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Promoting social interaction between young children with hearing impairments and their peers.

Social interaction with peers is an important component of the socialization of all young children and eventually becomes a major influence in their lives (Guralnick, 1986). Peer interaction presents children with opportunities to develop and practice communication, such as initiating and maintaining conversations through questions and comments (Nienhuys, Horsborough, & Cross, 1985; Wells, 1981 ). Research conducted with young children with hearing impairments (HI) indicates, however, that their interactions with peers of the same hearing status may be less frequent (Antia, 1982; Higginbotham & Baker, 1981) and of shorter duration (McKirdy & Blank, 1982; Vandell & George, 1981) than the peer interactions of children without HI of the same age. Researchers studying the interaction between children with and without HI in mainstream situations have also reported minimal interaction between the two groups (Arnold & Tremblay, 1979; Levy-Shift & Hoffman, 1985).

Researchers have proposed several reasons for the paucity of interaction between children with HI and their peers. Among these are the social skills of the children with HI; their lack of opportunity to be familiar with peers without HI; and, finally, the barriers that may be created by the inability to adequately communicate with peers, both with and without HI.

La Greca and Mesibov (1979) and Gresham (1982) have suggested that certain social skills are important for successful peer interaction. These skills include greeting behavior, extending and responding to invitations to join peer activities, conversation skills such as asking questions, responding to questions asked by others, and maintaining a conversation. Some evidence exists that young children with HI lack these skills. Research examining the interaction between children with HI and their mothers reveals that brief repetitive exchanges predominate, perhaps allowing these children fewer opportunities than children without HI to develop conversation skills (Henggeler & Cooper, 1983; WedellMonig & Lumley, 1980). McKirdy and Blank (1982) found that preschool dyads with HI were unable to sustain a dialogue and had difficulty responding to peer initiations. Children who lack the skills to engage their peers in social interaction may ultimately discourage further peer initiations and responses, resulting in low peer interaction rates for young children with HI (Higginbotham & Baker, 1981; Vandell & George, 1981).

Another reason for the infrequent interaction between children with and without HI may be the lack of familiarity between them. Children with HI are often placed in mainstream situations that do not promote familiarity with their peers without impairments. They may attend classrooms with 20 or more children without HI; moreover, they may be integrated with several different groups of children without HI and, consequently, do not have the opportunity to interact regularly with the same group of peers. Research conducted within these types of integrated programs indicates that the children with HI interact infrequently with their peers without HI (Antia, 1982). Lederberg, Ryan, and Robbins (1986), however, have suggested that when children both with and without HI are placed in a situation that promotes familiarity, interaction may improve. These authors found that the quality of interaction between children with HI and familiar peers without HI was similar to that of children with HI and familiar peers with HI. Apparently, familiar children had learned to adapt their communication to one another.

Several communication factors may also affect the quantity and quality of interaction among children with and without HI. Brackett and Henniges (1976) found a positive relationship between language-proficiency test scores of children with HI and their frequency of interaction with peers without HI. It is frequently assumed that the mode of communication (speech or sign language) of children with HI and the intelligibility of their speech will affect interaction with peers without HI, though few research data support this assumption. PIlaster (1980) found that speech was one component of an oral communication factor that contributed significantly to the academic performance of children with HI in mainstreamed classrooms; Reich, Hambleton, and Houldin (1977) reported that aural comprehension and speech reading skill contributed to the academic success of children with HI in mainstream programs. These researchers, however, did not examine the effects of these communication variables on the peer interaction of the mainstreamed children with HI whom they studied. Some research indicates that the lack of oral skills may not necessarily hinder interaction with peers without HI. Antia (1979) found that children who were profoundly deaf, who used simultaneous communication and were observed to have unintelligible speech, interacted at the same rate with peers without HI as did children with moderate hearing losses who used oral communication. Thus, although the communication skills of children with HI may affect their interaction with peers, the specific components of communication that are implicated in interaction are not very clear.

