TIES Peer Engagement Practice Guides

Many students with significant cognitive disabilities are unable to use speech to meet their communication needs and would benefit from the use of augmentative and alternative communication (AAC). AAC broadly refers to any mode of communication other than speech and can include gestures, facial expressions, and signs. However, this guide is particularly focused on students who use aided AAC. Aided AAC refers to external tools such as picture symbols, communication books, and speech-generating devices. When students with disabilities have access to AAC, needed support, and opportunities to spend time and work with their peers, opportunities for friendship formation and belonging can increase substantially. In the absence of these things, students may remain isolated or on the peripheries of educational experiences.

Educators should work directly with students with disabilities to improve interactions with peers. However, focusing only on the student with a disability ignores other factors that play a role in successful peer interaction. Social interactions do not just involve the student with the disability. Instead, social interactions involve multiple children communicating within a particular environment. Therefore, involving  peers and making modifications to the environment can also support positive peer interactions for students with disabilities. Many successful approaches to supporting peer engagement for students who use AAC do the following: (a) teach the students who use AAC, (b) teach classmates and other peers, and (c) make changes to the environment (Therrien et al., 2016).

Students who use AAC need to learn and use valuable life-long skills related to communicating effectively with peers. Peer interaction for students using AAC requires knowledge and skill in the use of language (often called linguistic competence), the use of their AAC system (often called operational competence), interpersonal skills (often called social competence), and compensatory strategies to overcome challenges (often called strategic competence; Light & McNaughton, 2014). For example, suppose a peer asks, “What did you do this weekend?” In order to answer the question a student who uses AAC would have to: (a) recognize that the peer was speaking to them and expecting an answer to the question (social competence), (b) plan a message such as “I went to the zoo with my Grandma” (linguistic competence), and (c) navigate through screens on the AAC system to find each word and speak the message (operational competence). Finally, if the message is not understood, the student would need to adapt to the new conversation or rephrase their response so that peers understand the message (strategic competence).

Peers are also likely to need support interacting with students who use AAC. Peers may be nervous or unsure of how to engage in conversation with a classmate who uses AAC. They, too, may need to be taught effective communication skills. When thinking of ways to support peers in developing friendships with students who use AAC, educators should consider skills and strategies that promote equal status relationships. Instead of seeing peers as mini-teachers and teaching them how to help or teach classmates who use AAC, peers should be taught interaction skills that allow students to be included equally in social activities. Peers can learn to recognize and respond to the communication of students who use AAC, to increase the time they wait for students to communicate, to direct questions and comments to these students, and to use a form of AAC to supplement their own communication. Each of these ways of interacting shows that they value their classmates who use AAC and want to include them in conversations and activities. Although these skills may seem simple, peers often need support to use them effectively. For example, a student with a disability may communicate using unconventional body movements, such as an eye blink to say “yes.” Peers will then need to learn to understand this communication so that they can respond appropriately.

The environment also can be modified to support peer interaction. The environment should be accessible to students with physical disabilities who use wheelchairs, walkers, and other mobility support so they can join their peers in all activities. To support increased interaction among students, desks can be arranged into groups instead of rows. Activities that motivate and support children to work and play together should also be included as part of the school day. Access to AAC is also an important part of the environment. Students with disabilities who are unable to use speech to communicate must have access to appropriate AAC that enables them to communicate effectively with peers. These AAC supports should be readily available for students’ use across environments, across the day, and across peer groupings. They need to be accessible to not only the student who uses them to communicate, but also to peers who are supporting their communication.

