Understanding friendships and promoting friendship development through peer mentoring for individuals with and without intellectual and developmental disabilities

CHAPTER ONE

Understanding friendships and promoting friendship development through peer mentoring for individuals with and without intellectual and developmental disabilities Lindsay S. Athamanahb, *, Cynde K. Josola, Danielle Ayeha, Marisa H. Fishera and Connie Sunga a

Michigan State University, East Lansing, MI, United States University of Missouri-St. Louis, St. Louis, MO, United States *Corresponding author: E-mail: [email protected] b

Contents 1. Introduction 1.1 Interpersonal barriers 1.2 Societal barriers 1.3 Approaches to improve outcomes 2. The nature of friendships for individuals with IDD 2.1 Defining friendship 2.2 Friendship characteristics 2.3 Friendship quality 2.4 Reciprocity of friendship 2.5 Friendship satisfaction 2.6 Friendships between youth with and without IDD 3. The nature of peer mentoring between individuals with and without IDD 3.1 Defining peer mentoring 3.2 Setting 3.2.1 3.2.2 3.2.3 3.2.4

Elementary school settings Secondary school settings Postsecondary education settings Country

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3.3 Disability 3.4 Outcomes 4. Theoretical framework 4.1 Self-Determination Theory International Review of Research in Developmental Disabilities, Volume 57 ISSN 2211-6095 https://doi.org/10.1016/bs.irrdd.2019.06.009

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4.2 Ecological Systems Theory 5. Future directions 5.1 The development of friendships between individuals with and without IDD 5.2 Social skills that encourage friendship development 5.3 The impact of peer mentoring programs on friendship 6. Conclusion References

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Abstract Friendships for individuals with intellectual and developmental disabilities (IDDs) provide enhanced community participation and improved quality of life. However, friendships between individuals with and without IDD continue to be scarce with limited opportunities for interaction. In this chapter, we discuss friendship development for individuals with IDD including friendship definitions, characteristics, quality, reciprocity, and satisfaction as well as interpersonal and societal barriers to friendships between individuals with and without IDD. Next, we describe how peer mentoring programs across ages, disability, and settings promote social interactions between individuals with and without IDD and provide opportunities to develop life-long friendships. Then, we propose merging two theories, the Self-Determination Theory (Ryan & Deci, 2000) and the Ecological Systems Theory (Bronfenbrenner, 1976), to use as a guide in creating peer mentoring programs that will support and build the intrinsic motivation and self-determination of individuals without IDD to have the confidence to engage with individuals with IDD. These theories also guide examination of the impact of peer mentoring programs on participants, communities, and society. Finally, we end this chapter with three critical areas for research in friendship development and peer mentoring programs to improve friendship outcomes for individuals with IDD.

1. Introduction For all individuals, friendships are considered one of the most important of all social relationships, enhancing psychological well-being, physical health, and quality of life (Bukowski, Newcomb, & Hartup, 1996; Hefner & Eisenberg, 2009; Lunsky & Benson, 2001; Wilkinson & Marmot, 2003). For individuals with intellectual and developmental disabilities (IDDs), friendships can lead to increased community engagement and participation (Lafferty, McConkey, & Taggart, 2013; Petrina, Carter, & Stephenson, 2014), as well as an increased sense of belonging, stronger self-worth, and lowered stress (Fulford & Cobigo, 2018; Petrina et al., 2014; Ward, Atkinson, Smith, & Windsor, 2013).

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Promoting social inclusion and community integration for individuals with IDD is a global priority. For example, the United Nations Convention on the Rights of Persons with Disabilities (2006) includes explicit statements related to the societal rights of individuals with disabilities. These include the right to full community inclusion (article 19), intimate relationships (article 23), marriage (article 23), the importance of freedom of choice (article 3), and facilitating peer support (article 24; Fulford & Cobigo, 2018). Within the United States, the Individuals with Disabilities Education Act (IDEA, 2004) mandates that youth with disabilities have access to the least restrictive environment, including participation in classrooms with typically developing peers. Finally, the Americans with Disabilities Act (ADA) protects the civil rights of individuals with disabilities, affording them protection from discrimination and guaranteeing them equal opportunity to participate in employment and community settings (ADA, 2008). Despite efforts to increase and promote inclusion and community participation for individuals with IDD, physical integration alone does not necessarily encourage social inclusion, acceptance, or the development of friendships (Hughes, Carter, Hughes, Bradford, & Copeland, 2002; Rossetti, Lehr, Lederer, Pelerin, & Huang, 2015). True friendships for individuals with IDD are often difficult to build and maintain (Carter, Asmus, & Moss, 2013), leading to high levels of loneliness (Bauminger & Kasari, 2000; Bhaumik, Tyrer, McGrother, & Ganghadaran, 2008), reduced emotional support and feelings of rejection (Meyer & Ostrosky, 2014), and social isolation (Fulford & Cobigo, 2018; Petrina, Carter, Stephenson, & Sweller, 2016; Petrina et al., 2014). Further, difficulties developing and maintaining friendships are associated with interpersonal barriers (e.g., social skills deficits, behavioral challenges) and societal barriers (e.g., poor attitudes toward IDD, limited opportunities). These difficulties highlight the importance of a multi-faceted approach toward improving social outcomes and friendships for individuals with IDD. In this chapter, we provide an overview of what we know about the friendships of individuals with IDD and describe how peer mentoring programs can support the development and maintenance of friendships between individuals with and without IDD. Because friendships and peer mentoring programs can take place throughout the lifespan, we explore the literature of across ages and settings. We begin by describing the attitudinal and societal barriers that impact social inclusion. Next, we describe what is known related to the nature of friendships for individuals with IDD. Then, we provide an overview of peer mentoring programs and discuss how these

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programs may be a catalyst to enhancing friendships between individuals with and without IDD. We then describe a theoretical framework to help understand how peer mentoring programs may influence participants, friendships, communities, and societal issues as a whole. This framework can be used to examine the effects of different systems interacting within two important constructs (i.e., friendship, peer mentoring). Finally, three specific research paths are identified to focus the future direction of research on friendships and peer mentoring for individuals with and without IDD.

1.1 Interpersonal barriers Social skills are the ability to effectively communicate and socially interact with people in educational, vocational, and community settings (Hughes et al., 2012). Social skills are critical throughout the lifespan and may differentially impact outcomes for individuals with IDD. Individuals with IDD exhibit a wide range of strengths and challenges relative to social skills (Lyons, Huber, Carter, Chen, & Asmus, 2016), with most having substantial difficulties learning, applying, and generalizing social skills (Carter & Hughes, 2005). For example, delays in the development of social communication skills are a core feature of autism spectrum disorder (ASD, American Psychiatric Association, 2013) and may lead to challenges sustaining social interactions with peers (Volkmar, Carter, Grossman, & Klin, 1997) and initiating social bids (Hauck, Fein, Waterhouse, & Feinstein, 1995). Individuals with Williams syndrome (a genetic condition resulting in mild to moderate intellectual disability [ID]) also experience social skills deficits with a juxtaposition in their extreme desire to approach and befriend individuals and their decreased social cognition and conversational skills (Thurman & Fisher, 2015). The poor social skills of individuals with Williams syndrome lead to difficulties navigating social relationships (Fisher & Morin, 2017). For both disorders, social skills deficits are also related to difficulties in peer relationships (Mervis & Klein-Tasman, 2000; Sterrett, Shire, & Kasari, 2016). For those with social skills deficits – including difficulties applying the skills with others in the community – social skills often must be explicitly taught and rehearsed in the natural environment. Given the link between social difficulties and poor social outcomes across the lifespan, social skills training programs to improve social success have been developed for individuals at all stages of development and intellectual functioning (e.g., Refs. Bellini, Peters, Benner, & Hopf, 2007; Gresham, Sugai, & Horner, 2001). For instance, several manualized interventions, such as the Program for the Education and Enrichment of Relational Skills (PEERS; Gantman,

