Peer engagement in toddlers with autism: Community implementation of dyadic and individual Joint Attention, Symbolic Play, Engagement, and Regulation intervention

Center-based classroom community interventions create opportunities for young children with autism to connect with peers. Yet, there has been little examination of the peer interactions of toddlers with autism who experience core challenges in social communication and play skills that may create barriers to successful peer interactions. Classrooms of toddlers were randomized to an experimental social communication intervention including peers or to the standard individual (adult-child) social communication intervention. Both toddlers in peer and no peer conditions demonstrated significant gains in social communication and play. Toddlers with greater receptive language and combination and presymbolic play skills were most likely to demonstrate peer engagement. Lay Abstract Although young children may participate in education and intervention programs that take place in classrooms or groups, there is little information about how toddlers with special needs, and specifically toddlers with autism, are engaging with their peers. This study takes place in a public center-based early intervention program for toddlers with autism. Classrooms of toddlers were randomly assigned to an individual social communication intervention or the same intervention adapted to include a peer. Children in both groups made gains in social communication and play skills. Children who had the peer intervention were more engaged with peers when an adult was present, but not when the children were unsupported. This article adds information about early skills that may be important for children to master so that they have more success when trying to interact with their peers. These skills include understanding language (referred to as receptive language at 12 months or more) and play skills including building and stacking (referred to as combination play-for example, building with blocks or completing a puzzle) and extending familiar actions to themselves, others, and figures (referred to as presymbolic play-for example, putting a bottle to the doll or to themselves). Understanding which skills to target can help practitioners focus their instruction to build children's skills toward connecting with peers through play.