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Acceptability and feasibility of classroom-based social interaction interventions for young children with disabilities.

Learning to interact positively with one's peers is an important skill that children usually acquire during the preschool years (Howes, 1988). For young children with disabilities, however, development of peer social interaction skills is often delayed (Guralnick & Weinhouse, 1984). Researchers have proposed that the development of social competence, especially with peers, become a major focus of early intervenfon programs for children with disabilities (Guralnick, 1990; Odom, McConnell, & McEvoy, 1992; Strain, 1990).

Different types of intervention approaches have been developed to promote the acquisition of social interaction skills (McEvoy, Odom, & McConnell, 1992). These interventions might be grouped broadly into three different types. In "environmental arrangement" interventions, teachers arrange features of the classroom environment to foster interaction among peers. Such arrangements might include restricting the area of the classroom in which play activities occur (Brown, Fox, & Brady, 1987), providing play activities that promote social interaction (DeKlyen & Odom, 1989), and providing a socially competent peer group (Guralnick & Groom, 1988; Jenkins, Odom, & Speltz, 1989).

In "child specific" interventions, teachers provide instruction or training directly to children on skills that they may use in social interactions with peers. Teaching social or toy play initiations (Haring & Lovinger, 1989; McConnell, Sisson, Cort, & Strain, 1991), coaching the use of skills in interactions (Ladd, 1981; Oden & Asher, 1977), or promoting social problem-solving skills (Strayhome & Strain, 1986; Vaughn, Ridley,& Cox, 1984) are all examples of a child's pecific interventions. In addition, strategies of this intervention include teachers' prompting children for engaging in social interaction with peers and reinforcing those interactions (Fox, Shores, Lindeman, & Strain, 1986: Odom & Strain, 1986; Strain & Timre, 1974).

Socially competent peers, rather than the teacher, serve as the direct intervention agents in "peer-mediated" interventions. In this group of intervention techniques, teachers provide instruction to peers on ways to initiate interactions with children with disabilities (Strain & Odom, 1986; Strain, Shores, & Timm, 1977), prompt or reinforce peers' initiations (Goldstein, Kaczmarek, Pennington, & Shafer, 1992; Odom, Hoyson, Jamieson, & Strain, 1985), introduce group contingencies or self-management strategies for supporting peers' initiations (Kohler, Strain, Maretsky, & DeCesare, 1990; Odom & Watts, 199 l; Sainato, Goldstein, & Strain, 1992), and fade teacher prompts (Odom, Chandler, Ostrosky, McConnell, & Reany, 1992). Also, affection training or group socialization activities have been used to teach peers to be affectionate with the children with disabilities (Brown, Ragland, & Fox, 1988; McEvoy et al., 1988).

Most of these interventions have produced positive effects for young children with disabilities (Odom & Brown, 1993). This literature could serve as a basis for developing approaches that teachers could use in classroom-based interventions. However, efficacy may not be the sole factor that determines teachers' use of instructional or intervention approaches (Witt, Elliott, & Martens, 1984). Teachers' perceptions of acceptability may also have a major impact on the likelihood that a teacher would actually use the intervention (Hall & Didier, 1987; Reimers, Wacker, & Koeppl, 1987).

Acceptability refers to "the judgments of lay persons, clients, and others of whether treatment procedures are appropriate, fair, and masonable for the problem or client" (Kazdin, 1981, p. 483). Most research on the acceptability of classroombased intervention strategies has focused on behavioral interventions for treating children's mild to severe behavior problems (Gullone & King, 1989). In these studies, researchers have found relationships between acceptability and the reported effectiveness of the intervention (Shapiro, 1987; Von Brock & Elliott, 1987; Whinnery, Fuchs, & Fuchs, 1991), teacher time required to conduct the intervention (Elliott, Witt, Galvin, & Peterson, 1984; Martens & Meller, 1989; Reimers et al., 1987; Von Brock & Elljolt, 1987; Wilt, Elliot, & Martens, 1984; Witt & Martins, 1983 ), skills required to implement the intervention (Elliott et al., 1984; Martens & Meller, 1989), theoretical orientation or nature of the intervention procedure (Epstein, Matson, Repp, & Helsel, 1986; Hall & Wahrman, 1988; Reimers et al., 1987; Shapiro, 1987), severity of the presenting behavior problem (Elliott et al., 1984; Reimers et al., 1987; Tarnowski, Rasnake, Mulick, & Kelly, 1989; Witt et al., 1984), and the positive (i.e., accelerative) versus negative (i.e., decelerative or aversive) nature of the intervention approach (Irvin & Lundervold, 1988; Tarnowski et al., 1989; Wilt et al., 1984).

