PEERS® for Preschoolers is an evidence-based program developed at UCLA by Dr. Elizabeth Laugeson, Dr. Mina Park, and Dr. Jennifer Sanderson. It teaches friendship skills to autistic and neurodivergent children aged 4–6.
It is the preschool adaptation of the PEERS program, which is implemented in more than 150 countries worldwide. It redesigns the ecologically valid social skills instruction used in the adult and adolescent versions to meet the developmental needs of young children.
The program teaches children skills such as finding playgroups, meeting and greeting friends, sharing and taking turns, participating in playdates, being a good playmate, and understanding and sharing information about their own diagnosis.
One of the defining features of PEERS for Preschoolers is that the child sessions are delivered through puppet shows and childhood games, while parents are trained as social coaches throughout the process. In the “Parent-Coached Play” component, parents directly practise the skills with their children.
The program consists of concurrent 90-minute child and parent sessions held weekly over 16 weeks. Each week, a new social skill is taught, while the skills learned in the previous week are reviewed.
| Week | Child Session | Parent Session |
|---|---|---|
| 1 | Listening and Following Directions | Introduction and Program Preparation |
| 2 | Meeting and Greeting Friends | Finding Playgroups |
| 3 | Sharing and Taking Turns | Selecting Playgroups |
| 4 | Asking for a Turn | Preparing for Playgroups |
| 5 | Staying Calm | Planning Playdates |
| 6 | Being a Good Playmate | Suggesting a Playdate |
| 7 | Show and Tell During Play | Preparing for Playdates |
| 8 | Not Being Bossy | Coaching During Playdates |
| 9 | Inviting a Friend to Play | Social Coaching Strategies |
| 10 | Joining Ongoing Play | Advanced Coaching |
| 11 | Suggesting a Different Game | Teaching Flexibility |
| 12 | Asking for and Offering Help | Reciprocal Helping |
| 13 | Staying in Your Own Space (Body Boundaries) | Body Awareness |
| 14 | Using an Inner Voice (Appropriate Voice Tone) | Voice and Emotion Regulation |
| 15 | Sharing Your Diagnosis or Difference with Others | Preparing to Explain the Diagnosis |
| 16 | Sharing the Diagnosis with Your Child and Final Assessment | Graduation Ceremony |
Each weekly child group session includes the following components:
PEERS® for Preschoolers can also be delivered via telehealth in a parent-only format. This format consists of weekly 90-minute parent sessions, providing access for geographically distant families.
The program is designed for children aged 4–6 and their parents. It has demonstrated evidence-based effectiveness in the following groups:
More broadly: Any preschool child who struggles to initiate play with peers or has limited friendships can benefit from PEERS® for Preschoolers.
The recommended group size is 8–10 children. The child-to-adult ratio for the child group is one adult (therapist or behavioural coach) for every two to three children.
PEERS® for Preschoolers is one of the most comprehensive evidence-based programs developed to date for teaching friendship skills to autistic children in the preschool age group.
Numerous scientific studies have demonstrated that the program produces significant improvements in children across the following areas:
These findings have been independently replicated by multiple research teams (Antezana et al., 2022; Factor et al., 2021, 2022; Park et al., 2022; Tripathi et al., 2021, 2023).
Follow-up periods ranging from four weeks to five years have shown that social skill improvements are maintained in children who complete the program (Tripathi et al., 2022). An even more compelling finding:
This outcome is largely attributable to parents continuing to utilize their social coaching skills beyond the completion of the program.
Studies have shown that the program also produces significant positive effects on parents:
Parents who continued to use social coaching strategies, such as priming, 1–5 years post-program reported greater improvements in their child’s friendship skills and lower levels of parenting stress.
Studies have shown that the program is effective in both the traditional format (once weekly for 16 weeks) and an abbreviated format (twice weekly for 8 weeks). This underscores the program’s adaptability to diverse clinical and community needs.
Research indicates that comparable gains are achieved regardless of parental employment status, race, or ethnicity. This suggests that the structured lessons and coached practice help mitigate cultural and scheduling barriers.
Children who complete PEERS® for Preschoolers and their parents serving as social coaches develop the following skills:
PEERS® for Preschoolers places parents at the heart of the training. Parents:
Peer rejection and social neglect are associated with school refusal, academic underachievement, and parenting stress during childhood. In adolescence, they represent significant risk factors for depression, anxiety, loneliness, low self-esteem, and suicidal ideation.
Conversely, having one or two close friends serves as a powerful protective factor predicting later life adjustment and buffering the impact of stressful life events.
Teaching friendship skills at an early age represents the most robust and evidence-based pathway to establishing this protective foundation.
Key features that distinguish PEERS® for Preschoolers from other early intervention programs:
PEERS® for Preschoolers does not suggest there is a single “correct” way of social being. The foundational stance of the program is as follows:
The program recognizes that families are often forced to focus predominantly on their children’s “challenges.” For this reason, the first session of PEERS® for Preschoolers opens with a ceremony where parents share their child’s unique strengths.
All strategies taught throughout the training are presented through the framework of “socially helpful” versus “socially risky” behaviors. Deciding which strategy to use and when remains entirely at the discretion of the family and the child.
PEERS® for Preschoolers can be implemented by mental health professionals (psychologists, psychiatrists, social workers, family counselors), speech-language pathologists, occupational therapists, education professionals, and preschool teachers who have completed the certified training seminar.
An implementation team of 3–5 professionals is required, comprising one group leader and two to three behavioral coaches for the child group, along with one group leader for the parent group. All team members are expected to be thoroughly trained in the PEERS® for Preschoolers curriculum and proficient in behavioral reinforcement and behavior management strategies.
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