Overview
PMII is designed to increase the social engagement of children and youth with autism spectrum disorders (ASD).
There are different sections to this module that provide (1) an overview of peer-mediated instruction and intervention (PMII), (2) descriptions of the various instructional approaches that make up peer-mediated instruction, (3) guidelines for implementing this approach with children and youth with ASD, and (4) answers to frequently asked questions regarding peer-mediated intervention strategies.
These materials are designed to help you assess the characteristics of children and youth with
ASD, make more informed decisions about particular strategies that might be useful with individual students, and evaluate student progress.
Throughout the module, we provide information across the age range so that you can find relevant information for the students you work with (i.e., preschool, elementary, secondary).
What is Peer-Mediated Instruction and Intervention (PMII)?
Social impairment and difficulty with social reciprocity - or understanding the back-and-forth nature of social interactions - is perhaps the single most defining feature of autism (American
Psychiatric Association, 1994; National Research Council, 2001).
Research has shown that children and youth with ASD respond less frequently to social initiations and engage in shorter interactions due to their difficulties in initiating interactions and understanding social cues.
Stereotypic, or repetitive, behavior (e.g., hand-flapping, body rocking, head rolling) or other inappropriate behaviors (e.g., tantrums) also may decrease the likelihood that typically developing peers will initiate social interactions (Bass & Mulick, 2007; Lee, Odom, & Loftin,
2007; McConnell, 2002). As a result, children and youth with ASD have fewer opportunities to engage in social interactions to practice and acquire social and play skills. Peer-mediated instructional approaches can address these concerns by teaching children and youth with ASD new social skills and increasing social opportunities within natural environments, often a primary goal of families.

PMII Across the Age Span
PMII can be implemented with pairs or small groups of learners across the age range starting in preschool and extending through high school. With young children (i.e., 3 to 8 years of age), practitioners can use peer-initiation training, or a buddy approach, to help learners with ASD acquire important social skills. Social networking strategies are more appropriate for older learners (i.e., 9 to 18 years of age). PMII has been shown to have positive effects on academic, interpersonal, and personal-social development, and may be the largest and most empirically supported type of social intervention for learners with ASD (Bass & Mulick, 2007; Maheady,
Harper, & Mallette, 2001; McConnell, 2002).
Throughout this module, we will be talking about both peers and focal children. The use of the term peers refers to typically developing learners and the term focal children or focal students refers to children and youth with ASD.
Goals of PMII
PMII is designed to increase the social engagement with peers for children and youth with ASD.
Specifically, the goals of PMII are to: o teach peers ways in which they can talk and interact with children and youth with ASD, o increase the frequency with which children and youth with ASD interact with typically developing peers, o extend peers' social initiations with students with ASD across activities in the classroom, o minimize teachers'/adults' support (e.g., prompts and reinforcement), and o promote interactions between typically developing peers and students with ASD that are positive and natural in quality.

This approach can be used by a variety of professionals including teachers, special educators, therapists, and classroom assistants in different educational and communitybased environments.
PMII is most useful for children and youth with ASD who have limited communication skills, who rarely initiate or respond to social interactions with peers, and who do not appear to be benefiting from group instruction. For these learners with ASD, the persistent social initiations from peers will increase social responding, sometimes increase social initiations, and heighten their social engagement. For children and youth with ASD who have communication skills (i.e., can express their needs to adults and understand verbal instructions), social skills training groups that involve both focal children and peers may be more effective. For middle school-aged and high schoolaged students with ASD, social networking groups may be more appropriate.
Peer-mediated interventions are based on principles of behaviorism and social learning theory (Bandura, 1977). Peers are carefully and systematically taught ways of engaging children and youth with ASD in positive and extended social interactions in both teacher-directed and child-initiated activities (English et al., 1997; Odom et al., 1999;
Strain & Odom, 1986). Peer-mediated interventions are beneficial for children and youth with ASD because they increase the likelihood that learners with ASD will generalize new social skills to different activities and with different peers that were not involved in the initial training and intervention (Rogers, 2000). This is particularly important given the difficulty that individuals with ASD have generalizing the use of skills to new situations and to different people.
The Focus of the Intervention
Peer initiation training involves directly teaching peers how to (1) socially initiate (or start) an interaction with the focal child and (2) appropriately respond to the focal child when he/she socially initiates.

In this module, social play and interaction with at least one peer are the primary focus of peermediated instructional strategies used with children with ASD. Social play and interaction involve all three of the following features: o orientation (being aware of other children as shown by looking at them, at their play materials, or what they are doing); o parallel/proximity play (playing independently beside or near another child and using the same play space or materials); and o common focus (engaging in activities directly involving one or more peers including informal turn-taking, active sharing of materials, giving and requesting items to and from someone else, asking someone to play).
An important focus of the planning and implementation process is to help children with ASD become socially engaged with peers. Therefore, practitioners help children with ASD acquire the skills they need to establish and maintain a common focus with peers. This, in turn, provides the opportunity for other social play skills, such as orientation and parallel play to develop (Bass &
Mulick, 2007).
Steps 1 and 2
Peer initiation training includes specific steps which are described in the following section.
Step 1. Selecting Peers
The first step in implementing peer initiation training is to select the peer or peers who will be involved in the interactions with the focal child. Selected peers should: o exhibit good social skills, language, and age-appropriate play skills; o be well-liked by other peers; o have a positive social interaction history with the focal child; o be generally compliant with adult directives; o attend to an interesting task or activity for 10 minutes; o be willing to participate; and o attend school on a regular basis (Strain & Odom, 1986; Sasso et al., 1998).