Collaborating

Collaboration among educational team and family members is essential for planning and implementing support for students with significant cognitive disabilities. Students who use AAC have diverse profiles of strengths and challenges, which means that the team members who support them may vary according to those needs. This may include general and special educators, speech-language pathologists, occupational therapists, physical therapists, and paraprofessionals. One consideration for planning to support peer engagement is that these interactions often take place outside of the classroom. This means that teams should consider collaborating with other school personnel like lunch staff, recess monitors, or bus aides. For example, bus aides may know which peers would make good seatmates, lunch staff may have ideas for ways to rearrange seating arrangements to be more accessible, and recess monitors may have ideas for games or activities students might enjoy participating in with each other.  Supporting peer engagement will be most effective when it involves collaboration among all the adults (and family members) who know the students, the activities, and the environments well.

Planning

Observe Social Interaction Among Students

The first step to plan how to support peer interaction for students who use AAC is to observe students throughout the school day. This includes both the student who uses AAC and their peers. Depending on the structure of the day, many team members could play a role in observing. For example, some students may spend the majority of the day in one classroom, while other students may transition frequently. If paraprofessionals are providing support to students who use AAC, they may be ideally situated to observe the student in a variety of contexts. However, other team members (e.g., specialized instructional support personnel, special educators, general educators) may want to supplement the observations of paraprofessionals.

Team members should first identify times and activities when social interaction occurs for peers, but where the student who uses AAC is not yet fully included. Once these times and activities are identified, observers can use the peer interaction planning document (Figure 1) to: (a) identify the different roles students play within activities, (b) describe what full participation in each activity looks like, (c) keep a record of what types of words or phrases peers use to participate and communicate during each activity, (d) consider the challenges to full participation for the student who uses AAC, and (5e identify strengths the student could bring to the activity.

Click to download Peer Interaction Planning Document

Choose Specific Activities as Places to Start

It can be helpful to start by choosing one activity or time within the school day to begin more deliberately providing support for peer interaction. Educators can expand to other activities after identifying effective support within the first activity. Guided by information from the observations, the educational team should select an activity that provides opportunities for social interaction, is motivating, and facilitates engagement for both the student and their peers. The team should then discuss: (a) the environmental modifications required to support participation and interaction, (b) the skills the student who uses AAC needs to learn or improve to support participation and interaction, and (c) the skills the peers need to learn or improve to support participation and interaction. Finally, the team should discuss who will be responsible for providing the various supports. The peer interaction planning document can be used to guide and record decisions made during these discussions (see Figure 1).

Plan Changes to the Environment

After choosing a starting activity, the team should consider the changes required within the environment. Physical and occupational therapists can determine whether a space is accessible to the student who uses AAC. They may recommend changes such as rearranging furniture, providing adapted seating, or offering tools to support sensory processing (e.g., fidget toys). The team should consider the arrangement of students within the space and how the seating arrangement can either facilitate or act as a barrier to peer interaction. Materials needed for the activity must also be accessible. Addressing the accessibility of materials may require collaboration among professionals, including a vision or hearing specialist, general or special educator, or occupational therapist.

Finally, for students who use AAC, an additional environmental consideration is the AAC system itself. Aided AAC systems require the student with a disability’s attention, in addition to the activities which are being asked of their peers within the environment. To communicate, students must attend to the activity and materials, their peers, and their AAC system at the same time. This can pose a potential barrier that can be reduced by merging the AAC system with the activity or by making the AAC system more intuitive. For example, laminated symbols can be attached to learning materials with Velcro. This ensures students do not have to shift attention between engaging in the activity and communicating. There are also ways to make an AAC device more efficient and intuitive to use. This can include using pre-programmed phrases and making sure the symbols and organization of the AAC system are easily understood by the student, as well as their peers.

One AAC feature, visual scene displays (VSDs), has been used both to make systems more intuitive and to embed communication within activities.  Instead of arranging icons for vocabulary in rows and columns within a grid, VSDs include digital pictures or videos with embedded communication hot spots (see example in Figure 2). Research on the use of VSDs with students who use AAC has shown that the context provided by VSDs supports quick, efficient communication (Laubscher et al., 2020). This can be particularly useful in the context of peer interaction, where VSDs can  be used to embed communication within activities that involve students looking at images together. For example, VSDs can be used to increase social interaction among students with and without disabilities while reading storybooks (Therrien & Light, 2018) or while sharing videos related to common interests (Caron et al., 2018).

