Preliminary Data on Individualized Social Skill Outcome Measures Associated with the START Group Social Skills Intervention for Adolescents with ASD

Background:  “High-functioning” adolescents with ASD are especially susceptible to limited access to crucial intervention services. These individuals often continue to have limited social success and difficulty with basic conversation skills, all while entering a developmental phase associated with increasingly complex social situations. Intervention at this stage is clearly essential to promote healthy outcomes. Social skills interventions have increased in popularity in recent years, with growing empirical evidence for their effectiveness (National Autism Center, 2009). Many of these interventions have been held in group formats to increase treatment availability while simultaneously providing opportunities for built-in peer practice (Barry et al., 2003). There is limited research, however, on the ideal format of social skill interventions to maximize therapeutic benefit.

Objectives:  Our current study evaluates the effectiveness a novel, multi-component group social skills intervention (START) for adolescents with ASD. The START program blends several established and novel treatment components, including motivational procedures, self-management, tailored individual target goals, an experiential format, and inclusion of typically developing peer facilitators.

Methods:  A repeated measures design was used to closely monitor participants’ social growth trajectories across two pre-intervention time points and serial reassessment after every five sessions of the START program. Participants were adolescents with a previous diagnosis of an ASD, conversational language use, and a verbal IQ above 70. The START program occurred weekly, and consisted of the following components: an individual check-in session, group socialization, group activity, group discussion of a social skill topic, role play, practice, an individual check-out session with parent involvement, and homework assignments to be completed between group sessions. In addition to the group curriculum, individual social skills were targeted for each participant (e.g. on-topic question-asking, on-topic comments, initiations, introduction of novel topics, elimination of negative statements, and equitable speaking time between conversation partners). Multiple forms of measurement were used to obtain a comprehensive picture of participants’ social competence, including direct observations of naturalistic conversations, parent report (SRS, SSIS), and adolescent self-report (SSIS). The direct observations also serve as measures of generalization, as this data was gathered outside of the START setting with unfamiliar peers.

Results:  The results of the study indicate that all socialization measures significantly improved following ongoing implementation of the START program. Data from several parent-report and adolescent self-report measures indicate significant social skill improvement. This poster highlights the improvement in individual target skills exhibited through direct observations of naturalistic conversations between participants and unfamiliar peers. Graphs of individual target skills show stability before intervention and improvement during participation in the START program, indicating generalization of social skill improvements. Medium to large effect sizes were observed across the majority of dependent measures.

Conclusions:  The preliminary START program target skill data provides strong evidence for its use as an effective group social skills intervention for adolescents with ASD. The incorporation of several unique components—peer facilitators, an experiential format, and the use of self-management to target individual skills—appear to directly drive improvements to all social measures, including generalized changes to directly observed social skill application in naturalistic settings.