Lack of social responsivity and impaired social skills have long been known to negatively impact the social functioning of adolescents with Autism Spectrum Disorders (ASD), making it difficult for many of these youth to develop close reciprocal friendships. Yet very few evidence-based social skills interventions have been developed and tested to improve friendship skills for teens with ASD, representing a large gap in the ASD treatment literature.
This study examines change in social responsivity and social functioning following the implementation of an evidence-based parent-assisted social skills intervention known as PEERS. Change in skills related to developing friendships were measured for high-functioning middle school and high school adolescents with ASD. Maintenance of treatment gains at a 14-week follow-up assessment were also examined.
Using a matched convenience sample, 28 participants were assigned to a treatment with follow-up or delayed treatment control condition. Participants attended weekly 90-minute small group sessions over a 14-week period. Skills were taught through didactic instruction using concrete rules and steps of social etiquette in conjunction with role-play demonstrations. Teens practiced newly learned skills during behavioral rehearsal exercises and parent-assisted weekly socialization homework assignments. Targeted friendship skills included: verbal and nonverbal communication; electronic communication and online safety; appropriate use of humor; expanding and developing friendship networks; peer entry and exiting strategies; good host/guest behavior during get-togethers with friends; good sportsmanship; methods for resolving peer conflict, including strategies for handling arguments and rumors/gossip; and strategies for handling rejection, including how to change a bad reputation and how to handle verbal teasing, physical bullying, or cyber bullying.
Major findings reveal that treatment participants, in comparison to delayed treatment control participants, significantly improved their social responsivity as measured by the Social Responsiveness Scale (SRS; p < 0.01) following the intervention. Increases in social awareness (p < 0.05), social cognition (p < 0.05), and social communication (p < 0.01) were observed. Results further suggest improved overall social skills on the Social Skills Rating System (SSRS; p < 0.01) following treatment. Improvements in cooperation (p < 0.01), assertion (p < 0.05), and responsibility (p < 0.01) were found. Data obtained at a 14-week follow-up assessment reveal that treatment gains were maintained on the SRS (p < 0.01) and the SSRS (p < 0.01), with further improvements in the areas of decreased problem behaviors (p < 0.01), decreased externalizing (p < 0.01), and increased self-control (p < 0.01).
This research represents one of the few treatment intervention studies aimed at improving the friendship skills of adolescents with ASD. Findings suggest that PEERS, a parent-assisted manualized social skills intervention, is efficacious in improving the social responsivity and overall social skills needed to develop and enhance friendships for teens with ASD. Possibly due to active participation of parents in the intervention, treatment gains were maintained at a 14-week follow-up assessment, and in some areas were further improved.