Examining the Social Outcomes of Practice Based Models of Social Skills Interventions for Children with Autism in Schools

Background: Social impairment is the most challenging core deficit for children with autism spectrum disorder (ASD). They experience challenges in social reciprocity and communication that impede their ability to navigate social interactions, impacting the presence and quality of relationships with peers. These social discrepancies exacerbate with age and if left untreated, continue through adulthood. Several evidence-based interventions address social impairment in children with ASD; however, adoption, use, and implementation of these interventions by schools is challenging.

Objectives: The purpose of this study was to compare three groups of children from: a) a district that has adapted and implemented evidence-based social skills programs to support included students with ASD; b) a university-based intervention program for children with ASD that was implemented within the school setting by outside researchers; and c) inclusion only settings.

Methods: A total of 92 children with ASD participated in this study. Data were drawn from multiple sources: a) two schools in a school district who adapted and implemented evidence-based social skills interventions for included children with ASD (n = 14); b) a randomized controlled field based trial in 23 schools of a university developed social skills intervention for included children with ASD (n = 45); and c) 16 schools that were not implementing a social skills intervention for participating students with ASD beyond inclusion (n = 33). The average age of students was 8.4 (SD = 1.6) years. The majority was male (88%) and Caucasian (52.2%). Children in the target student’s classroom completed sociometric ratings about various groups of children who hang out together in the classroom to determine children’s social network centrality. In addition, independent observers watched children on the playground using a time-interval behavior coding system. Observers recorded children’s solitary engagement on the playground, and frequency of initiations.

Results: Separate linear regression models were used to test for associations between the three groups and each of the social outcomes (i.e. social network centrality, solitary engagement, and number of playground initiations). Compared to children in the university-developed randomized controlled trial, children from the practice-based intervention models had significantly lower social network centrality (p = .05) and solitary engagement (p = .04) but significantly more initiations on the playground (p = .04). Children in the inclusion only settings had significantly lower social network centrality ratings than children in the university-developed intervention (p <.001).

Conclusions: These data suggest that different types of intervention strategies that address distinctive domains of social ability may be warranted. These data also suggest that practice-based research models may inform how to bridge the chasm between evidence-based, efficacious interventions and what actually occurs in practice.