Preschool Peer Social Intervention: Study Outcome and Integrative Summary

Background: Peer relations in typical development are cardinal for children's development of ample cognitive, linguistic, and social skills (e.g., Hay, et al., 2009). Longitudinal evidence shows that individual variations in behavior and in responding to peers’ behavior as well as in playing and conversing with peers at early ages predict later social competence (e.g., Coplan & Arbeau, 2009). These areas do not develop typically in children with ASD, thus limiting peer relationship experiences in young children with ASD and forming the basis for reduced peer engagement across development (Manning & Wainwright, 2010). Yet, relevant manualized evidenced-based social curriculum to enhance peer-interaction that are developmentally-based, ecological-school-based for preschoolers with ASD are scarce.

Objectives: To provide an integrative view on learning goals related to peer- social intervention through the summary of the Preschool Peer Social Intervention (PPSI) – Evidenced-based school social curriculum to promote Peer Play Conversation and Interaction for preschoolers with ASD. The objective of this talk is to present comparative results between treatment modalities (play, conversation, and interaction) and to teach us about the links between play, language, interaction and overall social competence in ASD. These young children’s ability to generalize from a treated social domain to an untreated one will be reviewed (e.g., from play to conversation and vice versa). Furthermore, we aimed to provide a critical overview of current literature.

Methods: The PPSI project included 65 children with high-functioning ASD (HFASD) randomly divided between four main groups: three intervention groups (play, conversation and interaction) and a waitlisted no-treatment control group. PPSI manualized curriculum is holistic, integrating CBT as well as developmental and ecological orientations, targeting three major areas of children’s social deficiency in ASD: splay, conversation and interaction with typical age-mates. Multi-method assessment procedures included pre-post behavioral measures of children's social competence completed by parents and teachers, and observations of children’s play, conversation and interaction with their peers. Post-treatment gains in untreated domains will identify generalizability of the groups' treatments.

Results: Overall, as expected, children in each treatment modality showed higher improvement in their learned skills compared to the other groups. For example, the play group improved play capabilities more than the conversation group that improved their quality of speech better than the interaction group. However, we also found two levels of important generalizations: 1.From one modality to the other (e.g., 20% of the children in the conversation group improved their social play complexity, and children in the interaction group improved their paralinguistic capabilities on the pragmatic scale) 2. Of the learned skills to the child's natural free-play situation in the preschool according to the blind teacher's report.

Conclusions: The PPSI outcome can help the future design of more individualized approaches to the treatment of core deficit in peer interaction, resulting in mitigation of the social withdrawal and isolation in older ages. Furthermore, the ecological nature of the PPSI can teach us about the implementation of social intervention within the child's natural social environment-his preschool, involving his natural peers. These issues will be further discussed.