Empathy As a Predictor of Treatment Outcome in Young Adults with ASD Following the UCLA PEERS® Intervention

Background:

Young adults with Autism Spectrum Disorder (ASD) are known to have social deficits which often impede their ability to develop meaningful relationships. However, increased empathic skills may be associated with better overall social functioning, possibly enhancing relationships with others. Although few evidence-based social skills interventions exist for young adults with ASD, one treatment has been shown to significantly increase social responsiveness, overall social skills, peer engagement, and empathy. The Program for the Education and Enrichment of Relational Skills (PEERS^®) for Young Adults is an evidence-based, caregiver-assisted social skills treatment targeting relationship skills in young adults with ASD without intellectual disabilities. While this program has been empirically-supported for youth with ASD, the complex relationship between empathy and treatment outcome has yet to be explored. 

Objectives:

The present study seeks to examine how baseline empathy in young adults with ASD impacts treatment outcome in a caregiver-assisted social skills intervention targeting the development and maintenance of relationships. 

Methods:

Thirty-two young adults with ASD, ranging from 18-28 years of age (M=20.6; SD=2.1), and their caregivers participated in concurrent weekly 90-minute group treatment sessions over a 16-week period. Skills were taught through didactic instruction using concrete rules and steps of social etiquette in conjunction with role-playing exercises, in-session behavioral rehearsal activities, and caregiver-assisted weekly socialization homework assignments. In order to assess baseline empathy, caregivers completed the Empathy Quotient (EQ; Baron-Cohen & Wheelwright, 2004), which assesses empathy levels among adults with ASD, prior to treatment. Treatment outcome was assessed using a battery of caregiver-reported measures including the Social Responsiveness Scale (SRS; Constantino, 2012), the Social Skills Rating System (SSRS; Gresham & Elliott, 2008), and the Quality of Socialization Questionnaire (QSQ; Frankel & Mintz, 2008) pre- and post-intervention. Pearson product-moment correlation coefficients were computed to assess the relationship between baseline empathy and treatment outcome following intervention. 

Results:

Results indicate that baseline caregiver-reported empathy, as measured by the EQ, significantly predicts treatment outcome on the SRS in the areas of social awareness (p<.05). and social cognition (p<.05),  with a trend for overall social responsiveness (p<.08). Baseline empathy on the EQ also predicts treatment outcome of the SSRS in the areas of cooperation (p<.05), responsibility (p<.05), and externalizing (p<.05), in addition to increased peer engagement through invited get-togethers from peers on the QSQ (p<.01). 

Conclusions:  

These findings suggest that better empathic abilities prior to treatment may result in stronger treatment outcomes for young adults with ASD following the PEERS^® for Young Adults intervention. In particular, greater improvement may be observed in the areas of social responsiveness, overall social skills, and peer engagement. These findings are useful in distinguishing those who may be more likely to receive greater benefits from targeted social skills treatment.