Examining the Relation Between Social Anxiety and Social Engagement Outcomes Among Adolescents with Autism Spectrum Disorder Following the UCLA PEERS® Intervention
Deficits in social skills, including impaired social-emotional reciprocity, poor nonverbal communicative behaviors used for social interaction, are common hallmarks for those with autism spectrum disorder (ASD) (Otero et al. 2015). As a result, adolescents with ASD often have difficulty understanding their peers and establishing social reciprocity with others (Volkmar 2011). These social skill deficits, in combination with elevated physiological arousal, can lead to the development of social anxiety, which is significantly associated with increased social avoidance (Bellini 2006). Previous research on the UCLA Program for the Education and Enrichment of Relational Skills (PEERS®), an evidence-based social skills intervention for adolescents with ASD, demonstrates increases in social engagement following treatment (Laugeson et al. 2012). While research suggests that social anxiety is associated with social avoidance, the extent to which social anxiety is related to frequency of social engagement in adolescents with ASD following PEERS®has yet to be examined.
The present study examines the relationship between social anxiety at baseline and social engagement in adolescents with ASD following the completion of a 14-week parent-assisted social skills intervention.
One hundred adolescents (males=84; females=16) with ASD ranging from 11-18 years of age (M=14.02; SD=1.81) and their parents participated in the study. Adolescents and their parents attended an evidence-based, parent-assisted social skills intervention, PEERS®. They attended 90-minute group treatment sessions over a period of 14-weeks to learn guidelines of social behavior related to the development and maintenance of social relationships. In order to assess social anxiety and social avoidance at baseline, adolescents and parents completed the Social Anxiety Scale (SAS; La Greca, 1999) pre-intervention. To assess change in frequency of social engagement, adolescents and parents completed the Quality of Socialization Questionnaire (QSQ; Frankel & Mintz 2008) which assesses the frequency of hosted and invited get-togethers with peers in the previous month at baseline and post-intervention. Pearson correlations were calculated to examine the relationship between social anxiety at baseline and change in social engagement from pre- to post-treatment.
Results reveal that 49 percent of participants (n=49) reported social anxiety in the clinical range at baseline, as measured by the SAS total score (≥50). While social engagement increased over the course of treatment for the full sample, as measured by adolescent and parent-reported hosted (p<.001) and invited (p<.05) get-togethers on the QSQ, overall social anxiety at baseline on the SAS was not associated with improvement in social engagement following intervention. However, higher scores on the SAS subscale of General Social Avoidance and Distress were significantly correlated with an increase in parent-reported hosted get-togethers (p<.05) following treatment.
Conclusions: Although there was no significant relationship between adolescents’ overall social anxiety at baseline and change in social engagement following PEERS®, there was a significant treatment effect for adolescent and parent-reported hosted and invited get-togethers. Greater general social avoidance and distress prior to treatment may be related to better treatment outcomes through improved social engagement. These findings suggest that social anxiety may not influence treatment outcomes related to social engagement for adolescents following the PEERS® intervention.