Several intervention programs have been developed to increase positive interaction between children with HI and their peers, both with and without HI. Programs to develop specific social skills have resulted in increased positive interaction among children with HI. Barton and Osborne (1978) increased physical sharing among preschoolers with HI through the use of teacher modeling and prompting of sharing during free play. Antia and Kreimeyer (1985) developed a teacher-mediated social skills intervention program for young children with HI, similar to interventions that have successfully increased interaction between other children with and without disabilities (Goldstein & Wickstrom, 1986; Odom & Strain, 1986; Odom, Strain, Karger, & Smith, 1986). The intervention required the teacher to design activities that would promote opportunities for interaction between peers (e.g., cooperative crafts activities, games, and role plays) and to model and prompt specific skills (greeting, sharing, assisting, and conversing) during these activities. The intervention was successful in increasing both linguistic and nonlinguistic positive peer interaction among preschool children with HI (Antia & Kreimeyer, 1987). The increases in peer interaction resulting from the intervention were found to generalize to free play (Kreimeyer & Antia, 1988) and were maintained for a short period after the gradual withdrawal of teacher model s and prompts (Antia & Kreimeyer, 1988).

Teacher-mediated social skills programs have been conducted only within segregated groups of children with HI. As yet, no data indicate that such programs will be equally successful when conducted within integrated groups of children with and without HI. Other kinds of intervention programs to increase interaction between children with HI and their peers without HI are few and have resulted in mixed success. Soderhan and Whiren (1985) were able to increase positive interaction between a 4-year-old child with moderate HI and his peers without HI in an integrated preschool setting, by reducing the frequency of adult-child interaction. Vandell, Anderson, Erhardt, and Wilson (1982) attempted to increase interactions among children with and without HI by engaging the children without HI in activities designed to provide them with knowledge about hearing loss, and practice in using appropriate communication when interacting with children with HI. They also paired children with and without HI for some activities. Postintervention measures indicated that the children with HI interacted less frequently and for shorter durations with the children without HI who received the intervention than with the children without HI who did not receive the intervention.

There is clearly a need to develop effective intervention programs to promote interaction between children with and without HI because over 50% of children with HI are educated in public schools (Moores, 1987). The purpose of this study was to examine the comparative effects on peer interaction of a teacher-mediated social skills intervention and an intervention that provided children with and without HI with the opportunity to become familiar with one another.

METHOD

In this study, we adapted the social skills intervention conducted by Antia and Kreimeyer (1987, 1988) in segregated preschool programs for children with HI, for use in integrated situations by providing opportunities for children without Hi to learn sign language during the intervention sessions, as necessary. It is possible, however, that gains in positive peer interaction attributed to a social skills intervention could be confounded by gains due to increased familiarity among children. Thus, we developed a comparison intervention--an integrated-activities intervention to provide integrated groups of children, both with and without HI, the opportunity to work or play together in physical circumstances similar to that in which the social skills intervention was conducted, but without teacher prompting or modeling of social skills and peer interaction.

A secondary purpose of the study was to determine whether peer interaction gains made by the children with HI due to the intervention were related to factors that might affect communication, such as degree of hearing loss, speech intelligibility, mode of communication and general social and communication development.

Subjects

The subjects were 105 children with and without HI, who were drawn from 13 different preschool, kindergarten, and 1st-grade programs in Arizona, California, Oregon, Washington State, Pennsylvania, and the District of Columbia. These programs included 10 public schools and I private school where children with HI were mainstreamed into regular kindergarten or 1stgrade classrooms for part of the school day; 2 preschool programs for children with HI that included children without HI in a reverse mainstreaming situation, and I child-care program on a college campus that included children with HI during part of the day. Twenty-five children with HI (12 boys and 13 girls) and 26 children without HI (13 boys and 13 girls) received the social skill s intervention, and 24 children with HI (16 boys and 8 girls) and 30 children without HI ( 18 boys and 12 girls) received the integratedactivities intervention. All children were between the ages of 3 and 7 years at the beginning of the study. Table 1 shows the numbers of children with and without HI at each age in each intervention group.

