Episode 343 - Peer Mediation (DUAL-DIAGNOSIS)

Summary

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ABA Inside Track – Episode 343: Peer Mediation (Dual-Diagnosis)

Release Date: April 29, 2026
Hosts: Robert Perry Crews, Diana Perry Cruz, Jackie McDonald

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Episode Overview

This episode explores peer mediation as an intervention strategy for supporting students with disabilities, including those with autism and ADHD. The hosts discuss recent research articles examining how peers can facilitate social skills, compliance, and task-related behaviors. They dig into the practicalities, benefits, challenges, and ethical considerations of leveraging peer mediation in educational settings.

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Key Discussion Points and Insights

1. Defining Peer Mediation in Behavior Analysis

• Not Just Conflict Resolution: Peer mediation here refers not to peer-facilitated conflict resolution, but rather to procedures where peers actively prompt, reinforce, or participate in skill-building for target students, typically those with disabilities.
• Multiple Forms: Peers can deliver reinforcement, prompt correct responses, and model behavior, making the concept applicable to a range of social and instructional interventions.
• Natural Environment Generalization: Peers as interventionists may enhance the generalization and maintenance of target skills outside of adult-facilitated settings.
  • “Building in peer opportunities into the acquisition process just makes a ton of sense from many angles.” – Diana Perry Cruz (08:23)
• Social Validity and Empathy: Peer mediation is underutilized in schools, yet benefits both neurodivergent students and their peers. Peers learn empathy and leadership, while target students receive meaningful opportunities for inclusion and skill use.
  • “I think everyone would benefit from learning how to do some level of peer mediation through their schooling.” – Robert Perry Crews (06:19)
• Practical Excitement: Rob notes he’s so enthused by this research that he’s already begun integrating peer mediation into his behavior plans, and staff have reacted positively.

2. Article 1 – Morrison et al. (2001): Peer and Self-Monitoring for Social Skills in Autism

[09:02–28:56]
Target Skills: Requesting, Commenting, Sharing
Participants: Four autistic students (with varying degrees of language and inclusion), plus teacher-nominated socially skilled peers
Procedures:

• Small mixed-ability peer groups played games (e.g., Trouble, Uno).
• Monitoring systems alternated: self-monitoring and peer-monitoring (checking frequency of target behaviors).
• Tangible reinforcement (primarily candy) used for correct monitoring and skill demonstration.
• Counterbalanced design: Some started with self-monitoring, others with peer-monitoring, later switched.
• Peers actively delivered prompts and reinforcement. Findings:
• Both self- and peer-monitoring increased initiations and target social skills.
• Generalization observed for some participants (especially those with higher baseline communication).
• Peer mediators spontaneously increased modeling/prompting and created evocative situations to elicit social interactions.
• Authors recommend self-monitoring for independence and generalization, but both systems are effective. Notable Moment:
• “Whether self or peer monitoring, who cares? Both of them do seem to increase social interactions in these sort of peer mediation groups.” – Robert Perry Crews (26:43)
• Discussion of logistical issues like which games facilitate interaction (don’t use ‘Don’t Break the Ice’!).

3. Article 2 – Bolio et al. (2013): Peer Mediation for Preschoolers’ Compliance

[32:38–44:54] Participants: Four typically-developing 5-year-olds; organized in dyads
Target Behaviors: “Compliance precursors” (stop activity, orient to instructor, say ‘yes’, wait for direction) and instruction following
Procedures:

• Behavior Skills Training (BST) for both precursor and peer mediation skills.
• Dyads: Children both acted as peer mediators for each other.
• Peer mediation involved giving praise (verbal, “hand-jive,” etc.) or prompts if the partner didn’t respond correctly.
• Visual feedback via check marks on folded construction paper, exchangeable for small rewards. Findings:
• Peer mediation led to substantial, low-variability increases in both precursors and instruction-following compared to baseline.
• Both praise and prompts as peer responses increased only after systematic teaching.
• Effects generally maintained during “maintenance” conditions with less adult support. Notable Quote:
• “I love that [both peers mediate]; because both participants are in charge, right?… not just one is in charge of one. I love.” – Jackie McDonald (41:00)

4. Article 3 – Grauvogel, McAleese, & Wallace (2010): Peer-Mediated Intervention for ADHD

[45:05–56:43] Participants: Three boys (ages 6–10) with ADHD, with peers (chosen by the participants), in after-school homework settings
Procedures:

• Functional analysis (FA) to assess maintaining variables for off-task behavior.
• FA included adult attention, work demand, and (distinctively) peer-attention conditions.
• Peers trained to provide attention (join, laugh, or follow) contingent on off-task behavior during FA; in intervention, praised/helped with on-task behavior, withheld for off-task (extinction + differential reinforcement).
• Use of vibrating pagers to cue peers. Findings:
• “Peer attention” robustly maintained off-task behaviors in FA—graphs were textbook examples of clear experimental differentiation.
• Peer-mediated differential reinforcement and extinction led to steep, immediate drops in off-task behavior; effect reversed when contingencies discontinued, confirming experimental control.
• Social validity: Most students and peers liked the procedures; minor ambivalence from some peers about the helper role. Ethical/Practical Concerns:
• “How weird is it for the peer? Can they be friends after? … Like I’d like to know more of… the qualitative [side].” – Jackie McDonald (58:34)

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Notable Quotes & Memorable Moments

• “It’s a great idea for adding to treatments… I already added peer mediation to some plans.” – Robert Perry Crews (07:17)
• “I love the idea of having it be…an in-the-round training…not just the child with a disability [making] the change… we as a group need to figure out how we’re all going to work best together.” – Diana Perry Cruz (11:17)
• “Everyone gets to be a peer mediator.” – Diana Perry Cruz (44:54)
• “This is what differentiation looks like!” – Jackie McDonald, reacting to the clear FA results from the ADHD study (51:50)

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Timestamps for Key Segments

• Peer Mediation Defined / Episode Theme: [04:00–08:50]
• Morrison et al. Article Discussion (Autism; Self/Peer Monitoring): [09:02–28:56]
• Bolio et al. Article Discussion (Preschool Compliance): [32:38–44:54]
• Grauvogel et al. Article Discussion (ADHD; FA): [45:05–56:43]
• Dissemination Station: Practicalities & Limitations (Peer Reactions, Generalization, Stigma): [56:43–63:50]
• Pairings (Related Episodes; The Swedish Chef metaphor): [64:21–65:54]

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Practical Insights and Ethical Considerations

• Logistics of Peer Mediation:
  • Child buy-in is generally high, but “peer” and “target” both benefit when procedures are reciprocal, not one-sided.
  • Peers need deliberate training; BST and reinforcers make participation rewarding.
  • Maintaining natural peer relationships and minimizing stigma is essential; best embedded in regular classroom activities.
  • Don't use siblings as peer mediators without careful consideration (possible confounding variables or emotional issues).
• Limitations:
  • Situations involving severe or unsafe behavior may not be suitable for peer mediation (risk of stigmatization, safety).
  • Sessions in studies are often brief (e.g., 5–15 min), results may differ with longer or more intense interventions.
• Generalization:
  • Peer mediation effects generalize better when peers perform monitoring, prompting, and reinforcement in natural settings.

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Episode Pairings and Further Learning

If you enjoyed this episode:

• Preschool Life Skills: Episodes 34, 95, 336
• Social Skills Curricula: Episode 150
• Self-Monitoring: Episode 115
• Dual-Diagnosis/ADHD: Episodes 16, 209
• Recent related content: Episode 342 (Ascent and PECS, peer mediation context)

Fun Note: Diana’s snack pairing is Swedish meatballs, inspired by the Swedish Chef puppet, operated by two people as a metaphor for collaboration!

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Conclusion & Takeaways

Peer mediation is underutilized but powerful in ABA, exhibiting strong effects across varied settings, populations (autism, ADHD, neurotypical), and behaviors (social skills, compliance, attention). Results suggest both target students and peers can learn vital, generalizable skills, especially when mediation is reciprocal and embedded in natural environments. While not a panacea—training, logistics, and context matter deeply—these studies underscore that “having peers in the room isn’t just resourceful, it’s evidence-based.”

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“I think all three of these studies really demonstrate that the use of peers… can be very effective. Now, lest you think, ‘Oh, throw peers in and that’ll magically make everything better,’ guess what? You still need to do the job that you as an adult would do. However, the addition of peers… was really very additive to the treatment.” – Robert Perry Crews (56:43)

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End of summary.

Transcript

[Diana Perry Cruz]

Foreign.

[Robert Perry Crews]

Hey, everybody. Welcome to ABA Inside Track, the podcast that's like reading in your car, but safer. I'm your host, Robert Perry Crews, and with me, as always, are my fabulous co hosts.

[Jackie McDonald]

Oh, hey there, Robert Perry Cruz. It's me, Jackie McDonald.

[Diana Perry Cruz]

And hello, it's me, Diana Perry Cruz. Nice to see you all.

[Jackie McDonald]

Oh, nice to hear you all.

[Diana Perry Cruz]

Nice to be here in the basement with you.

[Robert Perry Crews]

Oh, boy. So I don't know if you guys noticed, I think I told you I did this, but then I don't know how much you actually follow our podcast feed.

