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1 Title Registration for a Systematic Review: Social competence interventions for preschoolaged children with special needs in general and inclusive early childhood settings Adam S. Kennedy and Therese M. Pigott Submitted to the Coordinating Group of: Crime and Justice Education Disability International Development Nutrition Social Welfare Other: Plans to co-register: No Yes Cochrane Other Maybe Date Submitted: 7 May 2012 Date Revision Submitted: 20 May 2012 Approval Date: 20 May 2012 Publication Date: 01 November The Campbell Collaboration

2 TITLE OF THE REVIEW Social competence interventions for preschool-aged children with special needs in general and inclusive early childhood settings BACKGROUND The Problem The relationship between socially competent behavior and later success (particularly in school) has been well-documented (e.g., Gresham, Sugai, & Horner, 2001). Evidence suggests that possessing basic social competence allows children to participate successfully in a wider range of activities with peers, as well as to develop positive peer relationships over time. Both of these elements are necessary for success in school and beyond (Odom et al., 1999). Much of what we know about the benefits of social competence stems from research that has documented the negative consequences associated with social competence problems and deficits. Since play is most often the context for the learning of social behavior in early childhood, play has also been the context in which much of this research has taken place. The social problem-solving which occurs during play is most frequently done with peers, and peer-related social competence is essential if preschoolers are to reap the developmental benefits that early friendships provide (Buysse, Goldman, West, & Hollingsworth, 2008). Demonstrating social competence and positive peer relationships before reaching kindergarten may enhance school functioning and early achievement once children enter the school setting (Costin & Jones, 1992; Gresham & Reschly, 1987; Ladd, 1990). Unfortunately, many children fail to naturally or adequately develop these important skills. Children with disabilities, in particular, are more likely to face peer rejection and miss out on essential social experiences, often as a result of differences between their social and play skills and those of typical children. These differences are observable from a very young age (with some behaviors present in infancy), and include lower rates of social initiation, positive social behavior, and appropriate responses, as well as more disruptive entry to play activities and problematic behavior, poorer turn-taking and leadership skills, and higher rates of peer rejection (Craig-Unkefer & Kaiser, 2002; Guralnick, Connor, Hammond, Gottman, & Kinnish, 1996a; Guralnick, Connor, Hammond, Gottman, & Kinnish, 1996b; Kopp, Baker, & Brown, 1992; Lieber, 1993; Odom, Zercher, Li, Marquart, & Sandall, 1998; Odom et al., 2001). These differences exist in preschool-aged children with a wide array of disabilities (including autism, speech/language problems, cognitive disabilities, and emotional and behavior problems) as well as in children who are at risk for future problems due to factors such as poverty, abuse, and engagement with child welfare agencies (Campbell, 1990; Fantuzzo et al., 1988; Guralnick & Groom, 1987; Kopp, Baker, & Brown, 1992; Lieber, 1993; Mueller & Silverman, 1989; Webster-Stratton & Hammond, 1997). 2 The Campbell Collaboration

3 While early play and social relationships form the foundation of social development and influence academic achievement, the consequences of disability combined with insufficient or inappropriate social behavior destabilize that foundation. Over time, these differences and deficits are likely to worsen, as evidenced by research linking poor early social competence with negative outcomes such as emotional and behavior problems, disciplinary action, and school dropout (Hinshaw, 1992). Some evidence suggests that the social and behavioral problems of children with disabilities may worsen over time in the absence of intervention, and this research is often cited as a justification for an increased focus on improving social competence as early as preschool (Gresham, 1981). In this sense, social competence interventions may be viewed as essential forms of prevention. Interventions of various types are available to improve fundamental social skills, increase the frequency and quality of social interaction, and enhance social and language development (see Brown & Conroy, 2001; Brown et al., 2001; Lowenthal, 1996; Odom et al., 1999). These include arrangements of the classroom environment to facilitate social interaction, sometimes referred to as structured play (Odom et al., 1999); peer-mediated and caregivermediated approaches in which peers/caregivers are encouraged or trained to engage target children in interactive play (see Bailey & Wolery, 1992; English, Goldstein, Kascmarek, & Shafer, 1997); various behavioral strategies that incorporate cues, prompts, and positive reinforcement; instructional techniques (which may or may not involve direct instruction) (Lowenthal, 1996; Odom & McConnell, 1993; Odom et al., 1999); and combined approaches. Some of the positive outcomes associated with studies of preschool social competence interventions include increased social language and play initiations, decreased maladaptive behavior, and increased overall competence as observed by adults (Antia & Kreimeyer, 1993; Ferentino, 1991; Fewell & Vadasy, 1989; Jenkins et al., 1989; Koenigs & Oppenheimer, 1985; Odom et al., 1999). While some published research appears to indicate that these interventions have a generally positive relationship with various social skills and other dependent variables associated with social competence, a coherent picture of the effects of social competence interventions on preschool-aged children with special needs has yet to emerge. In summary, early childhood represents a critical period during which early social competence is established. While this typically sets the tone for positive early social relationships, for children with disabilities the picture can be bleak. By the time they reach the end of their third year of life, children with disabilities may have already established a pattern of failure in social initiation, interaction, and problem-solving that requires intervention to break. While social skills interventions have been widely used and studied with school-aged children, they have been less frequently used and studied in preschoolers. Nevertheless, studies examining the effectiveness of social competence interventions with young children have been published over the past four decades. 3 The Campbell Collaboration