To design social skills interventions that early childhood special education teachers would actually implement in their classrooms, it would be important to identify strategies that teachers judge as acceptable. However, it is possible that teachers may rate strategies as acceptable, but also judge that they are not feasible to conduct because of the resources or training required. If such were the case, it would be important to identify barriers that prevent implementation. In extending the research on intervention acceptability to social interaction training programs, it would also be useful to examine the relationship between feasibility and current use of strategies. Thus, this study addressed the following questions:

1. How do teachers rate the acceptability, feasi-

bility, and current use of social intervention

teaching strategies for promoting children's

social interaction skills?

2. What are the barriers to implementation for

the strategies?

3. What is the relationship of acceptability and

feasibility to the current use of specific inter-

vention strategies?

METHOD

Participants

A total of 131 preschool special education teachers participated in this study. These teachers were from Colorado (n = 17), Massachusetts (n = 25), Tennessee (n = 20), Minnesota (n = 21), and Washington state (n = 48). All but one of the respondents were female (99.3%), and their average age was 34.4 years (SD = 7.63, range = 23-57). The teachers had, on the average, 9.01 years of general teaching experience (SD = 5.57, range 1-35) and 6.07 years (SD = 4.12, range = 1-20) of experience as a preschool teacher. Ninety-eight percent of the teachers held certification in their respective states; types of certification included special education (47.1%), early childhood special education (34.3 %), elementary education (15.7%), and early childhood education (1%). In addition, 79.4% of the teachers had graduate hours beyond the bachelor's degree or held postbaccalaureate degrees.

Teachers reported that, on the average, their classes met 4.8 hr per day, although the class arrangements varied across full-day classes (25.4%), half-day classes (17.7%), two half-day classes (46.2%), and various other situations (10.8%). Fifty-five percent of the teachers had classes located in a school for children without disabilities, while the other teachers had classes in self-contained schools for children with disabilities (31.2%) and in mainstream preschools (13.6%).

In general, teachers reported that their classes contained children with mild developmental delays (23% of the teachers), children with moderate developmental delays (21%), children without general delays but with other disabilities (20%), children without disabilities (13.5%), children with borderline developmental delays (11%), and children with severe developmental delays (11%). About one third (33.9%) of the teachers indicated that their children had opportunities to play only with other children with disabilities, although for many of these children (26% of the total respondents) there were opportunities to play with peers with disabilities who were more socially competent than themselves. Other respondents reported that at least some opportunities for integration existed for their children.

Social Interaction Program Features Questionnaire

The Social Interaction Program Features Questionnaire (SIPFQ) was designed to measure acceptability, feasibility, and current use of strategies for promoting social interaction skills. We generated items describing specific strategies directly from the research literature. After we created the items, we assembled them in a questionnaire and pilot tested them with research staff not involved in the development of the questionnaire and a small sample of teachers in the Nashville, Tennessee, and Minneapolis-St. Paul areas. Feedback from respondents in the pilot test led us to revise the wording of the items (no items were dropped), which we then included in the final draft of the questionnaire. A copy of the questionnaire may be obtained from the first author.

Participants in this study were asked to complete the SIPFQ. The first section of this questionnaire contains 13 demographic items, 1 item about children in need of social interaction intervention, and 1 item related to the need for curficula and materials. The remaining sections of the questionnaire contain items grouped according to child-specific (CS) (15 items), peer-mediated (PM) ( 14 items), and environmental arrangement (EA) (8 items) intervention strategies and questions about barriers to implementation.