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Kapp, Orenski, & Laugeson, 2012; Laugeson, Frankel, Gantman, Dillon, & Mogil, 2012), and Aspirations (Hillier, Fish, Siegel, & Beversdorf, 2011), focus on the development of conversational skills and friendships. Social skills training programs often involve direct training approaches, in which social skills are directly taught to the individual in either group settings or one-on-one. Social skills training addresses an individual’s inability to understand and incorporate the social nuances that are often experienced in inclusive settings, such as general education classrooms and the workplace (Agran, Hughes, Thoma, & Scott, 2016). Unfortunately, despite movement toward increased school and community participation for individuals with IDD, opportunities are still limited for practicing social skills and interactions with individuals without disabilities (Carter & Hughes, 2005; Hughes et al., 2012). Another interpersonal barrier involves behavioral challenges. Challenging behaviors are described as verbal and nonverbal behaviors that disrupt and interfere with social interactions of some individuals with IDD. These can include repetitive or stereotyped behaviors (e.g., hand flapping, repeating irrelevant words and phrases), oppositional or destructive behaviors, and aggressive or self-injurious behaviors (Walton & Ingersoll, 2013). Often, individuals with IDD who demonstrate these behaviors have serious social difficulties (Lee, Odom, & Loftin, 2007; Walton & Ingersoll, 2013). Furthermore, adults with comprehensive behavioral support needs are found to be less likely to have an intimate relationship (defined as a friendship or romantic relationships; Friedman, 2019). While many interventions address challenging behaviors in individuals with IDD (Campbell, 2003), few have specifically focused on improving social skills and interactions for individuals with these complex behavior challenges (Walton & Ingersoll, 2013) and/or supporting the development of friendships.

1.2 Societal barriers In addition to the interpersonal barriers that impede friendship development, individuals with IDD also face societal barriers, including lack of opportunities for community engagement and poor attitudes toward individuals with IDD. Although individuals with IDD are increasingly participating in community-based settings, they still experience fewer opportunities to meet and interact with individuals without disabilities (Hall, 2017). During the school years, only about 7% of individuals with IDD spend at least 40% of the school day in the general education classroom. Most

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students with IDD (70.7%) spend the majority of the school day in segregated settings with only minimal inclusion in specials (e.g., art, music; Kleinert et al., 2015). In fact, in a survey of almost 6000 middle school students without disabilities, only 40% reported having had a student with ID in their classroom in the past and only 10% currently had a student in their classroom (Siperstein, Parker, Bardon, & Widaman, 2007). Even when students are included in general education settings, they often are accompanied by a one-on-one paraprofessional, which increases stigma and limits opportunities for social interaction (Carter, 2017; Carter, Biggs, & Blustein, 2016). For example, middle and high school peers in general education classrooms are more reluctant to initiate interactions or have social conversations in the presence of a paraprofessional (Carter, Sisco, Brown, Brickham, & Al-Khabbaz, 2008). Finally, as they age, individuals with IDD continue to have fewer opportunities to meet people and develop friendships (Kef, Hox, & Habekothe, 2000; Pottie & Sumarah, 2004). For example, compared to those without disabilities, individuals with IDD are less often employed (Kraus, Lauer, Coleman, & Houtenville, 2018; Roux, Shattuck, Rast, & Anderson, 2017). Un- or underemployment limits opportunities to interact with others. Individuals with IDD also report that problems with transportation access and lack of funds prevents them from socializing with friends (Friedman & Rizzolo, 2016; Welsby & Horsfall, 2011). These barriers to community participation lead to decreased opportunities to meet new people and develop authentic friendships. Also making it difficult to develop and maintain friendships are attitudinal barriers (Friedman, 2019). For example, Siperstein et al. (2007) found that individuals without disabilities did not think those with ID should be included in academic-related general education classrooms. Further, they reported that while students are willing to interact with individuals with ID at school, they are less willing to interact with a student with ID outside of school or through social functions (e.g., going to the movies, inviting to their house). Parents report negative attitudes of community members toward their child with a disability as one of the biggest barriers to participation in school and/or the community (Anaby et al., 2013; Gray, 2002; Howell & Pierson, 2010). Attitudes of support staff and family members impact the ability of older individuals with IDD to form friendships and social relationships, as they often rely on these supports to facilitate social inclusion and to help with expanding their social networks (Asselt-Goverts, Embregts, & Hendriks, 2015; Friedman, 2019). Friedman (2019) also found that

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individuals with more severe disabilities were less likely to have intimate relationships; the authors attribute this difficulty to historical attitudes and stereotypes that denied individuals with IDD many human rights.

1.3 Approaches to improve outcomes Peer mentoring programs could improve interactions, shape attitudes, and remove barriers for community participation while supporting the development of friendships between those with and without IDD in authentic settings. Peer mentoring programs may also provide individuals with IDD opportunities to learn and practice social interactions with same-aged peers in a comfortable setting, leading to improved social skills, independence, and friendships (Ames, McMorris, Alli, & Bebko, 2016; Carter et al., 2013; Moore & Schelling, 2015). At the same time, peer mentoring programs may also help encourage social engagement, build social competence, and improve attitudes of individuals without disabilities, leading to prosocial behaviors toward individuals with IDD (Chan et al., 2009; Copeland et al., 2004) and authentic friendships (Farley, Gibbons, & Cihak, 2014; Terrion & Leonard, 2007).

2. The nature of friendships for individuals with IDD Throughout the lifespan, friendships for individuals with IDD differ from those of individuals without disabilities and outcomes are often less optimal. For example, although the majority of children and adolescents with IDD report having at least one friend (Daniel & Billingsley, 2010; Kuo, Orsmond, Cohn, & Coster, 2011; Mendelson, Gates, & Lerner, 2016), they still have fewer friends than those without disabilities. In fact, individuals with IDD have an average of only 3.1 people in their social network (Verdonschot, DeWitte, Reichrath, Buntinx, & Curfset, 2009) compared to nearly 125 people in the social networks of those without disabilities (Hill & Dunbar, 2003). Similarly, children and adolescents with ASD report fewer friendships than those without disabilities (Bauminger & Shulman, 2003; Rowley et al., 2012), have fewer reciprocal friendships, and tend to have friendships based on activities rather than shared emotions (Petrina et al., 2014). Compared to children without disabilities, those with IDD also have lower frequency of contact with their friends outside of school (Bauminger & Shulman, 2003; Tipton, Christensen, & Blacher, 2013). Findings from the National Longitudinal Transition Study-2 indicate that 16.4% of individuals

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with ID and 44.3% with ASD never visit with friends outside of their class, and 24.8% of individuals with ID and 50.6% of individuals with ASD are rarely invited to social activities (Wagner, Cadwallader, & Marder, 2003). This lack of relationships can lead to a limited social network composed solely of other disability service users, paid staff, and family members (Bigby & Knox, 2009). At the same time, individuals with IDD want to have friends and to be involved in social relationships (Bauminger & Kasari, 2000; Fulford & Cobigo, 2018) as they value friendships and enjoy spending time with friends (Friedman, 2019; Fulford & Cobigo, 2018). In fact, individuals with IDD report more feelings of loneliness than individuals without IDD, and these feelings increase with age (Bauminger & Kasari, 2000; Bauminger, Shulman, & Agam, 2004; Chamberlain, Kasari, & RotheramFuller, 2007). Thus, it seems that friendship difficulties more often stem from lack of skills (e.g., social skills, functional play, understanding others’ perspectives), rather than lack of a social desire (Sterrett et al., 2017). In light of these poor friendship outcomes, it is imperative that we address the friendship difficulties experienced by individuals with IDD and work to improve their social outcomes. To better understand and develop interventions to improve friendship outcomes for individuals with IDD, it is important to examine what is currently known about their friendships. We examined the literature to understand how friendships are defined for individuals with IDD, what friendship characteristics are most often described, whether friendships are reciprocal, and whether individuals with IDD are satisfied with their friendship outcomes. Because the majority of the literature has been conducted to examine friendships of individuals with ASD, we present findings specific to ASD and, when possible, highlight findings related to IDD more broadly.

