5

Facilitating Social
Inclusion of Children
with an Autism
Spectrum Disorder
Saara Mahjouri and Connie Kasari

Children with autism face complex social challenges as they enter

the mainstream educational system. The social climate present in schools
can be difficult for these students to navigate, since a core challenge for
autism exists in the social domains (APA, 2000). With the current push to-
ward full inclusion, as mandated by the 1997 and 2004 reauthorizations
of the Individuals with Disabilities Education Act and No Child Left Be-
hind (IDEA, 1997; NCLB, 2001; reauthorized IDEA, 2004), children with
autism have more opportunities to interact with their peers. However, in-
clusion alone may be insufficient for the effective integration of children
with autism into the social networks of their typically developing peers
(Burack, Root, & Zigler, 1997), and could even be to their social disadvan-
tage (Ochs et al., 2001; Sale & Carey, 1995).
Parents identify social skills as the top priority for their child, but
also voice significant dissatisfaction with the availability of school-based
supports and level of attention schools pay to these issues (Kasari et al.,
1999). If they can afford it, parents seek social tutoring for their children,
usually in the form of clinic-based social skills groups. Several evidence-
based social skills interventions exist for children with autism; yet reviews
note that clinic-based social skills groups do not maintain gains over time
or generalize to school settings. One reason may be that these programs
are not personalized (Bellini et al., 2007). Group social skills programs
have a particular focus (e.g., emotion identification or friendship devel-
 I
Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

opment) and a set curriculum. Children who participate are rarely observed
in their natural environments so that their social “personality” and particu-
lar skills (strengths and weaknesses) are unknown. The selected social skills
program may not be a good match for the child’s individual needs, perhaps
explaining why treatment does not maintain or generalize.
In this chapter we describe interventions for children with autism that
focus on their core social impairments. We note that one of the most striking
aspects of autism is the variability of the symptoms. This variability has to be
considered in finding effective interventions.

Early Difficulties
At young ages, children with autism seem less aware of their peers than
children who are typically developing. Indeed, in one of the first published
studies about children with autism, Kanner (1943) noted that Richard was
“quite self-sufficient in his play” (p. 225) at 3 years, 3 months, a time when
most children are interested in playing with others. Likewise, Virginia “sat
among the children, seemingly not even noticing what went on, and gave the
impression of being self-absorbed” (p. 231). Frederick actively avoided oth-
ers; “when a fourth person entered the room, he retreated for a minute or two
behind the bookcase saying, ‘I don’t want you’ and waving him away.”
The last thirty years of research have confirmed many of Kanner’s origi-
nal observations. The children Kanner described (as above) likely suffered
from two under-developed core areas of development—joint attention, an
early social communication skill, and flexible social play skills. Both of these
areas of development affect the extent to which young children can engage
with others in general and other children, specifically.
Joint attention skills involve sharing information or experience with
others. These skills are shown through shared and coordinated looks between
people and objects, points to share, and attempts to show an object or share
an experience. These skills are different from requesting skills in which the
child may use points and reaches to indicate a need or desire for something.
Children with autism have less difficulty with requesting skills than they do
with joint attention or sharing skills. They also have greater difficulty with
initiating these skills than they do in responding to the gestures of others.
Joint attention skills are communicative because they provide an opportunity
to share something together; thus, young children may show a new toy to
their playmate, or they exchange looks vis-a vis some event or action.
Social play serves a similar function. Play acts are characterized as func-
tional or symbolic; children engage in play independently but they also spend
 Teaching Social Skills to People with Autism I


large amounts of time engaging in play with others. Functional play involves
using toys as they were intended. An example is when children play together
by stacking large blocks on top of each other to create a tower with the goal of
knocking it down. Symbolic play involves the representational use of objects,
either pretending one object represents another, or attributing imaginary
characteristics to objects. Symbolic play also affords children an opportunity
to use language in situations they co-create with others (using language to
demonstrate their imagination in the absence of objects).
Joint attention and symbolic play both provide an important develop-
mental opportunity. Significant associations have been found between these
early skills and subsequent language development (Mundy, Sigman, & Kasa-
ri, 1990), and later social interactions with peers (Sigman & Ruskin, 1999).

