An iterative intervention development process to inform the feasible implementation of supports for communicative interactions between non-speaking autistic pre-school children and their peers

BackgroundInteraction between autistic and non-autistic children is fundamental to accessing the learning opportunities afforded by inclusive education contexts. Peer-mediated interventions (PMIs) support autistic and non-autistic children to interact with each other. It is described as an evidence-based practice, but the efficacy of PMI with non-speaking children is yet to be interrogated, and stakeholders have made little contribution to the design and development of PMIs.AimsThis research aimed to identify and develop the evidence base for the use of PMI with non?speaking autistic preschool children in inclusive educational contexts.MethodFirst a systematic review was conducted to identify the evidence base for PMI with non-speaking autistic children. Second a qualitative study using focus groups and semi-structured interviews explored whether PMI is acceptable to stakeholders from the autism and early childhood education (ECE) communities. Third, a qualitative study protocol proposes how non-autistic peers can contribute to this discussion. Fourth, a qualitative iterative intervention design process was employed to investigate the acceptability and feasibility of a proposed PMI, and to elucidate how it can be feasibly implemented in real-life ECE contexts.ResultsPMI is efficacious with non-speaking autistic children, but engagement with stakeholders elucidated a discrepancy between PMI as it is described in the literature, and PMI as stakeholders want it to be conceptualised and implemented. PMI needs to be developed to meet the conditions for acceptability and feasibility desired by the autism and ECE communities. These include it being embedded in an ECE’s ethos and supported by the ECE environment, being responsive to the variable needs of individuals and ECE settings and addressing the complexities of implementation.ConclusionsCultivating a research landscape where stakeholders contribute to the design and adaptation of interventions can inform the evolution of PMI to be relevant and implementable in real-life contexts.<br>