Autism Intervention Research

Network – Behavioral Health

(AIR-B)

Remaking
Recess

By: Mark Kretzmann, Jill Locke & Connie Kasari

Illustrations by: Bere Muñiz and Graphikslava

Created by Mark Kretzmann, Jill Locke and the Kasari Research Group UCLA for the
Autism Intervention Research Network on Behavioral Health (AIR–B).

Illustrations by: Bere Muñiz and Graphikslava

The AIR–B network is supported by grant UA3 MC 11055 from the Maternal and
Child Health Research Program, Maternal and Child Health Bureau, Health Resources
and Services Administration, Department of Health and Human Services.

For more information go to www.asdweb.org or email [email protected].

Copyright 2013

2 3
Treatment Overview:

The purpose of this intervention is to improve the social inclusion of elementary– Why?
aged children with autism spectrum disorder through facilitated interactions with Research shows that successful social interactions between children result in
their peers. We would like to teach school personnel to facilitate opportunities friendship development over time. This is critical for children with autism as so-
for their students with autism to sustain periods of engagement with their peers cialization is one of their most challenging and least malleable core deficits. Many
during unstructured times in hopes of improving the social quality and quantity high-functioning children with autism experience loneliness and social anxiety,
of their interactions with peers at school. but often lack the social skills and opportunity to successfully engage with their
peers at school. Thus, in this intervention, we are targeting social engagement.

Philosophy
We believe the partnership between the school personnel and the professional Strategies
is important. As all children and school personnel are unique individuals, we We will go over specific strategies for you to use on the playground and in the
believe in an individualized intervention approach based upon an underlying cafeteria. Some will seem difficult, some will seem easy, some will even be strategies
general theory. We believe in providing school personnel with naturalistic strate- that you already use. Our previous research has shown these strategies are effective
gies that they can use within their daily routine and interactions with their student in improving children’s social involvement.
with autism and his/her peers. Thus, we believe that these intervention strategies
that target social engagement should complement the student’s other programs
and activities at school.

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4 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 5
Playground
Engagement States

In order to implement the strategies in this guide you will need to be able to
identify the state of peer engagement for a particular child or group.

Engagement States: Parallel The child and peer(s) are engaged

aware in similar activity and mutually
Solitary/ The child appears uninvolved with aware of each other.
Isolated peers and plays alone with no other
(Alone) children.

Joint The child and peer(s) direct social

engagement behavior with one another (e.g. the
Onlooker The child has a one–way awareness child and peer(s) offer objects,
(Watching) of another child or group of children have a conversation, exchange
who is farther away than 3 feet. turns in an activity like reading a
comic book, drawing, origami, etc.).

Games The child participates in an

Parallel The child and peer are engaged in with rules organized game with clear rules
a similar activity but there is no and/or engages in fantasy or
social behavior. pretend play with clearly defined
roles set by the child or his/her
peers. A game has to be with at
least one other child.

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6 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 7
Transitioning to an Engaging
Activity and Setting up
Initial Steps to Support Peer Engagement during Recess Time:
During transitions to play and lunch prime children to engage with peers:
Clearly and repeatedly state that the children should be thinking about whom 1. Circulate the play area, observing children as they play.
they will play with. 2. Scan the playground
Play a game or create a scenario during the transition that will have children • Actively seek out the target child on the yard especially if he/she may
engaged with peers as they arrive on the playground. be experiencing some difficulty.
Examples: 3. Facilitate an Activity/Game
1. Transition the children in pairs with a conversation topic. • Be prepared with materials you may need to start an activity/game that is
2. Play Follow the Leader or Simon says on the way to the playground. interesting to the target child.

3. Have the children pretend to be animals or characters as the group • Allow the target child the opportunity to initiate his/her own activities/
walks together. games with peers—it’s okay to pause.

Notice children who are slow to start to play and see if you can help them.
Recess is short and so we want to help children make the most of their
precious time to socialize.

• If the target child has difficulty finding an activity/game, initiate a game with
the target child and a group of children.
• Provide support and structure for the target child and his/her peers.
4. Remember to model having fun!
• Always demonstrate positive affect toward the children.
• Pay close attention to your body language, facial expressions, tone of voice,
language, etc.
• Be energetic!
Copyright 2013. Created by Kasari Research Group UCLA for the Autism Intervention Research Network
8 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 9
Providing Popular,
Developmentally Appropriate
Games and Activities
Following the Child’s Choice of Activity Facilitating Engagement
• This will ensure the target child will be motivated to interact. • Ensure all children understand the activity/game rules.
• Be sure the activity/game is developmentally and age appropriate for children. • Participate in the game until the game gets rolling (e.g. claim a role in the
• Build off the child’s strengths. game).

• Ensure that the activity/game will not be over–stimulating for the child. • Model appropriate behavior (e.g. turn taking, waiting in line, good
sportsmanship, etc.).
• Show interest in the activity the target child selects.
• Praise children’s positive behaviors (e.g. great hit, you run so fast, awesome
sharing the ball, etc.).