The top image is what children would see.  It is one page from a book about children seeing construction vehicles.  Children activate the communicative hot spot by pressing an object of interest. The bottom image shows what the programmer sees. The hot spots in this VSD might say (L-R): “You can’t go in! It’s not safe,” “Look at the big excavator <truck sound effect>,” and “They are watching.”

Plan Skills to Teach

In addition to creating an environment that supports interaction, educators should evaluate the strengths and challenges students with disabilities and their peers bring to the activity. What do they each contribute? What do they each need to learn to support effective interaction? Students who use AAC often require instruction in using their AAC system to communicate and in social interaction skills. For peers, it is helpful to share information about communicating with AAC and how to interact with someone who uses AAC (Therrien et al., 2016). For example, peers can be taught to model the use of AAC, to ask questions and provide choices, or to increase the time they wait after communicating to give their classmate time to respond. Instruction for students who use AAC and their peers can often happen simultaneously, with students working together to improve interaction skills. This gives educators the opportunity to use instructional strategies such as direct instruction, modeling, role play, guided practice, and constructive feedback to support both the student and their peers within the general education environment and activities.

Implementing

The planning document created by the team will drive the approach used to support peer interaction. The plan should also help team members distribute tasks and collaborate amongst multiple people. Implementing the plan effectively may require training educators and other school staff, selecting and modifying AAC systems, choosing and inviting peers to participate, and facilitating the prioritized activities.

Training Educators and Other School Staff

Paraprofessionals, when present, will take on some responsibility for facilitating peer interaction, but they often need support to do this well. Whether it is a paraprofessional or another school staff member who is supporting the student and peers, training and coaching may be required to ensure understanding of why a specific strategy is being used, how to use that strategy well, and to know what kind of support they can expect or request from the team. Training and coaching may be provided by general or special educators and specialized instructional support personnel (e.g., assistive technology specialists, speech-language pathologists). Training should include a description and demonstration of strategies used, along with time for practice with feedback. Coaching sessions can include observation, feedback, reflection, and joint problem solving. Approaching training and coaching collaboratively and strategically can increase the paraprofessional’s confidence and effectiveness in facilitating peer interaction.

Selecting or Modifying AAC Systems

If selecting or modifying AAC is a part of the plan, team members will need time to complete this step. Paper-based support can be created using specialized software. Personal images can also be used, or images that are available online. Selection of appropriate AAC for various uses will also depend on the particular student’s preferences (e.g., images of people they know, or peers that are part of the particular activity versus black and white line drawings). As discussed in the Planning section, one option to make it easier for students to balance the demands of both participating in an activity and communicating is to embed communication support within the activity. This may involve printing and laminating pictures to attach to  materials or programming communicative hot spots within VSDs.

It is also important to make the AAC system intuitive and easy to use during peer interaction. For students who do not already have a system, or who are not yet using one to communicate consistently, AAC evaluation should consider that student’s unique skills and needs in order to determine symbols, organization, and layouts that best support effective communication. A system that allows for the creation of VSDs can be considered to increase efficiency of communication. VSDs can be integrated within more traditional grid-based AAC systems, or used as a separate system.

No matter what AAC system a student uses or how it is organized, educators can implement AAC programming changes to support positive interaction with peers. As part of the observation step, members of the educational team should document words and phrases used by peers during social activities. These words and phrases can then be incorporated into the student’s AAC system. Another simple programming step is to give the student who uses AAC a way to say their peers’ names. If the school does not allow pictures of other students for privacy reasons, unique cartoon avatars could be created to represent classmates. The act of creating these avatars together could even be used as a fun activity that supports peer interaction.