Assessments to Determine Early

Intervention Targets
In determining appropriate intervention targets, structured assess-
ments should be completed prior to beginning intervention, during inter-
vention phases, and at the intervention completion and follow up assess-
ment time points. Assessments should be relevant to the intervention. Thus,
in targeting joint attention and play skills, we assess these skills in children
prior to beginning intervention. The Early Social Communication Scales
(ESCS) (Mundy, Hogan, & Doehring, 1996) are used to assess the child’s
initiations and responses to joint attention, behavior regulation, and social
interaction. Total frequency scores are summed within each category, and
these data provide needed information on existing, emerging, and absent
social communication skills.
Similarly, in determining appropriate play targets for intervention, we
use the adapted Structured Play Assessment (Kasari et al., 2010), in which
children are presented with five different toy sets that can elicit functional
and symbolic play acts. The child’s behaviors are coded for frequency of acts,
and the diversity of play. Diversity is the more important variable, as it yields
information on how solid the play acts are within a level of play. For example,
the child may brush the doll’s hair, wipe her nose, and wash her face—three
different play acts within the level of play referred to as “child as agent.” Lev-
el of play (from functional to symbolic levels) is coded using Lifter’s coding
scheme (1993). Intervention then begins at the child’s mastered level of play
and works toward emerging levels. Establishing play level and using this as an
entry into play interventions is important so that the child is not bored by play
routines, and also not overly taxed cognitively by playing at too high of a level.
 I
Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

Another means of assessing joint attention and play skills is to observe

the child interacting with a familiar play partner, such as a caregiver. These
data can be important in assessing how the child engages with others, and
also provides information on the appropriateness of treatment targets.

Interventions for Social Difficulties in

Early Childhood
Early difficulties in joint attention and play skills require targeted inter-
ventions. Several single subject designs and at least one group design have
been reported for targeting joint attention (Kasari et al., 2006; Rocha, Sch-
reibman & Stahmer, 2007). One issue is that researchers define joint atten-
tion in a variety of ways and sometimes confuse requesting and joint atten-
tion; however, the definitions are clear from the typical developmental lit-
erature, and the specific difficulties for children with autism have been well
documented (Mundy et al., 1986). Indeed, the skills that are the most difficult
to change in children with autism are initiating skills (more than responding)
and joint attention (more than requesting skills).
The methods used to teach joint attention matter. It is not clear that re-
peated drilling with little variation or drilling a skill out of context can lead
to maintained and generalized learning. Because joint attention skills are
used in the context of interacting with another person, more naturalistic
approaches are more successful. In a randomized controlled trial, we com-
bined a naturalistic behavioral and developmental approach to teach children
joint attention skills or play skills (Kasari et al., 2006). Compared to children
receiving early intervention services based on applied behavior analysis (30
hours per week) with no content in social play or joint attention, the children
receiving joint attention and play interventions demonstrated greater skill
development, and better language a year later. Most importantly, the skills
taught in sessions with a therapist generalized to parents, and the skills main-
tained and increased over the subsequent year (Kasari et al., 2008).
Two additional findings emerged from this line of work. One is that
the joint attention and play interventions yielded similar outcomes on lan-
guage. A possible shared active ingredient of each intervention was joint en-
gagement with the adult. Thus, it is likely that creating sustained joint play
routines with the child and targeting skills within this mutual engagement
resulted in greater skill in joint attention and play. Second, children with the
least amount of language to begin with made the most progress in later lan-
guage skills if they were assigned to the joint attention intervention. These
findings suggest that teaching children at their developmental level (teaching
 Teaching Social Skills to People with Autism I


prelinguistic skills prior to teaching verbal skills) is important to their later

developmental outcome.
Mediating the interventions via adults may be a necessary first step for
most children prior to peer-related interactions. Using a layered approach
that involves developmental and behavioral strategies to target joint engage-
ment, play, joint attention, and language skills, we have shown that caregiv-
ers can successfully improve these skills in their toddlers with autism (Kasari
et al., 2010) and that teachers can facilitate change in their preschoolers in
public preschool classrooms (Lawton & Kasari, 2011). The goal is that these
skills will then generalize to their peers, although this has not been tested.
Peer-mediated interventions are accepted as the most evidence-based
approach to improving peer interactions; yet, overall there are few preschool-
based intervention studies. Over the past thirty years, only ten studies total-
ing 32 children with autism and 48 peers have been reported (Chang, 2011).
All of these have been single subject designs, and fewer than half report main-
tenance and generalization data. Indeed, only one of three children typically
maintains the skills learned via peers, with somewhat more generalizing the
skills to a new context or peer. These limited findings may be due to poor
implementation, as none of the studies report fidelity data.