Step 2. Training and Supporting Peers
Peer training typically takes place in a quiet area of the classroom where all of the needed materials are organized and close at hand and involves a series of phases. The first phase (Step 2a) of the training process is to teach the pre-selected peers to recognize and appreciate individual differences. For example, practitioners talk to peers about similarities and differences (e.g., how we are the same and different in appearance, likes/dislikes, needs, abilities) and explain how we often learn from each other in the classroom
(e.g., games, songs, movements). During this initial phase, peers also are given a brief overview of the similarities and differences of children with ASD. This discussion will vary in content based upon the ages of the peers. For instance, in preschool the discussion will be very concrete and will focus on observable behaviors (e.g., "Taylor needs help learning how to play with other kids, so we are going to teach him how."). For school-age children, more detail about the specific characteristics of children with ASD can be given; however, the discussion should continue to focus on providing examples and observable behaviors.
[ Sample Scripts: Peer Initiation Training for Young Children (PDF) ]
[ Sample Peer Initiation Activity for Young Children (PDF) ]
The second phase (Step 2b) focuses on training and supporting peers by introducing specific strategies one at a time and then practicing them with the adult trainer. Peers are taught to take part in the intervention during daily training sessions and may require four or five sessions to reliably learn the initiation strategies (Strain & Odom, 1986). Peers learn specific behaviors that are used to facilitate play and social interaction during learning activities. These behaviors include: o organizing play (making suggestions for play activity, role, or other play for peers); o sharing (offering, giving, or accepting a play material to/from focal child); o providing assistance (helping focal child to complete a task, get on play equipment, or respond to requests for assistance); and o providing affection and praise through hugging, putting arms around, patting, holding hands, shaking hands (Odom et al., 1993; Strain & Odom, 1986).
After the teacher describes the skills, she/he demonstrates the social initiation in a role play with one of the peers. Other peers watch and identify when the teacher uses the skill in the demonstration. The adult then has the child use the skill in a role play with one of the other peers in the group. Prompts or suggestions are provided to the peer as necessary. Adults also provide subtle reinforcements (e.g., pats on the back, thumbs up) during the practice session to encourage the peers' use of the strategies. At the end of the practice session, adults provide more explicit

reinforcement and feedback (e.g., "I liked the way you handed me the block to put on the tower you were building") so that children are motivated to continue participation (Timler, Vogler-
Elias, & McGill, 2007).
Steps 3 and 4
Step 3. Peer and Focal Child Interaction in a Structured Play
Setting
In the initial training sessions, only peers are included. To help peers practice skills further, they then participate in structured play sessions with the child or children with ASD. In daily play sessions that last approximately five to eight minutes, the teacher introduces the play activity, provides prompts to the peer, and reinforces behavior as necessary. At the conclusion of the activity, children can then go on to another setting or remain in the activity if they wish. Once peers have become proficient, teachers implement daily activities with the focal child and peers with reduced prompting and reinforcement.
Step 4. Implementing in Classroom Settings
When planning and implementing peer-mediated interactions within classrooms, several factors should be addressed to promote the success of the activities: (1) classroom arrangement, (2) material selection, (3) identification of responsible staff, and (4) the use of prompts and reinforcement.
Classroom arrangement.
Peer-initiated learning activities should be a part of the daily schedule and should take place at approximately the same time each day. At least 15 minutes should be allowed for each play session, including the transition to and from the activity. Play activities should not take place during preferred activities such as outdoor play which could interfere with the peers' motivation to participate. Having a consistent time and place for these activities will help children with ASD transition to the activity more smoothly and will increase the likelihood that social interactions will occur because they will know what is expected of them. As children become more proficient and as interactions become more naturalistic, peer-initiation strategies can take place in all classroom routines and activities, both planned and spontaneous.
Material selection.
One way to increase peer interactions and social engagement is to limit the play materials to items that (1) contain a specific theme for each play session (e.g., blocks, prop box), (2) include an element of sociodramatic play, (3) may require assistance in operating, and

(4) are not normally available in the classroom. Specific activities and materials that promote social interaction between peers and children with ASD include the following: o sand table, o birthday party prop box, o doll house and people, o building a road; cars and trucks, o car garage, o doctor, o farm animals and blocks, o grocery store, o play-doh, o puppet show, o puzzles, and o zoo animals (Odom et al., 1993).
These types of activities encourage sharing, exchanging of materials, and other social behaviors that children with ASD often need to develop.
Identification of responsible staff.
During the play sessions, one staff member in the classroom should be consistently responsible for running and supervising play. This adult will (1) train peers, (2) implement the learning activities, and (3) observe child progress.
Use of prompts and reinforcement.
The use of prompts and reinforcement is essential to the success of peer initiation training. When prompting social exchanges, practitioners should use the following guidelines:
1.
Observe children to identify non-interaction. o When there has been no interaction between the focal child and peers for 30 seconds, a prompt should be provided.
2.
Provide a prompt to either the focal child or peer to begin an interaction or respond to an initiation.

Prompting often involves cueing the peers to use the strategies through the use of explicit instructions (e.g., suggest a game to play, "Try talking about Taylor's animals"), more subtle verbal instructions (e.g., "It's your turn to talk," "Try again"), picture cues (e.g., a drawing of two children talking), or gestures such as signaling the peer to move closer to the focal child
(Goldstein, Schneider, & Thiemann, 2007). If the child does not respond to the prompt within 10 seconds, repeat the prompt again and provide physical guidance (Ostrosky et al., 1990).
As peers become more proficient at engaging children with ASD in play, practitioners can withdraw their use of prompts and reinforcement. If the peers and focal children are engaging in relatively few social interactions, practitioners should temporarily increase the use of prompting and reinforcement to ensure that social interactions are occurring with a high level of frequency.
Gradual withdrawal of prompts and reinforcement will allow practitioners to periodically assess the progress of individual children.
Step 5
Step 5. Extending Initiations Across the Day
The final phase of the implementation process is to extend initiations across the day. This can be accomplished through the use of two strategies: (1) embedded intervention and (2) classwide peer buddy system. With an embedded intervention approach, instruction is provided within child-initiated, naturalistic, and contextualized interactions. For example, a teacher might seat a trained peer next to the focal child during a small group art activity with a limited number of materials to promote social interactions. The peer could be prompted to ask the child with ASD to pass the paint or assist the child in gluing. Practitioners should plan to include peer initiation strategies within at least three classroom routines and activities per day. The use of an activity

