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Parent- Assisted Social Skills Training: The UCLA Peers® (Programs for the Education and Enrichment of Relational Skills)- Thai Version for Adolescents with Autistic Spectrum Disorders in Bangkok, Thailand
Social impairment is one of the challenging problems among high- functioning autistic teenagers worldwide and requires social skills interventions. Programs for the Education and Enrichment of Relational Skills (PEERS® ) is a manualized, parent- assisted social skills training for high- functioning adolescents with Autistic Spectrum Disorder (ASD) developed by Semel Institute for Neuroscience and Human Behavior, UCLA, which the effectiveness was proved in western countries. In Thailand, there have been no previous studies regarding any parent- assisted social skills interventions before. Given social and cultural difference between Thailand and the country where PEERS® program was developed, cultural adaptation is one of essential elements of success and acceptance of the intervention among Thai autistic teenagers and their families.
Objectives:
To study the feasibility and effectiveness of The UCLA PEERS® (Programs for the Education and Enrichment of Relational Skills)- Thai Version delivered as an outpatient service for high- functioning adolescents with ASD at Division of Child and Adolescent Psychiatry, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. Adaptation of the program to Thai social and cultural context was highlighted.
Methods:
In a retrospective study , 12 high- functioning autistic adolescents were referred from their responsible child psychiatrists for the program in 2015. Parents completed the division intake form. Pre-intervention Clinical Global Impression- Severity (CGI-S) was assessed. The PEERS® - Thai Version was 10- weekly parent- assisted social skills training program with one booster session at 4 months, adapted from the original 14- session program regarding Thai culture. The program was led by a Thai certified PEERS® provider. Pre and post intervention Vineland Adaptive Behavior Scales (Survey Form), Children’s Depression Inventory (CDI), Thai version, Clinical Global Impression- Improvement (CGI-I) and parents’ behavioral report and satisfactory survey were evaluated. The data was analyzed by descriptive statistics, independent t test and chi-square test.
Results:
The participants’ mean age was 14.8±1.99 years, 83.8% were male, and average IQ was 94.7±20.21. All participants studied in regular classes, grade 5- 12. 58.3% were moderately ill, 33.3% were mildly ill and 8.3% were borderline ill. Overall, there was no attrition. The attendance rate of each session was ≥ 80%. Individual attendance rate was ≥ 70%. There were 7 in 10 social skills delivered in the program which at least half of parents reported improvement. Eight skills remained being reported the improvement four months after interventions. Eleven children were clinically improved (1 very much improved, 5 much improved and 5 minimally improved). In regard to Vineland Scales, there were significant increase in raw score for communication, domestic, community, daily living skill, play and social domain as well as decrease in maladaptive behavior domain standard score (p<0.05). No significant change demonstrated in CDI. Parents’ satisfaction survey was 81.92%.
Conclusions: The UCLA PEERS®- Thai Version is a feasible and promising social skills intervention among Thai adolescents with high- functioning ASD.