Because of the nature of the intervention programs, intact classrooms were used to enable the teacher of the children with HI, the regular classroom teacher, or both, to conduct the intervention procedures as part of the scheduled classroom curriculum. Thus, all the children with HI in the classroom participated in the intervention whenever possible. Participating children with HI were judged by their teachers to be of average or above-average intelligence and to have no disabilities that affected their development. Participating children without HI were receiving no special education services and were selected by their classroom teachers as being "typical children" academically and socially. These children were not selected at random because of the scheduling difficulties such a selection procedure would have caused. When possible, however, they were matched with the children with HI for age (within 6 months) and gender. Classroom teachers provided information on the mode of communication used by the children with HI. Five children in the social skills group and 10 children in the integrated-activities group used predominantly oral communication; 20 children in the social skills group and 14 in the integrated-activities group used total (i.e., oral and signed) communication. School records provided infornaation on unaided and aided pure tone averages in the better ear of each child with HI. To obtain information on speech intelligibility, the child's teacher or speech/language pathologist made audiotapes of the speech of each child with HI during spontaneous conversation with a familiar adult. After these tapes were sent to the researchers, trained listeners rated the tapes, using the National Techinical Institute for the Deaf Speech Scale, in which a rating of 1 is assigned when speech is completely unintelligible and a rating of 5 is assigned when speech is completely intelligible (Subtelney, Orlando, & Whitehead, 1981). We obtained individual speech scores by averaging the ratings of two independent listeners. When the ratings obtained by these two listeners were more than one rating apart, a third listener rated the tape, and an average of the two closest ratings was recorded.

We evaluated the communication skills and social behavior of the children, both with and without HI, by asking each classroom teacher to complete the Communication and Social Maturity subdomains of the Classroom Edition of the Vineland Adaptive Behavior Scale (Sparrow, Balla, & Cichetti, 1985) for the children in her class. Table 2 shows data on the characteristics of the children with and without HI in the social skills and integrated-activities group.

Because the subjects were not selected randomly, we examined differences in the characteristics of the subjects in the two groups, using a t test for differences between means. The children with HI in the social skills and integrated-activities groups differed on unaided hearing loss, t = 3.11,p < .01; aided hearing loss, t=2.12,p < .05; and speech scores, t = -2.07, p < .05. However, their Vineland Communication and Social Maturity scores were not significantly different, nor did they differ in chronological age. The children without HI in the social skills and integrated-activities groups did not differ significantly from each other on any measure.

Intervention Programs

Teachers were elected to conduct either the social skills or integrated-activities intervention within their classroom after receiving some brief information on the procedures and time requirements for each intervention. All teachers were told that both interventions were expected to increase interaction among children. Both interventions were conducmd with groups of four to six children, of whom between one and three were children with HI and ttae remainder were children without HI. Ten such small groups received the social skills intervention, and 12 received the integrated-activities intervention.

In most cases, the teacher of the children with HI conducted the intervention either in her own classroom or another space identified by the school. In some cases, the intervention was conducted within the regular classroom. Teachers conducted the interventions within these small groups for 20 min a day two or three times a week. The mean number of total intervention sessions was 37 with a range of 28 to 56. The intervention began at most sites in October or November, but two sites were unable to start until January. The intervention was completed between March and May. After the intervention ceased, only those children with HI who were regularly integrated (in addition to the integration required by this study) were able to continue social contacts with the children without HI.

Social Skills Intervention. Six social skills were taught to the children: greeting, sharing, cooperating, assisting, complimenting, and inviting. The skills were taught through social interaction routines. These routines provided teachers with a frmnework from which they designed activities that provided children with multiple opportunities to practice specific social skills while interacting with peers. Through the routines, children became familiar with the procedures and language required for interaction. Three types of social interaction routines were structured around familiar classroom activities: shared-product routines, cooperative game routines, and roleplay routines. Each routine had a predictable sequence though the specific activities conducted within that routine were varied to maintain interest, promote generalization, and incorporate curricular material being presented in the classroom, as follows:

* Shared-product routines required children to

work jointly on arts and crabs projects de-

signed to develop the social skills of sharing,

assisting, cooperating, and complimenting.