matrix may help practitioners organize the activities and provides a structure for making sure that the learning opportunities occur. The sample activity matrix below provides a visual reminder for practitioners to address specific behaviors (e.g., requesting, greeting, exchanging materials) in numerous activities across the day.
A class-wide peer buddy system also can be used to increase the number of peers who interact with the focal child. With this approach, children in the class have different play partners each day. A chart can be created that displays pairs of children's names printed on individual cards.
Each day, the cards are systematically rotated so that each child has the opportunity to buddy with a different peer. At "buddy time," children check the chart and find their name as well as the name of their buddy. During free play, children play with their buddies. Teachers prompt interactions as needed during this time. Prior to "buddy time," peers are taught specific skills.
They include the following: o Stay with your buddy.
Peers learn that they must stay with their buddy in the same area, playing and taking turns. However, they do not need to continually play with the same toys. o Play with your buddy.
Peers are taught to stay in the same area with their buddy and play with the same materials by joining in their buddy's activity, offering toys, and asking their buddy if he/she would like to play. o Talk to your buddy.
Peers are taught to (1) talk to their buddy about what they are playing with, (2) play pretend games, and (3) talk to each other while engaging in pretend play activities.
To increase motivation to participate, peers are told that if they stay with their buddy, play together, and talk to one another, they will be able to put their names in a box. Every day, a pair of names is pulled out of the box. The selected pair receives a special treat (e.g., candy, sticker, treasure, prize). This reinforcement strategy is withdrawn as children become more proficient at staying with their buddies (English, Goldstein, & Shafer, 1997; Laushey & Heflin, 2000).
Putting it All Together
In this next section, we provide you with specific knowledge that is needed to effectively implement PMII with young children wiht ASD.
A key to the success of peer-initiation training will be to individualize the instruction to meet the needs of each child. The following guidelines are suggested when planning intervention for individual children with ASD:
1.
planning for the intervention by assessing the focal child's existing skills, identifying the skills that need to be taught, and determining how the skills will be taught;

2.
implementing the intervention; and
3.
monitoring child progress (National Research Council, 2001).
Assessment and Identification of Skills
Direct observation will be the primary means for assessing individual children's existing skills.
Specifically, you will want to observe: o the child's communication abilities. How does the child get his/her needs met? Does he/she communicate verbally or nonverbally? o the child's current social behavior, both appropriate and inappropriate. What social behaviors does the child use when interacting with peers and adults (e.g., orientation, parallel/proximity play, common focus)? Does the child engage in any inappropriate behaviors (e.g., hitting, hand-flapping, body rocking) that prevent him/her from interacting with children and/or adults? o activities in the classroom where the social behaviors currently occur. During what activities does the child interact most with peers and/or adults? What times of the day are most conducive to implementing PMII (e.g., free play, outside, arrival)? Where the social behavior is occurring (e.g., block area, housekeeping, playground). o with whom the social behaviors are occurring. Does the child with autism have a favorite peer? What peer(s) does the child with autism interact with the most?
[ Sample: Pre-Assessment for Young Children (PDF) ]
The information that you gather for individual children will help you to identify o the skills that need to be addressed, o the strategies that should be used to facilitate the development of skills, o where the intervention should take place, o the peers that should be included in the intervention, o the areas of the classroom or activities that should be used as the context for the intervention, and o how the intervention will be implemented.
Case Study: Austin
Rochelle is a new teacher in an inclusive preschool classroom for 3- and 4-year-olds. Currently, there are 15 children in her class, including one child with autism, Austin. Through her informal

observations, she has learned that Austin does not interact much with his peers. During her studies, she learned about peer-mediated intervention strategies and would like to implement them in her classroom to help Austin engage in more frequent interactions with his peers. Prior to implementing the intervention, Rochelle observes Austin during free play and small group activities to identify the skills he already has and the skills he needs to learn in order to interact with his peers. During small groups, Austin does not engage in activities for more than a minute or so. Again, Rochelle has noted that he watches, but does not interact with his peers. Through her observations, she determines that Austin speaks in very clear, complete sentences, but spends most of his time wandering the classroom, interacting very little with his peers. He watches what the other children are doing, but does not get engaged in their activities. Rochelle decides that she must work on three specific skills with Austin: (1) playing near peers, (2) asking peers to play, and (3) exchanging materials.
Case Study: Kate, Benjamin, and Kiara
Three children in Rochelle's classroom, Kate, Benjamin, and Kiara, are very social and would be great peers for the intervention. As she begins to plan for the intervention, Rochelle decides to conduct the training with the peers for three days during outside time. This way she knows that the classroom will be quiet and free of distraction. Because the children will be missing out on outside time, Rochelle plans to give them stickers following each training session. She hopes that this will motivate them to participate. Also, she will only need approximately 30 minutes for each session, which will give the children time to play outside after they are finished.
Rochelle plans to vary the location of the peer training sessions by implementing them in different parts of the classroom. She has decided to use the same materials and conduct the trainings where the actual intervention activities will take place. For instance, the first training session will take place in the dramatic play area with a restaurant prop box that she plans to use during the intervention. The other training sessions will take place in the block area and at the sand table. Rochelle is going to focus on teaching the peers how to offer Austin materials, exchange toys, offer help, and respond to Austin's initiations. She has prepared a script so that the training sessions she will provide the peers with of all of the information they will need to be successful.
Rochelle's plan is to implement the first peer-mediated intervention during small group activities so that her assistant can help supervise the other children. One of the small group activities will be to use the restaurant prop box in the dramatic play area. Rochelle will implement the intervention while the other children in the class rotate between the water table and an art activity. She wants to use two other highly engaging activities so that the rest of the children will not be distracted by the prop box and want to take part as well. The program director also is available during this time to help out in the classroom, which will provide further support if necessary.

