THE WORK OF PLAY: HOW VIDEO GAMES AFFECT SOCIAL INTERACTIONS FOR
CHILDREN WITH AUTISM SPECTRUM DISORDER
By
Virginia A. Hiltz

A DISSERTATION
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
Educational Technology and Educational Psychology—Doctor of Philosophy
2017

ABSTRACT
THE WORK OF PLAY: HOW VIDEO GAMES AFFECT SOCIAL INTERACTIONS FOR
CHILDREN WITH AUTISM SPECTRUM DISORDER
By
Virginia A. Hiltz
This study examines the differences in play behaviors demonstrated by children with
Autism Spectrum Disorder (ASD) when they engage in play with typically developing (TD)
peers. Pairs of elementary school students, ages eight to 11, engaged in play in three settings:
typical school recess, facilitated play led by adults, and kinetic technology play using an XBox
Kinect video game console. Pairs consisted of one participant with ASD and a TD peer buddy
who played together multiple times in each setting. Positive social interactions between the
participants were observed and tracked. Visual analysis showed significance between the three
conditions in eliciting positive social interactions for children with ASD and also for TD peers,
specifically that more positive social interactions occurred within the kinetic technology play
setting. Participant surveys showed mixed preferences for play conditions, most preferring either
recess or kinetic technology play. This study contributes to our understanding of the way
students with ASD engage in play with peers and highlights the potential benefits of video games
in promoting positive play interactions for students with ASD, particularly in the school setting.

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ACKNOWLEDGEMENTS

Many people have taken this doctoral journey with me. Firstly, I’d like to thank my son,
Christopher, who has spent the first 5 years of life, and some time in utero, involved in this
process and is, always, my cheerleader. Thanks also to Eric who tirelessly supported me, even in
my most frustrated moments, and never doubted what I could accomplish. My parents, John and
Eileen Hiltz, spent many hours babysitting so I could complete coursework and this dissertation,
including stays on campus with me and Christopher, and also provided me with the drive and
determination to complete this journey. I couldn’t have better role models. I’d like to thank my
dissertation committee, and especially my advisor, Dr. Cindy Okolo, who has always been a
positive, encouraging, supportive and inspiring presence during this process. My EPET
cohortians really were my backbone, especially Colin Terry, who is one of the smartest and
hardest working academics I know.
Thank you to Shelley Fabrizio, my friend and professional partner and mentor who always
told me I could do anything and who listened patiently and supportively for five plus years. I’d
also like to thank the staff and students of Easton Elementary (pseudonym) who responded so
positively in supporting my research efforts, and to the District administrators and superintendent
who always supported the importance of continuing education. Thanks to Dr. Larry Hewitt, and
the administrators of District 28 who were so supportive in allowing me time and energy to
complete this work. Finally, thanks to my friends and extended family, especially Joan and Rich
Hackl, who always asked how things were going, helped with Christopher, and to John and
Ginger Hiltz who generally provided positive support throughout this journey. It takes a village
to be a working mom striving to earn her doctorate. I couldn’t have done it without all of you.

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TABLE OF CONTENTS

LIST OF TABLES……………………………………………………..……………

vi

LIST OF FIGURES…………………………………………………………………

vii

INTRODUCTION…………………………………………………………………..
Children with ASD in School…………………………………………………...
Building Peer Relationships…………………………………………………….
Technology as an Intervention Tool…………………………………………….
Purpose of Study and Research Questions……………………………………...
Benefits of Research…………………………………………………….………

1
1
3
4
6
7

LITERATURE REVIEW………..………………………………………………….
Social and Play Development and ASD…………………………………………
Social Skill Interventions for Children with ASD………………………………
The Role of Technology in Play for Children with ASD……………………….
The Rise of Video Gaming……………………………………………………..
Summary and Implications………………………………………………………

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8
14
17
22
25

METHODS………………………………………………………………………….
Pilot Study……………………………………………………………………….
Research Design…………………………………………………………………
Condition Descriptions…………………………………………………………..
Timeline………………………………………………………………………….
Participants……………………………………………………………………….
Measures…………………………………………………………………………….
Procedures and Data Collection…………………………………………………….
Data Analysis……………………………………………………………………….

27
27
30
32
34
34
40
44
49

RESULTS………………………………………………………………………………
Play Activities………………………………………………………………………
Positive Social Interactions………………………………………………….……..
Participant Survey……………………………………………………………….....

51
51
53
66

DISCUSSION AND IMPLICATIONS………………………………………………..
Positive Social Interactions Between Conditions………………………..…………
Participant Preferences……………………………………………………………...
Limitations………………………………………………...………………………...
Implications……………………………………………………………………….....

73
73
80
82
84

APPENDICES…………………………………………………………………………… 89
APPENDIX A Peer Buddy Nomination Survey via GoogleForms…………..……... 90
APPENDIX B Confidentiality Agreement for Recorders…………………………... 91

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REFERENCES…………………………………………………………………………..

v

92

LIST OF TABLES

Table 1. Description of Dependent Variable: Positive Social Interaction…………….…

43

Table 2. Types of Activities for Each Pair in Recess and Facilitated Play Conditions..… 52
Table 3. Data Analysis Summary of the Impact of Play Conditions on Positive Social
Interaction………………………………………………………………………..………. 58
Table 4. Means and Standard Deviations of Positive Social Interactions for Pair A….… 60
Table 5. Means and Standard Deviations of Positive Social Interactions for Pair B……… 62
Table 6. Means and Standard Deviations of Positive Social Interactions for Pair C.……

64

Table 7. Means and Standard Deviations of Positive Social Interactions for Pair D….… 66
Table 8. Participant Responses: “Which play environment was the most fun?”……….... 67
Table 9. Participant Responses: “Which play environment helped you to get to know
your buddy the best?”…………………………………………………………………..

68

Table 10. Participant Responses: “How much did you enjoy playing with your friend
during recess?”………………………………………………………………….…….

69

Table 11. Participant Responses: “How much did you enjoy playing with your friend
during Community Builders?”…………………………………………….…………

70

Table 12. Participant Responses: “How much did you enjoy playing with your friend
when using the XBox?”………………………………………………….… ……….

71

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LIST OF FIGURES

Figure 1. Average Percent of Positive Social Interactions for Alex and Brandon (5th
Graders)…………………………………………………………………………………... 54
Figure 2. Average Percent of Positive Social Interactions for Carl and David (2nd
Graders)……………………………………………………………………………….….. 55
Figure 3. Positive Social Interactions for Pair A Across Play Conditions……………….. 59
Figure 4. Positive Social Interactions for Pair B Across Play Conditions……………….. 61
Figure 5. Positive Social Interactions for Pair C Across Play Conditions……………….. 63
Figure 6. Positive Social Interactions for Pair D Across Play Conditions……………….. 65

vii

INTRODUCTION
It is well known that children with Autism Spectrum Disorder (ASD) experience social
deficits. Research abounds in this area, citing multiple social and play skill deficits as key
markers for the diagnosis of ASD (Bauminger, Solomon, Aviezer, Heung, Brown, & Rogers,
2008; Macintosh & Dissanayake, 2006; Nah & Poon, 2011; Sigman & Ruskin, 1999; Stichter,
Herzog, Visovsky, Schmidt, Randolph, Schultz, & Gage, 2010; Stone & Caro-Martinez, 1990;
Weiss & Harris, 2001). Diagnostic criteria for ASD from the American Psychiatric Association’s
(APA) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) (2013)
includes persistent deficits in communication and social interaction across multiple contexts.
Specific deficit areas identified in people with ASD center around elements of social
understanding including sharing, collaborating, negotiating, cooperation, self-control, and
understanding rules/norms/constructs (Bauminger et al., 2008; Macintosh & Dissanayake, 2006;
Nah & Poon, 2011; Sigman & Ruskin, 1999; Stone & Caro-Martinez, 1990).
Given the difficulty of succeeding in a world that typically requires frequent social
interactions, researchers, educators, and parents, have emphasized the importance of developing
interventions to build effective play and social behaviors in children with ASD (Pierucci, Barber,
Gilpin, Crisler, & Klinger, 2015). One common belief is that children who have effective peer
models for social behaviors will learn some of these skills via immersion. This has led many
parents to advocate for their children with ASD to attend school alongside typically developing
(TD) peers, a practice referred to as inclusion (Goodall, 2015; Symes & Humphrey, 2010).
Children with ASD in School
For a variety of reasons, including the belief in the advantages of peer modeling, more
and more children with ASD are being placed in general education public schools (Goodall,

1

2015; Symes & Humphrey, 2010). Inclusion, as an educational practice, attempts to have all
children educated together, regardless of developmental ability, with support structures in place
(Goodall, 2015). However, arguments abound about the actual benefits of inclusion, particularly
within the ASD community. At the heart of this debate is whether inclusion is successful in
supporting the social needs of students with ASD (Kasari, Locke, Gulsrud, & Rotheram-Fuller,
2011; Dybvik, 2004; Farlow, 1996; Fryxel & Kennedy, 1995; Harrower & Dunlap, 2001; Hauck
et al., 1995; Horne, Timmons, & Adamowycz, 2008; Lord & Hopkins, 1986; Zanolli, Daggett, &
Adams, 1996).
Proponents of inclusion argue that, if approached correctly, schools should meet the
needs of the child and not expect a child to adapt to an environment that is already in place
(Goodall, 2015). In inclusive schools all children are considered part of the school community.
Some researchers found children with ASD can learn from their typical peers, display more
appropriate behavior, and increase their social skills (Goodall, 2015; Reiter & Vitani, 2007).
Other research regarding the benefits of inclusive environments has been less conclusive (Chen,
2010; Majoko, 2016; Symes & Humphrey, 2010).
Unfortunately, the potential social benefits of inclusion are not realized in many schools
due, in part, to a lack of emphasis on teaching TD peers how to support students with ASD (Able
et al., 2015; Mojoko, 2015). Additionally, finding common interests and activities for children
with ASD to interact with TD peers can often be challenging (Chen, 2010). Symes & Humphrey
(2010) found students with ASD in general education settings experienced higher levels of
rejection, lower levels of peer social support and higher levels of bullying than peers with a
specific learning disability, and peers with no disabilities. Children with ASD in inclusive
environments tend to have fewer friends and poorer friendship quality than peers without

2

disabilities (Majoko, 2016). Researchers also found that physical proximity to typical peers may
not enhance social experiences for many students, and children with ASD may not mimic the
behavior of typical peers (Chamberlain, Kasari, & Rotheram-Fuller, 2007; Kasari et al., 2011;
Locke, Rotheram-Fuller, & Kasari, 2012; Rotheram-Fuller, Kasari, Chamberlain, & Locke,
2010; Sperry, Neitzel, & Engelhardt-Wells, 2010).
In some cases, inclusion can create an entirely opposite effect and children with ASD can
become targets for bullying behaviors (Kasari et al., 2011; Dybvik, 2004; Farlow, 1996; Fisher &
Taylor, 2016; Fryxel & Kennedy, 1995; Harrower & Dunlap, 2001; Hauck et al., 1995; Horne et
al., 2008; Lord & Hopkins, 1986; Zanolli et al., 1996). Researchers also found that bullying
behaviors occur most often during less structured times of the school day such as lunch and
recess when the opportunity for social interactions is typically at its highest for children (Able,
Sreckovic, Schultz, Garwood, & Sherman, 2015; Chen, 2010; Odom & Strain, 1986; Odom &
Watts, 1991).
Building Peer Relationships
School stakeholders agree that interventions addressing social skills for children with
ASD are necessary in inclusion environments (Able et al., 2015; Mojoko, 2015). Research also
shows that peer group relationships and social support are key indicators of effective social
inclusion (Symes & Humphrey, 2010). Moreover, when schools train TD peers on how to
interact with and support students with ASD, they increase interactive play (Carter, Hughes,
Copeland, & Breen, 2001; Celiberti & Harris, 1993; Hundert, Rowe, & Harrison, 2014;
Wolfberg & Schuler, 1993). Similarly, identifying and training TD peer buddies for students
with ASD has also been found to be an effective way to increase social support, therefore
decreasing bullying behaviors (Hundert et al., 2014).

3

One method that is supported by research is the use of facilitated or integrated play to
promote positive peer interaction for students with ASD and TD peers (Carter, Common,
Sreckovic, Huber, Bottema-Beutel, Gustafson, Dykstra, & Hume, 2014; Cogher, 1999; Gunn,
Trembath, & Hudry, 2014; Kok, Kong, & Bernard-Opitz, 2002). Facilitated play is led by a
trained adult who provides prompting and support throughout the play experience. Although
adult-supported play has been seen as effective in supporting joint attention and engagement for
students with ASD, it also has drawbacks (Carter et al., 2014; Cogher, 1999; Gunn et al., 2014;
Kok et al., 2002). Facilitated play requires guidance by an adult which may have negative impact
on budgeting/scheduling for schools and less potential engagement for typical peers, particularly
as they enter the intermediate grades and begin to desire more independence from adults.
The movement to include students with ASD in general education settings, along with the
serious concerns regarding bullying issues, is prompting school leaders to consider how to create
meaningful environments in which students can positively interact. Technology interventions
have been used successfully in other areas of deficit for students with ASD such as for functional
behavioral support, academic support, and executive functioning support. However, researchers
are now beginning to consider technologically based interventions as a way to facilitate more
positive peer interactions for students with ASD (Carter et al., 2014; Cogher, 1999; Gunn et al.,
2014; Kok et al., 2002).
Technology as an Intervention Tool
The body of literature on interventions for children with ASD across deficit areas is
substantial and growing quickly. Much of it supports the use of technology as an effective tool
for students with ASD to support functional behavior and academic instruction. Many children
with ASD seem innately drawn to technology (Colby, 1973; Goldsmith & LeBlanc, 2004).

4

Murray (1997) found that technological interventions provided a controlled, predictable setting
that allowed students with ASD to minimize distractions and stimuli. Murray (1997) also found
that children with ASD perceived technological interventions to be highly motivating. Similarly,
parents and doctors also report that children with ASD have a high motivation to use
technological devices and that this interest may be an asset in intervention design (Colby, 1973;
Goldsmith & LeBlanc, 2004).
Odom, Thompson, Boyd, Hedges, Dykstra and Duda (2015) completed a meta-analysis
of literature around the use of technology in interventions and instruction for adolescents with
ASD. Their research, reviewing more than 30 recently completed studies, supports the use of
technology in intervention and instruction for adolescents with ASD. These findings support
other recent studies that have identified various technologies as effective intervention tools for
school-aged children with ASD (Bouck, Savage, Meyer, Tabe-Doughty, & Hunley, 2014;
DiGennaro Reed, Hyman & Hirst, 2011; Fletcher-Watson, 2014; Ramdoss, Machalicek, Rispoli,
Mulloy, Lang, & O'Reilly, 2012).
Schools have effectively used technologies such as video modeling, interactive white
boards, computer-aided instruction (CAI), and educational apps to build students’ academic and
functional life skills (Huang, 2005; Murray, 1997; Goldsmith & LeBlanc, 2004; Knight,
Spooner, Browder, Smith, & Wood, 2013). Research also highlights the role of video gaming in
supporting students with ASD in these same areas of deficit (Blum-Dimaya, Reeve, Reeve, &
Hoch, 2010; Finke, Hickerson, & McLaughlin, 2015). Similarly, TD peers between the ages of
8-18 are also drawn to technology, and specifically to the use of video games, with 91 percent of
children between the ages of two and 17 reporting that they play video games according to a
survey completed by the NPD Group, a national consumer market research company (Reisinger,

5

2011). The increasing popularity of video games for children has led many schools to consider
ways to integrate gaming into education.
Purpose of Study and Research Questions
Given the social deficits of children with ASD outlined above, there is a clear need for
interventions focused on promoting positive social interactions with TD children. The promise of
technology in supporting children with ASD in specific skill areas, and the popularity of
technology, and video games specifically, begs the question of how technology may support
social interactions between students with ASD and TD peers. Little research exists regarding
how video games can be used as a potential social intervention for students with ASD. Likewise,
there is a need for research regarding how engagement with TD peers around technology,
specifically playing video games together, could impact social interactions for students with
ASD.
Therefore, this research aims to consider the potential benefits of video game play in
increasing positive social interactions between students with ASD and TD peers. Specifically,
the study investigates the benefits of video game play as compared with a common intervention,
facilitated play, and as compared with traditional recess. To uncover the potential benefits of
video game play on social interactions between children with ASD and TD peers, this research
addresses the following questions: (a) Which play condition (traditional recess, facilitated play,
or kinetic technology play) is most effective in eliciting positive social interactions for students
with ASD and TD peers, and (b) Which play condition do students with ASD and their TD peers
report as being most enjoyable?

6

Benefits of Research
The data captured in this research provide new information about how technology, and
interactive video gaming specifically, may be effective in supporting social interactions for
students with ASD in general education settings. This research adds to the body of work on
targeted interventions for social and play skill development that integrate TD peers. It may lend
an additional perspective on the role of gaming in education and its potential impact on students
with special education needs such as ASD. It also informs our understanding of how children’s
social interactions may change across conditions, and therefore, how practitioners can use more
effective play settings to promote positive interactions between students with ASD and TD peers.
An additional benefit of this research may be the practical implications, namely related to
personnel/staffing and budgeting, for schools. Schools that use facilitated play need to rely on a
trained adult, typically a social worker or counselor, to facilitate these sessions. This research
considers another option where children with ASD can engage effectively in play with TD peers
without an adult’s direct support. In the following chapter, I provide a review of research that
addresses the previously discussed topics in more detail and helps to provide a framework for
this study.

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LITERATURE REVIEW
In this literature review I will discuss the key research in the areas relevant to this study
including information on the following: (a) social behaviors for children with ASD; (b) social
interventions for children with ASD; (c) the role of technology in social development for
children with ASD; and (d) the rise of video gaming in education. The review of literature was
conducted by searching a variety of databases on key terms such as Autism, gaming, social/play
skills and ASD, peer buddy, and technology and ASD. The databases included were primarily
ProQuest, Google Scholar, and Mendeley Literature Search.
Social and Play Development and ASD
Children with ASD have a variety of deficits across developmental areas. These deficits
are highly variable in children, leading Dr. Stephen Shore, author and ASD advocate, to coin the
phrase, “If you’ve met one person with Autism, you’ve met one person with Autism”
(http://www.autismempowerment.org/understanding-autism/autism-spectrum-disorder/). That
said, there are two main areas of functioning that are impacted in all people with ASD: social
communication and interaction, and restricted or repetitive patterns of behaviors (Barnard-Brak,
Ivey-Hatz, Ward, & Wei, 2014). Therefore, deficits in social skills and social awareness are a
universal marker of ASD, regardless of a child’s capability in academics, functional life skills, or
behavioral needs (American Psychiatric Publishing [APA], 2013). This section will first discuss
how children with ASD may have delayed or impaired development in both social skills and play
skills and how these deficits impact social development and connection within an education
setting. The section will close with a discussion of how these deficits may be linked to bullying
issues for children with ASD.

8

Social skill development. People with ASD may experience challenges across a variety
of areas, however a hallmark of the disorder is pronounced impairments in adaptive social skills
which allow children to navigate many aspects of daily life including play experiences with
friends and following social norms or rules (Anderson, Oti, Lord, & Welch, 2009; Gillham,
Carter, Volkmar, & Sparrow, 2000; Klin, Jones, Schultz, Volkmar, & Cohen, 2002; Kraijer,
2000; Syriopoulou-Delli, Agaliotis, & Papaefstathiou, 2016). Typically, people with lower IQ
scores also show lower adaptive social skills. In people with ASD, deficits in these adaptive
social skill areas are not necessarily accompanied by a lower IQ. This potential lack of
connection between IQ and social skill deficits highlights an uneven developmental profile
unique to ASD (Anderson et al., 2009; Liss, Fein, Allen, Dunn, Feinstein, Morris, &
Waterhouse, 2001; Loveland & Kelley, 1988; Schatz & Hamdan-Allen, 1995).
Impairments in social skill development can be identified as early as the first year of a
child’s life by considering foundational social skills such as eye contact, response to name,
spontaneous imitation, and understanding and expressing emotion. When compared with
expected developmental norms, children with ASD typically display decreased abilities in these
areas (Anderson et al., 2009; Osterling, Dawson, & Munson, 2002; Werner, Dawson, Osterling,
& Dinno, 2000). As children grow to school age, these impairments often become more
pronounced as social skills become a more prominent aspect of daily life. For example, schoolaged children with ASD often experience challenges with the social aspects of language and
communication, fail to understand social cues, and have difficulty responding to or initiating
social interactions (Anderson et al., 2009; Bacon, Fein, Morris, Waterhouse, & Allen, 1998;
Celani, Battacchi, & Arcidiacono, 1999).