Peer Engagement
A challenge for young children with autism is their lack of awareness
of peers. For some children with little interest in peers, intervention with an
adult may be an important first step prior to moving to peer interactions. For
other children, peer-mediated interventions may be successful in helping to
socialize and bring them into interaction with others.
The heterogeneity of the autism disorder suggests that a single inter-
vention will not be effective with all children; thus, it will be important to
have a means for assessing child strengths and weaknesses that will lead to
effective social interventions. A child’s “social personality” may provide im-
portant information about potential effective interventions. Wing and Gould
(1979) provided such a categorization framework of children’s social differ-
ences, ranging from socially aloof and indifferent to passive to other’s attempts
to engage them to active but odd—the child has social interest but is mostly
inappropriate. Some children are expected to have appropriate social interest
and interaction.
It may be that for aloof and indifferent children, a peer-mediated inter-
vention will be more effective because the motivation for social engagement
will not occur without active involvement of other children. For children who
 I
Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

are aware of social relationships but do not have the skills to engage in them
appropriately, direct instruction with the child with autism may be more
effective because the child may have enough awareness and motivation to
change his or her behavior.
A number of programs that provide children direct instruction of social
skills are available. However, one issue is that most programs do not individu-
alize instruction to the participant; thus, the social personality of the child is
not considered. Another issue is that children are often unacquainted with
each other. That is, most come from different schools or classrooms, so that
skills learned in the group cannot be easily maintained with the same peers.
Thus, while these programs have shown change in individual child outcomes,
they tend not to maintain and generalize to other contexts, such as the school.
Another issue concerns how change in social skills is measured. While
there is agreement that certain skills (i.e., greetings, eye contact, conversa-
tion skills) constitute necessary social competencies, the efficacy of specific
treatments cannot be compared, without agreement upon the necessary skill
outcomes. The variability in outcome measures makes it difficult to make
reasonable comparisons across studies. Many studies have relied on rating
social skills before and after treatment. However, the evaluation of change
has often been obtained from informants who may or may not have access
to observed differences in the children (e.g., parents are asked to evaluate
social skills at school but may not be present at school). Or the informant is
actively involved in the treatment and thus may be biased (e.g., parent medi-
ated intervention in which parents also report on change in the children).
One solution to these issues is to use multiple informants (parents, teachers,
peers, self-report) and to use observers of children in natural settings who are
also blind to treatment condition.

Assessment to Inform Social Skills

Intervention
Examining the level of social interactions a child is having without in-
tervention can inform the specific targets of social skills intervention. As au-
tism is highly variable, it is important to assess each child’s social personality.
Is the child aware of others, actively attempting to engage but going about
it oddly or aggresively? Or is the child happy on his or her own, appearing
socially aloof? Most social skills programs do not do in-depth assessments
prior to beginning treatment. One goal of future intervention studies is to
assess child behavior using a variety of direct observations and reports from
informed others. This information should provide details about the child’s
 Teaching Social Skills to People with Autism I


social skills across a variety of contexts. Interventions targeted to the child’s

particular set of social strengths and weaknesses should translate to greater
maintenance and generalization of social skills, a persistent limitation in cur-
rent intervention studies.
Depending on the focus of the intervention, outcome measures should
link to the intervention content. Thus, if the goal is to increase engagement
with peers during playground time at school, an outcome measure should be
observations of playground behavior at school. Similarly, if the focus is on
friendship development, reports of friendship reciprocity, and friendship qual-
ity from the target child and his or her nominated friends should be obtained.

