Autism and Developmental Disorders
2023. Vol. 21, no. 4, 43–51
doi:10.17759/autdd.2023210405
ISSN: 1994-1617 / 2413-4317 (online)
Influence of Environmental Factors in the Activities of the Playgroup on Communicational Performance of Children with Autism Spectrum Disorders
Abstract
Objectives. With all the variety of models of assistance for children with autism spectrum disorders (ASD), there is a tendency to integrate different approaches, and the formation of communication skills and children’s socialisation occupies a large place in all correctional educators’ work. The criteria for organising a developmental or correctional environment conducive to the manifestation of communication skills in a group of children with ASD were identified.
Methods. The study with participation of 8 children (1 girl and 7 boys) 5—6 years old with diagnoses of autism spectrum disorders (ASD) was analysed using the case study method. The characteristics of the environment were analysed using video recordings of the lessons: zoning, noise in the room, stimulus saturation, motivating objects, types of interaction and its initiators, degree of accompaniment, pace of the lesson, movement activity, speech activity, etc. The relationship of environmental characteristics to each child’s communication success was examined. The total sum of scores on receptive and expressive communication and social interaction was calculated. At the stage of the experimental group formation, the following methods were used: the Autism Diagnostic Observation Schedule (ADOS-2); the Leiter-3 test of non-verbal intelligence and cognitive abilities in adults and children from 3 years of age; the Communication Matrix.
Results. The nature of the child’s motivational sphere was identified as the main factor in selecting the optimal environment for communicative skills development. It depends on how structured and guided by an adult the environment should be. The most frequent factor contributing to communicative activity was determined to be the active position of the adult communicative partner and his demands for a higher communication level. Also identified as factors favouring more frequent and complex communication were: small numbers of people and low noise levels in the room.
Conclusions. The organisation of an adapted environment is important for learning communication skills: zoning, reduction of noise in the room, stimuli and motivators saturation and their availability, the type of interaction with an adult suitable for the child and others. The quality and quantity of communicative acts of each child depends on the characteristics of the children’s motivational sphere, the activity of the adult and the individually organised environment The trends identified during the study: the leading role of the child’s motivational sphere, the requirements of a higher level of communication set by the adult — need further study.
General Information
Keywords: autism spectrum disorders; communication (ASD); playgroup; environmental approach; preschoolers; playgroup
Journal rubric: Research of ASD
Article type: scientific article
DOI: https://doi.org/10.17759/autdd.2023210405
Funding. Project of Sberbank Charitable Foundation “Contribution to the Future” to create a scientific, methodological, and educational center in the field of curative pedagogy on the basis of the Regional non-profit social organization “Center for Curative Pedagogics “, Moscow, Russia
Received: 05.10.2023
Accepted:
For citation: Bogoliubova-Kuznetsova D.V., Kazdym Yu.I., Karanevskaya O.V., Kharlamova E.O. Influence of Environmental Factors in the Activities of the Playgroup on Communicational Performance of Children with Autism Spectrum Disorders. Autizm i narusheniya razvitiya = Autism and Developmental Disorders, 2023. Vol. 21, no. 4, pp. 43–51. DOI: 10.17759/autdd.2023210405. (In Russ., аbstr. in Engl.)
Full text
Introduction
Difficulties in communication and social interaction, stereotyped actions and interests are key features of autism spectrum disorders (ASD), and the communicative and social behavior of people with ASD is qualitatively distinctive [10]. This brings working with these difficulties to the forefront of therapeutic and intervention interventions, whichever approach is chosen [5; 7; 9]. Depending on the understanding of the basis of communication and social interaction disorders, as well as other characteristics of people with ASD, these approaches suggest different ways of working. Behavioral approaches suggest learning specific skills related to communication and social interaction, relying on the individual's intrinsic or extrinsic motivation for this work and modifying the environment (e.g., by further structuring it and adding visual supports) [16]. Developmental theory-oriented approaches such as the Early Start Denver Model (ESDM) [6], Social Communication, Emotional Regulation and Transactional Support (SCERTS®) [15] or Joint Attention, Symbolic Play, Engagement and Regulation (JASPER) [12] also work on the development of communication and social skills in their ontogenetic order. Approaches focused on the development of relationships as the basis of social life (e.g., the therapeutic approach based on the DIR/Floortime Diagnostic of Child Functional Emotional Development Levels [2]) involve organizing interactions in a way appropriate to the client's level of emotional development, which provides the client with the opportunity to move to the next level of emotional development to improve communication skills [1].
