Students with autism often require support in developing communication, social, and academic skills (Chan et al., 2009). One treatment approach, peer-mediated intervention (PMI), utilizes neurotypical peers to support students with autism in building these skills (Laushey & Heflin, 2000). Though PMI can take different forms, it generally involves teaching neurotypical peers to perform a variety of tasks, such as modeling, prompting, and reinforcing appropriate behavior across social (e.g., lunch time) or academic (e.g., classroom) contexts. PMI is an established evidence-based practice for children with autism from three- to 18-years-old (National Autism Center, 2015; Steinbrenner et al., 2020). They have repeatedly shown to be effective for increasing both social and academic skills. Incorporating intervention into inclusion settings (e.g., general education classrooms) through PMIs allows for more opportunities for generalization of functional skills, as well as increased independence, community participation, and opportunities to build relationships with peers.
One variation on PMIs that can be easily incorporated into classrooms is peer support arrangements. Peer support arrangements involve one-to-one tutoring between a student with autism and a neurotypical peer with the goal of increasing the focus student’s access to the general education curriculum while also facilitating effective social interactions within these settings (Carter & Kennedy, 2006). While most research focuses on PMIs for the development of social skills, the literature on peer support arrangements is particularly rich in its focus on academic skills. For instance, Carter and colleagues (2016) found that compared to students in the control group who received exclusively adult support, students in the peer support arrangement intervention showed significant increases in academic engagement. Moreover, they found increases in active participation and decreases in the amount of time students spent pulled out of the classroom. In another study by Carter and colleagues (2005), researchers examined differences in active academic engagement (e.g., taking notes, reading, or completing an assignment) between students with autism who had one typically developing peer and those that had two typically developing peers in their peer support arrangements. Results demonstrated that those with two typically developing peers in their peer support arrangement had the greatest increases in the time they spent actively engaged in instructional activities. Taken together, these studies demonstrated that (a) peer support arrangements are effective in promoting academic engagement and (b) the efficacy of peer support arrangements for the promotion of academic skills can even be enhanced by adding another typically developing peer.
As stated earlier, in peer support arrangements, peers serve as the primary interventionists. They are taught to implement a peer support plan and promote participation and social interaction. Academically, this includes duties such as encouraging student engagement, praising participation, and helping with tasks related to class such as discussing assignments, brainstorming ideas, scribing responses, reviewing work, and asking comprehension questions (Schaefer et al., 2018). These supports are individually tailored and evaluated regularly using systematic data collection. This shifts the adult role from one-on-one involvement to a monitoring support role (e.g., offering feedback and monitoring peers). In addition to the academic benefits, this can help reduce autism stigma as well as promote independence and peer relationships. Further, there is evidence to indicate that peers who participate in these interventions may also reap academic benefits from their participation (Cushing & Kennedy, 1997; Shukla et al., 1998).
While peers deliver the intervention within peer support arrangements, teachers or paraprofessionals play an important role in facilitating the intervention (Brock and Carter, 2016; Brock et al., 2016). School personnel seeking to implement peer support arrangements should follow these steps:
- Identify Peers: Selecting the appropriate peers is essential to the success of the intervention. Peers should be recruited from the same classroom as the focus student and should be willing participants. They can be recruited via announcements, service clubs, or teacher nominations. Selected peers should have good conversational skills and be willing to engage with students with autism spectrum disorder (ASD; Bambara et al., 2018). It can also be beneficial to select peers with common interests to the focus student. There is emerging research focusing on the peers who serve as interventionists in these arrangements. Effective peers for this intervention often have higher levels of empathy, as well as a greater openness towards ASD (Laghi et al., 2018). Carter and colleagues (2001) also identified a significantly greater willingness to interact with people with disabilities in peers who volunteered, as well as those with more previous contact with students with disabilities.
- Develop a Peer Support Plan: A peer support plan is individually designed to promote social and academic achievement and sets individualized student goals based on needs. Teachers collaborate with other school professionals to create the peer support plan. The peer support plan outlines the student’s individual goal, as well as specific ways that peers can provide support in different kinds of classroom activities. Plans can include both social supports, such as modeling appropriate social skills or encouraging the student to talk with classmates, and academic supports. Academic supports include encouraging and praising engagement and participation, helping with in class tasks, brainstorming, scribing, discussing, redirecting, or working jointly on tasks. The individualized plan is tailored to match needs of each student and defines the roles of both facilitating adults and specified peer support behaviors.
- Train Peers: Prior to implementing the intervention, peers are oriented to the intervention and trained on the strategies they need to adapt class activities and instruction in action. This initial training involves an introduction to the intervention and rationale for the purpose of the peer support arrangement. Peers are oriented to their roles and the general goals of the intervention and receive background information about each other and the focus student. Expectations inside and outside the classroom are discussed, as well as the specific support strategies outlined in the peer support plan. Modeling and role play are incorporated throughout the training and peers are given coaching and feedback on their implementation of the support strategies. Other topics of focus during this initial training include how to seek adult help, confidentiality and respectful language, and feedback.
