Mediated Intervention to Improve Play in Children with Autism Spectrum Disorder.

Peer-mediated interventions (PMIs) are often used to support children with autism spectrum disorder (ASD) to develop social skills. However, more investigation is needed to better understand the role of peers as both intervention recipients and models. Sixty-five typically developing peers who participated in a PMI for children with ASD were investigated using a randomised control trial. Play sessions of the dyads were scored using the Test of Playfulness. Results showed a significant moderate intervention effect for the peers from pre- to post-intervention; outcomes for children with ASD were not influenced by peer characteristics; and, the children demonstrated a similar pattern of play interaction. Implications for practice are discussed.Clinical Trials Registry Australian New Zealand Clinical Trials Registry, https://www.anzctr.org.au/ (ACTRN12615000008527; Universal Trial Number: U1111-1165-2708).

Peer’s pragmatic language outcomes following a peer-mediated intervention for children with autism: A randomised controlled trial

BackgroundPeer-mediated pragmatic language interventions can be of benefit to children with autism as they simultaneously target an individual child’s pragmatic language skills and contextual factors related to social interactions. However, little is known about peer outcomes following peer-mediated interventions. AimsThis study evaluated the pragmatic language outcomes for typically-developing (TD) playmates who participated in a peer-mediated intervention for children with autism. MethodsDyads (child with autism and TD-playmate; n = 71) were randomised to a treatment-first or waitlisted-first comparison group. Dyads attended 10 clinic play-sessions with a therapist and parents mediated home-practice. The Pragmatics Observational Measure 2nd edition (POM-2), and Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention. ResultsChanges in both outcomes measures were equivalent for intervention-first and waitlisted TD-playmates, but all TD-playmates made significant gains in pragmatics following the intervention. Treatment effects maintained for 3-months (p < 0.001–0.014, d = 0.22–0.63), were equivalent in different environments (clinic and home). Peer relationship type and therapist profession mediated POM-2 scores across the study, while expressive language ability moderated SEE scores. ConclusionsThis peer-mediated intervention had a positive impact on TD-playmate’s pragmatic language capacity and performance.

Increasing Social Participation Using a Shared-Reading Peer-Mediated Intervention in Students with Autism

Peer-mediated interventions (PMIs) have been established as an evidence-based practice for individuals with autism spectrum disorder (ASD), yet few studies of this intervention have included students with ASD considered to be significantly impacted by the disorder. In the present study, a shared-reading PMI employing a three-step strategy including visual supports and token reinforcement was used to increase social interactions between four first and second grade participants with autism spectrum disorders (ASD) requiring substantial and very substantial support and 12 second grade participants with typical development (TD). A reversal design (ABAB) was used with sessions held twice a week over 2 months to measure social participation of participants during baseline and intervention phases. During intervention sessions, participants with ASD and TD were taught to stay, read, and talk with their buddies about a story. Visual analysis of graphical data and percent of all nonoverlapping data (PAND) effect size estimates indicated that all four participants with ASD increased social participation with typical peers over baseline measures, with two of the four participants with ASD increasing social participation to levels commensurate or surpassing that of participants with TD; however, two participants with ASD did not follow the expected reversal pattern. Additionally, three of four participants with ASD showed modest increases in initiations to peers. These results provide information about the use of PMI with participants with ASD requiring substantial and very substantial support, and the practicality of this intervention holds promise for sustainable use of PMI with this population in public-school settings.

A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism.

PurposeThis randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism.MethodsA sample of 71 children with autism were randomized to an intervention-first group (n = 28 analyzed) or waitlist-first (n = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM-2) and the Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention.ResultsPOM-2 gains were greatest for intervention-first participants (p = 0.031, d = 0.57). Treatment effects were maintained at 3-month follow-up (p < 0.001–0.05, d = 0.49–0.64). POM-2 scores were not significantly different in the clinic and home settings at follow-up.ConclusionFindings support the combination of play, peer-mediation, video-feedback and parent training to enhance pragmatic language in children with autism.

Training Soccer Skills to Adolescents with Autism Spectrum Disorder via Peer-Mediated Behavioral Skills Training.

Peer-mediated interventions have been identified as efficient means of promoting the acquisition of skills of students with autism spectrum disorder (ASD). Limited research, however, has evaluated the utility of such procedures for promoting recreational skills that may allow for greater interaction with peers. The purpose of the current study was to evaluate the effectiveness of peer-mediated behavioral skills training on the acquisition of discrete soccer skills of 3 students with ASD. Following the implementation of the intervention, all participants demonstrated substantial improvements in the accuracy of the target soccer skills.

A Play-Based, Peer-Mediated Pragmatic Language Intervention for School-Aged Children on the Autism Spectrum: Predicting Who Benefits Most.

