Long Term Outcomes of a Parent-Assisted Social Skills Intervention for Adolescents with Autism: The UCLA PEERS Program

Background: It is estimated that nearly 50% of teenagers with autism do not have a friend.  The Program for the Education and Enrichment of Relational Skills (PEERS) is a parent-assisted social skills intervention for adolescents with autism that specifically targets ecologically valid friendship skills.  There is limited research in the literature regarding the long term outcomes of social skills training programs.

Objectives: The major treatment goal for PEERS patients 1-5 years post-treatment would be having true friendships.  In prior research on the PEERS program, we found an increase in the frequency of hosted get-togethers, improved social skills knowledge, significant differences in quality of friendships and improvement in teen’s overall level of social skills at the end of treatment compared to wait-list control.  In this long term outcome study, we aimed to establish whether the intervention had long term positive social benefits for participants.

Methods: All teenage participants in the previous treatment outcome research with PEERS had a diagnosis of an autism spectrum disorder.  Participants received 12-14 weekly 90-minute sessions in which parents and teenagers were seen concurrently for social skills training.  For the current study, families who completed the PEERS program 1-5 years prior were recruited through mail, phone and email.  Data collection consisted of online questionnaires and an interview over the phone.  Differences in frequency of peer contacts and social skills measured over time were analyzed by pair-wise t-test.  Data was evaluated before the intervention (T1), immediately following the intervention (T2) and at long-term follow-up (T3).

Results: Preliminary analysis of 34 subjects out of 83 potential PEERS completers who were at least 12 months since completing treatment (41% response rate) reveal maintenance of treatment gains.  Participants were an average of 27 months post intervention at the time of follow up.  The mean age of the teen participants was 17.1 years and grade level was 11.0 at follow-up.  Pre- and post-test comparisons revealed significantly improved standard scores on the Social Skills Rating System for overall social skills (T1=78, T2=91, p<0.01) and problem behaviors (T1=113, T2=106, p<0.01).  These gains were maintained at long term follow up for both social skills (T3=93, p<0.01) and problem behaviors (T3=97, p<0.01).  Pre- and post-test comparisons of the frequency of peer contacts revealed significantly more get-togethers in the prior month (T1=1.6, T2=4.0, p<0.01) following treatment.  The number of get-togethers remained significantly improved at long term follow up (T3=3.4, p=0.01).  Pre- and post-test comparisons revealed significantly improved scores on the Test of Adolescent Social Skills Knowledge (T1=13.1, T2=22.0, p<0.01). While there was a slight decline from post-test findings, long term follow-up showed knowledge remained significantly improved from baseline (T3=18.6, p<0.01).

Conclusions: Assessment of the maintenance of social skills gains and frequency of peer contact 1-5 years post-treatment appear to suggest that the PEERS intervention is successful in maintaining treatment gains over time. Reasons for continued benefit will be discussed, including parent involvement in the treatment, as well as developmental maturation.