[Jackie McDonald]

I have been.

[Robert Perry Crews]

Okay, so on the past Fridays. I don't know what. What month is this? Now or May, back in March, when It was our 10 year advice array, which we could celebrate as long as we damn well please. I suppose. Every Friday I released episodes of my old podcast.

[Jackie McDonald]

I didn't see mine.

[Robert Perry Crews]

It just came out today.

[Jackie McDonald]

Okay, good.

[Robert Perry Crews]

I was listening to it this morning to make sure it was still there.

[Jackie McDonald]

It's still my favorite song.

[Robert Perry Crews]

Oh, well, it's. It's on there. But anyway, we were releasing some old podcasts we'd done before we did this podcast and that one was Jackie's first podcast. She talked about the song stars, your ex lover is dead.

[Jackie McDonald]

Such a good song, everyone. Such a good song. Still one of my favorites.

[Robert Perry Crews]

Yeah. Which was a podcast. When I just talked about songs with people, their favorite songs, which I think is a great idea for podcast. I don't know why I didn't take take off and make me a millionaire.

[Jackie McDonald]

You don't have enough friends?

[Robert Perry Crews]

I didn't have enough like right wing hate speech on it, I guess. Something like that. I don't know. In any case, it was a long time ago.

[Diana Perry Cruz]

It was like 12 years ago.

[Robert Perry Crews]

Yeah, the market for right wing hate speech just wasn't as good as it was now.

[Diana Perry Cruz]

Well, in the podcast more generally.

[Robert Perry Crews]

Okay. And in Jackie's first podcast episode ever, she. She mentions that we're going to do ABA Inside Track. And I just remembered it as like, yeah, we're going to do ABA Inside Track, a podcast about behavior analysis and behavior analytic research. Every week. Pick a topic, discuss it at length. Right. And she mentions coming soon we have an ABA podcast. But you know what she mentioned me and Diana have an ABA podcast coming. I was conveniently left out. Apparently she thought I was doing so well with my zero dollar podcast that I didn't need to be included in this.

[Jackie McDonald]

Sorry.

[Robert Perry Crews]

Awesome plan, you know?

[Jackie McDonald]

So glad you're part of it.

[Robert Perry Crews]

Well, I kind of wish that we Had a third person, some other peer on that episode to sort of, you know, prompt you to be like, you should include Robin, that he's also a behavior analyst and he owns the microphone, so maybe we should be nicer to him. And then you would have been prompted to comment on. You should come with your microphone.

[Diana Perry Cruz]

He owns the microphone.

[Robert Perry Crews]

I own the microphone.

[Jackie McDonald]

You do all the things, so I

[Robert Perry Crews]

do all the things.

[Jackie McDonald]

Without you, we would not be a podcast, to be honest, without any of us, we would not be a podcast. So we all hold vital pieces.

[Robert Perry Crews]

Yeah.

[Jackie McDonald]

So.

[Robert Perry Crews]

But anyway, I was holding a grudge this whole time. I'm. I'm just telling you now. I've been mad for, For, For. For days and days and months and months. If you're listening to this, for all you know, I've been bad since before March. And I said, you know what? I'm going to turn that rage. Let's turn it into a productive episode of this podcast that I wasn't invited to be on. Apparently, 343 episodes later, nobody asked me to be here. Who knew? And I thought, let's talk about the. Those peers mediating social scenarios. Let's talk about peer mediation. Do you like that?

[Diana Perry Cruz]

Yeah.

[Robert Perry Crews]

Landing, boom. And of course, I am just joking. I did not get mad. I forgot Jackie said that. Until this morning. Actually, when I forgot, I said that, too. Why even listen? I was like, oh, where was it? I was like, there's Jackie talking about our podcast we're all going to do together. And then I list this one. I was like, wait a minute. My name was not mentioned.

[Jackie McDonald]

I'm sorry.

[Diana Perry Cruz]

I'm going to.

[Jackie McDonald]

We can re record that because it still is one of my favorite songs. And I'll be like, Diana, Rob and

[Robert Perry Crews]

I. I can't wait till you join the podcast Diana and I are starting.

[Diana Perry Cruz]

Perhaps as host is the main character.

[Robert Perry Crews]

I don't think I'm the main character. I'm. I'm, you know, the narrator. I'm like the Shakespearean narrator character. Anyway, all that to be said, if you didn't listen to those old episodes, you totally should. There's apparently tons of drama we didn't even know was there, and it was fun. And now peer mediation, which is what we'll be talking about, peer mediation as an episode. Because peer mediation can be a technique used to help improve the skills of lots of different individuals, including individuals with disabilities other than autism. This is going to be a dual diagnosis episode. So if you are looking for Kwaba ces, this will be a dual diagnosis Episode. Now again, this isn't you know, or

[Diana Perry Cruz]

otherwise just so general.

[Robert Perry Crews]

Otherwise just general. C. Whatevsky. Use it or lose it, dudes. So, Diana, what three peer mediation exemplar articles will we be discussing today?

[Diana Perry Cruz]

Okay, we have three to discuss. As you noted, they include peer mediation and monitoring strategies to improve initiations and social skills for students with autism. That was by Morrison, Camps, Garcia and Parker, published in 2001 in the journal of Positive Behavior Interventions. Also effects of peer mediation non preschoolers compliance and compliance precursors. That was by Bolio, Hanley and Roberson and published in Jabba in 2013. And finally, use of peer mediated intervention in children with attention deficit hyperactivity disorder. That was by Grauvogel, Macalise and Wallace and it was in Java 2010.

[Robert Perry Crews]

Excellent. So when we talk about peer mediation, what we're really talking about are treatments in which peers of the target student, which again in the study is usually going to be the student with disabilities, are going to mediate some response. They're the prompters. They deliver the reinforcement. They co engage in the skill. There's all sorts of ways it could look.

[Diana Perry Cruz]

Yeah, it's not the other one that I thought, which is where you have two students who are having a disagreement and then they have another student come in and try to like mediate the disagreement. This is not that, which initially I thought it was.

[Robert Perry Crews]

I mean, technically that would fall into the same category in that there is a peer.

[Diana Perry Cruz]

Yeah, I guess.

[Robert Perry Crews]

Who is engaged in some sort of a procedure to support a different student.

[Diana Perry Cruz]

Yeah, but this isn't really like how this is set up. This is like peers are there to help foster learning and do some of the prompting.

[Robert Perry Crews]

Yeah, yeah. It's a topic I, working in public schools really love because I think really, I don't want to say taking advantage of, but utilizing just the presence of other peers who A should be learning useful leadership skills like how to support other individuals who might be struggling in some areas and B, because children really, really love when they have any sort of a role in which they are very, very clearly told you are helping somebody regardless what they do, do not have a disability. These are kind of underused resources in schools. It's always going to be, we got to pay an adult, give them health insurance and all this stuff. Okay. Very important to do that. I'm not saying don't give people health insurance for working hard in schools, but we have so many other students around and I think everyone would benefit from learning how to do some level of peer mediation through their Schooling, whether it just is to get them used to the idea that there are other individuals who might be struggling and to have more empathy for them or, or to really take on important leadership roles, like noticing how other people might be having a hard time and then using various, you know, appropriate behavioral techniques to help them in those situations, whether through prompting or reinforcement of some alternative behavior. I just think this is a really, really great idea for adding two treatments. And a lot of times on the show I will read some articles and I'll say I'm going to use that in the future. Well, I already added peer mediation to some plans. We, we didn't even record the episode and I'm just so jazzed on the idea. And guess what everyone said when I said, what about peer mediation? They said, love that idea. Everyone was so excited. They said it was going to be the best they got. So how are we going to show that the kids are peer mediators in the classroom? Everyone got very excited.

[Jackie McDonald]

I'm excited.

[Robert Perry Crews]

Social validity.

[Jackie McDonald]

I'm excited to get into this and ask you about that pro process because in mine they use peer mediation and I just would. I, I wonder how you like, bring it up to the other peer. Right. So we'll get there. But it, I was like, is this awkward? It might be. So they're like 10 year olds, so it might be awkward. So I wanted to just get your thoughts on that.

[Robert Perry Crews]

Yeah. All right.

[Diana Perry Cruz]

Well, it's also a great idea in terms of working toward ensuring that responses that are acquired are going to generalize to the natural environmental setting and be maintained in that environmental setting. So it's certainly one thing to do demonstrate a skill with an adult, but it's a whole other thing to demonstrate that skill with a peer. And so building in peer opportunities into the acquisition process just makes a ton of sense from many angles.

[Robert Perry Crews]

Well, we love this. That's it. That's all I want to talk about. Great idea.

[Diana Perry Cruz]

We're done.

[Robert Perry Crews]

Read these articles. Maybe we should talk about them. What do you say, folks? Why don't I start?

[Diana Perry Cruz]

I mean, we're here. No, I guess we should just go ahead and do it.