This study explored characteristics of children with autism with large intervention effects following a peer-mediated pragmatic language intervention, to devise algorithms for predicting children most likely to benefit. Children attended a 10-week intervention with a typically-developing peer. Data from a pilot study and RCT formed the dataset for this study. The POM-2 measured intervention outcomes. Children completed the EVT-2, TACL-4, and Social Emotional Evaluation at baseline, and parents completed the CCC-2 and CCBRS. High CCC-2 Use of Context and CCBRS Separation Anxiety scores and comparatively lower EVT-2, CCC-2 Nonverbal Communication and Cohesion scores predicted children with large intervention effects. Results can be used by clinicians to predict which children within their clinics might benefit most from participating in this intervention.

The Use of Peer Mediation and Educator Facilitation to Promote Turn Taking in Young Children With Autism Spectrum Disorder in Inclusive Childcare

A multiple-probe design across participants was used to investigate the effect of a peer-mediated intervention on the turn-taking behavior of 3 children with autism spectrum disorder (ASD) attending inclusive childcare centers. An educator trained peers to support the child with a disability to take turns playing a game on an iPad. The educator was also available to provide coaching for the peer when needed. An intervention effect was demonstrated for each of the children, and 2 were able to demonstrate maintenance of the skill when the training and coaching procedures were not implemented by the educator. Although some elements of the treatment procedures were not consistently applied by the educators or typical peers, the intervention was sufficiently robust to enable the children with ASD to improve their turn-taking skills.

Utilizing Peers to Support Academic Learning for Children With Autism Spectrum Disorder.

The inclusion of students with autism spectrum disorder in academic settings is becoming more common. However, most practices focus on increasing social skills even though students also struggle in academic areas. There is a need for strategies that address both social and academic skill deficits, are evidence based, and are easy to implement in the classroom. Peer-mediated interventions have evidence supporting their use in promoting social and academic behavior change and are socially valid and cost-effective. The purpose of this paper is to present examples of how to implement 2 common peer-tutoring strategies: Classwide Peer Tutoring and Peer-Assisted Learning Strategies. Examples for implementing both strategies are provided using a hypothetical student in a general education setting, followed by a brief summary of evidence supporting the peer-mediated academic instruction.

Exploring Feasibility and Fit: Peer-Mediated Interventions for High School Students With Autism Spectrum Disorders

Although peer-mediated interventions can provide effective pathways for enhancing the social outcomes of students with autism spectrum disorders (ASD), their application within secondary schools has been fairly limited. In this exploratory study, we examined the implementation of peer support arrangements and peer networks for 102 adolescents with ASD attending 15 public high schools. Our focus was on the characteristics of students selected to receive these two interventions, the fidelity with which each was implemented, and the views of participating educators on the social validity of both. Educators involved a wide range of students with ASD in these interventions, delivered each with varied levels of fidelity, and considered both approaches to be acceptable and feasible. We highlight some of the complexities associated with delivering these social-focused interventions in high school settings and offer recommendations for future research and practice.

Review of Interventions Supporting Secondary Students with Intellectual Disability in General Education Classes

Instruction and support for students with intellectual disability in general education classes should be informed by research-based interventions. In this systematic review, we examined the focus and impact of interventions delivered in inclusive classes to support middle and high school students with intellectual disability. We identified 40 intervention studies involving 177 secondary students with intellectual disability attending a range of core academic and elective classes. These multicomponent interventions fell within five primary categories: systematic instruction, peer support arrangements, self-management strategies, peer-mediated communication interventions, and educational placement changes. Although the overall focus was fairly balanced across academic, social, and behavioral outcomes, each intervention approach prioritized somewhat different dependent measures. Moreover, although the impact of the interventions on most outcomes was positive, the methodological quality of these studies was somewhat varied. We offer recommendations for future research and practice aimed at strengthening the availability and implementation of effective interventions within inclusive secondary school classes.

Effects of a peer-mediated performance improvement intervention on recording of child well-body checks by educational care-providers.

We report the effects of peer-mediated training as a performance improvement intervention on recording of well-body checks by classroom instructors at a specialized school for children and youth. The instructors were trained as peer mediators and then assumed performance monitoring responsibilities in the classroom. Compared to baseline phases in a withdrawal design, peer-mediation increased recording of well-body checks to near-100% among the instructors. Results of the study document positive training effects on a critical health and wellness objective, support and expand the limited research base concerning the effects of peer-mediated training, suggest further application of such training in human services settings.

