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Effect of PEERS Intervention On Self-Esteem and Self-Concept in Adolescents with ASD

Friday, 3 May 2013: 09:00-13:00
Banquet Hall (Kursaal Centre)
J. Wasisco, A. V. Van Hecke, J. S. Karst, S. Stevens, K. A. Schohl, B. Dolan, R. J. Remmel, N. Fritz, G. McDonald, J. Kahne and A. Reveles, Marquette University, Milwaukee, WI
Background:  Self-esteem is associated with many aspects of adolescent mental health, including relationship satisfaction, affect, and mood (Orth, 2012). However, few studies have investigated self-esteem in adolescents with Autism Spectrum Disorders (ASD). Lifelong social impairment likely impedes self-esteem development in children with ASD. Therefore, evaluation of interventions should include assessment of this construct. The Program for the Education and Enrichment of Relationship Skills (PEERS; Laugeson & Frankel, 2009) is an evidence-based, social skills intervention for adolescents with ASD. Though several studies have observed positive outcomes for teens following PEERS, there is little research discussing the impact of PEERS on self-esteem.

Objectives: The purpose of this study is to understand how involvement in PEERS intervention affects teenagers with ASD in terms of self-esteem and self-concept. Additionally, we explored the relationship between self-esteem and related constructs including social anxiety and cognitive functioning.

Methods:  Thirty-five teenagers with ASD were randomly assigned to an “Experimental” (n = 20) or “Waitlist Control” group (n = 15) prior to PEERS intervention. Prior to intervention, both groups were administered several measures including; The Autism Diagnostic Observation Schedule-General (ADOS-G), Kaufman Brief Intelligence Test–Second Edition (KBIT 2), and Piers-Harris Children’s Self-Concept Scale-Second Edition (Piers & Herzburg, 2002). The “Experimental” group then participated in weekly 1.5 hour sessions of PEERS over the course of 14 weeks. Both groups were then reassessed on the Piers-Harris scales immediately following treatment.

Results: A two-way, mixed between-within group Analysis of Variance (ANOVA) was performed to examine the impact of PEERS on overall self-esteem as well as specific components measured by the Piers-Harris, including: behavioral adjustment, intellectual and school status, physical appearance, freedom from anxiety, popularity, and happiness and satisfaction.  The group by time interaction was not statistically significant for any of the variables of interest.  However, there was a statistically significant main effect for popularity for both the Experimental and Waitlist groups F (1, 33) = 4.15, p = .05, with a larger mean change found in the Experimental group. Additionally, bivariate correlational analyses indicated a medium positive correlation between self-esteem change and social impairment on the ADOS, r = .379, n = 35, P = .025, with greater initial social impairment associated with greater change in self-esteem. In the experimental group, there was a positive correlation between Full Scale IQ score on the KBIT and change in self esteem, r = .436, n = 20, p = .054.

Conclusions:  Results did not suggest an overall change in self-esteem in adolescents with ASD following PEERS intervention over and above changes in a waitlist control group.  However, there was a significant main effect for popularity, suggesting that teens with ASD did feel more accepted by same-aged peers following intervention.  Results may have been limited by sample size, and it is important to further explore this question with a larger sample size.  In addition, correlational analyses suggested that greater impairment in social behavior prior to PEERS actually contributed to more change in self-esteem.

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