Examining Paraprofessional Interventions to Increase Social Communication for Young Children With ASD

Abstract

Interventions and Autism Spectrum Disorder Social communication skill development begins early in infancy and continues throughout childhood. During the first year of life, a child learns to deliberately communicate through social exchanges such as smiling, coordinating attention between objects and people, and using sound and gestures (Wetherby, 2006). Such early social engagement lays the foundation for more complex social interactions that emerge in early childhood, including imitation, imaginary play, and spoken language (Kohler, Anthony, Steigner, & Hoyson, 2001). Spoken language develops to fulfill communicative functions such as requesting wants and needs, labeling items, and obtaining information (Sundberg & Michael, 2001). Children with autism spectrum disorder (ASD) often struggle with early social engagement leading to further difficulties with more complex social communication, academic learning, and personal interactions (Kasari, Gulsrud, Wong, Kwon, & Locke, 2010). Research confirms that children with ASD spend more time in purposeless activity, interact less with others, and maintain greater physical distance from peers compared with typically developing peers (Goldstein, Lackey, & Schneider, 2014). Among the deficits related to a lack of social engagement is an absence of social communication, a core deficit in children with ASD (American Psychiatric Association, 2013). Early social communication skills, such as joint attention, imitation, symbolic play, and the ability to understand and express language, are skills that are often delayed or impaired in children with ASD (Ingersoll & Schreibman, 2006). In particular, spontaneous social communication is a typical behavior that children with autism often lack (Duffy & Healy, 2011). Recently, interventions combining behavioral and developmental approaches delivered in natural environments show promising results in increasing social communication behaviors in young children with ASD (Dawson 662870T ECXXX10.

A critical review of the professional development literature for paraprofessionals supporting students with externalizing behavior disorders

“…Studies published before 1979 conceptualized paraprofessionals as aides working in a hospital setting, counseling center, and so forth. Initially, seven published reviews were identified that included paraprofessionals, however the reviews included studies of paraprofessionals among multiple types of intervention providers and/or were limited primarily to the provision of supports for students with disabilities (i.e., Brock & Carter, 2013, 2017; Douglas, 2012; Garrote et al, 2017; Mrachko & Kaczmarek, 2017; Rispoli et al, 2011; Walker & Smith, 2015). These seven reviews and the studies found in the aforementioned databases and peer‐reviewed journals yielded a total of 108 articles.…”

“…Given the gap in paraprofessional training, a comprehensive appraisal of the extant PD literature is urgently needed. To date, existing reviews have included paraprofessionals among multiple types of intervention providers or have been limited to only support for students with severe intellectual or developmental disabilities (e.g., Brock & Carter, 2013, 2017; Douglas, 2012; Garrote, Dessemontet, & Opitz, 2017; Mrachko & Kaczmarek, 2017; Rispoli, Neely, Lang, & Ganz, 2011; Walker & Smith, 2015). Specifically seven reviews have included studies investigating training and supports for paraprofessionals in providing services to students with severe intellectual or developmental disorders or a broad range of disabilities, including core competencies and interventions and supports needed to meet the unique learning and social behavior needs of the students.…”

Practitioner-Implemented Naturalistic Developmental Behavioral Interventions: Systematic Review of Social Validity Practices

“…Search terms indicating NDBIs (e.g., Incidental Teaching and Pivotal Response Training) were based on those listed in the works of Schreibman and colleagues (2015). Immediately following the initial electronic search, ancestral searches of reference lists were conducted from related systematic reviews (i.e., Lane et al, 2016; Mrachko & Kaczmarek, 2017; Snyder et al, 2015; Verschuur et al, 2014). See Figure 1 for a PRISMA flowchart (Moher, Liberati, Tetzlaff, & Altman, 2009) outlining the specific systematic review sequence, number of studies located, and exclusions.…”

“…Previous systematic reviews have established many caregiver and practitioner-implemented NDBIs as effective, evidence-based practices for young children with disabilities (e.g., Lane, Lieberman-Betz, & Gast, 2016; Lang, Machalicek, Rispoli, & Regester, 2009; Mrachko & Kaczmarek, 2017; Rispoli, Neely, Lang, & Ganz, 2011; Snyder et al, 2015; Verschuur, Didden, Lang, Sigafoos, & Huskens, 2014). Yet, these reviews pay little attention to the assessment of social validity.…”

“…Yet, these reviews pay little attention to the assessment of social validity. In addition, results of these reviews indicate that maintenance of NDBI use by practitioners and skills of children are rarely assessed, and when present, results are often mixed (Lang et al, 2009; Mrachko & Kaczmarek, 2017; Rispoli, Neely, Lang, & Gantz 2011; Verschuur et al, 2014). This may indicate a lack of social validity for the intervention package (Kennedy, 2002).…”