Research to Practice: Teaching Peers to Improve Conversation with Autistic Teens

Students gathered around a tablet during a conversation.

Even in inclusive settings, high school can be a very lonely place for autistic teens or students with intellectual disability. Unlike struggling in an academic area where accommodations are typically provided, difficulties holding a conversation with a peer can make it hard for teens to make friends or form even casual relationships. As parents, having a child who has trouble making friends and holding conversations is much more concerning than academic performance or being good at sports. Engaging in a conversation is a critical life skill that helps make connections with those around us. Some kids are reluctant to engage in conversations or are passive participants who don’t know how to keep a conversation going or express their interests. Others may be extremely confident to communicate, but will limit conversations only to topics that only interest them and fail to ask questions or show interest in a conversational partner. Difficulties such as these can cause peers to give up trying to relate to them and eliminate future opportunities to have a conversation.

Although we may not realize it, holding a conversation is extremely complex and requires multiple skills from both the speaker and the listener which occur while the conversation is happening. It’s a lot like tapping your head and rubbing your stomach at the same time. A team of researchers from Lehigh University led by Dr. Linda Bambara helped me understand that holding a conversation is like a tennis game, with each partner taking a turn to expand upon what has been said. To be successful at conversations, each partner must know how to initiate conversation, maintain it, and extend the conversation to move in a new direction.

Merely putting teens together without training and hoping that they learn from one another is not a strategy that works to improve conversational skills, and may even decrease the possibility of future conversations as both conversation partners may fall into miscommunication patterns. The research team at Lehigh developed an intervention to improve the conversational interaction of autistic high school students by teaching socially confident peers how to support conversations at lunchtime.

Students who communicate well are recruited through service clubs or teacher recommendations and taught specific strategies to support conversations with autistic peers. Both peers and autistic teens receive instruction and practice with teachers first before conversing in the cafeteria. Although peers are often eager participants, they need to be given thorough instruction on how to support conversation by being responsive partners and encouraging their partner’s use of target communication skills.

Likewise, the autistic students were instructed on how to improve their skills such as starting conversations, asking questions, or commenting to extend conversations using reminders from visual prompts on phones or written on cards as needed. Once in the cafeteria, peers were observed and provided with feedback on how to keep their partners engaged in the conversation by using “conversation helpers” like asking open-ended questions. The students met with each other daily for 8-12 weeks and their conversational skills were measured through recordings of their time together.

Using peers as conversational teachers resulted in significantly improved skills in spontaneously initiating and maintaining conversations from the autistic students without the use of visual prompts. Both peers and autistic students reported that the training they received helped them have better conversations with one another, and teachers who didn’t know about the intervention reported that conversations were relaxed and natural teen interactions.

Before getting started, a collaborative team including parents, general and special education teachers, speech pathologists and paraprofessionals is required to develop a structured intervention and practice the strategies before sessions are turned over to a peer. Also, given the unpredictable life of teenagers, a team of four peer trainers shared the task and enabled two peer trainers to work together at each session. Finding common interests, like sports, music, video games also helps to create natural conversational partners.

Conversation Helpers These are some of the strategies taught to peers in order to support their conversations with autistic teens.

Show interest: Look at your friend, smile, talk about shared interests, be positive
Keep the conversation going: Ask open ended questions about what your friend has said, be sure
to share information yourself to avoid interviewing,
Help your friend respond: Gain your friend’s attention if distracted, repeat the question if your
friend doesn’t respond, rephrase or break down a question, ask your friend to clarify or explain
Move On/Redirect the Conversation – stop and redirect if your friend repeats a topic or question (e.g., What else do you want to talk about?) , or quickly changes topic before answering your question (e.g., Let’s finish talking about this first)

Bambara, L. M., Cole, C. L., & Thomas, A. (2021). Linking peer-mediated interventions to address conversational difficulties in adolescents with autism. Perspectives of the ASHA Special Interest Groups, 6(1), 55–68. https://doi.org/10.1044/2020_persp-20-00151

Being able to kick off and hold a conversation is an essential skill for everyone that will help foster relationships throughout the lifespan. Using peers to help support better communication provides an opportunity for true inclusion and benefits both conversational partners. With support and coordination from families and school staff, it could make a big difference in helping kids learn more about each other. For more information about using peers to support conversation skills, check out the full study by reading about it:

Bambara, L. M., Cole, C. L., Chovanes, J., Telesford, A., Thomas, A., Tsai, S.-C., Ayad, E., & Bilgili, I. (2018). Improving the assertive conversational skills of adolescents with autism spectrum disorder in a natural context. Research in Autism Spectrum Disorders, 48, 1–16. https://doi.org/10.1016/j.rasd.2018.01.002

Bambara, L. M., Thomas, A., Chovanes, J., & Cole, C. L. (2018). Peer-mediated intervention: Enhancing the social conversational skills of adolescents with autism spectrum disorder. TEACHING Exceptional Children, 51(1), 7–17. https://doi.org/10.1177/0040059918775057

Contributors: Writer Molly Dellinger-Wray is part of the Partnership for People with Disabilities at Virginia Commonwealth University, a university center for excellence in developmental disabilities. She is also the mom of two fabulous adult children, one of whom benefitted from special education and early intervention. Together, she and Linda Bambara lead the Home and Community Positive
Behavior Support Network.

Researcher Linda M. Bambara is an Emeritus Professor of Special Education from Lehigh University who remains professionally active writing, conducting research and engaging in community outreach. Her interests are in positive behavior support and social communication interventions. She is the mother of two adult children and four beautiful grandchildren all under age five. Email: [email protected]
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*In accordance with person-centered language, I was taught to use the term “person with autism” because it seems more respectful. However, recently people who have received an autism diagnosis prefer to be referred to as an “autistic person” and therefore the language has been updated for this article.

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This post originally appeared on our January/February 2023 Magazine

Research to Practice: Teaching Peers to Improve Conversation with Autistic Teens

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