Sometimes it is helpful to pretend you do not know the rules of the game.
Nominate a child to explain the rules to you and the group.
Remind children to pay attention and listen to the rules.

Copyright 2013. Created by Kasari Research Group UCLA for the Autism Intervention Research Network
10 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 11
In Vivo Social Skills
Instruction

Direct Instruction of Social Skills in Vivo Offer direct instruction on appropriate social skills.
• Be neutral in your tone when speaking to the target child and his/her peers. • Use specific instruction that is limited to what is most useful to the children
• Use clear, simple cues to direct or redirect children along with nonverbal in the moment.
gestures. • Use visuals as needed (e.g. draw a picture, use pictures, etc.).
• Stay near the target child as he/she is engaging with peers—participate as • Address the issue immediately and briefly.
needed! Remember to address inappropriate/problematic behavior by ignoring those
• Pay attention to the engagement to see whether “instructionally ripe moments” behaviors and reinforcing appropriate behaviors.
appear. Instructionally ripe moments are defined as inappropriate behaviors Correct their behavior on the playground—be explicit—validate what they are
children engage in that occur from interacting/engaging with peers doing and tell them what they should be doing instead (e.g. “I see that you are...,
that may harm children’s social experiences/relationships with peers. but I need you to...”) and continue the interaction.
These include:
Physically aggressive behaviors towards others Remember, punishment teaches children what you don’t want them to do.
Verbally aggressive behaviors towards others Instead, focus on teaching the children what you do want them to do and provide
Protesting when doesn’t get his/her way reinforcement when they exhibit the appropriate behavior.
Laughing when someone gets hurt or out of a game
Inappropriate nonverbal cues (e.g. rolling eyes, gasping, etc.)
Incessant verbal behavior

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12 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 13
Facilitating Peer Initiating and Responding

Helping the Target Child Initiate Helping Peers Initiate and Respond
Conversations and Respond to Peers to the Target Child

Remind the Target Child To: Remind Peers To:

• Pay attention to who he/she is • Be patient—give the target child

Conversations with Peers – Help children have conversations with each talking to. a few moments to respond.
other (defined as four or more back and forth exchanges between children). • Listen before trying to join an Sometimes it takes people a little
existing conversation. bit longer.
Conversation Starters – strategies that assist children in initiating and • Stay near the person he/she is • Be persistent—politely try again
maintaining conversations and improving reciprocal interactions with peers. talking to—not too close and if he/she does not respond.
If the target child has difficulty engaging in conversations with peers during lunch, not too far. Be sure that the tar- • Share a topic of mutual interest
provide fun topics to talk about. get child does NOT walk away. (talk about something they
There are many ways to stimulate conversations between children at school. • Use an appropriate tone of both like).
Remaking Recess focuses on using Social Menus, but other methods can also voice—not too loud and not • Be aware of the “right” time
stimulate conversation between children (i.e. a Topic Box, Picture Prompts, or too soft. to approach the target child
Interesting Objects). (e.g., when he/she is not already
• Direct their initiations to the
• During times when children have opportunities to converse give them direct peer by grabbing their attention engaged).
instructions to talk to each other. Example: “Now is the time for you to talk (e.g. use a name—(e.g., Hey • Make sure to trade information
to each other.” John!)—or lightly tap the child — take turns in the conversation.
• Offer social menus to all children in the area. Do not single out the target on the shoulder if he is not
child by approaching them only. Instead target the cluster of peers they are facing them).
closest to by offering the social menus to the group. • Use facial expressions that
• Give the menus to the children with the instructions “Here are some fun show how they are feeling—if
things for you and your friends to talk about” you’re happy, smile!
• Move away so that the children aren’t tempted to talk to you instead of each • Stay on the topic of conversation
other. (even if it is something they may
not be interested in).
• Observe the children from a distance. If needed, move back and prompt them
to ask each other the questions on the menu. Praise children who are having • Be sure to take conversational
good conversations. turns.

Copyright 2013. Created by Kasari Research Group UCLA for the Autism Intervention Research Network
14 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 15
Playing Games

Playing Games It may help to give the target child and a peer model/buddy a “job” (e.g. ball
• Always go to recess prepared! Bring all necessary materials with you to monitor, sign maker, recruiter, etc.).
facilitate a motivating game that the target child will enjoy. If needed, pre–teach the game privately with the target child so he/she can be
• Play games that are “cool for school.” If a particular game is “in” at the school, successful with peers during play time.
teach the target child that game to increase his/her social power both in the
classroom and on the playground.
• Clarify the rules of the game as a group.
• Practice good sportsmanship and prosocial skills.
• Practice participation with the target child and peers (e.g. entrance into games,
actively taking a role, maintaining engagement, and exiting a game).
• Be consistent—practice the same game (if the children still want to play it)
across several days.
• Build off children’s skills.
• Select games that are developmentally and age appropriate for the target child
that are not too overwhelming or over-stimulating.

