Social skill deficits lie at the heart of Asperger’s Disorder and often contribute to peer rejection, academic underachievement, emotional disorders and a limited capacity for employment and independent living in adulthood. Despite the profound impact that social difficulties have on the lives of children with Asperger’s Disorder, few evidence-based social skills programs have been developed for this population.
Objectives:
This study aimed to evaluate the efficacy of The Secret Agent Society: a new multi-systemic social skills program for children with Asperger’s Disorder.
Methods:
Forty-nine child participants with Asperger’s Disorder aged 7 ½ to 11 years were randomly assigned to a treatment (n=26) or wait-list control (n=23) condition. Treatment participants attended weekly two hour group sessions over a seven week period and a booster session at six-week follow-up. Parents attended concurrent parent training sessions and teachers were forwarded weekly handouts.
Child sessions typically began with children playing a computer game that taught them skills in emotion recognition, emotion regulation and social interaction. In the game, the player assumes the role of a Junior Detective who completes a three-level course to become a mind-reading specialist. In level one, the player decodes how suspects feel from their facial expressions, body postures and voice tones. In level two, they calibrate scales to show how their own body signals the nature and intensity of their feelings. In level three, the user completes virtual reality missions that require detecting how characters feel in social scenarios such as being bullied, playing with others and trying a new activity, and choosing how to respond appropriately. The game teaches children about simple and complex emotions (e.g. embarrassment, teasing) and includes animated and human characters.
Participants spent the remainder of the child session time doing role-play activities to help them apply and extend on the skills they learned in the computer game. After each session, children were asked to do ‘home missions’ to practise using their social skills in real life. They recorded their progress on these missions in a computerised ‘Secret Agent Journal’ for review in the next session. Concurrent parent training sessions and weekly teacher handouts helped parents and teachers to support children in using their social skills in real life.
Results:
Relative to wait-list controls, program participants showed significantly greater improvements in social skills, as indicated by parent-report measures. Teacher-report data also suggested that treatment participants made significant improvements in social functioning from pre- to post-treatment. Child-based competency measures indicated that children in the treatment group knew more appropriate emotion-regulation strategies at post-intervention than at pre-intervention, whereas children in the control group did not. Parent-report data suggested that treatment gains were maintained at 5-months follow-up, with 76% of children improving from the clinical to normal range of social functioning.
Conclusions:
These results support the use of a multi-systemic approach to social skills training for children with Asperger’s Disorder. Future research is needed to determine the effectiveness of the program in improving children’s observable peer-interaction skills and peer relationships.