Prior to both the peer training sessions and the intervention activities, Rochelle identifies the materials she will need and collects them into a bin that she can easily transport to the area when she is ready to begin. For example, Rochelle collects notepads, pens, aprons, and menus so that her prop box is ready for the training session and activity.
Implementing the Intervention
The first step when implementing the intervention is to identify the resources and materials you will need to implement the peer-mediated strategy. Most materials used during PMII will be available within the natural setting (e.g., classroom). For example, early childhood professionals could use the sand table with a limited number the focal child's preferred toy (e.g., cars, animals, dinosaurs) to promote initiations and interactions. Another consideration will be when to train the peers to use the peer-mediated strategies. You may need to vary the times when the training sessions occur so that the peers are not consistently missing the same activity (e.g., outside) that may be highly appealing to them.
Case Study: Kate, Benjamin, and Kiara (continued)
After Rochelle has successfully trained the peers over the course of 3 days, she implements the intervention with Austin in the dramatic play area using the restaurant prop box. She introduces the activity by saying, "Today, we are going to play restaurant. Kiara, why don't you be the chef?
Kate, you can be the waitress, and Austin and Benjamin will be the customers." Rochelle hands the menus, paper, and pen to Kate. Kiara puts on the apron and begins "cooking" at the stove.
Because the peers have practiced the activity earlier in the week, they know exactly what is expected of them. Kate offers the menus to Benjamin and Austin as they sit down at the table.
Benjamin takes the menu and begins looking at it. Austin does not initially take the menu from
Kate. Rochelle waits 10 seconds and then says, "Austin, Kate is giving you a menu," while pointing at the menu. Austin looks at the menu and takes it from Kate. He continues to stand next to the table, but does not sit down. Rochelle prompts Austin to have a seat by saying, "Austin, sit down with Benjamin." He sits down and looks at Benjamin. Kate goes to the stove with Kiara and begins to cook.' She continues playing at the stove while talking with Kiara, so Rochelle decides to prompt Kate to take the boys' orders: "Kate, Benjamin and Austin look hungry."
Kate takes the paper and pen and walks back to the table where Benjamin and Austin are sitting.
Kate says, "Benjamin, what do you want to eat?" He replies, "Grilled cheese and French fries."
Kate writes on the pad of paper and then says to Austin, "What would you like to eat, Austin?"
He looks at Kate and says, "Spaghetti." Kate walks back to the kitchen and tells Kiara to make what they boys want. Kiara and Kate begin cooking' their food. Both of the girls then walk back to the table with the food on plastic plates and offer it to the boys.
"Here, Benjamin. Here's your food," Kate says. Benjamin takes the food from Kate, says, "Thank you," and begins eating.' Kiara hands Austin's spaghetti to him, but he does not take it. Kiara

looks at Rochelle who says, "Why don't you tell him you have his food?" Kiara says, "Here is your spaghetti, Austin." Austin still does not take the food. Rochelle then prompts Austin by saying, "Austin, Kiara is giving you spaghetti." Austin looks at Kiara, but does not take the food.
Rochelle takes Austin's hand (gently guiding it to the play food) and says, "Austin, take the spaghetti from Kiara," while taking the plate out of Kiara's hand. Rochelle then says, "Thank you, Kiara. This looks delicious."
The children continue playing for 5 minutes with Rochelle prompting interactions as needed. At the end of the intervention activity, Rochelle says to the peers, "That was fun. You offered toys to Austin and he took them. That made Austin very happy. Way to go, guys!"
Monitoring Child Progress
Frequent monitoring of child progress will be an important component of implementing peerinitiation training to determine the effects of the intervention strategies on social interactions.
Direct observation will allow practitioners to assess both the quality and quantity of the children's social engagement. For example, practitioners should evaluate: o whether the peer initiates interactions with the focal child, o whether the focal child responds to the peer's initiations, o whether the focal child initiates with the peer, o whether the peer responds to the focal child, and o whether the focal child is engaging in any inappropriate behaviors (English, Goldstein,
Shafer, & Kaczmarek, 1997).
Collecting information about these aspects of children's social interactions provides the teacher with valuable information about how the activity can be altered to increase social initiation and engagement. For instance, if there are few initiations or responses, the activity may not be appropriate for promoting social interactions. In this case, the teacher would want to plan an alternative activity that provides more opportunities for engaging in social behaviors such as taking turns and requesting. However, if the activity seems appropriate, practitioners will need to determine if other behaviors are inhibiting social interactions. Examples of behaviors that may be interfering with positive social interactions include the following: o focal child pushes a toy toward a peer, but the peer does not respond; o focal child asks for help, but gets no response; o peer asks a question, but does not give the focal child time to respond; o focal child responds nonverbally, but doesn't realize that it was a response; or

o peer continually tells the focal child what to do (English et al., 1997).
Once the interfering behavior has been identified, practitioners can provide additional support to help improve the quality of the interactions. For example, if the peer asks a question, but does not give the focal child time to respond, then the peer will need to be taught to wait longer before providing the focal child with help. Frequent progress monitoring also can assist practitioners in: o determining the success of the activity, o recording specific skills that the children are consistently demonstrating, o determining target skills for individual children that can become the focus of future interventions, and o recording change across time (Odom et al., 1993).
Sample child and activity observation forms are included in the Resources section of the module. These forms enable practitioners to observe social interactions as they are occurring and make decisions about the effectiveness of the various intervention strategies being used.
[ Sample Progress Monitoring Form: Activity Observation for Young Children (PDF) ]
Case Study: Austin revisited
During the next intervention activity, Rochelle decides that she will begin collecting progress monitoring data for Austin. She uses a peer-mediated observation checklist during the dramatic play activity that helps her determine the success of the activity and keep track of Austin's social and play behaviors as well as how many prompts were necessary for him to become engaged in play with his peers. At the end of the activity, she also makes notes on the checklist about specific components of the activity that were successful in promoting social play and interactions. For example, Rochelle indicated that Austin did not seem very interested in the restaurant prop box. She thinks that next time she might try the intervention in the block area with dinosaurs since this is one of his favorite activities. Over the next few weeks, Rochelle continues to collect progress monitoring data. The observational information that she collects helps her to make decisions about the specific skills that Austin is consistently using, the skills that should be addressed next, and how his social play skills have changed over time. For example, she has decided that he is consistently exchanging materials, but still has difficulty asking children to play. She plans to focus on this skill during an intervention activity next.
Late Elementary through High School: Peer Social Networking
As children and youth with ASD proceed through late elementary school and into middle and high school, they are faced with increasingly difficult curricular content, more rapid instructional pacing, and increased expectations for academic performance. The peer culture also changes during adolescence with peer relationships becoming more prominent (Carter & Hughes, 2007).