Games
If you need help selecting and learning games refer to the internet or this book:
Hopscotch, Hangman, Hot Potato, & Ha Ha Ha: A Rulebook of Children’s
Games by Jack Macguire.

Copyright 2013. Created by Kasari Research Group UCLA for the Autism Intervention Research Network
16 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 17
Sustaining
Engagement

Supporting and Sustaining Engagement During Be direct with peer models. If you see the target child losing attention or
an Interaction with Peers straying from the game, prompt a peer model to intervene and direct the target
child’s social behavior. Some strategies may include asking the peer models to:
Participate in the game as the facilitator to:
• Call out the target child’s name.
• Model appropriate social behavior (e.g. good sportsmanship, praise, being
flexible, etc.). • Check in with the target child every now and then during the game.
• Once the game gets flowing and the children are independently playing, • Pay attention to the target child during the game (e.g. it is important that we
monitor the activity and step in as needed. be good friends to everybody, so if we see a friend leave the game, we should...).
• Be the cheerleader: offer specific praise to the target child. • Praise the target child.
• If needed, use reinforcers that are motivating to the target child and peers to
increase the amount of time spent engaged with peers.
• If needed, directly address a behavior with the target child by pulling him
aside for a quick minute (but still near his peers). It is important to address
“inappropriate” behavior immediately, so the target child knows what he/she
should correct in order for the game to continue smoothly.

Copyright 2013. Created by Kasari Research Group UCLA for the Autism Intervention Research Network
18 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 19
Fading Out of
an Activity

Knowing When to Fade Out After the child is successfully engaged in a game/interaction, fade back to moni-
• We want the target child to rely on an adult as little as possible, so they toring the interaction/activity/game.
become independent and socially successful during recess with their peers. Be mindful of the target child and his/her peers and continue to provide support
• Fading out may vary day to day pending how the child is doing in the activity if the children lose engagement or need assistance.
and the type of activity. Sometimes it may take 10 minutes, and sometimes it Continue to praise all children participating!
may take 5 minutes. Remember: use strategies to keep the child engaged in the interaction as needed.
• Some days you will have the opportunity to fade out of an activity, and some Remember: this goal may not be achieved tomorrow, next week, or a month from
days you may not. now, but this is something we should always strive toward.

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20 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 21
Quick Guide:
Boosting Peer Engagement
Engagement State Help Within The Current State Boost To a Higher State Strategies To Avoid

Solitary Adult engage with child to assess reason for solitary state. Recruit a peer to ask child to play. Give Avoid benching or isolating a child during
Listen to the child then offer support. friendly direct instruction telling the child social times. Avoid pushing a child into an
to engage with peers. Provide an appealing activity as opposed to inviting them and
and developmentally appropriate activity to drawing them in.
draw the child to parallel position with peers.

Onlooker Model being interested and focused on peers activities. Use Recruit a peer to invite the target child to Avoid embarrassing the peers by making
language like “Look at Jimmy,” or “What are they going to join in play. Encourage the target child to them feel that they must perform under
do next?!” play with peers or to ask a friend to play. scrutiny. Avoid reinforcing this state as a
preferred state, i.e. don’t let the child only
watch all the time.

Parallel Support good social positioning, reinforce parallel play Join into play with the child. Cue child to Avoid being overly directive or positioning
verbally or with other reward. notice peers. yourself in such a way that blocks children’s
view of one another. Avoid helping
too much.

Parallel Aware With well-timed comments, verbally highlight to the children Ask peers if they can demonstrate play Avoid interjecting too many comments or
that they are playing next to each other. Praise their play moves or games for each other. Verbally adding information that might obscure the
skills. Add elements to the play to keep it exciting. prompt target child to watch the peer. children’s awareness of each other. Don’t
Model focusing on and being interested in overly focus on the play objects.
the peer’s activities.

Joint Provide an environment that makes playing with peers easy. Prompt the children to make a game out Avoid interrupting play and over–managing
Engagement Clearly state that playing well with friends at school is the of what they are doing, i.e. taking turns behavior that might be less–skilled or a bit
goal. Fade back and support from a distance as children setting goals. Teach children the rules and rough. Instead, allow the children to set the
maintain successful peer engagement. pragmatics of popular games. Provide tone for what is fair and fun as much as
equipment and scaffold efforts by children possible.
to advance engagement.

Game With Help the children get the game started or iron out any Overlay a pretend play element onto the Avoid dominating play as an adult. Don’t
Rules problems related to the game rules, turn taking, etc. Play with game. Add a component that draws out stop the flow of play between peers. Avoid
the children for a few minutes and model the appropriate personal disclosures. Fade out of the activity implementing overly punitive measures
behaviors. Make sure to fade out. Cheer them on. to allow for maximum peer engagement when children exhibit rough behavior.
and check back periodically.

Copyright 2013. Created by Kasari Research Group UCLA for the Autism Intervention Research Network
22 on Behavioral Health (AIR-B). For more information go to www.asdweb.org or email [email protected]. 23