18587
Treatment Compliance As a Predictor of Treatment Outcome in Adolescents with Autism Spectrum Disorder Following the PEERS® Social Skills Intervention
Adolescents with Autism Spectrum Disorder (ASD) are known to have deficits in social functioning, impacting their ability to maintain reciprocal friendships (Laugeson & Frankel, 2010). Evidence has shown that social skills training interventions that promote increased social initiations and skill generalization through the use of homework assignments may improve social competence for youth with ASD (White, Keonig, & Scahill, 2007). The Program for the Education and Enrichment of Relational Skills (PEERS®), which is an evidence-based, parent-assisted social skills intervention for adolescents with ASD, attempts to enhance skill generalization through the completion of weekly homework assignments (Laugeson & Frankel, 2010). Previous research indicates that adolescents who participate in PEERS® demonstrate increased social engagement post-treatment (Laugeson et al., 2009; 2012); however, the extent to which homework compliance impacts treatment outcome has yet to be examined.
Objectives:
The purpose of this study is to examine the impact of homework compliance as a predictor of treatment outcome in adolescents with ASD after participation in a 14-week parent-assisted social skills program.
Methods:
Participants in this study included 104 adolescents (males=87; females=17) with ASD ranging from 11-18 years of age (M=13.97, SD=1.78) and their parents who presented for social skills treatment through the UCLA PEERS® Clinic. Adolescent and parent participants attended weekly 90-minute group treatment sessions over a 14-week period. To assess homework compliance, adolescents reported on their completion of their homework assignments each week, including making phone calls, joining conversations, and having get-togethers with peers. In order to measure treatment compliance, the mean of these three homework assignments was computed for each adolescent. Treatment outcome related to social engagement was assessed using change in scores on the Quality of Socialization Questionnaire (QSQ; Frankel & Mintz, 2008) pre- and post-intervention. The QSQ measures adolescent social engagement with peers through self-reported frequency counts of hosted and invited get-togethers in the previous month. Pearson correlations were calculated to examine the relationship between homework completion and change in social engagement on the QSQ from pre- to post-treatment.
Results:
Results reveal mean homework completion was 69.79% (SD=21.39) for participants. Higher levels of homework completion appear to predict greater increase in number of hosted (p<.05) and invited (p<.10) get-togethers over the course of treatment. In particular, lower homework completers (< 1SD below the mean) had an average of 0.35 fewer hosted get-togethers and 0.25 more invited get-togethers, while high homework completers (>1SD above the mean) had an average of 2.40 more hosted get-togethers and 0.88 more invited get-togethers over the course of the intervention.
Conclusions:
This study appears to be the first to examine treatment compliance as a predictor of treatment outcome in an evidence-based social skills intervention for adolescents with ASD. These findings suggest that adolescents with ASD who exhibit greater homework compliance may be more socially engaged with peers following intervention, suggesting greater generalization of skills due to treatment compliance. These results underscore the importance of homework completion in behavioral interventions for adolescents with ASD. Hence, practice in real world settings is critical to treatment outcome and generalization.