Neural and Behavioral Outcomes of Social Skills Groups in Children With Autism Spectrum Disorder (ASD)
Condition: Autism; Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive
Study type: Interventional

Summary: 
      The purpose of this study is to compare two different treatment approaches to social skills
      groups for high-functioning children with Autism Spectrum Disorder (ASD). This project will
      examine changes in both behavior and the brain following treatment.
    

Detailed description: 
      Despite the fact that social skills impairments are the most persistent and pervasive
      symptoms affecting individuals with ASD, treatments targeting social skills have been the
      subject of few controlled investigations. The available literature suggests that cognitive
      behavioral techniques are commonly used and may improve targeted social skills in individuals
      with ASD. However, drawing firm conclusions about the efficacy of social skills treatment
      remains difficult, particularly with respect to maintenance of skills and generalization to
      natural settings, owing to methodological limitations of extant studies (e.g., small sample
      size, lack of manual-based curricula, minimal assessment of generalization or maintenance).

      Several neuroimaging studies have found that individuals with ASD underactivate key brain
      regions involved in social cognition. However, there is also evidence to suggest that factors
      that increase attention to or interest in social stimuli are associated with more normal
      brain activity.

      The purpose of this investigation is to examine the acute and sustained effects of social
      skills treatment on social cognition and the neural architecture that supports it.
      High-functioning children with ASD will be randomly assigned to a 12-week cognitive
      behavioral social skills group or a social play-based therapy group. For both types of
      groups, a parent session will be held concurrently. Functional MRI scans as well as
      behavioral assessments of social cognition, adaptive functioning, and symptom severity will
      be acquired at baseline, immediately following treatment, and at a 3-month follow-up.
    

Intervention name(s): Cognitive Behavioral Therapy (CBT); Play Therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The CBT social skills curriculum is manualized and anchored in CBT strategies, such as problem identification, affective education, performance feedback, and weekly homework activities to facilitate generalization. The curriculum is a compilation of lessons targeting key social deficits in children with ASD, such as nonverbal communication, emotion recognition, and theory of mind. Structured teaching includes defining skills, breaking them down into simple, concrete steps, modeling the skill through role-play, and introducing a game or activity to practice the target skill. The approach to the parent group will be psychoeducational with a focus on reviewing target skills, rationale for teaching target skills, homework, progress or obstacles, and identifying strategies to promote generalization. Parent information handouts will be provided.; The social play group is manualized, led by a trained clinician and support staff, follows a specific routine, and contains a parent group component. Group leaders will follow participants' interests and suggestions for games. Group leaders utilize strategies such as reflective functioning statements on the child's behaviors to build emotion-focused play skills. The therapeutic setting incorporates play designed to encourage emotion-focused play including make-believe (dolls, houses), sensory (e.g. play-doh), and cooperative play (e.g. board games) toys. The approach to the parent group will be supportive rather than psychoeducational. Parents will set the agenda for discussion, facilitated by the group leader.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Autism; Autism Spectrum Disorder; Disorder; Autistic; Asperger Syndrome; social skills group; behavioral intervention; Imaging, Magnetic Resonance; fMRI; Functional MRI; MRI, Functional; Magnetic Resonance Imaging; Functional