Social Skills Training for Children with Autism Spectrum Disorders: Decreased Benefits for Children Prescribed Stimulant Medication

Background: Social skills interventions are very important in the treatment of children with Autism Spectrum Disorders (ASD). A substantial proportion of these children have been prescribed various psychotropic medications.  In our previous study of 24 children with ASD, we found that children prescribed psychotropic medication  did not benefit as much from social skills training as unmedicated children. The larger number of subjects in this study will afford a finer analysis by medication class.

Objectives: This study is intended to test if children with ASD prescribed different classes of psychotropic medication (stimulants, antidepressants, neuroleptics or no medication) by community practitioners have differential outcome after a manualized evidence-based social skills training program.

Methods:  Seventy-eight 6 to 12 year-old children with Autism spectrum disorders, who were high functioning, were given 12 weeks of parent-assisted children’s friendship training (CFT). Subjects were prescribed one of the following classes of medication by physicians in the community prior to treatment: antidepressants (n = 6), neuroleptics (n = 4), stimulants (n = 18) while 50 were not prescribed any psychotropic medications (Unmedicated). Two parent-rated and 3 teacher-rated social measures served as outcome variables.

Results: Results revealed that subjects prescribed stimulants were least improved on one parent-rated and one teacher-rated scales of social functioning after 12 weeks of CFT. Subjects prescribed  antidepressants showed greater improvement, subjects in the Unmedicated group were next higher and subjects prescribed neuroleptics showed the greatest improvement on these two measures.

Conclusions: The present results suggest that the detrimental effects of psychotropic medication upon outcome of social skills training  found in our previous research was confined to stimulants. It is not clear if the medication itself has some moderating effect on outcome, versus that children who require medication have greater functional limitations than those who do not. It is left to further research to resolve this issue.