Choosing and Inviting Peers

The educational team will need to make decisions about how many and which peers to include within the approach they are using to support peer interaction and engagement. It may be helpful to begin with a small number of peers at first, and then expand from there. Peers who have a history of positive interaction or who share a common interest with the student who uses AAC may be the first peers a team would want to engage. Focusing only on a small number of peers is a helpful way to start, but it can also end up limiting peer interactions to only the few peers who have been a part of AAC instruction. Therefore, planning from the beginning for how to expand the number of peers is important.

Facilitating Interaction

Educators who facilitate the activity and teach the interaction skills to the student and their peers should use evidence-based strategies for teaching. These are likely to include describing the interaction skill and the rationale behind it, modeling the skill, providing opportunities for students to practice the skill and receive feedback, proving prompting as needed, providing opportunities for independent practice, and looking for opportunities to generalize the skills to other contexts. As students become more proficient with the use of these interaction skills through guided and independent practice, adult support should be faded to encourage independent use. As in every step of planning and implementation, the unique characteristics of the students and school culture will drive the set-up of activities and the specific way the information is delivered to the student and peers. The goal is that over time the peers and the student with a disability will use the skills they are learning even in the absence of adult support.

Evaluating Outcomes

Although supporting students to interact and build relationships with peers is important, research in this area is still emerging. Educators should gather information about the effectiveness of their efforts to support peer interaction. The team can then use this information to make changes as needed to best support the student with disabilities and their peers.

For Students with Disabilities

Direct observation of students who use AAC with their peers will provide important information regarding changes in students’ communication and participation during activities with peers. Paraprofessionals are one way teams can collect data on students’ communication (e.g., initiations, responses, comments, questions, turn-taking, topic maintenance/relevance) and engagement with peers. When collecting data, paraprofessionals, in collaboration with other team members, can also determine whether additional vocabulary and phrases need to be added to the AAC system.

Students who use AAC can also contribute valuable information and should be asked questions about whether and how they  participate in the activities. It is important to provide students who use AAC with a way to effectively answer the questions. If students do not have the appropriate vocabulary built into their system or the skills to use that vocabulary to respond to these types of questions, educators can use visual rating scales (ranging from a happy face to a sad face), or other visual supports so that students can successfully share their opinions.

For Peers

Educators should also observe changes in how peers interact with the student. For example, if the team has decided to focus on peers initiating conversation and then providing wait time, a paraprofessional or other team member could document the frequency of peer initiations and appropriate use of extended wait time. Educators should also gauge peer enjoyment, frustrations, or ideas regarding the intervention activities. Peers who are able to use speech to answer should have an easier time responding to questions, but younger peers (K-2) may benefit from visuals like those described earlier in this guide. Finally, peers may be able to contribute valuable information to support even better interaction. For example, they may know words or phrases that would be good to add to the AAC system, or they may be able to think up ways to make the activity more interactive, engaging, and motivating.

For Others

Gathering data on the views of school staff and parents will also help with evaluating success. It may be helpful to meet with the team frequently to collect this data and discuss it together over time. When frequent meetings are difficult or impossible, web-based support such as an online survey or cloud-based documents may be helpful. The team should discuss: (a) the direct impact on the students who use AAC and their peers, (b) any generalization of social skills or related impacts on friendships at school or at home,  (c) the ease of implementing the strategies, and (d) ideas for improving or enhancing strategies being used. If the team feels things are working well, they will be more motivated to continue their efforts. Even when an approach is working, it is important to create systems of collaboration and communication that are reasonable to ensure the approach is continued over time and across settings and activities.

Sustaining and Expanding

Although this guide focuses on supporting individual students, supporting social interaction and relationship building for all students who use AAC can be a school- or district-wide focus. The culture of the school and school district should be considered when determining the best way to implement new programming to a greater degree.