* Cooperative game routines required children

to participate in noncompetitive children's

games designed to develop the social skills of

greeting, cooperating, and inviting.

* Role-play routines required children to follow

a loosely based script dramatizing a familiar

event, such as going to the zoo. Role plays

were sufficiently flexible to develop any re-

quired social skill.

During implementation of the routines, the teacher first modeled and then prompted the required social skills. The teacher introduced the routine with a brief explanation. The teacher and an assistant (classroom aide, interpreter, child, or a second teacher) then modeled the procedures of the routine, demonstrating the social skills and accompanying language. The modeled words and phrases were chosen by the teacher to reflect the linguistic abilities of the children. When the children with HI used total communication, the demonstration and explanation were in sign and speech; and the teacher asked all the children-- both with and without HI--to practice the signed and spoken utterances before beginning the routine. The teacher then asked children to complete the activity as modeled.

During the activity, the teacher prompted all children, both verbally (in sign or speech) and physically, to practice the social skills that had been modeled. The teacher used verbal prompts to direct children to interact in a specific manner ("Jay, you hold the paper and Sean can cut") or to use appropriate linguistic behavior ("Say, 'Jay, please pass the glue' "). The teacher used physical prompts only when verbal prompts failed; physical prompts involved physically guiding children through the required behavior. The teacher gave prompts to all children to interact with their peers, both with and without HI, and also to interact with groups of children, as appropriate for the activity. Teachers prompted children to interact as necessary (i.e., not on a schedule) and were careful not to interrupt ongoing interaction. Teacher prompting was gradually withdrawn during the last 2 weeks of the social skills intervention.

Integrated-Activities Intervention. The purpose of the integrated-activities intervention was to provide opportunities for children to become familiar with a small, stable group of peers. In 7 of the 12 small groups, the teacher conducted this intervention during regularly scheduled classroom periods, such as an or math. During these periods, all children participating in the intervention were seated together. The teachers planned a 20-min activity during which the children had opportunities to actively work with each other; and teachers discouraged activities such as completing worksheets or passively listening to a story. In the remaining five small groups, the children with and without HI played with materials or toys available in the classroom and received little teacher direction during the intervention session. The teachers conducting the integrated-activities intervention did not specifically model or prompt social skills or peer interaction between children.

Teacher Training to Conduct Interventions.

The researchers traveled to each site to train the teachers conducting the interventions. Teachers participating in the social skills intervention were asked to read a training manual and watch an accompanying videotape. The manual provided a detailed explanation of the intervention procedures demonstrated on the videotape. We assisted the teachers in planning a specific routine, observed them as the routine was conducted, and provided feedback on their use of the prompting and modeling procedures. The manual also included a number of sample lesson plans. We encouraged teachers to develop plans that incorporated curricular material being covered at other times in the school day. To monitor the intervention after the initial training, teachers made two videotapes of intervention routines, mailed the tapes to us, and received written feedback. We also periodically mailed lesson plans to the teachers. Teachers participating in the integratedactivities intervention also read an intervention manual and met with the researchers to plan activities. We assisted the teachers in planning activities where interaction between children was possible; the teachers received no instruction in procedures to model or prompt specific peer interaction.

Data Collection

Social interaction data were obtained from three 20-min free-play periods, which occurred at four times during the study:

Time 1. Immediately before the intervention.

Time 2. After approximately 15 intervention sessions had been conducted (approximately 6-8 weeks after the intervention began).

Time 3. Immediately after the intervention ceased (approximately 6-9 weeks after Time 2).

Time 4. Approximately 2-4 weeks after the intervention ceased.

At each data-collection time, three free-play periods were videotaped. The camera followed each child sequentially for 1 min, switching back to the first child after each of the children in the group had been taped. Three min of videotape were obtained on each child at each play session, thus providing 9 min of videotape per child for each data-collection time. The videotapes were mailed to the researchers. Four trained observers recorded positive and negative linguistic and nonlinguistic peer interaction. Definitions of the observation categories were as follows:

* Interaction: Refers to communication between two individuals through spoken words, signs, gestures or pantomime; cooperative play; exchange of materials; and physical contact.