[Robert Perry Crews]

Okay, Might as well. We got. How much, how much cassette tape do I have left for this recording? I got enough. We can keep going. So the article that I'll be sort of taking the lead on discussing is the Morrison Peer Mediation and monitoring strategies, which I kind of feel like wanted to be a self monitoring study and then turned into a peer mediation study to some extent. I think that was their plan all along, but it sort of feels like they had a lot of cool ideas and they're like, what if we just do them all? And oh, okay, great, it worked out fine. So when we look at social interactions, peer radiation is a really great idea in many cases for adding to your treatment because there are lots of interventions that one could use. You could use various prompts priming, you could use script fading. Right. But what about pure mediation? Could you use that with most of these treatments? Probably almost all of them, if not a good chunk of them. Another, you know, reason you might want to have peer mediation is that, well, we're talking about social skills. What are we trying to increase the amount of interaction and the amount of communication of various kinds between some target peer, usually with some sort of a disability that impacts their communication or, you know, social knowledge or utility of social skills, and have someone who is going to be prepared to prompt or reinforce communication bids. I think a lot of times we just sort of teach the child with disability, here's what you need to do. And then we throw in a big group with a bunch of kids who are doing God knows what and most likely are not as reinforcing as adults. I mean, how many of us have worked with particularly, you know, often with students, autistic students who love interacting with adults, they have all the social skills with adults because we are predictable, because we are attentive, because we understand that adults know more than children, therefore we should be more patient. Whereas a lot of peers are just not willing to give the children the time of day. And it's not their fault. No one's shown them that that's not a skill that you just magically learn.

[Jackie McDonald]

Right.

[Robert Perry Crews]

So why not kill two birds with one stone and just use the peers as part of the intervention? Right. It shouldn't be too different. And they did that. They also wanted to say, what if we also had self monitoring? And then flip the script, peer monitoring, which is just self monitoring, but the peer really excited.

[Diana Perry Cruz]

Yeah, I really just caveat or given aside, I guess it's not a caveat. I love the idea of having it be sort of like a, an in the round training. Right. With everyone who is involved in that classroom or who is intended to be involved in that classroom. Because what we don't want to do is end up in a scenario where it's only the child with a disability or autism that needs to make the change in their behavior in order to fit in to the classroom. And, and very often other students who do not have a disability just Need a chance to like you said Rob, to like, be educated about what, what the expectations are. And oh, I didn't realize. I need to, you know, maybe wait a little bit longer to listen for their response. Whether they might be using, you know, multiple modalities of, of requesting or that, you know, stereotypic behavior is. It's not intended to be scary. It's just something different that they do. Right. Just that kind of background information can be extremely helpful in everyone understanding that we have diverse perspectives within the class and really increasing the overall, like, interaction between those kids so that that type of intervention can benefit the child who, you know, traditionally would be targeted for the skill acquisition. And it is done on the other, on the flip side. Right. And so I love that perspective because that we're really like utilizing everyone in the classroom and it's no longer like, oh, this child some difficulty that we need to change. It's, hey, we as a group need to figure out how we're all going to work best together. And it just changes the whole, like, outlook and perspective on what we're there to do. And I just love it from like a theoretical kind of perspective.

[Robert Perry Crews]

Yeah. I think this study really captures kind of that, that picture of what if we take a bunch of kids, some with disabilities, some without disabilities, and we just put them in a room with some structured activities and teach them, some take a big old spoon, great time, stir them up and we give them some monitoring tools.

[Diana Perry Cruz]

Okay.

[Robert Perry Crews]

So in this case, the goal here, they have four target students, all autistic students, and they had three non dis. They keep referring to them as non disabled peers. So I, I may use that term. Three non target students also could be used per group.

[Diana Perry Cruz]

Yeah.

[Robert Perry Crews]

And they pretty much would just try to increase social interactions. And they sort of define social interactions as any sort of vocalization directed, you know, among, among the peers. But they're really only taking data on that target peer who was. They were hoping to improve that. That peer social skills, really focusing the areas of requesting, commenting and sharing items as an addendum to the peer mediation of having the peers engage in the different behaviors with the child. Really the focus was on the peers mediating the interaction through the use of the self monitoring procedure. Some of the skills that the peers demonstrated afterwards seems to develop somewhat spontaneously with the goal of either the monitoring, the self monitoring or the peer monitoring of how many requests did the target student make. And then with the peer monitoring, they sort of break them into two groups. So the non disabled peer would also take data on A different non disabled peer. And then one non disabled peer would take data on the target peer just so everyone got a chance to be practicing the peer mediation and then the self monitoring or sorry, the peer monitoring and the self monitoring. Again, if you haven't listened to our episode on self monitoring, you don't know self monitoring. It is basically a self assessment procedure where you compare your behavior to whether it, you know, some behavior of note is or is not happening. And then you do some amount of self recording. And then typically there's some sort of reinforcement, sometimes self reinforcement that you deliver reinforcer to yourself if you meet some sort of a goal. In this case, the peers mediated that and that the peers delivered the reinforcement to the target peer. They had four different groups of students. And I don't always go into this much detail with participants, but I think it's important because when we're talking about social skills and social skill outcomes, certainly prerequisite skills to a study are going to play a big part into things like how easy was generalization, how long did maintenance last, how much were the increase in social skills. Sort of able to mitigate some of the older patterns of kind of not necessarily inappropriate social behaviors, but more atypical social behaviors like perceptive speech echolalia, which some of the participants did engage in. So we had Karen who was in sixth grade. She was in a general education classroom 50% of the day, had an aide supporting her and really liked the idea of hanging out with friends, but often would sort of just engage in this. They just called it silly or inappropriate behavior around them. We had Stuart who according to some of the scores that they were using, scored as having mild to moderate autism symptoms. He was fully included in a 5th grade gen ed class with some para support for about 75% of the day. He did have some challenges with language in that he had some articulation problems. He would engage in some amount of echolalia. He really wasn't initiating very much and wasn't really motivated to play with peers. So very different than Karen in that regard in that he sort of seemed uninterested. However, as we'll see in the results, was that he was uninterested in engaging with peers, really wasn't sure what to do with peers, therefore just didn't engage with them that much. We had Rick, who according to some of their testing scored as having middle or moderate mid to moderate autistic behaviors. He was in a special education classroom in middle school. He was only in gen ed really for lunch and PE and Was mostly engaged in functional academics. He was very interested in peers and engagement with adults. But he only spoke in short sentences. So a lot of his initiations and interactions were considered to be inappropriate. And then finally there was Jason, who scored as having mild to moderate autistic behaviors. He was in gen ed setting, but he had parasport 100% of the time, which we'll come back to bite some of his results in the butt later on. He used two to three word phrases, so short phrases, and often would engage in per se topics. He was also a phasic, which is going to impact his ability to use language fluently. And again, really liked peers, but kind of, we said at the top, tended to initiate more with adults, probably because adults would, you know, either tolerate some of the preservative topics more, more readily or else had more patience when sort of some of his aphasia might come into play in some of the sentences he would make. The peers were nominated by teachers because they were great social peers. The goal here was to just set up the children and in out of a space doing a small group activity. They would play games once, once a day, three times a week. They do this sort of training for 10 minutes, play games for 10 minutes, little social group. The games were things like trouble and topple and kerplunk and uno. But you could also do like. Some of those games are good, Some of those games suck. Koosh throw, Koosh ball throwing. They could do drawing. They can look at magazines together. So a lot of different types of activities for each of the skills, which requesting, commenting and shooting, sharing. They had like a chart that allowed, kind of defined what the behaviors were for the students. And they also had a place on the monitoring sheet, Whether it was peer monitoring or self monitoring, where the students would write down what behavior was the one they were looking for. And then a place to note how many times it did or, well, how many times it did occur. And basically the only conditions where they did some amount of social skills training, Then they added in self monitoring and peer monitoring, it depended what group you were in. Of the four, they sort of counterbalanced it. So two would start with peer monitoring and then flip to self monitoring later and vice versa. They were really just looking for any sort of increase in the skill usage. So as the total number of initiations and social interactions increased, they would, for three sessions, they go back to baseline and then they'd switch to whatever monitoring system that had not been used. So in baseline, they just threw out a bunch of games, Put the Kids in a room and said, here you go, you got to stay here, but you can do whatever you want while you're here. And that was it. Surprisingly, not a lot of interactions from the target peer. Then they trained requesting first. So they did the intervention. They give skill charts to all of the participants in the peers and the target peer. They do training with direct instruction. So they take 10 minutes to define the skill, give examples, ask each student, tell me an example with the non disabled peer sort of switching between the target peer. So everyone had a turn. They would model how to make a request and then ask them again if they didn't have an answer or couldn't give an example of what a request would look like. Then they said, here's a monitoring sheet and pens. And they trained everyone how to do monitoring. Then depending on the group, they either started with self or peer monitoring. For self monitoring, they just write the word on the top requesting and the student. The target student was instructed earlier in that intervention piece to place a check mark every time they request it. They modeled what to do and if the student engaged in the self monitoring behavior throughout, they would get a tangible reward. So they would engage in the requesting if they requested without inappropriate behavior and record it in the right spot that they could earn earn candy for self monitoring. If it were peer monitoring, it was pretty much the same except they would have the peers doing the monitoring. That was, that was pretty much it. They'd practice, practice and then they'd say, great. For the rest of this time, we have 10 minutes. You can play with any of these activities here. And remember to practice requesting and do your monitoring, either peer or self monitoring in the practice session. So those intervention sessions, the trainer delivered any rewards as the participants were engaging in the requesting or commenting or sharing behavior, whatever it was, they'd correct mistakes. They'd do model modeling, they would prompt the skill to start, they'd give praise. But then once they were in the game, it was the non disabled peers who would deliver the rewards to the target students. So if they made a request, they, you know, respond to the request and then they would deliver other reinforcers. So it was typically candy. And then at the end of the time, the non disabled peers would also get candy or stickers just for participating. I don't know how they got through in a public school just giving out candy. I guess it was, hey man, 2001, we had bigger problems to worry about than how much candy kids were getting in public schools.