Over more than 30 years of work, the Centre for Therapeutic Pedagogy (CTP) has developed a format of playgroups for children aged 4-6 with various developmental disabilities. Among them, such groups are attended by children with ASD. The approach developed at the CLP can be called integrative: it includes both methods based on developmental and attachment theories, as well as techniques from the behavioral approach. The playgroup teachers pursue goals related to different areas of child development, achieved through individual and group sessions, which are planned according to the main objectives and characteristics of the individual child.
The practice of working with people with special developmental needs, including those with ASD, confirms the need for individualization of learning and correction processes [4]. It is recognized that the quality of social participation of preschool children with ASD depends on environmental parameters such as sensory properties, social and cognitive demands, etc. [13].
In the presented work we identified the environmental parameters (both material and interpersonal), primarily in need of individualization when working with children with ASD. The form of group work with children with ASD, as well as the environmental factors in the playgroup that influence the success of children’s communication was investigated. The aim of the study was to identify the environmental factors that most contribute to the use of communication skills by children with ASD and, consequently, to their development.
Materials and Methods
In preparation for the study, an initial diagnosis was carried out using the following methods: ADOS-2 (Autism Diagnostic Observation Schedule) to assess the severity of autistic traits (10 points - minimal severity of autistic traits, 28 - maximum); Leiter-3 Nonverbal Intelligence and Cognitive Function Test to assess non-verbal intelligence skills (the score corresponds to the IQ level); Communication Matrix - a means of describing and analyzing expressive communication skills, which takes into account preverbal means of communication; and a case study method. The case study method was used.
The sample consisted of 8 children aged 5 to 6 years (1 girl and 7 boys), who according to ADOS-2 fall into the diagnostic category of "autism" or "autism spectrum". The families of all children belong to the middle class and live in Moscow. Russian is the native language for all families. All parents gave voluntary consent to participate in the study. In the results presented, each child's name has been replaced by an initial.
.
Table
Degree of severity of ASD traits, intellectual and communication skills of participants, scores
|
|
Age |
ADOS-2 |
LEITER-3 |
Communication Matrix |
|
D. |
6 |
23 |
68 |
68 |
|
P. |
5 |
10 |
88 |
77 |
|
Yu. |
6 |
17 |
49 |
63 |
|
A. |
6 |
22 |
76 |
78 |
|
M. |
6 |
17 |
78 |
62 |
|
K. |
5 |
19 |
69 |
51 |
|
T. |
5 |
13 |
80 |
57 |
|
L. |
6 |
21 |
64 |
57 |
The study analyzed children's communication in natural environments by videotaping sessions without any specific modification. The video was then analyzed by a team of psychologists and speech-language pathologists using two data collection tools created for this study.
In the area of expressive communication, the use of communication skills of the levels of intentional communication through behavior, standard communication, concrete symbols, abstract symbols and speech in four intents was analyzed: refusal, getting what is desired, social interaction, giving information. In the area of receptive communication, the following were considered: responding to a name, following a pointing gesture, social smiling, making eye contact, and following instructions. In the area of social interaction, the following were considered: accepting an object from another person without giving a verbal instruction, observing another person's actions, imitation, joining another person's activities. Each communicative or social act was assigned a score depending on whether it was a simple communicative act (involving one modality, e.g. gesture only) or a complex one (e.g. gesture and eye contact), and its level was recorded (e.g. if a research participant used intentional non-standard communication through behavior, a score of 1 was assigned, and if an abstract symbol, a score of 4 was assigned. All scores were then totaled. Thus the total sum of scores for receptive and expressive communication and social interaction reflects both the number of communicative and social initiatives and their quality, i.e. the integration and level of communicative skills used.