2.1 Defining friendship Friendship is defined in a multitude of ways. Some define a friendship as a meaningful relationship, or bond, between individuals that is reciprocal, stable across time, and develops spontaneously through common interests, mutual benefits, and having fun together (Bukowski et al., 1996; Howes, 1983; Rossetti et al., 2015). Others highlight the importance of close, intimate, and affective ties between two individuals, the stability (at least six months or more) of the social interactions, and the individuals’ companionship capabilities (Bauminger, Solomon, Aviezer, Heung, Gazit et al., 2008). Definitions of friendship continuously evolve across the developmental

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lifespan, varying depending on age (Gilfford-Smith & Brownell, 2003). For example, friendships for young children are often defined as companionship or a mutual interest in playing together (Buysse, 1993; Dietrich, 2005; Petrina et al., 2014), whereas friendships for adolescents and adults are often formed and defined by shared interests, loyalty, and values (Carter, 2017). Given the various definitions of friendships, it has been difficult for researchers to determine the extent of friendships experienced by individuals with IDD. Thus, in order to study friendships in individuals with ASD, Bauminger and colleagues attempted to address inconsistencies or confusion in the literature by creating a more unified definition of friendship. Bauminger et al. (2008) defined friendship as “stable, frequent, and interconnected affective interactions that are manifested by certain classes of behavioral markers (e.g., sharing, play and conversational skills) that facilitate the functions of companionship, intimacy, and closeness” (Bauminger, Solomon, Aviezer, Heung, Gazit et al., 2008, p. 136). They also indicated that operational definitions of friendships must include a defined period of time (e.g., at least six months) and activities that occur out of school or structured settings (Bauminger, Solomon, Aviezer, Heung, Brown et al., 2008; Bauminger, Solomon, Aviezer, Heung, Gazit et al., 2008). Despite this uniform definition, it is critical to consider how individuals with and without IDD define friendship, as their definitions may not align with each other or with definitions identified in the literature. For example, compared to their typically developing peers, fewer individuals with ASD mentioned affection, intimacy, or companionship in their definition of friendship (Bauminger & Kasari, 2000); yet, individuals with ASD aligned with other parts of the conventional definition of friendship by including mutual benefits for both parties and pursuit of similar interests in their definition (Daniel & Billingsley, 2010; Howard, Cohn, & Orsmond, 2006; Rossetti, 2011). Similarly, a recent synthesis of the literature on friendships reported that individuals with IDD described friends as people who support them, are trustworthy, and who share similar interests (Fulford & Cobigo, 2018). Finally, the individual’s knowledge of what friendship is and what constitutes a good friendship does not necessarily mean it will translate into the specific behavioral manifestations described by Bauminger et al. (2008). Although individuals with ASD may know what makes a good friend, they may fail to display such qualities in their own friendships (Calder, Hill, & Pellicano, 2013; Locke, Ishijima, Kasari, & London, 2010), as such application requires complex social skills necessary for effective social

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interactions (Petrina et al., 2014). Given the inconsistencies in definitions of friendships and in an individual’s knowledge of what constitutes a friend, it is not enough to simply ask whether individuals with IDD have friends. It is more important to examine the characteristics of friendships of individuals with IDD that have been described in the literature and to determine whether these are similar or different from the friendships of those without disabilities.

2.2 Friendship characteristics There are both similarities and differences in friendships characteristics between individuals with and without IDD. Like those without disabilities, children and adolescents with IDD (ASD and other disabilities) prefer friends that are the same age and gender (Bauminger & Shulman, 2003; Buysse, 1993; Guralnick, Connor, & Hammond, 1995). Both children with and without ASD often engage in activities with their friends that involve minimal interaction, such as playing video or board games and watching television (Bauminger & Kasari, 2000; Bauminger & Shulman, 2003; Kuo et al., 2011). Individuals with ID look for friends who not only want to engage in similar leisure activities, but who can also provide practical assistance or emotional support through interpersonal communication (Bane et al., 2012; McVilly, Stancliffe, Parmenter & Burton-Smith, 2006). Despite the similarities, differences in friendships have also been reported. Compared to those without disabilities, mothers of children with ASD play an important role in fostering the development of friendships for their children. Mothers of children with ASD report that rather than their child developing friendships spontaneously, they are often more intimately involved in helping their child to identify appropriate friends and to arrange get-togethers (Bauminger & Shulman, 2003; Howard et al., 2006). Similarly, individuals with IDD report they need support from families and caregivers to help them keep their friendships (Bane et al., 2012) and that the initial step of reaching out of their comfort zone to make a friend is sometimes difficult (Daniel & Billingsley, 2010; O’Hagan & Hebron, 2017). Friendship characteristics may also vary across disability categories. For example, the literature suggests that compared to other disability groups, children with ASD report the lowest number of friendships (Rowley et al., 2012; Solish, Perry, & Minnes, 2010). These differences may be because of the social communication deficits displayed by individuals with ASD. For example, in semi-structured interviews coded for thematic

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patterns with 10 parents of school-age children with ASD, challenges in social communication such as conversation and play, turn taking, and following social norms were reported to affect the ability to initiate and maintain friendships for children with ASD (Daughrity, 2019).

2.3 Friendship quality Compared to those without IDD, the friendships of individuals with IDD can differ in quantity and quality. Although friendships for children with disabilities can include many of the same qualities – including positive affection, enjoyment, laughing, and sharing with one another (Buysse, 1993; Hollingsworth & Buysse, 2009) – stark differences in friendship quality have also been reported. In a meta-analysis of 18 descriptive research studies with 1768 participants, Mendelson et al. (2016) found that compared to school-aged boys without disabilities, those with ASD reported poorerquality friendships, with lower feelings of companionship, help, security, and closeness. Friendship quality may also worsen with age as younger children with ASD report a better friendship quality than older participants (Bauminger, Solomon, Aviezer, Heung, Gazit, et al., 2008). Specifically, levels of companionship and help are negatively correlated with age while conflict is positively correlated and increased with age. Certain factors may contribute to the poorer quality of friendships experienced by individuals with ASD. For example, when compared to individuals without disabilities, more affectionate and helping behaviors that can contribute to the formation of friendships (Buysse, 1993; Hollingsworth & Buysse, 2009) are less often observed in children with ASD (Petrina et al., 2014). In addition, individuals with ASD may not recognize they are standing at the periphery of social relationships and watching the behaviors but not actively socializing with others. Further, severity of impairment or type of disability may play a role in the quality of friendship. When compared to those without disabilities and with other disabilities, children and adolescents with ASD report their friendships being of lower quality (Petrina et al., 2014; Rowley et al., 2012). This lower quality may in part be explained by the deficits in social communication and interaction, including deficits in theory of mind and executive functioning, that is characteristic of ASD and which can negatively impact the formation and quality of friendships (Petrina et al., 2014). While an extensive literature exists on friendships of individuals with ASD, little is known about the quality of friendships for specific groups of IDD and within IDD groups. In addition, the majority of studies examining

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friendships in children and adolescents with ASD have only included individuals who do not have a co-occurring intellectual disability (Petrina et al., 2014). This is only a small subsample of the population and leaves unanswered questions regarding the friendship characteristics of children with ASD who are more severely affected and other IDD groups.

2.4 Reciprocity of friendship Similar to friendship quality, there is also a lack of research on the reciprocal nature of friendships for individuals with IDD (Petrina et al., 2014). What is known indicates that friendship reciprocity is important to individuals with IDD but is poorer for individuals with disabilities when compared to those without disabilities. Adults with IDD view reciprocity as an important component to being a friend that reinforces the friendship. For example, in a study aimed to understand the friendship experiences of individuals with IDD, adults with ID expressed the importance of reciprocity in terms of giving help (i.e., they help their friends just as much as their friends help them) and sharing jokes (i.e., the jokes are acceptable for both parties and reinforced the friendship as a result) (Callus, 2017). Despite the importance of reciprocity, children and adolescents with ASD have less friendship reciprocity, meaning that children with ASD are less likely to have a friendship nomination be reciprocated by a friend they nominated (Calder et al., 2013; Kasari, Locke, Gulsrud, & Rotheram-Fuller, 2011). Additionally, reciprocation seems to get worse with age with lower levels of best friendships reciprocated for older individuals with ASD (Rotheram-Fuller, Kasari, Chamberlain, & Locke, 2010). That is, friendship reciprocity in young children with ASD is comparable to typically developing children but significantly decreases as the children grow older. This lack of awareness and reciprocity in friendships may then lead to poorer friendship quality compared to those without disabilities (Bauminger, Solomon, & Rogers, 2010).

