Pilot Study of Emotion-Focused Social Skills Interventions for Children with ASDs

Background:  Social deficits in HFA or AD are apparent in many domains including emotion perception, reciprocal communication skills, and understanding others’ intentions (Bauminger, 2002).  Evidence is emerging to suggest individuals with ASD can show normal levels of activity in important regions if task demands allow for explicit processing of key social stimuli (e.g., facial expression, tone of voice) (Wang, et al., 2006).  Here we present a sub-analysis of outcomes from a larger trial evaluating neural and behavioral outcomes of two models of a 12-session, outpatient social skills intervention for high functioning children with ASDs targeting improvements in nonverbal communication, emotion recognition, and empathy. The main study compares child-directed vs. adult-led social skills interventions, and utilizes direct assessments, behavioral observation data, and neuroimaging of key social cognitive regions to evaluate outcomes. The present analysis is evaluating the short-term effects of directed, intervention approaches on children's emotion recognition skills. 

Objectives: To evaluate preliminary outcomes of interventions targeting emotion-learning in school-aged children with ASDs.

Methods: Twenty-four children, 8-11 years old with autism spectrum disorders, confirmed by comprehensive diagnostic evaluations utilizing DSM-IV, ADOS, and ADI were included in the present analysis.  Children were randomized into one of two conditions, with 4-6 children per group, 1 lead therapist and 1 assistant.  Sessions were 90-minutes in length and included concurrent child therapy and parent education sessions. The two treatment models included an adult-directed, cognitive-behavioral therapy based program and a child-led, play-therapy based program.  Both models included curricula focused on building emotion recognition and empathy skills.  Children were evaluated at baseline, 12-weeks, and 3 months post-intervention on all outcome measures.

Results: This preliminary analysis collapses data across treatment conditions and evaluates outcomes on two behavioral measures at the 12-week endpoint.  Across treatment groups, paired sample t-tests yielded significant improvement on emotion perception in voices, as measured by the Diagnostic Analyses of Nonverbal Behavior 2 (DANVA2). Improvement in direct assessment of emotion perception was also supported by parent reports on measures of affective empathy.

Conclusions:  These initial results suggest that the interventions as a whole produced significant changes in children's perceptions of emotions on social cognitive tasks as well as parent ratings of empathetic behaviors.  While data is currently being collected on the larger trial and analysis of group differences are not yet available, the results of this sub-analysis suggest the potential for improvement of affective perception and empathy from brief social skills interventions delivered in a small group setting.