Using Peer Supports to Encourage Adolescents With Autism Spectrum Disorder to Show Interest in Their Conversation Partners

Abstract

Purpose This study was conducted to evaluate the effects of a multicomponent peer-mediated intervention (PMI) on teaching adolescents with autism spectrum disorder (ASD) how to show interest in peer conversation partners by asking partner-focused questions about the person, their interests, or their experiences and by making partner-focused comments that positively affirm peer statements or express concern. Method A multiple-baseline design across three verbally fluent high school students with ASD was used to assess the effects of the PMI, which involved training peers ( n = 10) to support conversation and the students' use of target skills, and training the students to use partner-focused skills with the aid of a self-reflection cue sheet during conversation with trained peers in a high school cafeteria. Ten-minute samples of student–peer conversations were transcribed and analyzed. Generalization with untrained peers was assessed. Results The PMI was highly effective in increasing all students' use of partner-focused skills. Gains were maintained by two students in a return-to-baseline condition. Generalization was evident for all students with varied results. Peers and students with ASD perceived the intervention to be beneficial. Conclusions This study adds to the limited research showing that PMI can be used in high school settings to improve target conversational skills and provides preliminary evidence that PMI can successfully address an underresearched pragmatic language difficulty (i.e., introducing and maintaining topics of conversation of relevance and interest to conversation partners) common among adolescents with ASD. These findings invite replication to extend generality and assess the impact of the intervention on peer relationships. Supplemental Material https://doi.org/10.23641/asha.16915663

A Letter to the Editor Regarding Bambara et al. (2021), “Using Peer Supports to Encourage Adolescents With Autism Spectrum Disorder to Show Interest in Their Conversation Partners”

“…interlocutors (Rifai et al, 2021). Albeit that it is commendable that the autistic participants in Bambara et al (2021) were not forced to adhere to neurotypical backchanneling, the peer focus within the study means the skills are still comparable to the neurotypical peers. Thus, the peers were assigned more power in regard to their position within the research-that is, improving the autistic participants' conversation skills.…”

“…Recent studies including those by Crompton et al (2020) and Morrison, DeBrabander, Jones, Faso, et al (2020) found there are benefits for autistic people to socializing with those with an insider identity (e.g., being autistic). The neurotypical difficulties experienced by the mismatch in neurotype with autistic peers are an important part of the social difficulties (Davis & Crompton, 2021) upon which Bambara et al (2021) is based. Furthermore, Bambara et al (2021) indicate how the goal of demonstrating interest in their conversation partners was through verbal means, but other forms, such as nonverbal methods, also exist (e.g., nods, smiles, and eye gaze).…”

“…The neurotypical difficulties experienced by the mismatch in neurotype with autistic peers are an important part of the social difficulties (Davis & Crompton, 2021) upon which Bambara et al (2021) is based. Furthermore, Bambara et al (2021) indicate how the goal of demonstrating interest in their conversation partners was through verbal means, but other forms, such as nonverbal methods, also exist (e.g., nods, smiles, and eye gaze). Jack (2013) discusses that autistic communication does not seem to be constructed as neurotypical human communication.…”

“…The power imbalance noticeable in Bambara et al (2021) begs the question about reporting what was wanted by the autistic participants (and not just "enjoyed"). We need to acknowledge the impact of compliance (see Sandoval-Norton & Shkedy, 2019), the need to change the widely accepted normative idea about what being social means (neuroqueering interpersonal communication theory; Cole, 2021), and autistic people being valid in and of themselves (Yergeau, 2017).…”

Effectiveness of peer-mediated intervention on social skills for children with autism spectrum disorder: a randomized controlled trial

“…Peer-mediated intervention (PMI) refers to an intervention that systematically teaches normally developing peers to help children with ASD actively participate in social interactions, thereby enabling children with ASD to acquire appropriate social skills. A core part of the approach is the use of peers to facilitate interaction in children with ASD, and studies have shown that the therapy can promote the integration of children with ASD into the school environment (11,12). Watkins et al in 2015 reviewed 15 studies demonstrating the effectiveness of PMI in improving social interaction in ASD (13).…”