Using Behavioral Skills Training to Teach Peer Models

Covey, A., Li, T., & Alber-Morgan, S. R. (2021). Using behavioral skills training to teach peer models: Effects on interactive play for students with moderate to severe disabilities. Education & Treatment of Children, 44(1), 19-30. https://doi.org/10.1007/s43494-020-00034-y

Reviewed by: Xinyue Wang, BA, & Robert H. LaRue, PhD
Graduate School of Applied and Professional Psychology, Rutgers University

Why research this topic?

Procedures to teach specific skills for individuals with autism Playing with friends is an essential part of childhood that all children, including those with disabilities, should have the opportunity to experience. Research shows that when children play together, they develop crucial life skills, including better communication, increased independence across settings, and stronger social connections (Frey & Kaiser, 2011). However, many children with moderate to severe developmental disabilities experience ongoing challenges with interactive play with their peers. These challenges can include difficulty initiating play, maintaining engagement in play activities, understanding play rules, and responding to social cues from playmates (e.g., Simpson & Bui, 2016).

Difficulties with interactive play can have far-reaching effects. For young children, limited play skills can affect their ability to make friends in preschool and early elementary school. As children enter the middle school years, play and social interaction challenges may lead to fewer invitations to birthday parties or after-school activities. By high school, these difficulties can result in reduced participation in clubs, sports, or other social activities that typically help teenagers build important relationship skills. When children struggle with cooperative play activities, they often have fewer opportunities to practice important social, language, and thinking skills in natural settings. Failure to develop these cooperative skills in childhood may create challenges as children grow older. These “soft skills”, such as taking turns, sharing, and responding appropriately to others, become especially important for jobs that require customer interaction (e.g., the service industry) and play a critical role in future employment prospects. Prior research has shown that children with disabilities can learn appropriate play behavior through direct instruction from adults (e.g., Jung and Sainato, 2013; Lifter et al., 2011). While these adult-led interventions have proven effective for teaching basic play skills, they may not provide the same natural social opportunities as peer interaction. The current study explored a novel approach to teach typically-developing children to engage with their peers with disabilities during play activities. This peer-to-peer approach has potential advantages, as it creates more natural social interactions and provides practice opportunities throughout the school day.

What did the researchers do?

The study was conducted in a public school in the Midwestern United States, within a self-contained special education classroom serving students with various developmental disabilities. The classroom included one certified special education teacher, two assistants, and six to eight students with disabilities. Eight participants were included in the study (four peer helpers and four target students). Target students were considered for inclusion if they had IEP goals related to play skills. Peer helpers were selected based on their previous positive volunteer experience in the special education classroom. Peer helpers and target students were paired with each other randomly. The study used a multiple baseline design, which means the researchers introduced the training at different times for different participants. This approach helped show that improvements in play skills happened because of the training rather than by chance. They also planned follow-up observations to see if the improvements would last over time.

The peer helpers who led the teaching throughout the study were all sixth-grade girls aged 12 who had previously volunteered in the special education classroom. The four target students presented with varied diagnoses and ability levels. Kevin was an 8-year-old boy with autism who used an iPad with a specialized communication app. Caleb was an 8-year-old diagnosed with intellectual disability and ADHD and used both spoken language and an iPad to communicate. Quinn was a 6-year-old boy with cerebral palsy who used an augmentative communication device. Rachel was a 6-year-old girl diagnosed with autism and MPS III who used spoken language and picture symbols to communicate.

The researchers developed a comprehensive 16-step guide for interactive play. The guide had three main phases. In the first phase, peer helpers learned how to start play sessions by inviting students, showing toys, and using gentle prompts to encourage sitting together. The second phase focused on maintaining play interactions, teaching peer helpers to wait patiently for responses, and offering specific praise for any participation. The final phase described strategies for handling challenges, such as when students left the activity area.

The peer helpers were trained to implement three specific play activities: rolling a ball back and forth, building with blocks, and racing toy cars. The training process, called behavioral skills training (BST), included direct instruction about why each step mattered, demonstration of how to perform each step, practice opportunities through role-playing, and immediate feedback about what went well and what needed improvement. To illustrate how detailed this training was, consider the steps for a simple ball-rolling activity: First, the peer helper would position themselves at an appropriate distance and gain their partner’s attention. They would then demonstrate rolling the ball while saying “Roll the ball,” wait up to 10 seconds for a response, and provide encouragement. If their partner didn’t respond, they would show the action again, possibly using hand-over-hand guidance if needed. Throughout the activity, they learned to praise any attempt at participation.

The teacher conducted two to three training sessions per week, each lasting about 20 minutes, in a designated classroom area. During these sessions, the teacher first explained each step’s importance, demonstrated the proper technique, and then had peer helpers practice through role-playing while providing immediate feedback. During the interactive play activity, the researchers monitored how accurately the peer helpers followed the steps and the amount of time the target students were engaged in the play activity. The researchers conducted follow-up observations at 5, 8, and 13 weeks after the training ended to determine if the effects would maintain over time. In addition, peer helpers were also paired with novel students to see if the effects would generalize across partners.

