Incorporating a Peer-Mediated Approach into Speech-Generating Device Intervention: Effects on Communication of Preschoolers with Autism Spectrum Disorder
Thiemann-Bourque, Kathy; Feldmiller, Sarah; Hoffman, Lesa; Johner, Stacy (2018). Journal of Speech, Language, and Hearing Research, v61 n8 p2045-2061. Retrieved from: https://eric.ed.gov/?id=EJ1187754
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examining45Students, gradePK
Single Study Review
Review Details
Reviewed: February 2026
- Single Study Review (findings for Peer-mediated approach with a speech-generating device (SGD) - Thiemann-Bourque et al. 2018)
- Randomized Controlled Trial
- Meets WWC standards without reservations because it is a randomized controlled trial with low attrition.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Findings
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Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
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Preschool Language Scale - Fifth Edition (PLS-5): Expressive Communication (EC) |
Peer-mediated approach with a speech-generating device (SGD) - Thiemann-Bourque et al. 2018 vs. Business as usual |
0 Days |
Full sample;
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N/A |
N/A |
-- |
-- | ||
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Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
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|---|---|---|---|---|---|---|---|---|---|
| Show Supplemental Findings | |||||||||
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Preschool Language Scale - Fifth Edition (PLS-5): Total Language Score (TLS) |
Peer-mediated approach with a speech-generating device (SGD) - Thiemann-Bourque et al. 2018 vs. Business as usual |
0 Days |
Full sample;
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N/A |
N/A |
-- |
-- | ||
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Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
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|---|---|---|---|---|---|---|---|---|---|
| Show Supplemental Findings | |||||||||
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Preschool Language Scale - Fifth Edition (PLS-5): Auditory Comprehension (AC) |
Peer-mediated approach with a speech-generating device (SGD) - Thiemann-Bourque et al. 2018 vs. Business as usual |
0 Days |
Full sample;
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N/A |
N/A |
-- |
-- | ||
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
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Female: 20%
Male: 80% -
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Kansas
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Race Black 33% Other or unknown 11% White 56% -
Ethnicity Hispanic 2% Not Hispanic or Latino 98% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
The study took place in 14 preschools within 10 school districts in the Kansas City metropolitan area. Classroom ranged from full or partial inclusion settings to self-contained classrooms serving children with autism spectrum disorder (ASD) and other developmental disabilities. Most of the participating children attended preschool for a half-day (3 hours/day, 4 days/week); five children (2 treatment and 5 comparison) attended full-day preschool. Intervention sessions occurred in the child's regular classroom or nearby school spaces (e.g., hallway, empty room) during typical preschool hours.
Study sample
The sample consisted of 45 preschool children with autism spectrum disorder (36 boys, 9 girls). The intervention group (n = 23) had a mean age of 48 months (range = 37–60 months) and the comparison group (n = 22) had a mean age of 46 months (range = 35–58 months). The intervention group comprised 12 White, 8 African American, and 3 children of other or mixed race/ethnicity. The comparison group comprised 13 White, 7 African American, 1 Hispanic, and 1 child of other or mixed race/ethnicity.
Intervention Group
Intervention students participated in a peer-mediated speech-generating device (SGD) program. Each intervention child was paired with a trained peer and engaged in 15-minute dyadic sessions two to three times per week for 9 to 19 weeks (17–31 sessions total). Sessions took place during typical preschool activities in the classroom or nearby school spaces and incorporated structured opportunities for both initiations and responses using the SGD. For the first 5 min of a session, the interventionist reviewed Stay–Play–Talk (SPT) steps, reviewed “Gain Attention” and “Hold and Wait” steps, prompted child-peer SGD communication with at least one initiation (IN) and one response (RS), and highlighted other available symbols. The remaining 10 minutes focused on peer–child interaction, with the implementer observing and prompting approximately every 30 seconds if no communication occurred, using a least-to-most hierarchy (verbal cue, gestural prompt, hand-over-hand assistance) to support communication attempts.
Comparison Group
In the comparison condition, target children were paired with an untrained peer for 15-minute dyadic sessions held once per week for 9 to 19 weeks (9–14 sessions total). School staff were instructed to use the SDG as they deemed appropriate. Sessions took place during typical preschool activities in the classroom or nearby school spaces. School staff were directed to have one peer present, program the SGD with symbols matching the activity and the child’s skill level, have activity last for 10 min, and conduct the activity with the SGD as they normally would.
Support for implementation
All participating school staff participated in a 2-hour training on the study timeline, expectations, SGD programming, peer recruitment, and directions for four 15-min one-on-one SGD intervention sessions with an adult partner. Staff in the intervention group received an additional 1-hour training on peer-mediated intervention procedures, selecting preferred activities, and prompting child-peer SGD communication. Typically-developing peers in the intervention group participated in approximately 80 min of training over 2–3 days. Peers were taught to be responsive play and communication partners, and were trained on a modified version of Stay-Play-Talk (SPT) steps. Research staff provided ongoing coaching as needed during intervention sessions, monitored fidelity using structured checklists, and provided refresher peer training if needed.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
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