Acceptability, Feasibility, and Current-Use Items. Teachers used a 5-point Likert-type scale to rate acceptability, feasibility, and current use of the strategies. Acceptability was defined as "how much you feel that the particular procedure fits your philosophy of teaching social interaction skills to young children with disabilities." The behavioral anchors included (a) unacceptable, (b) may be acceptable on rare occasions, (c) acceptable under certain conditions, (d) acceptable under most conditions, and (e) completely acceptable.

Feasibility was defined as "your ability as a teacher to implement the approach in your classroom, given your current resources (e.g., personnel in the classroom, materials, space, training)." The behavioral anchors included (a) never feasible to use in my classroom, (b) appears to be feasible to use on infrequent occasions, (c) appears to be feasible to use in my classroom some of the time (i.e., at least once for one child on 50% of the school days), (d) appears to be feasible to use in my classroom most of the time (i.e., for at least one child on 75% of the days), and (e) appears to be feasible to use in my classroom nearly all of the time (i.e., for at least one child on 75% to 100% of the days).

Current use was defined as "how much you currently use the procedure in your present classroom(s)." Behavioral anchors included (a) never used in my classroom, (b) have used on infrequent occasions (once or twice), (c) have used sometimes in the classroom (up to 50% of the days for at least one child), (d) have used often (51% to 75% of the days with at least one child), and (e) use all the time (75% to 100% of the days with at least one child).

Open-Ended Questions About Barriers. After teachers rated the acceptability, feasibility, and current use of each item within an intervention type, they were asked, through an open-ended question, to identify the barriers to using that type of intervention in their classroom. We conducted content analyses separately for each type of intervention, using the constant-comparative methodology (Glaser & Strauss, 1967; Rosengren, 1981). Each teacher response was transcribed onto a 3- x 5-in index card. We then sorted these cards into groups according to similarity of meaning. Agreement on the classification of response cards into groups was reached by consensus. We then created categorical definitions for groups of responses (these definitions are available from the first author). After we had categorized and recorded all toacher responses, we randomly selected one third of the responses for each type of interventions. A research assistant read the definitions and reclassified the responses. We then computed the agreement between the original classification of the teacher responses and the research assistant's classification by dividing the number of agreements by the number of agreements plus disagreements and multiplying by 100. Agreement percentages for EA, CS, and PM responses were 93%, 97%, and 98%, respectively.

Sites and Return Rate

A nationally representative sample of respondents was obtained for this questionnaire. Individuals at universities in Denver, Boston, Minneapolis, Nashville, and Seattle served as contact persons. A set of 25-30 questionnaires was sent to each of these individuals, with instructions to distribute the questionnaires to teachers in their areas who were currently teaching early childhood special education classes. The authors requested that the contact persons directly contact (i.e., personally or by telephone) these teachers to increase the probability of return. The return rate for all the sites was 82.4%, while return rates for individual silos were 68% for Colorado, 83% for Massachusetts, 84% for Minnesota, 74% for Tennessee, and 160% for Washington state. For the Washington site, the contact person actually copied, distributed, and received back more questionnaires than we sent, creating the high return rate (this only counted as 100% in our computation of the overall return rate percentage). Contact persons reported that respondents were located in urban, suburban, and rural parts of their state, although no data were actually collected on this variable.

RESULTS

Need for Social Interaction Training Program

Teachers were asked to identify the percentage of children in their classroom who needed "to learn ways of interacting with peers in a more positive and age-appropriate manner." On the average, teachers reported that 74% (SD = 26.9, range = 5-100) of the children in their classes were in need of social skills instruction. Teachers were also asked if "there were sufficient curriculum materials and information available to assist you in designing a social interaction instructional program for children in your classroom." Forty-three percent of the teachers indicated that there was a great need, 47% indicated a moderate need, 8% indicated a small need, and 2% indicated no need.

Ratings of Acceptability, Feasibility, and Current Use

The items from the SIPFQ, in an abbreviated form, appear in Table 1 along with mean ratings for acceptability, feasibility, and current use.