* Positive Interaction: Includes normal conversation, sharing materials, playing cooperatively, polite requests and refusals, and participation in interactive games.

* Negative Interaction: Includes taking materials or toys without asking or receiving permission; refusing to play or share by shouting, throwing, pulling, or pushing away; and aggressive motor behavior.

* Linguistic Interaction: Includes one recognizable word or sign during the interaction.

* Nonlinguistic Interaction: Includes interaction involving exchanging objects, gestures, physical contact, and participation in a game without linguistic communication.

The definitions of interactive behavior were derived from the work of other researchers examining the social interaction of children with disabilities (Odom, Hoyson, Jamieson, & Strain, 1985; Sisson, Van Hasselt, Hersen, & Strain, 1985) and were adapted for use with children with HI (Antia & Kreimeyer, 1988).

A 5-s interval-sampling technique was used to record interaction data. Interaction was observed during a 5-s interval and recorded during the next 5-s interval. The observe-record sequence continued on a single child for 1 min. After 1 min, the camera moved to the next child, whose interactive behavior was then recorded by the observer. Children were observed for approximately 54 five-second intervals at each data-collection time. Fewer intervals were recorded if children were absent for any of the play sessions or if they could not be seen on the videotape.

Observer reliability was computed using Cohen's Kappa statistic that corrects reliability coefficients for chance occurrences (Kazdin, 1982). Kappa is particularly suited to assess interobserver reliability for categorical data, especially when the rate of behavior is either very low or very high (Hartmann, 1977; Kazdin, 1982). Observers were considered to be reliable when they achieved a reliability of 0.61 three times in succession. Reliability checks between observers were conducted every 2 weeks with one of two criterion observers. Reliability coefficients during these checks had a mean of 0.82, a standard deviation of 0.15, and a range of 0.54 to 1.0. When reliability fell below 0.61, observers were retrained until they reached the criterion reliability before recording additional data. It should be noted that Kappa provides a more conservative estimate of reliability than percentage agreement. The mean observer reliability for this study was within the guidelines suggested by Frick and Serereel (1978) for classroom observations.

RESULTS

Each child received three peer interaction scores.

1. A total positive peer interaction score was the

proportion of observed intervals during which

each child interacted positively with all peers

both with and without HI; this score provided

an estimate of social interaction that occurred

in the total group.

2. A positive interaction score with a different-

status peer was the proportion of observed in-

tervals in which a child with HI interacted

positively with peers without HI; and a child

without HI interacted positively with peers

with HI.

3. A positive interaction score with a same-sta-

tus peer was the proportion of observed inter-

vals in which a child with HI interacted

positively with peers with HI; and a child

without HI interacted positively with peers

without HI.

The proportion of negative interactions for all children was less than 0.1 throughout the study; these interactions were therefore not subjected to any further analyses. Linguistic interaction was infrequent and was therefore not subjected to statistical analysis; however, a descriptive analysis of linguistic and nonlinguistic interaction is provided.

To determine the treatment effects of the social skills and the integrated-activities intervention, we analyzed the data using a repeated-measures analysis of covariance (ANCOVA). Chronological age, Vineland Social Maturity scores, and Vineland Communication scores were the covariates. Although the children with HI in the two groups differed in degree of hearing loss and speech intelligibility, there is little evidence that these factors, in themselves, affect peer interaction. Social communication skills, however, are likely to affect peer interaction (Guralnick, 1992). Although hearing loss may affect communication skills, the relationship is likely to be affected by other variables, such as personality, motivation to communicate with peers, and educational and amplification history, that are difficult to control or to measure. In fact, the subject data indicate that, whereas the social skills group had a greater degree of hearing loss and poorer speech, they had higher social maturity and communication scores on the Vineland. Chronological age was chosen as a covariate, because although the two groups did not differ on mean chronological age, they did have different numbers of children at the different ages.

