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Peer Mediated 
Instruction and Intervention 
(PMII) 
Presented by Heidi Cooley-Cook 
Kentucky Autism Training Center 
University of Louisville 


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Peer Mediated Instruction and Intervention 
What is it??? 

.Evidence Based Practice 
.Used to teach typically developing peers ways to interact with 
and help learners with ASD acquire new social skills by 
increasing social opportunities within natural environments 


 

http://autismpdc.fpg.unc.edu/content/peer-mediated-instruction-and-intervention 
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Peer Mediated Instruction and Intervention 
Why is it important? 

.Students with ASD 
.Social impairment and difficulty with social reciprocity 
.Respond less frequently to social initiations 
.Engage in shorter interactions 
.Struggle understanding social cues 
.Struggle to acquire key social skills by simply observing 
others 






(American Psychiatric Association, 1994; National Research Council, 2001) 

(Bass & Mullick, 2007; Lee, Odom, & Loftin, 2007; McConnell, 2002) 



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Peer Mediated Instruction and Intervention 
Who is it for? 

.Research supports use for ages 3 – 18 
.Targets social skills 
.Responding to others 
.Understanding others 
.Interacting with others or in groups 
.Reciprocity 




 


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Peer Mediated Instruction and Intervention 
How do you implement the strategy? 

.Step 1: Select peers 
.Step 2: Train and support peers 
.Step 3: Implement structured teaching session 
.Step 4: Implement in classroom and school settings 
.Step 5: Extending Initiations Across the Day 



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PMII Step 1: 
Select Peers 

.Peers should 
.Exhibit good social skills, language, and age-appropriate play skills 
.Be well-liked by peers 
.Have a positive social interaction history with focal student 
.Be generally compliant with adult directives 
.Attend to an interesting task or activity for 10 minutes 
.Be willing to participate 
.Attend school on a regular basis (Strain & Odom, 1986; Sasso et al., 1998) 




(Sperry, Neitzel, Engelhardt-Wells, 2010) 

PMII for Preschool and Early Elementary 


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PMII Step 1: 
Select Peers 

.Select 4 -5 peers 
.Peers valued for time and effort 


(Sperry, Neitzel, Engelhardt-Wells, 2010) 

PMII for Preschool and Early Elementary 


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PMII Step 2: 
Train and Support Peers 

.2A : Teach selected peers: 
.Recognize and appreciate individual differences 
.Overview of ASD 
.Include similarities and differences 
.Provide examples and observable behaviors 






(Sperry, Neitzel, Engelhardt-Wells, 2010) 

 

PMII for Preschool and Early Elementary 
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PMII Step 2: 
Train and Support Peers 

.2B : Introduce specific strategies to facilitate play and 
interaction: 
.Remember to keep appropriate for age and maturity level 
.Preschool and Lower Elementary– focus on teaching play 
behaviors 






(Sperry, Neitzel, Engelhardt-Wells, 2010; Kamps, et al, 1992; Thiemann, 2007; Thieman & 
Goldstein, 2001; Carter & Kennedy, 2006) 

 

PMII for Preschool and Early Elementary 
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PMII Step 2: 
Train and Support Peers -Example: 

.Teacher: “Sometimes when you play with your friends, they do not 
want to play back. You have to keep on trying. What do you have 
to do?” 
.Peer: “Keep on trying.” 
.Teacher: “ Yes, you keep on trying.” 
.Teacher demonstrates skill using another peer 
.Provide both examples (persistent attempts) and non-examples 
(walking away after first attempt) 


See AIM PMII - Sample Scripts for Peer Initiation 

PMII for Preschool and Early Elementary 


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PMII Step 3: 
Implement Structured Teaching Session 

1.Peers only – practice skills 
2.Peer and focal student – 5-8 minute play sessions 
.Teacher introduces activity, provides prompts to peer, and 
reinforces behavior 
.Visual supports can be added for student with ASD 
.At end of time can move to new environment or continue 
playing 




(Sperry, Neitzel, Engelhardt-Wells, 2010) 

PMII for Preschool and Early Elementary 


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PMII Step 4: 
Implement in Classroom and School Settings 

.For successful PMII – Remember: 
.Classroom arrangement 
.Material selection 
.Identification of responsible staff 
.Use of prompts and reinforcement 