9

Unfortunately, these difficulties with adaptive social skills can have a far-reaching
negative impact for people with ASD. Barnard-Brak et al. (2014) found children with ASD have
significantly poorer self-regulation and social interaction skills than peers diagnosed with an
intellectual disability. Social isolation and bullying issues may also impact children with ASD
(Chen, 2010). Other studies have shown that children with social skill deficits, unrelated to IQ,
struggle academically and report poorer outcomes as adults (Anderson et al., 2009; Howlin,
Goode, Hutton, & Rutter, 2004). As well, adults with ASD who continue to struggle with
adaptive social skills may experience more psychiatric complications such as depression and
anxiety (Bauminger & Kasari, 2000; Eaves & Ho, 2008; Muller, Schuler, & Yates, 2008).
Conversely, greater successes with learning adaptive social skills have been related to more
success as an adult including establishing friendships and living and working independently
(Howlin et al., 2004). Therefore, interventions during childhood are critical to help people with
ASD develop these adaptive social skills.
Play development. Researchers found that play can facilitate language development,
increase cognitive skills, and provide opportunity for social interaction (Pierucci et al., 2015).
However, children with ASD have impairments in the quality and sophistication of play (BaronCohen, 1987; Blanc, Adrien, Roux, & Barthelemy, 2005; Rutherford & Rogers, 2003) and they
participate in less symbolic play, meaning they may not use toys in creative or pretend ways and
instead participate in repetitive or stereotyped play (Tsao, 2008, Wolfberg, DeWitt, Young, &
Nguyen, 2015). Thomas & Smith (2004) found children with ASD might lack social motivation,
social understanding, and flexibility, which are key characteristics in the development of play
skills. Children with ASD are also less able to participate in joint attention which impacts play

10

skills such as turn taking, following directions, and even making eye contact (Tsao, 2008,
Wolfberg et al., 2015).
Given these issues, it becomes clear that children with ASD experience specific
impairments in play skills (Jarrold, 1997; Lewis, 2003; Tsao, 2008). Therefore, play therapy is
often used as an intervention for children with ASD to support these areas (Goldstein & Cisar,
1992; Fox & Hanline, 1993; Ingersoll & Dvortsak, 2009; Stahmer, 1995l, Wolfberg et al., 2012;
Wolfberg et al., 2015). “Interventions that focus on teaching play skills or using play as a
meaningful context for social and language interventions could become an important and
necessary part of an overall intervention program” (Tsao, 2008, p. 42). In fact, improving skills
such as joint attention, turn taking, and imitation can have an impact on language and social
development later in life (Dawson, Toth, Abbott, Osterling, Munson, Estes, & Liaw, 2004;
Mundy, Sigman, & Kasari, 1990; Tsao, 2008).
Social and play development and education. Social inclusion is a core element of
human rights recognized in multiple publications by the United Nations including the UN
Convention on the Rights of the Child (United Nations, 1989), the UN Declaration on Human
Rights (United Nations, 1948), and the UN Convention on the Rights of Persons with Disabilities
(United Nations, 2006). In the United States, public schools must abide by the Individuals with
Disabilities Education Improvement Act (IDEA) of 2004 that includes the requirement of
providing the least restrictive educational environment (LRE) for students with disabilities. To
promote the concept of social inclusion, the LRE can often be the general education classroom if
students are provided with the appropriate supports (Leach & Duffy, 2009).
However, the benefits of inclusion are much debated. Previous research examining the
effectiveness of a general education placement for children with ASD found that students in this

11

placement showed increases in social engagement skills and built more friendships than students
in special education exclusive environments (Fryxell & Kennedy, 1995; Hunt, Farron-Davis,
Beckstead, Curtis, & Goetz, 1994). That said if teachers and TD peers are not provided with
appropriate support, the developmental challenges that children with ASD face can become a
barrier for success in the general education setting (Leach & Duffy, 2009). Students with ASD
who participate in an inclusive setting are most successful with the following supports: highly
structured environments, positive approaches to instruction and discipline, empathy from adults
and peers, reduced sensory inputs, and consistency (Roberts, Beadle-Brown, & Youell, 2011).
Perhaps the downfall of many inclusion efforts is that although children with ASD
receive instruction in a general education setting, they lack a connection to the classroom’s social
structure (Chamberlain et al., 2007; Kasari et al., 2011; Locke et al., 2012; Rotheram-Fuller,
Kasari, Chamberlain, & Locke, 2010). As Sperry, Neitzel, & Engelhardt-Wells (2010) argued,
being there is not enough. Therefore, it is imperative that TD peers play a role in creating
inclusive social environments for children with ASD. Research shows that TD peers can have
success connecting socially with children with ASD while maintaining a strong and positive role
in the classroom (Locke et al., 2012). However, TD students are more likely to prefer interaction
with TD peers if they have not received direct training on how to socially include students with
ASD (Sperry et al., 2010).
Bullying and children with ASD. Bullying behaviors have garnered more attention in
education and the media over the last several decades, and it has been well documented that
students with disabilities, including ASD, are often targets of these behaviors (Able, Sreckovic,
Schultz, Garwood, & Sherman, 2015; Chen, 2010; Kasari et al., 2011; Dybvik, 2004; Farlow,
1996; Fisher & Taylor, 2016; Fryxel & Kennedy, 1995; Harrower & Dunlap, 2001; Hauck et al.,

12

1995; Horne et al., 2008; Lord & Hopkins, 1986; Odom & Strain, 1986; Odom & Watts, 1991;
Zanolli, Daggett, & Adams, 1996). Wolfberg et al. (2012) found that from the earliest years,
children with ASD are at risk from being excluded from essential peer play experiences.
Sreckovic, Brunsting, and Able (2014) completed a meta-analysis of bullying issues in relation
to children with ASD and found that most studies reported bullying issues across a monthly span.
Results varied in reported frequency of bullying behaviors toward children with ASD with most
studies reporting between 30%-77% of children with ASD had been bullied within the previous
month as reported by teachers and the students themselves. Fisher and Taylor (2016) found that
22 of 30 interviewed participants with ASD reported having experienced bullying behaviors
including verbal, physical, and relational victimization.
Not surprisingly, children with ASD are particularly vulnerable to bullying behaviors due
to their social skill deficits (Sreckovic et al., 2014). Fisher and Taylor (2016) interviewed high
school children with ASD about their perceptions on why they were bullied. Participants noted
that their personal attributes, including interests and lack of shared interests, as well as lack of
interaction with peers were potential reasons for the bullying behavior. Perhaps even more
alarming is that Sreckovic et al. (2014) found that children with ASD who are the targets of
bullying may experience deterioration of social skills or communication skills, sleep issues, selfinjury, and loss of other developed skills such as self-care and control of aggressive tendencies.
Given these serious concerns regarding the frequency and impact of bullying on children with
ASD, it is critical to consider social skill interventions for children with ASD as well as training
and supports for TD peers.

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Social Skill Interventions for Children with ASD
Given the documented deficits in social skill development for children with ASD, it is
critical to provide specialized support to target play interactions with TD peers. However, for a
number of reasons, there have been few interventions investigated that focus on play, and
specifically play with TD peers (Wolfberg, Bottema-Beutel, & DeWitt, 2012). Wolfberg and
Schuler (2006) found the same lack of research and hypothesized the following:
"Particularly when dealing with children whose behaviors defy developmental
expectations, play is more likely to be viewed as a luxury only to be targeted when more
basic deficiencies have been remedied. Moreover, the [field's] current emphasis on
accountability, quantification and empirically validated programs may have inadvertently
discouraged the pursuit of play in a broader developmental and cultural context" (p. 182).
That said, the research that exists shows that play-related activities have been found to be
successful in building children’s social skills (Vaughn et al., 2003). The National Research
Council (2001) found social, language, and symbolic play skills are the most common focuses of
early intervention for children with ASD. For example, interventions designed to build joint
attention skills are popular for children with ASD (Jones & Carr, 2004; Mundy & Crowson,
1997). Baker (2000) found that children with ASD were able to learn play skills such as joint
attention when taught play behaviors based on thematic rituals or interests and were able to
generalize their new skills to different settings. The type of intervention strategies used to teach
new skills differs based on philosophy and the needs of the child with ASD. Discrete-trial
training and facilitated play, discussed more below, are two interventions widely used to support
play skills in children with ASD. As well, for students with ASD who are educated alongside TD

14

peers, peer-training programs are an effective intervention to increase positive social supports
and are also discussed in this section.
Discrete trial training (DTT). One of the most well-researched intervention strategies
used to develop play skills is the DTT approach which has been successful in teaching early play
skills such as object manipulation as well as more complex play themes (Cardinal et al., 2017;
Lifter, Sulzer-Azaroff, Anderson, & Cowdery, 1993; Nuzzolo-Gomez, Leonard, Ortiz, Rivera, &
Greer, 2002). DTT involves teaching a person in simplified and structured steps in an effort to
break down a skill into steps and then build it up using discrete trials to teach each step, one at a
time (Smith, 2001). Researchers found that through DTT, children with ASD can learn and
follow scripts, which help to improve their peer interactions.
Young, et al. (2016) completed two studies utilizing TD peers to deliver intervention via
DTT. In the first study, six elementary aged TD children were trained to use DTT to support
children with ASD on academic tasks. The study showed that the training for typical peers was
effective in increasing integrity of the DTT protocol. In the second partner study, five of the six
peer tutors used the DTT protocol to support children with ASD with whom they had no prior
experience. The results showed that the peer tutors were able to generalize the DTT training and
therefore, the children with ASD made rapid improvements in the target training areas. As a
measure of social validity, Young et al. (2016) examined social engagement during unstructured
times before and after the intervention and found substantial increases in duration of
engagement. This pair of studies is significant in considering how peers may support children
with ASD in academic tasks while also building opportunities for meaningful interaction.
Facilitated play and integrated playgroups. Tsao (2008) argued that, “the element of
effective strategies for prompting social, language, and play skills of children with autism is to

15

incorporate social, language, or communication skill training in play contexts involving TD peers
within highly structured interactions” (p. 44). Facilitated play is one intervention that focuses on
connecting children with disabilities such as ASD with TD peers. Facilitated play relies on the
instruction of a trained facilitator and uses incidental teaching during multiple, more free form,
play experiences (Soorya et al., 2015). Facilitated play has been found to produce gains in
appropriate communication and play in children with ASD (Kok et al., 2002).
Facilitated play is similar in many ways to other forms of guided play therapy such as
structured play and integrated playgroups, where trained adults guide children with ASD through
play with TD peers (Wolfberg et al., 2012). These research-based interventions vary in details
such as size of group and training provided to TD peers, but all rely on facilitated peer play as a
method for improving play skills in children with ASD and in building understanding in TD
children. Yang, Wolfberg, Wu, and Hwu (2003), studied the impact of integrated playgroups on
two elementary-aged students in Taiwan. One playgroup took place at school and the other in a
child’s home and 17 to 21 group play sessions were analyzed. Researchers observed children’s
cognitive/symbolic and social dimensions of play using a single-subject A-B design. Findings
indicated that the children with ASD made notable gains in social and symbolic play via the
playgroup intervention. Parents also shared observations that their children with ASD were able
to generalize the skills learned during the playgroups. As researchers study ways to integrate
play for children with ASD and TD peers, they must also consider how to train these TD peers to
increase understanding of ASD and how to effectively interact with and support peers with ASD.
Peer training. Many schools have attempted to identify ways to connect TD peers with
students with ASD through formal training models. For example, Peer-mediated Instruction and
Intervention Strategies (PMII) is a research-based approach designed to “systematically teach

16

typically developing peers ways of successfully engaging children with ASD in positive social
interactions” (Sperry et al., 2010, p. 256). PMII includes specific guidelines for the selection of
appropriate TD peers, training and supporting the TD peers, implementing structured teaching
sessions for TD peers, and implementing peer-mediated experiences in classrooms and other
school settings as well as across the day for a child with ASD (Sperry et al., 2010). PMII and
similar approaches are ways to scaffold social interaction between students with ASD and typical
peers and are particularly important in the less structured portions of an elementary school day
such as lunch and recess (Able et al., 2015).
Battaglia and Radley (2014) studied case examples of children with ASD who interacted
with peers who volunteered to be trained in ways to support the children with ASD in social
interactions and play. Case examples of two elementary-aged children with ASD showed, via
observation and survey scales, that training for peers in initiating play with children with ASD
and in accepting requests from children with ASD to play, were effective in increasing social
engagement between children with ASD and TD peers. A common thread found throughout
research on inclusion and peer buddy support strategies is the need for structure and training for
the TD student in order to make an inclusive setting socially supportive for a student with ASD.
The Role of Technology in Play for Children with ASD
Given the wide array of strengths and challenges for children with ASD, and the influx of
new methods and approaches, research has been integral in testing interventions and educational
strategies. Technology-based interventions have garnered interest in many schools given the
response and engagement of students with ASD when utilizing technology (Goldsmith &
LeBlanc, 2004; Murray, 1997; Reffert, 2008). As technology advances, so do the opportunities to
use technology to support the development of play and social skills for children with ASD.

17

Currently, the bulk of research relating to technology and students with ASD centers on
academic instruction, functional skills, and behavioral supports. However, some research has
begun to consider technology interventions in relation to play and social skill development.
Prompting devices, video modeling, and CAI have all shown positive results for children with
ASD (Goldsmith & LeBlanc, 2004) and are discussed in further detail below. For the most part,
these interventions interject technology into traditional play settings, which is very different from
looking at technology as a condition in which children play. That said, it is still useful to
understand how technology has begun to be considered in supporting the play skills of students
with ASD.
Tactile prompting. Tactile prompting was the earliest venture into examining the
research behind using technology to advance play skills in students with ASD. Taylor and Levin
(1998) found using a tactile prompt was successful in increasing verbal initiations for children
with ASD as compared with no prompting or verbal prompting. The tactile prompt submitted a
vibration after a preset interval to remind the student to initiate verbally. Shabani, et al. (2002)
found some support for the use of tactile prompting to increase verbal initiations for children
with ASD. This research helped to support the initial use of technology as a way to increase
verbal interaction during play with peers.
Video modeling. The use of video technology is widely accepted as effective for students
with ASD across multiple settings and domains (Becker & Watry-Christian, 2016; Cardinal et
al., 2017; Goldsmith & LeBlanc, 2004; Sturmey, 2003). In fact, in January 2003, the Journal of
Positive Behaviors Interventions dedicated a special issue to the use of video with students with
ASD. Video modeling has been used in academic instruction, as a behavioral support for
students, and has also been studied as an intervention to teach play and social skills (Boudreau &

18

D’Entremont, 2010; D’Ateno, Mangiapanello, & Taylor, 2003; Goldsmith & LeBlanc, 2004).
Video modeling has been found to be immediately effective in teaching play skills by modeling
expected and appropriate actions for students (Boudreau & D’Entremont, 2010; D’Ateno et al.,
2003).
Boudreau & D’Entremont (2010) researched the use of video modeling to increase play
skills with four-year old boys with ASD. In this study, the children watched video models of an
adult playing with a toy set and showed increases in modeled actions and scripted verbalizations
as a result of the intervention. Maione & Mirenda (2006) studied the impact of video modeling
and video feedback as a social language intervention for a five-year old child with ASD. They
found that video modeling was effective in increasing social language with a TD peer in two of
three play activities. Social language, both scripted and unscripted, was increased in the third
play activity with the use of video feedback and prompting. Kimball, Kinney, Taylor, & Stromer
(2004) found that the combination of technology-based activity schedules and video modeling
were effective in building social skills, such as play initiation. Students were successful in
following their interactive activity schedules, which were supplemented with video models of
desired social behaviors such as play initiation.
Computer aided instruction. Computer aided instruction (CAI) also has a wealth of
research supporting its effectiveness (Gal, Bauminger, Goren-Bar, Pianesi, Stock, Zancanaro, &
Weiss, 2009; Goldsmith & LeBlanc, 2004; Hansen, 2015). CAI is a broad-reaching category that
can include the use of software tools, graphics and simulations to teach skills (Hansen, 2015).
Early research raised concerns about the use of CAI with children with ASD due to potential
social withdrawal and encouragement of repetitive or compulsive behaviors (Bernard-Optiz,
Sriram, & Nakhoda-Sapuan, 2001). However, CAI environments can be a useful tool in

19

supporting social skills development for children with ASD (Herrera, Plasencia, Labajo, Jordan,
& de Pablo, 2004; Parsons, Mitchell, & Leonard, 2005; Piper, O’Brien, Ringel, & Winograd,
2006; Revel, Nadel, Maurer, & Canet, 2002; Silver & Oakes, 2001). As well, continued
advancements in computer technology have demanded additional research on CAI as an effective
intervention.
Gal et al. (2009) conducted a study about the use of CAI, in this case the use of a colocated touch table interface, to facilitate collaboration and social interaction between students
with high functioning ASD. Students were paired and asked to collaborate to narrate a story
through the use of an interactive StoryTable system to test the enforced collaboration theory. Gal
et al. (2009) found students with ASD were more likely to initiate positive social interaction with
peers after the StoryTable intervention and that their levels of shared play increased.
Bauminger-Zively, Eded, Zancanaro, Weiss and Gal (2013) completed a study with 22
children with ASD on the impact of two computer programs to teach collaboration and social
conversation. Using a variety of measurement tools such as a dyadic drawing task, the
researchers found that the programs helped children with ASD improve in the socio-cognitive
area particularly in finding solutions to social problems and a more appropriate understanding of
collaboration and social conversation.
Ben-Sasson et al. (2012) found positive results in increasing the frequency of positive
social interaction and collaborative play for six dyads of children with ASD when using an
“enforced collaboration” mode of a virtual puzzle game. The enforced collaboration required the
dyads to move puzzle pieces together and was found to be more effective than the free play
mode that allowed children to move pieces independently.

20

Additional research is currently exploring the use of a range of technologies to support
social skill interventions for children with ASD. For example, Kim et al. (2013) completed a
study that examined social behaviors of 24 children with ASD between the ages of four and 12 in
triadic groups including an adult, the child, and either a robot or touchscreen video game. The
study showed that that children spoke as much with the robots as with the adults, and more than
toward the video game. These findings may indicate the potential for use of “social robots” as an
intervention for children with ASD.
Kinsella, Chow and Kushki (2017) reviewed the use of a Google glass application called
Holli, a wearable technology that serves as a social skills coach to children with ASD by
listening to conversations and prompting the user with socially appropriate responses. Fifteen
children (average age of 12) were able to utilize the prompts in a 10-turn interaction with a
researcher while engaged in a conversation at a restaurant. Although this type of new interface
requires more research, this study shows the potential promise of technology to support peer-topeer interaction. This body of new research including robotics and wearable technology is
promising when considering the use of a variety of technologies to facilitate the development of
play skills for children with ASD.
However, considering how technology can be used as an intervention is markedly
different than considering how play behaviors may naturally change for children with ASD in a
technology-based condition. As discussed in the next section, one newer approach, the use of
video game technology, often considered a subset of CAI, may also provide promising avenues
for research in this area, namely because it does not consider technology as an individual
intervention, but instead as a typical environment in which children play with one another.