[Diana Perry Cruz]

I guess I remember my fourth grade teacher would, would he had A big jar of Jolly Ranchers. And if you got a question right, he would throw it. Oh yeah, you had to catch it. But he called him happy farmers. I know.

[Robert Perry Crews]

We got fireballs in one of my history classes. Those are great. After that, the kind of first session, they moved to 10 times of the target skill. And everyone earns a reward. And so it's pretty much the same thing. 10 minutes training, then 10 to 15 minutes of gameplay. After they saw the improvement in the skill, they'd go back to baseline two, just say, hey, we're not doing monitoring today. Then they would switch whatever monitoring it was. And then they repeated this for commenting and they repeated this for sharing. So there you go. And as they added more, you would do more recording for all of the skills. So you would just keep recording all of the different skills. And then they kept fading the reinforcement throughout the. Finally, kind of, for some scoring purposes, they took like a randomly chosen 5 minute samples of play of that play time. And they'd score things like the initiations. Any motor or vocal behavior clearly directed to a peer that attempted to occasion a response from the target student to the non disabled peers. They'd also score responses, again, same thing, but in the direction of the target peer to the non disabled peers, responses by peers to the target student, invitations or initiations, sorry, social interactions, inappropriate behaviors of the target students because at least three out of four, they all engage in some amount of inappropriate social behavior. And then the, the plain old occurrences of requesting and commenting and sharing, which were the target skills. All right, now they scored everything as one type. So you couldn't score as having engaged in a request and a comment and a sharing. It was sort of like broken into blocks. You did one, you could do multiple kinds of each one, but you couldn't get scored as doing multiple ones within like one of their, you know, bins.

[Diana Perry Cruz]

Right.

[Jackie McDonald]

I wonder if that. I bet that would change because my study does include all of those in all of the bins. And I wonder if their, their data would change.

[Robert Perry Crews]

I mean, you could do each, you could do them kind of within the bins, but you know, if it's scored as a statement, it just got coded as one of the. One of the, like, you couldn't kind of score in each. And then they did some generalization during recess and during lunch. And then they did follow up for Karen and Stuart only a year later to see how they were doing. So the results were really good. All four participants increased their initiations to peers during interventions from like, you know, 16% of the time, or 16% initiations to 44% for Karen. Rick was 2 to 27%, you know, or even 36% with the peer monitoring. Jason was 2 to 36% with the self monitoring. Stuart was 13 to 52% with the self monitoring. Now you might say, oh, I said self monitoring or peer monitoring. It must mean that those were significantly better for each of them. No, not really. They kind of all worked. Some were slightly higher than the other. But whether it was peer or self monitoring, all of the monitoring was effective at increasing the initiations to the students. Chris, Karen and Stewart, who began the study with more communicative ability, did demonstrate generalization at lunch and recess. Jason engaged in those increased initiations at recess time, but not at the lunchroom. Although I don't know why they bother reporting this, because then when they get into the detail, they're like. And in one of the lunchrooms, the children were told they could not talk. And in another one, aid was like kind of a busybody. And didn't one of the participants talk? Which doesn't feel, doesn't feel like a failure of generalization. It feels like a failure to communicate as they're not being allowed to do so. So the monitoring did not seem to matter. Again, slight differences in them, but both of them increased the use of target social skills. Requesting and commenting and sharing. Commenting was often the highest with the students that engaged in the most verbal behavior total. And while some of those numbers might seem low, like oh, 34 interaction, that's not great the way they were scoring it. There was some kind of interaction happening in 50 to 75% of intervals. And they go to the trouble of giving you a, a different looking at a different study looking at peer interactions in general. And it's not like all typically developing peers are 100 of the time interacting. That can range as well. They looked at some social, kind of social variability study from a different sample video of non disabled peers and their mean social interactions were like 58% of the time they were interacting. The range was 5 to 100%. So sometimes tons of interaction. Sometimes everyone ignored everyone else. And the thing that they really also commented on being exciting was the non disabled peers really started doing a lot of modeling and prompting of the social skills regardless of the monitoring. Like they really got into this purpose of the study and really were trying to like juj it up. There was an example where they talked about how they were trying to sort of laugh and get, you know, get Rick involved more with the activity. And they saw Decreases in inappropriate behaviors during the intervention. Again, mostly because the peers were modeling so much. And some of the participants, I think Karen and Stuart mostly, they were seeing a lot of novel vocal statements being modeled by the peers. And then Karen and Stuart were saying new things. Rick and Jason, they didn't have quite as much novelty in their speech. They would mostly sort of say the statements that were modeled or say things that they saw model. But again, they were able to engage a lot more. Rick didn't totally eliminate some of his inappropriate behaviors, but again, there was a nice decrease in some of them because there was much more reinforcement for his appropriate social behaviors. Again, we talked about some of the challenges, generalization that had nothing to do with the participants. It was a little weird. And they couldn't do maintenance because at least one of the students, if not two of the that went to another school. So what do we learn here? Well, whether self or peer monitoring, who cares? Both of them do seem to increase social interactions in these sort of peer mediation groups. We also learned that, you know, their thoughts might be that it doesn't matter the type of feedback. There is some feedback. Like they noticed that the target peers were watching the peer mediators engage in the peer monitoring. So it may just be, oh, somebody's writing something down. That's the feedback. Which is why social. Sorry, why. Why monitoring systems tend to work. There's some amount of feedback being given, and if you had to pick between them, the authors say, I mean, you could do it idiosyncratically, but it might be best to just do self monitoring because that's going to allow itself to have the skill generalized. It can go to different settings. It also allows for independence of the target peer rather than counting on peers. It's one thing to say, wouldn't it be great if all the peers were good at prompting and reinforcement? And another, be like, wouldn't it be great if they were in control of all of the feedback that the target peer gave? I don't like that one as much in the authors didn't either. Also, if you're going to use some of these games, they did mention some of the games were kind of a dud at allowing for. I think kerplunk was one. What was the other one?

[Diana Perry Cruz]

And don't break the ice.

[Robert Perry Crews]

Oh, don't break the ice is like, I'd like to set this game up for 20 minutes and then I want one kid to whack it real hard and then the game is over.

[Diana Perry Cruz]

Yep.

[Robert Perry Crews]

Don't use. Don't break the ice.

[Diana Perry Cruz]

Don't break the ice. Sometimes you get one, one trial out of don't break the ice.

[Robert Perry Crews]

Yeah, it's no good.

[Diana Perry Cruz]

Kerplunka's fun.

[Robert Perry Crews]

It can be very complicated to set up.

[Diana Perry Cruz]

It's also a pain to set up.

[Robert Perry Crews]

And they did mention that even with the games, that they were sort of like, yikes, these games were bad. I wish we hadn't chosen them. The peers really did try very hard to set up opportunities, which also lends me to think, oh man, if the peer monitoring or self monitoring increased, kind of changed the goal of the interactions. For some of the peer mediators, it's like they started setting up little evocative situations like, wow, that's, that's gold. You should be paying these kids. But it's free labor. Isn't. That's even better. All right, so moving on. Moving on. Monitoring. Super great. Let's take a little break because I think we to kick everything off with our intro and when we come back, two more examples of how peer mediation can be used in treatment of for to support children with disabilities. We'll be right back.

[Jackie McDonald]

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[Diana Perry Cruz]

Sure. We all do.

[Jackie McDonald]

Now you can come to Regis College in Weston, Massachusetts to get your graduate degree just minutes outside of Boston.

[Diana Perry Cruz]

Choose from any one of these courses.

[Jackie McDonald]

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[Diana Perry Cruz]

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[Jackie McDonald]

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[Diana Perry Cruz]

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[Jackie McDonald]

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[Diana Perry Cruz]

Come enjoy. Approved fieldwork placements, ethics, mini handbooks, PhD levels, professors, small class sizes, and a service trip to Iceland if interested.

[Jackie McDonald]

And don't forget, our program is accredited by the association of Behavior Analysis International or ABAI as a Tier 1 master's degree program.

[Diana Perry Cruz]

Don't delay. Supplies are limited. Learn more at regiscollege.

[Jackie McDonald]

Edu Again, that's www.regiscollege.edu regiscollege.edu One more time, www.regiscollege.

[Diana Perry Cruz]

edu See you there. Bye.