Social Skills Intervention Research

Most social skills intervention programs use adults to deliver social
skills information to children with ASD. Children may practice their skills
with other children in the group, but the actual information often comes from
the adult leader. Outcome measures are often rating scales of whether there
has been an improvement in social skills, and raters are often the group lead-
ers, or the parents. Sometimes the child with ASD is also tested for increases
in his or her social knowledge using paper and pencil tests.
Few studies of school-aged children with autism have used peers as
mediators of social skills interventions. Trained peers can be important
change agents since they can increase the dose of intervention delivered
to children with autism throughout the school day. When peers deliver the
intervention, the outcomes are typically observational measures, and the
study designs are overwhelmingly single subject designs (Chang, 2011).
Kasari et al. (2011) implemented a randomized controlled trial in schools
that compared peer mediated versus child assisted (1:1 adult-mediated) in-
terventions and found several positive changes for children who received
the peer interventions. In this study, outcome measures included observa-
tions as well as self and other reports (peers and teachers). At the end of
treatment, children with autism receiving peer interventions were iden-
tified by more peers as friends, were observed to spend more social time
(e.g., recess) engaged with peers, and were perceived by their classmates
as being more socially connected. Teachers also noted improvements in the
social skills of children randomized to the peer condition.
Similarly, Bauminger (2002) found that her peer-mediated, school-
based intervention resulted in increased peer interaction and decreased
isolation. The findings of these studies highlight two important elements in
social skills interventions. First, the shift toward using peers in a naturalis-
 I
Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

tic environment, rather than teaching discrete skills in isolation, may have
better results in generalizing to the school environment. Second, measuring
increased friendships and social time engaged appear to be important out-
come measures that may be more telling about children’s social experience
than measuring specific skill knowledge.
Unfortunately, few studies have examined the effects of social skills
interventions delivered in the school environment. Several practices have
emerged successful; however, they often lack the empirical evidence needed
for widespread dissemination. School-based interventions are difficult to im-
plement, given the abundance of obstacles presented by school systems. It is
often difficult to randomize children to treatment and no treatment groups,
as schools will not agree to withhold treatment. Further, the school envi-
ronment presents several uncontrollable factors, potentially rendering the
fidelity of intervention and delivery and quality of data collection less than
desired. These practical difficulties help explain the current gap between re-
search and practice.

Practical Suggestions for Social Skills

Interventions in School
Informed by current research, assessment, and observations of children
in the school setting, a few consistent recommendations for improving so-
cial skills in children with ASDs have emerged. The following section iden-
tifies why school is an important setting for intervention, then describes a
few guiding principles for implementing social skills intervention in primary
aged children.
School-based Treatments: Schools provide a rich social environ-
ment, fraught with different demands and pressures. Bringing a model of
social skills treatment into schools is recommended for intervention efforts.
All students can benefit from school-based social skills training. Further, by
teaching skills in the context that they are usually encountered, students are
more likely to generalize skills taught by practicing them in a relevant envi-
ronment. Friendships developed in school groups may also better generalize
to other social settings in school.

Strategy #1: Facilitate Engaging Social Play on

the Schoolyard
Recess is a very important part of the school day for children. For many,
it is one of the only times to connect with friends, as well as to get energy
 Teaching Social Skills to People with Autism I


out in a productive manner. Unfortunately, children with ASDs can be over-

whelmed with the social expectations of the playground and the excessive
sensory stimuli. Many may not know how to join in games, or cannot respond
appropriately to the rules and structure of games. These behaviors can result
in stigmatization or a preference for social isolation. Therefore, it is hypothe-
sized that an effective social skills intervention at school will incorporate gen-
eralizing to the playground. Adults (school personnel and clinicians) should
be trained and supported to look for kids who are isolated and encourage
them to participate in games, use peers to redirect negative or isolating social
behaviors, create fun and engaging games that encourage participation by all
children, and fade out once children are in a sustainable level of play.

Key components: positive affect and enthusiasm from adults facilitating

intervention. A high level of cooperation and investment from school personnel.
Adequate supplies, play areas, and supervision.
Positive group leader qualities: flexible, creative, energetic, and play-
ful. The ability to communicate effectively with all adults (teachers, aides, ad-
ministrators, parents) in the school environment.

Strategy #2: Engineering Social Experiences

with Peers
For many children with ASDs, the intrinsic reward of social interaction
is not strong enough for them to initiate interactions with peers. Therefore, it
is important to examine their specific interests, and create social opportuni-
ties around shared interests for children. Any structured activities or clubs
that focus on activities children normally enjoy can provide a rich environ-
ment to practice social skills and foster friendships.
Often, children with ASDs do not have the social acuity to seek out and
identify peers with similar interests, and therefore they have difficulty de-
veloping their social niche. Schools can play an important role, by providing
the environment and clinician or school personnel support to create social
groups where kids participate in activities they enjoy, and improve social
skills and increase friendships as a byproduct.

