Excerpted by permission from Chapter 7, by Maureen A. Conroy & William H. Brown, of Promoting Social Communication: Children with Developmental Disabilities from Birth to Adolescence, edited by Howard Goldstein, Ph.D., Louise A. Kaczmarek, Ph.D., & Kristina M. English, Ph.D.

Copyright © 2001 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Alexis, a 3-year-old child with spastic cerebral palsy, is enrolled in an inclusive early childhood program. Often during free play, Alexis sits with an adult and watches the other children play from a stationary place in the room. When her classmates approach her to play, she looks at them and wants to play but is unable to respond to their initiations. Alexis’s peers want to play with her, but they don’t know how. Alexis’s significant communication, cognitive, and motor delays interfere with her ability to play with the other children in her class.

Jacob, a 4-year-old with communication delays and behavior problems, is enrolled in a Head Start program. Jacob often fights with his peers during free play over play materials. When he wants to play with a toy, Jacob will grab the toy away from another child. If the child tries to regain possession of the toy, Jacob will hit him or her and scream. Because of his disabilities, Jacob cannot play well with his classmates.

Both Alexis’ and Jacob’s teachers are concerned about the children’s peer-related social-communicative competence. Alexis and Jacob need intervention to facilitate their peer-related social interactions, but their teachers are uncertain about how to encourage their social-communicative development.

Employing an Ecological Perspective for Planning Interventions

Designing interventions from an ecological perspective places children in an environment conducive to peer interaction. Practitioners should plan for and develop an appropriate social and physical context that facilitates social-communicative skills. The physical and social environment should be motivating in order to encourage exploration and peer-related interactions. It is important that the materials in the classroom are within an appropriate developmental range for the children and that peers are familiar and socially responsive. The physical and social environment should be responsive so that when children engage in social-communicative exchanges, these interactions are reciprocated and successful.

Because the ecological environment is critical, both Alexis’ and Jacob’s teachers have included toys and materials that are appropriate for their levels of development and abilities. Alexis’ teacher has adapted materials (e.g., paint brushes, sponges, scoops) at the sand and art tables, two of Alexis’ favorite areas, so that she can manipulate materials independently. Jacob’s teacher has planned for there to be a sufficient number of toys for all children in the classroom to share. In addition, both teachers have made certain that peers in the classroom are socially responsive and model appropriate peer interaction skills.

Hierarchy of Intervention Techniques

As illustrated in Figure 7.3, several levels of interventions can be implemented to foster social-communicative competencies. These interventions vary according to intensity level and should be implemented based on the individual needs of the child as determined through observational assessment. Practitioners should begin intervention using the least intensive strategy and progress to more intense interventions if warranted. Typically, the more significant the needs of individual children, the more intensive intervention strategies are warranted (Odom, McConnell, & McEvoy, 1992). That is, if a child has significant delays in the areas of social and communicative skills, such as Alexis does, the practitioner will most likely need to employ more intensive intervention strategies.

Including children with developmental delays in preschool programs with socially responsive peers (Odom et al., 1996) and in environments that are developmentally appropriate and engaging (Bredekamp & Copple, 1997; Sainato & Carta, 1992) is the initial level of intervention that practitioners should use to facilitate social-communicative competencies. Practitioners should arrange the physical and social environments to facilitate social-communicative exchanges among children with disabilities and their peers. The activities and space should be arranged to encourage active engagement and exploration with peers. Peers should be socially responsive so that when children initiate social-communicative exchanges, their efforts are reciprocated. The materials should be developmentally appropriate for children in order to encourage active engagement. Developing an environment that is developmentally appropriate and fosters active exploration and engagement with socially responsive peers is the initial step for increasing children’s social-communicative competencies. Although almost all children can benefit from this level of intervention, many children need a more intensive level of intervention, such as incidental teaching.

Incidental teaching is a naturalistic intervention strategy that practitioners can use to increase appropriate social-communicative competencies (McGee et al., 1992). There are typically four steps described in the literature for implementing incidental teaching strategies on social behaviors (Brown, McEvoy, & Bishop, 1991). The first step is to target unstructured activities that children with disabilities are showing interest in and are actively exploring. Once a practitioner observes a child with disabilities actively engaging, the next step is to prompt the child to engage in a social-communicative behavior. The third step is for the practitioner to elaborate on the child’s response or to model an appropriate response (if needed). The final step is for the practitioner to provide positive feedback and praise to the child with disabilities. The following is an example of how Alexis’ and Jacob’s teachers use incidental teaching strategies to facilitate their peer-related interactions.

Rebecca and Tyrone are playing in the art area. Alexis’ teacher, Ms. Jennifer, observes Alexis looking at Rebecca and Tyrone playing. Ms. Jennifer asks Alexis “Do you want to play at the art table?” Alexis looks at Ms. Jennifer and then at the art table. In response, Ms. Jennifer verbally prompts Alexis to point toward the art table and provides a gestural model to encourage her to smile indicating that she wants to play. Next, Ms. Jennifer physically guides Alexis to point toward the art table and moves Alexis over to the table. Ms. Jennifer asks Rebecca and Tyrone if they will share their art materials with Alexis. Rebecca says, “Alexis, you can have my sponge. We are making fall leaves.” Alexis begins to make flowers with Rebecca and Tyrone. Ms. Jennifer says, “Alexis, it is nice to see you play with Rebecca and Tyrone.”

