This RCT study examined efficacy of a preschool peer social intervention (PPSI) in facilitating social engagement of preschoolers with high-functioning ASD (HFASD; N = 65). HFASD participants were randomly assigned by preschool to a 6-month intervention (play, interaction, or conversation) or a waitlisted-treatment-as-usual control group. Trained on-site therapists led the PPSI in preschools, in small (n = 3–4) mixed (HFASD/typical) groups. Results showed that all intervention groups improved over time, each mainly in its own targeted peer-engagement domain, but the control group even deteriorated on some measures. Intervention groups also showed generalization to untrained domains (adaptive skills) and settings (play complexity during preschool activities). It is advised that individualized needs-based holistic peer intervention, comprising all three domains, should be part of early ASD intervention.
Peer relations are cardinal for children’s development of ample cognitive, linguistic, and social skills (e.g., Hay et al. 2009). Longitudinal evidence shows that individual variations in behavior and in responding to peers’ behavior at early ages predict later social competence (e.g., Hay et al. 2009). Also, lower levels of peer engagement in early childhood have been linked with indicators of poorer social adaptation in the general population (Vaughn et al. 2016). Yet, in the three key domains associated with efficient peer interaction—namely, social interactive skills, play, and conversation (Coplan and Arbeau 2009)—young children with autism spectrum disorder (ASD) do not appear to show the same patterns as their typically developing (TYP) counterparts (e.g., Jordan 2003; Stefanatos and Baron 2011). The early social engagement challenges experienced by young children with ASD may limit their early peer relationship experiences and reduce later peer engagement across development (Manning and Wainwright 2010; Schuler and Wolfberg 2000).
Although peer relations comprise a core social-communicative deficit in ASD (e.g., APA 2013) relevant randomized controlled trials (RCTs) of peer programs for young children with ASD are scarce. The current study aimed to close this research gap by evaluating the efficacy of the preschool peer social intervention (PPSI) in facilitating peer engagement among preschoolers with ASD.