Peer Mediated Instruction and Intervention (PMII)?
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.
Who Can Use PMII and How Does it Work?
Who Can Use PMII?
This approach can be used by a variety of professionals including teachers, special
educators, therapists, and classroom assistants in different educational and communitybased environments.
Who Would Benefit Most from PMII?
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.
How Does it Work?
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.
PMII for Early Childhood: Peer Initiation Training
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, VoglerElias, & 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).
Steps for Implementation
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.
Discussion Questions
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1. Why are peer-mediated intervention approaches important
for children with ASD?
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.
2. How would you go about training peers using a peerinitation training approach?
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.
3. How are peer social networks different from the peerinitiation training approach?
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).
4. Several types of peer-mediated intervention strategies were
presented in this module. Which do you feel would be most
beneficial to the child with ASD?
Answers to this question will vary. Each should be supported by content taken
directly from the module regarding a particular peer-mediated intervention
strategy.
5. Continuing your answer to Question 4, what steps would
you take prior to implementation to promote its success?
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.