Evaluating the Social Validity of PEERS® for Young Adults, Teens, and Preschoolers in a Clinical Replication

Background:

PEERS® is an empirically supported, parent-assisted social skills group for teens. Employing a comprehensive curriculum, the program builds skills through instruction, role-playing, modeling, and practice with feedback. PEERS® research suggests positive and durable effects on the social skills of teens with ASD and related disabilities (Laugeson et al., 2012). Currently, researchers are evaluating PEERS® curricula for young adults and preschoolers.

Few studies are devoted to evaluating the social validity (SV) of research-demonstrated autism interventions such as PEERS®. However, stakeholder approval is paramount when considering intervention diffusion and refinement. Indeed, stakeholders are more likely to select interventions they deem acceptable, while discontinuing those viewed as too demanding or inappropriate (Kazdin, 2000). Capitalizing on the burgeoning PEERS® evidence-base, research must pivot to empirical questions regarding stakeholder experiences.

Objectives:

Informing the development of our PEERS® clinical replication, we are surveying parent and patient participants across four SV domains: acceptability, feasibility, perceived effectiveness, and satisfaction.

Methods:

We are collecting clinical replication data of PEERS® at a university-based clinic. We have gathered data from 24 stakeholders involved in one teen, one young adult, and one preschool group (n = 12 parents; n = 12 adolescent/ young adults) and aim to gather data from 56 more participants by May 2017. Our inclusion criteria were identical to those described in PEERS® research. Every group had one female patient and the majority had ASD. Groups were supervised by a certified PEERS clinician and licensed psychologist. Attrition was minimal (three drops after session one). We found adequate reliability of item assignment to SV subdomains. We distributed the social validity questionnaires on the final session (response rate = 92%). The questionnaire used a 5-point scale: strongly agree = 5 to strongly disagree = 1.

Results:

Overall satisfaction across the groups was 3.9, with relatively high levels of group enjoyment (4.0). Stakeholders were modestly accepting of the intervention (3.6) and found it feasible (3.8)—parents of young adults were more neutral, whereas parents of preschoolers were more positive. For young adults and teens, parents were more neutral than patients. The perceived effectiveness on patients approached neutral (3.4), particularly for young adult perceptions of change (3.16) and parent perceptions of teen change (3.1). Attendance was high (mean = 90%; range: 67-100%). Exploratory correlations suggest, at p < .05, that (a) perceived effectiveness on parent behavior was negatively correlated with feasibility (r = -0.62) and positively correlated with overall satisfaction (0.77), (b) perceived effectiveness on patient behavior was positively correlated with program acceptance (r = 0.54), and (c) attendance was correlated with overall satisfaction (r= 0.49). Open-ended responses included: “I enjoyed learning new social skills” (teen), “It got me into the city regularly and reminded me to attend social events” (young adult), and “Now [young adult] is thinking about joining groups where he had not at all before” (parent).

Conclusions:

Preliminary results suggest modestly positive SV of PEERS®. Understanding the SV of PEERS® could help stakeholders improve successful contact with intervention. Our results are promising and warrant more rigorous investigation.