[Robert Perry Crews]

And we are back talking all about peer mediation. But before we continue on with the remainder of our articles for discussion, I want to remind our listeners that Aba InsideTrack is ACE and Kwaba approved. By listening, you're able to earn one either learning CE or Kwaba approved, folks. Dual diagnosis CE. All you need to do is finish listening to the episode, then go to abainsidetrack.com or click the link in your podcast player to be magically whisked away to the page for this episode. Episode. There you're going to need to enter in some information about yourself, answer some quiz questions, and put in two secret code words. The first one I'm going to give you right now. It's Randy R A N D Y. Originally, I was going to go for, like, a Woody Buzz thing, and I was like, that's too easy. People will guess if we say Woody the introverbal is and Buzz. We're talking about friends. So I went in a totally different direction, and I picked Randy, the puppet from Peewee's Playhouse. He was kind of a jerk, so he wouldn't be much of a good. Maybe he wouldn't be good for peer mediation because he would probably sabotage your peer mediation.

[Jackie McDonald]

100% SA.

[Robert Perry Crews]

And Peewee would go, randy, He.

[Jackie McDonald]

Like, I'm going to punch in the nose, Peewee.

[Robert Perry Crews]

That's not very nice, Randy. That's the way to be. You like that?

[Diana Perry Cruz]

You are good.

[Robert Perry Crews]

Penman in the studio.

[Jackie McDonald]

Did he die?

[Diana Perry Cruz]

He did.

[Jackie McDonald]

Okay.

[Diana Perry Cruz]

Unfortunately, the documentary is really good. What is it titled?

[Robert Perry Crews]

Pee Wee as himself.

[Diana Perry Cruz]

It's really good. Really, really good.

[Jackie McDonald]

I'm gonna watch it because we watched the entire first season of Pee Wee's Playhouse, and then we moved to the second season, and we had to stop because the. The characters slightly changed because they moved the set from Los Angeles to New York and, like, Globey changed differently, and Sylvie could not handle it.

[Robert Perry Crews]

Oh, no.

[Jackie McDonald]

She could not.

[Diana Perry Cruz]

No.

[Jackie McDonald]

There was a globe. Yeah. Which is a different Globey, and it wasn't the same Globey.

[Diana Perry Cruz]

And she.

[Jackie McDonald]

And like, the. The. Like one of the. The. Like the. The trumpeter. When the. The king comes.

[Diana Perry Cruz]

She.

[Jackie McDonald]

Yeah, she wasn't there in the second season, and she was, like, distraught, and

[Diana Perry Cruz]

we had to stop. You know, that happened with Crazy Ex Girlfriend is really the first season that you should watch because after that.

[Jackie McDonald]

Yeah, it goes downhill.

[Robert Perry Crews]

You get about a season and a half.

[Diana Perry Cruz]

Yeah, I guess. What's the name? Santino. Yeah, his name now.

[Robert Perry Crews]

Anyway. Yeah, anyway. Randy.

[Diana Perry Cruz]

Right. I forgot we were doing that. Secret word is we just started friend talking.

[Robert Perry Crews]

Peer mediation. All right, Diana.

[Diana Perry Cruz]

Oh, good, it's my turn. So this. This. My article, it was conducted with preschoolers with no diagnosis. So we actually have three different populations in this particular study. So this is the Bolio et al article, and it was titled Effects of Peer Mediation on Preschoolers Compliance and Compliance Precursors. I would wonder if they rewrote this article. Now if they might say instruction following or something like that, rather than compliance, just because I feel like that word has maybe fallen out of favor a little bit. But this was a really very well constructed, very thoughtful study that they were conducting here. So they let us know that instruction following is really important for preschoolers. But sometimes preschoolers have a hard time with this skill. It's the most common psychiatric or psychological referral that is given out is lack of instruction following. So it might be something that we could work on. And they know that there's two ways that this is often approached. One is avoidance based tactics. So that means if the child is avoiding the task for some reason, can we make the task a little bit more palatable, which is basically, can we modify the eo, Right? So examples of that would be change the instruction to a suggestion or do some type of curricular revision like modify the context or the delivery of the instruction. However, the challenge here is that students may not really learn to respond to the original form that the original demand was, and therefore that skill may not generalize to other settings. Because you don't always get asked to do things. Sometimes you get told to do things. So that's, that's a challenge there. And then the other approach is a skill based antecedent approach which would involve teaching the component precursor skills that are necessary in order to successfully follow instructions. And so this is building upon previous research that I know, Rob, you're familiar with that Bolio and colleagues did in the past that were like some of the preschool life skills components, including when your name is called, stopping the activity you're doing, orienting towards the teacher and saying, yes.

[Robert Perry Crews]

Oh yeah, yeah, okay, I read the prequel article. I remember.

[Diana Perry Cruz]

Yeah, yeah, yes, we're familiar with this. So those were the. When it says precursor skills in this article, those are the skills that they're talking about. And they said that when they conducted a study focusing on teaching those precursor skills in 2012, they noticed that sometimes the peers would, would also join in praising or prompting each other to do those precursor skills. So they said maybe it would make sense to utilize the peers in a more systematic way. And in doing so, it could kind of help with the implementation of this across the classroom because the teacher is very busy and might miss some of those opportunities because she's running the class.

[Robert Perry Crews]

She or he is running enthusiasm.

[Diana Perry Cruz]

They are running the class. Yes. So they said these peer mediated contingencies have been used in other contexts as well. So increasing academic achievement, peer social interactions, or decreasing off task behavior. So in this study, the purpose here was to use those peers to look at the precursor behavior, teach those skills, and then maintain them when the teacher was less available, basically. And then they did social floodgating also. So as I noted in the study, there were four participants who did not have a diagnosis. They were all age 5. Three of them were in the previous version of the study that they did in 2012, but they were not maintaining their precursor behaviors. So that was Lisa, John, and Ken. And then another one didn't have any prior experience. That was Bob. You know, do you guys know a lot of five year olds named Bob?

[Jackie McDonald]

No, but I mean, I mean, I

[Robert Perry Crews]

guess technically I could have been a five year old named Bob.

[Diana Perry Cruz]

That's true.

[Jackie McDonald]

You could have been a Bobby.

[Diana Perry Cruz]

You could have been a Bobby. I never was Bobby. I feel like. Yeah, I don't know many five girls named Bob.

[Jackie McDonald]

Hey, Bob.

[Diana Perry Cruz]

Yeah. Okay. And so like I said, the dependent variable we're measuring here are those precursor behaviors. So does the child, when, when either their name is called or a general like, hey, everyone is called out, does the child stop the activity, look, orient and look towards the experimenter, say yes, and then wait to see what else the grown up says to do? So they measured that and then they measured what they called it, compliance, which was instruction. Following. Completing the instruction within six seconds of the instruction. Why not five? I don't know.

[Robert Perry Crews]

They gave them six divides into 60. Better.

[Diana Perry Cruz]

You think so?

[Robert Perry Crews]

I. I don't think so.

[Diana Perry Cruz]

I don't think they were giving an instruction every 10 seconds.

[Robert Perry Crews]

No.

[Diana Perry Cruz]

Okay.

[Robert Perry Crews]

Maybe their timer was broken.

[Diana Perry Cruz]

Maybe five was just not enough. Maybe they just need. You needed one more second at that age.

[Robert Perry Crews]

Don't you know the old rule, give everyone one more second than their age to follow an instruction.

[Diana Perry Cruz]

Instruction.

[Robert Perry Crews]

You know, when you get older, you need more time, so.

[Diana Perry Cruz]

Yeah.

[Robert Perry Crews]

Right. I gotta get off the floor.

[Diana Perry Cruz]

I get like four minutes. I don't think I did that math correctly.

[Robert Perry Crews]

Not at all.

[Jackie McDonald]

I love you.

[Diana Perry Cruz]

Thanks. I love you too. They also measured peer mediation in two ways. The peer could either provide praise independently. So this is if their, if their peer completed the task that was in question. If they, if the, if they gave their peer a praise statement or a hand jive, which is apparently an umbrella term that includes several different hand gestures, such as a high five or a fist bump.

[Jackie McDonald]

I love that.

[Diana Perry Cruz]

I don't know. When you're doing the hand jive, all of the things that you're doing. Right, right.

[Robert Perry Crews]

What about the one where you stick your thumb over your shoulder?

[Diana Perry Cruz]

Yeah. So it's it's tap your lap, clap your hands. Do your hands on top of each other. Do your fist bump on top of each other. Wiggle thumb backward. Wiggle thumb backward. That's the hand jive.

[Robert Perry Crews]

This is a stretch. That's where the term came from. And then captures all of the hand.

[Diana Perry Cruz]

I'd never. I'm just. I'm just sharing my experience of reading this article with you.

[Robert Perry Crews]

Okay.

[Diana Perry Cruz]

Which is. That was my takeaway.

[Robert Perry Crews]

You just dropped everything and watched Greece for a while.

[Diana Perry Cruz]

Yeah, it's the word. You didn't know that?

[Robert Perry Crews]

I knew that.

[Diana Perry Cruz]

Okay. So they could do a praise statement, but the peer mediation peer mediator could also give a prompt to their friend if they didn't do the task. So that would be either a vocal or a gestural reminder within three seconds when they didn't do it or they did it incorrectly.

[Robert Perry Crews]

Then the they stopped, looks up and said, no.

[Diana Perry Cruz]

Yeah. And they're like, well, remember, I don't know if that wasn't them friends, but everyone liked the do participating in the study and it all seemed to go fine.

