Day after day in the summer heat, Kara assumes the responsibility of painting face after face of the students with autism. Never stopping, she continues until every child has had the opportunity to participate. The children, engrossed in watching the artistic transformations, practice waiting their turn as part of a Peer PALS module on nonverbal communication. It is almost as fun to watch as it is to choose a character. Yet, the best part is the big reveal when each child turns to the mirror and catches their first glimpse. The joy of watching their reactions motivates this Peer PAL to do it again and again. Here in her words Kara describes what it is like to be a Peer PAL.
My name is Kara Lunny. I am 14 years old and an 8th grader. I have been a Peer PAL every summer since 3rd grade. Each summer, I volunteer and work with children with autism. I’ve worked with pre-kindergarten through middle school students. I was trained by Mrs. Apap, a behavior analyst, in sign language, picture communication, and to be a friend to students with autism. I have learned that students with autism are regular kids but learn differently. My favorite age group to work with is pre-kindergarten, kindergarten, and first grade. The kids are so cute, funny, smart, and fun to be around. They make me laugh! One of my favorite activities working with the children is face painting. Students with autism have difficulty with understanding facial expressions. The kids really enjoy having their face painted. Each summer I get to work with the students and see how much they have grown and learned. I really enjoy seeing the changes in the students each year. I have become very attached to the students and look forward to working with them each summer. Peer PALS is a highlight of my summer.
Kara’s story is one of many showing the mutual benefits of starting a Peer PALS program. The program has two components: a school year, and intensive summer program. The mission is to facilitate social relationships between neurotypical peers and children with autism while providing opportunities to work on core deficits, learn, and have fun. The program relies on trained typical peers who “navigate the way” by providing modeling, guidance, feedback, and reinforcement to shape and strengthen skills.
It all began one summer 12 years ago with a nonverbal student, who communicated inappropriately by hitting people up to 200 times a day. As a behavior analyst, I knew she needed the motivation of typical children, so I pulled my 4th grade daughter’s hair into a ponytail, snatched my 9-year-old niece, armored them in long sleeve shirts, jeans, and sneakers and said, “OK, here’s the deal, she’s going to try to deck you and here’s what you are going to do and say.” Day after day, they enjoyed coming to the extended school year program to play and teach their new friend. They learned their skills so well, they were never hurt and the student’s aggression decreased 90% with them. When I heard my daughter pray that summer for God to let all children talk, I realized it impacted her as much as the student. That initial experience began a 90% decrease for me too, in my free time, as I started to formalize the Peer PAL Program.
Consulting with school districts for 20 years as a behavior analyst, I know how difficult it is during the busy school day for students to experience quality and quantity social interactions. Academic demands leave little time to implement structured programs, and pullout programs often lack the generalization needed. In many general education classes, social skills are embedded into the day, often not salient enough for students with autism spectrum disorders (ASD). Given their limited free time, neurotypical peers usually like to spend it with close friends. Even if they did have the time, a lack of trained and sensitive peer models puts existing friendships at risk. In Exceptional Student Education, I’ve observed countless teachers laboriously creating supports in an attempt to implement social skill programs. The time, cost, and labor involved in adapting programs can be overwhelming. With all of these confounding variables, I continued to observe students making the same social mistakes, further isolating them from their typical peers.
RESEARCH BASED PROGRAM
I began my career in birth-3 early intervention over 20 years ago, and realized the power of play and the natural environment on social behavior. Peer PALS has evolved over the past 12 years based on my research findings. Since, school districts are mandated to implement evidence-based programs, you will need the following information to support the validity of the model.