2.5 Friendship satisfaction Attention should also be paid to how friendships fulfill the needs and expectations of individuals with IDD. Regardless of the quality or quantity, individuals with IDD still report satisfaction with their friendships. For example, despite the fewer number of friendships, interviews with children with ASD indicated high levels of friendship satisfaction (Calder et al., 2013). In another study using self-report questionnaires with 77 children with ASD and their friends from 49 nominated friendships, relatively high levels of

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friendship satisfaction are reported by the children with ASD and their nominated friends with no significant difference between friendship dyads (Petrina et al., 2016). Similar to other variables, however, friendship satisfaction changes as individuals with IDD grow older. In a study using interviews, outside reports, and direct observations of 1341 adults with IDD, only 56% of participants reported satisfaction with the number of friends they had and even less (46%) were satisfied with the amount of contact with their friends (Friedman & Rizzolo, 2018). Unfortunately, the mechanisms underlying friendship satisfaction for individuals with IDD are still largely understudied (Petrina et al., 2016).

2.6 Friendships between youth with and without IDD The literature reviewed thus far indicates that individuals with IDD have fewer friendships than those without IDD and their friendships are often lower quality and less reciprocal than the friendships described between friends who do not have IDD. When examining friendships between individuals with and without IDD, there is evidence to indicate these friendships occur infrequently (Tipton et al., 2013; Webster & Carter, 2007). The interactions between individuals with and without IDD tend to be low in quality and not reciprocal or mutual in nature (Carter et al., 2008; Kuo et al., 2011; Rotheram-Fuller et al., 2010), relying on shared interests and activities (Fulford & Cobigo, 2018; Howard et al., 2006; Rossetti, 2011) rather than companionship and intimacy (Bauminger & Kasari, 2000). Despite their less frequent occurrence, evidence does indicate that friendships between individuals with and without IDD do occur. When individuals with and without IDD form friendships, the role of each person may be important in facilitating and maintaining the relationship. For children with and without disabilities, the importance of roles in their friendship may develop over time, with roles changing from being a mentor/tutor and mentee to having more flexibility where the balance of power is more equal (Griffin, Mello, Glover, Carter, & Hodapp, 2016a; Griffin, Wendel, Day, & McMillan, 2016b; Richardson & Schwartz, 1998). The benefits of friendships between individuals with and without IDD can be observed across age groups. For children with ASD, friendships with typically developing peers can significantly impact responsivity, receptive language, and complex coordinated play (Bauminger et al., 2008) and improve social acceptance from other peers (Copeland et al., 2004; Owen-DeSchryver, Carr, Cale, & Blakeley-Smith, 2008). In addition, having at least one high-quality friendship with a typically-developing peer is

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related to feeling less lonely and depressed for adolescents with ASD (Whitehouse, Durkin, Jaquet, & Ziatas, 2009). The same benefits have also been observed between adults with and without IDD, extending to reports of decreased anxiety and increased well-being (Mazurek, 2014). Given the benefits of friendships between individuals with and without IDD, it is important to implement programs that promote and foster these friendships throughout the lifespan.

3. The nature of peer mentoring between individuals with and without IDD Peer mentoring programs may be one path to fostering relationships and developing friendships between individuals with and without IDD. Typically, peer mentoring programs are designed to help individuals with IDD build skills for academics and their careers. Beyond partnering individuals without disabilities as mentors for individuals with IDD, peer mentoring programs often incorporate additional social and communication skill trainings (e.g., interpersonal skills, social cognitive skills, and social perspectivetaking) for the individual with IDD that are useful for academic, career, and friendship development (Patterson & Smith, 2010). Thus, as individuals with IDD spend time with their peers without IDD and they learn important social and communication skills (Murphy & Quesal, 2002; Sidorowicz & Hair, 2009), meaningful friendships may develop. Peer mentoring programs have been developed and implemented in a variety of settings to help support individuals with IDD. Table 1 provides a summary regarding the characteristics of various peer mentoring programs found in the literature. Most programs have been developed within the United States and for individuals with ASD, however, there are a few specific to IDD more broadly. While there are differences among existing peer mentoring programs, each of the programs also share similar characteristics. The following section will first define peer mentoring programs and then explore a variety of the programs for individuals with IDD based on their setting, disability type, and the country where the program is implemented.

3.1 Defining peer mentoring Mentoring is defined as the process by which a mentor (i.e., someone who has information) guides a mentee (i.e., someone who needs the information) through activities such as role modeling, counseling, acceptance-and-confirmation, and friendship to develop a sense of competence and confidence

Author

Country

Setting

Peer Mentor’s age

Mentee’s age

Roeyers, 1996

Belgium

Elementary School

N ¼ 48, (Ages 5e13)

N ¼ 85, (Ages 5e13)

ASD

Mason et al., 2014

USA

Elementary School

N ¼ 4e6 (Age 6e8)

N¼3 (Age 6e8)

ASD

Disability

Program description Program for students with ASD who are grouped in pairs or trio with neuro-typical peers. Mentees and mentors are matched based on age and gender. Neurotypical peers came to the schools of students with ASD on holidays, during lunch breaks, or during the school day to play with students. Peer mentors are paired with students with ASD to provide support during recess. The intervention occurred during recess. School

Duration and freq of contact

Incentives

Outcome

15 sessions

NA

The initial initiations in recess interactions are made by peers without disabilities. However, researchers found significant improvements in continued initiations by students with ASD

NA

NA

School based implementers noticed positive improvement in students with ASD in social interactions.

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Table 1 Peer mentoring programs in the United States and internationally.

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Table 1 Peer mentoring programs in the United States and internationally.dcont'd

Author

Harper et al., 2008

Country

USA

Setting

Elementary School

Peer Mentor’s age

N¼6 (Ages 8e9)

Mentee’s age

N¼2 (Ages 8e9)

Disability

ASD

Program description

Baseline 13e16 days; Intervention 7 days; Generalization 4e5 sessions

Incentives

Outcome

NA

Students maintained improvement even after the intervention. Inclusion of multiple peers to assist one student with ASD (3:1 ratio) helped in the improvement of students.

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based implementers also assisted peer mentors. Mentees with ASD received training to learn how to interact with peer mentors. The Pivotal Response Training (PRT) is used as an intervention for students with ASD during playtime. Peer mentors are trained how to support mentees with ASD on the playground. Each mentee with ASD is paired with two peer mentors

Duration and freq of contact

USA

Community based

N ¼ 14 (Ages 8e9)

N¼3 (Ages 8e9)

HFASD

Cushing & Kennedy, 1997

USA

Middle School

N¼3 (Ages 11e13)

N¼3 (Ages 11e13)

ASD & ID

25e30 min sessions over the course of 3e4 days a week

NA

Improvements in students’ performance both in social and academic skills (reading) for students with ASD and their typical developing peers.

2 months

NA

Positive academic outcomes for students without disabilities.

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(Continued)

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Kamps et al., 1994

with two other students served as alternates in case main mentors are absent. The Class-wide Peer Training (CWPT) is to support students with and without disabilities. The goal of the program is to help students with disabilities working closely with their peer mentors in improving their reading skills and practical skills. Student with disabilities and peer mentors are paired based on their agreement to work together. Mentors received on how to adapt the assignments by providing verbal

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Table 1 Peer mentoring programs in the United States and internationally.dcont'd

Author

USA

Setting

Middle School

N ¼ 5 (Ages 13e15)

Mentee’s age

N¼3 (Ages 12e15)

Disability

IDD, CP, ASD

Program description instructions, positive reinforcement, and modeling behavior. Peer mentors received supervision from the special education and general education teachers respectively to better provide peer supports for mentees with moderate to severe disabilities. Observed social interactions between peer mentors, other typical developing students in the class, and target

Duration and freq of contact

Incentives

Outcome

NA

NA

Improvement in social interaction and increase in mutual social supports between peer mentors and

Lindsay S. Athamanah et al.