[Robert Perry Crews]

So love being mediator.

[Diana Perry Cruz]

So they did this as a multiple baseline across dyad. So two of the peers were paired up together. Each of the two were paired up with one another. And then that was how they were like the peer mediators for each other. So in baseline, they did 10 trials, five where they call the individual child's name and fiber was the group, everyone. And then check to see if they followed the instruction. Instructions were like super common preschool things like put the play DOH in the container or wipe your hands or push in your chairs. And if they did it correctly, then they got five seconds of individual attention or some additional like, interaction with the materials. Then after that, they taught them how to respond to the precursors. So this is not the peer mediation part. They did that alone and then with the demand attached to it. And in both cases, they used behavior skills training to teach the precursor. They did like a pre session role play and practice several times, both the individual and the group. And then went into the observation session for them to practice in, in the real. The real setting. And it was like an 80% criterion to move from the one to the next. And then after they did all of that, they reran the baseline and then they did the teaching of the peer mediation component. So they're like, hey, Ken, your partner is Bob. And when, if Bob doesn't do it, then here's what I want you to do is basically. And then Ken got the same Instruction. And then Bob got the same instructions for Ken.

[Jackie McDonald]

So I like that. Because both participants are in charge, right?

[Diana Perry Cruz]

Yes, exactly. Of each other.

[Jackie McDonald]

Each other. And not just one is in charge of one. I love.

[Diana Perry Cruz]

I know.

[Jackie McDonald]

They did that for yours.

[Diana Perry Cruz]

Yeah, I like that too. Yeah. Because you could really run into some weirdness.

[Jackie McDonald]

Yeah.

[Diana Perry Cruz]

Yes. And that they did not have that here. And they used behavior skills training. Did I say that? Maybe. And the. In addition to the bst, which they practiced beforehand, they also had like a visual feedback component here, which they made sound super fancy, but guess what it was. It was a piece of construction paper folded in half that they added five boxes to. And when you did either the praise or the prompt, then you got a check mark on the piece of construction paper, which they called a visual feedback cue or something like that. I love it when you, like break it down and you're like, wait a minute, all this is, is a sheet of paper. But then they had a treasure box in the classroom, and you got to trade in your 5 check marks for something out of the treasure box, like a little mini stretchy guy or a yo yo or something along those lines. And then at the end of it, which is also cool, they did an alternating treatments comparison between a base, the baseline phase and the teaching peer mediation phase. And initially it was like one baseline to two teaching sessions. And then they did one on one. This allowed them to monitor for maintenance of the skill when they didn't have the, the visual checklist and all the additional reinforcers in place, which I thought was a really cool kind of way to approach that. And then at the end of everything, they had a social validity assessment for the teachers who viewed pre and post video samples and answered questions about it. And then there were several graphs. They measured the precursor acquisition, maintenance, and then they measured the instruction following as well. Those graphs looked super duper similar both across the two dependent variables and across all of the participants. They do. Yeah. Because if you, I mean, it's like a chain of behaviors, basically. And so if you did them, then you are probably going to continue doing those and then just adding on the instruction following on the end. Pretty much, right? Yes. So everyone's baseline was, you know, moderate, moderately present skills, highly variable, with the exception of John, who had a decreasing trend over time. I'm, I'm, I'm talking specifically about the instruction following that I'm looking at here. Then they taught the precursors. Everyone's behavior jumped to very high levels with much lower variability. When they returned to baseline, they generally recovered the same baseline levels, although a few folks, stayed a little bit higher, but the variability definitely increased and some points were lower. And then when they added in the teaching peer mediation, everyone's own personal instruction following staged super high and was hardly variable at all. Then they looked at the frequency of the peer mediation responses, both the praise and the reminder levels, which, you know, whichever. They could do either one. And it kind of depended on what the peer did. Right. So they weren't trying to make a distinction between those. So they didn't see any of that happening until they taught it. So they definitely had experimental control there. And then once they put the teaching of the peer mediation in place, those responses increased to moderate to high levels across the condition. And then when they moved over to the comparison between the baseline and the teaching phases to evaluate for maintenance, they saw it. It was mostly present across both types of conditions, although for a couple participants, let's see, Bob and Lisa, it was a little bit higher in the teaching condition and then in the baseline condition. But it was really cool looking graphs, right? Yeah. And that's kind of what I wanted to tell y' all about this study. It was very well designed and pretty cool, the approach that they did.

[Robert Perry Crews]

Everyone gets to be a peer mediator.

[Diana Perry Cruz]

Yep. That's all I got to say about that.

[Robert Perry Crews]

All right, Jackie, on our. Rounded out with our discussion of peer mediation with children with adhd.

[Jackie McDonald]

Yeah, I'm. I need help with the. The last name Diana.

[Diana Perry Cruz]

I'm. I believe G.R. vogel, McAleese et al. And Wallace in 2010.

[Jackie McDonald]

Yeah, yeah.

[Diana Perry Cruz]

It's just two people.

[Jackie McDonald]

Oh, yeah. So there's no. At all. It's. And Wallace.

[Diana Perry Cruz]

So, you know, I feel for people who have hyphenated names, so.

[Jackie McDonald]

Oh yeah, you do?

[Diana Perry Cruz]

Yeah, yeah.

[Robert Perry Crews]

Not me. I have no pity for them.

[Jackie McDonald]

Okay, so this article is looking at participants with ADHD and they are three boys age 6 to 10 years of age who had ADHD in their respective peers. Only one of them was taking medication at the time of the study. It was the six year old. And what they wanted to do is look at replicating previous studies that had peers engage in FA procedures as well as assessment, I mean, as well as intervention procedures, and do a multi component intervention, extinction and differential reinforcement. Because in previous studies they only did it in an elementary analog setting. This one's in an after school setting, and they only used extinction. So now they're doing extinction and differential reinforcement. And I find it interesting that the participants got to choose their target peer. They're like, who do you want to work with. And then they chose them. And then the teachers verified that yes, those were fine peers to work with. But here's what I'm thinking. So the sessions were only five minutes and it was during homework time and after school sessions. But they did a training for the peers on what they needed to do. And that just seems weird, right? I mean they're like when your child, when your like friend is off task, here's what I want you to do. And when they're not off task, that one seems fine for me with the intervention. But the FA condition seems weird.

[Diana Perry Cruz]

Yeah, that does seem weird. Unless you have a specific concern that the mediating variable, the maintaining variable is only related to peer.

[Jackie McDonald]

Well, that's what they think. But that's what they think. They think it is the hypothetical reinforcer, which it is in these FA conditions. But it just seems weird to be like, hey, when your friend acts out, when they're off topic, join in for 10 seconds and there'll be a vibrating pager on you. And then when the vibrating stops, you have to ignore them.

[Diana Perry Cruz]

Yeah, it seems really strange, right?

[Robert Perry Crews]

I mean, I've done that before in classrooms. It is awkward. The few times I've done that. The, the, the target, sorry, this, the student who's sort of the, the confederate was like, okay. And they, they would do it, right?

[Jackie McDonald]

I mean, yes, I know it just seems weird, right, because we have like 7 to 10 year old boys and just. I don't know, that seemed weird for me. But I, it, the, the results are great, so the ends justify the means here. But I wonder if they could.

[Diana Perry Cruz]

It's like different if you're like, it just. Are you then wanting them to like be like real and true friends with one another after this? Because I feel like it messes up the dynamic.

[Jackie McDonald]

That's what I'm.

[Diana Perry Cruz]

Right. That's what you're trying to say. Yeah.

[Robert Perry Crews]

At this age I tend to see children like, they're not so against the idea of like, oh, this kid's engaging in some sort of class clownery. And my laughing about it is, it feels very natur. So if you're like, you know what, it's okay, it's not that big a deal. That's almost just, you know, making sure they understand like the rules have slightly changed right now. It's not a big deal.

[Jackie McDonald]

Maybe I just didn't. I just. It would have been nice to hear what they said to the, the peer. Right. I understood the staff training. The peer training makes sense. What they told them to Do. But I wondered what they said to them, like, to lead up, like, probably

[Robert Perry Crews]

we're doing a functional analysis. And what we're really looking at is

[Diana Perry Cruz]

by systematically manipulating variables, if you're like, oh, you. They. The target child picked this friend.

[Jackie McDonald]

Right.

[Diana Perry Cruz]

And then you're like, almost like, now I'm betraying their trust a little bit.

[Jackie McDonald]

Right.

[Robert Perry Crews]

I would like. I would like to think it's like,

[Diana Perry Cruz]

it might have been totally different than we were silly.

[Robert Perry Crews]

Right.

[Jackie McDonald]

And I bet it is. Yeah, I bet it is. I bet what they said to the kids was very different than what we're saying. They just didn't tell us. So when I was reading it, I was like, oh, I wonder how they approach that. So it wasn't weird. So they could be friends later, right? Yeah. So I don't know. So. But the off task behavior were talking about subjects unrelated to homework. That was all participants leaving or falling out of your seat. That's all participants wandering around the room. That was two of them leaving the homework area. That was one. Hiding behind objects.

[Robert Perry Crews]

Was one participant the same one that left the homework?

[Jackie McDonald]

Yep. And crawling under tables was one. Right. And so they did partial interval recording using 10 seconds.