- Coach and Supervise Peers: Throughout the duration of the intervention, peers should be coached and supervised. In doing this, the adult transitions to the role of “hidden safety support.” After each session, implementers meet with peers briefly (i.e., 5–10 min). If an observation or recording was done of the session, this can be reviewed with the peer. The teacher or paraprofessional responds to the peer’s use of the goal-setting strategy, provides feedback on performance, and engages in any sort of role-play or modeling to remediate any difficulties observed. Further, this is an opportunity for peers to voice comments or concerns, and receive support from the adult. Data are collected throughout the intervention on the target behaviors outlined in the peer support plan and are reviewed with peers. Meetings are continued until a clear and consistent change in behavior (the target goal) is detected.
Peer support arrangements pose a practical and effective intervention to support students with autism in the natural environment. Following the steps outlined above, teachers and paraprofessionals can implement peer support arrangements in the general education classroom. By recruiting peers as interventionists in inclusive settings, PMIs, and peer support arrangements, provide increased opportunity for social interactions and generalization of skills.
Alyssa Balzarotti, MEd, RBT, and Christina Wood, MEd, BCBA, are Registered Behavior Technicians and Elise Settanni, MEd, BCBA, LBS, is a Behavior Analyst with Lehigh University Autism Services.
For information about Lehigh University Autism Services, please contact our office via phone at (610) 758-2441 or visit our website.
Bambara, L.M., Thomas, A., Chovanes, J., & Cole, C.L. (2018). Peer-Mediated Intervention: Enhancing the social conversational skills of adolescents with autism spectrum disorder. TEACHING Exceptional Children, 51, 7-17.
Brock, M. E., Biggs, E. E., Carter, E. W., Cattey, G. N., & Raley, K. S. (2016). Implementation and generalization of peer support arrangements for students with severe disabilities in inclusive classrooms. The Journal of Special Education, 49(4), 221–232. https://doi.org/10.1177/0022466915594368
Brock, M. E., & Carter, E. W. (2016). Efficacy of teachers training paraprofessionals to implement peer support arrangements. Exceptional Children, 82(3), 354–371. https://doi.org/10.1177/0014402915585564
Carter, E. W., Hughes, C., Copeland, S. R., & Breen, C. (2001). Differences between high school students who do and do not volunteer to participate in peer interaction programs. Journal of the Association for Persons With Severe Handicaps, 26, 229–239. https://doi.org/10.2511/rpsd.26.4.229
Carter, E. W., Asmus, J., Moss, C. K., Biggs, E. E., Bolt, D. M., Born, T. L., Brock, M. E., Cattey, G. N., Chen, R., Cooney, M., Fesperman, E., Hochman, J. M., Huber, H. B., Lequia, J. L., Lyons, G., Moyseenko, K. A., Riesch, L. M., Shalev, R. A., Vincent, L. B., & Weir, K. (2016). Randomized evaluation of peer support arrangements to support the inclusion of high school students with severe disabilities. Exceptional Children, 82(2), 209–233.
Carter, E. W., Cushing, L. S., Clark, N. M., & Kennedy, C. H. (2005). Effects of peer support interventions on students’ access to the general curriculum and social interactions. Research and Practice for Persons with Severe Disabilities, 30(1), 15–25
Carter, E. W., & Kennedy, C. H. (2006). Promoting access to the general curriculum using peer support strategies. Research and Practice for Persons with Severe Disabilities, 31(4), 284–292.
Chan, J. M., Lang, R., Rispoli, M., O’Reilly, M., Sigafoos, J., & Cole, H. (2009). Use of peer-mediated interventions in the treatment of autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 3(4), 876-889.
Cushing, L. S., & Kennedy, C. H. (1997). Academic effects of providing peer support in general education classrooms on students without disabilities. Journal of Applied Behavior Analysis, 30(1), 139–151. https://doi.org/10.1901/jaba.1997.30-139
Laghi, F., Lonigro, A., Pallini, S., & Baiocco, R. (2018). Peer buddies in the classroom: The effects on spontaneous conversations in students with autism spectrum disorder. Child & Youth Care Forum, 47(12), 517–536. https://doi.org/10.1007/s10566-018-9449-y
Laushey, K. M., & Heflin, L. J. (2000). Enhancing social skills of kindergarten children with autism through the training of multiple peers as tutors. Journal of Autism and Developmental Disorders, 30, 183–193.
National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: Author
Schaefer, J. M., Cannella-Malone, H., & Brock, M. E. (2018). Effects of peer support arrangements across instructional formats and environments for students with severe disabilities. Remedial and Special Education, 39(1), 3–14. https://doi.org/10.1177/0741932517727865
Shukla, S., Kennedy, C. H., & Cushing, L. S. (1998). Adult influence on the participation of peers without disabilities in peer support programs. Journal of Behavioral Education, 8(4), 397–413. https://doi.org/10.1023/A:1022801215119
Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy-Özkan, S., & Savage, M. N. (2020). Evidence-based practices for children, youth, and young adults with autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team.