Improving Peer Engagement of Children With Autism on the School Playground: A Randomized Controlled Trial

•Randomized controlled wait list design in school setting for fully included children with an autism spectrum disorder (ASD)•Focus on treatment implementation by nonspecialist paraprofessional aides at recess in mainstream elementary schools•Results support improved peer engagement for children with ASD during regular school recess•Implications for adoption high given low intensity, brief intervention delivered with minimal interruption during regular school days

This study aimed to test the effects of a psychosocial intervention, Remaking Recess, on peer engagement for children with autism spectrum disorder (ASD). Using a randomized, wait-list-controlled design, the intervention was implemented during recess at four elementary schools. The immediate treatment (IT) group consisted of 13 (2 female) elementary school students with ASD and the wait-list (WL) group contained 11 (4 female) students with ASD. All of the children with ASD were fully included in the general education program. Analyses revealed that time spent engaged with peers was significantly increased for the IT group and maintained over the follow-up. School playground staff in the IT group showed increased behaviors aimed at improving peer engagement for children with ASD compared to playground staff at the WL sites. These improvements did not maintain to follow-up. These results suggest that a low dose, brief intervention can be beneficial in increasing peer engagement for children with autism in inclusive settings, but continued support of playground staff is likely needed.