Key components: school culture promoting the involvement of peers.

Teacher and parental involvement in identifying supportive peers. Creativity in
determining activities to capture the interest of children and peers.
Social activity ideas: playground games that are varied and age appro-
priate. Some examples are: cooking class, LEGO ™ or Puzzle club, video game
tournament, filmmaking group, drama games, or a movie club.
 I
Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

Strategy #3: Sequential Interventions to

Account for the Variability of Symptoms
A primary struggle in implementing social skills interventions is that
a “one size fits all” approach is simply not sufficient for the variability that
autism spectrum disorders present. Some children may benefit from specific
skill instruction, whereas others may need practice interacting with peers in
socially acceptable ways.
In order for a successful social skills treatment to account for the various
needs of children, it is important to first instruct the child in skills necessary
for social interaction, and then create and facilitate social opportunities for
students to practice these skills with peers in naturalistic settings. In order for
social skills treatments to be effective, both of these areas must be addressed
and intervention maintenance should occur. For example, a child may be in-
structed in how to join a game in a small group, and then supported in joining
a group of peers to play the game. Once the child has sufficiently shown the
ability to interact with peers, clinicians or school personnel should be avail-
able to provide additional social coaching, as needed.

Key components: specific assessment to determine intervention tar-

gets. Flexible timeline for completion. Long-term investment from parents and
schools to follow through and maintain social supports.
Active ingredients of sequence: 1) Priming a skill in young children
using behavioral strategies, and then 2) Using more developmental and natu-
ralistic strategies to help solidify the skill. (Example is the study by Kasari et
al., 2006, in which brief discrete trial training was used prior to milieu play
episodes to teach joint attention or play skills.) 3) Reassessing children’s social
needs through development, to determine the need for increased/decreased in-
tensity and follow up.
A practical example of a sequential intervention approach is to break down
skills needed in separate sets such as below:
1. Instruct skill   accepting the rules of a game and being a
good winner/loser.
2. Priming activity   practice game of handball in classroom,
with group members. Positive feedback for turn-taking, and
responding appropriately to winning/losing.
3. Supported activity   with adult support, join recess game of
handball with trained peers. Adult feedback, when positive
skills are displayed, to all children involved.
4. Generalization   children with ASDs are encouraged to join in a
game, general adult supervision to ensure no children are isolated.
 Teaching Social Skills to People with Autism I


Support Throughout the Life Course

Thus far, the issues this chapter has addressed are pertinent to early
childhood and primary aged children. Unfortunately, the difficulty children
with autism have in developing and maintaining positive peer relationships
and friendships continues well into adulthood. Orsmond, Krauss, and Seltzer
(2004) asked 235 parents about the peer relations of their adolescent and
adult children with autism. Almost half reported no peer relationships at all.
Likewise, Howlin and colleagues (2004) found that 56% of 68 adults with
autism reported no friends or acquaintances. Additionally, school inclusion
with typical age mates was not associated with having peer relationships.
Thus, an individual’s participation in an inclusive setting did not result in a
greater chance of having a friend.
Some models to improve social competency in adolescents incorporate
parents as part of the treatment (Laugeson, Frankel, Mogil, & Dillon, 2008).
In the social skills program (PEERS) of Laugeson and colleagues, teenagers
are instructed on positive and relevant social etiquette. For example, one ses-
sion focuses on the differences in communication etiquette via e-mail versus
the telephone. Additionally, teenagers in the group are encouraged to have
social gatherings as homework. This aspect is aimed to improve generaliza-
tion, as the groups are conducted in clinical settings. Concurrently, parents
attend informational sessions instructing them on the best ways to support
the social skill development in their teenager. After the intervention/parent
sessions, teenagers and parents are briefed on what each covered. This aspect
of simultaneous treatment of both the adolescent and their parents seems
likely to influence long-term change.
Adolescents are a difficult group for which to design and implement ef-
fective social skills interventions. Research has indicated that adolescents
with high functioning autism are aware of their difficulties in peer interac-
tions. It stands to reason that their heightened awareness of their social status
would result in increased sensitivity. This should be taken into account when
developing interventions. Adolescents with ASDs were also found to experi-
ence higher levels of loneliness than their typical peers (Locke et al., 2010).
Perhaps an effective approach to improving social skills for this age group
would include activities that the adolescents naturally enjoy or are interested
in. Project-based groups can teach social skills, teamwork, and cooperation,
all while providing enrichment. Projects can also include community service
activities. This can intensify the benefit of social skills programs for society.
Not only are adolescents improving their skills, they are becoming more en-
gaged with their peers, and visible and connected to their communities.
 I
Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