Shukla et al., 1999

Country

Peer Mentor’s age

USA

Middle School/ High School

N ¼ 3 (Ages 12e17)

N¼6 (Ages 11e17)

ID

students with disabilities.

NA

NA

Improvements in social interaction among students with disabilities Results also show that peer mentors can help adapt assignments to meet the needs of peers with disabilities.

19

(Continued)

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Carter et al., 2005

students with disabilities. Supported peers with disabilities by adapting class assignments, assisting in communication, and providing behavioral supports. Peer mentors received prior training from instructional aids. Peer support program for students with and without disabilities. Peer mentors consented to participate in the program, teachers and paraprofessionals also consented. Peer mentors facilitated communication between mentees with disabilities and

Author

Hamilton et al., 2016; Siew et al., 2017

Country

Australia

Setting

University

Peer Mentor’s age

Mean age 26

Mentee’s age

(Ages 17e20 years)

Disability

ASD

20

Table 1 Peer mentoring programs in the United States and internationally.dcont'd Program description

1 year

Incentives

Outcome

Each mentor received 30AUD/ hour for 3e4 h per week.

Increase in sensitivity toward individuals with ASD; decrease in peer mentors’ anxiety

Lindsay S. Athamanah et al.

other classmates, adapted class work, provided feedback, and received training about how to interact with peers with disabilities from general education teachers and research personnel. The Curtin Specialist Mentoring Program at Curtin University is for first year undergraduate programs diagnosed with ASD. Mentees with ASD and peer mentors meet for 1 h to

Duration and freq of contact

USA

University

N ¼ 38 (Ages 18e19)

NA

ID

NA

Each mentor received a $50 Target gift card.

Increase in knowledge and work experience, improved interpersonal skills and formed friendship

21

(Continued)

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Farley et al., 2014

discuss mentees needs. Mentors attend group supervision by the facilitators. The training sessions for peer mentors are facilitated by program coordinators. Students with disabilities who are enrolled in the 2-year postsecondary program for students with ID. These students are paired with peer mentors who are graduate or undergraduate students in the university. Around 5e7 mentors are assigned to one mentee. Peer mentors provide assistance with social activities (going to lunch

Author

Roberts & Birmingham, 2017

Country

Canada

Setting

University

Peer Mentor’s age

N ¼ 9 (Mean age 25)

Mentee’s age

N¼9 (Mean age 21)

Disability

ASD

Program description

Duration and freq of contact

Incentives

Outcome

2 semesters

NA

These findings are based on themes facilitating the formation of natural open relationships, learned the importance of setting goals e academic and career, importance of encouraging mentee selfadvocacy.

Lindsay S. Athamanah et al.

and exercising) and academic activities (assisting with classwork). Mentors participated in training and received supervision from program coordinators. The Autism Mentorship Initiative Program at Simon Fraser University is a collaborative project between Office for Students with Disabilities, Department of Education, and Psychology. Peer mentors and mentees meet up for an average of 1 h once per

22

Table 1 Peer mentoring programs in the United States and internationally.dcont'd

USA

University

N ¼ 31 (Ages 18e42)

NA

ID

2 semesters

NA

Mentors assisted mentees with academic needs, increased awareness of healthy eating, improvement in social and communication skills.

23

(Continued)

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Giust & Valle-Riestra, 2017

week. Discussed mentees’ learning, goals, individual guidance, and supports. The Project Panther Life at Florida International University provides an opportunity for mentees who are non-degree seeking to enrolled at a 4year university. Paired with graduate and undergraduate peer mentors. Enroll in university courses, completed job shadowing, participated in campus activities, job shadowing, community internships, and attend required program activities.

Author

Country

Setting

Ryan et al., 2017

USA

University

Peer Mentor’s age

Mentee’s age

N ¼ 18 (Mean age 20)

N ¼ 14 (Ages 19e30)

Disability ID/IDD

24

Table 1 Peer mentoring programs in the United States and internationally.dcont'd Program description

3 years (length of research study)

Incentives

Outcome

NA

Themes generated from interviews that are associated with the program include: work experience, building relationships, seeing growth in the mentee.

Lindsay S. Athamanah et al.

The peer mentoring program embedded in the Think College at University of Vermont Program is designed for students with ID/IDD enrolled in a 3year program at a university. Mentors underwent vetting process before being selected. Mentors served as friends and “academic support” to their mentees and worked about 7.5 h/week for 30 weeks/year.

Duration and freq of contact

USA

Summer Camp

N ¼ 19 Undergraduate students

Ages 20-54

ASD, ID, WS, DS, HFASD

Camp Blue Skies and Camp Twin Lakes are summer camps for adults with disabilities. Undergraduate students without disabilities attended this camp with a goal to change their attitudes toward persons with disabilities. Mentors and mentees lived in the same facility. Mentors are required to attend the camp as well as meetings before and during the camp.

1 week

Each mentor is paid $175 to attend the camp

Improvements in attitudes of peer mentors toward individuals with disabilities which includes increase in volunteering to work with people with disabilities and a passion for support for social issues.

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Kropp & Wolfe, 2018

Notes: ASD, autism spectrum disorder; HFASD, high functioning autism spectrum disorder; ID, intellectual disability; IDD, intellectual and developmental disability; CP, cerebral palsy; WS, Williams Syndrome; DS, Down Syndrome.

25

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(Kram, 1983). Within the mentoring process, Kram (1983) has identified four phases of mentoring: initiation (starting the relationship), cultivation (relationship builds upon needs of individuals), separation (relationship changes due to organizational contexts and/or psychological changes of the individuals), and redefinition (relationship matures to a new form or ends). When the individuals have moved into the redefinition phase, a friendship rather than a mentoring relationship between the individuals may emerge. Mentoring programs have been implemented in a number of settings (e.g., education, business, medical; Ehrich, Hansford, & Tennent, 2004) and have the potential to assist in the psychosocial and friendship development for all those involved (Kram, 1983). Peer mentoring programs for individuals with IDD often follow a similar path to those for individuals without disabilities. For example, although individuals begin the relationship in their respective mentor/mentee roles, they learn from each other as the relationship grows and hopefully redefine their roles into friendship. Implementing peer mentoring programs, also known as peer-mediated interventions in the special education literature, may provide a structured environment for individuals with and without IDD to develop interaction skills and practice in a natural, authentic setting. Thus, structured peer mentoring programs may provide an opportunity for individuals with and without IDD, who would not have the chance to meet otherwise, to develop a long-lasting friendship.

3.2 Setting The settings where peer mentoring programs take place are critical for understanding how to effectively implement the program and support students with IDD within different environmental contexts. Peer mentoring programs are offered in school and community-based settings, including elementary, secondary school settings, and post-secondary settings. 3.2.1 Elementary school settings At the elementary school level, peer-mediated interventions are introduced to improve the academic, social, and language skills of students with IDD, afford opportunities for students with and without IDD to interact, and provide same-age models in inclusive settings (e.g., general education classrooms; Carter & Kennedy, 2006; Thielmann & Goldstein, 2004). Further, a solid foundation for relationship and friendship development could be laid by improving these skills, social competence, and confidence at a young age (Thielmann & Goldstein, 2004).