Peer PALS is a peer mediated teaching model, based on an applied behavior analysis (ABA) naturalistic teaching paradigm called Pivotal Response Training (PRT) (Koegel, O’Dell, and Koegel, 1987.) Initial studies showed that most of the participants’ challenging behaviors correlated to the teaching conditions and an inability to communicate. Using PRT with nonverbal children greatly increased their vocabularies while decreasing their disruptive behavior. The procedures work with even the most severe on the spectrum. Since these children have developed repertoires of inappropriate behaviors, working on behaviors one at a time is not realistic. By targeting “pivotal behaviors,” those that affect broad levels of functioning, there is an overall improvement in behavior. In PRT, motivation is increased through child choice, natural reinforcers, reinforcing attempts, mastered skills interspersed with emerging skills, and embedding prompts into natural interactions. This results in increased social, communication, and academic skills as well as decreased inappropriate and selfstimulatory behaviors. One major advantage of PRT is generalization of skills. Schreibman, Stahmer, & Pierce (1996), found that children who participated in PRT maintained play behaviors and generalized them to new toys and people. Research shows a naturalistic approach increases verbalizations, symbolic/ dramatic play, joint attention, language engagement, responsiveness to peers, longer interactions between children, initiation in play and conversation, and produces better spontaneity, maintenance, and generalization. Study after study substantiates teaching social skills in a natural learning environment.
INTERVENTION DOSAGE AND INTENSITY
Some children with ASD require an intensity or focus that many peer-based social programs just cannot offer during the school day. That is why for the past 12 years I focused on the extended school year component. Summer provides a wonderful opportunity for intensive, quality social experiences, role models, and friendships. The 4-8 week intensive social-behavioral model operates like a camp. The program operates using Surviving Social Situations, a Peer PALS social skills curriculum. All children receive a survival kit (minimal cost to parents) with specific items correlating to audiovisual lessons teaching strategies for anger, frustration, and anxiety. Behavioral strategies are the foundation. Here, typical children trained in specific strategies surround and promote positive behaviors, engagement, and social interaction through high-interest, low-cost thematic activities. Students participate in play, learning, social/communication, and behavioral “challenges” and are reinforced with tribal beads. Smiles emerge on faces that rarely smile, and kids are caught being kids. The bulk of the training occurs for Peer PALS during the summer. For the past three years, data was collected on the program and lesson modules from pre-k through middle school have been tested for replication. Joanne Sweazey, autism program specialist, is working on lessons for the high school level.
EVIDENCE BASED PROGRAM
OK, so that all sounds like fun − it is, and it is based in behavior analytic research. The summer program begins with a 10-skill assessment in the four critical areas of play, learning, social skills, and behavior skills. Once the initial baseline assessment is completed, staff members know what skills to target for each student. Using a 5-point scale, data is recorded and progress monitored on prepared Excel spreadsheets. Table 1 (see opposite page) shows the results of the Summer 2009 Exit Survey. All 10 teachers, 35 students with ASD (grades 1-8), a sampling of Peer PALS, and parents participated. Questions based on program outcomes included the following: student improvement, positive behavior change, effects of training, and overall experience. Using visual supports, staff members interviewed younger students and those unable to respond independently just to ensure understanding. Pre-K and kindergarten students were not surveyed, yet observable behaviors and parent/teacher feedback, indicated enjoyment and benefit. All neurotypical peers surveyed responded that they understood children with autism better. Ninety-five percent reported the program helped the students with ASD pay attention better, and 84% responded that the students improved the way the ASD students interacted with them socially, but interestingly, only 26% reported that the ASD students appeared less odd or socially awkward. All of the students with ASD said they enjoyed having the Peer PALS, and 100% of staff and parents reported they saw the benefit of having the typical peers model and interact. The best part was that 100% of students in grades 6-8 said they made at least one new friend, as did 95% of students grades 1-5. While quantitative data is necessary, it is the testimonials from students and parents that give the greatest reward and show the value of the program. Christopher attends Anderson Middle School. His mother says, “This is a great program, and it’s been a big help in so many ways. ‘Normal’ kids can always use the same positive social education, too, the younger the better.” Emma’s mom, Kelly loves the summer program as much as her daughter. “Since Emma started the program, she is sharing a lot better and seems to be more in tune to other children’s feelings. Prior to the Peer PALS program, she would lock her bedroom door and tell other children they were not allowed in her room or to touch her things. These last few weeks she has been taking other children in her room and sharing her toys. She has also been tending to the younger children who come to our house as if she is pretending to be a Peer PAL.” Emma is now a first grade student at Felix Williams Elementary and Alice is her Peer PAL during the school year. They have lunch together a few days a week. The rest of the week Emma practices the skills with her classmates. This is one of many ways to fit the program into their busy day without losing academic time.