 

(Sperry, Neitzel, Engelhardt-Wells, 2010) 

PMII for Preschool and Early Elementary 
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PMII Step 4: 
Implement in Classroom and School Settings 

.Use of prompts and reinforcement 
.Cue peer to use strategy 
.Explicit instructions – suggest a game or verbal 
instructions “Try talking to Jacob about trains” 
.Subtle verbal instructions – “Try again” “It’s your turn” 
.Gestures – peer to move closer to focal child 








IF NO RESPONSE IN 10 SECONDS – REPEAT PROMPT AGAIN 
AND PROVIDE PHYSICAL GUIDANCE 

 

(Sperry, Neitzel, Engelhardt-Wells, 2010; Goldstein, Schneider, & Thiemann, 2007; 
Ostrosky et al, 1990) 

PMII for Preschool and Early Elementary 
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PMII Step 5: 
Extending Initiations Across the Day 

.Embedded intervention 
.Pair focal student and trained peer during small group 
activity – provide limited materials to promote interaction 
.Pair students for transitions and/or classroom chores 
.Goal = 3 Peer Mediated interactions per day 


.Classwide peer buddy system 
.All students are paired up by teacher 
.Teachers prompt interactions as needed 






(Sperry, Neitzel, Engelhardt-Wells, 2010; Laushey & Heflin, 2000) 

PMII for Preschool and Early Elementary 


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FROM AIM: PEER MEDIATED INTERVENTION & INSTRUCTION 
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PMII Step 1: 
Select Peers 

.Peers should 
.Exhibit good social skills and language 
.Be well-liked by peers 
.Have a similar schedules as focal student 
.Be willing to participate 




AIM – Peer Mediated Intervention & Instruction 

PMII for Late Elementary - High School 


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PMII Step 1: 
Select Peers 

.Select 6 peers 
.1 or 2 peers in peer social network for 3-4 months 
.Additional peers added to promote generalization of skills 


(AIM – Peer Mediated Intervention & Instruction; Carter& Kennedy, 2006; Thiemann, 2007; 
Utley, Mortweet, & Greenwood, 1997) 

PMII for Late Elementary - High School 


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PMII Step 2: 
Train Peers 

.Develop Peer Network Interventions 
.Peers will be provided with 
.Goals for intervention and rationale for their involvement 
.Overview of expectations 
.Information about how students with ASD communicate, 
interact with their environment, and learn 
.Descriptions of focal student’s likes and dislikes 






AIM – Peer Mediated Intervention & Instruction; Carter& Kennedy, 2006) 

PMII for Late Elementary - High School 
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PMII Step 2: 
Train Peers 

.Describe basic strategies 
.Providing frequent, positive feedback 
.Modeling relevant communication skills 
.Facilitating interactions with other peers (Carter & Kennedy, 2006) 
.Peers record anecdotal information about interactions to share 
with staff 




AIM – Peer Mediated Instruction and Intervention 

PMII for Late Elementary - High School 
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PMII Step 3: 
Support Peers 

•Provide ongoing support and feedback to peers 
•Elementary – model the specific strategies (feedback, modeling 
relevant communication skills, facilitating interactions with other 
peers) 
•Middle & High School – peers are actively involved in weekly 
problem-solving meetings – may need to include other teachers if 
peer support interventions occur during their class periods 




AIM – Peer Mediated Instruction and Intervention 

PMII for Late Elementary - High School 


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PMII Step 4: 
Implement in Classroom and School Settings 

.For successful PMII – Remember: 
.Create supportive social environment 
.Provide classroom learning opportunities 
.Monitoring social interactions 
.Using prompts and reinforcement 




 

AIM – Peer Mediated Instruction and Intervention 

PMII for Late Elementary - High School 


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PMII Step 5: 
Extending Initiations Across the Day 

.Natural settings 
.At least 2 or 3 different routines each day 
.Contain a choice of 2 activities during each session 
.Use 5-8 games rotated every 3-4 months to promote 
generalization 
.Retain same group of 4-6 trained peers to promote 
friendships and connections 
.Social network activities should last at least 10 minutes 




