Tackling Teenage in High Functioning-Autism Spectrum Disorder Adolescents (HF-ASD): A Pilot Project in Barcelona

Background: Adolescence is a transition period of life, especially difficult for Autism Spectrum Disorder (ASD) adolescents, who have scarce social understanding and difficulties to cope with changes. Discrepancies between socio-emotional and physical development arouse driving to frustration and disturbances in socio-emotional behavior (Stokes, 2007; Ballan, 2011). At Yulius Health Institution in The Netherlands, Dutch researchers have developed the Tackling Teenage (TT) Training, a program based on previous psychoeducative and cognitive models (Hellemans, 2007; Sperry and Mesibov, 2006) and aimed to improve psycho-sexual development in ASD adolescents.

Objectives: 1) To adapt the TT program to our environment in collaboration with the Rotterdam research team. 2) To replicate the previous positive results in High-Functioning ASD (HF-ASD) adolescents.

Methods: The TT consists of 18 weekly individual sessions with a trained psychologist. The topics and themes of the TT adapt the psychosexual education and interpersonal abilities to the knowledge and functioning levels of the adolescent. Effects of TT were investigated by comparing the knowledge and skills of the HF-ASD adolescents before (T1) and after the training (T2). Baseline assessment included the ADI-R, WISC-IV or the WAIS-III depending on age, the Social Responsiveness Scale (SRS), the Child Behavior Checklist (CBCL) and the Knowledge Test (KT) about human biology. The SRS, the CBCL and the KT were administered again at T2. At the moment, 14 adolescents with DSM-IV diagnosis of HF-ASD and with VIQ>80 have been recruited and six have completed the training.  All diagnoses were confirmed with ADI-R and clinical consensus of the research team. Ethical board committees of both hospitals have authorized the present study.

Results: Mean age of the recruited sample (n = 14) was 15.36 years (SD 1.6) and included 3 females. The IQ was in the normal range (102.2; SD 13.84). They showed significant level of autistic symptoms, with means of 17.91 (SD 5.24), 14.91 (SD 4.32), 4.36 (3.14) and 1.9 (2.13) for the ADI-R areas. The SRS mean at baseline was 79.92 (SD 28.26). The CBCL mean total score was 60.4 (SD 10.84). They had a mean of 24.39 (SD 7.15) in the KT. No significant differences were found between the recruited sample and participants who have finished the training (n = 6).

The pre-post analysis showed a significant improvement of social communication deficits (t = 4.95, p = 0.004) and a significant improvement of knowledge (, t = -3.52, p = 0.010) after intervention. No significant differences were found in the total score of the CBCL (p = 0.436) nor in the internalized or externalized symptoms subscales (p = 0.41). A negative significant correlation was found between increase knowledge after intervention and age (r=-0.77, p=0.036).

Conclusions: These preliminary findings suggest that the TT increases knowledge on sexuality as well as decreases of severity of communication deficits as measured by SRS in HF-ASD adolescents.  In this Spanish sample, younger ones seem to improve more.