Acceptability of Intervention Strategies. The means of the mean item-acceptability rating for CS, PM, and EA interventions were 4.41, 4.38, and 4.16, respectively. A one-way analysis of variance (ANOVA) indicated that these acceptability ratings did not differ significantly across types of interventions, df = 2, 34, F = .44. All items within each intervention type received mean ratings above the mid-point of the scale, indicating that they were at least moderately acceptable to teachers. However, to provide a gauge for relative acceptability, a confidence interval of 1 standard deviation above and below the mean for the total group of intervention items was established (i.e., mean of the mean ratings for each item + 1 standard deviation). Items with mean ratings above the confidence interval were identified as relatively well accepted, and items below the confidence interval were identified as relatively less accepted (i.e., this created a 2-standard-deviation difference between the "well accepted" and "less accepted" items).

For the CS items, "Teach specific social skills" and "Teacher praises the use of social skills," both were relatively well accepted. "Test mastery of social skills" and "Child self monitoring" were less well accepted. For the PM items, "Model cooperative behavior for groups" and "Praise the group to work cooperatively" had mean ratings above the confidence interval. The only item with a mean rating below the confidence interval was "Activity or tangible reinforcers for interacting with the child with disabilities ." For EA, the item "Provide toys that promote interaction" had a mean rating above the confidence interval, whereas "Provide videotaped examples of social interaction," "Teacher introduces play activities," and "Activities with high structure" had mean ratings that fell below the confidence interval.

Feasibility of intervention Strategies. The mean feasibility scores for CS, PM, and EA interventions were 4.24, 4.03, and 3.82 respectively. A one-way ANOVA revealed no differences in mean scores across groups, df= 2, 34, F = 1.96. For the feasibility ratings, most--but not all-- items received mean ratings above the midpoint of the scale. To examine relative feasibility of the individual items, 1-standard-deviation confidence intervals were computed in the manner described previously. These reflected relatively more and less feasible strategies. For CS interventions, the items receiving mean ratings above the confidence interval were "Praise use of social skills," "Teach specific social skills," "Teacher models social skills," and "Teach labels for emotions." Items with mean ratings below the confidence interval were "Test mastery of social skills" and "Child self-monitors own social interactions." Items representing PM interventions with ratings above the confidence intervals were "Praise groups of children for cooperating," and "Model cooperative behavior for the group." The single PM item below the confidence interval was "Activity or tangible reinforcer for interacting with children with disabilities." For EA, the single strategy with a mean rating above the confidence interval was "Toys that promote social interaction"; and the items below the confidence interval were "Videotaped examples of social interaction," "Play groups include children with and without disabilities," and "Activities with high structure."

Current Use. The mean ratings of current use for CS, PM, and EA were 3.88, 3.42, and 3.35, respectively. As before, a One-way ANOVA detected no significant differences for mean rating scores across types of interventions, df= 2, 34; F = 1.98. Again, 1-standard-deviation confidence intervals were created. CS items with ratings above the confidence interval (i.e., used relatively more frequently) were "Teach specific social skills," "Praise use of social skills," and "Teacher models social skills." The single item below the confidence interval was "Child selfmonitors own social interactions." PM items with ratings above the confidence interval were "Praise groups of children for cooperating" and "Teachers model cooperative behavior for groups." The item used less frequently was "Activity or tangible reinforcer to peers for interacting with children with disabilities." The single EA item with a mean rating above the confidence interval was "Toys that promote social interaction," whereas "Videotaped examples of social interaction" and "Play groups include children with and without disabilities" received ratings below the confidence level.

Barriers to Implementation

The teachers' identification of barriers that would prevent them from implementing the different intervention strategies is listed in Table 2. These barriers are rank ordered, and the percentages of total responses are found in parentheses. The resources needed to conduct the interventions, such as number of trained staff, teacher and child time in the day to conduct the intervention, and space in the classroom, were frequently identified as barriers to all three types of interventions. For the PM and EA interventions and, to a lesser extent, the CS interventions, the teachers also mentioned limited access to children without disabilities as a major barrier. Teachers noted that the characteristics of some of the children in their classroom might be a barrier, particularly for the CS and EA interventions. That is, some teachers' classes included children with very severe developmental or behavioral disabilities; these children could not play independently or were very disruptive in a group setting. In addition, a few teachers felt that the PM and CS interventions might produce negative side effects because the instruction "highlighted" the disabled nature of the children with disabilities. Also, a small percentage of teachers had personal objections to all three of the intervention strategies.