The second means of gathering information took into account the characteristics of the environment. The following criteria were considered: stimulus saturation, number of items or types of interaction that motivate the child and their availability, zoning, by whom the interaction is directed, number of questions, presence or absence of higher-level communication requirements, degree of accompaniment, pace of the activity, number of people in the room, movement activity, noise level, speech activity of the attendant, and overall speech intensity in the room [3; 8].
Результаты и обсуждение
D.'s (6 years old) diagnostic results: ADOS-2 - 23 points, Leiter-3 - 68 points, Communication Matrix - 68 points. The following were considered for D.: individual play session, subject-practical activity session and group play session. The games (both individual and group) took place in the same room (a busy room with unclear space zoning); the number of people, their movements and noise level differed, as did the activity of the chaperone in relation to D. It was determined that the activity was higher in the case of the individual game. In both games, D. directed the interaction. The hands-on activity session was conducted in a less rich and clearly structured environment. During this activity, the teacher guided the interaction. The most motivating activities and games for D. were those involving the participation of a partner: swinging in a hammock (it is important for the boy to be rocked), tactile games. The number of D.'s communicative acts and their quality were highest during individual play and lowest during object-practical activities. Analyses of D.'s communication showed that the boy communicates more often and of higher quality in a saturated environment where he needs adult assistance in obtaining some of the motivating items or in interaction, but the interaction is largely self-directed. Fewer people in the room and lower noise levels also contribute to D.'s more active communication. An important factor for frequent communication at the highest level for this child is the activity of the chaperone: their questions and prompts for communication at the most difficult level for D.
P.'s (5 years old) diagnostic results: ADOS-2 - 10 points, Leiter-3 - 88 points, Communication Matrix - 77 points. Sensory integration sessions, group play and a group circle activity were analysed for P. During the sensory integration sessions and the group play, the interaction was guided by P. and during the circle session by the teacher - the educator. The space for sensory integration and play in the group was rich and not clearly zoned, the circle space was - was less saturated and clearly zoned. During sensory integration and circle sessions, the educator provided cues for more complex communicative responses and asked questions, while this was rarely the case during group play. Object manipulation, emotional interaction, and vestibular play were equally motivating for P. In the situation of the sensory integration session, he had little access to objects, and for vestibular games he most often needed the help of a teacher. Analyses of P's communication showed that it was important for him to be in a quiet space with a small number of people and to be able to direct the interaction himself. At the same time, the activity of a chaperone who asks questions and thus stimulates communication is important.
Yu.'s (6 years old) diagnostic results: ADOS-2 - 17 points, Leiter-3 - 69 points, Communication Matrix - 43 points. The following were considered for Yu.: group play, board games and physical education activities. Yu. guided the interaction in the group play situation, while during the board games and PE activities the interaction was guided by the teacher. The group play environment was saturated, less saturated during physical activity sessions, and impoverished for board games. The maximum number of people and the maximum noise level were present during the board game sessions, the number of people and noise level were less during PE and group play. For Yu., the maximum motivating activities were vestibular games for which he did not need adult help (e.g., swinging independently in a hammock) and objects, and specific sensations that the boy received through autostimulation. Analyses of Yu.'s communication showed that for a higher quality and quantity of communicative acts, it was important for him to be in a space with a small number of people and low noise level, as well as to have more intensive accompaniment.