The between-subjects factor (2) was Treatment (social skills intervention or integrated-activities intervention), with Time (3) as the repeated measure. Separate ANCOVAs were computed to determine the effects of intervention on the following:

1. Total positive peer interaction.

2. Interaction with different-status peers.

3. Interaction with same-status peers.

Although data were collected four times during the year, several schools were not able to complete the fourth data collection because of scheduling difficulties. Data at Time 4 were obtained on 67 of the 105 children; these data were not included in the statistical analysis and are not reported further.

Total Positive Peer Interaction

Significant main effects occurred for Treatment, F = 9.97, p < .01, indicating a differential effect between the social skills and the integrated-activities intervention, Time, F = 6.83, p < .01, indicating that there was an overall change in the frequency of interaction between Times 1, 2 and 3, and Treatment by Time, F = 3.01, p < .05, indicating that the pattern of change over time was different for the two groups. Post hoc contrasts between means with a Bonferroni adjustment for alpha levels indicated that the children receiving the integrated-activities intervention interacted significantly more, p < .01, with each other at Time 2 and 3 than at Time 1. No significant differences between means at Times 1,2, and 3 were found for the children receiving the social skills intervention, although the dam in Table 3, which displays means and standard deviations for positive interaction for both groups, indicate a slight upward trend.

Interaction with Peers of Different Hearing Status

A significant main effect for Time, F = 3.85, p < .05, but no main effects for Treatment, F = .61, n.s., or for Treatment x Time, F = 1.38, n.s., occurred for positive interaction of all children with peers of different hearing status (Table 3). Thus, though the children increased their interaction with peers of different hearing status, one treatment was not more effective than the other. Post hoc contrasts between means showed that, overall, children interacted significantly more, p < .01, with peers of different hearing status at Time 3 than at Time 1. An examination of the means in Table 3 indicates that the children in both groups showed a small but steady increase during the time that the intervention was in effect.

Interaction with Peers of Same Hearing Status

A significant main effect for Treatment, F = 10.94, p < .01, and Treatment x Time, F = 4.52, p < .01, was found for positive peer interaction between children without HI and their same-status peers. No significant effects were found for positive interaction between children with HI and their same-status peers.

To determine if the children with and without HI differed significantly in their interaction with same-status peers, repeated-measures ANCOVAs with Hearing Status (2) as the between-subjects factor, Time (3) as the repeated measure, and Chronological Age and Vineland Communication and Social Maturity scores as covariates, were computed separately for the social skills group and the integrated-activities group. No significant effects were found for the social skills group, indicating that none of the children--either with or without HI--changed their positive interaction with same-status peers as a result of the intervention. A significant Time effect, F = 6.32, p < .01, was found for the integrated-activities group; however, the lack of a Hearing Status effect and a Time x Hearing Status effect indicated that the interaction of children with HI with their same-status peers was not significantly different from that of the children without HI, nor did their interaction with their same status peers change over time in a manner different from that of children without HI. Post hoc contrasts between means at Times 1, 2, and 3 indicated that the integrated-activities group interacted significantly more with their same-status peers at Time 2 than at Time 1.

The lack of a Hearing Status effect for both groups indicated that the children with HI did not differ from the children without HI in their frequency of positive interaction with same-status peers. The data in Table 3 indicate that the children with and without H1 in the social skills group tended to interact more with their same-status peers than did the children in the integrated-activities group. Within treatment groups, however, the interaction of the children with and without HI with their same-status peers was remarkably similar. An examination of the mean percentage of positive interaction intervals in Table 3 shows that all children interacted more frequently with same-status peers than with different-status peers, though the difference is more marked for the social skills than the integrated-activities group.

Linguistic and Nonlinguistic Interaction

Table 4 shows the mean percentage of intervals in which positive linguistic and nonlinguistic interaction occurred between children and their peers of different heating status and the same hearing status. These data indicate that when children without HI interacted with same-status peers, they used more linguistic than nonlinguistic interaction; however, when children with HI interacted with same-status peers, they used more nonlinguistic than linguistic interaction. When children interacted with a peer of different hearing status, they used primarily nonlinguistic interaction. The children in the integrated-activities group showed a small but steady increase in the number of linguistic interactions with different-status peers.

