Establishment of Social Skills Training Group in Adolescents With Autism Spectrum Disorder and Effectiveness Analysis
Condition: Autism Spectrum Disorder High-Functioning
MeSH terms: Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive
Study type: Interventional

Summary: 
      Autism spectrum disorders (ASD) is a neurodevelopmental disorder characterized by persistent
      deficits in social communication and social interaction, and the presence of restricted,
      repetitive behavior and interests. Their social relationships with peers may remain a
      challenge or even worsen for individuals with ASD throughout the school years and beyond.
      Adolescence may be a particularly difficult developmental period, as they may have greater
      motivation or desire to engage with peers but also have greater awareness of their social
      disability. Adolescents with ASD are reported to experience greater loneliness and mood
      disturbances, and have poorer friendship quality and social network status than their
      typically developing peers. Moreover, a growing body of literature indicating that students
      with ASD have increased risk at all kinds of bullying involvement. These findings underscore
      the importance of providing social skills training. One of the empirically supported
      intervention program that targets adolescents with ASD is the Program for the Education and
      Enrichment of Relational Skills (PEERS®). This is a parent-assisted, manualized social skills
      training program that addresses crucial areas of social functioning for adolescents.
      Psycho-education and cognitive-behavioral therapy techniques are employed to help adolescents
      develop ecologically valid skills for making and maintaining friendships. Moreover, caregiver
      attendance at the same time in the caregiver group was a mandatory component to enhance the
      child/s generalization of social skills.

      Adolescents with ASD and normal IQ will be recruit to attend the 14-week PEERS® group
      training together with a parent. The participants will be stratified by gender and randomized
      to a treatment (TX) group or delayed treatment control (DTC) group. A team member uninvolved
      in the program made the random allocation with random digit generated by computer.

      This study investigated the acceptability, feasibility and effectiveness of the Taiwanese
      adolescent PEERS® program.
    

Detailed description: 
      The PEERS® group will be run by PI and the special education teacher (one is the leader for
      teen session and the other is the leader for parent session) both with substantial experience
      conducting social skills programs for children and adolescents, and parent education groups
      related to ASD, under the on-site supervision of co-PI with comprehensive training through
      the UCLA PEERS® Clinic by the program developer. Three research assistants (one is a
      psychiatrist, another is an occupational therapist, and the other is a social worker) will
      take the part of role-play (following the social scenario script) during PEERS® intervention.

      The TX group received 14 weeks of the PEERS® intervention immediately following a baseline
      assessment, while the DTC group received the same intervention after a 14-week waiting
      period. Parents and teens attended concurrent sessions held in separate rooms.
    

Intervention name(s): PEERS® Social Skills Training
Intervention type(s): Behavioral
Intervention description(s): The PEERS® consisted of 14 weekly 90-min didactic sessions. Adolescents and their parents attended separate concurrent sessions.
Each session began with a review of the homework assignment from the previous week and allowed time for troubleshooting problems encountered in completing the behavioral assignment. This was followed by a didactic lesson on the weekly topic. Didactic lessons included content related to various social skills and peer interactions. Parents attendance was a mandatory component of PEERS® intervention. Parents were expected to enhance generalization of social skills through in vivo social coaching in natural social settings and increase homework compliance as well as practice of newly learned social skills. A 10-min reunification between adolescents and caregivers was arranged at the end of each session to review the skills taught in the session and assign corresponding homework for the next session.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: autism spectrum disorder; social skills training program; adolescents