In some districts or schools, a bottom-up approach that starts small and builds may be most appropriate. Schools can start by focusing on one student who uses AAC and that student’s educational team. Experiences of success should be shared both informally (e.g., when teachers chat with one another throughout the day) and formally (e.g., at IEP and faculty meetings). Sustaining and expanding is thus built upon the success of the early adopters of an approach—it begins in one classroom, then expands to two and three, and so on.

On the other hand, school districts or even individual schools that decide to make peer engagement a priority and are committed to making big changes quickly may take the opposite approach. This top-down approach has the potential advantage of incorporating training on supporting peer interaction and engagement into existing ways of providing professional development. An all-school or all-district training can kick-off the new initiative. This way, many educational teams can participate in group training and planning meetings together, brainstorming and coming up with strategies to support peer interaction and engagement. A hybrid approach is also possible. A school or district can begin with a single student or classroom, expand until a threshold of success is met, and then switch to school- or district-wide implementation. This approach may offer the best of both worlds.

Considerations

Across Ages and Grades

Social interaction and friendship look different at different ages. For early elementary students (K-2), friendships tend to be playing relationships. If students enjoy playing with each other, they typically consider each other to be friends. As students grow older, friendships become rooted in sharing thoughts and feelings, shared interests, and shared experiences. Considering the developmental appropriateness of different approaches to supporting social interaction and relationship building is important. This is also why planning starts with observation. Just as peer interactions change as students age, the activities and context that support peer interaction will also change. For example, younger students often enjoy the attention of adults. At the middle school level, however, the presence of adults can change the way students interact, and close proximity of an adult could impede friendship development. Age-appropriateness should be considered in every aspect of the planning, from choosing an activity to brainstorming what supports will be best for the student and peers.

Individualized Supports

Students who use AAC are a diverse group. Each individual student who uses AAC will have a unique profile of strengths and challenges, which precludes a one-size-fits-all approach to providing support for peer interaction. The planning and implementation steps suggested in this guide can be highly individualized and take this diversity into consideration. For example, some students who use AAC may have a need within the area of communicating through their behavior, especially so during interactions with peers. For students who are learning to more consistently  regulate their behavior or who have sensory processing needs, it is important to provide them with a way to communicate that they need a break, advocate for themselves, or want to leave an activity. If a student is consistently asking to leave an activity, then the planning process should start over from the beginning to identify if more effective support is necessary, focusing on the student’s interests, strengths, and challenges.

Cultural Responsiveness

Social interaction and expressions of friendship may vary in different geographic areas and within different cultural groups. When following the recommended planning and implementation steps, the student who uses AAC and their family members should always be included as active members of the educational team to ensure that AAC is inclusive of family input and consideration. This means they should be encouraged and supported to provide input on the goals, activities, strategies, and desired outcomes to ensure cultural appropriateness. Interactions among students should always be monitored to make sure students treat each other with respect, that is true with students who use AAC as well. An additional consideration for students using a speech-generating device as their form of AAC is to make sure that the voice selected matches the age, gender, and expressions of the home and school environments and culture of the students.

Case Application

Observation

Throughout the day, notice times and activities during which students engage in social interaction. Consider the following questions, in an effort to better understand opportunities for students who use AAC to play an active role with their peers.

Activity

Center time – book center

Who participates? What roles do students play?

2-3 students at a time.  No defined roles.

Description of participation (What are peers doing? How are students interacting with each other?)

Children are choosing picture books to look at.  When they’re doing this together, they negotiate a choice of book. Then they sit or lie down on the floor facing the same direction so they can both see the book. They turn the pages, sometimes quickly, and point to pictures when they’re interested.  Sometimes it seems like they’re “telling the story” – not really reading, but attempting to sound like they are.  Other times they are just commenting on the pictures.  Some questions are asked, but students don’t always answer each other’s questions.