Effect of Other Variables on Gains in Positive Interaction

To determine the effects of other variables on the interaction of children with HI, we computed gain scores for total positive interaction between Time 1 and Time 3, with same and different hearing status peers, for each child with HI. These gain scores served as the dependent variables for a multiple-regression analysis with chronological age, unaided hearing loss, aided hearing loss, speech scores, Vineland Social Maturity scores, Vineland Communication scores, mode of communication, and length of intervention (because of the wide range 24-56 sessions) as the independent variables. No single factor accounted for a significant amount of variance in gain scores for interaction with peers without HI. Chronological age was the only significant factor accounting for 14%, p < .01, of the variance in gain scores for interaction with peers with HI.

DISCUSSION

The major purpose of this study was to examine the effectiveness of a social skills or an integrated-activities intervention on the peer interaction between children with HI and their peers, both with and without HI. The social skills intervention was a teacher-mediated intervention that had been successful in increasing interaction among children with HI (Antia & Kreimeyer, 1987, 1988). The integrated-activities intervention was primarily designed to provide children an opportunity to become familiar with one another without specific teacher mediation. The resuits indicated the following:

1. The integrated-activities intervention resulted

in greater gains in total positive peer interac-

tion than did the social skills intervention.

2. Interaction of children with peers of different

hearing status increased from preintervention

to postintervention, but one treatment was not

more effective than another.

3. Children with HI interacted with their same-

status peers as frequently as children without

HI interacted with their same-status peers be-

fore, during, and after the intervention.

4. All children continued to interact more fre-

quently with peers of the same hearing status

than with peers of different hearing status dur-

ing the period of the study.

5. Interaction between children with and without

HI was primarily nonlinguistic.

6. The increase in interaction of children with HI

and their different-status peers was not ac-

counted for by the factors of hearing loss,

speech, social and communication develop-

ment, mode of communication, or chronolog-

ical age.

7. The increase in interaction among children

with HI and their same-status peers was sig-

nificantly and positively related to chronolog-

ical age.

Before discussing the results, we must consider some of the limitations of the research. Most of these limitations result from doing research within classrooms and having to adapt to school schedules and preferences. None of the children-either with or without Himwas randomly selected, nor were the treatments randomly assigned. The subject data indicate that there were differences in characteristics of children with H1 between groups, as well as within groups. An attempt has been made to control subject differences statistically through the use of covariates in the statistical analysis. Although teachers selected the treatment in which they wished to participate, all teachers had the expectation that the treatment would increase interaction; thus, any effects due to treatment selection should be similar across both intervention groups. Moreover, data on interaction were taken during free-play periods, where minimal teacher direction occurred. No information was obtained on the amount of contact between the children with and without HI apart from the intervention sessions. Thus, we could not assess the impact of additional contact between the children on the outcome.

Several possible explanations can be offered for the superiority of the integrated-activities intervention over the social skills intervention in increasing total peer interaction. The opportunity to work and play frequently with a small, stable group of peers in a situation in which familiarity can be established may be sufficient to increase positive interaction with peers. The superiority of the integrated-activities intervention may also reflect differences in the generalizability of the two interventions. A post hoc review of the activity records from teachers conducting the social skills interventions indicated that approximately 50% of the intervention activities were shared-product routines. These routines may not generalize to free play as readily as cooperative game and roleplay routines because shared-product activities involved the use of arts and crafts materials that were unavailable to children during the free-play sessions. Previous research (Kreimeyer & Antia, 1988) indicated that generalization is facilitated when naaterials used during intervention activities are available during free play.

In contrast to the social skills groups, children in 5 of the 12 integrated-activities groups came together to play during the intervention sessions. Therefore, the situation in which the intervention was conducted was similar to the situation in which data were collected. It is possible that this similarity promoted generalization across settings. Unfortunately, because we did not obtain data on peer interaction during the intervention sessions, we could not examine the frequency of peer interaction during the intervention activities to clarify whether the difference between the groups was the result of differences in the generalizability of the two interventions.

