Can we help young children with a diagnosis of autistic
spectrum disorder (ASD) to interact with others in nurseries?
Researcher: Pam Czerniewska: Doctoral student, University College London
Supervisor: Dr John Swettenham, Senior Lecturer, University College London
Clinical Adviser: Dr Elaine Clark, Consultant Paediatrician, Barnet & Chase Farm Hospitals
What helps young children
with ASD to become social
communicators?
Most children are diagnosed around 3 years of age and
early intervention shows promising effects.
Most approaches lead to some gains for some children at
some points in their development for some time.
What does this study ask?
Do Social Communication groups help children to interact with others?
Are groups more effective if they occur in Speech & Language Therapy
clinics or in the child’s nursery?
What is the underlying approach?
The approach is a social-pragmatic one, developing social communication
skills in children’s everyday activities matched to their developmental level.
Parents and nursery staff are fully involved in the small groups.
What is a social communicator?
Brings
you things
to share
Enjoys
joint games
Bur we lack evidence about what helps them to join in
with their peers This is surprising when most children
are now included in regular nurseries.
Points and checks
that you are looking
Looks at others
when they talk
Listens and follows
other people’s
language
Takes turns
Many nurseries and Speech & Language Therapy clinics
run Social Communication groups to prepare children
with ASD to play with peers.
But do they help?
What do we know about ASD ?
ASD affects 1-2% of the population
People with ASD find it hard to understand how we do things together:
How we:
•
share attention
•
share emotions and
•
share intentions
ASD is diagnosed when there are significant difficulties in three areas:
•
impairment in social interaction
•
impairment in social communication
•
restricted and stereotyped behaviour
Uses gestures and
words to talk about
what’s happening
Smiles when
you smile
Imagines how
someone else feels
Turns when
you call
their name
What do parents tell us?
Many parents are asked to collect their children before Circle Times because they can’t
sit in the group and listen. But that means they miss this important social time with
peers.
One mother cried when the local playgroup asked her child to leave because he
couldn’t play properly with the other children. How will he learn to play with others if
he stays at home?
How is the research designed?
The study uses a single case multiple baseline design
:
Key features of the design
• Eight 3-4 year olds with a diagnosis of ASD attending pre-schools will
take part with full permission of all involved.
• Each child acts as his or her own control.
• Baseline pre-intervention measures of social skills will be collected in each
child’s nursery twice a week by filming their interaction with peers.
• Each child joins either a nursery-based or clinic-based intervention group.
• Children join intervention groups after different numbers of weeks in
nursery. This controls for length of time in nursery as a factor.
• Post-intervention measures are collected by repeating observations of
interaction in nursery.
•‘Blind’ assessors will measure pre- and post- intervention interaction to
reduce bias.
Observation Phase 1
Observe eight 3-4 year olds in their nurseries. Collect baseline measures of
how each child:
• Initiates interaction
• Responds to bids for interaction
• Looks at others during activities
• Takes turns
• Uses gestures or words about their play
These 8 children are allocated to Set A or Set B for Intervention.
Intervention Phase 2
• Set A (N=4) join a small group in the nursery with their peers.
The activities will focus on social interaction skills. Staff are trained
to run these groups.
• Set B (N=4) join a small group in Speech and Language Therapy
clinics with the same activities as the nursery-based group. Parents
attend with their children.
Outcomes Phase 3
Observe each child using the same measures as in Phase 1
• Are there differences in their social interaction after intervention?
• Can these be explained by the small group intervention?
• Is one intervention more effective than the other?
References
Ingersoll, B. 2010. Teaching social communication: a comparison of naturalistic behavioural and development, social pragmatic approaches for children with autism
spectrum disorders. Journal of Positive Behaviour Interventions. 12 (33) 33-43.
Prizant, B., Wetherby, A., Rubin, E., Laurent, A. and Rydell, P. 2006. The SCERTS Model. A comprehensive approach for children with Autism Spectrum Disorders.
Baltimore: Brookes.
Wetherby, A.M. and Woods, J.J. 2006. Early social interaction project for children with autism spectrum disorders beginning in the second year of life: preliminary study.
Topics in Early Childhood Special Education, 26 (67): 67-82.