Designing Social Competence Interventions for Adolescents with Autism: The SCI Project

Background:

Youth with autism spectrum disorders (ASDs) experience social competence deficits that impact their ability to make and sustain friendships, initiate and maintain social interactions, and understand emotions in themselves and others. Without targeted intervention services, these youth often exhibit problematic social behaviors or can become socially withdrawn, which negatively impacts their quality of life and can lead to other developmental skill deficits.

Objectives:

This project developed a curriculum, the Social Competence Intervention (SCI), designed to impact social competence performance for a specific ASD subtype characterized by a diagnosis of an ASD, a full scale IQ of 70+, and access to general education curriculum for at least one hour a day. The curriculum utilizes primarily cognitive-behavioral intervention within an applied behavior analysis structure. The curriculum targets social cognition deficits as characterized by deficits in theory of mind  (ToM), executive function (EF) and recognizing emotions.

Methods:

The SCI includes five units (each comprised of approximately 4 hours of content), which are typically delivered in consecutive two-week increments (i.e., 1 hour twice a week for 10 weeks). Each unit focuses on a different critical aspect of social competence. Foci include: (a) recognizing facial expressions, (b) sharing ideas, (c) turn taking in conversations, (d) recognizing feelings and emotions of self and others, and (e) problem solving.  Within each unit, the delivery of the content is done using a consistent structure of (a) reviewing a previously learned skill and introducing a new skill in an instructional and group discussion format, (b) skill modeling, (c) providing opportunities to practice the skill in structured and naturalistic activities, and (e) engaging in various closing activities or review.

An interdisciplinary research agenda has been executed to identify the programmatic effectiveness of the curriculum across ages, settings and stakeholders. All related research has employed a multi-faceted assessment methodology to determine programmatic effectiveness, and the impact of the intervention curriculum on functional characteristics of the subtype. Common screening and standardized tools designed to assess ToM, EF and facial recognition are administered via parent ratings and student performance pre and post. This initial investigation focused on the curriculum for 11-14 year old group (SCI-A) in an after school delivery (Stichter et al, 2010).

Results:

Results from a sample of boys (n = 27, M_age = 12.57yrs) supported the hypothesis that the SCI-A program improved outcomes in the three targeted core deficits. Specifically, student performance improved on measures of facial expression recognition (p < .05), ToM (p < .05), and EF as indicated on a problem solving instrument (p < .001). Additionally, parents reported improvement in EF (p < .001) and overall social behaviors/interactions (p < .001).

Conclusions:

Results indicate support for the hypothesis that participation in the SCI program is accompanied by positive change in several measures related to social competence. Extension of the curriculum to additional age groups, settings and the use of additional measures, controls, are forthcoming.