(AIM – Peer Mediated Instruction & Intervention; Thiemann, 2007) 

PMII for Late Elementary - High School 
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From AIM – PMII– Sample Planning Form for 
Peer Social Network Activities 

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Additional information and videos: 

.Autism Internet Modules – 
Peer Mediated Instruction & 
Intervention 
.Step – by – Step 
Instructions – by age/grade 
level 
.Implementation Checklists 
.Activities 




 

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Resources: 

Autism Internet Module – Peer Mediated Intervention and Instruction 

NPDC – EBP Brief: http://autismpdc.fpg.unc.edu/content/peer-mediated-instruction-and-
intervention 

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental 
disorders (4th ed.). Washington, DC: Author. National Research Council, 2001 

Bass, J. D., & Mulick, J. A. (2007). Social play skill enhancement of children with autism using 
peers and siblings as therapists. Psychology in the Schools, 44(7), 727-735. 

Carter, E. W., & Kennedy, C. H. (2006). Promoting access to the general curriculum using peer 
support strategies. Research and Practice for Persons with Severe Disabilities, 31(4), 284-292. 


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Resources: 

Goldstein, H., Schneider, N., & Thiemann, K. (2007). Peer-mediated social communication 
intervention: When clinical expertise informs treatment development and evaluation. Topics 
in Language Disorders, 27(2), 182-199. 

Kamps, D. M., Leonard, B. R., Vernon, S., Dugan, E. P., Delquadri, J. C., Gershon, B., Wade, L., 
& Folk, L. (1992). Teaching social skills to students with autism to increase peer interactions in 
an integrated first-grade classroom. Journal of Applied Behavior Analysis, 25, 281-288. 

Laushey, K. M., Heflin, L. J. (2000). Enhancing social skills of kindergarten children with autism 
through the training of multiple peers as tutors. Journal of Autism and Developmental 
Disabilities, 30, 183-193. 

Lee, S., Odom, S. L., & Loftin, R. (2007). Social engagement with peers and stereotypic 
behavior of children with autism. Journal of Positive Behavior Intervention, 9, 67-79. 


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Resources: 

McConnell, S. R. (2002). Interventions to facilitate social interaction for young children with 
autism: Review of available research and recommendations for educational intervention and 
research. Journal of Autism and Developmental Disorders, 32(5), 351-372. 

National Research Council. (2001). Educating children with autism. Washington, DC: National 
Academy Press. 

Ostrosky, M., Chandler, L., Odom, S. L., McConnell, S. R., & Peterson, C. A. (1990). 
Comprehensive intervention manual. Vanderbilt-Minnesota Social Interaction Project, 
Minneapolis, MN: University of Minnesota. 

Sasso, G. M., Mundschenk, N. A., Melloy, K. J., & Casey, S. D. (1998). A comparison of the 
effects of organismic and setting variables on the social interaction behavior of children with 
developmental disabilities and autism. Focus on Autism and Other Developmental 
Disabilities, 13(1), 2-16. 


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Resources: 

Sperry, L., Neitzel, J., & Engelhardt-Wells, K. (2010). Peer-Mediated Instruction and 
Intervention Strategies for Students with Autism Spectrum Disorders. Preventing School 
Failure, 54(4), 256-264 

Strain, P.S., & Odom, S. L. (1986). Peer social initiations: effective intervention for social 
skills development of exceptional children. Exceptional Children, 52, 543-551. 

Thiemann, K. (2007). Effective instructional practices for teaching students with ASD in 
the classroom. Autism Spectrum Disorders-School Support Program, McMaster 
Children's Hospital, Ottawa, Ontario, Canada, July 9, 2007. 

 


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Resources: 

Theimann, K. S., & Goldstein, H. (2001). Social stories, written text cues, and video 
feedback: Effects on social communication of children with autism. Journal of Applied 
Behavior Analysis, 34, 425-446. 

Utley, C. A., Mortweet, S. L., & Greenwood, C. R. (1997). Peer-mediated instruction and 
interventions. Focus on Exceptional Children, 29, 1-23. 

 


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For additional information: 

Heidi Cooley-Cook 

Field Training Coordinator 

Kentucky Autism Training Center 

University of Louisville 

502-852-6401 

hacool01@louisville.edu 

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