Words or phrases peers use to participate and communicate

 Unspecific/General:

• Turn the page.
• Wait! Go back.
• Look!
• The end.
• No.
• Not that one.
• Let’s get a different book.
• What do you want?
• What’s that?
• Words for feelings (often talk about how characters are feeling)
• Color words (e.g., red, yellow)

Book-specific:

• He’s sleeping! (makes snoring noise; they laugh)
• There’s the bulldozer.
• Oh no! He’s stuck!

Challenges to participation for student who uses AAC

Benny takes longer to respond than his peers.

Benny’s speech is not understood by peers.

 Peers may not recognize Benny’s attempt at communication.

Strengths student who uses AAC brings to this activity

Benny loves to sit and read picture books with adults.

Benny already has some pre-literacy skills.

Benny can answer questions about pictures or stories by pointing (e.g. “What do you see?”)

Uses gesture indicating “no” (head shaking)

Benny can walk and navigate through the classroom independently.

Planning for Intervention

With your team, select a starting activity.  Great starting places are activities with high levels of social interaction and activities that are particularly motivating to the student who uses AAC. Then, consider what changes need to be made and who will be responsible for making those changes.

Activity: Center time – Book Center

Part 1. Changes to the Environment

A. What changes need to be made in the physical space or the arrangement of the physical space?

Change	Team members responsible	Date to be completed
Add a table and chairs (try different options – may need an adapted chair) to the reading area to provide physical support for Benny.	Classroom teacher & OT	Sept 26
Put iPad with book VSDs in book center on shelf.	SLP to give to teacher on Oct 2, teacher responsible for iPad	October 4
Make hard copy of books that are on the iPad available in the book center.	Classroom teacher & SLP to coordinate	October 4
Hang hard copy laminated visual showing “rules” for reading (also on the iPad) in the reading center.	Paraprofessional to hang	October 4

B. What changes need to be made to make materials for the activity accessible?

Change	Team members responsible	Date to be completed
Create a visual for the book center showing the “rules” for using the iPad.  Include images to facilitate understanding. Laminate for durability.	Paraprofessional	October 2

C. What changes need to be made to the student’s AAC system?

Change	Team members responsible	Date to be completed
Create book VSDs for one new book/week on class iPad.	SLP to create 4 books before intervention begins.	October 2
Program 1-4 vocabulary hotspots per book page.  Include the following: generic activity vocabulary (“Wait! Go back”, “Turn the page”); words/phrases to ask questions about the story or picture (e.g. “What is he doing?”); words/phrases to make comments about the story or picture (e.g. “I see a dog!” “His shoes are blue now!”); sound effects for animal sounds as this is a particular interest, and peers think it’s “cool”.	SLP to teach  programming steps to general and special educators.	October 16
Add another book every week.	Special educator to consult with the classroom teacher and add one new book per week to align with thematic units in the classroom.	Weekly starting October 23

Part 2. Teaching Skills to Students

For each skill your team decides to teach, document who needs to learn the skill, who’s teaching the skill, and how and when it will be taught.

Knowledge or skills to teach	Who is the learner?	Who will facilitate, how & in what context?	When & with what frequency?
Navigating to vocabulary to talk about books	Student who uses AAC Peer	Special educator to introduce the book VSDs and teach children social interaction and communication skills during circle time using the following instructional strategies: modeling the skill providing opportunities for practice during circle time wait time gestural prompts providing feedback Classroom teacher to step in during independent practice in the reading center to provide support as needed.	Starting Oct 4, special educator to push into class during circle time 2x/wk for 10 min
Initiating and responding by commenting or asking questions about the book	Student who uses AAC Peer
Recognizing and responding to Benny’s “no” gesture	Peer	Paraprofessional to observe Benny & peers in the reading center 2x/wk for 10 min to provide needed support and to collect data on communication, participation, & engagement.	Paraprofessional to collect data 2x/wk for 10 min
Giving enough time for Benny to respond without moving on	Peer	Team to meet to evaluate, modify, or expand as needed.	1x per month starting Nov 4