[Diana Perry Cruz]

Yeah, I can confirm those are all off task behaviors, right?

[Jackie McDonald]

Yes, they all are.

[Robert Perry Crews]

I like, hard to do your homework under the table.

[Jackie McDonald]

I love when someone's like, and they ran away. So that's hard. So they ran a traditional FA with attention, demand and play conditions. And they also included that peer attention condition because they hypothesized that it was the peer attention that was maintaining this off task behavior they had.

[Diana Perry Cruz]

Which seems likely.

[Jackie McDonald]

Which seems very likely, right?

[Diana Perry Cruz]

Yes.

[Jackie McDonald]

So they had worksheets that they were given in homework. So the least preferred worksheet was assigned to the demand condition. And the other worksheets from the homework were assigned to the staff condition, Staff attention condition, and the peer attention condition. So they. For the control condition, they use play word searches and crossword puzzles.

[Diana Perry Cruz]

I love that.

[Jackie McDonald]

Okay. And so during the peer attention contingent on off task behavior, the peer gave 10 seconds of attention. So they asked them to join in. Like, if he is laughing about something, laugh about him. If he's under his chair, go under his chair, do it for 10 seconds and then stop. And they had the vibrating timer to help the remember if. So if you weren't doing it, then they would page you.

[Diana Perry Cruz]

I love.

[Jackie McDonald]

It was a. It wasn't a vibrating term. It was a vibrating pager.

[Robert Perry Crews]

Oh, I was gonna say 10 seconds. The things.

[Diana Perry Cruz]

No, no. Okay, that makes more sense.

[Jackie McDonald]

Yeah. And then during the staff, they gave attention contingent on probable behavior. And then the demand condition, the participant could escape the work contingent on problem behavior, but couldn't access peer or staff attention.

[Diana Perry Cruz]

Yeah.

[Robert Perry Crews]

Do you think they added the adult attention in because this was a little bit of a non traditional FA and they thought to get it published, we have to put in our phone 2010.

[Jackie McDonald]

Yeah.

[Diana Perry Cruz]

So I think maybe in 2010.

[Robert Perry Crews]

Yes. Okay. Because otherwise, bother with the adult. You either think it's pure attention and test it, or you're not sure. Or any attention. Good attention. And then why bother with the kids? It's just like one more favorite. I think it's.

[Diana Perry Cruz]

It was well more traditional to, like, include all of the main components and then add an additional one.

[Jackie McDonald]

I think that was it, because that's how they said it. We're using the Iwata and all.

[Robert Perry Crews]

Yeah.

[Jackie McDonald]

Standard FA with an addition of a peer attention. And for this one, wow. Can you see a peer attention. It is differentiated beyond belief. All the other conditions are very, very low in the FA condition. I mean, the FA conditions in the peer attention is all always.

[Diana Perry Cruz]

Yeah.

[Jackie McDonald]

High. This is like, if I wanted to teach students, like, this is what differentiation looks like.

[Diana Perry Cruz]

That's a beautiful one.

[Robert Perry Crews]

I forget the. What. What was the adult response in the attention? Did the adult do the traditional, like, hey, don't do that. Stop that. Get out from under the table. Or do they go under the table?

[Jackie McDonald]

No, I think they said, hey, stop. Yeah.

[Robert Perry Crews]

Yeah.

[Jackie McDonald]

Oh, my God. Can you imagine if your teacher went under the table?

[Robert Perry Crews]

Because I'd be curious if the teacher went under the table. Is that as reinforcing as your friend goes under the table?

[Diana Perry Cruz]

I made it bigger for you.

[Jackie McDonald]

Oh. I was like, did you delete my graph?

[Diana Perry Cruz]

No, sorry. I was just making it bigger.

[Jackie McDonald]

Okay. So for treatment, they use a multiple baseline across participants with one reversal to assess treatment. So baseline was similar to the FA peer attention conditions. And it seems like it included the three FA conditions. The peer attention condition as part of the baseline for starting, but then they had staggered baseline. So some of the participants experience more of those baseline sessions. And the treatment condition was the peer provided help and praise and attention for on task behaviors on the worksheet and withheld attention for off task behavior. So that was the extinction. And then the other stuff was the differential reinforcement. And this was just a random worksheet given by staff. So it didn't have, like, preferred referred. And I mean, the graphs are great.

[Diana Perry Cruz]

Oh, yeah.

[Jackie McDonald]

Like, when you see a really nice craft looking at the Percentage of intervals with off task behavior, they're pretty high and increasing. In baseline, the kid was probably like, yes. Right.

[Robert Perry Crews]

If you've ever been in a classroom where there are multiple children that are engaging in like elopement or grabbing toys or, you know, throwing objects, if you get two kids doing that together, it's like, well, we're gonna leave.

[Diana Perry Cruz]

We're done for the day.

[Robert Perry Crews]

You own this classroom now.

[Jackie McDonald]

Right. So for one participant, when they did differentiating reinforcement and extinction, they saw, I mean, basically with all of them, nothing was higher than 20% of the total intervals.

[Diana Perry Cruz]

Yeah.

[Jackie McDonald]

So there was 30 intervals in that five minute session. And I mean, that's pretty good. They're very low. They. And they did a follow up with Drew1. That's the final participant one month later, without the vibrating timer, like, didn't tell the per. Didn't tell the peer. And his. His behavior remained really low, which is good. And then for one of the participants, they did that reversal. And as soon as baseline came around again, behavior skyrocketed. And then as soon as they implemented the differential reinforcement and extinction peer mediation training, behavior dropped right back down.

[Robert Perry Crews]

Surprise. If the kid goes back under the table with you, you find that fun again?

[Jackie McDonald]

Yeah. So here's something else I thought was interesting that I was, you know, this is where I really thought. They did a social validity questionnaire for both the target participants, the peer participants, and the staff. And they said, do you like working with them? Like, do you like working together? And all of the three participants, the target participants said yes. And two of the three peer participants said yes. One of them said sort of okay. And all the teachers said yes, it was really helpful for the student and it might be helpful for other people. And all of them, the peer participants said that they liked participating. All three of them did. But only one of the target participants said that they liked participating. The other one said sort of. So I'm one. I mean, they're probably sad that they're being.

[Robert Perry Crews]

I liked it better when they just be odd.

[Diana Perry Cruz]

Right?

[Robert Perry Crews]

Yeah, yeah.

[Diana Perry Cruz]

It's more fun to goof off.

[Jackie McDonald]

So here's some limitations, Right. They do say that there was another peer interacting with participants. And for two of the participants in the FA condition, one of them said, one of them, like, it's okay because it was during that attention condition and there was target behavior. And the other one, they just moved the kids down a couple seats. But they said, you know, that's a challenge of doing an FA in an actual classroom setting is that behavior occurs and Then other kids will reinforce that behavior.

[Robert Perry Crews]

The content was other kid.

[Jackie McDonald]

Yeah. And then with the one student that ran away and hid his sister was I think, I guess his target peer. His peer. And. And she corrected his homework and he ran away. So they gave her. Or maybe she was just there and corrected his homework. I think that may have been the case.

[Robert Perry Crews]

Don't use siblings.

[Jackie McDonald]

Because then they said, oh, and then we trained her on the procedures and it was fine. So I bet she was just there and then was like, your homework's wrong and he ran away. And so they, they sisters. Right. They. They do assert the fact that it's challenging to implement because you have to rely on the peers to do it. Right, right. Especially in this. And this thing is all peer mediated. And they said that one of the challenges was that the session was only five minutes long. But they did say we did multiple sessions within the homework time, so it could be longer. But we know that five minutes doesn't. Isn't like the entire after school program.

[Diana Perry Cruz]

Right.

[Robert Perry Crews]

So you might see 20, 30.

[Jackie McDonald]

Right. You might see some more, you know, you might see some reappearance of problem behavior later on. Yeah. So there it is. It's so quick and easy, but very effective.

[Robert Perry Crews]

Cool. All right, well, I guess now that we've gone over three examples of peer mediation, let's move on to the dissemination station. Ah, we're here. So when it comes to peer mediation, I think all three of these studies really demonstrate that the use of peers in a variety of treatments, different treatment modalities, different settings, different needs of students can be very effective. Now, lest you think, oh, throw peers in and that'll magically make everything better, guess what? They still used a doctor procedure, they still used a self monitoring procedure. They still used some sort of, you know, kind of like a behavior skills training model and prompting. So you still need to do the job that you as an adult would do. However, the addition of peers, at least in these cases, was really very additive to the treatment. Now, would it be as useful to use peers if, say, the function of the students with homework was escape? I just hate homework so much. Maybe, you know, then it might have been more like a simultaneous reinforcement kind of procedure than a doctor procedure in that regard. But doesn't mean we couldn't. You couldn't try it. So there may be situations where peer mediation is out, certainly with dangerous or very, very unsafe behavior, intense behavior. You may not want to use peers, especially because if there's. The peer makes a mistake or the child does start to Engage in like high rates of self injur. Injurious behavior. You know, now the peer is sort of in the middle of that. That could be very difficult. They could be very stigmatizing for the peers, for the target individual as well. So those might be times you wouldn't want to use peer mediation. But again, if you have peers that are interested and you think it will be additive to a procedure you're already doing that has evidence based behind it, perhaps peer mediation will be well, well liked and make your treatment more effective. Now Jackie, you said you had some questions in terms of kind of logistics.