Diagnostic results of girl A. (6 years old): ADOS-2 - 22 points, Leiter-3 - 76 points, Communication Matrix - 78 points. Tea, group play and individual defectology classes were analyzed for A. The individual defectology session and tea were held in an impoverished, highly structured environment, and it was in them that A. communicated most frequently and qualitatively. Group play took place in a rich, low-structured environment. The stimuli attractive to A. were controlled by the adult in the situation of tea and defectology class, but this was not always the case in the situation of play. The interaction in the situation of tea and defectology class was directed by the adult and in the situation of the game to a greater extent by A. In the defectology class and during tea, the adult made demands and gave an example of more complex communication, while in the situation of the game there were no such episodes. The greatest motivation for A. is represented by objects with which she tends to perform non-specific actions serving the purpose of obtaining visual and tactile sensations. It can be assumed that the high structuredness and low saturation of the environment, the presence of very attractive objects in it, combined with the active position of an adult who directs interaction, interprets A.'s behavior as communicative and provides cues for communication at a higher level, turned out to be the conditions ensuring more frequent and qualitative communication. At the same time, according to our observations, the number of people in the room does not significantly affect the quantity and quality of A's communicative acts.
M.'s (6 years old) diagnostic results: ADOS-2 - 17 points, Leiter-3 - 78 points, Communication Matrix - 62 points. The following were analyzed for M.: individual play, group play and group activity "circle". "Circle" is characterized by a high degree of structure and the fact that the interaction is directed by an adult. The adult controls the objects that are attractive to M. The most motivating for M. is manipulation with objects that provide specific visual sensations. In the case of individual and group play, adult guidance was less active, and the environment was more rich and less structured. In both the individual play and circle play situations, the adult provided cues for and expected M. to communicate at a more complex level. In the situations of individual play and "circle" the environment was less saturated with speech than in the situation of group play. It can be said that M. communicates more often and of higher quality in an impoverished and structured environment, with little speech activity from others, when the adult is active, asking questions and providing cues for more complex communicative responses. It is also important for the adult to control the materials that appeal to M. in order to use M.'s motivation to receive them as a reason to communicate.
K.'s (5 years old) diagnostic results: ADOS-2 - 19 points, Leiter-3 - 69 points, Communication Matrix - 51 points. Individual sensory integration classes, a game and a defectology class were analyzed. The sensory integration and play sessions took place in a rich, medium structured environment, while the speech-language pathology session took place in a depleted, well-structured environment. The adult position was the least active in the sensory integration session and the most active in the defectology session. In the play situation, there were many objects in the space that were attractive to K., and he often needed adult help to use them. During the game, the teacher provided K. with cues for a more complex communicative response: she presented objects of interest to him, bringing them closer to his face, and waited for K. to communicate the level of intentional behavior. K. was equally motivated to manipulate objects independently, receiving tactile sensations, and to influence the adult's behavior (by asking him to perform certain actions, e.g., blowing into a blowpipe, naming pictures and objects). It is concluded that K. communicates more actively and more qualitatively in situations when the contribution to the interaction from his side and from the adult's side is approximately equal, when there is a large number of objects that attract the boy in space and he needs help in getting some of them. Also, the number of communicative acts and their quality increase if the adult uses cues for more complex communication. If K. moves around a lot in space, he communicates less often (probably because moving around requires his active attention).
T.'s (5 years old) diagnostic results: ADOS-2 - 13 points, Leiter-3 - 80 points, Communication Matrix - 57 points. The following were analyzed: individual play, group play and practical activities. To a greater extent the situation was directed by T. himself during individual play, to a lesser extent he directed the process in the situation of practical activities. The adult's position was most active in situations of individual play and hands-on activities. For T., vestibular and tactile games with an adult are the most motivating. T. communicates more often and at a higher level when he can more actively direct the interaction, when there is a large number of attractive stimuli in the space, and when the number of people and noise level are small. At the same time, the adult should be active: interpret unintentional and intentional communication by behavior, but offer in these cases a model of higher level communication.