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The Rise of Video Gaming
Research addressing video gaming in early education for TD students began to surface in
the early 2000s when game-based learning environments began finding their way into K-12
education. Studies found many advantages of these environments for TD students (Gee, 2007;
Greenfield, 2010). Gaming in education promotes higher-order thinking skills and improved
social skills (Dondlinger, 2007; Steinkuehler & Duncan, 2008). As well, gaming can increase
interactivity, engagement, and motivation, as well as the opportunity for deep immersion in
problems and scenarios, and the creation of three-dimensional learning spaces (Barab et al.,
2010; DeKanter, 2005; Gee, 2003). Video gaming is finding a foothold in education as gaming
systems become more interactive, physical, and collaborative (Cohen, 2011; Saez-Lopez, Miller,
Vazquez-Cano, & Dominguez-Garrido, 2015).
While schools are experimenting with technology interventions to support students with
ASD, gaming as an educational tool for TD students is also gaining traction (Connolly, Boyle,
Hainey, McArthur, & Boyle, 2012; Durkin, Boyle, Hunter, & Conti-Ramsden, 2013; Griffiths,
2002; Rosas, Nussbaum, Cumsille, Marianov, Correa, Flores, & Salinas, 2003; Saez-Lopez et al.,
2015; Squire, 2006; Subrahmanyam, Greenfield, Kraut, & Gross, 2001). Some schools adopted
elements of gaming into their instruction, and others, such as Quest to Learn in New York, have
gone as far as using gaming theory to define their core curricula (http://www.q2l.org/; Cohen,
2011). With the rise of the gaming movement in education, it is important to consider the early
research on how gaming impacts students with ASD.
Video games in schools. Interactive video games such as the Nintendo Wii have begun
to be used in classrooms for a variety of purposes. Hawkins (2009) found schools have
incorporated the Wii into physical education classrooms to encourage more physical activity at

22

school. The Wii is a motion-sensing platform that allows users to display movements that
correspond with a typical activity (e.g., bowling or golf). The Wii can provide physical activity
for students who use the platform in the classroom and can also provide cognitive engagement
for students via Nintendo’s Big Brain Academy (Maldonado, 2010). Research on kinetic video
games, such as the XBox Kinect, found that competition within these types of games improves
children’s psychological responses (affect and rate of perceived exertion) compared with single
player games (Lisón et al., 2015).
The Wii has also found a home in Music classes, in use with English Learners (EL)
students, and in relation to social studies and science content with games such as Endless Oceans
and Age of Empires II; The Age of Kings (Maguth, List, & Wunderle, 2014; Maldonado, 2010).
The Wii may also provide scaffolding for students in a differentiated and engaging way, and
specifically by embedding social language and interactive responses into game play (Maguth et
al., 2014; Maldonado, 2010).
Platforms such as the XBox Kinect motion-sensing system mirror the functionality of the
Wii and are picking up steam in education. For example, the Steuart W. Weller Elementary
School in Ashburn, VA has been profiled by many media outlets including USA Today, to share
their use of the XBox Kinect platform specifically to support the social interaction of students
with ASD. A teacher, Lynn Keenan, who is involved in the project in Ashburn, shared the
following (Faur, 2014):
“Communicating with each other, giving each other directions, giving compliments... I
can teach social skills and communication with board games and with other games but
the students are so much more motivated to take part in games like this, and with games
like the Kinect we get a lot more out of them" (p. 1).

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Researchers highlight concerns around video games specifically, including addiction
issues, aggression, heath issues, and lowered school performance (Blunt, 2007; Ferguson, 2010;
Young et al., 2012). However, enough research exists to support the potential positive benefits of
gaming in education for school districts and educational researchers to take notice.
Video games and ASD. Unfortunately, despite promising leads in mainstream media,
little scholarly research exists on the use or impact of video games on students with special
education needs (Ceranoglu, 2010). Durkin et al. (2013) reviewed the emerging literature on the
use of gaming for students with special education needs and found many concerns, including
accessibility, particularly as games become more complicated and detailed with increasing
amounts of information to navigate. As well, video games often require logic, knowledge of
cause and effect relationships, and navigation skills which may be difficult for students with an
intellectual disability (Durkin et al., 2013). However, some children with ASD may also have
particular strengths in the areas of logic and game navigation, allowing them to effectively play a
video game (Durkin et al., 2013).
Students with ASD may also interact differently with video games than children with
other disabilities, given their established preference for technology (Durkin, 2010; Griffiths,
2002; Kee, 2009; Ploog, Banerjee, & Brooks, 2009). For example, Ploog et al. (2009) found
children with ASD are more attuned to prosodic and linguistic parts of speech while interacting
with a video game, while their TD peers were solely focused on the linguistic aspects. This may
indicate children with ASD are able to process more details, which would potentially allow them
to more successfully interact with video games. As well, Durkin (2010) found children with ASD
may be more drawn to video game elements given their characteristic focus and attention on

24

preferred activities. They may find interest and motivation in amassing information about
specific video game environments and characters.
Finke et al. (2015) published a study examining the behaviors of children with ASD and
their use of video games, as well as parental views on video game play. They found children
with ASD play video games, but the time, type, and intensity of play did not relate to the severity
of a child’s ASD symptoms. They also found parents, overall, supported video game play for
their children with ASD and that some believed that video game play had a positive impact on
their child’s development. Indeed, children with ASD are “strongly attracted to screen-based
entertainment, including virtual reality displays and video games” (Durkin et al., 2013 p. 81).
Summary and Implications
Technology is changing rapidly and, as it does, it provides more potential opportunity for
interaction through play. Single-player, non-interactive video games have morphed into online
worlds of multi-player interactivity promoting goal setting, collaboration, and other prosocial
behaviors traditionally not associated with video games. In aiming to better understand how
students’ social behaviors might adapt to a technology-rich play condition, this study provides a
first step into the consideration of technology, and video games specifically, as an effective
strategy for facilitating positive social interaction between children with ASD and TD peers.
The literature cited above outlines an important pattern. Children with ASD have
challenges with social skill and play development and that interventions can potentially support
those deficits (Baker, 2000; Jones & Carr, 2004; Mundy & Crowson, 1997). It has also been
established that technology has been successful in interventions for children with ASD in other
deficit areas and that technology, and gaming specifically, are being adopted into the mainstream
of education (Goldsmith & LeBlanc, 2004; Murray, 1997; Reffert, 2008). Therefore, it is

25

important, and the goal of this study, to understand if technology, specifically kinetic technology
play, promotes more positive social interactions for students with ASD and TD peers as
compared with traditional play such as recess and adult-facilitated play. Additionally, the type of
positive social interactions that occur between peers may provide more insight into potential
social benefits of kinetic technology play as compared with recess and adult-facilitated play.
If we can determine a play structure or activity that is more conducive for students with
ASD to engage positively with typical peers, and that typical peers also find engaging, without
the constant support of an adult to facilitate the interaction, we can potentially address some of
the concerns regarding inclusion. Students with ASD who can positively engage in play with TD
peers could potentially build more social support and establish more friendships. As more
children are being diagnosed with ASD and being educated in general education environments,
more focus needs to be placed on how to support social interactions with TD peers in ways that
benefit all students. Technology, and video gaming specifically, may be this type of resource.
Therefore, as stated previously, the purpose of this study is to better understand the
potential benefits of video game play in increasing positive social interactions between students
with ASD and TD peers as compared with another common intervention, facilitated recess, and
as compared with traditional recess. The study considers the interactions between pairs of
children with ASD and TD peer buddies as they engage in play during traditional recess,
facilitated play, and kinetic technology play using an XBox Kinect system, a motion-sensing
input device that allows players to use their bodies to navigate games, as opposed to a traditional
controller. The following chapter will provide specific detail on the design and research methods.

26

METHODS
This single-subject study addresses the following questions: (a) Which play condition
(traditional recess, facilitated play, or kinetic technology play) is most effective in eliciting
positive social interactions for students with ASD and TD peers, and (b) Which play condition
do students with ASD and their TD peers report as being most enjoyable?
Pilot Study
To inform the planning for this research, a pilot study was conducted from January 25February 4, 2016 at Easton Elementary (pseudonym), the site of the dissertation study. One
third-grade male student with ASD and one teacher-nominated third-grade male peer buddy
participated in the pilot study. Students met for three sessions during the first week to play board
games (proxy for a more structured play setting) and the second week to play video games on the
XBox Kinect. Students met for approximately 15 minutes per session and sessions occurred in
the special education classroom of the student with ASD. Parental permission was granted for
each child to participate and each child gave his verbal assent to participate. A social story was
provided to the child with ASD to prepare him for the change in his daily schedule due to
participation in the study. I coded samples of the pilot sessions using a previously published
coding framework, adapted, called the Friendship Observation Scale (FOS) and found the
following initial results (Bauminger et al., 2008).
Sessions one through three of the pilot study focused on board game play. Results for one
coded session showed four instances of cooperative play, 19 incidents of prosocial behaviors,
five incidents of non-verbal behaviors, and no incidents of positive affect for the child with ASD.
Most of the time in this session was spent in collaborative play. The child with ASD was

27

attentive to the game and took turns but did not always follow the rules of the game. The pair
also showed an average level of fun/enjoyment interacting with one another.
Sessions four through six of the pilot study focused on kinetic technology play. As an
example, results for one coded session of kinetic technology play showed one instance of
cooperative play, seven instances of prosocial behaviors, no incidents of non-verbal behaviors,
and 13 incidents of positive affect for the child with ASD. Like the coded board game session,
most of the time in this session was also spent in collaborative play. The child with ASD was
very attentive to the game and took turns, including waiting/watching for approximately four
minutes while his peer took a turn in the game.
The pilot study results showed a potential difference in the two conditions particularly in
the area of affect where the kinetic technology play elicited a higher number of smiles, laughter,
and joint laughter (13 instances compared with zero in the board game play). In the prosocial
behaviors category, board game play elicited a higher number of responses by the child with
ASD to help offered by his peer (19 instances compared with seven in kinetic technology play).
Although accepting help is a desirable positive social behavior, this may also be interpreted as
the child with ASD needing more prompting to stay on task in the board game play. Both
sessions elicited the same type of collaborative play, but the level of fun/engagement was
perceived to be higher when the students were interacting with the kinetic technology play
condition. Anecdotally, the child with ASD engaged in less scripting/repetitive talk during the
kinetic technology play sessions than he did during the board game sessions.
The pilot study was integral to informing the design of this study. Primarily, it provided
informal data that supported an initial hypothesis that the kinetic technology play condition may
promote different social interactions for students than other play conditions. It also provided

28

insight into the constraints of using a scale designed to measure broader peer interactions (the
FOS) and led to additional research and considerations for narrowing the scope of this research
to the ultimately defined variable of positive social interactions and to use a present/not present
coding structure. The pilot study also informed the procedures developed for this research,
including the following:
•

It is important to train all students on the games to avoid confusion with the game rules.

•

Training for TD peers needs to address ways in which peers can model and encourage
appropriate social interaction with peers with ASD (e.g., if peer with ASD initiates
conversation unrelated to game, it is appropriate to engage in that conversation).

•

It is important to ensure that the XBox is set up and ready for play prior to the session
starting (e.g., students will not take time to create avatars or navigate the other options
such as online chatting).

•

When training coders, it is important to develop a coding rule to avoid confusion around
delayed echolalia, also known as “scripting”, by the child with ASD. Scripting is the
repetition of verbal messages previously heard by someone with ASD, and which he or
she repeats after a time delay. For many people with ASD, scripting involves the
repetition of words from previously viewed videos, TV shows, games, or books (Kim,
2012). For example, during one session in the pilot study, the child with ASD repeated,
“Bye Gordo. Uhhh, Thomas! You can’t catch me” multiple times. This type of scripting
should not be included in coding for positive social interactions, even if it appears that the
child is repeating a positive message to a peer (e.g., “Hello, let’s play.).

29

•

It is important to position the recording device in such a way that the facial expressions of
the child with ASD are easily seen. Lighting in the room is also important to ensure good
recording quality.

Research Design
This single-subject design study alternated three play conditions. Four pairs of students
participated, each including one student with ASD and a TD peer. Students were paired for the
duration of the study. Single-subject designs are widely accepted as an appropriate approach
when studying the behaviors of students with disabilities, and particularly those with ASD,
because they allow researchers to show causality in a smaller sample and help to establish
evidence-based practices (Barlow & Hayes, 1979; Barlow & Hersen, 1984; Creswell, 2009;
Gillis & Butler, 2007; Horner, Carr, Halle, McGee, Odom & Wolery, 2005; Kratochwill &
Levin, 1992; Sindelar, Rosenberg & Wilson, 1985). Within single-subject designs, individuals or
small groups of participants are selected and findings are replicated across others (Gillis &
Butler, 2007). This design allows a research to document relationships between independent and
dependent variables by considering performance of subjects prior to intervention and during or
after an intervention (Horner et al., 2005). Many single-subject designs employ the use of a
baseline or no treatment condition as a comparison for the treatment or intervention conditions
(Horner et al., 2005).
The adapted alternating treatment design (AATD) is a form of single-subject research,
adapted from Barlow and Hayes’ (1979) alternating treatment design. In AATD, researchers can
demonstrate functional control of the dependent variable, positive social interaction, by
extending the baseline/no-treatment condition, traditional recess, while implementing treatment
conditions (Sindelar et al., 1985). The baseline or no treatment phase was compared with the

30

change in dependent variable within the two experimental conditions (Sindelar et al., 1985). The
AATD is particularly useful when researchers do not expect participant behaviors to return to
baseline conditions, or reversal, following intervention. For this study, the adapted alternating
treatment design allowed for the evaluation of the relationship between each play condition and
positive social interactions between the child with ASD and his TD peer buddy.
In this study, the baseline phase was omitted because the baseline/no treatment sessions
were randomly interspersed within the design, which allowed comparisons between the
baseline/no treatment sessions and the treatment conditions throughout the study (Barlow &
Hayes, 1979). Although it is common with alternating treatment designs to conclude with several
sessions of a best treatment to ascertain durability of treatment effects, this study was limited by
the school schedule as previously mentioned. Students transitioned out of their pairs following
the duration of the Community Builders session and continuing a best treatment phase would
have required an adaptation to the pairing system for the upcoming session. Lack of a best
treatment structure is a clear limitation of this research and is addressed in the limitations section.
The two treatment conditions, facilitated play and kinetic technology play, were chosen
to demonstrate alternative possibilities to traditional recess, the baseline or no treatment
condition. The kinetic technology play and typical recess conditions were presented randomly to
reduce any potential for carryover effects or confounding variables. The facilitated recess
condition followed the school’s typical schedule for offering facilitated play, meeting once every
other week on Tuesdays or Wednesdays. Data were collected over three months with the aim of
collecting five video samples for each pair in each condition. Pair C had multiple absences and
therefore, only had four samples collected in the facilitated play condition. Due to video upload
malfunctions, two additional videos were lost, leaving Pair B with four samples in the facilitated

31

play condition and Pair C with four samples in the kinetic technology play condition. Four
sessions of traditional recess were not included in the analysis because they took place indoors
due to weather. This left Pairs A and B with four sessions of recess and Pair D with three.
Barlow & Hayes (1979) suggest the need for three to five samples of conditions to be able to
interpret preliminary data on the efficacy of an intervention.
Condition Descriptions
Recess. Collecting data on a no treatment condition of typical recess interactions allowed
me to contrast both treatments with what students experience in a typical inclusion setting.
During the traditional recess condition, students played according to the typical recess
procedures used by the school including playing freely on the playground equipment, blacktop
area, or fields. Students were directed by the person recording the session to play together for the
duration of the recess, approximately 25 minutes and were told that it was acceptable to play
with additional children, but that the pair needed to stay together. Although students were
directed to play together which is a change from typical recess, the environment was not changed
and, therefore, this condition was considered to be no treatment. In the event of inclement
weather, the school moves children inside for indoor recess and they play board games or build
with blocks or Legos in the school hallways. Due to weather, four of the 20 recess sessions were
recorded during indoor recess time. These sessions were excluded from the research findings due
to the differences in play between traditional outdoor recess and inside recess activities such as
board game play and building games.
Facilitated play. Facilitated play is also known as “Community Builders” within the
school. Community Builders is organized by the school’s two licensed Social Workers, two
special education teachers trained in working with children with ASD, and one general education

32

teacher who serves as one of the “buddy classes” for two of the participants with ASD. This
group designs collaborative games and activities that involve all students in the school’s special
education programs, and volunteer buddies from the same-aged TD peer population. Activities
for the sessions included: (a) people facts scavenger hunt—identifying people in the group who
fit various characteristics on a paper; (b) team relay races in the gym; (c) craft design—directed
design of a snowman using construction paper, scissors, and glue; (d) Giant Jenga game in
groups of six to ten students; (e) collaborative artwork—painting various squares on the same
large paper. One additional Community Builders session took place during the research that
involved technology based play with the iPads. Due to multiple participant absences and some
technical difficulties with the iPads, the recordings for this session were excluded from the data.
Kinetic technology play. The second treatment condition involved using technology in
the form of a video game system that required movement. Multiple systems exist that require
players to use their bodies to move avatars within the game. The element of movement was
critical in this research to better align with the movement associated with traditional recess and
to eliminate the learning associated with the use of a video game controller. For this research, the
XBox Kinect game console, with motion-sensing technology, was used. In this study, pairs were
invited to play an XBox game together during a 25-minute session. The XBox Kinect was set up
in a location known to the students; one was set up in the school’s sensory room and the other in
one of the special education classrooms across the hall. Students were directed to choose from
one of the games within XBox Kinect’s Adventure game series. These choices included the
following: 20,000 Leaks; River Rush; Rally Ball; Reflex Ridge; and Space Pop. Each game was
dual-player and involved using the students’ bodies to move the bodies of the avatars in the
games. For example, in 20,000 Leaks, participants were required to lean and bend, moving arms

33

and legs to plug “leaks” on a submarine. River Rush required participants to co-navigate a raft by
leaning and jumping to follow a river course with obstacles. Students were directed to play
together from the list of game options for the entire session.
Timeline
The timeline for this research followed the school’s schedule for the Community
Builders, or facilitated play program. Sessions for this program ran from November 1, 2016
through January 24th 2017 and were held every other week with the exception of school holidays.
Sessions for the Kinetic Technology Play and Recess conditions were held during this same
timeline to avoid confounding variables such as difference in TD buddy and student growth over
time in social abilities, communication skills, etc. This timeline was limited by the school’s
procedure of assigning new buddies for each new Community Builders session. Therefore, all
sessions involving the pairs in this research took place during this specific session of Community
Builders.
The lunch recess period for students at the school is 25 minutes each day. Therefore, play
sessions were recorded with the goal of achieving 20 minutes of play allowing for time for
participants to arrive to the appropriate location and for the students and recorders to locate one
another and begin the recording process. All recorded sessions used in the research spanned
between 17.5 and 20 minutes due to the timing of student arrival to the play location. Two
sessions were recorded but fell under 10 minutes of playtime due to a student forgetting his or
her participation on that day. Recordings of these sessions were not analyzed.
Participants
Site information. This study occurred in an elementary school, Easton Elementary, a K5 school in suburban Chicago, IL that includes a population of approximately 500 students, 47 of

