Autism & Developmental

Examination of the Effectiveness and Acceptability of a Play-Based Sibling Intervention for Children with Autism: A Single-Case Research Design

Glugatch et al. (2021) · Education & Treatment of Children 2021
★ The Verdict

A single BST session turns neurotypical siblings into effective play partners for their brother or sister with autism.

✓ Read this if BCBAs doing home-based early-intervention or social-skills groups.
✗ Skip if Clinicians who only see clients in center-based 1:1 rooms without family present.

01Research in Context

01

What this study did

Glugatch et al. (2021) taught neurotypical brothers and sisters how to play with their autistic sibling. The team used a short BST package: show the skill, practice, give feedback, then try again.

Each sibling pair practiced at home. Researchers watched on video and measured how much back-and-forth play happened. They ran the study across three families to be sure the change was real.

02

What they found

Every trained sibling learned the play steps quickly. Play that went both ways—sharing, taking turns, laughing together—jumped up right after training.

The new play levels stayed high weeks later, even when no adult reminded them. Siblings also used the skills with other kids, showing the learning spread.

03

How this fits with other research

Akers et al. (2018) first showed siblings can run script fading at home. Glugatch keeps the home setting but swaps script fading for BST plus a support group, giving siblings more choices of what to say and do.

Neff et al. (2017) used a two-minute video to teach prompting. Their gains were smaller and shakier. Adding live BST and a support group, as Glugatch did, looks like an upgrade.

Hutchins et al. (2020) ran the same BST plan with ADHD brothers and sisters and saw big social gains. The positive result now repeats with autism, showing the package travels across diagnoses.

04

Why it matters

You can train a sibling in one afternoon and see play double the same day. No clinic space, no extra staff, no tokens needed. If you already run parent BST, invite the siblings in for the last ten minutes. Show one play skill, let them practice with feedback, and send them home with a toy and a data sheet. You just gained extra therapists who live with the client.

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Pick one simple play skill, model it for the sibling, have them practice with praise and correction, then send them to play while you collect five minutes of data.

02At a glance

Intervention
behavioral skills training
Design
multiple baseline across participants
Sample size
6
Population
autism spectrum disorder, neurotypical
Finding
positive
Magnitude
large

03Original abstract

Complementary and reciprocal interactions are a defining feature of sibling relationships for young children. However, the social and communication difficulties of children with autism spectrum disorder (ASD) can make reciprocal play more difficult and play between siblings can be less rewarding. Sibling play can serve an important role in intervention and family cohesiveness, but there is no consistent method for involving siblings in intervention benefitting the sibling dyad. This study evaluated a novel treatment package including training siblings on play strategies to increase positive sibling play in combination with a sibling support group to offer social support for the neurotypical sibling (NT). The effects of the treatment package on NT sibling play and fidelity of implementation of naturalistic play strategies was examined using a concurrent multiple-baseline design across six dyads, five of whom completed the intervention. After behavior skills training, all NT siblings increased the number of strategies they used, and increased the frequency of initiations towards their sibling with ASD. In addition, the percentage of reciprocal play between siblings increased. Generalization probes and follow-up probes demonstrated above-baseline levels of performance across most dyads, indicating that the skills learned generalized across other toys and were maintained over time. Only three of the sibling support group sessions were completed due to the COVID-19 pandemic. Although the effectiveness of the sibling support group cannot be determined, social validity questionnaires suggest siblings and parents valued and liked the support group. The online version contains supplementary material available at 10.1007/s43494-021-00043-5.

Education & Treatment of Children, 2021 · doi:10.1007/s43494-021-00043-5