Relationship Between Intervention Strategies

To examine the relationship between acceptability and feasibility, and teachers' current use of intervention approaches, we conducted Pearson Product-Moment Correlations between the mean item ratings for the three dimensions of the scale. The correlations were .87 (p <.01 ) between acceptability and current use, and .97 (p <.01) between feasibility and current use. A t-test between correlations indicated that there was a significant difference between these two coefficients, t = 6.32, p < .05.

DISCUSSION

In this study, we examined the acceptability, feasibility, and current use of specific components of three intervention strategies for promoting young children's social interaction skills. Within each type of intervention, there was a relative range of acceptance and feasibility, although generally ratings tended to be above the midpoint of the scale. Researchers have noted that positive, accelerative interventions tend to be rated more acceptable by teachers than decelerative interventions (Irvin & Lundervold, 1988; Tamowski et al., 1989; Whinnery et al., 1991; Witt et al., 1984). It could be that the positive nature of these strategies influenced teacher acceptance. Also, teachers' reports of the number of children in need of such interventions (i.e., 74%) and the need for classroom-based instructional strategies or materials may have influenced the ratings.

Child-specific strategies, in particular, received very positive ratings for acceptability and feasibility. Strategies that teach skills were highly favored by teachers, as was social reinforcement for use of social skills. However, teachers rated children' s self-monitoring, a strategy sometimes proposed as a method for supporting generalization (Sainato, Goldstein, & Strain, 1992; Stokes, 1992), relatively less favorably.

The peer-mediated strategies that teachers rated as most acceptable involved teaching groups of children to work and play more cooperatively with one another. Cooperation suggests centering activities around joint tasks and providing common goals. Strategies such as the cooperative learning approach (Johnson & Johnson, 1981; Lew, Mersh, Johnson, & Johnson, 1986) designed for older children, might be perceived as a very acceptable strategy if adapted for preschool children with disabilities. In addition, because cooperation suggests that instruction might focus on children both with and without disabilities, it may be possible to revise more direct instructional interventions to include all children in instructional groups. Such a strategy could combine aspects of the peer-mediated and child-specific interventions.

Some components of the peer-initiation approach (Strain & Odom, 1986) were also rated as acceptable, although feasibility was rated lower. The complexity of certain aspects of this approach (i.e., teacher prompting, teaching peers initiation strategies) may have influenced teacher ratings. Although praising peers for interacting with children with disabilities was generally acceptable and considered feasible, providing activities or tangible reinforcers was less acceptable. One trend in social interaction research has been to reduce or remove the teacher-administered consequences for the peers (i.e., tangible reinforcers), as well as teacher prompts (Odom & Watts, 1991; Odom et al, 1992). Teachers may well have more favorable opinions of peer-initiation interventions that are able to remove such teacher support and communicate procedures in a relatively simple manner.

Environmental arrangement interventions did not differ significantly from the other types of interventions, although these strategies received slightly lower ratings. Teachers tended to favor providing toys to support social interaction and placed the least confidence in videotaped models as a strategy. Given that environmental arrangements would take the least teacher time of any interventions, one might expect that they would be rated higher than the other two more labor intensive techniques. Von Brock and Elliott (1987) noted that teachers tend to rate more efficacious behavioral interventions for behavior disorders more acceptable. It could be that the teachers in this study saw environmental arrangements as relatively less effective than the other more intensive interventions and therefore less acceptable.

A primary set of barriers for all three strategies was the time and resources necessary for conducting social interaction interventions. Because resources are limited, teachers are more likely to implement intervention strategies or packages that require less time or that may be worked into the existing schedule of the children. For example, teachers might conduct a social interaction instructional lesson during a large-group opening activity. Group affection training (McEvoy et al., 1988; Twardosz, Nordquist, Simon, & Botkin, 1983) is one strategy that embeds the "intervention" in activities that occur in typical early childhood settings. However, it should be noted that if social interaction skill development is an area of need for some students, as our data appear to indicate, then resources should be devoted to its instruction, just as resources are devoted to teaching fine motor, language, or preacademic skills.