34

who are educated in specialized programs to support students with more extensive special
education needs. The school district that houses Easton Elementary serves students in a town of
about 75,000 residents educating just over 5,000 students. The school district’s population
includes three percent low-income students, 15 percent students with disabilities, and nine
percent students who are English learners. The district spends approximately $12,000 per pupil
per year and employs 380 full-time teachers across its seven elementary schools (K-5) and two
middle schools (6-8). One elementary school also houses an early childhood center designed to
provide early intervention for students with disabilities.
This is a high-achieving district according to IL state testing, with 68% of students
meeting or exceeding standards on the new PARCC test, compared with the state average of
33%. The district provides three instructional programs for elementary-aged students with
special education needs. One is focused on students with behavioral needs and is housed at
another of the K-5 elementary schools. The other two instructional programs are housed at
Easton Elementary. As the names of the instructional programs are unique to the school and
district, pseudonyms have been used for the names of the programs to help avoid identification
of the school and students.
Easton Elementary provides educational support for students with a range of disabilities
through these two academic-based instructional programs that serve children across the district.
The Base program (pseudonym) serves students who are two to three years behind grade level
and need a more structured approach to instruction including repetition, a slower pace, and
review of fundamental academic skills. Students in the Base program have a variety of
disabilities including Specific Learning Disabilities, Traumatic Brain Injuries, Intellectual
Disabilities, and ASD. Classes are typically six to 12 students with a teacher/teaching assistant to

35

student ratio of 1:2. Easton Elementary hosts three Base classrooms (Kindergarten/first,
second/third, fourth/fifth). One of the fifth grade participants in this study, Brandon (pseudonym)
came from the Base program.
The second instructional program, Engage (pseudonym), provides structured,
individualized support for students with instructional needs related to their receptive and
expressive communication abilities. Students in this program have a wide range of academic
abilities from two to three years behind grade level to at or above grade level. Typically, their
behaviors and sensory needs require more specialized support than can be found in a general
education setting. Therefore, the Engage classrooms, of which Easton Elementary has three
(first, second, third/fourth/fifth), have a teacher/teaching assistant to student ratio of close to 1:1.
Students have specifically designed sensory supports to provide opportunities for regulation and
input throughout the day. They have structured schedules, and teachers use research-based
methods of instruction including visual supports, video modeling, hands-on activities, and
integrated speech therapy. Several students in this program also utilize an augmentative
communication device with programs such as Proloquo2Go or LAMP. These programs are used
with a technology device such as an iPad and allow students to choose picture cues of things they
want to communicate. The device then reads the word the child has selected. Most students in the
Engage program were verbal. Three participants in the study, both 2nd graders, Carl and David
(pseudonyms) and the other 5th grader, Alex (pseudonym), came from the Engage program.
All students in both the Base and Engage classrooms are paired with a buddy class from
the general education population at their grade levels. They join those students for Specials
classes such as Art, Music, and Physical Education (PE). They also join the general education
classroom for content-based instruction such as Social Studies and Science activities as much as

36

is appropriate for their ability levels and Individualized Education Plan (IEP) goals. Students in
these programs also receive support from a variety of related service providers including Social
Work, Speech Language Therapy, Occupational Therapy, Physical Therapy, Adaptive PE, and
behavioral support from the Psychologist. Easton Elementary also coordinates with the local
special education cooperative, of which the district is a member, to provide additional support
through an Autism Coach, parent support, and teacher training.
Teachers hired for the Engage and Base programs maintain specialized certification and
have experience working with students with ASD. The district and school support teachers in
utilizing a variety of interventions to support students’ academic, functional, and social skill
development. The teacher in the third through fifth grade Engage classroom holds a Master’s
degree and has worked at Easton Elementary for three years. The teacher in the 2nd grade
Engage classroom holds a Master’s degree and has worked at Easton Elementary for six years
and was involved in the creation of the program at the District level. The current teacher in the
4th-5th grade Base classroom holds a Bachelor’s degree and this is her first year working at
Easton Elementary. On the current academic year evaluations, the Engage teachers received an
excellent rating. At the time of this research, the new Base teacher had not yet been evaluated.
Children across Easton Elementary, including those in the specialized programs, were
exposed to a variety of technology on a daily basis. All classrooms were equipped with
interactive whiteboards, document cameras, multiple iPads, desktops, and laptops. One teacher in
the specialized programs experimented with using the Nintendo Wii video game system for
“brain breaks” with students, using the dancing game and sports games associated with the
system. A Technology Facilitator and a Building Support Technician supported teachers at
Easton Elementary by responding to technology troubleshooting issues, adding requested apps,

37

and providing training on new technologies for teachers. Therefore, the participants in the study
had at least a beginning exposure to a variety of technologies.
Information for participants with ASD. In an effort to provide consistency across the
sample, several parameters were used as criteria for selecting participants. All participants had an
IEP with the primary eligibility for services listed as Autism and were drawn from the Base or
Engage programs. Participation in these programs indicated a more moderate to severe form of
ASD as compared with students with ASD who may be able to be successful in a full inclusion
general education setting. Although some participants had an augmentative communication
device, all had the ability to communicate verbally. Participants were second or fifth graders, and
were therefore between seven and 11 years old. All participants had a history of regular
participation (at least five 30-minute sessions weekly) with their general education buddy classes
(i.e., Art, Music, PE, Social Studies, Science, and Library). At Easton Elementary, twelve
students met the above criteria. Parents were sent a letter to solicit interest. I accepted the first
four students from the Base and Engage programs who returned their signed parental consent
forms.
Information for TD participants. Peer buddies were familiar to the children with ASD
as they were drawn from classrooms with which the student with ASD consistently interacts,
also known as his or her “buddy class.” Typical peer buddies were selected from a group of
approximately 40 volunteers using a teacher survey designed to highlight students with
characteristics shown to be effective for peer buddies including the following: prosocial
leadership, positive views about people with disabilities, and same age and gender (Jackson &
Campbell, 2009). General education buddy teachers at the school were asked to nominate three
exemplar peer buddies, including one best peer buddy, as well as three students who would not

38

be recommended to serve as a peer buddy. This feedback ensured that positive peer buddies were
chosen for the study (Jackson & Campbell, 2009). Teachers responded to the above questions via
a GoogleForm survey (see Appendix A). Peer buddies for this study were drawn from the pool of
volunteers from the established general education buddy classes of the children with ASD and
cross-referenced with those students who were highlighted by teachers as ideal peer buddies. All
peer buddies selected for this study were included on their teacher’s feedback form as being one
of the exemplar peer buddy options. If multiple students volunteered and were noted by their
teacher as an exemplar peer buddy, I chose the volunteer who turned in his or her participation
form first.
After students with ASD were selected for participation, they were paired with the TD
peer from their existing buddy class with whom they have had previous interaction. All
participants provided verbal assent for their participation in the study. More specific details
regarding the participants (utilizing pseudonyms throughout the paper) are discussed below.
•

“Alex”, Pair A, Child with ASD: 5th grade, (10 years old)

•

“Alvin”, Pair A, TD peer: 5th grade, (11 years old)

•

“Brandon”, Pair B, Child with ASD: 5th grade, (10 years old)

•

“Brenda”, Pair B, TD peer: 5th grade, (11 years old)

•

“Carl”, Pair C, Child with ASD: 2nd grade, (7 years old)

•

“Cara”, Pair C, TD peer: 2nd grade, (7 years old)

•

“David”, Pair D, Child with ASD: 2nd grade, (7 years old)

•

“Donna”, Pair D, TD peer: 2nd grade, (7 years old)

39

Following participant selection, I facilitated a 30-minute small group training session for
peer buddies highlighting effective strategies for being a peer buddy using the PMII model
discussed in the literature review. The “peer initiation training” portion of the PMII model
focused on teaching peers how to socially initiate an interaction with a child with ASD and how
to appropriately respond to the peer with ASD when he or she initiates an interaction. Per the
PMII model, the training for typical peers addressed the following areas (Odom & Strain, 1986;
Odom & Watts, 1991):
•

How to recognize and appreciate individual differences (likes, dislikes, needs, abilities)

•

Overview of similarities and differences of characteristics of children with ASD

•

Initiation strategies in play settings including how to organize play, make suggestions,
and share

•

How to provide assistance to the peer with ASD

•

How to provide appropriate affection and praise

Each of the selected peer buddies had previously participated as a buddy throughout their
classrooms and during “Community Builders.” Therefore, the peer initiation training was a
refresher of previously shared material.
Measures
The measures in this study focused on the positive social interactions between the student
with ASD and his TD peer buddy. The dependent variable, positive social interaction, was
evaluated by recording each play session and using partial interval coding, every 20 seconds, to
determine if a positive social interaction had occurred on the part of the child with ASD, the TD
peer buddy, or both. Play sessions were 17.5 to 20 minutes long and although there is no
accepted guideline for a specific partial interval length, the choice to use 20-second intervals was

40

informed by the pilot study. Given the shorter duration of many positive social interactions (e.g.,
high five, laughter, comment), a shorter interval was preferable. Breaking the coding into 20second intervals allowed for approximately 60 possible opportunities during a play experience
where a social interaction could occur. Using the frequency-ratio approach to calculate the
number of positive social interactions noted during these 60 intervals is appropriate because the
research questions address frequency of behaviors observed during a session and do not require a
deeper level of understanding about exactly when the behaviors occurred. Given the difference in
length of recorded sessions (between 17.5-20 minutes), I reported results as a percentage of
intervals for each session rather than total number of intervals per session.
I also provided a measure of effect size using Tau-U. Although most researchers agree
that visual analysis is the most appropriate way to analyze data within single subject designs, the
calculation of effect sizes adds confidence to conclusions about differences among treatments
(Allison & Gorman, 1993; Rakap, 2016). However, there exists widespread disagreement about
the appropriate way to determine effect size for single case studies. There are multiple ways to
compute effect size (e.g., Tau-U, PND, SMD, IRD, etc.), however, appropriate procedures for
calculating effect size are also in part based upon the type of single case design (e.g., ABAB,
multiple-baseline, etc.) (Allison & Gorman, 1993; Lenz, 2013; Parker, Vannest & Brown, 2009;
Parker, Vannest & Davis, 2011; Rakap, 2016). Tau-U is the percentage of nonoverlap between
phases or the percentage of data that show improvement between two phases or interventions
(Rakap, 2016). Tau-U scores range from 0% to 100% and can be interpreted using the following
assessment: 65% or lower: weak or small effect; between 66% and 92%: medium to high effect;
and 93% to 100%: large or strong effect (Parker & Vannest, 2009). In this research, the Tau-U
effect size calculation was appropriate because Tau-U combines non-overlap between phases

41

with the trend data from within the intervention phase (Vannest & Davis, 2011). Unfortunately,
as an index, Tau-U calculations require the use of a statistical package. I have used Vannest et
al.’s (2011) web-base calculator for Tau-U, which can be found at
www.singlecaseresearch.org/calculators/tau-u.
For the purposes of this research, the variable positive social interaction includes social
initiations or positive social behaviors that begin an interaction with a peer and responses to a
peer’s social initiations (Davis, Langone, & Malone, 1996; Owen-DeSchryver, Carr, Cale &
Blakeley-Smith, 2008). Bauminger et al.’s (2005) previously referenced FOS, and other studies
that used an adapted version (Ben-Sasson, Lamash, & Gal, 2012), also helped to inform the
definition of positive social interaction including example definitions of the following: (a)
affection (shows affection verbally or non-verbally); (b) help (responsive to help from a peer
such as redirecting behavior based on a peer suggestion); (c) compromise (shared discussion
including at least one verbalization by each participant); and (d) non-verbal behaviors (eye
contact, smile, shared laughter). Based upon the previously established definitions of prosocial
behaviors as a foundation, in this study, positive social interactions may include greetings,
statements, praise, conversation, questions, and gestures. The table below provides more specific
details on the positive social interaction variable as defined for this study including example and
non-example behaviors.

42

Table 1. Description of Dependent Variable: Positive Social Interaction
Definition

Examples

Non-examples

The percentage of
intervals where the
participant has positive
social interactions with
his or her peer. This
includes any greeting,
statement, praise, ongoing
conversation, question,
laughter, etc. This also
includes positive gestures
such as a high five, hug,
handshake, etc. that
participants make to their
peers.

Affection:
• Initiates or responds to high
five or hug
• Shares affection verbally

Affection:
• Ignores peer’s greeting

Help:
• Requests or offers help with a
portion of the activity
• Encourages peer to take part in
the activity
• Says peer’s name in an
attempt to engage him/her in
the activity or gain his/her
attention
• Follows directions given by a
peer to engage in the activity
(e.g., if the child jumps when
directed to jump or moves
backwards when directed by
peer)

Help:
• Does not respond to peer’s
question or statement
• Declines to follow peer’s
prompts in relation to the play
activity

Compromise:
• Answers a peer’s question
with an on-topic response or
discusses the activity with peer
in a positive way

Compromise:
• Engages in verbal “scripting”
of unrelated topics
• Argues with peer

Non-verbal Behaviors:
• Shows positive emotion such
as smiling or laughter in
relation to peer or the activity

Non-Verbal Behaviors:
• Plays alongside peer without
interacting or completes
activity with peer without
interacting
• Leaves the play area where the
peer is

Note: Behaviors must only relate to peer buddies, not others with whom the children may interact during play.

43

In single-subject design, a traditional method for measuring the social validity of the
outcomes of an intervention is subjective evaluation through the use of questionnaires (Kennedy,
2005). In this research, I used a five-question survey to determine which play condition was
preferred by the participants. Questions included the following:
1.

Which play environment was the most fun (recess, Community Builders, XBox play)?
Why?

2.

Which play environment helped you get to know your buddy the best? Why?

3.

How much did you enjoy playing with your buddy at recess?
not at all

4.

a lot

How much did you enjoy playing with your friend during Community Builders?
not at all

5.

a little

a little

a lot

How much did you enjoy playing with your friend when using the XBox?
not at all

a little

a lot

Procedures and Data Collection
The pairs engaged in play across three conditions over a 12-week period and were
recorded by two videographers who are former educators. One videographer is a former school
psychologist and the other is a former school social worker. I trained the videographers in a onehour session at the research site including reviewing fidelity checklists, training on recording
equipment (iPads, external microphones), training on the XBox’s basic functions, and
scheduling. They were also introduced to the students and given a tour of the school site.
Videographers signed a school district confidentiality agreement as well as a confidentiality
agreement prepared by me (see Appendix B). Videographers were paid an hourly rate for their
participation in the study. They met all requirements for attending sessions, recording, and

44

uploading videos as specified. They also completed IRB-required Human Subjects training
sessions.
All study participants were trained on how to use the XBox Kinect system and each game
option during 15-20 minute sessions preceding the first day of data collection. A Teaching
Assistant familiar with the child with ASD was present for the play sessions. Pairs participated in
play sessions during normally scheduled recess times (12:10-12:40 or 12:40-1:10). Special
education teachers provided students with ASD a social story to introduce the change in schedule
and the expected activity for the day. When students arrived to the setting they were met by the
recorders who followed the procedural checklists below to begin play. The procedural checklists
were followed for each session of play throughout the research. The recorders turned in these
checklists to me to show that they had followed these specific procedures in 100% of the
sessions. I also supervised at least 20% of the sessions including at least one session for each pair
in each play condition to ensure procedures were being followed appropriately.
Recess sessions procedures and fidelity checklist. This checklist included the following
steps:
1.

Pairs of children meet researcher at exit door to playground.

2.

Researcher gives ground rules. “The goal today is for you to play together during
recess. You may also play with additional children in a larger group if you’d like.
Please do not run so that you can more easily be recorded. Please remember to
follow the school’s rules for recess.”

3.

Researcher begins recording, following children within 5-10 feet of play to ensure
audio and video recording is effective, attempting to get a view of children’s faces.

45

4.

Recording is centered on the pair of students, with view of their faces, regardless of
other students/adults who interact with the pair during the play.

5.

After 20 minutes, recording is ended.

6.

Students line up to return to their classrooms.

Facilitated play sessions procedures and fidelity checklist. This checklist included the
following steps:
1.

Pairs of children meet researcher in whatever location is required by the facilitated
play schedule (e.g., library, gym, etc.).

2.

Children follow guidelines of certified staff members (teachers and social workers)
to engage in play together.

3.

Researcher begins recording at the start of the session.

4.

Researcher stays within 5-10 feet of the play to ensure audio and video recording is
effective.

5.

Recording is centered on the pair of students, in view of their faces, regardless of
other students/adults who interact with the pair during the play.

6.

Recording stops approximately 20 minutes later, or at the end of the session.

7.

Students return to their classrooms.

Kinetic technology play sessions procedures and fidelity checklist. This checklist
included the following steps:
1.

Prior to children entering the space, researcher prepares environment.
a.

Move any equipment out of the way to ensure a safe environment to play.

b.

Turn on XBox and insert XBox Kinect Adventures disc.

46

c.

Navigate game to window providing choice of Adventure games. [Note: This
step was included to prevent wasted time for students to navigate through the
multiple opening screens included when inserting a new video game disc.]

2.

Pairs of children meet researcher in the sensory room. Teaching Assistant familiar
with the student with ASD accompanies children.

3.

Researcher explains rules of using XBox.
a. Stand 5-10 feet away from the television.
b. [Students] follow directions provided by the game.

4.

Researcher begins recording (tripod can be used in this setting), standing 5 feet from
the students to avoid being in the field of play, but in view of their faces.

5.

Researcher says, “You may now choose a game from the options in XBox Kinect
Adventures.”

6.

Children begin gameplay.

7.

Researcher supports students with any technical difficulties with the XBox
(recording continues during any troubleshooting).

8.

After 20 minutes, researcher tells students they are out of time and tells them to turn
off the game. Researcher thanks them for their time.

9.

Researcher ends recording.

10. Students return to their classrooms.
Data were collected via video recordings of all sessions of play. Videos were recorded on
iPads via the camera app in an effort to capture the participants’ facial and body movements and
verbal interactions. External microphones were used with the iPads during the outdoor recess
sessions to better capture participant verbal interaction. After each session, videos were uploaded

47

to a closed YouTube channel to review for coding. To ensure students attended the play sessions,
I emailed their teachers the day before, or the morning of, to remind them of the recording
session and where students should report. Six of the Kinetic Technology Play and Recess
sessions were missed due to student absence on the specified day. Those sessions were made up
on different days in the same three-month period.
Coding process. As the lead researcher, I coded all of the play sessions. Two additional
coders who were blind to the conditions reviewed the first 20% of the data, representing one
video from each condition from each group. The coders were current members of the Michigan
State University Educational Psychology and Educational Technology (EPET) program. I trained
the coders in a one-hour online session using a sample video clip (non-experimental session).
During the session, the coders were introduced to the variable definition of positive social
interaction. We discussed, in detail, examples of positive social interactions as defined in the
previous section. We also discussed the nature of parallel play and shared that side-by-side
playing (e.g., swinging, moving to the XBox game) without verbal or physical interaction should
not be counted as a positive social interaction. Coders were given access to a secured playlist via
a closed YouTube channel. All videos were coded in 20-second intervals indicating if a positive
social interaction occurred, from the child with ASD, the typical peer, or both.
Inter-observer agreement (IOA). To ensure reliability of my coding, I compared my
coding responses and those of the two additional coders for 20% of sessions for each pair in each
treatment setting (i.e., one video per pair, per play condition). IOA was calculated by dividing
the number of agreements of the codes across all three coders by the number of agreements plus
disagreements and multiplying by 100. The results of the three coders’ data meet the threshold of
Cohen’s Kappa (Cohen, 1960), where agreement is 80% or greater, for all but one pair in one

48

condition. Pair A’s recess video initially received a 65% IOA across the three coders. In
reviewing the video, it was noted that there were parts where the sound was not ideal, likely due
to the amount of wind outside or a malfunction of the external microphone. No other recess
videos appeared to have the same sound issue, despite some being taken on the same day.
Therefore, the three coders evaluated an additional video for Pair A in the recess play
condition and we achieved an 80% agreement rate. I determined that no further training or
adjustment was needed to address the initial lower agreement for Pair A in the recess condition.
The overall 1:1:1 coder agreement across 20% of data was 82%, therefore meeting the Cohen’s
Kappa standard. As well, each pair’s total and each play condition’s total also met the 80%
agreement threshold. Specifically, IOA for each pair included the following levels: Pair A-80%;
Pair B-86%; Pair C-81%; and Pair D-82%. IOA for the facilitated play condition was 84%. IOA
for the kinetic technology play condition was 80% and IOA for the recess condition was 83%.
With the knowledge that the IOA was at or above the standard, I moved forward with coding the
remaining 80% of videos using the same coding standards.
Data Analysis
I analyzed the coded data to answer the first research question, which play condition
(traditional recess, facilitated play, or kinetic technology play) was most effective in eliciting
positive social interactions for students with ASD and TD peers. I used visual data analysis to
compare play settings for each pair by graphing the average number of positive social
interactions for each student in each play condition. I reviewed the occurrence of positive social
interaction based on the percent of intervals where the participant had positive social interaction
with a peer (number of intervals including a positive social interaction divided by the total
number of intervals). Visual analysis, used frequently within single-subject research designs,

49

allows researchers to come to a conclusion about the reliability or consistency of an
intervention’s effects by graphing data and visually examining the results (Kazdin, 1982). I
calculated the stability of the data using Gast and Ledford’s (2014) standard of 80-90% of data
points falling within a 25% range of the mean level. I reviewed the trend of the data by
calculating a trend line to determine the direction of the data path. The trend line indicated if the
data was accelerating, decelerating, or remaining consistent (zero). Results of the data including
range, mean, median, stability, trend, and Tau-U effect size are reported in the following section.
To address the second research question, which play condition students with ASD and
their TD peers reported as being most enjoyable, I analyzed the student survey responses. This
also provided a measure of social validity within the single-subject research design. Social
validity is the “estimation of the importance, effectiveness, appropriateness, and/or satisfaction
various people experience in relation to a particular intervention” (Kennedy, 2005). In this case,
the survey provided a measure of validity regarding the interaction between the child with ASD
and the TD peer as reported by the students themselves. Results of the surveys are shared in the
following section.