What did the researchers find?

The results indicated that both the peer helpers and the students with disabilities showed significant improvements in the target skills. Prior to training, the performance of peer helpers was inconsistent. Two of the helpers, Bethany and Nicole, correctly completed 23% and 26% of the steps during baseline. Abby and Megan performed slightly better, averaging 46% and 47% respectively during baseline. After training, all four peer helpers demonstrated dramatic improvements in implementing the 16-step play protocol. Their average performance ranged from 80 to 100% of the steps implemented correctly following training. This improvement remained stable throughout the intervention phase and during follow-up checks up to 13 weeks later. The peer helpers also successfully transferred their skills to new activities not specifically practiced during training, including games like Poppa’s Pizza Topple, Legos, Jenga, and Spill the Beans. These findings suggested they could also use their new skills with different partners and in novel situations. The impact on the students with disabilities was also significant. Caleb’s interactive play increased from an average of 6% of intervals during baseline to 62% of intervals during intervention, and further improved to 73% during maintenance checks. Quinn showed an increase from 14% to 78% of intervals engaged in play, while maintaining at 81% during follow-up. Rachel improved from 9% to 43% of intervals engaged in interactive play during intervention. However, her interactive play did decrease to 29% during maintenance observation. Kevin demonstrated dramatic improvement, increasing from 18% to 80% of intervals with interactive play during intervention, and maintaining at 88% of intervals during follow-up.

What are the strengths and limitations of the study?

This study has several strengths. First, it was conducted in a real classroom setting by a practicing special education teacher, showing that the intervention can work in typical school environments. In addition, the teacher was able to implement the training during regular school hours without disrupting normal classroom routines. The study also showed strong experimental control through its multiple baseline design, meaning the researchers could be confident that the improvements were due to the training rather than other factors. The maintenance data, collected up to 13 weeks after the intervention, showed that the improvements lasted over time without additional training. The authors also noted that the study has strong social validity as the peer models reported feeling more confident and better equipped to help their peers with disabilities after the training.

However, there were some notable limitations to this study. The four to six-year age gap between the peer helpers and target students was larger than ideal, as children typically play with peers closer to their own age. The researchers noted that future studies should examine whether the intervention works equally well with same-age peers. The way students were paired was another limitation. Rather than matching students based on personalities, interests, or skills, pairs were assigned randomly. A more strategic pairing process might have produced stronger treatment effects. The researchers also noted that the way activities were selected (sometimes by adults, sometimes by students) might have influenced the results.

What do the results mean?

For parents and caregivers, this research offers hope and practical guidance. The step-by-step approach used in this study could be adapted for various settings, including school-based peer buddy programs, community recreation programs, therapeutic playgroups, informal neighborhood play opportunities, and sibling interactions at home. Importantly, the success of simple activities like rolling balls and building with blocks suggests that expensive or specialized equipment is unnecessary for meaningful play interaction.

The study also highlights important elements for successful play interaction. These include clear, systematic instruction for peer helpers, opportunities for practice with feedback, use of familiar, engaging activities, consistent praise and encouragement, and a gradual increase in the complexity of interactions. Perhaps most importantly, this research challenges the assumption that children with moderate to severe disabilities cannot engage in meaningful play with peers. For children with disabilities, the intervention provides opportunities to develop play skills, social communication, and friendships in natural, everyday settings. For typically developing peers, the experience can help to develop empathy, leadership skills, and a better understanding of individual differences. Looking forward, this approach has exciting implications for children’s future development. The social interactions and communication practice during play can help children build skills needed for success in school, community participation, and employment settings. Parents can use these findings to advocate for similar programs in their children’s schools or to guide interactions between siblings or neighborhood friends at home, helping create more inclusive environments that benefit all children.

References

Frey, J. R., & Kaiser, A. P. (2011). The use of play expansions to increase the diversity and complexity of object play in young children with disabilities. Topics in Early Childhood Special Education, 31, 99–111. https://doi.org/10.1177/0271121410378758.

Jung, S., & Sainato, D. M. (2013). Teaching play skills to young children with autism. Journal of Intellectual & Developmental Disability, 38(1), 74–90. https://doi.org/10.3109/13668250.2012.732220.

Lifter, K., Foster-Sanda, S., Arzamarski, C., Briesch, J., & McClure, E. (2011). Overview of play: Its uses and importance in early intervention/early childhood special education. Infants & Young Children, 24(3), 225–245. https://doi.org/10.1097/IYC.0b013e31821e995c.

Simpson, L. A., & Bui, Y. (2016). Effects of a peer-mediated intervention on social interactions of students with low-functioning autism and perceptions of typical peers. Education & Training in Autism & Developmental Disabilities, 51(2), 162–178. https://doi.org/10.1177/0271121419839136.

Reference for this article:

Wang, X., & LaRue, R. H. (2025). Research synopsis: Using behavioral skills training to teach peer models: Effects on interactive play for students with moderate to severe disabilities. Science in Autism Treatment, 23(2).

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Using Behavioral Skills Training to Teach Peer Models: Effects on Interactive Play for Students with Moderate to Severe Disabilities