A child diagnosed with autism spectrum disorder (ASD) is likely to have difficulty socializing with peers. School lunchrooms and playgrounds are powerful, notorious settings for interactions between children. Yet, despite ripe and recurrent opportunities to boost social development (and academic engagement) of students during lunch/recess, teachers and administrators are usually taking a break themselves. Regularly, the responsibility for cultivating the lunch/recess experience is given to under-appreciated, underpaid, undertrained school staff. Not surprisingly, children with ASD often struggle to make productive social connections under these circumstances, as do their classmates. Given the increase in the number of children with ASD entering the general education population, the topic of their engagement with peers is timely.
Objectives:
We aimed to deliver a psychosocial intervention to participating children with ASD at school during lunch/recess. The naturalistic intervention was fashioned to 1) reduce solitary time and increase time spent engaged with peers, 2) activate school staff to facilitate peer engagement for all children, and 3) demonstrate that children who receive the intervention perceive more peer engagement and rate their overall lunch/recess experience as better than those in the WL condition.
Methods:
We implemented the study using a randomized, wait-list-controlled design across two cohorts in four public elementary schools within a major metropolitan area in the Western U.S.A. Randomization at the school level produced two initial treatment (IT) groups consisting of 13 (two female) elementary school students with autism and a wait-list (WL) group of 11 (four female) children with ASD. Treatment was delivered daily at school lunch/recess for three weeks (15 sessions), then faded over the next three weeks (6 sessions) for a total of 21 sessions. Measurements employed included observational coding of peer engagement, behavior checklists and child surveys.
Results:
Our analyses revealed that, for participating children, the proportion of time spent alone or isolated from peers was significantly reduced in the IT group (p = .012) and time spent engaged with peers was significantly increased in the IT group (p = .01). School staff at the sites where initial treatment was delivered showed increased responsive (p < .01) and strategic behaviors (p < .01) around participants at lunch/recess compared to staff at the WL school. Children receiving the intervention reported talking and playing with more peers (p < .01) and having an overall better lunch/recess experience (p < .01) than those in the wait-list group.
Conclusions:
It is possible to increase the amount of observable peer engagement for children with ASD at school. Lunchroom and playground staff, despite being under-valued, will significantly change their behavior to improve outcomes for children with ASD and peers when presented with relevant information. Children appreciated our efforts and the cost-effectiveness of this approach suggests a good investment for all. Future directions might include increased articulation of the lunch/recess experience for all children and a reassessment of the pay, training and supervision for the school staff given the responsibility of overseeing lunchtime and recess.