50

RESULTS
Play Activities
Each pair participated in a variety of activities throughout this research. During the
kinetic technology play, each pair rotated through different games throughout each session. Each
game took less than 5 minutes and most pairs played each game at least once during each
session. As stated previously, the games included the following: 20,000 Leaks; River Rush; Rally
Ball; Reflex Ridge; and Space Pop. The following table shows the types of activities each pair
participated in for the recess and facilitated play sessions.

51

Table 2. Types of Activities for Each Pair in Recess and Facilitated Play Conditions
Session

Recess

Facilitated Play

1
2
3
4
5

Pair A
Swinging
Swinging
*
Swinging, playing catch
Swinging, playing catch

People scavenger hunt
Relay races
Snowman craft
Giant Jenga
Collaborative painting

1
2
3
4
5
1
2
3
4
5

1
2
3
4
5

Pair B
Basketball, bouncing ball against
wall
*
Basketball, catch
Basketball, catch
Basketball, swinging
Pair C
Swinging, playing in leaves
Playing on playground equipment
Playing on playground equipment,
chasing/tag
Chasing/tag, going down the slide
Playing in snow
Pair D
Swinging, walking around
playground
Playing with leaves, playing on
playground equipment
*
Playing chase/tag, playing on
playground equipment
*

Relay races
Snowman craft
Giant Jenga
Collaborative painting
*
People scavenger hunt
Snowman craft
Giant Jenga
Collaborative painting
*

People scavenger hunt
Relay races
Snowman craft
Giant Jenga
Collaborative painting

Note: The * designates a session that was discarded from analysis due to indoor recess, student
absence, or video loss.

52

Positive Social Interactions
I began by examining data trends, through visual analysis, across sessions for participants
with ASD. The following figures show the data for each child with ASD, for each session across
conditions. The graphs are followed by a discussion of the results for each child.

53

Figure 1. Average Percent of Positive Social Interactions for Alex and Brandon (5th Graders)

54

Figure 2. Average Percent of Positive Social Interactions for Carl and David (2nd Graders)

55

Alex. Alex presented the highest number of positive social interactions within the kinetic
technology play condition (average = 59% of the possible intervals recorded in this condition).
Recess was less effective, eliciting an average of 23% of positive social interactions. The
facilitated play condition was least effective, eliciting an average of 21% of positive social
interactions.
Brandon. Brandon presented the highest number of positive social interactions within the
kinetic technology play condition (average = 68%). Facilitated play was less effective, eliciting
an average of 24% of positive social interactions. The recess condition was least effective for
Brandon, eliciting an average of 21% of positive social interactions.
Carl. Compared with Alex and Brandon, Carl showed lower overall positive social
interactions across all conditions. Carl also presented with the highest number of positive social
interactions in the kinetic technology play condition (average = 27%). The recess condition was
less effective, eliciting 11% of positive social interactions. The facilitated play condition was
least effective, eliciting only eight percent of positive social interactions.
David. Like Carl, David presented with lower overall positive social interactions across
conditions, however, kinetic technology play elicited the highest overall for David as well
(average = 21%). Like Carl, the recess condition elicited the second highest average of positive
social interactions at 11% and the facilitated play condition was least effective at only 7% of
positive social interactions.
Due to the nature of social interactions involving at least two people, it was also critical
to understand which play condition (traditional recess, facilitated play, or kinetic technology
play) was most effective in eliciting positive social interactions between students with ASD and
TD peers. To assess this, I calculated the total number of positive social interactions for each

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child in every pair for all sessions in each of the three conditions (i.e., the number of 20-second
intervals including a positive social interaction divided by the total number of 20-second
intervals in the session). For the facilitated play condition, the paired mean positive social
interaction was 25% (SD =12.1). For the recess condition, the paired mean was 19.8% (SD
=15.3). For the kinetic technology play condition, the paired mean was 55% (SD = 26.4).
Results, including range, mean, median, stability, trend, and Tau-U for each pair are presented
below.

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Table 3. Data Analysis Summary of the Impact of Play Conditions on Positive Social Interaction
Measure

Recess Baseline

Facilitated Play
Condition

Kinetic Technology
Play Condition

16.7%-63.9%
38.9%
40%
Variable
Decelerating
0%
5

74.4%-82.3%
77.5%
75.8%
Stable
Accelerating
100%
5

22.1%-54.8%
31.5%
24.5%
Variable
Zero
100%
4

76.3%-80%
78.1%
78.4%
Stable
Decelerating
100%
5

8.5%-19.7%
15%
15.9%
Stable
Decelerating
20%
4

16.7%-46.7%
30%
28.3%
Variable
Accelerating
90%
4

0%-23.1%
14.7%
16.7%
Stable
Decelerating
60%
5

19.4%-46.7%
34.4%
35.2%
Stable
Decelerating
100%
5

Pair A
Range
Mean
Median
Stability
Trend
Tau-U*
# of sessions

21.3%-60.7%
42.4%
43.8%
Variable
Decelerating
-4
Pair B

Range
Mean
Median
Stability
Trend
Tau-U*
# of sessions

10.5%-18.3%
15.3%
16.1%
Stable
Decelerating
-4
Pair C

Range
Mean
Median
Stability
Trend
Tau-U*
# of sessions

9.2%-18.3%
13.4%
13.3%
Stable
Decelerating
-5
Pair D

Range
Mean
Median
Stability
Trend
Tau-U*
# of sessions

6.5%-10.2%
8.3%
8.2%
Stable
Decelerating
-3

Note: * denotes Tau-U between the recess and kinetic technology play conditions and between
the recess and the facilitated play conditions.

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Alex (child with ASD) and Alvin (TD peer). Alex and Alvin are 5th grade students aged
10-11. They played together five times in each condition, for a total of 15 sessions. The
following graph shows the percent of positive social interactions for each session for the children
in Pair A as well as their combined average. FP designates the facilitated play condition; R the
recess condition; and KTP the kinetic technology play condition.
Figure 3. Positive Social Interactions for Pair A Across Play Conditions

Alex and Alvin both showed higher levels of positive interaction throughout all of the
kinetic technology play sessions. Alex showed higher levels of positive social interactions in the
kinetic technology play condition as compared with the other two conditions, ranging between
55% and 65%. Alvin also demonstrated positive interactions more commonly in the kinetic
technology play condition, ranging from 90% to 100% of the time. Kinetic technology play
sessions also showed a consistently smaller range in number of positive social interactions,
varying only 10% for both participants. Comparatively, the variation in the facilitated play

59

condition ranged 40% for Alex and 57% for Alvin, and in the recess sessions ranged 44% for
Alex and 49% for Alvin. Means and standard deviations for each condition are presented in the
table below.
Table 4. Means and Standard Deviations of Positive Social Interactions for Pair A
Facilitated Play
Condition

Recess Condition

KTP Condition

Participant(s)

Mean

SD

Mean

SD

Mean

SD

Alex (Child with
ASD)

21.17

15.37

22.89

16.82

59.23

3.71

Alvin (TD Peer)

56.71

19.81

64.23

19.93

95.78

4.04

Alex and Alvin
Combined

44.51

17.35

43.56

17.24

77.50

3.34

Note: Mean was calculated by summing the total number of 20-second intervals containing a positive
social interaction divided by the total number of 20-second intervals during the play session. Sessions
typically spanned 20 minutes.

Brandon (child with ASD) and Brenda (TD peer). Brandon and Brenda are also 5th
grade students who are 11 years old. They played together 14 times during the study, missing
one facilitated play session due to absence. The following graph shows the percent of positive
social interactions for each session for the children in Pair B. FP designates the facilitated play
condition; R the recess condition; and KTP the kinetic technology play condition.

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Figure 4. Positive Social Interactions for Pair B Across Play Conditions

Like Alex and Alvin, Brandon and Brenda also showed more consistent positive social
interactions during kinetic technology play as compared with the other two conditions.
Brandon’s positive social interactions in kinetic technology play ranged from 65-72% while
Brenda’s ranged from 87-89%. Positive social interactions in the recess and facilitated play
conditions showed a wider range and lower overall mean than the kinetic technology play
condition. Ranges for the facilitated play sessions were 29% for Brandon and 38% for Brenda.
One notable exception was the second recess session that had a higher mean of 83% and 90% for
Brandon and Brenda respectively. The second recess was an indoor recess session due to the
extremely cold weather and Brandon played a board game with Brenda called Headbandz that
involved asking one another questions to get clues about a picture. The other four sessions of

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recess were on the playground. Means and standard deviations for each condition are presented
in the table below.
Table 5. Means and Standard Deviations of Positive Social Interactions for Pair B
Facilitated Play
Condition

Recess Condition

KTP Condition

Participant(s)

Mean

SD

Mean

SD

Mean

SD

Brandon (Child with
ASD)

24.32

14.04

21.45

33.91

68.18

3.14

Brenda (TD Peer)

38.57

17.48

37.24

29.58

88.16

0.27

Brandon and Brenda
Combined

32.45

15.68

29.35

31.61

78.17

1.59

Note: Mean was calculated by summing the total number of 20-second intervals containing a positive social
interaction divided by the total number of 20-second intervals during the play session. Sessions typically spanned 20
minutes.

Carl (child with ASD) and Cara (TD peer). Carl and Cara are seven year-old students in
the second grade. They played together 14 times, missing one facilitated play session due to
absence. However, due to video difficulty, one session of kinetic technology play was unable to
be coded, leaving the pair with 13 viable play sessions to analyze. The following graph shows
the percent of positive social interactions for each session for the children in Pair C. FP
designates the facilitated play condition; R the recess condition; and KTP the kinetic technology
play condition.

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Figure 5. Positive Social Interactions for Pair C Across Play Conditions

Overall, Carl had fewer instances of positive social interactions than either Brandon or
Alex, but like the previous pairs, Carl and Cara showed higher levels of positive social
interaction during kinetic technology play. Three of the four samples of play in the kinetic
technology play condition for Carl and Cara elicited more positive social interactions, ranging
from 27% to 37%, than either of the other conditions. One recess session showed no instances of
positive social interaction on Carl’s behalf. Means and standard deviations for each condition are
presented in the table below.

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Table 6. Means and Standard Deviations of Positive Social Interactions for Pair C
Facilitated Play
Condition

Recess Condition

KTP Condition

Participant(s)

Mean

SD

Mean

SD

Mean

SD

Carl (Child with
ASD)

8.23

4.49

10.71

6.3

27.08

12

Cara (TD Peer)

21.71

8.22

16.12

4.33

32.91

18.81

Carl and Cara
Combined

14.97

5.52

13.42

3.68

29.99

13.53

Note: Mean was calculated by summing the total number of 20-second intervals containing a positive social
interaction divided by the total number of 20-second intervals during the play session. Sessions typically spanned 20
minutes.

David (child with ASD) and Donna (TD peer). Like the participants in Pair C, David and
Donna are seven year-old 2nd graders. They played together for 15 sessions including five
sessions in each condition. The following graph shows the percent of positive social interactions
for each session for the children in Pair D. FP designates the facilitated play condition; R the
recess condition; and KTP the kinetic technology play condition.

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Figure 6. Positive Social Interactions for Pair D Across Play Conditions

Like Carl and Cara, David and Donna had fewer overall instances of positive social
interactions than Alex/Alvin and Brandon/Brenda. Although the average positive social
interactions were more variable across all settings than for Pairs A and B, Pair D showed higher
levels in the kinetic technology play condition, ranging from 13-39% for David and 26-63% for
Donna. Means and standard deviations for each condition are presented in the table below.

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Table 7. Means and Standard Deviations of Positive Social Interactions for Pair D
Facilitated Play
Condition

Recess Condition

KTP Condition

Participant(s)

Mean

SD

Mean

SD

Mean

SD

David (Child with
ASD)

6.99

5.64

10.98

9.89

21.23

10.32

Donna (TD Peer)

22.46

14.24

18.05

10.27

47.47

14.29

David and Donna
Combined

14.72

9.51

14.51

10.02

34.35

10.56

Note: Mean was calculated by summing the total number of 20-second intervals containing a positive social
interaction divided by the total number of 20-second intervals during the play session. Sessions typically spanned 20
minutes.

To discover if participant views matched the above data, I reviewed participant survey
responses regarding their feelings on the different play environments. Each participant filled out
a survey after the final session. Results are reviewed below.
Participant Survey
To address the second research question, which play condition do students with ASD and
their TD peers report as being most enjoyable, I used data from the social validity measure, the
participant survey. Each participant was surveyed using five questions. All participants with
ASD were able to read and write as demonstrated by their classwork and IEP goals, therefore all
participants were asked to elaborate in writing as to why they chose answers throughout the
survey. Responses to each survey question are outlined below with “*” indicating which answer
each participant chose on the survey.

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Table 8. Participant Responses: “Which play environment was the most fun?”
Participant

Facilitated Play
Condition

Recess Condition

Alex (Child with ASD)

*

Alvin (TD Peer)

*

Brandon (Child with ASD)

*

Brenda (TD Peer)
Carl (Child with ASD)

KTP Condition

*
*

Cara (TD Peer)

*

David (Child with ASD)

*

Donna (TD Peer)

*

Note: The * represents the condition chosen by each participant as “the most fun.”

Participants in Pair A both chose recess as the most fun setting. The typical peer noted
that recess was more fun “because I liked making new games and there was more interacting.”
Both children in Pair B also chose recess as the most fun condition. The child with ASD in Pair
B noted that he liked going on the swings. His typical peer shared that recess was the most fun
“because I love playing basketball and so does [Brandon].” Pair C participants showed a split
preference. The child with ASD did not elaborate as to why he chose facilitated play as the most
fun play condition. His typical peer buddy noted kinetic technology play as her choice “because
[Carl] was more excited.” Finally, Pair D participants both agreed that kinetic technology play
was the most fun play condition. The child with ASD in Pair D did not elaborate, but his typical
peer buddy noted that kinetic technology play was her favorite because, “I like helping [David]
to play games.”

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All participants were also asked which play condition they felt helped them to get to
know their buddy the best. Overall responses, indicated with “*”, to this question are outlined
below.
Table 9. Participant Responses: “Which play environment helped you get to know your buddy
the best?”
Participant

Facilitated Play
Condition

Recess Condition

Alex (Child with ASD)

*

Alvin (TD Peer)

*

Brandon (Child with ASD)

*

Brenda (TD Peer)
Carl (Child with ASD)

KTP Condition

*
*

Cara (TD Peer)

*

David (Child with ASD)
Donna (TD Peer)

*

Note: The * represents the condition chosen by each participant as the one that helped them get to know their
buddy best. David did not provide an answer to this question on his survey.

Again, participants were asked to elaborate on their answer to this question. Pair A
participants again both chose recess as their preferred condition. Although the child with ASD
did not elaborate as to why he chose recess, his typical peer buddy noted that he chose recess,
“because there was more interacting and I asked him many questions during recess.” Pair B
participants were split on this question. The child with ASD did not elaborate as to why he chose
kinetic technology play, however his typical peer buddy noted that her preference for recess was
“because I never knew [Brandon] could throw the tennis ball that far.” Pair C participants were
again split in their preferences. The typical peer buddy in that pair noted that she found the
kinetic technology play condition to help her get to know her peer best, “because he was eager to
do it.” In Pair D, the child with ASD was not able to choose an answer for this question. His TD

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peer noted that she enjoyed the facilitated play condition in helping her get to know her buddy
“because I like to see what [David] can do.”
The final three questions asked participants to note how much they enjoyed playing with
their friend in each condition overall. Results for each environment are noted below, using “*” to
show the participants’ answer choices. Participants were not asked to elaborate on their choices
for these questions.
Table 10. Participant Responses: “How much did you enjoy playing with your friend during
recess?”
Participant

Not At All

A Little

A Lot

Alex (Child with ASD)

*

Alvin (TD Peer)

*

Brandon (Child with ASD)

*

Brenda (TD Peer)

*

Carl (Child with ASD)

*

Cara (TD Peer)

*

David (Child with ASD)

*

Donna (TD Peer)

*

Note: The * represents the answer option chosen by each participant.

All participants noted enjoyment in playing with their peer during recess, with 50%
selecting “a little” enjoyment and 50% selecting “a lot” of enjoyment. Three of the children with
ASD selected that recess play brought “a lot” of enjoyment while only one TD peer selected “a
lot.” All participants in both Pair A and Pair B noted the same level of enjoyment for the recess
condition. Next, participants were asked about enjoyment in the facilitated play sessions.
Participant responses, marked by “*” are provided in the following table.

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Table 11. Participant Responses: “How much did you enjoy playing with your friend during
Community Builders?”
Participant

Not At All

A Little

Alex (Child with ASD)

A Lot
*

Alvin (TD Peer)

*

Brandon (Child with ASD)

*
*

Brenda (TD Peer)

*

Carl (Child with ASD)

*

Cara (TD Peer)

*

David (Child with ASD)

*

Donna (TD Peer)

*

Note: The * represents the answer option chosen by each participant. Community Builders is the name used to describe
facilitated play at the school. Alvin marked both “a little” and “a lot” on his survey response for this question.

The TD peer in Pair A, “Alvin”, wrote in a response on his survey of “something in
between” “a lot” and “a little” for his rating of enjoyment during facilitated play. Again, the
participants were split almost 50%-50% between “a lot” of enjoyment and “a little” enjoyment
during facilitated play. Participants in Pair C and Pair D were reversed between the typical peer
and the child with ASD from the first question about recess to the second about facilitated play.
None of the participants rated the same level of enjoyment within their pairs for this condition.
Finally, participants were asked about their enjoyment level with the kinetic technology play.
Participant results, indicated by “*” are provided in the following table.

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Table 12. Participant Responses: “How much did you enjoy playing with your friend when using
the XBox?”
Participant

Not At All

A Little

A Lot

Alex (Child with ASD)

*

Alvin (TD Peer)

*

Brandon (Child with ASD)

*

Brenda (TD Peer)

*

Carl (Child with ASD)

*

Cara (TD Peer)

*

David (Child with ASD)

*

Donna (TD Peer)

*

Note: The * represents the answer option chosen by each participant.

