Peer Relationships Among Children With ASD: Interventions Targeting Social Acceptance, Friendships, and Peer Networks

Background: Developing meaningful friendships is an important protective factor for young children (Ladd, Kochenderfer, & Coleman, 1996; Rubin, LeMare, & Lollis, 1990) and is a skill with which children with autism spectrum disorder (ASD) often struggle (Chamberlain et al., 2007). Therefore, interventions targeting those skills play an important part in improving social outcomes. Aim: The purpose of this review is to describe and examine the effectiveness of intervention trials that have targeted the development of friendship, peer networks, and discrete social skills (e.g., engagement, social initiations) in young children with ASD. Method: Both single subject research designs (SSRDs) and randomized controlled trials (RCTs) examining interventions were evaluated for methodological quality (Logan, Hickman, Harris, & Heriza, 2008; Higgins & Green, 2011). Data regarding participant and study characteristics (i.e., age, gender, measures, intervention setting, approach, and effect sizes) were extracted from all included studies. Results: 10 RCTs and 24 SSRDs with a combined sample size of 956 children were included. The majority of the interventions took place in children's schools and consistent effects were noted in increasing children's engagement with peers, especially when peer-mediated interventions (PMIs) were used. Less consistent effects were found for initiating, and responding to peers' social bids. Discussion: PMIs appear to be a promising intervention approach to help children with ASD to engage with peers. Targeted interventions in general saw larger effects than comprehensive intervention packages. There was also a trend towards the implementation of interventions in natural contexts such as schools and the use of community members as the agent of intervention, improving the generalizability of the interventions. Understanding which approaches and intervention components work for specific targets remains an important direction for future research, there is also a clear need to evaluate critical outcomes such as friendship development, as friendship was rarely explicitly measured.