Developing the evidence base for preschool social circles: An intervention to support social inclusion for children with autism spectrum disorder

Abstract

Background Successful social inclusion in early childhood education is associated with positive outcomes for all children in later life, irrespective of disabilities or complexity of needs. Many children with additional needs experience significant difficulties with social skills. These challenges are particularly prevalent for children with autism spectrum disorders (ASD). These children generally need support to access the social learning opportunities and benefits afforded by social inclusion in the early childhood education. At present, there is a lack of research investigating and developing evidence-based supports to improve outcomes for children with additional needs within the inclusive early childhood education context. Aim The aim of this research was to evaluate evidence-based practices derived from the science of applied behavior analysis to inform the development of a systems-wide, context specific social skills intervention for children with ASD in preschool settings. Methods Two systematic reviews were conducted to explore the empirical base to provide pertinent information towards answering the research questions. Study 1 is a systematic review of the social skills intervention literature for children with ASD, to evaluate the status of this literature regarding generalization and maintenance, generalization-promotion strategies and factors influencing these outcomes. Study 2 is a systematic review of peer mediated interventions with preschool aged children with ASD and their peers, to evaluate the efficacy of peer mediated interventions with this age group and identify the most successful training and intervention formats within this context. A single case research design was employed to evaluate a parent training protocol and parent implemented intervention for typically developing preschool children in Study 3. This parent training protocol and parent implemented intervention was evaluated in Study 4 with preschool children with ASD. Studies 3 and 4 evaluated the practicalities of parent involvement in intervention and subsequent outcomes for parents and children. Furthermore, the intervention modifications required for children with additional needs were investigated. Study 5 employed in-situ observations and descriptive analysis of preschool children’s social interactions to inform a greater understanding of the preschool social context in which social skills are learned. Findings from this study informed the empirical identification of social skills targets and xiv measurement. Furthermore, relevant contextual factors for social skills intervention likely to evoke and maintain preschool social behavior were identified through the development of a unique coding system and descriptive analysis. The observation protocol developed in Study 5 was preliminarily evaluated with children with additional needs in Part 2 of this study. Synthesis of the findings from each of the studies in the current thesis informed the development of Preschool Social Circles, an intervention to support social inclusion for children with ASD in preschool services. The development of the Preschool Social Circles, and a pilot study protocol are outlined in Chapter 7. Findings The systematic review of generalization and maintenance within the social skills intervention literature indicated that generalization promotion strategies, in general, support positive generalization outcomes. A number of generalization promotion strategies demonstrating higher levels of success were identified, along with contextual factors that influenced this success within social skills intervention for children with ASD. Within the review of peer-mediated interventions, it was found that peer-mediated interventions are a useful and successful intervention strategy for preschool children with ASD. Peer selection criteria and training protocols, as well as intervention formats associated with higher success rates were identified. The parent training protocol and parent implemented intervention evaluated in Studies 3 and 4 led to an increase in parent teaching skills and children’s life skills for all participants, however individual results varied. In general, the intervention required adaptations for children with ASD, especially for those with deficits in listening and communication repertoires. For typically developing children and children with ASD with typical listening and communication skills, social skills represented the most problematic target skill group. Study 5 identified social skills that typically developing children frequently engaged in within the preschool environment. Specific social initiations, responses, and concurrent social behaviors were observed. Analyses of the contextual variables, perceived motivating operations, and consequences for social behavior indicated factors that are likely to influence preschool social behavior in the natural environment. As such, Preschool Social Circles, as outlined in Chapter 7, represents a contextually-informed, evidence-based social skills intervention, developed from existing research and empirically informed by direct observation within the natural environment. Conclusion xv Overall the series of studies in the current thesis demonstrate the positive impact of evidence based practices on improving social outcomes for typically developing children and those with additional complex needs. The current research also demonstrated the utility of a systematic, empirical approach to intervention development. Consideration of the existing issues within the social skills intervention literature, and efforts to systematically address these gaps, have informed the development of a comprehensive, context-specific, social skills intervention to support social inclusion within ECE. As such, the development of Preschool Social Circles is thoroughly grounded within the existing social skills literature, and informed by novel, empirical research. Findings from the current thesis also emphasised the importance of considering the natural environment, and contingencies and interaction partners therein, within the context of teaching social skills.