Increasing Access to Empirically-Validated Interventions for Autism Spectrum Disorder: Dissemination of PEERS into Community Mental Health Settings

Background: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder marked by significant impairment in social communication and interaction and presence of restricted, repetitive patterns of behaviors and interests. A recent needs-assessment of families affected by ASD in the state of Delaware identified a critical need for social skills interventions among parents of children with ASD (Rhoton & Ekbladh, 2012; University of Delaware, 2013).

Objectives: This research project aims to build capacity for social skills interventions for ASD for adolescents in community mental health settings in Delaware, using The Program for the Education and Enrichment of Relational Skills (PEERS), a social skills group program developed at UCLA (Laugeson and Frankel, 2010). Aim 1: Build capacity for ASD interventions by providing formal education to community clinicians in PEERS; Aim 2: Assess family outcomes following participation in PEERS regarding social skill symptoms, parenting stress, and family quality of life.

Methods: Aim 1: A two-day education on PEERS was provided to community clinicians (n=15). Clinicians completed a survey developed by the researchers assessing their perception of implementing a social skills group intervention for families affected by ASD prior to the two-day education, after the two-day education, and following PEERS group completion. Aim 2: Five PEERS groups were held at three community mental health locations across the state of Delaware. Caregivers (n=14) completed 1) Social Responsiveness Scale, Second Edition (SRS-2) 2) Stress Index of Parents of Adolescents (SIPA) and 3) Beach Center Family Quality of Life Scale (FQOL).

Results: Clinicians reported increased confidence in their ability to deliver social skills intervention following two-day education on PEERS, as rated on a Likert Scale with 0 being no confidence and 5 being most confidence (pre: M=3.2, SD=1.3; post: M=4.1, SD=.9; t(14)=-2.82, p=.014). Furthermore, the clinicians who facilitated a PEERS group (n=9) reported a clinically significant increase in confidence (t(8)=-2.309, p=.05). Thirty families enrolled in PEERS across Delaware (age range of child: 7-17; M=13 years; Males=23, Females=7), and 14 families were considered to have completed PEERS (attended 10 or more sessions and completed both pre and post measures). No difference was reported regarding family quality of life (FQOL: t(13)=-.737, p=.474), social skills (SRS-2: t(11)=-1.183, p=.261), or parenting stress (SIPA: t(11)=.549, p=.594).

Conclusions: This study shows the feasibility of expanding social skills interventions for children and families affected by ASD into community mental health settings, as 15 clinicians received additional education regarding social skills interventions and five more group opportunities using the PEERS program were made available in the community. Although the PEERS program did not show changes in family quality of life, adolescent’s social skills, or parenting stress, the study was limited by a small sample size of 14 families completing the intervention. Future research is needed to understand family characteristics and barriers that may impact completion of social skills programs in the community.