As a result, children and youth with ASD have an increasingly difficult time establishing and maintaining interactions and relationships with peers. Peer social network interventions were developed to help students with ASD gain access to the general curriculum as well as develop peer relationships (Carter & Kennedy, 2006).
Goals of the Intervention
The specific goals of a peer social network are to: o help students with ASD gain meaningful access to peer relationships and the general education curriculum by focusing on specific target skills such as responding to peers, maintaining conversations and interactions, and initiating interactions with peers; o decrease the widening social gap between students with ASD and peers; o provide a network of support to students with ASD to promote independence; and o support the potential development of relationships with peers (Carter & Hughes, 2007;
Carter & Kennedy, 2006; Thiemann, 2007).
Implementing peer social network activities includes specific steps that are described in the following section.
Step 1
Step 1. Selecting Peers
The first step in implementing peer social networks is to initially select peers who will provide social support to the focal student. Selected peers should: o exhibit good social skills, language, and be well-liked by peers; o have similar schedules or academic groupings as the focal child; and o express a willingness to participate.
Teachers also should obtain parent permission, particularly if organized social events take place after school. At least six peers should be selected by teachers to participate so that peer/focal student dyads can be rotated. Teachers should plan to include one to two peers in the peer social network activities for a minimum of three to four months to promote acquisition of skills. After this time period, additional peers can be included to promote generalization of skills (Carter &
Kennedy, 2006; Thiemann, 2007; Utley, Mortweet, & Greenwood, 1997).

Step 2
Step 2. Training Peers
The specific content of the peer training sessions will vary according to the age of the students.
For example, elementary students will need much more direct instruction than middle and high school students. The specific activities for training elementary, middle school, and high school students are provided in the categories within this section of the module
Elementary School
The initial training sessions with elementary school students should take place in an area of the classroom that is quiet and free from distraction. During the training sessions, peers learn specific behaviors that are used to facilitate social interactions during structured activities. They include the following: o initiating interactions, o responding to initiations, o keeping an interaction going, o starting and engaging in conversations (e.g., greetings, topics), o giving and accepting compliments, o taking turns and sharing, o helping others and asking for help, and o including others in activities (Kamps et al., 1992; Thiemann, 2007; Thiemann &
Goldstein, 2001).
Appreciating individual differences.
At the beginning of the training session, the adult trainer teaches the pre-selected peers to recognize and appreciate individual differences. For example, teachers engage the peers in a brief discussion about individual differences and similarities that exist between peers and the focal student. At this time, the teacher also provides descriptions of the focal students including their level of communication, likes, and dislikes.
Identifying preferred activities of focal student.
Teachers then engage peers in a discussion about the specific games and activities that the focal student enjoys. Preferred activities will most likely become the activities in which peer support will be provided. Teachers can use a dry-erase

board or chart paper to record a list of these preferred activities as well as the possible social interactions that could occur between the peers and the focal student.
Generating scripts for interactions with focal student.
Teachers should encourage peers to generate words or phrases that they can say during these preferred activities that match the target skills (responding to peers, maintaining conversations and interactions with peers, initiating interactions) for focal students. These phrases are written on a skill sheet with a label of the target skill at the top, and a picture of two students with topic bubbles. The phrases or words are written in the topic bubbles. A list of prompts and models that might be necessary to promote social interactions also can be generated by teachers and peers at this time (Sasso et al., 1998).
The target skill sheets can be placed in the activity area to provide a "script" for the interaction and provides peers and the focal student with information about what to do, what to say, and how to respond. Scripts can be particularly helpful with school-aged children because they help them organize social information while also providing continuous access to ideas, comments, and questions related to the activity.
After the initial brainstorming session, peers are taught to "look, wait, and listen." This approach allows the focal student time to initiate and/or respond to a peer. The teacher then role plays with a peer to provide an example of how to use the skill in an activity. Peers also have the opportunity to role play with one another to further practice the use of the target skill. Following each role play, the teacher provides feedback and reinforcement for participating in the activity
(Garrison-Harrell, Kamps, & Kravits, 1997; Haring & Breen, 1992; Pierce & Schreibman, 1995;
Thiemann, 2007).
Middle and High School
Because middle and high school students do not remain in one classroom for the entire day and they often have different teachers for specific subjects, a special educator may be the most appropriate person to implement the peer support network interventions. Training middle and high school students involves less direct instruction by the special educator and more active participation in the development of peer network interventions. During initial training sessions, peers are provided with (1) the goals for this intervention and the rationale for their involvement in the intervention activities (to help focal student respond to peers, maintain conversations and interactions with peers, and initiate interactions with peers); (2) an overview of what is expected

of them during their interactions with the focal student; and (3) information about how students with ASD communicate, interact with their environment, and learn (Carter & Kennedy, 2006).
The special educator also may provide descriptions of the focal student's likes and dislikes.
Next, special educators describe basic strategies peers can use to support the focal student during social interactions. These strategies include: o providing frequent, positive feedback; o modeling contextually relevant communication skills; and o facilitating interactions with other peers (Carter & Kennedy, 2006).
Special educators should model the use of these strategies with peers at this time. Peers also can role play with one another to practice skills.
At the conclusion of the activity, the special educator and peers discuss when and where the focal student may need support from peers to engage in social exchanges with others. For instance, peers write down their daily class schedules and match them with the focal student's schedule. A schedule of interactions then is developed based upon the times the focal student needs additional support and when one of the peers is available to provide this support. The special educator and peers also identify methods for prompting and reinforcing the focal student's social interactions. Peers then are provided with a notebook that they will use to record anecdotal information following each intervention activity. The information that peers include in their notebooks will be used during weekly meetings to problem-solve how to further support the focal student as well as ways in which the intervention can be improved. The initial training may occur over two to four class periods, depending on the support needs of the focal student as well as the school activities that will serve as the context for implementing the interventions (Carter &
Kennedy, 2006; Haring & Breen, 1992).
Step 3
Step 3. Supporting Peers
Another important step in the implementation process is to provide ongoing support and feedback to peers. Similar to the training component of the intervention, follow-up support for peers will vary according to the age of the students. The following discussion describes how teachers and other professionals can support peers at different ages.
Elementary school.
After the initial training sessions, specific strategies (providing frequent, positive feedback; modeling contextually relevant communication skills; and facilitating interactions with other peers) that can be used to support the focal student during social interactions are modeled during a planned activity involving peers and the focal student.
Teachers also make any individualized curricular and instructional adaptations that are needed

