Background and aims Peer-mediated interventions (PMIs) are effective strategies to foster socialization of children with autism spectrum disorder (ASD) in natural settings. However, research examining the efficacy of peer mediation for students with ASD who have the greatest cognitive and language impairments remains limited. Additionally, previous studies essentially targeted communicative abilities of participants. To address this gap, the present study evaluated the effects of a play-based PMI on three socio-communicative skills (play, social engagement and imitation) of minimally verbal students with ASD who also have a comorbidity of intellectual disability (ID). Methods Seven children with ASD attending ordinary school settings and 14 typically developing (TD) preschoolers participated. Seven single-sex groups were formed, and children played together during two 30 min weekly sessions. TD children were trained according to the principles of the integrated play group model. We used a multiple-baseline design across participants to measure the effects of the intervention on play skills, social engagement and motor imitation of students with ASD. Results Outcomes revealed an intervention effect for most of the participants, despite some variations across children. After the peer training, four children increased their duration of functional/symbolic play, six children improved their duration of interactive play and five children increased their rates of motor imitation. Concerning maintenance gains, inter-individual differences are also important. Conclusions and implications These findings suggest that a play-based PMI may be a feasible option for targeting inclusive education and improving socio-communicative skills of some minimally verbal students with ASD who also have an ID. However, variations across children invite further research to clarify how individual factors can moderate the effects of PMIs in children with ASD who are the most impaired.

中文翻译：

---

游戏环境中对患有自闭症谱系障碍的言语最少的学生进行同伴调解。

背景和目标 同伴介导的干预措施（PMI）是促进自闭症谱系障碍（ASD）儿童在自然环境中社会化的有效策略。然而，关于同伴调解对于认知和语言障碍最严重的自闭症谱系障碍学生的有效性的研究仍然有限。此外，之前的研究主要针对参与者的沟通能力。为了解决这一差距，本研究评估了基于游戏的 PMI 对患有自闭症谱系障碍 (ASD) 且同时患有智力障碍 (ID) 合并症的语言能力极低的学生的三种社会沟通技能（游戏、社交参与和模仿）的影响。方法 7 名在普通学校就读的 ASD 儿童和 14 名典型发育 (TD) 学龄前儿童参与其中。七个单性别小组组成，孩子们在每周两次 30 分钟的课程中一起玩耍。TD 儿童根据综合游戏小组模型的原则进行训练。我们对参与者使用了多基线设计来衡量干预措施对患有自闭症谱系障碍的学生的游戏技能、社交参与和运动模仿的影响。结果 尽管儿童之间存在一些差异，但结果显示对大多数参与者都有干预效果。经过同伴训练后，四名儿童增加了功能/象征性游戏的持续时间，六名儿童增加了互动游戏的持续时间，五名儿童增加了运动模仿的比率。关于维持收益，个体之间的差异也很重要。结论和意义 这些研究结果表明，基于游戏的 PMI 可能是一种可行的选择，可用于实现全纳教育，并提高一些语言能力极差、同时也有 ID 的自闭症谱系障碍 (ASD) 学生的社交沟通技能。然而，儿童之间的差异需要进一步的研究来阐明个体因素如何调节 PMI 对受损最严重的 ASD 儿童的影响。