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Peer-mediated interventions in the elementary school setting are typically designed for students with IDD who are between the ages of 4 and 13 (Harper, Symon, & Frea, 2008; Mason et al., 2014). Depending on the nature of the program, peer-mediated interventions have different recruitment strategies, selection criteria, as well as expectations and requirements for peer mentors. Overall, however, most peer mentors in elementary school settings are recruited through referrals and/or recommendations from teachers. Those students who are referred often have common selection criteria, including good communication and social skills, regular class attendance, a history of volunteering, and high academic performance (Cushing & Kennedy, 1997; Harper et al., 2008). Finally, to support the friendship development between the peer mentors and mentees, it is critical to find a good match between the students. Thus, students are most often matched based on their age and gender (Roeyers, 1996) or by using the teachers’ referral and recommendation to inform the peer mentor-mentee match (Harper et al., 2008; Mason et al., 2014). In addition to ensuring the mentor-mentee match, most peer mentoring programs incorporate disability awareness trainings into the programs to provide the peer mentors with knowledge and strategies of appropriate ways to interact with their peers with IDD. For young children, this training often includes teaching the students without disabilities how to interact with and support students with IDD (Harper et al., 2008) and how to be responsive to social communication partners by teaching them strategies for interacting. These strategies include proximity to each other, initiating social interactions, prompting for answers, reinforcing responses, and persisting engagement in more natural settings (e.g., classroom, recess; Zagona & Mastergeorge, 2018). Once the program is initiated, there are large variations of program requirements, length, and structure depending on the nature and setting of the program in order to meet the needs of the peer mentors and mentees. For instance, the duration of the peer-mediated interventions ranged from weeks to months (Harper et al., 2008; Mason et al., 2014). Additionally, programs took place in a range of settings such as play sessions, lunch, recess, and non-academic classes (e.g., cooking lab, social skills group; Zagona & Mastergeorge, 2018). While there are several differences across peer mentoring programs in elementary school settings, these programs continue to produce positive outcomes (e.g., social communication skills) for both individuals with and without IDD.

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3.2.2 Secondary school settings The transition to adolescence is multifaceted and the needs of adolescents are consequently complex. Middle and high school are critical time periods when youth strive to attain their own autonomy, understand the social world, manage their relationships with peers, and explore other social interactions. In addition, secondary school classes include a more complicated curriculum, higher expectations, and faster instruction than in elementary school (Carter & Kennedy, 2006). Thus, for those who have IDD, these transitions and changes might be even more challenging due to their unique disability conditions (e.g., difficulty initiating and/or maintaining conversation, developing and/or maintaining friendships). Compared to individuals without disabilities, adolescents with ASD are more likely to be rejected by peers, more vulnerable to peer victimization/bullying, and encounter more academic challenges (Adams, Fredstrom, Duncan, Holleb, & Bishop, 2014, Adams, Bishop, & Taylor, 2017). As a result, appropriate and timely interventions (e.g., peer supports, mentoring) for adolescents with IDD are crucial. Overall, secondary school peer mentors provide academic- and social-related supports to students with IDD to ensure their meaningful access to inclusive educational experiences (e.g., attend classes and provide study assistance to the mentees with IDD). Additionally, several programs help foster social connections within these inclusive experiences by promoting participation in social activities with the mentees and serving as a link between their peers with disabilities and other students (Carter, 2017). While programs vary, some common features include similar aged peer mentors and mentees, self-motivated peer mentors, and mentors who are interested in working with individuals with disabilities. School professionals (e.g., special education teachers, paraprofessionals) also play an important role in many of the peer mentoring programs at the secondary level, such as promoting the programs and/or recruiting interested students to be peer mentors (Shukla, Kennedy, & Cushing, 1999). They also provide necessary training and regular supervision to peer mentors to ensure that they are appropriately interacting with and supporting their mentees with IDD to fulfill the program requirements and responsibilities (Cushing & Kennedy, 1997; Shukla et al., 1999). While there is limited research about peer mentoring at the secondary level, positive outcomes for individuals with and without IDD are emerging.

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3.2.3 Postsecondary education settings The majority of the peer mentoring programs in the existing literature occurred at postsecondary institutions and mostly at four-year university campuses (Farley et al., 2014). Depending on the nature of the programs in the postsecondary settings, a number of similarities and differences are identified with respect to the characteristics of peer mentors and mentees, recruitment strategies, and program expectations. In terms of similarities across programs, peer mentors are recruited through several common strategies including posting flyers/posters across campus, using “word of mouth”, and reaching out to different academic departments, counseling services units, and disability services offices (Hamilton, Stevens, & Girdler, 2016; Roberts & Birmingham, 2017; Siew, Mazzucchelli, Rooney, & Girdler, 2017). Upon recruitment, most peer mentoring programs required mentors to undergo specific disability etiquette/awareness training on ways to interact with individuals with disabilities and receive ongoing supervision from senior program staff (Giust & Valle-Riestra, 2017; Hamilton et al., 2016). Peer mentors and mentees are expected to meet regularly (e.g., weekly or biweekly) where they engage in targeted conversation around multiple topics related to academic and social aspects as well as provide necessary supports for the mentees (Ames et al., 2016; Griffin, Wendel et al., 2016b; Roberts & Birmingham, 2017). For instance, the peer mentoring program embedded in the Think College at the University of Vermont Program specified that peer mentors are required to spend approximately 7.5 h per week supporting and working with their mentees (Ryan, Nauheimer, George, & Dague, 2017). While there are many common features among the peer mentoring programs in postsecondary education settings, one main difference observed across programs is whether or not the mentors are provided with incentives for their participation in the peer mentoring programs. Incentives ranged from monetary (e.g., gift cards, remuneration) to academic credits (Carter et al., 2018; Farley et al., 2014). Some studies argued the pros and cons of including remuneration or payment for the peer mentors, especially for programs in which development of genuine and authentic friendships is the ultimate goal. In addition to incentives, another variable that differs across programs is the length of time that mentors and mentees spend together. Programs ranged from as short as one week (e.g., during spring break) to one academic year depending on the design of the program (Giust &

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Valle-Riestra, 2017; Kropp & Wolfe, 2018). Thus, further investigation is warranted on incentives and the ideal length of peer mentoring programs that result in friendships. 3.2.4 Country Using peer-mediated interventions has become a global trend to improve understanding and attitudes toward disabilities and to facilitate friendship development between individuals with and without disabilities. Although the majority of studies examining peer mentoring programs have been conducted within the United States, studies are also found in Canada (Ames et al., 2016; Roberts & Birmingham, 2017), Australia (Siew et al., 2017), and Belgium (Roeyers, 1996) with most of the non-U.S. peer mentoring programs implemented in higher education institutions. Comparing programs within and outside of the US, most peer mentoring programs are structured and organized in a similar manner, including participant recruitment, program requirements, and sustainability. One difference observed among programs is the age range of the participants. For example, Roeyers (1996) conducted a study in Belgium with students between the ages of 5e 13 recruited as peer mentors. However, the age range tends to be narrower for programs in the US as they are typically recruited based on educational setting (e.g., elementary, middle, high school or postsecondary).

3.3 Disability The mentees that participated in the peer mentoring programs mostly have an initial diagnosis of ASD, ID, and/or other developmental disabilities (e.g., epilepsy, William Syndrome, Down Syndrome), including comorbid diagnoses (Kropp & Wolfe, 2018). In several studies, the mentors disclose that they also have a disability, although the nature of their disability is not provided (Carter et al., 2018; Farley et al., 2014). In addition, the mentees are usually required to have evidence indicating a formal diagnosis in order to participate in the peer mentoring programs (Ames et al., 2016). Several differences across programs are related to educational settings for the individuals with IDD as well as a large discrepancy between ages of the peer mentors and mentees. The type of academic programs hosting peer mentoring programs where students with disabilities are enrolled, are quite different depending on their disability type. For peer mentoring programs that are specifically designed for students with IDD, mentees are typically enrolled in a certificate training program or are classified as non-degree seeking students (e.g., Giust & Valle-Riestra, 2017; Ryan et al., 2017).

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Whereas peer mentoring programs specifically designed for students with ASD usually include mentees enrolled in a wide array of educational settings including four-year university programs (e.g., Refs. Ames et al., 2016; Siew et al., 2017). Furthermore, several programs also have a significant age difference between the peer mentors and mentees. For instance, Ryan et al. (2017) and Kropp and Wolfe (2018) include students with ASD and ID that are paired with peers who are significantly younger (e.g., mentees age range ¼ 19e54 years, mentors age range ¼ 18e22 years). It may be particularly difficult for both individuals with and without IDD to sustain true friendships past the mentoring relationship when their ages differ significantly.

