The Effects of Prelinguistic Milieu Teaching Implemented in Classrooms for Preschoolers with or at Risk for Autism Spectrum Disorder
Dubin, Ashley H.; Lieberman-Betz, Rebecca G.; Ayres, Kevin M.; Zawoyski, Andrea (2020). Focus on Autism and Other Developmental Disabilities, v35 n2 p79-89. Retrieved from: https://eric.ed.gov/?id=EJ1253243
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examining3Students, gradePK
Practice Guide
Review Details
Reviewed: March 2026
- Practice Guide (findings for Prelinguistic Milieu Teaching)
- Single Case Design
- Meets WWC standards with reservations because it is a SCD design where the independent variable is manipulated by the researcher, each outcome is measured systematically over time by multiple assessors with a sufficient number of assessment points and inter-assessor agreement, but there are an insufficient number of phases and/or assessments per phase to meet without reservations.
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
To view more detailed information about the study findings from this review, please download findings data here.
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: 33%
Male: 67% -
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Race Black 33% White 67% -
Ethnicity Not Hispanic or Latino 100% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
The study was conducted in two preschool classrooms. One classroom was described as a private, inclusive preschool program that included typically developing children as well as children with developmental disorders, and the other was a public, self-contained special education preschool classroom. The classrooms were presumably from two separate schools, located in the southeastern United States.
Study sample
Participants included three students from two classrooms. All three students were 4-years old; two were male and one was female; one was Black and two were White. All were eligible for special education based on state requirements, and had individualized education programs (IEPs) related to functional communication. All participants demonstrated characteristics of autism spectrum disorder on both a teacher-report measure and a researcher-administered measure. In addition, two participants met eligibility criteria for services under significant developmental delay, and all three met eligibility criteria for services under speech-language impairment.
Intervention Group
During intervention sessions, milieu teaching strategies were used to teach prelinguistic communicative behaviors. When each child demonstrated interest in something, the interventionist initiated a planned social routine with teaching episodes targeting intentional communication (IC) behaviors. These episodes consisted of a series of prompts and episodes, which were implemented approximately once per minute. One primary researcher and two secondary clinicians who were special education master's students trained by the primary investigator provided prelinguistic milieu teaching (PMT) with each student in an area of their classroom separate from other students. PMT sessions, which lasted for 20 minutes each, were conducted 3 days per week for 6 weeks. Two of the sessions were conducted with the primary researcher and the other was conducted with one of the two secondary clinicians.
Comparison Group
There is no comparison group in single-case designs. Baseline sessions occurred in the student's classroom with the primary investigator. During these sessions, communication was not prompted or encouraged.
Support for implementation
One primary researcher and two secondary clinicians who were special education master's students trained by the primary researcher provided the intervention.
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.
An outcome is the knowledge, skills, and attitudes that are attained as a result of an activity. An outcome measures is an instrument, device, or method that provides data on the outcome.
A finding that is included in the effectiveness rating. Excluded findings may include subgroups and subscales.
The sample on which the analysis was conducted.
The group to which the intervention group is compared, which may include a different intervention, business as usual, or no services.
The timing of the post-intervention outcome measure.
The number of students included in the analysis.
The mean score of students in the intervention group.
The mean score of students in the comparison group.
The WWC considers a finding to be statistically significant if the likelihood that the finding is due to chance alone, rather than a real difference, is less than five percent.
The WWC reviews studies for WWC products, Department of Education grant competitions, and IES performance measures.
The name and version of the document used to guide the review of the study.
The version of the WWC design standards used to guide the review of the study.
The result of the WWC assessment of the study. The rating is based on the strength of evidence of the effectiveness of the intervention. Studies are given a rating of Meets WWC Design Standards without Reservations, Meets WWC Design Standards with Reservations, or >Does Not Meet WWC Design Standards.
A related publication that was reviewed alongside the main study of interest.
Study findings for this report.
Based on the direction, magnitude, statistical significance, and sample size of the findings within a domain, the WWC assigns effectiveness ratings as one of the following: Tier 1 (strong evidence), Tier 2 (moderate evidence), Tier 3 (promising evidence), uncertain effects, and negative effects. For more detail, please see the WWC Handbook.
The WWC may review studies for multiple purposes, including different reports and re-reviews using updated standards. Each WWC review of this study is listed in the dropdown. Details on any review may be accessed by making a selection from the drop down list.
Tier 1 Strong indicates strong evidence of effectiveness,
Tier 2 Moderate indicates moderate evidence of effectiveness, and
Tier 3 Promising indicates promising evidence of effectiveness,
as defined in the
non-regulatory guidance for ESSA
and the regulations for ED discretionary grants (EDGAR Part 77).