Meta-Analysis of Group Social Skills Interventions Using the SRS in Children with High Functioning Autism Spectrum Disorders

Poster Presentation
Friday, May 11, 2018: 11:30 AM-1:30 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
J. Wolstencroft1, W. Mandy2 and D. H. Skuse3, (1)UCL GOS ICH, London, United Kingdom, (2)University College London, London, United Kingdom of Great Britain and Northern Ireland, (3)Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom

Social skills deficits are an important target for intervention for children with Autism Spectrum Disorders (ASD) because they have a significant impact on academic, adaptive and psychological functioning. Group social skills interventions (GSSIs) are one of the most popular treatments recommended for children with high functioning ASD. Previous meta-analyses of GSSIs have evaluated the efficacy of GSSIs by combining the scores of different social skills assessments, despite evidence that these tools may be measuring different underlying constructs. As a high proportion of GSSIs now use the Social Responsiveness Scale (SRS), this presents an opportunity to examine which domains of social skills are changed by intervention.


Conduct a meta-analysis of multimodal GSSI randomised controlled trial studies using the SRS as parent-report outcome measure.


Online electronic searches were conducted on four databases. The search used medical subject heading key terms including ‘social skills’ and ‘group interventions’. Two independent reviewers rated the abstracts against the eligibility criteria (1) age (6-25years), (2) no intellectual disability, (3) multi-modal GSSI, (4) conducted and assessed in English, (5) used Social Responsiveness Scale (SRS). The Cochrane Collaboration tool Risk of Bias (RoB) v2 tool was used to assess bias. Authors were contacted for unpublished total scores and subscale scores for the meta-analysis.


The initial electronic search returned 593 articles after duplicates were removed. 9 studies that met criteria for eligibility were retained for RoB analysis, after which one study was excluded from the meta-analysis due to poor study methodology. SRS total and subscale scores were available from 7 studies following correspondence with authors.

Participants that received a GSSI obtained better outcomes than the control group on the total standardised score (SMD= -0.85, 95% CI [-1.12,-0.59], Z= 6.35, p=0.000) and all the SRS subscales. The effect sizes on the social communication (SMD= -0.89, 95% CI [-1.2,-0.59], Z= 5.71, p= 0.000) and ritualised and repetitive behaviours subscales (RRB; SMD= -0.9, 95% CI [-1.23,-0.57], Z=5.4, p=0.000) were large. The effect sizes for the social awareness (SMD= -0.57, 95% CI [-0.87,-0.28], Z= 3.78, p= 0.000), social cognition (SMD = -0.53, 95% CI [-0.98,-0.09], Z= 2.34, p= 0.019) and social motivation subscales (SMD= -0.55, 95% CI [-1.02,-0.07], Z= 2.27, p= 0.023) were moderate.


Large and significant effect sizes in the SRS on social communication as well as the RRB subscales suggests that GSSIs had the largest impact on these domains. Improvements on the RRB subscale were unexpected, as the teaching materials of GSSIs do not explicitly target the reduction of these behaviours. One hypothesis might be that the cognitive and emotional skills taught during GSSIs such as cognitive flexibility, problem solving or controlling emotional impulses are mediating this change. It may be that these skills help to make the participants more confident and less anxious in social situations, which in turn reduces their restrictive and repetitive behaviours.