Dataset Information

A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism.

ABSTRACT:

Purpose

This randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism.

Methods

A sample of 71 children with autism were randomized to an intervention-first group (n = 28 analyzed) or waitlist-first (n = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM-2) and the Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention.

Results

POM-2 gains were greatest for intervention-first participants (p = 0.031, d = 0.57). Treatment effects were maintained at 3-month follow-up (p < 0.001-0.05, d = 0.49-0.64). POM-2 scores were not significantly different in the clinic and home settings at follow-up.

Conclusion

Findings support the combination of play, peer-mediation, video-feedback and parent training to enhance pragmatic language in children with autism.

SUBMITTER: Parsons L

PROVIDER: S-EPMC6776827 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism.

Parsons Lauren L Cordier Reinie R Munro Natalie N Joosten Annette A

Frontiers in psychology 20190827

<h4>Purpose</h4>This randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism.<h4>Methods</h4>A sample of 71 children with autism were randomized to an intervention-first group (<i>n</i> = 28 analyzed) or waitlist-first (<i>n</i> = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM- ...[more]

PMID: 31611828

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Project description:BackgroundPeer-mediated intervention (PMI) is an intervention that teaches normally developing peers to help children with autism spectrum disorder (ASD) actively participate in social interactions. Previous studies have shown that PMI applied to school settings is effective for children with ASD, but more multiple-baseline single-subject design. Many questions are still not clear due to the large clinical variability in children with ASD. This study investigated the effectiveness of PMI on social skills of children with ASD at varying symptom levels and analyzed the specific changes.MethodsThis study used a randomized, single-blind, parallel-controlled design to analyze the effect of PMI in a hospital setting. Fifty-five children aged 4-12 years were diagnosed with ASD by clinicians using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and stratified randomly allocated to either the experimental group or the control group using the envelope method. The experimental group utilized PMI, whereas the control group utilized behavioral therapy based on applied behavior analysis (ABA) [early intensive behavioral intervention (EIBI)]. This study primarily utilized the Social Responsiveness Scale (SRS) to evaluate the social performance of autistic children prior to and after the intervention.ResultsFifty-five participants were recruited and analyzed, the experimental group (n=29; mild to moderate n=18, severe n=11) and the control group (n=26; mild to moderate n=15, severe n=11). After the intervention, the experimental group's SRS score fell significantly more than the control group's (t=-3.918, P=0.000), d=-1.043; the mild to moderate subgroup experienced the same situation (H=17.811, P=0.009), d=-1.642. At the same time, the decline in social communication scores was significantly greater in the experimental group compared to the control group (t=-3.869, P=0.000), and the 95% confidence interval was -10.067 to -3.193. The social motivation of the mild-to-moderate subgroup of the experimental group (H=16.894, P=0.011), -3.000 (25th percentile, 75th percentile: -3.000, 0.000), and the behavioral patterns of autism (H=18.150, P=0.006), -3.000 (25th percentile, 75th percentile: -5.000, 0.000), the decreased value was significantly larger.ConclusionsPMI therapy can increase social motivation in children with mild to moderate ASD, minimize undesirable behavior patterns, effectively improve overall social skills and enhance effective social communication with others.Trial registrationChinese Clinical Trial Registry ChiCTR2100049185.

Project description:Using language for social purposes can be a real challenge for children with autism spectrum disorder (ASD) and developmental language disorder (DLD). Despite the positive effects of the Pragmatic Intervention Programme (PICP) already known in both populations, the effects needed to be established with a larger sample and analysed separately for each condition. This study aims to analyse the effectiveness of PICP on preschool-age children with ASD or DLD with pragmatic impairment. A non-randomised controlled trial was conducted. Thirty-six children were assigned to experimental (n = 22) or control group (waiting list) (n = 14). Each child attended 24 PICP-based intervention sessions provided by a speech and language therapist. The primary outcome measure was a Goal Attainment Scale (GAS). The secondary outcomes were Escala de Avaliação de Competências Comunicativas (EAC) and Teste de Linguagem - Avaliação da Linguagem Pré-Escolar (TL-ALPE). The results indicated that all children achieved clinically significant progress in GAS after intervention. Statistically significant differences were observed between the experimental and control groups in the EAC and TL-ALPE after post-intervention assessment (T2). These results reinforce that PICP improves language in preschool-age children with ASD and DLD with pragmatic impairment. Differences between conditions and implications for future studies are discussed.Lay abstractChildren diagnosed with autism spectrum disorder (ASD) and developmental language disorder (DLD) often have difficulties using language in social contexts. An intervention programme for preschool-age children with pragmatic difficulties, called Pragmatic Intervention Programme (PICP), showed positive effects for these children. However, it was important to confirm these effects with a larger group and analyse them separately for each condition. In this study, the effectiveness of the PICP was analysed in preschool-age children with ASD or DLD with difficulties in using language in social contexts. The study was carried out with 36 children. Twenty-two were allocated to an experimental group to receive the PICP-based intervention first, and 14 children were assigned to a control group (waiting list). Each child attended 24 PICP-based intervention sessions provided by a speech and language therapist. Progress was measured using a Goal Attainment Scale (GAS) and other language assessment instruments. The results showed that all children in the experimental group made significant progress in their language competencies, compared to the control group after the intervention. This study confirms that the PICP is effective in improving language competencies in preschool-age children with ASD and DLD with difficulties in using language for social purposes, regardless of their condition. These results emphasise the importance of tailored interventions for these children and point to areas for further research.

Project description:Children with autism spectrum disorder (ASD) have significant difficulty in social functioning to include engaging in natural play with peers. Many children with ASD exhibit significantly less interactive play and more physiological stress during benign social encounters with same-age peers on a playground. Theatrical role-playing and performance with expert role models may provide a unique opportunity for children with ASD to learn to engage with other children in a safe, supportive environment. SENSE Theatre® is a peer-mediated, theater-based program aimed at improving social competence in youth with ASD. Previous studies have shown significant improvements in social and communication skills following SENSE Theatre® intervention. The current project examined play with novel peers and self-reported anxiety before and after participation in SENSE Theatre®. Participants included 77 children between 8 and 16 years with high-functioning (IQ ≥ 70) ASD. The combined sample of three cohorts was randomized to the experimental (EXP, N = 44) or waitlist control (WLC, N = 33) group. Participants in the EXP group received 40 h (10, 4-h sessions) of SENSE Theatre®. The Peer Interaction Paradigm (PIP), an ecologically valid measure of natural play, was administered before and after the intervention. Group Play and Self Play on the playground equipment during solicited (T4) and unsolicited (T1) play were used in the current study. The State Trait Anxiety Scale for Children (STAIC; Spielberger et al., 1983) was used to measure self-reported current and persistent anxiety, respectively. Following treatment, children in the EXP group engaged in significantly more Group Play with novel peers [F(2,73) = 7.78, p = 0.007] and much less Self Play [F(2,73) = 6.70, p = 0.01] during solicited play compared to the WLC group. Regression analysis revealed that pretreatment play and group status were significant predictors of solicited Group Play. Children in the EXP group reported significantly less Trait anxiety following intervention [F(2,71) = 6.87, p = 0.01]; however, State anxiety was comparable. Results corroborate previous findings of significant changes in social and play behavior in children with ASD following the peer-mediated, theater-based intervention. Acting and theatrical performance with supportive role models facilitates social engagement in everyday settings with novel peers and reductions in self-reported anxiety.

Dataset Information

A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism.

Purpose

Methods

Results

Conclusion

Publications

A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism.

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