3.4 Outcomes Regardless of format, setting, or disability type, peer mentoring is beneficial for both the peer mentor and the mentee. For instance, peer mentors have reported gains such as increased personal insight, enhanced interpersonal skills and individual growth, and enhanced friendships and personal connections (Farley et al., 2014; Terrion & Leonard, 2007). Furthermore, mentors reported that peer mentoring provides them with a better understanding of how to interact with others, including interacting with and supporting individuals with IDD (Hamilton et al., 2016). Individuals with IDD who have participated in peer mentoring programs report having a high number of social interactions with those without disabilities as well as improving their social-communication skills and social-emotional well-being (e.g., reduced anxiety in interacting with peers), gaining independence and confidence, and making new friends (Roeyers, 1996; Siew et al., 2017). In addition to social benefits, studies also revealed academic gains in mentors who have participated in peer mentoring programs. Specifically, peer mentors reported that the program improves their academic performance (Cushing & Kennedy, 1997; Kamps, Barbetta, Leonard, & Delquadri, 1994) and retention in academic programs (Siew et al., 2017). They also reported that peer mentoring impacts their career interests, either confirming their chosen career interest or leading to a change in career goals toward professions working with individuals with disabilities (Beltman & Schaeben, 2012; Calder, 2004; Gilles & Wilson, 2004). Across all studies, the outcomes of peer mentoring programs are quite promising. However, researchers continue to question the maintenance and generalization of the skills learned in peer mentoring programs to other settings, such as workplace settings and the community. Further, while there is preliminary

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evidence that the mentor/mentee relationship evolves into friendship, there is little research examining how these relationships evolve and the long-term maintenance of these friendships. Therefore, additional research is warranted focusing on the outcomes of peer mentoring programs for both peer mentors and mentees and the degree to which the mentoring relationships evolve into friendships.

4. Theoretical framework As demonstrated, peer mentoring programs may be a key factor in providing opportunities for individuals with and without IDD to build friendships. While peer mentoring programs have shown to be a starting point to develop friendships, understanding how to develop and promote these programs to have the most impact on participants has not been explored or discussed in the literature. We propose combining Ryan and Deci’s (2000) Self-Determination Theory e which focuses on intrinsic motivation and self-determination e with Bronfenbrenner’s (1976) Ecological Systems Theory e which describes interactions between individuals and various social systems. Although described schematically in Fig. 1, we elaborate on both below.

4.1 Self-Determination Theory The Self-Determination Theory (SDT) (Ryan & Deci, 2000) has three main psychological needs that Ryan and Deci suggest is warranted for increasing intrinsic motivation. The needs are: (1) competence, (2) relatedness, and (3) autonomy. By addressing each of these three needs within a socially acceptable setting, peer mentors may improve their own motivation to interact and socialize with individuals with IDD without monetary incentives. The first psychological need is competence, which is defined as possessing the necessary skills, knowledge, and capacity to accomplish a particular outcome (Deci, Vallerand, Pelletier, & Ryan, 1991). Individuals without IDD have reported they struggle with knowing how to interact with individuals with IDD on a more personal level in the community (Siperstein et al., 2007). This lack of competence to interact may be a reason why individuals without IDD do not spontaneously engage with individuals with IDD. In peer mentoring programs, peer mentors learn strategies regarding how to effectively interact with individuals with IDD and practice using those strategies with support from trained stakeholders (e.g., teachers,

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Fig. 1 Proposed theory merging Self-Determination Theory (Ryan & Deci, 2000) and Ecological Systems Theory (Bronfenbrenner, 1976). PM ¼ Peer Mentors; M ¼ Mentees.

counselors). By increasing their competency of applying these strategies, peer mentors may be able to generalize the strategies in additional interactions with individuals with IDD in the work place or community. This could potentially help increase awareness of and decrease the stigma of disability, promote a more inclusive environment, and encourage positive attitudes toward individuals with IDD. The next psychological need is relatedness, which promotes a connection between peer mentors and mentees with similar interests and settings (Deci et al., 1991). During adolescence, peers become a stronger influence than parents or family as youth develop similar interests to same-aged peers, and pursue more interactions with each other (Carter, 2017). As indicated in the earlier section, it is quite common for peer mentoring programs to pair the peer mentors and mentees by matching their age and interests. As

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peer mentors and individuals with IDD are given ample opportunities to interact with each other across settings such as school and the community, this matching is important in fostering the relatedness, developing the mentoring relationships, and maintaining friendships among peer mentors and mentees. Finally, the last psychological need is autonomy. It is vital for the peer mentors to feel they have freedom and control of their actions including making decisions about their own life (Deci et al., 1991). Mentoring relationships between individuals with and without IDD may begin with guidance and support from adults; however, at the end of the mentorship, the individuals either end the relationship or become friends. Supporting the peer mentors to become more autonomous within the peer mentoring program may help them to become independent leaders and advocates for individuals with IDD and feel confident in interacting with and supporting those with IDD in school, work, and the community. We propose that meeting each of these three psychological needs among the individuals with and without IDD who participate in peer mentoring programs will facilitate the growth of their intrinsic motivation and potentially their future friendships.

4.2 Ecological Systems Theory Bronfenbrenner’s Ecological Systems Theory (EST) provides a framework to understand the experiences of the individual peer mentors and mentees in peer mentoring programs, how the growth and development of mentors and mentees are influenced by different types of environmental systems, and how they influence relationships, communities, and society. In addition, the ecological approach also helps us gain in-depth insight into how to create a peer mentoring program that can enhance mentors and mentees development. This theory argues that the environment individuals grow up in affects every facet of their life. Social factors determine their way of thinking and the emotions they feel. However, the individuals are also capable of changing their surrounding system, such as their beliefs, attitudes, and values. Bronfenbrenner’s (1976, 1994) ecological model describes the individual’s ecology in terms of a set of nested levels within the environment. Currently, there are five interrelated types of environmental systems in Bronfenbrenner’s classic rendition of the EST, namely, the (1) micro-, (2) meso-, (3) exo-, (4) macro-, and (5) chronosystem. These levels range from smaller, proximal settings in which individuals directly interact with each other to larger, distal settings that indirectly influence the individuals

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and community including changes within individuals and settings across time. At any point in time, different systems may be simultaneously influencing each other, providing for complex and diverse outcomes. Additionally, the EST provides a framework to better understand the particular factors between the individuals and environments that can promote engagement and the development of positive relationships or friendships. The most proximal ecological level is the microsystem, which includes the individuals and the settings where they directly interact. Peer mentors and mentees participating in peer mentoring programs represent just one microsystem, as they are involved in different types of activities and interpersonal relations. We propose that the development of friendships among peer mentors and mentees is influenced by various systems. As the friendships develop and grow, they also impact larger systems. Peer mentors are supported and encouraged to be involved in planning activities, to become leaders in the community, and to foster social relationships between the mentors and mentees. These features are important to build the peer mentors’ sense of belonging and autonomy in the program and to create a socially valid, safe, and supported environment. Meanwhile, mentees are also encouraged and supported to develop social competence and confidence through engagement in social interactions with typically-developing peers. Providing such meaningful interactions in a natural environment is critical in promoting long-term friendships between individuals with and without IDD. The second level in EST is the mesosystem, which explores the interactions among microsystems. Each interaction forms a microsystem, and a collection of these interactions create a mesosystem. Peer mentors and mentees interact with additional microsystems such as their parents, friends, school and university personnel, community members, and employers. These interactions (i.e., microsystems) are located within the mesosystem. Each system may affect the other differently, so it is important to understand the social structure and relationships (e.g., student/teacher, friend/family) within each microsystem. For instance, peer mentors may set up weekly meeting times or monthly social events, participate in disability awareness and etiquette training, and provide support to the mentees. Thus, these interactions may play a critical role as a support network and can exert important impacts on the peer mentor and mentees’ experiences that foster their competence and motivation to interact across systems and settings. Furthermore, peer mentors and mentees interact with people outside of the peer mentoring program. By having this contact, they may be impacting additional microsystems (e.g., families, the community, employers) which

