Efficacy of the Multi-Media Social Skills Project for Adolescents with ASD

Background:  Despite increases in research examining the efficacy of social skills interventions for individuals with Autism Spectrum Disorder (ASD), few studies have targeted adolescents. This is problematic as peer relationships during adolescence demand social fluency, flexibility and responsiveness for optimal social outcomes. 

Objectives:  The authors sought to examine the effectiveness of a social skills intervention for adolescents with ASD. It was hypothesized that individuals who participated in the intervention would display significant decreases in social difficulties and increases in conversational skills. Additional differential treatment effects by internalizing and externalizing symptoms were explored in post hoc analyses.

Methods:  Thirty-six adolescents diagnosed with ASD ages 13- to 18-years-old (M = 14.61, SD = 1.36; 81% male; 97% Caucasian) enrolled in the Multi-media Social Skills Project which utilized manualized group instruction, video modeling, and peer generalization. ASD diagnosis was confirmed via the Checklist for Autism Spectrum Disorders (CASD; M = 21.83, SD = 4.59) and verbal IQ was estimated using the Kaufman Brief Intelligence Scale, Second Edition (KBIT 2; M = 104.33, SD = 18.85). Exclusionary criteria included verbal IQ below 70. Samples of five minute conversations between participants and a same-age confederate were coded for social behaviors and fluencies pre- and post-intervention, as well as at a three-month follow-up. The Social Responsiveness Scale, Second Edition (SRS 2) and the Strengths and Difficulties Questionnaire (SDQ) were obtained at each time point.

Results:  Repeated measures ANCOVAs were conducted to assess effectiveness of the intervention. Cohort, age, and verbal IQ were entered as covariates. Caregivers and participant’s report of peer difficulties significantly decreased [F = 7.22, p < .01 (caregiver); F = 4.15, p < .05 (self)]. Additionally, changes in seconds of silence (F = 4.73, p < .05), number of questions asked (F = 6.32, p < .01), validation statements (F = 5.64, p < .01), topic changes (F = 2.82, p < .08), and run-on statements (F = 3.53, p < .05) were found at post-intervention and three-month follow-up. Post hoc analyses found that participants who were younger (≤ 14-years-old), had lower verbal IQs (< 102), and were less impaired in ASD symptoms asked more questions following the intervention. Similarly, participants who were younger were found to display significant decreases in run-on statements while those with more peer difficulties and more restricted and repetitive behaviors displayed significant decreases in topic changes. Finally, participants who were more anxious made improvements in conversational skills (e.g., total words spoke, number of commenting statements); however, this was not maintained at three-month follow-up. 

Conclusions:  The Multi-media Social Skills Project for adolescents with ASD was found to demonstrate significant improvements in peer difficulties, as well as several observable conversational skills. The majority of these improvements were maintained at a three-month follow-up. Post hoc analyses found that social fluency improved for individuals who were more anxious, social flexibility improved for adolescents who had more peer difficulties and restricted and repetitive behaviors, and social responsiveness improved for adolescents who were younger, had lower IQs, and were less impaired in ASD symptoms.