PEERS® in New York City: An Initial Feasibility Effort

Background: Clinicians and researchers alike have increasingly placed emphasis on providing interventions to individuals with autism spectrum disorder (ASD) to facilitate the acquisition of social skills and foster positive peer relationships. These interventions are particularly important in adolescence, when social isolation has been linked to poor psychological health and academic achievement (Hall-Lande, Eisenberg, Christenson, & Neumark-Sztainer, 2007). During this developmental window, close friendships have been shown to increase self-esteem and protect against symptoms of anxiety and depression (Buhrmester, 1990).

Emerging evidence has shown that the Program for the Education & Enrichment of Relational Skills (PEERS^®; Laugeson & Frankel, 2010) – a 14-week parent-assisted social skills intervention – may improve social competence and increase friendships among adolescents with ASD. While these initial efforts are promising, numerous areas of investigation remain, including and beyond independent replication. For example, given the heterogeneity of ASD, the following questions warrant investigation: which teens best benefit from PEERS^®? Can we identify behavioral or other objective markers that predict response to treatment in participating teens and parents?

Objectives: Our long-term plan is to address the aforementioned questions in a randomized-controlled design and identify predictors of response to treatment at neuronal, cognitive, and or clinical domains. As a first step towards this long-term goal, we aim to establish a PEERS^®intervention program in our northeastern urban clinic and assess its feasibility.

Methods: A group of licensed clinicians and postdoctoral fellows completed PEERS^®training and certification led by the program developers in Summer 2014. Shortly after, they began recruitment and treatment for interested families. Treatment is currently ongoing in an open-label fashion and we are in the process of obtaining IRB approval to examine data collected pre- and post-treatment. Adolescents enrolled in the treatment have social impairments consistent with a diagnosis of ASD, average IQ, and at least one parent available for group meetings and treatment-related activities. Scores on the Test of Adolescent Social Skills Knowledge (TASSK; Laugeson and Frankel, 2006) were selected as the primary outcome. The Social Responsiveness Scale, Second Edition (SRS-2; Constantino, 2012) and a range of other clinical measures were selected as secondary outcome measures. Recruitment challenges and treatment attrition are also tracked.

Results: We will report data on the recruitment rates, barriers at enrollment (e.g., scheduling conflicts, inclusion criteria), and rates of response on our primary and secondary outcome measures. Based on previous studies, we anticipate participants will demonstrate gains in their knowledge and performance of social skills, engage in more get-togethers, and show decreases in core autistic symptoms and problem behaviors from pre- to post-intervention.

Conclusions: This represents our initial step toward replicating and extending previous findings. This effort will allow us to refine our objectives for future research.