for the focal student to participate fully. For example, the teacher may provide the focal student with a "script" that was developed by peers prior to the intervention activity. As peers become more proficient at supporting the focal student during daily activities, teachers decrease their level of involvement. This allows peers to assume the primary role of providing social support to the focal student (e.g., clarifying instructions, offering choices, supporting participation at lunch or recess). Peers may continue to need occasional prompting, however, to interact with the focal student during peer social network activities (Carter & Hughes, 2007).
Middle and high school.
Weekly problem-solving meetings are the primary ways in which special educators provide ongoing support and feedback to peers. Classroom teachers also may be included if the peer support interventions are being implemented during their class period.
The purpose of these activities is to encourage peer involvement and input as well as minimize the special educator's role in the scheduling and identification of interaction strategies. Special educators conduct the sessions; however, peers are actively involved through open discussion, problem-solving, and sharing of anecdotal information from their notebooks (Carter & Hughes,
2007). A standard format is recommended to help organize each session and includes the following: o assess the previous week's interactions through an open discussion among the special educator, teachers, and peers; o modify the interaction schedule as needed by peer written and spoken feedback; o identify target skills for focal student that will be addressed; o discuss strategies that can be used by peers to facilitate social interactions between focal student and peers; o role play or model strategies as needed; o assess informally the satisfaction of peers regarding the network meetings and responsibilities; and o reinforce peers' participation through verbal praise, letters home, and occasional group social activities such as having pizza for lunch (Haring & Breen, 1992).
Step 4
Step 4. Implementing in Classroom Settings and Throughout the Day
When planning and implementing peer-mediated interactions with older children and adolescents, several factors should be addressed to promote the success of peer social networks.
They include the following: o creating a supportive social environment,

o providing classroom learning opportunities, o monitoring social interactions, and o using prompts and reinforcement.
Supportive social environment. When implementing a peer social network approach in classrooms, teachers and other practitioners should focus on creating a social environment that supports peer to peer interactions. For example, teachers should keep peer social groups small
(e.g., one to two peers), but continually rotate the peers included in the activities to promote generalization of skills. Seating trained peers next to the focal student during whole-class and small group activities increases the likelihood that interactions with peers will occur.
Learning opportunities.
Peer social networking activities can occur throughout the school day; however, some activities are more likely to support positive social interactions than others. For example, ongoing classroom activities that are particularly conducive to supporting social interactions include the following: o small academic groups such as math and reading; o class centers such as calendar and money activities, computers, puzzles; o special areas such as physical education and library; o card games such as memory and matching games, Go Fish, Uno; and o board games such as Trouble, Kerplunk, and Don't Break the Ice (Kamps et al., 1997;
Thiemann, 2007).
Lunch also is an appropriate time to incorporate peer social networks. However, specific materials and supports must be provided to the focal student and peers in order to successfully facilitate interactions. For example, peers can help teachers generate topic cards that they can use to start conversations with the focal student. Topics should be age-appropriate and focused on the interests of the focal student to promote optimal interactions. Other materials that can be used during lunch time to increase peer social interactions include the following: o open-ended topic starters, o funny photos or pictures, o magazines, o restaurant guides, o photos taken by peers to use as topic starters, and

o school subject/events topic cards (Thiemann, 2007).
Peer social networks also can be used to promote social interactions at recess. Activities such as four square, basketball, Monkey in the Middle, frisbee, and map games are very appropriate activities for supporting peer interactions.
Monitoring social interactions.
As peers assume the responsibility of providing ongoing support to the focal student, teachers should frequently monitor interactions and provide periodic feedback and assistance. This support will ensure that the adaptations, assistance, and interactions taking place are appropriate and relevant for the focal student. Feedback should be provided to peers at the end of each activity, class period, or during weekly problem-solving meetings.
Use of prompts and reinforcement.
The use of prompts and reinforcement is integral to the success of peer social networks and promotes sustainable social interactions across time. With the peer social network approach, prompting and reinforcement are primarily provided by peers to the student with ASD. As such, teachers must focus on teaching peers how and when to deliver specific prompts and reinforcement to the focal student when they are needed. For example, teachers instruct peers to observe focal students during an activity and provide the necessary prompts if they do not interact with a peer or respond to another student's social initiations.
During peer social network activities, prompting may involve cueing the focal student with general verbal prompts while pointing to a written-text or picture cue (e.g., "Mary, what can you say?"). Written-text and picture cue cards prompt social behavior by displaying pictures of students interacting through the use of controlled, short phrases written at the focal student's reading and vocabulary level. The cue cards are functional, age-appropriate, and directly related to target skill for each activity. These prompts are particularly useful with this age group because they are portable and are available to peers throughout the activity.

As the focal student is better able to interact with others, teachers direct peers to withdraw their use of prompts. This withdrawal of prompts is done under the direct supervision of the teacher or special educator. If the focal student is engaging in relatively few social interactions, practitioners should instruct peers to temporarily increase the use of prompting and reinforcement to ensure that social interactions are occurring with a high level of frequency.
Gradual withdrawal of prompts and reinforcement will allow practitioners to periodically assess the progress of individual learners with ASD.
Step 5
Step 5. Extending Initiations Across the Day
The final phase of the implementation process is to extend peer social networks across the day so that students with ASD can begin to generalize skills. Teachers should focus on extending peer social network activities across the day in activities that o occur in natural settings (e.g., recess, lunch, centers, games), o occur in a minimum of two to three different routines each day, o contain a choice of two activities during each session (both peers and the focal students should be given opportunities to choose an activity each day), o use five to eight games rotated every three to four months to promote generalization, o keep the same group of four to six trained peers to promote interpersonal connections and friendships, o are social in nature, and o last a minimum of 10 minutes (Kamps et al., 1997; Thiemann, 2007).
The sample activity planning form helps teachers and special educators organize the focal student's daily schedule and identifies where additional support is needed by the student to engage in social interactions with peers.
Putting it All Together
Throughout this section on older children and adolescents, we have provided you with an overview of PMII that can be used to facilitate social interaction and connections with learners with ASD in later elementary, middle, and high school. In this next section, we provide you with critical information that is needed to effectively implement peer social networks with older students.
A key to the success of peer social networks will be to individualize the instruction to meet the needs of each student. Therefore, the use of specific peer-mediated instructional approaches will