HOW TO START A PEER PALS PROGRAM
Schools have limited resources, the three major being staff, funding, and time. It’s not that they don’t want to have a program, they do. It’s how to “do it” that is so perplexing. Basically, I had to perform a miracle. I had to find time in busy schedules, make it easy, flexible, the majority of it paperless, and ensure typical children would not miss any instructional time. In addition, I had to provide instruction for staff, Peer PALS, and students. Pheww, MIRACLES DO HAPPEN! Here is how you can overcome these obstacles.
If you want the program, be willing to offer your efforts. If you are a parent, a simple statement such as, “How can I help you make this happen…” and then offering assistance works best. Offer to correct papers so teachers have time to do this; you probably won’t be asked to grade papers, but the teachers see you are willing to do whatever it takes. If you can donate a few dollars or slightly used toys/materials in good condition, you will get great returns on your investment. I recycle everything useable.
It takes work, but the payoff is worth it. You can reach hundreds of children with and without autism. The program requires a coordinator to initiate, train, and manage communications. This person may also act as the facilitator, whose role is to provide feedback and guidance making it a successful experience for Peer PALS and students. By sharing the responsibility among a few willing teachers, a mainstream consultant, or guidance counselor, the program quickly takes off. Julianne Gagliardo teaches a varying exceptionalities class at Citrus Grove Elementary and has had a Peer PAL Program for years. She operates the program herself, coordinating easily through e-mail form letters with parents and the 5th grade teachers of the Peer PALS. Training is a must, so she reviews the Facilitator’s Training Manual on CD. It takes her a few hours to coordinate and plan. Then she spends several hours (sessions) training Peer PALS. After that, the school year program pretty much runs itself until the end, when she prints their certificates and recognizes them at the end of year celebration.
PEER PALS IS GREEN SOME TRAINING AND IMPLEMENTATION MATERIALS ARE AVAILABLE FOR FREE DOWNLOAD
The Peer PALS Coordinator Facilitator’s Manual on CD explains everything: how to set up your program with suggested time line for activities and efficient forms sent through e-mail to teachers and parents. The manual also includes a section on how to fund your program. Go to the website http://www.peerpals.us where you can download parts of the manual, customizable templates, award certificates, and the logo for brochures, name badges, and teeshirts.
It is important for relationships to begin early, so Peer PALS starts in elementary school. Our experience shows that rising fourth graders and up are best suited for the responsibility. Younger children have a hard time remembering their role as a volunteer. Melissa DuBois teaches at JD Parker Elementary. She describes the efficient e-mail process of choosing Peer PALS in May for the following year: “I announce the program to the 4th grade teachers and have them start picking 3 to 5 students from each of their classes. I send the parent permission letter and photo releases home with the students. Once their paperwork is returned, I set up a schedule for the new recruits to observe this year’s PALS. As I’m sure you’re aware, our classroom budget for copies is limited, and I’m running low, so the e-mail forms on the CD are great.” Although Melissa chooses new Peer PALS at the end of the year, you can also select them at the beginning of the school year (5th grade). Either way works.
KEEP IT MANAGEABLE
I recommend 10-12 Peer PALS so your program does not get too big or unmanageable. However, I’ve had schools with nearly 50. If your program gets too big, the consistency and effectiveness may suffer. To combat this, parent volunteers are encouraged to send out e-mail letters or assist with other tasks they can do from home. TRUST ME, it can be overwhelming to train, schedule, and implement, so keep it small to start! Ultimately, it is best if Peer PALS can spend some time together each day with the ASD students. However, assigning only a few days a week to each Peer PAL or changing Peer PALS every semester prevents satiation and allows others the opportunity to participate. However, most do not want to leave. Juan, one of Melissa’s student’s says, “I’ll be so sad when I have to stop, I’m going to miss George so much.”
