Literature Review Chapter: Social Skills Interventions for Hfasd

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[. . .] , 2012). Parent, child, and staff ratings for intervention satisfaction were high across the board (Thomeer et al., 2012).

Two to three months following completion of the intervention the parents evaluated how persistent the changes were and all improvements remained intact except for one: social responsiveness was no longer statistically significant (Thomeer et al., 2012). These results confirm the efficacy of the manualized, comprehensive SSI developed by this group of researchers for improving the social knowledge and competence of HFASD children.

The Program for the Education and Enrichment of Relational Skills (PEERS) is an adaptation of the Children's Friendship Training (CFT) course that emphasizes parent participation (reviewed by Schohl et al., 2013). The PEERS program, however, incorporates modifications designed to address the needs of HFASD children specifically (Schohl et al., 2013). The program includes didactic instruction, role-playing, modeling, rehearsal, feedback, social rules instruction, social etiquette, handling difficult behaviors in others, hosting, changing personal social habits, and homework, but also requires active participation of parents in the intervention sessions (Schohl et al., 2013).

Adolescents (N = 58) between the ages of 11 and 16 were enrolled in the study and randomly assigned to a treatment or wait-list group (Schohl et al., 2013). The intervention consisted of weekly 90-minute sessions over the course of 14 weeks (Schohl et al., 2013). Outcome measures included social responsiveness, knowledge, skills, and anxiety, along with friendship quality, socialization frequency and quality, adaptive behaviors, and intelligence (Schohl et al., 2013). Seven of the eleven outcome measures significantly improved in the treatment group compared to the wait-list group and these were: (1) adolescent-reported social skills knowledge, (2) adolescent-reported hosting, (3) adolescent-reported inviting, (4) adolescent-reported anxiety, (5) parent-reported social skills, (6) parent-reported problem behaviors, and (7) teacher-reported problem behaviors (Schohl et al., 2013).

The Skillstreaming, SDARI, and PEERS SSIs are intensive, short-term interventions designed to have an immediate impact on groups of HFASD children and adolescents. In Ireland a consultation model has been studied which involves school psychologists working with teachers to provide remedial help with autism-related behavioral challenges (reviewed by Minihan, Kinsella, and Honan, 2011). The consultation process involved four phases: (1) problem identification, (2), problem analysis, (3) plan implementation, and (4) plan evaluation (Minihan, Kinsella, and Honan, 2011). The consultation consisted of 10 sessions spread over 7 to 13 weeks (Miinhan, Kinsella, and Honan, 2011). Each session tackled one social skill (Minihan, Kinsella, and Honan, 2011).

The outcome measures were social responsiveness (SRS) from the perspective of teachers and parents (Minihan, Kinsella, and Honan, 2011). Some of the skills the school psychologists focused on included eye contact, listening skills, reciprocity, managing a conversation, and respecting personal boundaries (Minihan, Kinsella, and Honan, 2011). Teachers also evaluated the acceptability and effectiveness of the intervention (Minihan, Kinsella, and Honan, 2011). Given that the design of this study was case control, the findings should be considered primarily qualitative.

The study by Minihan and colleagues (2011) found clinically-significant improvements in social responsiveness for four of the five students enrolled in the study. Teachers felt universally encouraged by the program and expressed a desire to have permanent access to consultation services (Minihan, Kinsella, and Honan, 2011). From the parent's perspective, the improvements in social skills were mild to modest, but across all parents the gains proved to be statistically significant (Minihan, Kinsella, and Honan, 2011).

In the absence of a control group, however, the improvements cannot be definitively attributed to the consultation program. For example, the enrolled children could have improved because they were being attended to more frequently. The same limitation applies to the studies discussed above that used a wait-list group as a control. The only study in this discussion that addressed this limitation was the direct comparison of Skillstreaming and SDARI by Lerner and Makami (2012), which revealed several significant differences. Yet, RCT studies investigating the efficacy of the many SSIs available remain rare; therefore, definitive statements concerning the efficacy of SSIs will have to await the completion of more comprehensive and rigorous studies in the future. A few of the other main limitations are small sample sizes and non-randomization of study subjects.

References

Lerner, Matthew D., Mikami, Amori Yee, and Levine, Karen. (2011). Socio-Dramatic Affective-Relational Intervention for adolescents with Asperger syndrome & high functioning autism: Pilot Study. Autism, 15(1), 21-42.

Lerner, Matthew D. And Makami, Amori Y. (2012). A preliminary randomized controlled trial of two social skills interventions for youth with high-functioning autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 27(3), 147-157.

Lopata, Christopher, Thomeer, Marcus L., Volker, Martin A., Toomey, Jennifer A., Nida, R.E., Lee, Gloria K. et al. (2010). RCT of a manualized social treatment for high-functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 40, 1297-1310.

Matson, Johnny L., Hess, Julie A., and Mahan, Sara. (2013). Moderating effects of challenging behaviors and communication deficits on social skills in children diagnosed with an autism spectrum… [END OF PREVIEW]

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