19308
Adolescent Peer Inclusion in Community Settings Versus Social Skills Group Training
Autism Spectrum Disorder (ASD) is a developmental disorder that is characterized by behavioral and social deficits. Much research has been done to determine the best interventions in helping children learn and apply social skills. Direct instruction and therapy groups have been traditional approaches for social skills intervention in children; however, peer-mediated training may be more effective for social skill development than more traditional methods of direct instruction. While these techniques have proven effective for children with ASD, little has been done to test their efficacy with adolescents.
Objectives:
This study extends research on peer-mediated intervention beyond school settings to community groups, addressing the needs of adolescents with ASD in particular. Direct instruction in social skills is compared to peer-mediated training in community settings such as Boy Scouts of America. An additional benefit of the research is the provision of a model for community inclusion that can be applied in a variety of settings as a low cost, but effective alternative or addition to direct instruction approaches to social skills intervention.
Methods:
A single-subject, randomized control design was used. Participants were required to have an ASD diagnosis or educational classification (verified by ADOS, SCQ,and SRS), language levels consistent with an ADOS-2 Module 3 (Fluent Speech), and an ability to participate in group settings independently. Existing community group membership whas also required. Groups were randomly assigned to either direct instruction (using the PEERS® curriculum for 8-12 weeks) or peer-mediated (two 1-hour sessions) groups. Psychoeducation (awareness), peer initiation, and peer prompt and reinforce techniques were used as the bases for peer training. At the end of the initial intervention period, the groups were crossed over to the other treatment condition, allowing all participants access to both interventions. Wait list controls participated in both treatment conditions subsequently. Measures of social functioning (Bellini’s 2006 Autism Social Skills Profile and SRS) and social inclusion (Kasari’s 2012 Social Network Salience measures) were taken at baseline, at crossover, and at follow up. Social interaction data taken from video recordings of the community group meetings and direct instruction sessions were coded for analysis.
Results:
Results reported include participant characteristics, autism symptoms and longitudinal social functioning. Video observations quantified social interactions within community group settings at baseline, at crossover, and at follow-up. In addition to these probes, social interactions during intervention in both conditions are reported. Results in each condition separately, and in combination (after crossover) are reported. Social validity results are also reported.
Conclusions:
If peer-mediated inclusion interventions in natural environments can be delivered efficiently, in less time, and show positive effects, such interventions may prove beneficial to the general population, and be better suited for generalization of skills in adolescents with ASD. Using existing community groups to deliver peer-mediated interventions is a low cost, low intensity, easily accessible method of delivering intervention, especially for families who are not able to access more traditional direct instruction social skills groups due to barriers of income, location, or opportunity.