Participants showed more consistency in this answer, with 75% rating “a lot” of
enjoyment playing in the kinetic technology play condition. There was also the same within-pair
agreement in response to the kinetic technology play environment as to the recess condition.
Overall, participants appeared to enjoy the kinetic technology play condition most, with
recess and facilitated play closely following. Participants did not rate any of the environments as
“not at all” enjoyable, which demonstrates at least a minimal level of positive interest in each
play condition. There are some inherent contradictions to note in the responses. For example, the
child with ASD in Pair B noted in the first question that the recess condition was the most
desirable for helping him get to know his buddy, but then rated only “a little” enjoyment in
playing at recess with his peer buddy, while he rated the facilitated play condition as eliciting “a
lot” of enjoyment. Likewise, the TD peer in Group B noted that recess was both the best
condition for getting to know her buddy and the most fun overall, but then rated playing as recess
as eliciting only “a little” enjoyment. Similarly, the child with ASD in Pair C selected facilitated
play as the most fun condition and also the environment that helped him get to know his peer the

71

best, but then rated only finding “a little” enjoyment in playing at facilitated play while both of
the other conditions were rated as “a lot” of enjoyment. Finally, it is important to note that when
elaborating as to why they chose conditions as the most fun or the best setting to get to know
their buddy, TD peer responses often centered on perceptions of their buddy’s enjoyment. I
consider the potential causes and implications of these potential contradictions in the discussion
section.

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DISCUSSION AND IMPLICATIONS
The goal of this study was to determine if the kinetic technology play condition elicited
more positive social interactions between children with ASD and TD peer buddies when
compared with traditional recess and facilitated play. The study proposed to answer two
questions: (a) Which play condition (traditional recess, facilitated play, or kinetic technology
play) is most effective in eliciting positive social interactions for students with ASD and TD
peers, and (b) Which play condition do students with ASD and their TD peers report as being
most enjoyable? The findings support that the kinetic technology play condition was more
effective in eliciting positive social interactions between children with ASD and TD peers when
compared with facilitated play and traditional recess. This suggests kinetic technology-based
interventions, and movement-based video games specifically, may be important when
considering how to support positive interactions between children with ASD and TD peers.
Positive Social Interactions Between Conditions
Overall, the results of this study suggest play in the kinetic technology play condition
helped children positively interact more often than in either the recess or facilitated play
conditions. However, despite the research supporting facilitated play as an effective intervention,
there was no significant difference found in play interactions when comparing traditional recess
and facilitated play, suggesting that recess is just as effective as facilitated play in eliciting
positive social interactions between children with ASD and TD peers. Moreover, when
examining trends in positive social interactions over the course of the research, the kinetic
technology play condition remained the most constant for Pairs A and B while those pairs saw
positive social interactions drop as sessions continued in the recess and facilitated play
conditions. Pairs C and D had more inconsistency of frequency of positive social interactions

73

throughout each condition. This suggests that participants’ positive social interactions within the
kinetic technology play condition, at least for the older participants in the study, could remain
relatively consistent over time, while positive social interactions may decrease over time in the
recess and facilitated play conditions.
Types of positive social interactions. As I watched the video recordings, I noted some
interesting patterns of social interaction that I had not anticipated at the onset of the study.
Specifically, there was some consistency in the type of positive social interaction displayed by
the pairs across conditions. Considering the types of interactions displayed within each condition
may provide additional insights into why the kinetic technology play condition was most
successful. I therefore conducted a secondary analysis, which I report here, to augment the
primary research findings by adding information about the nature of interactions. In this
analysis, I noted the types of positive social interactions students displayed. Four types of
positive social interactions were identified in the definition of the dependent variable. These
included affection, helping behaviors, non-verbal behaviors, and compromise.
Types of affection seen between pairs most commonly included high fives and hugs as
well as initial greetings and saying goodbye. Examples of help seen between pairs most
commonly included the TD peer giving verbal or physical prompts or direction to the child with
ASD and the child with ASD following those prompts/directions. Instances of compromise most
commonly included negotiations about which games to play whether to view the photos taken by
the XBox console while children played the games. Examples of non-verbal interactions
included smiles directed at the peer or shared laughter.
Helping behaviors observed within the research across conditions included the TD peer
giving directions or prompts to the child with ASD and the child with ASD complying with those

74

directions or prompts. Helping behaviors were the most common positive social interaction
observed during the kinetic technology play condition as TD peers helped the child with ASD
follow the rules of the video game (e.g., jumping during the white water rafting game). TD peers
also had several instances of providing hands-on support to children with ASD such as helping
them to flap their arms correctly by guiding their arms.
Compromise during the kinetic technology play sessions included choosing what game to
play and how many times to play each game. In Pair A, compromise between Alex and Alvin
also included whether to look at photos of the two playing that appeared on the screen after the
game was finished. In Pair C, Carl also initiated some compromise interactions by asking
questions such as “Try again?” During recess, compromise for the participants included choosing
an activity and considering when to switch to a new activity.
Non-verbal positive social interaction behaviors most often included smiling at a peer and
sharing laughter. For example, during one of the kinetic technology play sessions, Carl, the child
with ASD in Pair C pretended to fall, which would cause Cara to say his name and laugh. He did
this multiple times during one kinetic technology play session. Also, Cara and Carl had multiple
instances of shared laughter and smiling at one another during recess play compared with fewer
instances during kinetic technology play and still fewer instances in facilitated play. This type of
positive interaction did not occur more often in the kinetic technology play condition for all
pairs, indicating that non-verbal behaviors may be less dependent upon play setting than other
types of positive social interaction, or that the kinetic technology play condition was less
effective at eliciting non-verbal positive social interactions.
Affection behaviors included high-fives, greetings, and farewells. For example, there
were many instances where Alvin and Brenda initiated a high five to Alex and Brandon

75

respectively during the kinetic technology play condition as compared with fewer high fives
observed during facilitated play and recess for both pairs. Carl and Cara showed affection by
holding hands and had more physical positive interactions while playing at recess than in the
kinetic technology play or facilitated play conditions. In Pair D, “affection” interactions across
conditions most often included high fives and David thanking Donna for playing with him.
Overall the affection interactions for Pair D were low across conditions. These data suggest the
kinetic technology play session was more effective in eliciting affectionate interactions, perhaps
in celebration of a completed goal (e.g., earning coins or popping bubbles in a game). Students
were much less likely to high five or hug one another when accomplishing a task in the
facilitated play sessions such as completing a collaborative piece of art, taking a turn in Giant
Jenga, or checking off a box in a people scavenger hunt. The results suggest if schools wish to
increase appropriate showings of affection between TD peers and children with ASD, kinetic
video game play may be an effective intervention.
These results are not surprising given the social skills deficits for children with ASD
discussed earlier. Often outward displays of emotion are rare among children with ASD
(Bauminger et al., 2008; Nah & Poon, 2011; Sigman & Ruskin, 1999; Stichter et al., 2010). To
see some of these behaviors exhibited by the younger participants may indicate the younger TD
peer buddies enjoyed the play with their peer with ASD while older students may have enjoyed
the play, but viewed themselves more in a helping role, representing an uneven play dynamic.
The difference between the older and younger pairs in relation to the amount and types of
positive social interactions raises a question about the impact of age on peer interaction and
interventions.

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The art of compromise. In both the recess and kinetic technology play conditions TD
children were observed to most often concede to the preference of the children with ASD. For
example, at recess, the older participants typically chose one activity and stuck with it for the
entire recess period (e.g., swinging on swings, playing basketball or catch). Younger participants
most often chose to chase one another around the playground equipment. Interestingly, the
compromise behaviors among all pairs during the recess condition involved when to include
other children in the play. For example, the TD peer in Pair A asked multiple times if the peer
with ASD would consider switching from swinging to a game of catch. The child with ASD
declined each time and the pair remained swinging. As a compromise, the TD peer asked if they
could play catch while on the swings and the peer with ASD agreed. Therefore, for the remainder
of the time, the TD peer threw a tennis ball back and forth with the peer with ASD who was
sitting in the swing. Similar compromise interactions were witnessed during the kinetic
technology play, with the TD often asking which game the child with ASD would prefer to play.
Some negotiations took place where the TD peer pushed back on the child with ASD to switch
games.
There are several implications of this data. Primarily, in training TD peers to be peer
buddies, it is important that the adult facilitator discuss interactions included in compromising
and particularly that the TD peer need not always concede to the wishes of the child with ASD.
This practice at compromise may help the child with ASD practice how to navigate following the
interests of another child. As well, discussing which game to play on the XBox appeared to be a
more even negotiation than trying to compromise on activities played at recess, potentially
because of habitual behaviors adopted by the children with ASD for how to navigate recess.

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The role of the adult facilitator. All pairs had fewer instances of helping behaviors in
the facilitated play sessions and during the recess sessions as compared with the kinetic
technology play sessions. These data indicate children are more able to positively interact when
trying to accomplish a task (e.g., earn points in a game) than when they are left with less
structured expectations such as recess. During the facilitated play sessions, TD participants were
observed to more often wait for adult support to help direct the behavior of the children with
ASD. Perhaps the presence of adult facilitators may inadvertently hinder the positive social
interactions between children with ASD and TD peers, at least in how the TD peers offer help.
Little compromise behavior was observed during the facilitated play sessions as activities
were set and explained by the facilitating adults. This may indicate that although adults can
support the interactions between children with ASD and TD peers, children may rely more
heavily on adults to give direction, leaving little room for more naturally occurring compromise.
These observations suggest that although adult coaching can be valuable in teaching specific
social skills, when adults facilitate interactions between children with ASD and TD peers, both
children rely more heavily on adult direction and experience fewer positive social interactions
with one another.
Age. Although age was not a specific research focus identified in the research questions,
it is worthwhile to note that the older participants, the fifth graders in Pairs A and B, had a much
higher level of positive social interactions across the conditions. Although the kinetic technology
play condition still elicited a higher number of positive social interactions for all pairs, for
participants in Pairs C and D, the second grade students, the positive social interactions ranged
from zero to 47%. For Pairs A and B, the range was higher, from 11-86%. These data suggest

78

younger children with ASD as well as their TD peers have had less opportunity to develop and
practice social and play skills.
The younger children, in Pairs C and D, had a higher number of non-verbal positive
interactions than the older Pairs A and B. This may indicate that younger children who have
more limited verbal skills and play experience rely on more basic displays of positive
interactions, including smiling and laughter. The younger participants in Pairs C and D also
showed greater overall variability in their positive social interactions within each condition. As
the older children showed a steadier average of interactions, particularly in the kinetic
technology play condition, the younger children had a wider average range of positive social
interactions in the kinetic technology play condition. Therefore, the age of the student may play a
role in determining the effectiveness of any play intervention, including those involving video
games or other technology.
The role of movement. The recess and kinetic technology play conditions both invited a
great deal of movement for the participants as compared with the facilitated play. Of the
facilitated play sessions, only two of the three activities required students to actively move as a
part of the activity. The higher levels of positive interaction observed in the kinetic technology
play condition may indicate the importance of coupling opportunities for peer interaction with
physical movement in pursuit of a goal, such as achieving a high score in a game. The movement
observed during outdoor recess was not goal-oriented and often the movement was dictated by
the child with ASD who had clear preferences of movement-based activities (e.g., swinging,
bouncing a ball). As well, the sessions of facilitated play that included movement with a goal
such as the people scavenger hunt and the relay races produced higher numbers of positive social
interactions when compared with other facilitated play activities that did not require much

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movement. The data from this research suggest that movement may have a positive impact on
the number and type of positive interactions, particularly when it is coupled with a common goal.
Indoor recess outliers. As stated previously, four of the 20 recess sessions were moved
indoors due to inclement weather. Data from those four sessions varied, with two of the indoor
sessions resulting in much higher observations of positive social interaction than the other recess
sessions. For example, Pair B played a board game during indoor recess in one session that
required questions and answers and therefore provided prompting for more positive social
interactions. Dewey, Lord and Magill (1988) found children with ASD associated rule-governed
games with more fun and more complexity when playing with TD peers. It may be an interesting
future avenue of research to consider how non-technology based games, such as traditional board
games, compare with game systems such as the XBox Kinect in eliciting positive social
interactions. It may also be important for educators to consider the nuances of an indoor recess
environment for children with ASD and how they may increase or decrease the potential for
social interactions with TD peers, both positively and negatively.
Participant Preferences
Participant preferences provided interesting details with which to consider the other
results. For example, despite the frequency of positive social interactions seen in the kinetic
technology play condition, half of the participants chose recess as the most fun play
environment, while only three chose the kinetic technology play. The four participants who
chose recess as the most fun were those in Pairs A and B, the older students. They indicated that
they enjoyed recess the most because of shared interest in the outdoor games such as swinging
and basketball. Interestingly, outdoor recess was the most integrated with the entire grade level
and therefore, other peers often joined the pairs in their play. For example, the participants in

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Pair A were almost always joined by a third peer, not included in the study, while playing at
recess. This peer would join them on the swings or in playing catch. This peer was presumably
close friends with the TD child. The involvement of other peers may have created some
additional enjoyment for the TD peers, leading them to select recess as most enjoyable.
Reponses to the question of which play condition helped participants get to know their
peer best were very scattered with three choosing recess play, two choosing facilitated play, and
two choosing kinetic technology play (with one participant declining to answer). The older TD
peers remained consistent in their selection of recess as being the best environment to get to
know peers and both elaborated that recess allowed them more time to talk, ask their peer
questions, and learn about things their peer could do. The data again suggest the importance of
training for TD peer buddies, particularly in interacting with students with ASD during
unstructured times when bullying behaviors are more likely to occur (Able et al., 2015; Chen,
2010; Odom & Strain, 1986; Odom & Watts, 1991).
All of the participants indicated “a little” or “a lot” of enjoyment playing with their peer
within all of the play conditions. The fact that children did not select “not at all” when asked how
much they enjoyed playing in each condition suggests that peer buddy interventions are viewed
as at least somewhat positive from the perspectives of children with ASD as well as TD peers.
The kinetic technology play condition had the most consistent responses from students with six
of the eight participants indicating that they had “a lot” of enjoyment playing with their friend
while using the XBox. Preferences for the other two conditions were split with half of
participants selecting “a little” enjoyment and half selecting “a lot” of enjoyment. This indicates
that, for the majority of the participants, kinetic technology play was the most enjoyable play
environment. It would be appropriate to expect that there would be a positive relationship

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between and increase in frequency of positive social interactions and student enjoyment, so the
results from the student surveys validate the data collected about positive social interactions. In
both cases, the kinetic technology play condition was more favorable.
Limitations
There were a number of limitations associated with this study as outlined below. A major
limitation of this study is that it only meets the What Works Clearinghouse Standards with
Reservations, at most. In order to meet standards without reservations, a study requires five
repetitions of an alternating sequence. The data collected in this study, due to scheduling and
school constraints, include only four alternating sequences for three pairs of participants and only
three alternating sequences for another pair (Kratochwill et al., 2013). Of note, the case with only
three alternations would not meet standards even with reservations. This limitation reduces the
confidence one can have in these results.
Variables present in the daily lives of the children with and without ASD (e.g., health and
wellness, classroom variables, attendance, etc.) could also potentially impact some of the results.
Although single subject designs allow a researcher to make causal inferences based on data, the
generalizability of any one study is limited. Replication is required to establish stronger evidence
for the generalizability of these findings (Barlow & Hersen,1984). Furthermore, children with
ASD are a particularly heterogeneous group, with varying needs and abilities and therefore, may
all react to an intervention differently.
Researcher subjectivity could also be a concern. I have established relationships with the
participants in this study as well as in-depth knowledge of their abilities and deficits. I attempted
to counteract this potential subjectivity by using blind coders and recorders unfamiliar with the
participants.

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The study was limited by the duration and schedule of the facilitated play condition as it
was offered in the school. As previously discussed, the facilitated play option was offered by
staff members every other week and buddy pairs were changed each session. I matched the
timeline of this study to the facilitated play sessions as scheduled by the school. Unfortunately,
due to school scheduling conflicts and student absences, I was unable to record a full five
sessions for all pairs. Moving into the next session of the facilitated play program to collect data
would have compromised the study as participants with ASD traditionally change partners each
session. This would have introduced an unacceptable confound, as the pairs in latter sessions
would be different than the pairs in earlier sessions.
Another limitation was the impact that weather had on the recess condition. Once the
data for sessions that had to be moved indoors were coded, it became clear that the indoor recess
activities were too different from outdoor recess play and a decision was made to exclude the
data from these sessions. For example, indoor recess options typically included little to no
physical movement. Most activities were board games or building with blocks or Legos. The
behaviors elicited by these types of activities are very different from the structure of outdoor
recess. When these data were excluded, the number of recess sessions were reduced to three or
four for some pairs.
As stated previously, this study did not include a best treatment phase due to the school’s
schedule and likelihood that ASD participants would be paired with different buddies each cycle.
Therefore, the stability of the results of the kinetic technology play may be considered
questionable and future research would need to be completed to ascertain if the results of
increased positive social interaction in that condition remained consistent over time.

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Implications
The intent of this research was to consider a potential play intervention for children with
ASD and TD peers and to provide data on whether this intervention was effective in eliciting
positive social interactions. Findings led to important implications for future research as well as
implications for educational practice.
Implications for future research. As stated previously, the body of literature on
interventions for children with ASD is growing quickly. To further this line of research regarding
the impact of technology on social interactions between children with ASD and TD peers, future
researchers may consider how other forms of technology impact social interactions between
children with ASD and TD peers. Potential technologies may include the use of tablets and
various apps and web-based collaborative activities. Researchers may consider the ubiquity of
tablets and laptop devices in K-12 schools and how to capitalize on these devices, which are
already familiar to most students. For example, multiple entry-level coding applications exist
(e.g., Kodable, codeSpark Academy, and Scratch Jr) that require minimal technological
knowledge and may allow for students to collaborate on games, aiming to accomplish a common
goal. Similarly, the Osmo, an app that interacts via a tablet’s camera, allows users to manipulate
physical shapes and letters to direct movement of avatars on the tablet. Although these
technology options, like the video game play, have the potential to allow for interaction between
students, a key consideration for researchers pursuing this topic would be the level of skill
required to operate these applications and how that may impact children with disabilities.
Other technologies such as the Sphero, a robotic ball operated by simple code via an app,
and Fisher Price’s Think & Learn Code-a-pillar, a robotic caterpillar that requires children to add
different segments to direct the robot where to go via code, may be more effective in combining

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technology with the physical movement required by the kinetic video games. Both technologies
require children to move with the devices as the robots follow the paths determined by the
child’s codes. This element of movement may help engage the children but also may require a
higher level of skill than the kinetic video game play. As technology continues to evolve, and
schools continue to add new devices and applications, it is worth considering how these new
technologies may help to elicit positive social interactions between children with ASD and TD
peers.
Given the differences observed between the older and younger pairs of students, it also
may be worthwhile to consider how age relates to peer interactions across a variety of areas. An
area of specific interest may be how a child’s age impacts the use of technology, and video
gaming specifically, as an intervention or peer-connected play opportunity for children with
ASD. Age-related research may also consider the timeline for social skill development and how
that may or may not relate to children with ASD who attend general education schools with a
focus on inclusion. Age may play a key role in future research as negative behaviors toward
children with disabilities tend to increase with age, creating a stronger need to identify common
areas of interest between children with ASD and TD peers. Whether these common interests are
related to technology or other areas (e.g., Star Wars pop culture, board games), it may be useful
for researchers to consider how age impacts all social interactions between students with ASD
and TD peers when presented with activities of a common interest.
Younger TD peers also appeared less confident in directing and supporting their buddies
with ASD, so research targeting the training of younger peers may be of interest as well.
Similarly, when adults were present, the younger pairs in this study appeared to be more
dependent upon adult direction to facilitate peer interactions and, therefore, additional research

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may be warranted to consider how the effectiveness of facilitated play programs may be
impacted by age of the child. Overall, the age of children, both with and without disabilities, has
a clear impact on their play development and ability to interact socially. Continuing to tease out
the impact of age on various interventions, both with and without technology, will inform further
understanding of the best ways to support children with disabilities in inclusive environments.
Another possible avenue of future research may be the difference between traditional
recess and indoor recess, which at may schools involves board game or building play. Given the
outlier data points discovered in this study related to indoor recess activities, future research may
consider how board game play or other non-adult facilitated games compare with video gaming
as a platform for peer interaction. One key variable to consider in this research would be the
identification of how activities not facilitated by adults compare with one another as potential
interventions for children with ASD to develop positive interactions with their typical peers. For
example, in most schools, indoor recess is supervised by adults but not specifically facilitated,
and children choose their activities from a set of available games and materials.
The additional variable to consider in future research along this avenue would be the
impact of movement within these activities. It may be interesting for researchers to pursue the
difference in adult-facilitated play involving movement (e.g., the adult-led relay races in this
study) with non-adult-facilitated play involving movement such as a group basketball game
played at recess. Similarly, it would be worthwhile to consider how these activities further
compare with interventions that do not necessarily involve movement (e.g., board games,
listening to music) but may or may not be facilitated by an adult. These two key variables, adult
facilitation and movement, considered together, may powerfully inform future practice for
educators seeking to create inclusive settings for children with disabilities.

