In typically developing adolescents, high self-esteem or self-concept has been linked to peer acceptance and social activity (McDougall, Hymel, Vaillancourt, & Mercer 2011). This relationship has been seen to also exist for youth with Autism Spectrum Disorders (ASD; Atwood, 2003), who regularly face deficits in social behavior, and tend to suffer from self-blame, low self-esteem and peer rejection. The Program for the Education and Enrichment of Relational Skills (PEERS®) is a 14-week evidence-based social skills intervention that addresses poor social skills for adolescents with ASD by teaching lessons on how to make and keep friends. Previous research indicates that PEERS® is effective in improving overall social skills for youth with ASD; however, the extent to which self-esteem predicts treatment outcome has yet to be investigated.
This study examines how youth-reported self-esteem predicts improvement in parent-reported autism spectrum behaviors related to social skills following a school-based, teacher facilitated social skills intervention for middle and high school adolescents with ASD.
Participants included 146 adolescents, ranging from the age of 11-18 (M=15.08; SD=1.82). Participants received approximately 30 minute of daily social skills instruction over a 14-week period. Teachers provided instruction on the PEERS® curriculum through didactic presentation, role-play demonstrations, behavioral rehearsal activities, and review of socialization homework assignments. In order to understand the relationship between self-esteem and treatment outcome, students completed the Piers Harris Self-Concept Scale Second Edition (PHS2; Piers, Harris, and Herzberg, 2002) at post-test to measure self-esteem, while parents completed the Social Skills Improvement System (SSIS; Gresham and Elliott, 2008) at pre-test and post-test to evaluate social skills treatment outcome. Pearson correlations were calculated to examine the relationship between PHS2 subscales and the SSIS Autism Spectrum Subscale, which measures behaviors such as preoccupation with objects, perseveration, and poor eye contact.
Results revealed that higher youth-reported overall self-esteem on the PHS2 significantly predicted improvement in parent-reported autism spectrum behaviors on the SSIS (p<.02), particularly in the areas of Behavioral Adjustment (p<.04), Physical Appearance (p<.03) and Happiness (p<.01). Intellectual Status (p<.07) and Freedom from Anxiety (p<.07) on the PHS2 predicted treatment outcome on the SSIS Autism Spectrum subscale at trend levels. The PHS2 Popularity subscale did not predict improvement in autism spectrum behaviors on the SSIS.
These findings suggest adolescents with ASD who report higher self-esteem are less likely to demonstrate autism spectrum behaviors related to social skills following treatment, according to parent report. In particular, adolescents receiving the PEERS® intervention in the classroom who endorse fewer problematic behaviors, greater confidence in personality attributes and physical appearance, and greater happiness and satisfaction post-treatment are more likely to decrease nonfunctional routines and rituals present in their daily lives.
See more of: Epidemiology
See more of: Prevalence, Risk factors & Intervention