A Comparison of Social Skills Intervention in Three Different Contexts

Background:  

Social reciprocity deficits are a core feature of the autism spectrum disorders (ASD) and a major source of impairment regardless of cognitive or language ability (Carter, Davis, Klin & Volkmar, 2005). Since these impairments do not naturally remit with age, it is critical to intervene as early as possible to offset potential risk factors. (Tantum, 2003). Group training approaches provide children with teaching opportunities with other children and allow for the direct instruction of skills within a structured environment (Bellini, Peters, Benner & Hopf, 2007). Research in social skills group research has increased but several questions remain.

Objectives:  

This study evaluated the outcome of a social skills curriculum for 37 children between the ages of 8 to 14 years with a diagnosis of ASD within three different treatment contexts, the camp, clinic and combined model. The camp model simulates a natural setting where children with ASD spend 5 hours each day for 10 days where social skills are taught through engaging activities and interactions with peers both typical and with ASD. The clinic model on the other hand is a one hour a week session spread over 10 to 12 weeks where social skills are taught and practiced while parents observe through a one way mirror and are trained on the intervention methods. Both clinic and camp model treatments are then compared with a third group who experience both treatments within the clinic and camp setting.

Methods:  

Twelve children between the ages of 8 to 14 years with an ASD diagnosis (Autism, Aspergers, Pervasive developmental Disorder, Not otherwise specified (NOS) received from a psychologist or physician and referred to the clinic for social skills training were selected from each of the 3 treatment modalities: camp alone, clinic alone and from those who had attended both camp and clinic treatments. Before participating in the social skills groups, the children completed a manualized social skills assessment for individuals with ASD (Stone, Ruble, Coonrod, Hepburn, & Pennington, 2002) to ensure that they had appropriate task demand skills.

Two dependent variables were measured at outcome: (a) the Social Responsiveness Scale (SRS; Constantino, Przybeck, Friesen &Todd, 2000), and  

(b) the TRIAD Social Skills Assessment (TSSA; Stone, Ruble, Coonrod, Hepburn, & Pennington, 2002).  Parents of children completed the SRS, and the TSSA before and after the treatments.

Results:  

Results show that the combined context had the highest treatment effects followed by the camp model and finally the clinic model. Analysis of covariance did not show the groups to differ from each other significantly in terms of treatment gains. There was a significant posiitve correlation between intervention time and treatment effect.

Conclusions:  

More intervention indicates better treatment effects, especially when treatment allows for skill generalization through parent training, incorporating the natural milieu and typical peers. While the intervention and results are promising, replication with larger samples and use of a control group is needed.