TRAINING AND TOOLS
Four-year-old Jack insisted on playing with the trains by himself. On the first day with his Peer PAL, Jack pushes her hand away every time she attempts to try to get into his play, but she persists. She discovers by using behavioral interruption, closing the crossing gate as he comes by her, it blocks his ability to engineer down the tracks by himself. He must interact with her. Not only is she in, after several repetitions, she gets him to verbalize, “OPEN PLEASE.” There are several video modeling scenarios; this is one of the vignettes included in the Peer PAL training. Preparing Peer PALS involves training provided through audiovisual presentations and a post test. They receive a Survival Guide, explaining roles, responsibilities, techniques, and safety strategies. Training provides the basics for understanding augmentative and alternative communication (AAC) systems and the use of visuals to prompt. A trademark of Peer PALS is bubbles: we teach, “When in trouble blow bubbles” (i.e., a distracting technique until help arrives). Likewise, our Break Cards are given to ASD students and they are told they can simply give the break card to an adult or Peer PAL if they become overwhelmed or over stimulated. Having permission to take a break often prevents acting out behavior for those students who don’t know how to get out of an overwhelming situation and exhibit challenging behavior.
NO TIME LIKE NOW
In today’s fast-paced world of academics, there is much to learn. Making the most of every minute counts. Don’t be surprised if you are met with, “I don’t have time for that.” Many staff members will say there is no time in the school day. For that reason, I came up with several models. Moreover, you can show that your program can fill a need and conserve resources or provide solutions to problems like, “We do not have staff members to individually walk Joey to class or sit with him once he finishes lunch.” Use this as an opportunity to recommend starting a program. Most schools have a character education program. Character-based education helps build a positive schoolwide culture by emphasizing such character traits as integrity, respect for others, citizenship, fairness, caring, and trustworthiness. Peer PALS are inspiring role models who demonstrate these traits. Introducing it as part of the school’s character-based program is one way to embed it into the curriculum.
MAKE IT YOUR OWN
In order for any intervention to work, you must individualize it. Design your Peer PALS Program to match the needs of your students and resources. There are few social opportunities that are not under the direct control of an adult. Therefore, lunch, free time, and recess are targeted times.
PEER PALS NAVIGATION SERVICE
The Peer PALS motto is, Navigating the Way and our logo depicts a compass surrounded by a circle of helping hands. It makes sense that assistance with transitions is one way to help. This reduces the need for an adult and looks much more natural. Louise Rathbun, a mainstream consultant at Seawind Elementary, coordinates a school program using the following model for students in their selfcontained classes.
Morning Escorts – before school begins, meet at car or bus and assist in transitioning students to the classroom
Morning Sit and Socialize – with student in a designated “wait area” until teacher arrives, practice waiting in area, passing the time, small talk
Teach Arrival Routines in Classroom – if time permits assist with executive functioning organizational skills: unpack, put away, turn in homework, go to seat, “see you tomorrow”
Departure – meet at classroom, walk to bus or car line, teach parting sequences
New Students – with special permission, Peer PALS spend the morning helping a new child transition to the classroom and learn the classroom routines
Assembly Escorts – accompanying their pals to assemblies rather than sitting with their own class helps to shape “audience” behaviors
THE THREE R’S
As part of the neurotypical peers reading program, the entire class participates in the Peer PALS Program. By going to a pre-k, kindergarten, or self-contained class once or twice a week to read, it increases their fluency and reading skills while students with ASD practice listening and comprehension skills.
Peer PALS participate in the program as an additional or alternative related arts choice, along with art, music and PE. Guidance counselors, speech language pathologists, behavior analysts, and behavior technicians have run the Peer PALS program successfully. This is a great way to have a block of time dedicated to participate in the program. Another alternative is to adjust the schedules of students with ASD so they are able to attend PE, music or art with the class of their Peer PAL rather than their own.
Accompany students to recess to teach and practice safe equipment use, playground skills and group games. A favorite is playing tag. It reduces perseverative behaviors; pacing; self-stimulatory behaviors with sand, objects or water; injury; walking into swinging children; or escaping through open gates. Sydney remembers the first day she met her pal Nancy. “The day I met her she was sitting alone under the steps on the playground watching the kids play. I think she was a little scared to try things. So, when I walked over to her and introduced myself, I said, ‘follow me’ and she stared up at me, grabbed my hand and then followed along.” Sydney understands these children well; she has a sibling with autism. She says, “I will continue to tell people, just because they can’t speak, doesn’t mean they don’t have anything to say.”
