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Exploring predictors of response to a peer-mediated communication intervention for minimally verbal preschoolers with ASD

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PROJECT SUMMARY This R21 proposal will explore and examine individual child social variables that predict response to a peer-mediated intervention for preschoolers with autism spectrum disorder (ASD) and limited to no spoken communication. This subgroup of children with ASD present with a myriad of social and communication challenges that restrict participation in educational and social environments, and approximately 30% remain minimally verbal by the time they reach kindergarten. Peer-mediated interventions (PMIs) are a widely-used and evidence-based approach to teach social communication to young children with ASD. Recent reports have documented the benefits of incorporating augmentative and alternative communication (e.g., speech-generating devices) into PMIs to increase communication and social interactions with peers in inclusive setttings. Children's social competence with peers is considered a fundamental developmental process that contributes to later language, social-emotional development, and academic achievement. To date, we are not aware of studies identifying specific child variables that predict child response to PMIs. There is evidence of differences in social attention (i.e., visual attention/scanning of social stimuli) for children with ASD compared to typically-developing children. It is probable that among individuals with ASD, variability in performance on measures of social attention (i.e., visual attention to the face) and interest in peers (i.e., showing joint attention and imitation) may be important predictors of response to PMIs. Measuring proximal behaviors such as social attention and peer interest moves beyond prior efforts focusing on more global child variables (e.g., cognitive skills) and should allow for identifying those children who require tailoring of PMIs. The overall objective of this innovative study is to examine potential child variables that predict response to PMI for preschoolers with ASD (n=40) with limited to no spoken communication. Two peers without disabilities will be paired with each child with ASD (n=80 peers). All children will participate in a PMI developed and examined by the PI over a series of empirical studies. The specific aims are to: determine what social variables (i.e., social attention and peer interest) predict response to the PMI at 8 weeks post-treatment and in generalization probes, and to determine if variance in child communication gains, accounted for by the social variables, differs based on the pre-treatment measurement context (i.e., semi-structured peer assessment, naturalistic observations, and eye-tracking paradigms). The team is highly qualified to accomplish these aims as investigators have developed social interventions for children with ASD, created observational methods to assess child-peer communication, and have used eye-tracking technology to measure early attention and communication. Expected outcomes could have important clinical implications for optimizing PMIs (e.g., for children who have poor social attention and peer interest), and identifying stratification variables that could be incorporated into future intervention research for an understudied group of children with ASD.
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