differ according to the skills that need to be taught to individual learners with ASD. The following steps are suggested when planning intervention for individual learners:
1.
assessing the focal child's existing skills, identifying the skills that need to be taught, and determining how the skills will be taught;
2.
implementing the intervention; and
3.
monitoring child progress (NRC, 2001)
Assessment and Identification of Skills
Direct observation will be the primary means for assessing individual student's existing skills.
Specifically, you will want to observe: o the student's communication abilities. How does the student get his/her needs met? Does he/she communicate verbally or nonverbally? o the student's current social behavior, both appropriate and inappropriate. What social behaviors does the student use when interacting with peers and adults (e.g., eye contact, maintaining proximity, common focus)? Does the student engage in any inappropriate behaviors (e.g., hitting, hand-flapping, body rocking) that prevent him/her from interacting with peers and/or adults? o activities throughout the day where the social behaviors currently occurs. During what activities does the student interact most with peers and/or adults? What times of the day are most conducive to implementing peer social networks (e.g., library, computer, lunch, recess)? Where is the social behavior occurring (e.g., recess, lunch, small groups)? o with whom the social behaviors are occurring. Does the student with ASD have a favorite peer? What peer(s) does the student with ASD interact with the most?
[ Sample: Pre-Assessment for Older Children and Adolescents (PDF) ]
The information that you gather for individual students will help you to identify o the skills that need to be addressed, o the strategies that should be used to facilitate the development of skills, o where the intervention should take place, o the peers that should be included in the intervention, o the areas of the classroom or activities that should be used as the context for the intervention, and

o how the intervention will be implemented.
Case Study: Mary: Pre-Assessment
Mary is a special educator who works with six students with autism ranging in age from 12 to 14 years. One of her students, Vince, has good communication skills, but limited social skills. Vince also takes part in some general education classes such as music and physical education. Mary has noticed through informal observations that he seems most isolated at physical education and during lunch. She also has observed that Vince interacts some with one other student, Mark, who does not always respond to his initiations. Mary believes that some of this has to do with Vince's arm flapping and sometimes incoherent speech. Vince does have some verbal language, but it is often hard to understand what he is trying to say. Mary thinks that creating some peer social network activities might be helpful for promoting positive social interactions with peers. Mary decides to conduct some formal observations in the classroom to identify the skills that Vince already has and the skills that he needs to learn in order to interact with peers. During lunch, music, and physical education, Mary notes that Vince does not make eye contact with peers when initiating interactions and often mumbles. Because of this, his peers are unaware that Vince is trying to start a conversation with them. During physical education, Mary notices that Vince spends most of his time pacing back and forth and talking to himself. Some students point and laugh at him. He looks at them, but continues his activity. Every now and then, Vince stops to watch some of the students who are playing a game. In the cafeteria, Mary notes that Vince sits by himself, glancing up occasionally at students at the next table. Mary decides that three specific skills should be addressed to help Vince engage in more social interactions with peers:
(1) making eye contact and using appropriate tone of voice during interactions with others, (2) initiating and maintaining interactions with others, and (3) engaging in conversations with others.
Case Study: Mary: Planning for the Intervention
During her observations of Vince, Mary noted that two students, Mark and Jake, both 13-yearsold, are very social and would be great peers for the intervention activities. Another consideration is that they are in both Vince's physical education class and that they have lunch with Vince. Including Mark in the intervention also would be beneficial because Vince often tries to initiate interactions with him during physical education. As Mary begins to plan for the intervention, she decides to conduct the training session and weekly problem-solving sessions during lunch in her office. She decides to order pizza for the boys as an extra incentive and hopes that this will motivate them to participate. However, first she must get permission from the boys' parents. Because Mary wants to implement the intervention during physical education, she also decides to invite the physical education teacher, Ed, to be involved in the training session and weekly problem-solving sessions. This way he will know exactly what is going on and may be available to provide support to Mark and Jake if needed.

Before the training begins, Mary gathers all of the materials that she will need including notebooks for the boys, note cards, and a dry erase board that can be used to write down the peers' ideas about how to support Vince's social interactions during physical education. During the training, Mary provides the boys with a brief introduction of peer support networks including why they need to be involved, what is expected of them during the activities, and information about ASD. Next, Mary talks with Mark and Jake about how they can support Vince during the activities by providing positive feedback about his attempts at social interactions and modeling communication skills. Finally, Mary tells the boys that Vince really needs help interacting with others during lunch and physical education. She asks them if they have noticed anything about
Vince during these activities. Mark says that Vince "acts weird" during physical education because of the way he "paces and flaps his hands." Jake tells Mary that he has noticed that nobody sits with Vince during lunch and says that other kids are afraid of him. Mary tells the boys that hand flapping is very common in students with ASD. She also tells them that Vince doesn't know how to talk and interact with other students and that there is really no reason for them to be afraid of him. He just needs some help learning how to make friends. Mary, Jake, and
Mark then problem-solve ways to get Vince engaged with them during physical education. Mark offers that he can ask Vince to play soccer. Mary tells him that if Vince does not respond, Mark can give him a picture-text cue card that will show Vince exactly what he can say in return to
Mark. Mary also helps the boys create picture-text cue cards that will prompt him to make eye contact and initiate interactions with either Mark or Jake. At the conclusion of the training session, Mary gives each of the boys a notebook that they can use to write down their thoughts about the intervention activity including how often Vince initiated interactions, responded to peers, and made eye contact. Mary also tells the boys that they can use the notebooks to write down their thoughts and feelings about their participation in the activity.
After the boys leave, Mary and Ed briefly discuss exactly what will happen during the intervention activities. Mary explains that she will come to the class in order to provide Mark and Jake with the support they need to implement the intervention. As all of the boys, including
Vince, become more skilled, she will provide less support so that the interactions between Vince,
Mark, and Jake become more naturalistic.
Summary o Social impairment is a defining feature of autism spectrum disorders. o Peer-mediated instruction and intervention can be effectively used to increase social interactions of children with ASD and typically developing peers across the age range. o Peer-initiation strategies can be used to promote social initiations, responses, and interactions between young children with ASD and peers. o Peer social networks can be used with older children to promote social interactions and relationships.

