23498
Symptoms of ADHD, Depression, and Social Anxiety As Predictors of Social Skills Outcomes Among Adolescents with ASD Following the UCLA PEERS® Intervention
Deficits in social skills, including impaired social-emotional reciprocity and poor nonverbal communicative behaviors, are common hallmarks for those with autism spectrum disorder (ASD) (Otero et al. 2015). These social deficits are often accompanied by deficits associated with other comorbidities that frequently occur in children with ASD (Leyfer et al., 2006). Among these comorbidities, anxiety, depression and Attention-Deficit/Hyperactivity Disorder (ADHD) are most common (Siminoff et al., 2008). 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 skills outcomes (Laugeson et al. 2012). While research suggests that ADHD, depression, and social anxiety are common symptoms yielding social deficits among adolescents with ASD, the extent to which these symptoms predict social skills outcomes following PEERS®requires examination.
Objectives:
The present study examines symptoms of ADHD, depression, and social anxiety as predictors of social skills outcomes among adolescents with ASD following a 14-week parent-assisted social skills intervention.
Methods:
Ninety-nine adolescents (males=81; females=18) with ASD ranging from 11-17 years of age (M=13.74; SD=1.65) and their parents participated in the study. Participants attended PEERS®, an empirically-supported parent-assisted social skills intervention. They attended 90-minute group treatment sessions over 14-weeks to learn guidelines related to the development and maintenance of social relationships. To assess baseline adolescent comorbidities, parents completed the Swanson, Nolan, and, Pelham Questionnaire-4thedition (SNAP-IV: Bussing et. al., 2008), which measures ADHD symptoms, and the Social Anxiety Scale (SAS; La Greca, 1999). Adolescents also completed the SAS at baseline, as well as the Children’s Depression Inventory (CDI; Kovacs, 1992). Treatment outcome was assessed by examining parent- and adolescent-reported change in frequency of social engagement using the Quality of Socialization Questionnaire (QSQ; Frankel & Mintz 2008), and parent-reported change in social responsiveness on the Social Responsiveness Scale (SRS; Constantino, 2005) pre- and post-intervention.
Results:
Paired samples t-tests reveal significant improvement in number of adolescent-reported hosted (t=-5.22, p<.001) and invited (t=-2.50, p<.05) get-togethers from pre- to post-treatment. Results also reveal significant improvement in parent-reported social responsiveness (t=7.84, p<.001) over the course of treatment. Multiple linear regression was used to assess baseline ADHD, social anxiety, and depression symptoms as potential predictors of treatment outcome. Change in social responsiveness was not related to baseline ADHD-inattentive, ADHD-hyperactive/impulsive, depression, or social anxiety scores (p>.10; R2=.009). These baseline scores were also not predictive of change in hosted get-togethers (p>.10; R2=.005). ADHD-inattentive, social anxiety, and depression baseline scores were not predictive of change in invited get-togethers (p>.10), but ADHD-hyperactive/impulsive baseline scores predicted less improvement at a trend-level significance (p<.10; R2=.075).
Conclusions:
Findings reveal that baseline ADHD, depression, and social anxiety symptoms are not predictive of improvement in social responsiveness or frequency of social engagement following the PEERS® intervention. However, a trend level significance was found for ADHD-hyperactive/impulsive youth, who presented with slightly less social reciprocity through invited get-togethers from peers.