Peer Play in Inclusive Child Care Settings: Assessing the Impact of Stay, Play, & Talk, a Peer-Mediated Social Skills Program

ABSTRACT Peer-mediated interventions are highly effective strategies in supporting the development of social skills for young children; however, research has focused on how peer-mediated interventions are beneficial for children with social communication challenges such as Autism Spectrum Disorder. The goal of this study was to measure the efficacy of Stay, Play, & Talk for typically developing children in an inclusive child care setting to extend the use of the intervention beyond its previous focus on children with identified or suspected social communication challenges. Using pre- and post-intervention measures, social skills (communication, cooperation, empathy, and responsibility) increased significantly and problem behaviors (hyperactivity/inattention and internalizing behaviors) decreased significantly for children in the intervention group; whereas, their peers in the control group experienced significant increases in communication skills and bullying behaviors. These findings provide preliminary support for the efficacy of this peer-mediated intervention in supporting the development of social skills in typically developing young preschool-aged children.

Interventions for students with autism in inclusive settings: A best-evidence synthesis and meta-analysis.

Students with autism spectrum disorder (ASD) are increasingly educated alongside typically developing peers in regular education environments. These students have impairments that may hinder their success in inclusive school settings and require individualized supports to improve outcomes. The purpose of this meta-analysis and best-evidence synthesis is to examine the characteristics of interventions for students with ASD in inclusive settings, offer quantitative analysis of intervention effects, examine potential moderating variables that influence outcomes, analyze the social validity of these interventions, and provide recommendations for practice and future research. The 28 included studies met the What Works Clearinghouse standards for group design and single-case design research. Studies focused mostly on social communication skills, produced moderate to large effects, and were generally found to be socially valid. Function-based interventions, visual supports, self-monitoring strategies, and peer-mediated interventions resulted in mostly large effects, and teacher delivered interventions produced the largest overall effects. More high-quality studies for students with ASD in inclusive school settings are needed to advance evidence-based practice for this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Peer-Mediated Interventions to Address Social Competence Needs of Young Children With ASD: Systematic Review of Single-Case Research Design Studies

We conducted a systematic review and summarized the outcomes of single-case research design studies conducted in the last decade that have implemented peer-mediated interventions (PMI) to address the social competence needs of children with autism spectrum disorder (ASD) younger than 8 years of age. Eighteen studies with 53 children with ASD were included. Data from those studies were extracted independently by two coders and coded for characteristics of children with ASD, characteristics of peers, characteristics of the intervention, risk of bias, and success estimate. Findings suggest that PMI are effective for increasing interactions between children with ASD and peers but may not be as effective for increasing initiations made by children with ASD or increasing responses made by children with ASD to peers’ initiations. Researchers should prioritize conducting studies that seek to promote positive interactions initiated by children with ASD, possibly by modifying PMI to include preferred stimuli identified through systematic assessments.

Effectiveness of a low-intensity peer-mediated intervention for middle school students with autism spectrum disorder

BackgroundPeer-mediated interventions (PMI) are used to promote social interactions and academic engagement between individuals with autism spectrum disorder (ASD) and their peers. Most PMI research has been conducted with preschoolers and students in the early elementary grades. There is a need for additional research examining the effectiveness of low-intensity PMI for older students. MethodThis study used a non-concurrent multiple-baseline, multiple-probe across participants design to investigate the effectiveness of a low-intensity PMI on engagement and communicative acts for middle-school aged students with ASD during lunch breaks at school. Nine typically developing peers received 40–50 minutes of peer coach training. Peer coaches were encouraged to interact with their classmate with ASD during lunch breaks at school, using the strategies they learned. They were provided with brief feedback and/or praise after each probe observation during intervention and follow-up. ResultsResults showed a functional relation between the intervention and both engagement and communicative acts, with three demonstrations of effect across participants. Indicators of mutual enjoyment were observed for the majority of probe observation sessions across groups. There was some maintenance of effect at 1–4 weeks follow-up. Social validity was high for both peer coaches and classroom teachers. ConclusionsThis study contributes to and extends the existing PMI research by including middle school students with varying intellectual and social-communication abilities. Schools may be more likely to adopt evidence-based interventions such as the one used in this study if they are also efficient.

Peer-Mediated Social Skill Generalization for Adolescents with Autism Spectrum Disorder and Intellectual Disability

ABSTRACT Many researchers and practitioners cite concerns with maintenance and generalization as a serious issue for individuals with autism spectrum disorders (ASD), although few studies explicitly target performance of behaviors outside training environments. After an initial intervention failed to produce robust generalization outcomes, the present investigation examined the combinative effects of a peer-mediated intervention with video-based group instruction on the generalization of social skills by four high school students with ASD and co-occurring intellectual disability. A multiple probe across behaviors design was used to examine the effects of the packaged intervention on generalization of social skills to three natural settings within the high school. All participants demonstrated an increase in performance of social skills across all generalization environments following peer-mediated intervention for social skills that had been acquired—but minimally generalized—in a previous video-based group instruction study. Results suggest peer mediated intervention enhanced the generalization outcomes of an already effective intervention teaching social interaction to adolescents with ASD.