4 At this point in time, a systematic review of social competence intervention research with preschool children is warranted in order to determine the overall effects of these interventions, as well as the individual, subject, and study-related variables that moderate those effects. As a result, the present study was designed to review available evidence on these interventions by incorporating published studies and other forms of research that examine either individual preschoolers or groups of preschoolers. Intervention effects will be examined in relation to the overall body of research, as well as in relation to relevant variables and methodological differences across the studies themselves. The Population At least two-thirds of the participants are required to be between the ages of 3 years and 5 years, 11 months. If studies reported that nearly all of participating children were between the ages of 3 and 5, they will be included. Generally, children should be selected for treatment based upon the presence of a disability or risk factor(s) associated with later school or behavior problems. Disability is defined here as any of twelve of the thirteen categories recognized by the Individuals with Disabilities Education Act of 2004: deafblindness, deafness, emotional disturbance, hearing impairment, mental retardation, multiple disabilities, orthopedic impairment, other health impairment, specific learning disability, speech or language impairment, traumatic brain injury, or visual impairment. Since several of these categories are unlikely by definition to apply to young children (e.g., traumatic brain injury, specific learning disability), the more appropriate and widely used IDEA eligibility category of developmental delay will be included. The thirteenth IDEA category of autism (which includes all Pervasive Developmental Disorders) will be excluded since other reviews have examined this population as a distinct group, and previous metaanalyses have already examined the types of intensive, life-long social skills training appropriate for children (of various ages) with autism. Studies of children described as at risk for future problems will be included, since children living under conditions of risk (e.g. poverty, history of abuse) have been well-documented as exhibiting a higher frequency of social competence problems. These children are eligible for Head Start services, frequently experience developmental delay, and may be served and studied within inclusive classroom environments. These participants will be examined relative to their geographic location (urban, rural, suburban, etc.), as well as the types of settings in which they are served (preschool, child care, Head Start, etc.). The Intervention In order to be selected for inclusion in this review, studies must include a center-based or classroom-based intervention designed or chosen to address social competence. Studies that consist primarily of parenting classes or interventions conducted in the home will be excluded. Interventions in included studies should utilize teacher-mediated (e.g., social 4 The Campbell Collaboration

5 skills training), parent-mediated, and peer-mediated approaches in early childhood settings (e.g., preschool, child care, Head Start). No limits will be placed on intervention duration, but it is expected that they last from one week to an entire school year depending upon the needs of the population. Environmental approaches (e.g., structured play), behavioral strategies, instructional, or combined approaches are all eligible for inclusion. The focus of the intervention or program in included studies must be increasing overall social competence or its component skills (i.e., verbal and non-verbal initiation, response, interaction, and problem-solving behaviors). The impact of social competence interventions has been found to vary across variables such as gender, age groups, risk factors, and disabilities (e.g., Odom et al., 1999). Intervention-related variables that have been found to impact results include program types, intervention length and intensity, type of interventionist, treatment integrity, and presence of follow-up. Few of these variables have been explored sufficiently, and findings are often limited due not only to individual differences, but to limited opportunities for random assignment to treatment groups and small sample size as well (Hartle, 1996). All of these will be examined here. Studies will typically compare intervention groups to those receiving typical classroom activities/instruction. Outcomes: What are the intended effects of the intervention? Dependent variables must represent socially competent behaviors, broadly defined here to include social skills, social or play initiation, social language, and communication and interaction skills with peers and teachers (such as turn-taking in play or conversation, management of emotions, and self-control). The primary outcome for this review will be overall social skills/social competence as perceived by teachers, caregivers, or independent observers. However, specific social skills (initiations, responses to play invitations, etc.) will also be examined. OBJECTIVES The research objectives to be addressed in this review are: 1) To describe the features of studies examining the effects of social competence interventions for young children with special needs; and specifically, to clarify the definition of social competence as operationalized in studies of this population; 2) To characterize the evidence to date on the effects of social competence interventions for preschool-aged children with disabilities/risk factors from 1965 to the present; 5 The Campbell Collaboration

