Naturalistic behavioral interventions for social-communication skills in young children with autism spectrum disorder
Dubin, Ashley Heather
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Significant social communication impairments, including deficits in joint attention (JA) are present in individuals with autism spectrum disorder (ASD) and impede development across several aspects of functioning (American Psychiatric Association [APA], 2013). Much research has been devoted to evaluating interventions designed to improve early social communication deficits, as improvement in these pivotal skills is thought to lead to overall improvement in the developmental trajectory (e.g., Mundy & Crowson, 1997). The purpose of the following two studies was to synthesize the extant research on naturalistic behavioral interventions designed to target early social communication skills for children with ASD and further the research base by conducting an empirical investigation of one such naturalistic behavioral intervention, Prelinguistic Milieu Teaching (PMT), implemented in preschool classrooms with children with or at risk for ASD. The first study was a systematic review of studies examining the effects of naturalistic behavioral interventions on prelinguistic social communication skills in children with ASD. Results suggested evidence for interventions effects; however, methodological issues precluded interpretation of effects in several studies. Information was provided regarding study quality, the students and behaviors for which naturalistic interventions have demonstrated functional relations, information about components of effective interventions as well as generalization and maintenance of effects. In the second study, PMT was empirically investigated within the context of a multiple baseline design across participants. Results provide support for the use of PMT in preschool classrooms, as all three participants exhibited gains in intentional communication skills upon implementation. Furthermore, although PMT was implemented by graduate students, teachers were observed to utilize some strategies consistent with PMT during teacher-child play samples. Results from the systematic literature review and empirical investigation of PMT implemented in preschool classrooms have implications for future research and practice in the area of intervention to improve prelinguistic social communication skills for students with or at risk for ASD.