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RCT of a Manualized Social Treatment for High-Functioning Autism Spectrum Disorders

Zang, J., & Wheeler, J. J. (2011). A meta-analysis of peer-mediated interventions for young children with autism spectrum disorders. Education and Training in Autism and Developmental Disabilities, 46, 62-77.

Reviewed by: Kathleen Moran, Caldwell College

Why research this topic?

For children with autism, social interaction with peers is a key skill domain to address in treatment. One strategy for increasing the quality and quantity of social interaction is to use peer-mediated interventions, in which typically-developing peers are trained to coach children with autism or model skills for them. Many studies have tested whether peer-mediated interventions are effective in improving the social interaction skills of children with autism. However, it remains unclear whether such interventions have enough scientific support to be considered evidence-based and, if so, whether the effectiveness of the intervention is influenced by individual characteristics of the child, interventionist, or intervention procedures.

What did the researchers do?

The authors conducted an electronic search with keywords that included autism, social interaction, social skills, peer relation, and young children. They then selected studies that were published in English between 1977 and 2006 and that focused on peer-mediated interventions to improve social interaction for children with autism under eight years old. They found 45 peer-reviewed articles that met their criteria for inclusion in their analysis. Research assistants extracted data from these studies on: (1) the effect of the intervention on social interaction and (2) characteristics of the child, intervention, and intervention procedures. Effect sizes were calculated by statistically comparing the rate of social interaction during intervention to the rate during baseline.

What did the researchers find?

Results showed that peer-mediated interventions are effective for children with autism under the age of eight. Additional findings suggested that slightly older boys were the most effective models for boys with autism and that intervention was most successful when it took place in the home and when the child’s family and instructors participated in implementing the intervention. Areas that the authors identified as needing further research include: (1) applications of peer-mediated interventions to girls and to children with diagnoses other than autism, (2) studies on peer-mediated interventions that involve using peers as models for social interaction, and (3) procedures to improve responses to social bids from peers and to promote generalization and maintenance.

What are the strengths and limitations of the study?

One limitation of the study is that the authors only searched for and included peer-reviewed journal articles. This resulted in a biased meta-analysis if authors are more likely to publish their results if they obtain positive results than if they obtain limited findings, a review of the published literature only may overestimate the effects of the intervention.

One strength of the study is that it builds on a careful literature review that identified gaps in what is known about peer-mediated intervention. Another is that it clearly defines peer-mediated intervention and describes variations in how this intervention is delivered in different studies. In addition, the authors illustrate how meta-analyses of single-subject research can be used to identify evidence-based practices.

What do the results mean?

This review established that peer-mediated intervention is an evidence-based teaching procedure.