Social Skills Training for Preschool Children with Autism Spectrum Disorders: The UCLA PALS Program

Background: Although social skills training has become an increasingly common approach in improving the social deficits found in young children with Autism Spectrum Disorders (ASD), few interventions use valid and reliable standardized assessment measures to evaluate treatment efficacy. In addition, most intervention studies in this area have a small sample size, involve school-aged children, and/or do not use multiple raters to assess treatment efficacy.   

Objectives: This study examines the efficacy of a manualized social skills intervention, known as the UCLA Preschool Applied Learning of Social Skills (PALS) Program, in improving overall social skills among preschool children with Autism Spectrum Disorders. 

Methods: 10 children completed the PALS intervention over a period of 15 weeks as part of their enrollment in an intensive therapeutic social recreational program for children 3-6 years of age diagnosed with high-functioning autism, Asperger’s Disorder, or PDD-NOS. Prior to receiving the PALS intervention, parents and teachers rated the participants’ social skills, problem behaviors, and social responsiveness using the Social Skills Rating System (SSRS; Gresham & Elliot, 1990) and the Social Responsiveness Scale (SRS; Constantino, 2005). Participants receiving the PALS intervention attended 20 minute manualized treatment sessions 2-3 times per week and participated in several structured games and activities throughout the week involving behavioral rehearsal of the targeted skills. Parents received weekly handouts describing the social skills lessons as well as strategies for reinforcing these skills in the home and community setting. Targeted social skills included: social communication and conversational skills; turn-taking and sharing; peer entry skills; good sportsmanship and teamwork; helping behavior; and appropriate body boundaries. Skills were taught through puppet-facilitated scripted didactic lessons using concrete rules and steps of social etiquette followed by role-playing exercises by group leaders and peer models. Participants practiced newly learned skills during structured and unstructured behavioral rehearsal exercises with peers. Following the 15 week intervention, parents and teachers again completed the SSRS and SRS to assess for treatment outcome.

Results:  Findings reveal significant improvement on parent report of social responsiveness on the SRS (p = 0.006) following the treatment intervention. Further analysis of the SRS revealed significant improvement on parent report of three subscales, including Social Awareness (p = 0.031), Social Cognition (p = 0.019), and Social Motivation (p = 0.007). Examination of the SSRS indicated significant improvement on teacher report of Assertiveness (p =0.042), and trends in parent-reported increased Self Control (p = 0.057), parent-reported decreased Hyperactivity (p = 0.066), and parent-reported decreased Problem Behaviors (p = 0.058) following the treatment intervention. Parent report of overall social skills and teacher reports of problem behaviors, overall social skills, and social responsiveness were not significant.

Conclusions: These findings suggest that the use of PALS, a manualized social skills treatment intervention, may be efficacious in improving the social responsiveness of children with ASD along the dimensions of social awareness, cognition, and motivation, and may improve their assertiveness in the classroom setting.