L.'s (6 years old) diagnostic results: ADOS-2 - 21 points, Leiter-3 - 64 points, Communication Matrix - 57. The "circle" activity, defectology activity and group play were analyzed. The highest number of objects and reciprocal actions attractive to L. was in the situation of the defectology session, and the lowest number was during the "circle" session. The adult's position was also the most active in the situation of the defectology lesson and the least active during the group game: during the defectology lesson, the teacher asked questions and gave cues for higher-level communication. Her speech was represented by comments, short sentences, long sentences, and statements with exaggerated intonation. The most motivating cues for L. are objects and nonspecific manipulations of them in order to obtain tactile, visual, and gustatory sensations. It is concluded that L. communicates more often and of higher quality in an environment where there are more objects and acts of interaction that motivate him, with a small number of people and high adult activity. The adult should guide the interaction, ask questions, give cues for communication, but also interpret L.'s behavior as communicative.
The analysis of the eight presented cases shows that the characteristics of the environment, both material and interpersonal, influence the quantity and quality of communicative acts in children with ASD. At the same time, the nature of the organization of the environment, optimal for communication of each participant, differs. For six children, the activity of a communicative partner providing cues for communication at the most difficult level for the child was important. In five out of eight cases, the quantity and quality of participants' communicative acts were higher in spaces with low noise levels and fewer (compared to the other situations analyzed) people. For four participants it was important to have attractive stimuli and adult control over them. For three participants it was important to be able to control the interaction (choose what to do). Two participants communicated more often and with higher quality in a structured space with adult-directed interaction.
Based on the material of the eight cases considered, we can conclude that the most significant characteristic of the environment is the nature of interaction, namely, the activity of the communicative partner and his efforts to develop communication of a child with ASD: providing cues for communication of a higher (but accessible to the child) level, asking questions. Similar results were obtained by Kärnä, Dindar and Hu in their study of the relationship between teaching techniques and communication of children with ASD in Finland and in China [14], as well as by Derei [11]. Small numbers of people, low noise and soft speech in a space are also quite common needs in children. A deprived environment is needed about as often as a rich one, but the availability of attractive objects or activities and actions without the participation of a communicative partner plays a major role. Children with ASD who are most motivated by objects are less likely to communicate when those objects are readily available. Children who are most interested in activities that require a partner (e.g., vestibular play) are more likely to communicate in a rich environment because they need to turn to a partner to get what they want. The same is true for child or adult leadership: children who are most interested in activities that require a partner are more and better communicators when they can choose what they want to do. This is probably because in this situation, activities and actions are the most motivating, and control over reinforcement remains in the hands of the adult. Children interested in the object world, on the other hand, communicate more and better in situations organized by an adult, provided that the adult pays active attention to communication.
Probably, it is the child's motivational sphere that is the main factor for choosing one or another strategy of organizing the environment, which may be the most optimal for the development of his/her communication: the degree of expression of ASD traits or the intellectual development level in the cases considered do not matter.
Conclusions
The information obtained in this study can be useful for practitioners when planning their work with children with ASD. The proposed approach to analyzing the influence of environmental factors on the success of communication of children with ASD in different activities can be used both to modify the characteristics of the environment and to select activities that are most suitable for the child's tasks at this stage of his/her development. Thus, first of all, the specialist should find out what tangible and intangible stimuli are motivating for the child and establish control over them. For children who are most interested in activities that require a partner, a more client-centered approach is optimal; for those who are more interested in objects, a more structured approach is optimal. The practitioner should be attentive to the child's communication at basic levels, and encourage (through prompting or questions) communication at higher, symbolic levels. Careful attention should also be paid to the number of people in the room and the noise level.
In the future, in order to clarify the patterns identified in this study, a study with purposeful design of the environment according to certain criteria and with comparison of the quantity and quality of communicative acts depending on the given parameters can be carried out.
It may also be advisable to expand the number of cases investigated using this design.
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