The Reciprocal Effects Social Inclusion Intervention (RESII): The design of an intervention to improve the social outcomes of students with Autism Spectrum Conditions (ASC) attending mainstream secondary schools

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Abstract

Autism Spectrum Condition (ASC) is a lifelong, developmental disability characterised by a ‘triad of impairments’ in social interaction, social communication, and social imagination (Wing, Gould & Gillberg, 2011). Increasing numbers of children and young people with ASC are now receiving their education in mainstream schools (Crosland & Dunlap, 2012). Inclusion in mainstream classrooms is perceived by some to provide the best opportunity for students with ASC to make improvements in social functioning, through modelling the behaviour of their peers (Boutot & Bryant, 2005; Connor, 2000). Evidence suggests, however, that this may not necessarily be the case. In fact, students with ASC are likely to experience a range of negative outcomes such as fewer friendships, more loneliness, less social support and more bullying and social rejection than their typical peers (e.g. Bauminger & Kasari, 2007; Humphrey & Symes, 2010a, 2011). These outcomes may be exacerbated further by the lack of appropriate interventions to adequately address them. Current interventions tend to overlook the role others can play in the social outcomes of students with ASC (Bauminger, 2002), are not designed with the school setting in mind (Crosland & Dunlap, 2012), overlook the needs of older students (Bond et al., 2016), and demonstrate limited generalisability beyond the intervention setting (Flynn & Healy, 2012). This thesis describes the design and development of an intervention designed to improve the social outcomes of students with ASC, by addressing these limitations.The intervention, named Reciprocal Effects Social Inclusion Intervention (RESII), comprises three parts, designed to be delivered simultaneously. These are: a social skills group for students with ASC; a peer-awareness campaign to improve attitudes towards those with the condition; and a training package for TAs to help them better support social interaction in the classroom. An intervention-research framework that outlines the key steps of intervention design guided the development of RESII. In the first step, a programme model that identified the factors underlying the negative social outcomes of students with ASC (the problem theory) and change strategies to address them (the programme theory), was developed. In the second step, the specific content for RESII was selected. In the third, and final, step, RESII was trialled in two studies involving five schools and 10 students with ASC to establish the feasibility and initial efficacy of RESII. There was some evidence that RESII could be implemented in mainstream secondary schools and have a positive impact on the intended outcomes. Overall, however, the data suggests that RESII is not currently ready to be disseminated more widely. Before its use can be recommended, further research is needed to address the identified theoretical, implementation and research issues. Specifically, future research should establish the feasibility and efficacy of each of RESII’s components individually, include a more homogenous ASC sample and be delivered in schools by the intended delivery agents.

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