Julianne teaches several grade levels in her self-contained class. Many of Julianne’s students use assistive technology. Her Peer PALS help them learn how to use the computer and increase opportunities to practice with their communication devices.
A CLASS OF PEER PALS
Some ambitious teachers work it into the curriculum having their entire class become Peer PALS. Peer PALS make excellent video models and think of solutions quickly when interacting with young children. Some classrooms are simply used as photo/video models. Although a bit young to take on the responsibility of navigating the way, Mrs. Brown’s third grade students make excellent photo and video models. A form letter is sent to parents explaining the purpose, so that photo/ video releases can be signed. Media is then used for social stories and video rehearsals.
GIFTED STUDENT PEER PALS
Gifted children excel academically and benefit from additional social experiences to enrich their lives. Remember Melissa DuBois, she teaches gifted students who come from other classes throughout the day. Using this model as a component of her gifted program, she enlists her 4th and 5th grade students as Peer PALS and requires them to choose a disability, research it, write a report, make a poster, and give a 5-minute oral presentation to parents and invited guests. They also are required to self-evaluate, reflecting on what they got out of the program. These testimonials are from the heart. Mikayla says, “When I help Paul, it makes me feel good. I make him wait for the child in front of him to get on the slide and go all the way down before he gets on. That teaches him patience which is needed every day. When Paul made me a pizza in the play kitchen and presented it to me with a smile, that made it clear he was very proud of it. It made me happy to see he was able to share with other people. When he made Play-Doh hearts and counted to ten with them it gave me a huge sense of accomplishment.” Kassidy, a first year Peer PAL, teaches them the real world. She says, “When working with the kids, it is helpful to treat them the same as any other person. You shouldn’t give them what they want when they scream. Instead they have to learn they don’t always get what they want.”
One or more days a week, Peer PALS join individual students or classes for lunch, helping with various skills. PECS (Picture Exchange Communication System cards), communication boards, or AAC devices must accompany nonverbal children so that they can have cafeteria conversations. Consider preferred seating, a special table where it is quieter. Conversation skills and relationship building is more successful when the table is out of the major traffic paths.
The cafeteria can be painful for most of us. It is crowded, noisy, and it is difficult to teach in that environment. Some programs have a Lunch Bunch who eat in a separate room. Andrea, a paraprofessional at Bessey Creek Elementary, runs this model to teach cafeteria rules and friendship skills while Tiffany Cook, a speech language pathologist at Jensen Beach elementary, finds this a valuable therapy model.
My birthday generally falls on the last day of our summer program. Every year, my colleague and autism specialist Joanne Sweazey buys a huge cake to celebrate with all the children. We will keep working on “guessing someone’s age,” since I have been known to range from four to ninety years old each year. In the photo above, I am rushed by adoring fans, the children with autism, as if I were a rock star. They spontaneously hug me, offering gifts and kind sentiments. The best present I ever got was from Ethan, the little blonde boy holding the birthday bag. With tears in his eyes, he gave me three small rocks and said, “If you keep these rocks with you they will make you happy.” I keep my birthday rocks on my night stand. They are the last thing I look at every night. Ethan was right − they really work.
So it comes to this: can you get your child or student with autism to initiate play, socially interact with peers, attend to lessons, or use alternative behaviors? Well, Peer PALS can. Peer PALS will navigate the way. Chelsea, a fifth-grade Peer PAL says, “These children need as much help as they can get. I think I made a difference in my pal’s life by teaching him things needed later in life, I taught him words. He never said my name then he started saying, Che-Che, now he says Chelsea like anyone else. If I hadn’t worked extra on those letters in a fun way no one would have been able to understand him. The more time we spend with them, the more chance they have at making a difference in the world.” I agree with Chelsea, so, commit, start a program, and watch the beauty of it all unfold. It changes lives.