Randomized Control Trials for Social Skills Interventions: Exploring the Initial Results for the SCI-a Program

Background:   Autism has been identified as a national health crisis. Social skills deficits are key signifiers of autism and manifest in varying severity across the spectrum. There is a paucity of well-designed research examining social skills interventions that utilize a package of research-supported teaching strategies and phenotype-specific social programming for those with High Functioning Autism (HFA). The Social Competence Intervention for Adolescents (SCI-A) utilizes evidence-based practices to target phenotype-specific skills associated with the social competence of individuals with HFA. Six years of development, including IES Goal 2 funding, has demonstrated the feasibility and acceptability of SCI-A for delivery to this group of students within school settings. Moreover, data indicates the promise of SCI-A in improving a variety of student social skills and behavioral outcomes.

Objectives:  The current proposal shares the results of year one of a 5 year Goal 3 IES funded cluster-randomized trial (CRT) to examine the efficacy of SCI-A on student social, behavioral and classroom functioning as compared to Business as Usual (BAU) practices across twelve middle schools. 

Methods:  As part of the CRT design, half of the classroom teachers were trained and delivered the complete intervention during school programming to middle school students in groups of 4- 6. Assessment batteries were conducted with all students (n = 57) and one general educator per student about two weeks before (T1) and after (T2) the treatment students received intervention. Batteries included student performance on executive function (DKEFS, SPSI-R), theory of mind (NEPSY-II), and facial expression/emotion recognition tasks (NEPSY-II), and teacher reports of student social (SRS-2) and executive functioning (BRIEF) behaviors in the classroom. 

Results:  Random-effects ANCOVA models were used to analyze between-group differences (SCI vs BAU) on each outcome assessment. SCI students’ theory of mind improved from T1 to T2, and the improvement was greater than that of BAU students. Increased affect recognition was not found in either group. The SCI group evidenced greater increases in their reported rational problem solving than BAU. Results were mixed for SCI vs BAU comparisons on EF performance. Teachers reported improvements in SCI students’ social and EF behaviors, and these improvements were greater than that of BAU students. ANCOVA results and effect sizes will be presented. Fidelity measures on teacher implementation indicate high levels of treatment integrity.

Conclusions:  Congruent with six years of prior research on the Social Competence Intervention, the results of the present cluster-randomized trial indicated potential gains in execute functioning, rational problem solving, and social behavior for students with deficits in social skills who undergo the SCI-A.  With the promise of future analyses anticipating 3-4 times more participants, SCI outcome measures will cut across categorical diagnoses, targeting phenotype-specific effects and informing teachers and clinicians alike of personalized treatment plans.  Future research will determine the efficaciousness of SCI-A at 6-month follow-up. Furthermore, the implications and importance of CRT in applied settings by practitioners for social skills interventions will be explored.