Predicting Treatment Outcomes of a Teacher-Facilitated Social Skills Intervention for Adolescents with Autism: The School-Based UCLA PEERS Program

Background:  

High-functioning adolescents with Autism Spectrum Disorders (ASD) present with an array of deficits, most of them impacting social behaviors. Given the presence of deficits in social behavior and communication in ASD, improvement in social functioning is of paramount importance. Studies investigating the effectiveness of social skills training for individuals with ASD indicate that intervention during childhood and adolescence is critical, yet few programs exist for middle and high school adolescents with ASD. The Program for the Education and Enrichment of Relational Skills (PEERS) is an empirically supported parent-assisted social skills intervention for high-functioning teenagers with ASD that specifically targets ecologically valid friendship skills. Research investigating the effectiveness of an adapted version of PEERS in the school setting revealed significant improvements in social functioning for teens with ASD using teacher-facilitation; however, little is known about the factors that predict treatment success. 

Objectives:  

The purpose of this study is to investigate the factors that predict treatment outcome in a 14-week teacher-facilitated social skills training program (PEERS) for middle school students with ASD. 

Methods:  

The intervention took place under the auspices of The Help Group-UCLA Research Alliance.  Sixty middle school students with ASD from the Village Glen School at The Help Group participated in the study over a 14-week period. Adapted social skills lessons from the PEERS curriculum were conducted daily in the classroom for 30 minutes at a time by teachers and teacher aides who were trained and supervised on the curriculum.

Targeted social skills included: verbal and nonverbal communication; electronic communication and online safety; appropriate use of humor; expanding and developing friendship networks; peer entry and exiting strategies; organizing and having successful get-togethers; good sportsmanship; methods for resolving peer conflict; and strategies for handling rejection. Measures of social functioning were collected at pre- and post-using the Social Responsiveness Scale-Teacher Report (SRS-T: Constanino & Gruber, 2005) and the Social Skills Rating System-Teacher Report (SSRS-T: Gresham & Elliot, 1990). 

Results:

Results reveal that higher baseline scores on the SRS-T in the area of Social Cognition predict improvement in social skills as measured by the difference between post-intervention and pre-intervention Social Skills Total Score on the SSRS-T(p<.05).  In addition, higher scores on overall Social Responsiveness and Social Communication predicted improvement in social skills at a trend level (p<.10).   The areas of Social Awareness, Social Motivation, and Autistic Mannerisms did not predict change in social skills. 

Conclusions:  

Perhaps due to the advanced nature of the skills taught in PEERS and the higher demands placed on social communication and perspective taking in this curriculum, findings suggest that the use of the PEERS curriculum in school-based settings is likely to be more beneficial for teens with better social cognition, and possibly greater social responsiveness and social communication skills.