Conclusions
In the case of autism, no single intervention will suffice. If children are
to build social competency, then intervention efforts must address the vari-
ability of the disorder itself. Given the success of interventions such as those
by Barry et al. (2003) and Bauminger (2002), peer-mediated models are nec-
essary to promote the generalization of social skills across different contexts
of a child with autism’s life. Additionally, both in the early joint attention and
symbolic play interventions and adolescent social skills groups, parents and
caregivers are a necessary component of successful intervention implementa-
tion. It is recommended to provide intervention efforts throughout the devel-
opmental trajectory, targeting different aspects of the core deficits of autism.
Additionally, it is necessary to include all members of the child with autism’s
social network (e.g., parents, school, and community).
Child: Change begins with the child. The child is the primary target of
any intervention, be it early communication or social skills and engagement.
The most intense intervention efforts must be directed towards the child. In
early childhood, interventions targeting joint attention and symbolic play
skills can foster and support communication and language development.
Once those abilities are adequately developed, social skills training programs
in naturalistic settings can improve the child’s behaviors that enable him or
her to engage with peers. Through adolescence, the target of intervention
must continue to build and develop these skills. Adolescents must be taught to
functionally transfer early developed social competence into behaviors that
allow them to interact with their peer group.
Family: Parents, family members, and anyone involved in the child’s
home life are an integral part of catalyzing and sustaining positive change.
Parents are involved in implementing and supporting intervention directly
in early childhood and indirectly in childhood through adolescence. For any
intervention effects to be lasting, people in the child’s home must continue to
foster an environment that supports the child and his or her newly acquired
skills. Improved communication, language, and social behaviors can improve
family relationships. They can also reduce caregiver stress.
School: Once children have developed early competencies that have
been supported in their home life, they can enter school with improved social
abilities. These skills will allow them to fully benefit from inclusive opportu-
nities. Additionally, interventions targeting social interactions, conducted in
a school environment, increase the ability to generalize skills. Members of
the school community must be supported to facilitate positive interactions
 Teaching Social Skills to People with Autism I


between peers, so that everyone in the school environment can grow as a

result of the experience.
Community: There is less evidence for community involvement in the
positive social development of children with autism. It stands to reason, how-
ever, that once these children are supported to become contributing mem-
bers of society, communities will benefit. Additionally, any intervention ef-
forts targeted toward adolescents can incorporate community service com-
ponents. Thus, adolescents have a shared cause to work toward, and practice
their social skills.

When conceptualizing and implementing social skills interventions,

researchers and practitioners are urged to consider the child as embedded
in a family, school, and community context. Within this guiding framework,
changes can promote individual social competency and create environments
that foster and support the continued growth of social skills. If we are to ex-
pect inclusion to be a successful practice, it is necessary to develop systems
that facilitate positive inclusion opportunities and value the learning experi-
ence it provides.
This task is multifaceted. First, children with autism must be supported
to develop adequate communicative skills to function at a level that allows
them to interact with their peers. Once these skills are developed, they must
then be fostered in ways that improve social interactions. Through targeted
interventions, addressing the core deficits of autism throughout the devel-
opmental trajectory, children can acquire skills and the social competences
necessary for positive interactions with their families and peers. Given the
variability of autism spectrum disorders, interventions must be tailored to ad-
dress all domains that affect social communication and functioning and also
deliver specific support, contingent on the child’s social profile. Targeted in-
terventions, addressing different developmental periods throughout the life
course, can be an effective way to improve outcomes and provide meaningful
skills and opportunities for social engagement in school and life contexts.

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Facilitating Social Inclusion of Children with an Autism Spectrum Disorder

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