Incorporating Behavioral Strategies to Teach Social and Play Skills with Peers

Imitation of peers also has been the target of behavioral interventions. A training session that included prompts and praise was used to teach children with autism to follow an adult then peer model, which was effective in getting the children with autism to participate in a follow-the-leader game that occurred in a different setting (Carr & Darcy, 1990). Small-group imitation training that incorporated a least-to-most prompting strategy and praise for imitating a peer was successful for preschoolers with autism during the training session but did not maintain into the follow-up period for any but one of the participants (Garfinkle & Schwartz, 2002). Two children with autism were taught to imitate their peers when the peers used pivotal response training, and gains in language, communication, and joint attention (although not targeted) were maintained at a 2-month follow-up (Pierce & Schreibman, 1995).

Play has been used as a context for teaching play skills and social interaction with peers. Stahmer, Ingersoll, and Carter (2003) provide a thorough review of the research using behavioral strategies to promote play. They site research publications that have incorporated the following behavioral strategies to teach play and peer interaction involving children with autism spectrum disorders: discrete trial teaching (Lifter, Sulzer-Azaroff, Anderson, & Cowdery, 1993), pivotal response training, imitation training, differential reinforcement of appropriate play, self-management (Stahmer & Schreibman, 1992), video-modeling (Jahr, Eldevik, & Eikeseth, 2000), and the use of play scripts (Goldstein & Cisar, 1992). Incidental teaching was used by typical peers to increase the play and social interaction skills of their classmates with autism (McGee, Almeida, Sulzer-Azaroff, & Feldman, 1992).

Advanced play skills such as symbolic play have been taught to children with autism spectrum disorders using pivotal response training or using clear instructions, child choice, turn-taking, direct reinforcement, and reinforcing attempts and interspersing maintenance tasks with skill acquisition (Schreibman, Stahmer, & Pierce, 1996; Stahmer, 1995; Thorp, Stahmer, & Schreibman, 1995). During play activities, social competence is targeted by educators who encourage and extend conversation, use exaggerated positive affect, model social statements, and redirect inappropriate behavior (Schreibman et al.).

Kamps, Kravits, and Ross (2002) have outlined the steps needed to implement social skills groups and playgroups that incorporate behavioral principles and strategies such as reinforcement, progress monitoring, self-monitoring, and self-instruction.

Taylor and Jasper (2001) have designed behaviorally based programs that can be used to increase social interaction with peers that include beginning skills (eye contact, greetings, request items), intermediate programs (follows directions, pretends, offers information), and advanced skills (comments about play, expresses empathy, responds to changes in conversational topic). The description of each target skill in the curriculum includes the suggested prerequisite skills, procedures for implementing the teaching strategy, including any prompts, and instructions for peers.

R. L. Koegel and his colleagues evaluated the social interaction between two children with autism and their typical peers during play dates with and without contextual support (Koegel, Werner, Vismara, & Koegel, 2005). Increases in reciprocal social interaction and positive affect occurred during the contextual support condition when a facilitator selected mutually reinforcing activities and structured the play activities so that cooperation between peers was critical to the activity (e.g., arranging for one child to hold the measuring cup while the other poured ingredients). The authors state that more research is needed on the effects of contextual support on the facilitation of play between peers (Koegel et al.).