[Jackie McDonald]

I think my logistics are like when I already brought them up, but like how weird is it for the peer?

[Diana Perry Cruz]

Right.

[Jackie McDonald]

Can they be friends after? Like what? Like I'd like to know more of like that. Like the qualitative.

[Diana Perry Cruz]

Yeah.

[Jackie McDonald]

Like I love the idea of both peers monitoring each other's behavior. Right. So that even if there's a target participant and a peer participant, I'm sure that peer participant isn't always on task. Right. Probably, probably more so than the child with ADHD. But I have been in a classroom with 10 year old boys and, and girls. Right. And so I think that, that would have, that would have solidified a little more for me. But to be fair, that was, this was a long time ago and, and

[Diana Perry Cruz]

young kids, I think you see a wide variety of behavior in the classroom. And so it's not unusual to see, to see behavior like this. It's not unusual to have kids who have extra help coming in and out of the classroom too for like a whole variety of things. And so in my past experience when I was helping to support someone in this type of setting, kids would ask like, oh, why is this person or that person here? And you just say like, oh yeah, well they're here to help. And kids don't even like really question it after that. So I don't think it is super duper unusual to have this type of scenario, especially in your study, Jackie, you were never going to be able to address, well that. But you're never gonna be able to address this if you don't address the peer component.

[Jackie McDonald]

Right.

[Diana Perry Cruz]

So even if you had been like, well, I surmise that it's peer attention, you're still going to need to say, hey friends, when your friend calls under the table, I need you to not, not pay attention to that. Like it's, it's going to have to happen at some point that it gets addressed with the peers because the peers are the problem. Right. So there's really no way around it. And if you address it early enough, then it doesn't like maintain as a long standing issue for this, for this kid. And chances are everyone forgets that this ever happened because it happened back in elementary school. Yeah, right.

[Robert Perry Crews]

If the children are young, I think you're right. Then it's sort of just kids are doing lots of stuff, so including them in a procedure won't look too different. Kids come in and out of classrooms, they're going to different places, they have accidents, they spill water. You know, there's all sorts of reasons. And I think older, older participants too. So like teenagers, adolescents might also have an easier time in that they may have some friendships, they may be able to have those conversations. You know, a lot of individual individuals, especially, you know, with either disabilities or identify as autistic or neurodiverse, are very open about the fact that they are autistic or they, they are, you know, neurodiversion. And would, you know, potentially say, I, you know, this would be easier with a friend or hey, would your friend want to help you? They might say, I want to ask them. That would be cool. They might really like being able to do that as much as possible. I think it is sort of the, hey, I'm going to teach you to be a helper and here are the things you're looking for to help or hey, we're going to have a helper group and oh, we just happen to have these five kids, two of whom, or one of whom has a need in terms of improving social skills within the classroom would probably be the easiest way to do it without it being so stigmatizing. The more you're doing things outside of a general education classroom. So we're going to do pull out sessions in a separate room or with the counselor or with the behavior analyst. Then you do start getting into, you're going to have to have the conversation about why are, why are my children who may not have, say, IEP related needs to social skills being taken out of their instruction? So in that case, you do have to have conversations with families and with the students. So then you're really doing a lot of, you know, explaining why you think this is important and important enough to potentially kind of blow up someone's spot as I have an iep, you know, these confidential pieces of FERPA information.

[Diana Perry Cruz]

Yeah.

[Robert Perry Crews]

So, you know, again, as much as you can do it in the settings where children already are, it's a lot easier to set up in such a way that no one person is being stigmatized or needs to disclose anything about their learning style. But otherwise, I think just have open conversations about why you think this is the best option for treatment and see how people feel about it.

[Diana Perry Cruz]

My other closing thought here is I was so surprised when I started going back through, like, our past episodes that we've never had an episode that focused exclusively on peer interaction.

[Robert Perry Crews]

We don't have a lot of friends. You know, I don't know what to say.

[Diana Perry Cruz]

I have friends. I definitely have friends. That's my. That's my second crazy ex girlfriend reference in this episode, in case you missed

[Robert Perry Crews]

it, the hat trick.

[Diana Perry Cruz]

So, you know, is it that there's not a lot of research on it or that we just haven't focused on it? I'm not. Right. We haven't talked about it. So we gotta up our game in this area. It's a really interesting area, and these three studies were great. But I can think of so many other ways that you might want to incorporate peers. I think that there's good ways to do it and not good ways to do it. Right. That really respects, like you said, Rob, like the, you know, the client and their dignity and their relationships with their peers. And I would be interested to learn more about how we can ensure that that is a primary piece here that we're, you know, protecting. Right. And then moving from there into thinking about how can peers help, support or teach new skills or. Etc. That's it.

[Robert Perry Crews]

Did you want to actually do pairings?

[Diana Perry Cruz]

Yeah. Did you want me to do that, too?

[Robert Perry Crews]

Oh, did I give you the cue? I thought I gave you the pairings cue.

[Jackie McDonald]

Yeah, I thought so too.

[Diana Perry Cruz]

Oh, I wasn't listening.

[Robert Perry Crews]

Do parings. Do it now.

[Diana Perry Cruz]

Oh, okay, great. Now it's. I'm sorry, I thought I was giving my two cents, but no, I'm only here for pairings.

[Robert Perry Crews]

You don't get another segment of the show called Diana's 2 cents. All right.

[Diana Perry Cruz]

And that was my dissemination part.

[Jackie McDonald]

He did it. He, like, wrapped it all up. Yeah.

[Robert Perry Crews]

Good thing. Your peers are here to prompt you to do the section of the show you're responsible for.

[Jackie McDonald]

Okay, go ahead. Time to click him.

[Diana Perry Cruz]

Oh, great. Now it's time for pairings. Pairings is the part of the show where I tell you about past episodes. You might want to check out if you liked this one. While we've never talked directly about peers, we've talked about some of these topics in a variety of ways. We talked about preschool life skills three different times on episodes 34, 95, and 330. 6. So you could check out any of those if you want to learn more about that. In just the preceding episode, we actually had another example of peer mediation. In our episode 342, Ascent and Pecs with Armando Bernal. In episode 150, we talked about social skills curricula, which involves peers. In episode 115, we talked about self monitoring. And then if you came here for the dual diagnosis episodes, we have two others that discuss ADHD episodes 16 and 2. 09. I also like to recommend a snack to go with this episode. My snack for today is the Swedish meatballs. Yes, exactly.

[Jackie McDonald]

No, no, I think you had the IKEA meatball.

[Robert Perry Crews]

That's the same thing.

[Diana Perry Cruz]

No, this is. No, this is the meat. The Swedish meatballs made by the Swedish Chef.

[Jackie McDonald]

Made by Ikea.

[Diana Perry Cruz]

No, he also made. He also makes Dirk Chichen. But do you know why? Why am I choosing this?

[Robert Perry Crews]

Oh, because Jim Henson and Frank Oz both worked together to puppet this chef.

[Diana Perry Cruz]

Yes, that's right. Very good, Rob. It takes two people to operate the Swedish Chef. And that was pairings. Please enjoy.

[Robert Perry Crews]

All right, well, thank you, Diana. And that brings us to the end of our episode of ABA Inside Track. Thank you so much for listening. If you haven't already, please subscribe to the show, leave reviews on Apple Podcasts or wherever you get your podcasts. We really do love getting reviews. It does make it a lot easier for folks to find the podcast as well. So if you have not done that, we'd really appreciate it. No matter what the feedback, we love to get it. If you want even more ABA InsideTrack, you can subscribe on our Patreon page, patreon.com abainsidetrack where you can subscribe at the 3, 5, 10, or $20 levels. At the $5 level, you're able to get access to a free CE for our quarterly listener choice podcast. We're going to have one of those coming up pretty soon. What won the listener choice poll? I don't know because that just came out a few days ago. We're a little, little ahead of the recording schedule, but it could be one of three fun topics, but I won't tell you which one it is because I don't know yet. You at the $10 level can get access to our book club podcast, which are two hour podcasts. We do four of those a year. You get two free CES for listening. Three of those are only available for patrons when they come out. Everyone else has to wait until a whole nother year has passed and those books are old hat and nobody cares anymore. I think they still do. That's not how books work. They're not like blockbuster movies. And Again, that'[e-mail] ABA Inside Track Some final thanks. I want to say thanks to Dr. Jim Carr for recording our intro and outro music, Kyle Sturry for interstitial music, and Dan Ava, the podcast doctors for his amazing editing work. And I wouldn't be a good peer to all of you if I didn't give you the second of our secret code words. And it is beholder. B E H O L D E, R. It was a different code word before. D has given me a face. I changed it because I realized it would be too easy to guess what it was. Beholder. It's like. Okay, it's like you know someone who's looking at something, you're holding it. Sure, sure, whatever. I know Diana wants me to say it's that monster with ten eyes from Dungeons and Dragons. Favorite game. All right, we'll be back next week with another fun filled episode, but until then, keep responding. Bye.

[Jackie McDonald]

Bye.