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could indirectly influence overall attitudes toward individuals with disabilities. Extending outward to the next level, the exosystem includes microsystems in which individuals are involved but not directly embedded. Influential structures in the exosystem may include disability-related laws and policies for individuals with IDD. As the peer mentors may interact with individuals with IDD in an education or work setting, their disability awareness and understanding of disability rights may change societal attitudes toward individuals with disabilities within the larger community (e.g., classmates, coworkers, employers). As peer mentors work alongside and support individuals with IDD in different settings, the positive interactions may also affect the understanding and perception of classmates or coworkers in that particular environment. The peer mentors can help show potential strengths and work through challenges that individuals with IDD encounter (e.g., societal stigma, limited transportation, accessibility). As societal attitudes and policies become more inclusive of individuals with IDD, peer mentors and mentees may have additional outside support to evolve their mentoring relationship into a friendship. The outermost system of EST is the macrosystem, which is defined as the set of overarching beliefs, values, and norms, as reflected in the cultural, religious, and socioeconomic organization of society. A primary aim of peer mentoring programs should be to bring awareness and promote inclusion in the communities where it is located e essentially changing the beliefs and attitudes about individuals with IDD of the community members. Peer mentors may become leaders in their fields and apply their advocacy skills, knowledge, and awareness to their communities expanding the effects of the peer mentoring program across environments. In addition, the mentees may learn more about their rights and develop self-advocacy skills to use across these settings. While the macrosystem does not necessarily have a direct impact on the peer mentors and mentees, the overall beliefs and values may change to become more inclusive and friendships between the peer mentors and mentees may become the societal norm. A final dimension of the EST is the chronosystem, which encompasses changes over time across people and environments (Bronfenbrenner, 1994). Elements within this system can be either external, such as the timing of transitioning out of school and into the work setting, or internal, such as the physiological changes that occur with the aging of a child. As children get older, they may react differently to environmental changes and may be more able to determine how that change will influence them. Peer

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mentoring programs need to be adapted based on participants’ ages, settings, and interests. People and their interests change as they grow which may affect the interactions between mentors and mentees. These potential changes need to be taken into consideration when developing peer mentoring programs for the mentors and mentees to be able to work through disagreements, deal with growing apart, and realize their interests may change to ensure smooth transitions between stages of the mentor relationship. We propose this merged theoretical framework as a guide to develop peer mentoring programs supporting the peer mentors’ self-determination and motivation growth and to understand how the peer mentors and mentees are impacted while impacting others across systems. Moreover, individuals with and without IDD do not necessarily have direct access to each other and may not have opportunities to get to know one another naturally. Peer mentoring programs can be an effective way for individuals with and without IDD to interact in a more natural setting and to potentially develop life-long friendships.

5. Future directions This chapter first focused on the nature of friendships for individuals with IDD, and then presented how peer mentoring programs provide opportunities for socialization between those with and without IDD with the potential to lead to friendships. The limited research on friendships of individuals with IDD clearly shows that while the definition of friendship may differ, friendship characteristics and development are similar to individuals without IDD. Same-age and gender peers, mutual benefits, and similar interests are important friendship characteristics reported by individuals with and without IDD (Bauminger & Kasari, 2000; Daniel & Billingsley, 2010; Rossetti, 2011). However, individuals with IDD may not define friendship or describe what constitutes a quality friend in the same way as individuals without IDD. Additionally, peer mentoring programs have been shown to be beneficial to improve social skills and interactions across ages and disabilities (Carter et al., 2018; Cushing & Kennedy, 1997); yet, developing friendships between the participants with and without IDD have not been a primary focus for these programs. Despite these findings, additional research must be conducted to better understand the relation between friendship development for individuals

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with IDD and programs that provide opportunities for individuals with and without IDD to socially interact. We offer suggestions in three critical areas for future research that will provide a more extensive picture of friendships and peer mentoring programs: (1) the development of friendships between individuals with and without IDD, (2) social skills that encourage friendship development, and (3) the impact of peer mentoring programs on friendship.

5.1 The development of friendships between individuals with and without IDD Minimal research has been conducted to determine how individuals with and without IDD engage in friendships or how these friendships are maintained over time. Friendship is a critical factor for overall quality of life, yet long-lasting friendships are scarce between individuals with and without IDD (Duvdevany & Arar, 2004). Thus, it is necessary to critically examine how friendships develop and are sustained through time when creating inclusive programs that address socialization and friendship development. Exploring how friendship is defined, what constitutes high-quality friends, and important factors necessary for friendships between individuals with and without IDD will help establish a comprehensive picture of how friendships grow. These investigations will shed light on the factors individuals with IDD deem necessary in a friend without disabilities and how these factors change over the lifespan within various settings (e.g., educational, community). These investigations should further examine the factors that individuals without IDD feel are imperative when they develop friendships with individuals with IDD. With this information, stakeholders can create inclusive opportunities for potential friendships and know how to support the individuals to continue those friendships for the long-term.

5.2 Social skills that encourage friendship development Individuals with IDD have difficulty learning and applying social skills in a variety of settings (Carter & Hughes, 2005; Fisher & Morin, 2017). The inability to converse and socially interact with same-age peers may prevent individuals with IDD to develop and maintain friendships with those without disabilities and this lack of friends could potentially lead to increased loneliness and decreased quality of life. Social skills programs focus on building the social skills deemed appropriate or necessary for use across people and settings (e.g., educational, clinical; Bellini et al., 2007; Gantman et al., 2012; Gresham et al., 2001). In addition, social skills programs such as PEERS, have focused on teaching

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individuals with ASD and their families the social skills needed to improve their social skill knowledge as well as to increase peer interactions (Gantman et al., 2012; Laugeson et al., 2012). However, individuals with IDD struggle with applying the social skills learned and generalizing these skills to different people and settings (Carter & Hughes, 2005). Additionally, social skill programs generally work on how to initiate and maintain conversation and not necessarily how to develop and maintain friendship. Thus, social skills particularly necessary for friendship development have not been established. Future research should extend current programs that simply teach social skills with programs that address developing true and long-term friendships between individuals with and without IDD. By identifying and evaluating which distinct skills are crucial for friendship development, social skills programs can embed these skills as part of the core curriculum – using the peer mentoring program to teach skills, how to apply skills, and to generalize skills for potentially positive friendship outcomes that may not have been possible with previous programs.

5.3 The impact of peer mentoring programs on friendship While it is important to understand the impact of friendships on individuals with IDD and the social skills necessary to build long-term friendships, how friendships between individuals with and without IDD affect those without IDD is also fundamental. Such knowledge will extend the limited literature on the benefits of friendships for those without IDD and help create appropriate support for individuals without IDD in peer mentoring programs. Peer mentoring programs have been shown to be beneficial for the peer mentors without disabilities in shaping their attitudes toward individuals with IDD, developing important friendships with those with IDD, and solidifying their future career choice (e.g., special education) or moving them to pursue a career involving disabilities (Fisher, Sung, Athamanah, & Josol, under review; Griffin, Mello, et al., 2016a; Griffin, Wendel, et al., 2016b). However, opportunities for same-age peers with and without IDD to interact and build true friendships remains limited (Carter et al., 2017). Thus, future research should focus on developing and evaluating peer mentoring programs to provide social guidance for individuals with IDD while also encouraging friendships that last beyond the program. Additional research on how peer mentoring programs impact the peer mentors and how friendships grow is warranted to understand the influence of peer mentoring programs on friendship development between individuals with and without IDD.

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6. Conclusion We have provided a comprehensive picture of the development of friendships for individuals with IDD and how peer mentoring programs can provide individuals with IDD access to those without IDD for an opportunity to build friendships. In spite of the limited research on their friendship development, individuals with IDD are eager to socially engage with and build friendships with others. Moreover, peer mentoring programs may provide a chance for individuals with and without IDD to learn and practice social skills in more authentic settings. It is time to focus research on understanding the friendship process for individuals with IDD and how peer mentoring programs can assist in building these friendships. In the future, we encourage programs to focus on building social skills for the individuals with IDD, but to also guide mentors to refine their abilities to promote more inclusive environments and to advance their friendships with individuals with IDD.

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