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Introduction:

Social Skills Training for Adolescents with Asperger Syndrome and High-Functioning AutismBy Jeanie Tse, Jack Strulovitch, Vicki Tagalakis, Linyan Meng, Eric Fombonne

Journal of Autism & Developmental Disorders, ©2007 1

Topic: What is autism?(Goldstein & Nagieri, 2007)

• Spectrum of behaviors and developmental difficulties

• Developmental disorder

• Cognitive deficits

• Symptoms:

• Social

• Language

• Repetition or Restricted Interests2

Topic: Criteria for diagnosis (Impairments)

1. Social interactions

•Nonverbal queues, emotions

2. Communication

• Conversation

• Echolalia

• Imaginative play

3. Restricted interest/movements

• Self stimulatory behavior 3

Why is this topic important?

• Social interactions becomes increasingly important

(Kanner, Rodriguez, & Ashenden, 1972; Shopler & Mesibov, 1983)

•Awareness, but lack of ability to fit in

• Anxiety, depression, suicide(Howlin, 2000, Krasny,, Williams, Provencal, & Ozonoff, 2003; Storch, Sulkowski, Nadeau, Lewin, Arnold, Mutch, et al., 2013)

4

Current Interventions (Tse et al, 2007)

Focus:

• Social knowledge & behaviors

• Theory of Mind

• Group format

Deficits

• Few peer reviewed, evidence-based interventions

• Case series

• Lack of valid and reliable tools for assessment 5

Hypothesis

• Teaching social skills to adolescents with

high functioning autism will:

• Increase social functioning,

• Will not effect other behavior problem

areas

6

Methods

• 44 Adolescents (13-18)• clinical sample

• Criteria for inclusion in study • Diagnosis, ability to participate, & desire

• Group curriculum with rules

• Standard sequence of events

• Social skills taught• Conversational

• Hygiene

• Emotional expression 7

SOCIAL SKILLS USED IN GROUP ACTIVITY/ROLE PLAY

Method & Statistics (Measures)Parents were asked to complete three questionnaires (pre/post):

• Social Responsiveness Scale (SRS)

• Aberrant Behavior Checklist (ABC)

• Nisonger Child Behavior Rating Form (N-CBRF)• Social Problems (SP)

• Problem Behaviors (PB)

Participant and Parent Satisfaction Survey (post)

Data analysis:

• Wilcoxon matched pairs test 9

Results & Statistics:

• Sample characteristics (n =44)

• Missing Data

• Feedback Surveys 26 participants

• Pre/post tests

• Attrition

Significant change in:

• Social competence (P<.05 effect: .34 to .46)

• Problems Behaviors (p<.05 subscales, except hyperactivity) 10

11

12

Conclusions & Discussion • Effective

• Parents’ difficulty in assessing social awareness

• Motivation to attend = gains in social competence

• SRS and N-CBRF-PS shows moderate effect.

13

Conclusions & Discussion

• Improvements on some problem behaviors

•Adolescents who completed feedback survey had more improvement

14

Conclusions & Discussion (limitations)

• Sample size

• Control group

• Using only parent report

• different perceptions

• Global adaptive functioning unavailable

• Lack of follow-up data

• Long-term retention, generalizability

• Confound with medication

• Not manualized 15

Conclusion (benefits & future directions)

• Moderate effect size

• Low cost, simple intervention

• Discord with previous findings

• “Real world” setting & need

• More research into psychosocial intervention with manualized interventions

• Randomized, control group

• Parallel group for parents 16

ReferencesBieber, J. (1994). Learning disabilities and social skills with Richard Lavoie: Last one picked, first one

picked on. Washington, D.C.: Public Broadcasting Service.

Goldstein, S., & Naglieri, J. (2013). Interventions for autism spectrum disorders translating science into practice. New York, NY: Springer.

Gray, C. (1994a). The new social story book. Arlington: Future Horizons.

Gray, C. (1994b). Comic strip conversations. Arlington: Future Horizons.

Howlin, P. (2000). Outcome in adult life for more able individuals with autism or Asperger syndrome. Autism, 4, 63-83.

Kanner, L., Rodriguez, A., & Ashenden, B. (1972) How far can autistic children go in matters of social adaptation? Journal of Autism and Childhood Schizophrenia, 2, 9-322

Krasny, L. Williams, B. J., Provencal, S., & Ozonoff, S. (2003). Social skills interventions for the autism spectrum: Essential ingredients and a model curriculum. Child and Adolescent Psychiatric Clinics of North America,

Storch, E. A., Sulkowski, M. L., Nadeau, J., Lewin, A. B., Arnold, E. B., Mutch, P. J., et al. (2013) The Phenomenology and Clinical Correlates of Suicidal Thoughts and Behaviors in Youth with Autism Spectrum Disorders. Journal of Autism and developmental disorders, 43, 2450–2459.

Schopler, E., & Mesibov, G. B. (1983). Autism in adolescents and adults. New York: Plenum Press.

White,, S. W., Scahill, L., & Ollendick, T. (2013). Multimodal Treatment for Anxiety and Social Skills Difficulties in Adolescents on the Autism Spectrum. CBT for Children and Adolescents with High Functioning Autism Spectrum Disorder. New York, NY: The Gulford Press. 17