o Effective implementation of PMII with young children involves selecting appropriate peers, training peers and practicing initiation strategies, extending initiations across the day, and monitoring child progress on a regular basis.
[ Export PDF with Answers | Export PDF without Answers ]
A correct answer should include a statement such as: o o o o
Social impairment is a defining feature of autism.
PMII increases the number of opportunities that children with ASD have for interacting with peers.
PMII helps children with ASD learn important social skills, such as exchanging materials and initiating interactions.
PMII has positive effects on children's' academic, interpersonal, and personal-social development.
A correct answer should include a statement such as: o o o o
Select highly social peers to be included in the training.
Teach peers how to use specific strategies that can be used to facilitate play and social interaction (e.g., organizing play, sharing) through the use of peer-adult and peer-peer role play.
Allow peers to practice skills with focal child in a structured play setting by providing prompts and reinforcement as necessary.
Extend social initiations across the day by embedding social interaction opportunities into ongoing classroom routines and activities so that the focal child has multiple occasions to practice skills in different settings and with different peers.

A correct answer should include a statement such as: o o o
Peer social networks are typically used with older children and adolescents.
Peer social networks involve teaching peers how to maintain physical proximity with focal children throughout the day, establish and maintain eye contact, and initiate social interactions with focal children.
Peer-initiation training approaches are focused on the use of play-based skills (e.g., organizing play, sharing) and are more appropriate for young children (i.e., ages 3 to 8 years).
Answers to this question will vary. Each should be supported by content taken directly from the module regarding a particular peer-mediated intervention strategy.
Answers to this question will vary. Each should be supported by content taken directly from the module regarding a particular peer-mediated intervention strategy.
Activities
Activities on this page of the AIM site are provided at both the introductory and advanced level allowing the user to target specific needs. Activities can be copied and used within an existing platform such as Blackboard or WebCT. In addition, a general email link has been provided.
Participants can send their activity response directly to another person (such as a professor or staff developer) by clicking the "Respond" link below.
Introductory Activities
1.
Implementing PMII: Early Childhood
Using the sample activity script provided in the "Peer-Initiation Training" section, create a new activity that can be used with the children in your classroom.
2.
Implementing PMII: Elementary School and Early Adolescence

Using the sample activity script provided in the "Peer Support Network" section, create a new activity focused on a specific skill that can be used with the students in the classroom.
3.
Extending Initiations across the Day: Early Childhood
Using the activity matrix template presented in the section focused on "Peer-Initiation Training," create an activity matrix for a child with ASD.
4.
Extending Initiations across the Day: Elementary School and Early Adolescence
Using the activity planning form presented in the section focused on "Peer Support Networks," create an activity plan for a student with ASD.
5.
Implementing PMII: Early Childhood Activity 2
Devise the steps you would take to develop an intervention plan for Taylor that could be implemented in his preschool classroom based upon the information provided in the case example below. State in your plan the reasons for including each step in the process.
Example Taylor:
Taylor is a 4-year-old child with autism who spends most of his time wandering around the classroom and has few interactions with typically developing peers. He also has difficulty getting and staying engaged in activities and will remain in an activity for only about a minute before leaving. Upon leaving the activity, he usually wanders around the room while flapping his hands.
Most of the children in the classroom seem hesitant to interact with him because of these behaviors. His teacher, Melissa, has noticed that one peer, Anna, often tries to hold Taylor's hand when they are on the playground; however, he pulls his hand away. Melissa has observed that
Taylor is most engaged with toys that have moving parts such as cars, trucks, and trains. He often lines them up and spins their wheels. Another concern is that Taylor's communication skills are very limited. He only is able to say a few words including "more," "help," "food," and
"drink." Because of his limited play and communicative skills, Melissa is concerned that he will not be able to interact with peers. Melissa would like for Taylor to have more interactions with peers as well as increase his ability to initiate and stay engaged in activities.
6.
Implementing PMII: Elementary School and Early Adolescence Activity 2
Identify the steps you would take to develop an intervention plan for Emily that could be implemented in her classroom based upon the information provided in the case example. Include in your plan the reasons you included each step in the process.
Example Emily:
Emily is a 10-year-old girl with ASD with good verbal and academic skills, but she interacts very little with other children. During small group learning activities throughout the day she does

not initiate conversations or interactions with her peers. On the playground, Emily spends most of her time talking to and staying close to her teacher, Evan, and does not play with the other children. When she is not near Evan, she sits in the grass and watches the other children play. At lunch time, Emily often sits at an empty table in the back of the cafeteria. During informal observations, Evan has noticed that Emily seems very interested in one of the other girls in the class. Emily always wants to be behind this student when they are waiting in line or walking down the hall to another activity. He has tried having Emily sit next to this student during small group activities, but this strategy has not promoted any social interactions between Emily and her peers. A goal on Emily's IEP is to interact more with peers throughout the day; however, Evan is not certain how to accomplish this goal. Emily's mom also is very concerned that Emily is lonely and does not have any friends.
Advanced Activities
1.
Making Adaptations to Existing Activities
Adapt an activity or daily routine to incorporate peer-mediated strategies.
2.
Research Activity
Using the Evidence-Based Practice list provided in the Resource section, read at least two articles on PMII and prepare a summary to share with a parent group or school team.
3.
Teaching Others about PMII
Using what you have learned from the PMII module, design a visual format for presenting this information to others working with a child with ASD. This might include strategies for describing peer-mediated strategies that are useful for different children to general educators, a brochure or fact sheet that explains to parents and siblings how to implement PMII at home and in the community, etc.