Jacob’s teacher, Mr. Timothy, observes Jacob approach his friend, Richard, who is riding a bike on the playground. Mr. Timothy says to Jacob, “Do you want to ride bikes with Richard?” Jacob says, “That is my bike!” Mr. Timothy prompts Jacob, “Ask Richard to share his bike.” Jacob says, “Richard, can I ride the bike?” Richard gives Jacob the bike, and Mr. Timothy praises both Jacob and Richard for sharing their play materials.

Incidental teaching strategies have many advantages for use to facilitate social-communicative exchanges. They are relatively simple to use. The intervention strategies are primarily child directed and natural consequences reinforce and maintain appropriate behaviors. Table 7.2 provides practical suggestions for using incidental teaching strategies to facilitate social-communicative behaviors.

Some children who demonstrate significant developmental delays may need a more intensive intervention strategy than simply rearranging and enhancing the environment or implementing incidental teaching strategies. As illustrated in Figure 7.3, practitioners can also use adult and peer-mediated coaching strategies to teach social-communicative skills. Coaching strategies are intervention strategies that are highly planned, directed, and monitored by the practitioner. They include direct intervention between the practitioner and the children who are demonstrating social-communicative delays. In addition, the practitioner can teach coaching strategies to peers, and in return peers may play the role of an interventionist.

When implementing adult-mediated intervention techniques, the practitioner in the classroom may directly prompt children to use their social and communicative skills to interact with one another and provide positive feedback such as praise to children when they begin to interact. For example, when Alexis’ teacher observes her and a peer playing at the water table side by side rather than cooperatively, her teacher suggests to the children to begin playing together. Once the children begin to share water toys and interact with one another, she praises them for sharing their toys and playing together.

A second adult-mediated strategy that practitioners may use is to conduct social-communicative peer-interaction training groups. The practitioner can lead role-playing groups or group games that facilitate social-communicative exchanges. For example, Jacob’s teacher has chosen to conduct an affection activity to the song “The Farmer in the Dell” to facilitate positive peer-related social interactions among Jacob and his friends. In this activity, Mr. Timothy instructs all the children in the class to show affection toward each other (e.g., hug each other) as they sign the song. After conducting this activity, Mr. Timothy notices that Karin, a peer in Jacob’s class, asks Jacob to share a book during free play, and Jacob responds in a positive manner.

Affection activities are another type of adult-mediated intervention strategy to facilitate social-communicative interactions. A thorough description of affection activities is beyond the scope of this chapter, but further description of affection activities can be found in Brown, Ragland, and Bishop (1989). In addition, the reader is referred to Odom and McConnell’s (1993) Play Time/Social Time and Mize’s (1995) Cognitive-Social Learning Intervention Model for further descriptions of adult- and peer-mediated intervention techniques.

Similar to adult-mediated interventions, peers can be used to teach social-communicative competencies to children with developmental delays. There are several steps practitioners need to consider in order to use peers as interventionists. First, targeting peers who are socially and communicatively sophisticated is important. Peers who have a high level of appropriate social interaction skills and are able to communicate successfully should be targeted as peer interventions. Not only should the practitioner target appropriate skills and strategies and plan the environment to support these skills, but the practitioner will also need to plan for and train peers to implement the interventions. That is, practitioners must train the peers to make social-communicative bids to children with disabilities and be responsive to the children’s bids to social-communicative exchanges. In addition to being responsive, peers need to learn how to be persistent in their social bids. For example, if a peer suggests joint play to a child with disabilities and this child is unresponsive, it is important for the peer to persist with this child to further encourage a social-communicative exchange.

Providing positive feedback to the peers for making social bids to the children targeted for intervention is an important role of the practitioner when implementing this strategy. In addition to training the peers, the practitioner often will need to teach the children with disabilities specific appropriate social-communicative competencies to use when interacting with their peers. Role-playing sessions may be needed to practice and master these skills in a structured environment. After the environment is arranged and training is provided to both the peers and the target children, the practitioner will still need to use adult-mediated prompting and praising to facilitate social-communicative interactions. After structuring and adapting the environment and implementing incidental teaching strategies, Alexis’ teacher observes that her social interactions still need improvement. She decides to implement a peer-directed coaching strategy.

Ms. Jennifer chooses several children in the class to become better friends with Alexis. Using role-playing, Ms. Jennifer teaches these children how to interact with Alexis by instructing them to “read” Alexis’s communication skills such as looking and smiling. She also teaches the peers to encourage Alexis to respond to their initiations and persist at interacting with her. Following the role-play activity, Ms. Jennifer coaches the peers to ask Alexis to play house with them during free play. She prompts both the peers and Alexis to play together and provides feedback and praise as they begin to interact.

Coaching interventions have been demonstrated to successfully increase social and communicative behaviors in young children with developmental delays. There are a variety of techniques to use when implementing coaching interventions (e.g., English, Goldstein, Kaczmarek, & Shafer, 1996; English et al., 1997). Table 7.3 provides an overview of factors that the practitioner will want to consider when implementing peer-mediated interventions that facilitate social-communicative competencies.