Examining PEERS® for Young Adults: Improvements in Social Responsiveness and Depression and Relations to EEG Activity

Background: Social skills deficits among individuals with ASD lead to isolation and lack of friendships. For adults with ASD, poor social skills translate to under- or unemployment and dissatisfying social relationships (Venter, Lord, & Schopler, 1992). The latter is particularly concerning given the high rates of comorbid depression and withdrawal that exist within the ASD population (Stewart, Barnard, Pearson, Hasan, & O’Brien, 2006). The Program for the Education and Enrichment of Relational Skills for Young Adults (Gantman, Kapp, Orenski, & Laugeson, 2012) is an empirically based, manualized, caregiver-assisted treatment program designed to teach motivated young adults with high-functioning ASD the social skills needed in order to make and keep friends.

Objectives: There are no published studies that have replicated PEERS for Young Adults outside of its site of development, and no studies that have evaluated effects on brain function. Thus, this study seeks to be an independent replication of PEERS for Young Adults in order to evaluate the effectiveness of the program for improving social skills and decreasing depression, and how the intervention affects measures of brain function related to emotion: EEG asymmetry and ERP responses to emotional face and non-face stimuli.

Methods: The analysis included 27 young adults (18 to 26 years old) with ASD. All participants had a verbal IQ > 70 and diagnoses were confirmed with the ADOS. The intervention was the 16-session PEERS for Young Adults. Measures were taken at pre- and post-intervention and included: (1) the Social and Emotional Loneliness Scale for Adults (SELSA: DiTommaso & Spinner, 1993); (2) the Social Responsiveness Scale (caregiver report; SRS: Constantino, 2005); (3) the Beck Depression Inventory (BDI: Beck, 1987); and (4) a 3-minute continuous, resting state EEG recording and an ERP paradigm including positive and negative social/nonsocial IAPS (International Affective Picture System: Lang, Bradley, & Cuthbert, 2008) images.      

Results: For the experimental group, young adults’ caregivers at post-treatment reported improvements in social awareness (Wilks’ Lambda = .71, F(1, 25) = 10.07, p < .05), social communication (Wilks’ Lambda = .82 F(1, 25) = 5.48, p < .05), and total social responsiveness (Wilks’ Lambda = .82, F(1, 25) = 5.34, p < .05). On the BDI, group differences did not reach traditional levels of significance; however, young adults receiving PEERS demonstrated a trend toward a decrease in depressive symptoms at post-treatment while the waitlist group exhibited an increase in depressive symptoms. Group differences did not emerge on the SELSA. Planned analyses will include two additional cohorts to further assess PEERS in terms of caregiver-reported social responsiveness and self-reported depression and social loneliness, as well as analysis of the EEG asymmetry and ERP data.

Conclusions: Young adults receiving the PEERS intervention demonstrated a significant improvement in many domains of caregiver-reported social responsiveness. Young adults’ self-reported depression also suggested a trend toward a decrease in these symptoms post-intervention. The results from this study corroborate findings reported in the initial pilot study (Gantman et al., 2012) and add to the minimal literature that has examined efficacious social skills interventions for adults.