Examining the Effectiveness of the PEERS Program on Social Skills and Anxiety in Adolescents with Autism Spectrum Disorder

Background:  Poor social functioning is a hallmark feature of Autism Spectrum Disorder (ASD). As such, recent research has focused on developing social skills interventions for individuals with ASD. Research indicates that the Program for the Enhancement and Enrichment of Relational Skills (PEERS), a manualized social skills intervention for high functioning adolescents with ASD, is efficacious. However, to date, no studies have examined the effectiveness of the PEERS program in community settings. Moreover, high functioning youth with ASD often present with comorbid anxiety. Social skills interventions may increase participants’ self-efficacy in social interactions, thereby reducing the anxiety that participants may feel in social interactions, yet only one study (Schohl et al., 2014) has sought to extend the current findings linked to PEERS by examining the program’s effects on participants’ anxiety. 

Objectives:  This small-scale pilot study aimed to evaluate the effectiveness of the PEERS program not only on improving social skills but also on reducing anxiety.

Methods:  Participants included 5 high functioning adolescents ages 13 to 15 with ASD and their parents. The intervention consisted of 90-minute, weekly parent and teen sessions over the course of 14 weeks. Pre and post measures were completed by the parents and adolescents and included the Social Skills Improvement System (SSiS), the Social Responsiveness Scale (SRS-2), the Test of Adolescent Social Skills Knowledge (TASSK), the Quality of Play Questionnaire (QPQ), and the Screen for Child Anxiety Related Disorders (SCARED). Pre- to post-intervention improvement was examined using paired samples t-tests.

Results:  Results from the paired samples t-tests are presented in Table 1. There was significant improvement in adolescents’ knowledge of the specific social skills taught during the intervention. Autism symptomatology and internalizing symptoms (measured by the SSiS Internalizing scale) showed a significant decrease from pre- to post-intervention. While the paired-samples t-test failed to reveal a significant decrease in pre- to post- anxiety as measured by the SCARED, SCARED Total scores generally decreased for most participants (Fig. 1). Furthermore, the two participants with clinical levels of anxiety (SCARED Total score > 25) prior to intervention reported non-clinical levels of anxiety at post-test. For the variables of interest, the strength of the effect sizes for the mean change scores on the outcome variables in this study were small to large, and most were comparable to the effect sizes for the mean change scores calculated from the published PEERS efficacy studies (see Table 1).

Conclusions:  This independent and community-based small-scale pilot study supports the effectiveness of the PEERS program in community-based care for improving the social functioning of high functioning adolescents with ASD. Although reducing anxiety is not a direct target of the PEERS program, our findings are consistent with the findings of Schohl et al. (2014), which indicate that participation in the PEERS program also leads to reductions in anxiety.