6 3) To identify and, if possible, attempt to explain variation in the effects of these interventions related to intervention type, participant characteristics, and other study characteristics; 4) To identify gaps in this area of research, and generate recommendations for further study METHODOLOGY This review will focus on studies with randomly or non-randomly assigned groups as long as a control group was present. Control groups will be required to resemble treatment groups in terms of their makeup. In other words, if a study s aim is to increase the social competence of hearing-impaired children, the control group must contain hearing-impaired children as well (as opposed to typical children, as is the case in some published research). Typical measures in such studies include behavioral observations during play and teacher/parent surveys in which global competence scores (and, in some cases, subscale scores for specific competencies) are obtained before and after interventions are offered. It is not anticipated that these studies include many meaningful assessments of long-term impact (via follow-up measures), but in cases where these are included, it is anticipated that the measures are administered within a few weeks of post-test. Inclusion criteria The present review will focus on studies published or conducted from 1965 through summer The date range was established in order to potentially include any study that was conducted following the federal Head Start initiative of While peer interaction research has historically been limited almost exclusively to the United States and Western Europe, and the number of articles published in other countries is quite limited, international studies will be sought. Exclusion criteria Interventions provided outside of the classroom (i.e., in the home or in residential/hospital settings) will be excluded. In addition, studies focusing exclusively on children with autism will not be included. It is suspected that many published studies (particularly those addressing children with more severe skill deficits) would utilize single-case designs. These studies will be sought and set aside for alternative analysis at a later time. Your method of synthesis We will use meta-analysis to complete the review with standardized mean difference as the effect size metric. 6 The Campbell Collaboration

7 REFERENCES Antia, S. D., & Kreimeyer, K. H. (1993). Promoting social interaction between young children with hearing impairments and their peers. Exceptional Children, 60, 3. Bailey, D. B., & Wolery, M. (1992). Teaching infants and preschoolers with disabilities. New York: Merrill. Brown, W. H., & Conroy, M. A. (2001). Promoting peer-related social-communicative competence in preschool children with developmental delays. In H. Goldstein, L. Kaczmarek, & K. English (Eds.), Promoting social communication in children and youth with developmental disabilities (pp ). Baltimore, MD: Paul H. Brookes Publishing Co. Brown, W. H., Odom, S. L., & Conroy, M. A. (2001). An intervention hierarchy for promoting young children s peer interactions in natural environments. Topics in Early Childhood Special Education, 21(3), Buysse, V., Goldman, B., West, T., & Hollingsworth, H. (2008). Friendships in early childhood: Implications for early education and intervention. In W.H. Brown, S.L. Odom, & S.R. McConnell (Eds.), Social competence of young children: Risk, disability, and intervention (pp ). Baltimore, MD: Paul H. Brookes Publishing Co. Campbell, S. B. (1990). Behavior problems in preschool children: Clinical and developmental issues. (Second Edition) New York: Guilford Press. Costin, S. E., & Jones, D. C. (1992). Friendship as a facilitator of emotional responsiveness and prosocial interventions among young children. Developmental Psychology, 28(5), Craig-Unkefer, L., & Kaiser, A. (2002). Improving the social communication of at risk preschool children in a play context. Topics in Early Childhood Special Education. 22(1), English, E., Goldstein, H., Shafer, K., & Kaczmarek, L. (1997). Promoting interactions among preschoolers with and without disabilities: Effects of a buddy skills-training program. Exceptional Children, 63(2), Fantuzzo, J. W., Jurecic, L., Stovall, A., Hightower, A. D., Goins, C., & Schectel, D. (1988). Effects of adult and peer social initiations on the social behavior of withdrawn, maltreated preschool children. Journal of Counseling and Consulting Psychology, 56(1), Ferentino, S. C. (1991). Teaching social skills to preschool children in a special education program (Doctoral dissertation). Retrieved from ProQuest Digital Dissertations (AAT ). Fewell, R., & Vadasy, P. (1989). Play as an intervention strategy with young children with deaf-blindness. In M. Bullis (Ed.), Research on the communication development of young children with deaf-blindness (pp ). (ERIC Document Reproduction Service No. ED328007) 7 The Campbell Collaboration

