University Scholar's project aims to expand the worlds of children with autism
By Kevin Foley Article published March 31, 2004
Consider play: It’s a fundamental human need, a chance for children to act out the dramas of adulthood (or for grown-ups to escape from them) and build friendships with others. But for many kids with autism, the inability to get a game going with another child is an ongoing source of frustration, isolation and pain.
Patricia Prelock, professor of communication sciences and a University Scholar in the social sciences and humanities this academic year, is pursuing a novel study that offers intensive in-home social training for kids with autism and their peers without it and monitors their interactions over the course of 15 weekly playdates. She’ll present some preliminary findings from her ongoing project on April 1 at 4 p.m. in Memorial Lounge, Waterman Building. The title of her seminar is “Facilitating Joint Attention and Social Interaction in Children with Autism.”
Most of the past research on the topic, Prelock says, has focused on working with the children in school settings, instead of the home. Older studies have also tended to focus on training either the child with the disorder or on their peer without it, rather than working with both. By setting up within the comfortable confines of a child’s own home, with his or her own toys, and offering training and consistent coaching from a skilled and sympathetic interventionist, Prelock hopes her pairs of children will spend more time actively engaged with each other and less time in conflict or ignoring each other. This, in turn, will hopefully help make a child who struggles in social situations better able to make friends, with all the therapeutic and existential benefits that such connections carry.
Much of the training is heartbreakingly simple. Some children with autism can’t ask a potential friend about what they feel like doing, or even recognize why the question is important. So the interventionists teach kids how to suggest an idea for play, listen to a response, take turns, adopt another person’s perspective and manage conflict.
“When I decided to do this lecture, it was risky, because this is new research and we are right in the middle of it,” Prelock says. “We did two dyads last year, and we don’t have all the data compiled yet. In the first there was some increase in interaction, but the results weren’t all we wanted. Our second dyad just went crazy with the intervention and has been amazing. The child still has play dates with the first kid, but he has three other friends… he’s attending birthday parties.”
That kind of inclusion is more important than it might seem for a child with autism.
“Kids who have successful social relationships have better long-term outcomes in terms of being satisfied and successful,” Prelock says. “All learning involves social opportunities – if you’re in a classroom, and the teacher is doing peer groups and you can’t work with a peer, you’re not going to do well. Our ultimate goal is to increase their ability to attend to other things that are happening beyond what they’re interested in and expand their view of the world.”
Doing this requires patience, well-trained and empathetic student coaches to prod the play sessions in positive directions, and many hours spent painstakingly watching and coding videotapes of play. It also requires extensive travel and consultation with vulnerable families to conduct the research as sensitively as possible. Because of all these challenges, in-home studies measuring how well autism interventions work are not being produced at a pace matching the need for them.
“The brain research is sexy, and it’s important and I use it, but I realized that we needed to do more efficacy research in intervention,” Prelock says. “That’s difficult because no one wants to do it. It’s hard to control variables and we have to go with what the family and child needs.”
Prelock and her graduate students can tweak their intervention strategies on the fly if observations of sessions or comments from parents reveal trouble spots. It’s not the typical randomized, strictly controlled, double-blind pattern for research – but Prelock says it is possible, by conducting additional projects with her evolving research design and consistently replicating results, to eventually divine some sound conclusions from her single-subject projects.
Finding a balance between the requirements of academic research and the needs of families struggling with a confounding and profoundly difficult ailment is essential to Prelock.
“I’m trying to give something back to the families. They don’t have to go to me, I go to them, and we leave them with some strategies,” she says. “Instead of always asking children to be subjects in our research, we’re giving them something at home.”