A second major barrier appeared to be access to children without disabilities as peers. Many respondents either did not have children without disabilities in their building, could not integrate them into their classroom if those children were in the building, or mainstreamed children into preschool or kindergarten settings in which the special education teachers had little control over the instructional activities. Access to socially responsive peers is a major prerequisite to successfully implementing these intervention approaches. In some classes, peers with mild disabilities may have very good social interaction skills and can serve as social partners. However, for classes in which most children are in need of social skill instruction, the teacher would need to establish a process for integrating peers without disabilities into the classroom. The other, more normalized, alternative would be to integrate children with disabilities into regular education classes while providing direct consultation and training for the receiving staff (Odom & Brown, 1993).

In this study, both acceptability and feasibility of social interaction interventions were highly correlated with teachers' reports of current use. This replicated the positive relationship others have found between acceptability and the practicality of the intervention (Elliot et al., 1984; Hall & Didier, 1987; Witt & Martens, 1983; Witt et al., 1984). However, the correlation between feasibility and current use was significantly higher than between acceptability and current use. It is consistent with these data to suggest that when a teacher chooses an intervention to use in the classroom, the practical circumstances in the classroom will sway his or her choice, perhaps to a greater degree than the strategy' s acceptability (i.e., there may be more acceptable strategies that are not feasible). The respondents' reports of barriers to implementation, with needed resources being mentioned frequently and personal objections mentioned less often, may reflect the relative importance of these variables.

This study differs from other research on treatment acceptability in several important ways. First, it investigates a different type of intervention (i.e., social interaction interventions); much of the previous literature has focused on interventions designed for behavior disorders (Gullone & King, 1989). Second, most of the previous research has examined the relative acceptability or utility of single interventions or a small number of treatment packages. In this study, teachers rated many individual components of potential intervention treatment packages. Third, in previous research, treatment acceptability has largely occurred through the evaluation of one or more hypothetical case studies (Epstein et al., 1986; Shapiro, 1987); in this study, teachers were asked to use their own classrooms and children as a basis for evaluating intervention procedures. Although some control over the context for teachers' judgments may have been sacrificed, using the teachers' classroom as the referent increased the ecological validity of this study. Last, in many previous studies, the participants were preservice teachers in training or student teachers (Hall & Didier, 1987). In this study, the respondents were experienced teachers who were currently teaching in early childhood special education classes. However, we should still be cautious in interpreting these data. The total number of respondents, although nationally distributed, was relatively small. A larger sample might have been desirable.

In conclusion, early childhood special education teachers who responded to this survey indicated that a large percentage of the children in their classrooms would benefit from social interaction interventions. They rated most of the intervention strategies as acceptable and feasible, although they also identified barriers to implementing the intervention. The challenge to the field will be to use this information to design interventions or curricula that teachers will implement in programs for young childre. n with disabilities.

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ABOUT THE AUTHORS

SAMUEL L. ODOM (CEC TN Federation), Associate Professor, Department of Special Education, Peabody College, Vanderbilt University, Nashville, Tennessee. SCOTT R. MCCONNALL (CEC PA Federation), Director, Institute on Community Integration, University of Minnesota, Minneapolis. LYNETTE K. CHANDLER (CEC #466), Assistant Professor, Department of Special Education, Northern Illinois University, DeKalb.

This research was supported by Project No. G008730527 from the Office of Special Education Programs, U.S. Department of Education. Final preparation of this article was supported by a postdoctoral training project awarded to the University of California at Santa Barbara. We wish to thank Kevin Cole, Susan McBride, Susan Sandall, and Michaelene Ostrosky for their assistance in completing this study. Address correspondence to Samuel L. Odom, Box 328, Peabody College, Vanderbilt University, Nashville, TN 37203.

Manuscript received February 1990; revision accepted January 1993.
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Author:Odom, Samuel L.; McConnell, Scott R.; Chandler, Lynette K.
Publication:Exceptional Children
Date:Dec 1, 1993
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