Enhancing Social Initiations Using Naturalistic Behavioral Intervention: Outcomes from a Randomized Controlled Trial for Children with Autism
Gengoux, Grace W.; Schwartzman, Jessica M.; Millan, M. Estefania; Schuck, Rachel K.; Ruiz, Andrés A.; Weng, Yingjie; Long, Jin; Hardan, Antonio Y. (2021). Journal of Autism and Developmental Disorders, v51 n10 p3547-3563. Retrieved from: https://eric.ed.gov/?id=EJ1310603
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examining42Students, gradePK
Single Study Review
Review Details
Reviewed: March 2026
- Single Study Review (findings for Social initiation motivation intervention (SIMI) - Gengoux et al. (2021))
- 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
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
||
|---|---|---|---|---|---|---|---|---|---|
|
Clinical Global Impressions – Improvement (CGI-I): percentage much improved |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
32.00 |
15.00 |
No |
-- | ||
|
Vineland Adaptive Behavior Scale-II (VABS-II): Socialization Domain |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
74.80 |
73.80 |
Yes |
|
||
|
Social Responsiveness Scale, Second Edition (SRS-2) |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
70.90 |
75.00 |
No |
-- | ||
| Show Supplemental Findings | |||||||||
|
Clinical Global Impressions – Improvement (CGI-I): percentage with any improvement |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
78.00 |
35.00 |
Yes |
|
||
|
Vineland Adaptive Behavior Scale-II (VABS-II): Socialization Domain: Coping Skills subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
20.10 |
19.10 |
Yes |
|
||
|
Vineland Adaptive Behavior Scale-II (VABS-II): Socialization Domain: Play and Leisure Time subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
22.00 |
23.30 |
No |
-- | ||
|
Vineland Adaptive Behavior Scale-II (VABS-II): Socialization Domain: Interpersonal Relationships subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
32.20 |
35.10 |
No |
-- | ||
|
Social Responsiveness Scale, Second Edition (SRS-2): Social Communication and Interaction (SCI) subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
70.50 |
75.00 |
No |
-- | ||
|
Social Responsiveness Scale, Second Edition (SRS-2): Restricted Interests and Repetitive Behavior (RRB) subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
68.60 |
71.00 |
No |
-- | ||
|
Peer Play Observation (PPO): Joint attention subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
Yes |
-- | ||
|
Peer Play Observation (PPO): Social interaction subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
Yes |
-- | ||
|
Peer Play Observation (PPO): Behavior regulation subscale |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
Yes |
-- | ||
|
Peer Play Observation (PPO): Total initiations |
Social initiation motivation intervention (SIMI) - Gengoux et al. (2021) vs. Business as usual |
0 Days |
Full sample;
|
N/A |
N/A |
Yes |
-- | ||
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: 5%
Male: 96% -
Race Other or unknown 100% -
Ethnicity Other or unknown 100% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
The study was conducted in collaboration with a community agency that housed an on-site inclusive preschool and had active social skills group programming for the students.
Study sample
The initial, randomly assigned sample included 44 children with Autism Spectrum Disorder (ASD), ages 4 to 6, of whom 96% were male. Race/ethnicity and free/reduced-price lunch status were not reported. All participants had IQ scores of 70 or higher and were receiving stable community-based services for one month prior to participation. Two study participants left the study and were excluded from the analysis; demographic information for the analytic sample is not reported.
Intervention Group
The Social Initiation and Motivation Intervention (SIMI) aims to help children with ASD make social connections with peers. The intervention was delivered in groups of up to 5 ASD students and 5 typically developing peers. Intervention group leaders arranged the play environment with features that encourage interaction, such as group activities. Group leaders prompted children with ASD to make appropriate social interactions and reinforced these attempts. The intervention was implemented over 8 weeks and consisted of eight weekly sessions, each lasting 75 minutes. Intervention sessions included at least 15 to 20 minutes of play activities (such as crafts or board games) and snack time.
Comparison Group
Students in the comparison condition continued their existing community-based services—such as special education, speech therapy, or Applied Behavior Analysis (ABA)—with no changes for 8 weeks.
Support for implementation
The study did not describe the training or backgrounds of the group leaders. During intervention sessions, group leaders used structured, naturalistic strategies from established manuals to explicitly teach behavior regulation initiations to children with ASD. These strategies, based on cooperative arrangements, were drawn from prior work by Fredeen (2005), Vismara et al. (2006), and Koegel (2012).
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.
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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).