Objectives: Aims were to (1) assimilate previous research on effective social skills treatments into a single program for children with high functioning ASD; (2) examine treatment fidelity, consumer satisfaction, and social validity variables; and (3) measure generalization and maintenance effects outside of treatment settings.
Methods: The program was piloted in three settings: a school for children with autism; a public elementary school; and an outpatient clinical setting. Twelve children with ASD participated. Inclusion criteria were (1) current educational classification or clinical diagnosis of ASD; (2) score at or above cutoff for ASD on multiple measures, including ADOS, GADS, and SRS; (3) verbal IQ at or above 69; and (4) parental consent. University, mental health agency and school district IRB approval was obtained. Typical peers were also included.The program has 18 units covering introductory, intermediate, and some advanced social skills taught weekly in two 30-45 minute sessions or one 90-minute session. Multiple components of the program included: (1) instruction delivered by original animated superhero characters rather than adult didactic instruction; (2) video modeling of social scripts by peers; (3) peer-mediated intervention; (4) self-management by tracking skill practice on individual superhero collectible cards; (5) parental involvement through reading comics and watching DVDs with children; and (6) naturalistic settings for skill practice via teachers and parents tracking on collectible cards in class and at home. Treatment fidelity was accomplished by using two-page lesson plans with consistent format.
Treatment effects were assessed through a direct observation system that measures social engagement skills and has been used in prior research (Bellini, 2007). Ratings of specific social behaviors during unstructured analogue free play and recess periods were gathered. The Autism Social Skills Profile (ASSP) and Social Responsiveness Scale (SRS) were completed by teachers and parents prior to and following treatment. The Behavior Intervention Rating Scale (BIRS) and other study-developed measures of consumer satisfaction and social validity were collected. Treatment fidelity was rated by observers after each session.
Results: Preliminary results indicate primarily large effect sizes (ES) across observation settings and clinical and preschool groups for social engagement (.74 to 1.47). Percentage of nonoverlapping data points (PND) showed a range from 16.67% to 100% across all measures with 1 outlier of 0%. ES by Parent Daily Report ranged from .25 to 3.05. Treatment fidelity, social validity, and consumer satisfaction variables are still being analyzed, as well as some of the data from the elementary school setting.
Conclusions: Multiple evidence-based components were shown to successfully integrate into a single program delivered in a specialized school for children with autism, a public school, and clinical settings. ES for social engagement were primarily large with some medium ES across settings.