Observation of Peer Engagement in a Peer Mediated Intervention Model for Adolescents with ASD

Background: Adolescents with ASD report poorer peer relationships, fewer friends, and greater loneliness than their typical age classmates (Bauminger & Kasari, 2000; Chamberlain, Kasari & Rotheram-Fuller, 2007). Current efforts are focused on improving social skills and peer relationships in adolescents through social skills interventions. Thus far, most of these studies have relied on self-report and parent-report data to measure outcome which may be subject to bias or inaccuracy (Tantam 2000). There is limited availability of naturalistic observational measures to capture change in peer engagement in response to these interventions.

Objectives: The main objective of the current study was to determine if observation of teen engagement changed after implementation of a school-based peer mediated model of intervention.

Methods: Adolescents with ASD were randomized into either a social skills treatment delivered in a didactic learning style with emphasis on practice of rote skills (SKILLS, n = 16) or a peer mediated model of teen engagement (ENGAGE, n = 18). Treatment consisted of 8 weekly sessions held after school or during lunch in the school. The Teen Observation of Peer Interaction (TOPI) is a behavioral observation measure that allows for observation of peer interactions (e.g., proximity to peer, level of complexity in social engagement with another peer). The TOPI consists of five 90-second observation intervals and rates “engagement state” from “solitary” to “joint” on a six point scale for each interval. The TOPI was administered during school lunches at pre-intervention, post-intervention, and at 8-12 weeks after the end of intervention.  Observers of teen engagement were naïve to intervention type status and time point. An overall average engagement state was calculated at each time point.  

Results: There were no differences in observed levels of peer engagement between groups prior to intervention. At post-intervention, adolescents in the ENGAGE intervention were rated significantly higher on levels of peer engagement compared to the those in the SKILLS intervention (F(1,31) = 4.11, p = .05) (ENGAGE: M = 3.74, SD = 1.75; SKILLS: M = 2.63, SD= 1.35). Although there was no significant difference between groups at 8-12 week follow up, the ENGAGE group continued to have higher engagement scores than at pre-intervention. 

Conclusions: Results suggest that adolescents in the ENGAGE model participated in more complex peer social interactions post-intervention compared to adolescents in the SKILLS model. Although there were no differences between groups at follow-up, improvement in social engagement in the ENGAGE group was maintained from end of treatment to follow-up. It may be that adolescents participating in the ENGAGE intervention exhibited greater peer engagement due to more opportunity for social interactions with other peers in the group. Participants in the ENGAGE group were encouraged to speak to each other outside of group, and social engagements were frequently planned ahead of time. This type of structured approach to increasing engagement between teens with ASD and their peers may have been important for teaching teens to alter their social “routine.”