Another factor that may have contributed to the increased gain for the integrated-activities group, as compared with the social skills group, was the role of the teacher during the intervention. The social skills intervention required the teacher to take an active role in prompting interaction; such teacher prompting did not occur during the integrated-activities intervention. Although several researchers (Antia & Kreimeyer, 1985, 1988; Odom, Hoyson, Jamieson, & Strain, 1985) have documented that teacher prompting results in increased peer interaction during teacher-directed activities, Soderhan and Whiren (1985) have suggested that decreasing teacherchild interaction may lead to increased interaction among peers; and McEvoy, Odom, and McConnell (1992) pointed out that children may develop a reliance on teacher prompts that inhibits generalization to situations where teachers are not present. During the integrated-activities intervention, teacher prompting was not a component of the intervention. In contrast, the teacher prompting required during the social skills intervention may have resulted in higher frequencies of teacher-child interaction. Despite. the promptfading procedure, children may have learned to depend on macher prompts for peer interaction.

A finding of this study was that statistically significant, but clinically small, gains were found for positive interaction of children with peers of different hearing status. The lack of a Time x Treatment effect indicated that one intervention was not more effective than the other in promoting interaction; thus, we conclucled that familiarity, the factor common to both groups, was responsible for affecting interaction. The steady nature of the gains during the intervention is encouraging and may indicate that continued smallgroup contact could result in further gains in positive interaction with peers of different hearing status.

It is also encouraging that the interventions implemented in this study resulted in increased positive interaction with peers of different hearing status, in contrast to the intervention implemented by Vandell et al. (1982) that resulted in decreased interaction between children with and without HI. Thus, interventions that provide children opportunities to become familiar with a stable group of peers by frequently working and playing together are likely to be more effective than interventions that provide children without HI with information about hearing loss.

The data from this study indicate that the children with and without HI in both groups preferred to interact with peers of the same hearing status, rather than with peers of different hearing status before, during, and after the intervention. These data are in agreement with the self-segregating tendencies reported by other researchers (Arnold & Tremblay, 1979; Levy-Shift & Hoffman, 1985). Neither intervention resulted in children either with or without HI preferring to interact with peers of different hearing status. Such change may not be possible given the limited interaction opportunities available for children with and without HI to interact with each other in most mainstream situations.

In contrast to other reports (Antia, 1982; Higginbotham & Baker, 1981) the children with HI interacted as frequently with their same-status peers as did the children without HI. Thus, the hypothesis that children with HI lack the social skills to interact with peers may be inaccurate.

Increases in interaction between children with HI and their peers without HI were not related to factors commonly assumed to be important, such as degree of hearing loss or speech intelligibility, possibly because the interaction that occurred was primarily nonlinguistic--and these factors are likely to be related to linguistic communication. The relationships between social interaction and factors related to degree of hearing loss and oral communication may be different for older children, for whom linguistic communication is an important component of peer interaction. This finding may also suggest that, in addition to the intervention, other unmeasured factors, such as motivation or personality, may be responsible for changes in interaction.

Increasing interaction between children with and without HI appears to be a much more complex process than increasing interaction of children with HI among themselves. The results of this study indicate that intervention needs to be conducted in stable groups of children with and without HI over a lengthy period of time because familiarity appears to be a factor that positively influences peer interaction.

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ABOUT THE AUTHORS

SHIRIN D. ANTIA (CEC #195), Associate Professor, KATHRYN H. KREIMEYER (CEC #195), Adjunct Assistant Professor, NANCY ELDREDGE, Assistant Professor, College of Education, Special Education and Rehabilitation, University of Arizona, Tucson.

This research was supported by Grant #HO23C80087-90 from the U.S. Department of Education. We wish to thank all the teachers and our graduate assistants Lisa Coynet and Abha Gupta who participated in the study.

Manuscript received December 1991; revision accepted March 1993.
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Author:Antia, Shirin D.; Kreimeyer, Kathryn H.; Eldredge, Nancy
Publication:Exceptional Children
Date:Dec 1, 1993
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