The Use of Video Self Modeling and Peer Training to Increase Social Engagement in Preschool Children on the Autism Spectrum
Impairments in social functioning are common in children with autism spectrum disorder (ASD) and can create great difficulties in the life of an individual on the autism spectrum. Social skill deficits increase the likelihood of children experiencing social failure, peer rejection, and isolation, leaving them vulnerable to developing anxiety, depression, and other forms of psychopathology. The present study expands previous research addressing deficits in social functioning, through the implementation of a video self modeling (VSM) procedure and a brief peer training intervention. The VSM only phase led to rapid and marked increases in social engagement for all three preschoolaged children with ASD. The addition of a peer training intervention did not lead to improvements in social engagement when compared to the VSM only phase. The findings are discussed within the context of previous research, and suggestions for future research and implications for school psychologists and other school personnel are provided. Social skills are essential components of successful social, emotional, and cognitive development. Impairment in social functioning is a fundamental feature of autism spectrum disorder (ASD) and is well documented in the research literature (American Psychiatric Association, 2013; Rogers, 2000) In particular, young children with ASD exhibit significant deficits in the ability to initiate and maintain social engagement, often leading to social withdrawal. Social engagement is a pivotal social behavior that provides the gateway to more sustained and complex social relationships. Further, poor social skills are associated with detrimental long term outcomes, such as poor academic achievement, social failure and peer rejection, anxiety, depression, substance abuse, and other forms of psychopathology (Bellini, 2006; Tantam, 2000; Welsh, Parke, Widaman, O'Neil, 2001) Young children with ASD are in critical need of effective social skill interventions that increase positive social engagement, and help to impede the development of deleterious social and emotional outcomes. Unfortunately, few young children with ASD are receiving social skill interventions as part Correspondence concerning this article should be directed to Scott Bellini, Department of Counseling and Educational Psychology, 201 N. Rose Avenue, Bloomington, IN 47401; sbellini@indiana.edu. Copyright 2016 by the National Association of School Psychologists, ISSN 1938 2243 of their early childhood education program (Hume, Bellini, Pratt, 2005) Furthermore, based on the results of meta analytical research on children with ASD and other disabilities, children who are receiving social skills programming may not be receiving effective social skills programming (Bellini, Peters, Benner, Hopf, 2007; Gresham, Sugai, Horner, 2001) Gresham and colleagues (2001) noted that the weak outcomes of social skill interventions could be attributed to the fact that these interventions often take place in "contrived, restricted, and decontextualized" (p. 340) settings, such as resource rooms or other pull out settings. This assertion is supported by the findings of a meta analysis conducted on school based social skill interventions for youth with ASD (Bellini et al. 2007) Results of the metaanalysis indicated that intervention, maintenance, and generalization effects were significantly lower for social skill interventions that were implemented in pull out settings only. In contrast, interventions that were implemented in the child's typical classroom produced higher intervention, generalization, and maintenance effects. In addition to implementing social skill interventions in natural environments, interventions should also include typically developing peers (National Research Council, 2001) Early intervention practices that promote positive social interactions with peers in natural settings would be instrumental in the improvement of quality of life and learning for young children with ASD. VIDEO SELF MODELING AND PEER TRAINING TO TEACH SOCIAL SKILLS Video self modeling (VSM) is considered an evidence based practice for youth with ASD (National Autism Center, 2015) Results of meta analytical research have indicated that VSM is effective for children across the autism spectrum, often producing rapid and substantial changes in children irrespective of verbal or cognitive ability (Bellini Akullian, 2007) In VSM interventions, children view a video of themselves demonstrating the successful performance of a target behavior. VSM involves recording the child's behavior and then editing the footage into 1 2 minute video clips that display positive, efficacious behavior. The edited videos are shown to the child multiple times per week in evenly spaced intervals for approximately 2 8 weeks. VSM has been used across multiple disciplines and populations to teach a wide variety of skills including motor behaviors, social skills, communication, self monitoring, functional skills, vocational skills, athletic performance, and emotional regulation (Bellini Akullian, 2007; Delano, 2007; Dowrick, 1999; Hitchcock, Dowrick, Prater, 2003; Kehle Bray, 2009) Most salient to the present study, VSM has been shown to be an effective strategy for rapidly improving the social behaviors of young children with ASD (Buggey, 2012; Buggey, Hoomes, Sherberger, Williams, 2011) Peer mediated instruction is another evidence based strategy used to facilitate social interactions between young children with ASD (and other disabilities) and their typically developing peers (Banda, Hart, Lan Liu Gitz, 2010; Laushey Heflin, 2000; National Autism Center, 2015; Odom, McConnell, McEvoy 1992; Sasso, Mundschenk, Melloy, Casey, 1997) Peer training is an important component of peer mediated instruction. Peer training involves teaching typically developing children how to interact with and help their peers with ASD acquire and perform targeted social skills (Neitzel, 2008) In particular, the typically developing peers, or peer buddies, may be trained to make social initiations or respond promptly and appropriately to the initiations of their peers with ASD. Peer mediated instruction allows children with ASD to perform social behaviors through direct social contact and by modeling the social behaviors of peers. Peer mediated instruction allows teachers to structure the physical and social environment to promote successful social interactions between children with ASD and their peers. Peermediated instruction can be used in naturalistic settings (classroom and playground) and also in structured settings (structured playgroups) The use of peer mentors allows the teacher and other adults to act as facilitators (via prompting of the peer mentors) rather than participate as active playmates with children with ASD. The use of trained peer mentors may also facilitate generalization of skills by ensuring that newly acquired skills are performed and practiced with peers across natural settings (Zhang Wheeler, 2011) Similar to the present study, Banda and colleagues (2010) examined the effectiveness of peer training in combination with direct instruction in increasing social initiations and responses of young children with NASP School Psychology Forum: Research in Practice Video Self Modeling for Young Children With ASD 208 ASD. The study included two male kindergarten students diagnosed with ASD and three typical peers in a school setting. The peer training intervention occurred in two parts. First, the investigators conducted a 4 5 minute training session involving the children with ASD and their typically developing peers. During this brief training procedure, the children were trained to ask questions and respond to questions from their peers. Intervention strategies used during the peer training phase included adult modeling, prompting, and reinforcement. Immediately following the training, the children with ASD and their peers were observed in the children's typical classroom. The interventionists continued to provide prompting to facilitate questions between the target children and their peers. The results showed immediate and substantial improvements for both participants with ASD. PURPOSE OF THE PRESENT STUDY One aim of the current study is to replicate and expand on the work of Bellini, Akullian, and Hopf (2007) The researchers implemented a VSM intervention in a public school preschool classroom for two preschool age children with ASD. In the study, teachers were asked to prompt social engagement (initiations and responses) between the children with ASD and their classmates during the video recording portion of the study. Teacher prompts were then edited out of the videos prior to showing the videos to the children with ASD. The edited clips showed exclusively autonomous, positive, and efficacious engagement with peers. The intervention led to rapid and substantial increases in unprompted social engagement with peers. In addition, levels of social engagement were maintained after the VSM intervention was withdrawn. In spite of the substantial improvements in social engagement for the participants with ASD, the researchers and classroom teachers noted on the social validity assessment that there were many instances during the observational period that the children with ASD attempted to engage their typically developing peers, but were rejected or ignored by the peer. Teachers also noted that in some situations the children with ASD had few opportunities to respond because the other children in the class rarely initiated play with them. It was hypothesized that social engagement would have increased even further had the research team implemented a peer training program that taught and encouraged typically developing peers to appropriately initiate and respond to their classmates with ASD. The present study will expand this previous research by examining the combined eff