8 Gresham, F. M. (1981). Social skills training with handicapped children: A review. Review of Educational Research, 51(1), Gresham, F. M., & Reschly, D. J. (1987). Dimensions of social competence: Method factors in the assessment of adaptive behavior, social skills, and peer acceptance. Journal of School Psychology, 25(4), Gresham, F. M., Sugai, G., & Horner, R. H. (2001). Interpreting outcomes of social skills training for students with high-incidence disabilities. Exceptional Children, 67(3), Guralnick, M. J., Connor, R., Hammond, M., Gottman, J. M., & Kinnish, K. (1996a). Immediate effects of mainstreamed settings on the social interactions and social integration of preschool children. American Journal on Mental Retardation, 100, Guralnick, M. J., Connor, R., Hammond, M., Gottman, J. M., & Kinnish K. (1996b). The peer relations of preschool children with communication disorders. Child Development, 67, Guralnick, M. J., & Groom, J. M. (1987). The peer relations of mildly delayed and nonhandicapped preschool children in mainstream playgroups. American Journal of Mental Retardation, 58, Hartle, L. (1996). Effects of additional materials on preschool children s outdoor play behaviors. Journal of Research in Childhood Education, 11, Hinshaw, S. P. (1992). Externalizing behavior problems and academic underachievement in childhood and adolescence: Causal relationships and underlying mechanisms. Psychological Bulletin, 111(1), Jenkins, J., Jewell, M., Leicester, N., Jenkins, L., & Troutner, N. (1991). Development of a school building model for educating students with handicaps and at-risk students in general education classrooms. Journal of Learning Disabilities, 24, 5, Koenigs, A., & Oppenheimer, L. (1985). Development and training of role-taking abilities with emotionally disturbed preschoolers: A pilot study. Journal of Applied Developmental Psychology, 6, Kopp, C. B., Baker, B. L., & Brown, K. W. (1992). Social skills and their correlates: Preschoolers with developmental delays. American Journal of Mental Retardation, 96, Ladd, G. W. (1990). Having friends, keeping friends, keeping friends and being liked by peers in the classroom: Predictors of children s early school adjustment? Child Development, 61(4), Lieber, J. (1993). A comparison of pretend play in young children with and without disabilities. Early Education and Development, 4, Lowenthal, B. (1996). Teaching social skills to preschoolers with special needs. Childhood Education, 72, Mueller, E., & Silverman, N. (1989). Peer relations in maltreated children. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and 8 The Campbell Collaboration

9 consequences of child abuse and neglect (pp ). New York: Cambridge University Press. Odom, S. L., & McConnell, S. R. (1993). Play time/social time: Organizing your classroom to build interaction skills. Tucson, AZ: Communication Skill Builders. Odom, S. L., McConnell, S., McEvoy, M., Peterson, C., Ostrosky, M., Chandler, L., Favazza, P. (1999). Relative effects of interventions supporting the social competence of young children with disabilities. Topics in Early Childhood Special Education, 19(2), Odom, S. L., Zercher, C., Marquart, J., Li, S., Sandall, S. R., & Wolfberg, P. (2001). Social relationships of children with disabilities and their peers in inclusive preschool classrooms. In S.L. Odom (Ed.), Widening the circle: Including children with disabilities in preschool programs (pp ). New York: Teachers College Press. Odom, S. L., Zercher, C., Li, S., Marquart, J., & Sandall, S. (April, 1998). Social relationships of preschool children with disabilities. Paper presented at the Annual Conference of the American Educational Research Association, San Diego, CA. Webster-Stratton, C., & Hammond, M. (1997). Treating children with early-onset conduct problems: A comparison of child and parent training. Journal of Consulting & Clinical Psychology, 65( 1), The Campbell Collaboration

10 SOURCES OF SUPPORT Internal funding None External funding None DECLARATIONS OF INTEREST N/A REQUEST SUPPORT Support is not needed at this time. AUTHOR(S) REVIEW TEAM Lead reviewer Name: Adam S. Kennedy Title: Assistant Professor Affiliation: Loyola University Chicago Address: School of Education, 820 N. Michigan Ave. Suite 1100 City, State, Province or County: Chicago, IL Postal Code:60611 Country: USA Phone: (312) Mobile: (630) The Campbell Collaboration

11 Co-author Name: Therese M. Pigott Title: Professor Affiliation: Loyola University Chicago Address: School of Education, 820 N. Michigan Ave. Suite 1100 City, State, Province or County: Chicago, IL Postal Code: Country: USA Phone: (312) Mobile: (312) ROLES AND RESPONSIBLIITIES Content: Adam Kennedy Systematic review methods: Terri Pigott Statistical analysis: Terri Pigott, Adam Kennedy Information retrieval: Adam Kennedy PRELIMINARY TIMEFRAME A draft protocol is complete and can be submitted at any time. We anticipate that the review itself will be completed by August The Campbell Collaboration