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Implications for practice. Primarily, this study shows video game technology may be a
potential asset for schools in finding ways to improve social interactions between children with
ASD and TD peers. Children find video games enjoyable and they provide an environment that
encourages positive social interaction, particularly in helping behaviors and affectionate
behaviors. Educators may want to consider how to incorporate game consoles such as the XBox
Kinect or Nintendo Wii as an alternative play environment for students who struggle during lessstructured recess. XBox and Wii consoles are typically available for $300-$500 including several
basic games. They are also mobile and easy to hook up to existing televisions or projectors. As
well, many children are familiar with these platforms from use at home. These factors indicate
that kinetic technology play may be a viable intervention tool for many schools to consider based
on budget and ease of implementation as well as children’s interest and engagement.
This study also highlights the importance of peer buddies and training for TD peers about
how to interact with and support children with ASD to help ensure a positive inclusive
experience and minimize bullying behaviors. TD peers who are trained in how to positively
interact with children with ASD, or other disabilities, may show more empathy and
understanding toward those students. This was witnessed by the responses of TD participants in
this study who indicated that they enjoyed getting to know things about their partner with ASD
such as his talents and interests. TD peers in this study also expressed enjoyment about the
opportunity to play with their peers with ASD. That level of understanding and openness is
essential if the social promises of inclusion are to be realized.
This research also informs the practice of how to support children with ASD and TD
peers of different ages, namely the need for additional support for younger children in how to
positively interact with one another. Although the younger children in this study shared positive

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feedback about their experiences playing together, their overall lower levels of positive social
interactions compared with the older participants suggest that younger students may not be
developmentally ready for some types of social interventions. Or, perhaps, the expectations of
educators need to be adjusted in terms of what constitutes a successful level of positive social
interactions for younger students in Kindergarten, first, and second grade as compared with
students in third, fourth, and fifth grade who may be more developed in their social interactions.
Either way, age is a factor that warrants consideration as schools put interventions and structures
in place to encourage positive interactions between children with ASD and TD peers.
This research also informs educational considerations regarding traditional recess as a
way for children with ASD to interact with peers. Research is clear that bullying behaviors can
happen more often within unstructured settings and this study supports that even when asked to
play with a trained peer buddy, children with ASD experienced lower levels of positive social
interactions during traditional recess. Educators may consider the potential impact of adding a
degree of structure to traditional recess by way of regularly paired peer buddies, smaller games
or activities facilitated by older students or staff, or alternatives to outdoor physical play if they
wish to enhance the positive social interactions of children with ASD and TD peers. As
educators seek new research-based interventions for children with ASD, and as technology
continues a firm foothold in educational practice, it is imperative that educational researchers
continue to evaluate the effectiveness of a variety of approaches, particularly in connection with
how children with ASD are educated in an inclusive environment.

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APPENDICES

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APPENDIX A
Peer Buddy Nomination Survey via GoogleForms

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APPENDIX B
Confidentiality Agreement for Recorders

91

REFERENCES

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REFERENCES
Able, H., Sreckovic, M. A., Schultz, T. A., Garwood, J. D., & Sherman, J. (2015). Views from
the trenches: Teacher and student supports needed for full inclusion of students with
ASD. Teacher Education and Special Education, 38(1), 44–57.
Allison, D. B. & Gorman, B. S. (1993). Calculating effect sizes for meta-analysis: the case of the
single case, Behavior Research and Therapy, 31, 621–631.
American Psychiatric Publishing. (2013). Diagnostic and statistical manual of mental disorders:
DSM-5. Washington, D.C: American Psychiatric Association.
Anderson, D., Oti, R. S., Lord, C., & Welch, K. (2009). Patterns of growth in adaptive social
abilities among children with Autism Spectrum Disorders. Journal of Abnormal Child
Psychology, 37, 1019–1034.
Bacon A. L., Fein D., Morris R., Waterhouse, L., & Allen, D. (1998) The responses of autistic
children to the distress of others. Journal of Autism & Developmental Disorders, 28,
129-142.
Baker, M. J. (2000). Incorporating the thematic ritualistic behaviors of children with Autism into
games: Increasing social play interactions with siblings. Journal of Positive Behavior
Interventions, 2(2), 66–84.
Barab, S. A., Dodge, T., Ingram-Goble, A., Pettyjohn, P., Peppler, K., Volk, C., & Solomou, M.
(2010). Pedagogical dramas and transformational play: Narratively rich games for
learning. Mind, Culture, and Activity, 17, 235–264.
Barlow, D. H., & Hayes, S. C. (1979). Alternating treatments design: One strategy for comparing
the effects of two treatments in a single subject. Journal of Applied Behavior Analysis,
12: 199-210.
Barlow, D. H., & Hersen, M. (1984). Single case experimental designs: Strategies for studying
behavioral change. New York: Pergamon.
Barnard-Brak, L., Ivey-Hatz, J., Ward, A. K., & Wei, T. (2014). Self-regulation and social
interaction skills among children with autism across time. Advances in Mental Health
and Intellectual Disabilities, 8, 271–279. doi:10.1108/AMHID-12-2012-0007
Baron-Cohen, S. (1987). Autism and symbolic play. British Journal of Developmental
Psychology, 5, 139-148.
Battaglia, A. & Radley, K. (2014). Peer-mediated social skills training for children with autism
spectrum disorder. Beyond Behavior, 23(2): 4-10.

93

Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high-functioning children with
Autism. Child Development, 71, 447–456.
Bauminger, N., Rogers, S. J., Aviezer, A., & Solomon, M. (2005). The friendship observation
scale (FOS). Unpublished manual, Bar Ilan University, Israel and University of
California, Davis, CA.
Bauminger, N., Solomon, M., Aviezer, A., Heung, K., Brown, J., & Rogers, S. J. (2008).
Friendship in high-functioning children with Autism Spectrum Disorder: Mixed and
non-mixed dyads. Journal of Autism and Developmental Disorders, 38, 1211–1229.
Bauminger-Zviely, N., Eden, S., Zancanaro, M., Weiss, P., & Gal, E. (2013). Increasing social
engagement in children with high-functioning Autism Spectrum Disorder using
collaborative technologies in the school environment. Autism, 17, 317–339.
Becker, E. A. and Watry-Christian, M. (2016). Occupational therapy and video modeling for
children with autism. Journal of Occupational Therapy, Schools & Early Intervention,
9, 226-241.
Ben-Sasson, A., Lamash, L., & Gal, E. (2012). To enforce or not to enforce? The use of
collaborative interfaces to promote social skills in children with high functioning
Autism Spectrum Disorder. Autism, 17, 608–622. doi:10.1177/1362361312451526
Bernard-Opitz V., Sriram M. & Nakhoda-Sapuan, S. (2001) Enhancing social problem solving in
children with Autism and normal children through computer-assisted instruction.
Journal of Autism and Developmental Disorders, 31, 377-384.
Blanc, R., Adrien, J. L., Roux, S., & Barthelemy, C. (2005). Dysregulation of pretend play and
communication development in children with Autism. Autism, 9, 229–245.
Blum-Dimaya, A., Reeve, S., Reeve, K. & Hoch, H. (2010). Teaching children with Autism to
play a video game using activity schedules and game-embedded simultaneous video
modeling. Education & Treatment of Children, 33, 351-370.
Blunt, R. (2007). Does game-based learning work? Results from three recent studies. In
Proceedings of Interservice/Industry Training, Simulation & Education Conference
(I/ITSEC). Orlando, FL: NTSA.
Bouck, E. C., Savage, M., Meyer, N. K., Taber-Doughty, T., & Hunley, M. (2014). High-tech or
low-tech? Comparing self-monitoring systems to increase task independence for
students with autism. Focus on Autism and Other Developmental Disabilities, 29, 156167.
Boudreau, E., & D’Entremont, B. (2010). Improving the pretend play skills of preschoolers with
Autism Spectrum Disorders: The effects of video modeling. Journal of Developmental
and Physical Disabilities, 22, 415–431. doi:10.1007/s10882-010-9201-5

94

Busk, P. L., & Serlin, R. C. (1992). Meta-analysis for single-case research. In T. Kratochwill &
J. Levin (Eds.), Single case research design and analysis (pp. 187-212).
Cardinal, J., Gabrielsen, T., Young, E., Hansen, B., Kellems, R., Hoch, H….Knorr, J. (2017).
Discrete trial teaching interventions for students with Autism: Web-based video
modeling for paraprofessionals. Journal of Special Education Technology, 32(3), 138148.
Carter, E., Common, E., Sreckovic, M., Huber, H., Bottema-Beutel, K., Gustafson, J.R., Dykstra,
J., & Hume, K. (2014). Promoting social competence and peer relationships for
adolescents with Autism Spectrum Disorders. Remedial and Special Education, 35, 91101.
Carter, E. W., Hughes, C., Copeland, S. R., & Breen, C. (2001). Differences between high school
students who do and do not volunteer to participate in a peer interaction program.
Research and Practice for Persons With Severe Disabilities, 26, 229-239.
Celani, G., Battacchi, M. W., & Arcidiacono, L. (1999). The understanding of the emotional
meaning of facial expressions in people with Autism. Journal of Autism and
Developmental Disorders, 29(1), 57-66.
Celiberti, D. A. & Harris, S. L. (1993) Behavioral intervention for siblings of children with
Autism: A focus on skills to enhance play, Behavior Therapy, 24, 573–99.
Ceranoglu, T. A. (2010). Video games in psychotherapy. Review of General Psychology, 14,
141–146.
Chamberlain, B., Kasari, C., & Rotheram-Fuller, E. (2007). Involvement or isolation? The social
networks of children with Autism in regular classrooms. Journal of Autism and
Developmental Disorders, 37, 230–242.
Chen, P. (2010). The prevalence and predictors of bullying and victimization among elementary
students with ASD (Order No. 3421550). Available from ProQuest Dissertations &
Theses A&I: Social Sciences; ProQuest Dissertations & Theses Global: Social
Sciences. (755482494).
Cogher, L. (1999) The use of non-directive play in speech and language therapy, Child
Language Teaching and Therapy, 15(1), 7–15.
Cohen, A. (2011). The gamification of education. The Futurist, 16–17.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological
Measurement, 20, 137-146.

95

Colby, K. M. (1973). The rationale for computer-based treatment of language difficulties in
nonspeaking Autistic children. Journal of Autism and Childhood Schizophrenia, 3,
254-260.
Connolly, T. C., Boyle, E. A., Hainey, T., McArthur, E. & Boyle, J. M. (2012). A systematic
literature review of empirical evidence on computer games and serious games.
Computers & Education, 59, 661–686.
Creswell, John W. (2009). Research design: Qualitative, quantitative, and mixed methods
approaches. Thousand Oaks, CA: SAGE Publications, Inc.
D’Ateno, P., Mangiapanello, K., & Taylor, B. A. (2003). Using video modeling to teach complex
play sequences to a preschooler with Autism. Journal of Positive Behavior
Interventions, 5, 5-11.
Davis, M.T., Langone, J., & Malone, M. (1996). Promoting prosocial behaviours among
preschool children with and without disabilities. International Journal of Disability
Development and Education, 43, 219-246.
Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A. & Liaw, J. (2004). Early
social attention impairments in Autism: social orienting, joint attention, and attention
to distress. Developmental Psychology, 40, 271-283.
DeKanter, N. (2005). Gaming redefines interactivity for learning. TechTrends: Linking Research
& Practice to Improve Learning, 49(3), 26–31.
Dewey, D., Lord, C., & Magill, J. (1988). Qualitative assessment of the effect of play materials
in dyadic peer interactions of children with Autism. Canadian Journal of
Psychology/Revue Canadienne de Psychologie, 42(2), 242.
DiGennaro Reed, F. D., Hyman, S. R., Hirst, J. M. (2011). Applications of technology to teach
social skills to children with autism, Research in Autism Spectrum Disorders, 5(3),
1003-1010.
Dondlinger, M. J. (2007). Educational video games design: A Review of the literature. Journal
of Applied Educational Technology, 4(1), 21–31.
Durkin, K. (2010). Video games and young people with developmental disorders. Review of
General Psychology, 14, 122–140.
Durkin, K., Boyle, J., Hunter, S., & Conti-Ramsden, G. (2013). Video games for children and
adolescents with special educational needs. Zeitschrift Für Psychologie, 221(2), 79–89.
Dybvik, A. C. (2004). Autism and the include mandate: What happens when children with severe
disabilities like Autism are taught in regular classrooms? Daniel knows. Education
Next, 4(1), 42.

96

Eaves, L. C., & Ho, H. H. (2008). Young adult outcome of Autism Spectrum Disorders. Journal
of Autism and Developmental Disorders, 38(4), 739-747.
Farlow, L. (1996). A quartet of success stories: How to make inclusion work. Educational
Leadership, 53(5): 51.
Faur, F. (2014). Video games offer hope for autistic children. Accessed July 13, 2017 at
http://www.gmanetwork.com/news/scitech/technology/355311/video-games-offerhope-for-autistic-children/story/
Ferguson, C. J. (2010). Introduction to the special issue on video games. Review of General
Psychology, 14(2), 66–67.
Finke, E. H., Hickerson, B., & Mclaughlin, E. (2015). Parental intention to support video game
play by children with Autism Spectrum Disorder: An application of the theory of
planned behavior. Language, Speech and Hearing Services in Schools, 46, 154–165.
Fisher, M. H., & Taylor J. L. (2016). Let’s talk about it: Peer victimization experiences as
reported by adolescents with autism spectrum disorder. Autism, 20(4), 402-411.
Fletcher-Watson, S. (2014). A targeted review of computer-assisted learning for people with
autism spectrum disorder: Toward a consistent methodology. Review of Research in
Autism and Developmental Disorders, 1, 87-101.
Fox, L., & Hanline, M. F. (1993). A preliminary evaluation of learning with developmentally
appropriate early childhood settings. Topics in Early Childhood Special Education, 13,
308–327.
Fryxell, D., & Kennedy, C. H. (1995). Placement along the continuum of services and its impact
on students’ social relationships. Journal of the Association for Persons With Severe
Handicaps, 20, 259–269.
Gal, E., Bauminger, N., Goren-Bar, D., Pianesi, F., Stock, O., Zancanaro, M., & Weiss, P. L.
(2009). Enhancing social communication of children with high functioning Autism
through a co-located interface. Artificial Intelligence and Society, 24(1), 75–84.
Gast, D. & Ledford, J. (2014) Single case research methodology: Applications in special
education and behavioral sciences. New York, NY: Routledge.
Gee, J. P. (2003). What video games have to teach us about learning and literacy. New York,
NY: Palgrave.
Gee, J. P. (2007). Learning and games. In K. Salen (Ed.), The ecology of games: Connecting
youth, games, and learning (pp. 21- 40). Cambridge, MA: MIT Press.

97

Gillham, J. E., Carter, A. S., Volkmar, F. R., & Sparrow, S. S. (2000). Toward a developmental
operational definition of autism. Journal of Autism and Developmental
Disorders, 30(4), 269-278.
Gillis, J., & Butler, R. (2007). Social skills interventions for preschoolers with Autism Spectrum
Disorder: A description of single-subject design studies. Journal of Early and Intensive
Behavior Intervention, 4(3), 532–547.
Goldsmith, T. R., & LeBlanc, L. A. (2004). Use of technology in interventions for children with
Autism. Journal of Early and Intensive Behavioral Intervention, 1(2).
Goldstein, H., & Cisar, C. L. (1992). Promoting interaction during sociodramatic play: Teaching
scripts to typical preschoolers and classmates with disabilities. Journal of Applied
Behavior Analysis, 25, 265–280.
Goodall, C. (2015). How do we create ASD-friendly schools? A dilemma of placement. Support
for Learning, 30(4): 305-326.
Greenfield, P. M. (2010). Video games revisited. In R. van Eck (Ed.), Gaming and cognition:
Theories and practice from the learning sciences (pp. 1-21). Hershey, PA: IGI Global.
Griffiths, M. (2002). The educational benefits of video games. Education and Health, 20, 47–51.
Gunn, K. S., Trembath, D., & Hudry, K. (2014). An examination of interactions among children
with autism and their TD peers. Developmental Neurorehabilitation, 17(5), 327-338.
Hansen, M. (2015). Helping children with Autism learn with mathematics software. Dissertation.
Harrower, J. K., & Dunlap, G. (2001). Including children with Autism in general education
classrooms: A review of effective strategies. Behavior Modification, 25(5), 762–784.
Hauck, M., Fein, D., Waterhouse, L., & Feinstein, C. (1995). Social initiations by Autistic
children to adults and other children. Journal of Autism and Developmental Disorders,
25, 579–595.
Hawkins (2009). Using gaming equipment to teach. Curriculum Review, 48(6), 10.
Herrera G., Plasencia A., Labajo G., Jordan R., de Pablo C. (2004). Using ‘ambient intelligence’
for compensating intellectual difficulties of people with severe learning difficulties
and/or Autistic Spectrum Disorders. Lecture Notes in Computer Science, 3118, 969975.
Horne, P. E., Timmons, V., & Adamowycz, R. (2008). Identified teacher supports for inclusive
practice. Exceptionality Education International, 18(3), 82-94.

98

Horner, R., Carr, E., Halle, J., Odom, S., & Wolery, M. (2005). The use of single-subject
research to identify evidence-based practice in special education. Exceptional
Children, 71(2), 165-179.
Howlin, P., Goode, S., Hutton, J. & Rutter, M. (2004). Adult outcome for children with Autism.
Journal of Child Psychology and Psychiatry, 45, 212–229.
Huang, C. (2005). Scaffolding sight vocabulary acquisition for children with Autism using
Computer-Assisted Instruction. Dissertation.
Hundert, J., Rowe, S., & Harrison, E. (2014). The combined effects of social script training and
peer buddies on generalized peer interaction of children with ASD in inclusive
classrooms. Focus on Autism and Other Developmental Disabilities, 29(4): 206-215.
Hunt, P., Farron-Davis, F., Beckstead, S., Curtis, D. & Goetz, L. (1994). Evaluating the effects
of placement of students with severe disabilities in general education versus special
classes. Journal of the Association for Persons With Severe Handicaps, 19, 200–214.
Ingersoll, B. R., & Dvortcsak, A. (2009). Teaching social communication to children with
Autism: A practitioner’s guide to parent training and a manual for parents. New York,
NY: Guildford Press.
Jackson, J. N., & Campbell, J. M. (2009). Teachers’ peer buddy selections for children with
Autism: Social characteristics and relationship with peer nominations. Journal of
Autism and Developmental Disorders, 39, 269–277.
Jarrold, C. (1997). Pretend play in Autism: Executive explanations. In J. Rusell (Ed.), Autism as
an executive disorder (pp. 101-140). New York: Oxford University Press.
Jones, E. A., & Carr, E. G. (2004). Joint attention in children with Autism: Theory and
intervention. Focus on Autism & Other Developmental Disabilities, 19, 13-26.
Kasari C., Locke J., Gulsrud A. & Rotheram-Fuller, E. (2011). Social networks and friendships
at school: comparing children with and without ASD. Journal of Autism and
Developmental Disorders 41, 533–544.
Kazdin, A. E. (1982). Single case research designs. New York: Oxford.
Kee, K. N. (2009). Informal learning from video games of three Autistic children in a family: A
case study. The Journal of Reading and Literacy, 1, 45–60.
Kennedy, C. (2005). Single-case designs for educational research. Boston, MA: Allyn & Bacon.
Kim, H. Y. (2012). The use of differential reinforcement of other behavior (DRO) to reduce
scripting in a child with autism (Order No. AAI1539953). Available from Linguistics
and Language Behavior Abstracts (LLBA). (1537584421; 201408830).

