Efficacy of CBT-BASED SOCIAL SKILLS INTERVENTION

Background:  

School-aged children with Autism Spectrum Disorder (ASD) experience significant difficulty with peer interaction (Lord & Bishop, 2010), an important aspect of childhood. Unresolved social skills difficulties lead to continued dysfunction in relationships which influence long term success. Research into the most effective strategies has increased but several questions remain. One approach that appears to help school-aged children is Cognitive Behavior Therapy (CBT) which focuses on changing how a person thinks about specific social situations as well as how they behave.  

Objectives:  

This study evaluated a 15-week CBT-based social skills group intervention for boys aged 10-12 years diagnosed with an Autism Spectrum Disorder by comparing a waitlisted group with an immediate intervention group and by comparing the waitlisted group across 3 timepoints, before beginning the waitlist period, before  beginning the group, and after completion of the group.

Methods:

Boys with average or better receptive language skills and IQ attended weekly 2 hour sessions focused on teaching self-monitoring skills, social perception and affective knowledge, conversation skills, taking another person’s perspective, social problem-solving, and friendship management skills. Parents were given weekly “homework assignments” to work on with their child. These were directly related to the group activity and application of social skills at home and in the community. Group size varied from four to six participants. The intervention was based on two intervention programs available commercially and was manualized. Eight of the fifteen participants were waitlisted (Delayed Treatment group) while the remaining participants began 15 sessions of intervention immediately (Immediate Treatment group). A repeated measures ANOVA was used to compare the Delayed Treatment group to the Immediate Treatment group on pre and post measures of social perception, peer interaction, social knowledge, social responsiveness and general socialization skills. Scores for the group that was waitlisted were also examined across three time points using a repeated measures ANOVA.

Results:  

Compared to the Delayed Treatment group, the Immediate Treatment group showed significant improvements after intervention in social perception, peer interaction, and social knowledge. The Delayed Treatment group was also examined on all measures at three time points: prior to the waitlist time, pre-intervention, and post-intervention. Significant improvements only after intervention were present for peer interaction and social knowledge, similar to the results of the Immediate Treatment group. They also showed improvements on a parent report measure of socialization.

Conclusions:  

The findings are discussed in relationship to a model of social information-processing. Cognitive behaviour therapy techniques show promise for social skills intervention for children with ASD who have IQ and language skills that are low average and above. The intervention used in this study now needs replication with larger samples.