Parent-Assisted Social Skills Training to Improve Friendships in Teens with

Autism Spectrum DisordersLaugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2008)

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Background

● Inclusion● Increase social interaction complexity*● Decrease nonsocial activity*● Lonelier, poor quality friendships**● Isolation, rejection, bullying***

● (*Sigman & Ruskin, 1999; **Capps et al., 1996; **Bauminger &Kasari, 2000, *** Tse et al., 2007)

Background

● Typical Teens vs. Teens with ASDs● Typical Teens:

– Best Friends● By 4th grade*● Aids resilience to life events**● Aids self esteem***● Aids social competence & social problem solving****● Neg correlated with anxiety and depression***

● Teens with ASDs– Missing out on these experiences– Need extra support and instruction

– (*Fankel, 1996; *McGuire & Weisz, 1982; **Miller & Ingham, 1976; ***Buhrmester, 1990, ****Nelson & Aboud, 1985)

Background

● Previous Research● Mostly children● Lower functioning range● Not formally tested (social competence)

● Exceptions:● Ozonoff and Miller (1995)● Tse et al (2007)

Out-Patient Social Skills Program

● PEERS intervention content● Adapted from Children's Friendship Training

– Evidence base: ADHD, Fetal Alcohol Spectrum, children with ASD

● (Frankel & Myatt, 2003), (O'Connor et. al., 2006), (Frankel & Myatt, 2007)Small Group Format

● Small Group Format● Parent instruction

● Separate concurrent sessions

Current Study

● PEERS intervention content:● Evidence base practices

– Didactic instruction, role playing, modeling, behavioral rehearsal, coaching with performance feedback, weekly socialization assignments with consistent homework review

● Social etiquette– Social situations with accompanying rules & steps– Teens provided instruction in steps

● Parents provided information to supervise

Targeted Skills

● Conversation

● Peer entry and exit

● Friendship networks

● Expanding & developing● Bullying, teasing, arguments

● Good sportsmanship

● Good host

● Changing reputations

Participants

● Teens (n = 33)● 13-17 years of age, mean 14.6● Male (28), Female (5)● Diagnosis of ASD

– HFA, Asperger's, PDD-NOS

● Caucasian (14), Hispanic/Latino (6), African American (3), Asian (4), Middle Eastern (3), Mixed ethnicity (3)

● Regular Ed (17), Special Ed (8), Pull out (2), Home-school (3), other Ed (3).

● Participants were randomly assigned to either the Treatment or the Delayed Treatment Group

Outcome Measures

● Test of Adolescent Social Skills Knowledge TASSK

● Teen● 22 items, Sentence stems with 2 choices● Knowledge of teen social skills

● (TASSK; Laugeson and Frankel, 2006)

● Friendship Qualities Scale● Teen● 23 yes/no questions regarding their best friend(ship)

● (FQS; Bukowski et al, 1994)

TASSK Example Items

● The goal of a conversation is to

● Make the other person like you● Find common interests

● One of the rules for having a two way conversation is

● To be an interviewer● Do not be an interviewer

● If you try to join a conversation and the people ignore you:

● Move on● Speak louder so they can hear you

Friendship Qualities Scale

● Yes / No Questions● Think of Best Friend

● My friend and I spend all of our free time together

Outcome Measures

● Social Skills Rating Scale● Parent & Teacher● 38 item questionnaire, never, sometimes, very often● Social skills scale, problem behavior scale

● (SSRS: Gresham and Elliott, 1990)

● The Quality of Play Questionnaire● Parent & Teen● 12 item questionnaire, frequency of get-togethers &

conflict● Hosted & invited get-togethers

● (QPQ; Frankel and Mintz, 2008)

SSRS Info and Sample Items

● Social Skills

● Cooperation

– Follows your direction● Assertion

– Invites others to join in activities

● Responsibility

– Requests permission before leaving the house

● Self Control

– Responds appropriately when pushed or hit

● Problem Behaviors

● Externalizing

– Fights with others● Internalizing

– Is easily embarrassed● Hyperactivity

– Acts impulsively

● ** Likert

– Never– Sometimes– Always

The Quality of Play Questionnaire

● Frequency of play dates

● Number of Dates invited vs. hosted

● Level of conflict● Criticized or teased

each other

Treatment

Completely manualized & delivered over 12 weeks

● Students– Reciprocity in conversation– Diminishing importance of rejecting peer group– Reversing negative reputations– Instruction to promote get-togethers– Competence with teasing, bullying, conflicts– Didactic lessons– Modeling, Role-playing, Performance feedback– Homework assigned

Treatment

● Parents● Review of homework assignments● Troubleshoot homework problems● Instruction to help teen overcome homework

problems

● Teen and Parents reunited● Teens deliver review for parents● Homework finalized

Quick Recap

● Random Assignment● Treatment & Delayed Treatment Group● Demographic information gathered● Pre-test outcome measures gathered

– Teens, Parents, Teachers● Treatment● Post-test outcome measures gathered

– Teens, Parents, Teachers

Results

Non-Significant Differences at Baseline Between Treatment Group and Delayed Treatment Groups

Results

● Statistically Significant scores for Pre and Post-test outcome variables for Treatment and Delayed Treatment

Discussion

● Findings● Knowledge of social etiquette● Hosted get-togethers● Quality of friendships● Parent report of overall social skills

● Limitations● Bias in Parent Report?

– Increase Teacher report● Need Maintenance Data● Would have liked ADOS or ADI-R● SSRS not designed for ASD

Thank you !

TA McDonaldIntegrated Autism Education, Treatment, and Leadership

Wendy MachalicekColleen Moore