99

Kim, E. S., Berkovits, L. D., Bernier, E. P., Leyzberg, D., Shic, F., Paul, R., & Scassellati, B.
(2013). Social robots as embedded reinforcers of social behavior in children with
Autism. Journal of Autism and Developmental Disorders, 43(5), 1038–1049.
Kimball, J. W., Kinney, E. M., Taylor, B. A. & Stromer, R. (2004). Video enhanced activity
schedules for children with Autism: A promising package for teaching social skills,
27(3), 280–298.
Kinsella, B. G., Chow, S., & Kushki, A. (2017). Evaluating the usability of a wearable social
skills training technology for children with Autism Spectrum Disorder. Frontiers of
Robotics and AI, 4.
Klin, A., Jones, W., Schultz, R., Volkmar, F., & Cohen, D. (2002). Defining and quantifying the
social phenotype in autism. The American Journal of Psychiatry, 159, 895–908.
Knight, V. F., Spooner, F., Browder, D. M., Smith, B. R., & Wood, C. L. (2013). Using
systematic instruction and graphic organizers to teach science concepts to students
with autism spectrum disorders and intellectual disability. Focus on Autism and Other
Developmental Disabilities, 28(2), 115-126.
Kok, A. J., Kong, T. Y., & Bernard-Opitz, V. (2002). A comparison of the effects of structured
play and facilitated play approaches on preschoolers with Autism: A case
study. Autism, 6(2), 181-196.
Kratochwill, T., Hitchcock, J., Horner, R., Levin, J., Odom, S., Rindskopf, D. & Shadish, W.
(2013). Single-case intervention research design standards. Remedial and Special
Education, 34(1), 26-38.
Kratochwill, T. & Levin, J. (1992). Single-case research design and analysis: New directions for
psychology and education. Lawrence Erlbaum Associates, Inc., Hillsdale, NJ.
Kraijer, D. (2000). Review of adaptive behavior studies in mentally retarded persons with
autism/pervasive developmental disorder. Journal of Autism and Developmental
Disorders, 30(1), 39-47.
Lang, R., Rispoli, M., Sigafoos, J., Lancioni, G., Andrews, A., & Ortega, L. (2011). Effects of
language of instruction on response accuracy and challenging behavior in a child with
Autism. Journal of Behavioral Education, 20(4): 252-259.
Leach, D. & Duffy, M. L. (2009). Supporting students With Autism Spectrum Disorders in
inclusive settings. Intervention in School and Clinic, 45(1), 31–37.
Lenz, A. S. (2013). Calculating effect size in single-case research: a comparison of nonoverlap
methods, Measurement and Evaluation in Counseling and Development, 46, 64–73.

100

Lewis, V. (2003). Play and language in children with Autism. Autism, 7(4), 391-399.
Lifter, K., Sulzer-Azaroff, B., Anderson, S., & Cowdery, G. (1993). Teaching play activities to
preschool children with disabilities: The importance of developmental considerations.
Journal of Early Intervention, 17, 139-159.
Liss, M., Fein, D., Allen, D., Dunn, M., Feinstein, C., Morris, R. & Waterhouse (2001).
Executive functioning in high-functioning children with autism. Journal of Child
Psychology and Psychiatry and Allied Disciplines, 42, 261–70.
Lisón, J. F., Cebolla, A., Guixeres, J., Álvarez-Pitti, J., Escobar, P., Bruñó, A., … Baños, R.
(2015). Competitive active video games: Physiological and psychological responses in
children and adolescents. Paediatrics & Child Health, 20(7), 373–376.
Locke, J., Rotheram-Fuller, E., & Kasari, C. (2012). Exploring the social impact of being a
typical peer model for included children with autism spectrum disorder. Journal of
Autism and Developmental Disorders, 42(9), 1895–905.
Lord, C., & Hopkins, J. M. (1986). The social behaviour of Autistic children with younger and
same-age nonhandicapped peers. Journal of Autism & Developmental Disorders, 16,
449-462.
Loveland, K. A., & Kelley, M. L. (1988). Development of adaptive behavior in adolescents and
young adults with Autism and Down Syndrome. American Journal of Mental
Retardation, 93(1), 84-92.
Macintosh, K. & Dissanayake, C. (2006) A comparative study of the spontaneous social
interactions of children with high-functioning Autism and children with Asperger’s
disorder. Autism, 10, 199–220.
Maguth, B. M., List, J. S., & Wunderle, M. (2014). Teaching social studies with video games.
The Social Studies, 106(1), 32-36.
Maione, L., & Mirenda, P. (2006). Effects of video modeling and video feedback on peerdirected social language skills of a child with Autism. Journal of Positive Behavior
Interventions, 8(2), 106–118.
Majoko, T. (2016). Inclusion of children with Autism Spectrum Disorders: Listening and hearing
to voices from the grassroots. Journal of Autism and Developmental Disorders, 46(4):
1429-1440.
Maldonado, N. (2010). Wii: An innovative learning tool in the classroom. Childhood Education,
86(4), 284–285.

101

Mazurek, M. O. & Engelhardt, C. R. (2013). Video game use and problem behaviors in boys
with autism spectrum disorders, Research in Autism Spectrum Disorders, (7)2,
316-324.
Müller, E., Schuler, A., & Yates, G. B. (2008). Social challenges and supports from the
perspective of individuals with Asperger Syndrome and other Autism Spectrum
Disabilities. Autism, 12(2), 173-190.
Mundy, P., & Crowson, M. (1997). Joint attention and early social communication: Implications
for research on intervention with Autism. Journal of Autism & Developmental
Disabilities, 27, 653-676.
Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and
language development in Autistic children. Journal of Autism and Developmental
Disorders, 20, 115-128.
Murray DKC (1997) Autism and information technology: therapy with computers. In: S Powell
and R Jordan (eds.) Autism and Learning: A Guide to Good Practice. London: David
Fulton Publishers, pp. 100–117.
Nah, Y. & Poon, K. (2011) The perception of social situations by children with Autism Spectrum
Disorders. Autism 15, 185–203.
National Research Council. (2001). Educating children with Autism. Washington, DC: National
Academy Press.
Nuzzolo-Gomez, R., Leonard, M. A., Ortiz, E., Rivera, C. M., & Greer, R. D. (2002). Teaching
children with autism to prefer books or toys over stereotypy or passivity. Journal of
Positive Behavior Intervention, 4, 60-67.
Odom, S. & Strain, P. (1986). A comparison of peer-initiated and teacher antecedent
interventions for promoting reciprocal social interactions for autistic preschoolers.
Journal of Applied Behavior Analysis, 19, 59-71.
Odom, S. L. & Watts, E. (1991). Reducing teacher prompts in peer- mediated interventions for
young children with autism. Journal of Special Education, 25, 26-43.
Odom, S. L., Thompson, J. L., Hedges, S., Boyd, B. A., Dykstra, J. R., & Duda, M. A. (2015).
Technology-aided interventions and instruction for adolescents with Autism Spectrum
Disorder, Journal of Autism and Developmental Disorders, 45(12), 3805.
O’Hara, M., & Hall, L. (2014). Increasing engagement of students with Autism at recess through
structured work systems. Education and Training in Autism and Developmental
Disabilities, 49(4): 568-575.

102

Osterling, J. A., Dawson, G., & Munson, J. A. (2002). Early recognition of 1-year-old infants
with Autism Spectrum Disorder versus mental retardation. Development and
Psychopathology, 14(2), 239-251.
Ottenbacher, K. J. (1990). Visual inspection of single-subject data: An empirical analysis.
Mental Retardation, 28(5), 283.
Owen-DeSchryver, J., Carr, E., Cale, S., & Blakeley-Smith, A. (2008). Promoting social
interactions between students with Autism and their peers in inclusive settings. Focus
on Autism and Other Development Disabilities, 23(1): 15-28.
Pan, C. (2008). Objectively measured physical activity between children with Autism Spectrum
Disorders and children without disabilities during inclusive recess settings in Taiwan.
Journal of Autism and Developmental Disorders, 38, 1292.
Parker, R., Vannest, K., & Brown, L. (2009). The improvement rate difference for single-case
research. Exceptional Children, 75, 135-150.
Parker, R. I., Vannest, K. J. & Davis, J. L. (2011). Effect size in single-case research: a review of
nine nonoverlap techniques, Behavior Modification, 35, 303–322.
Parsons, S., Mitchell, P., Leonard, A. (2005). Do adolescents with Autistic Spectrum Disorders
adhere to social conventions in virtual environments? Autism 9(1), 95-117.
Pierucci, J., Barber, A., Gilpin, A., Crisler, M., & Klinger, L. (2015). Play assessments and
developmental skills in young children with Autism Spectrum Disorders. Focus on
Autism and Other Developmental Disabilities, 30(1), 35–43.
Piper, A.M., O’Brien, E., Ringel, Morris M. & Winograd, T. (2006) SIDES: A cooperative
tabletop computer game for social skills development. In Proceedings of the
CSCW’06, Banff, Alberta, Canada. ACM press.
Ploog, B. O., Banerjee, S. & Brooks, P. J. (2009). Attention to prosody (intonation) and content
in children with Autism and in typical children using spoken sentences in a computer
game. Research in Autism Spectrum Disorders, 3, 743–758.
Rakap, S. (2015), Effect sizes as result interpretation aids in single-subject experimental
research: description and application of four nonoverlap methods. British Journal of
Special Education, 42: 11–33.
Ramdoss, S., Machalicek, W., Rispoli, M., Mulloy, A., Lang, R., & O'Reilly, M. (2012).
Computer-based interventions to improve social and emotional skills in individuals
with autism spectrum disorders: A systematic review. Developmental
Neurorehabilitation,15, 119-135.

103

Rao, P. A., Beidel, D. C., & Murray, M. J. (2008). Social skills interventions for children with
Asperger’s syndrome or high-functioning autism: A review and recommendations.
Journal of Autism & Developmental Disorders, 38, 353–361.
Reffert, L. A. (2008). Autism education and early intervention: What experts recommend and
how parents and public schools provide. Theses and Dissertations. 1224.
http://utdr.utoledo.edu/theses-dissertations/1224
Reisinger, D. (2011). 91 percent of kids are gamers, research says. CNET. Retrieved on
September 4, 2017: https://www.cnet.com/news/91-percent-of-kids-are-gamersresearch-says/
Reiter, S. & Vitani, T. (2007). Inclusion of pupils with autism: The effect of an intervention
program on the regular pupils’ burnout, attitudes and quality of mediation. Autism, 11,
321-333.
Revel, A., Nadel, J., Maurer, M., Canet, P. (2002) VE: A tool for testing imitative capacities of
low- functioning children with Autism. In Proceedings of the 2nd workshop on robotic
and virtual interactive systems in therapy of autism and other psychopathological
disorders, La Salpêtrière, Paris.
Rideout, V. J., Foerh, U. G., & Roberts, D. F. (2010). Generation M2: Media in the lives of 8- to
18-year-olds. Kaiser Family Foundation. Retrieved from
http://www.kff.org/entmedia/upload/8010.pdf
Roberts, R., Beadle-Brown, J., & Youell, D. (2011). Promoting social inclusion for children and
adults on the Autism spectrum – reflections on policy and practice. Tizard Learning
Disability Review, 16(4), 45–52.
Rosas, R., Nussbaum, M., Cumsille, P., Marianov, V., Correa, M., Flores, P. & Salinas, M.
(2003). Beyond Nintendo: Design and assessment of educational video games for 1st
and 2nd grade students. Computers & Education, 40, 71–94.
Rotheram-Fuller, E., Kasari, C., Chamberlain, B., & Locke, J. (2010). Grade related changes in
the social inclusion of children with autism in general education classrooms. Journal of
Child Psychology and Psychiatry, 51, 1227–1234.
Rutherford, M. D., & Rogers, S. J. (2003). Cognitive underpinnings of pretend play in Autism.
Journal of Autism and Developmental Disorders, 33, 289–302.
Saez-Lopez, J.-M., Miller, J., Vazquez-Cano, E., & Dominguez-Garrido, M.-C. (2015).
Exploring application, attitudes and integration of video games: MinecraftEdu in
middle school. Journal of Educational Technology & Society, 18, 114–128.
Schatz, J., & Hamdan-Allen, G. (1995). Effects of age and IQ on adaptive behavior domains for
children with Autism. Journal of Autism and Developmental Disorders, 25(1), 51-60.

104

Shabani, D. B., Katz, R. C., Wilder, D. A., Beauchamp, K., Taylor, C. R., & Fischer, K. J.
(2002). Increasing social initiations in children with Autism: Effects of a tactile
prompt. Journal of Applied Behavior Analysis, 35, 79-83.
Sigman, M., & Ruskin, E. (1999). Continuity and change in the social competence of children
with Autism, Down Syndrome, and developmental delays. Monographs of the Society
for Research in Child Development, 64.
Silver, M., Oakes, P. (2001). Evaluation of a new computer intervention to teach people with
Autism or Asperger syndrome to recognize and predict emotions in others. Autism, 5,
299-316.
Sindelar, P., Rosenberg, M., & Wilson, R. (1985). An adapted alternating treatments design for
instructional research. Education and Treatment of Children, 8, 67-76.
Smith, T. (2001). Discrete Trial Training in the treatment of Autism. Focus on Autism and Other
Developmental Disabilities, 16, 86-92.
Soorya, L. V., Siper, P. M., Beck, T., Soffes, S., Halpern, D., Gorenstein, M…. Wang T. (2015).
Randomized comparative trial of a social cognitive skills group for children with
Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent
Psychiatry, 54, 208-216.
Sperry, L., Neitzel, J., & Engelhardt-Wells, K. (2010). Peer-Mediated Instruction and
Intervention Strategies for Students with Autism Spectrum Disorders. Preventing
School Failure: Alternative Education for Children and Youth, 54, 256–264.
Squire, K. (2006). From content to context: Videogames as designed experience. Educational
Researcher, 35(8), 19–29.
Sreckovic, M., Brunsting, N., & Able, H. (2014). Victimization of students with autism spectrum
disorder: A review of prevalence and risk factors. Research in Autism Spectrum
Disorders, 8, 1155-1172.
Stahmer, A. C. (1995). Teaching symbolic play skills to children with Autism using pivotal
response training. Journal of Autism and Developmental Disorders, 25, 123–141.
Steinkuehler, C., & Duncan, S. (2008). Scientific habits of mind in virtual worlds. Journal of
Science Education and Technology, 17, 530–543.
Stichter, J., Herzog, M., Visovsky, K., Schmidt, C., Randolph, J., Schultz, T., & Gage, N. (2010).
Social competence intervention for youth with Asperger syndrome and highfunctioning autism: An initial investigation. Journal of Autism and Developmental
Disorders, 40, 1067-1079.

105

Stone, W.L. & Caro-Martinez, L.M. (1990) Naturalistic observations of spontaneous
communication in Autistic children. Journal of Autism and Developmental Disorders
20, 437–453.
Sturmey, P. (2003). Video technology and persons with Autism and other developmental
disabilities: An emerging technology for PBS. Journal of Positive Behavior
Interventions, 5, 3-4.
Subrahmanyam, K., Greenfield, P. M., Kraut, R. E., & Gross, E. (2001). The impact of computer
use on children’s and adolescents’ development. Journal of Applied Developmental
Psychology, 22, 7–30.
Symes, W. & Humphrey, N. (2010). Peer-group indicators of social inclusion among pupils with
autistic spectrum disorders (ASD) in mainstream secondary schools: A comparative
study. School Psychology International, 31, 478-494.
Syriopoulou-Delli, C. K., Agaliotis, I., & Papaefstathiou, E. (2016). Social skills characteristics
of students with autism spectrum disorder. International Journal of Developmental
Disabilities, 1-10.
Taylor, B. A., & Levin, L. (1998). Teaching a student with Autism to make verbal initiations:
Effects of a tactile prompt. Journal of Applied Behavior Analysis, 31, 651-654.
Thomas, N., & Smith, C. (2004). Developing play skills in children with Autistic Spectrum
Disorders. Educational Psychology in Practice, 20, 195-206.
Tsao, L.-L. (2008). Social, language, and play behaviors of children with Autism. Behavioral
Development, 14, 40–51.
United Nations (1948), Declaration on Human Rights.
United Nations (1989), Convention on the Rights of the Child.
United Nations (2006), Convention on the Rights of Persons with Disabilities.
Vaughn, S., Kim, A., Morris Sloan, C. V., Hughes, M. T., Elbaum, B., & Sridhar, D. (2003).
Social skills interventions for young children with disabilities: A synthesis of group
design studies. Remedial and Special Education, 24, 2-15.
Weiss, M. J., & Harris, S. L. (2001). Teaching social skills to people with autism. Behavior
Modification, 25, 785-802.
Werner, E., Dawson, G., Osterling, J., & Dinno, N. (2000). Brief report: Recognition of Autism
Spectrum Disorder before one year of age: A retrospective study based on home
videotapes. Journal of Autism and Developmental Disorders,30, 157-162.

106

Wolfberg, P., Bottema-Beutel, K., & DeWitt, M. (2012). Including children with autism in social
and imaginary play with typical peers: Integrated play groups model. American
Journal of Play, 5, 55-80.
Wolfberg, P., DeWitt, M., Young, G., & Nguyen T. (2015). Integrated play groups: Promoting
symbolic play and social engagement with typical peers in children with ASD across
settings. Journal of Autism and Developmental Disorders, 45, 830-845.
Wolfberg, P. J. & Schuler, A. L. (1993) Integrated play groups: A model for promoting the social
and cognitive dimensions of play in children with Autism. Journal of Autism and
Developmental Disorders, 23, 467–89.
Wolfberg, P. J. & Schuler, A. L. (2006). Promoting social reciprocity and symbolic
representation in children with Autism Spectrum Disorders: Designing quality peer
play interventions. In Social and Communication Development in Autism Spectrum
Disorders: Early Identification, Diagnosis, and Intervention, edited by Tony Charman
and Wendy Stone, 180-218.
Yang, T., Wolfberg, P., Wu, S., and Hwu, P. (2003). Supporting children on the Autism
spectrum in peer play at home and school: Piloting the integrated play groups model in
Taiwan. Autism, 7, 437-453.
Young, M. F., Slota, S., Cutter, A. B., Jalette, G., Mullin, G., Lai, B….Yukhymenko, M. (2012).
Our princess is in another castle: A review of trends in serious gaming for education.
Review of Educational Research, 82, 61–89.
Yun, S. S., Choi, J., Park, S. K., Bong, G. Y. & Yoo, H. (2017). Social skills training for children
with autism spectrum disorder using a robotic behavioral intervention system. Autism
Research, 10, 1306–1323.
Zanolli, K., Daggett, J., & Adams, T. (1996). Teaching preschool age autistic children to make
spontaneous initiations to peers using priming. Journal of Autism and Developmental
Disorders, 26, 407-422.

107