Measuring Change in Social Competence Observationally in Adults with ASD

Background:  

Very little research has explored the impact of interventions targeting improved social competence in adults with Autism Spectrum Disorders (ASD). One obstacle to research in this area is lack of sensitive and objective measures of actual change in social functioning. Preliminary evidence indicates that the PEERS program is feasible to implement and helpful to improving social functioning in adolescents and young adults with ASD.

Objectives:  

This study was undertaken to examine the utility and validity of the CASS (Contextual Assessment of Social Skills; Ratto et al., 2011) in evaluating change in social functioning in young adults who completed the PEERS intervention. The CASS is a behavioral observational measure of social skills in which trained raters, uninvolved in the treatment implementation or outcome, rate specified behaviors (e.g., number of conversational statements) during brief conversations with confederates. In the first conversation, the confederate is engaged and interested and in the second, the person acts indifferent or bored. At the end, the participant is asked to indicate how interested or bored the other person (the confederate) was in the conversation, to gauge accuracy of the participant’s perception. A secondary objective of this study is to evaluate change in social anxiety over the course of intervention, as it is proposed that social anxiety may hinder social competence and improve in the course of the supportive, group environment.

Methods:  

Approximately 12 young adults (18 – 26 years of age) with confirmed ASD will participate in this study. Delivered over the course of 16 sessions, treatment includes 90-minute weekly group sessions focusing on ecologically valid rules and steps of social etiquette related to developing and maintaining relationships. Measures of social anxiety (self-report and other-report) will be taken prior to treatment and at endpoint. The CASS will also be done prior to treatment and at endpoint. Individual change indices (Reliable Change Index; Jacobson & Truax, 1991) will be computed, as well as paired t-tests, to assess statistically significant change. 

Results:  

Results are forthcoming and are anticipated to reveal significant improvement in social competence as measured through behavioral observation ratings on the CASS, and decreased social anxiety as measured by self- and other-report.

Conclusions:  

Assuming the CASS is found to be feasible to implement in the context of this pilot treatment study, and shows promise as a sensitive measure of change with intervention, results will be informative to the design of future trials involving adults with ASD. The CASS, or similar brief observational measures, may supplement the outcome assessment battery, which is typically comprised of self-report measures with questionable validity and sensitivity. In addition, if we observe change in social anxiety, as anticipated, this may indicate that scientific attention to social anxiety as a potential mediating mechanism may be needed.