Sex Differences in Outcomes of a Social Skills Intervention for Children with ASD

Background: Research is mixed regarding whether or not girls with autism spectrum disorder (ASD) present differently from boys (Lai et al., 2015). Although some studies show no differences between boys and girls with ASD (e.g., Sutherland et al., 2017), other studies have found differences between the two in age of diagnosis and symptom presentation (Lai et al., 2015). Little and colleagues (2017) found that parents of young girls (2- to 11-years-old) reported fewer concerns regarding their children’s social difficulties. Importantly, although Hiller, Young, and Weber (2014) found that girls performed better on a number of metrics of interpersonal interaction (e.g., ability to maintain a reciprocal conversation), their ability to maintain friendships remained impaired. Unfortunately, few studies have explored whether girls with ASD have similar outcomes to boys following participation in a structured social skills intervention targeting ASD. Children’s Friendship Training (CFT) is a manualized parent-assisted social skills intervention for children with ASD in grades 2 -5. Autism Ontario has been running CFT at sites across Ontario, Canada for the past three years.

Objectives: The present study examines sex-differences in the outcomes of children with ASD who participated in the CFT program.

Methods: Participants were 42 children with ASD (33.3% female) between the ages of 7 and 12 (M = 9.59, SD = 1.40) who participated in the CFT program in Toronto between April 2016 and June 2017. Parents and children were asked to complete a number of measures before and after participation in the program. Measures evaluated social skills (measured by the SSQ-P and SSQ-PU), social anxiety (measured by the SASC-R), and the number of play dates the child hosted or was invited to in the past month. No differences existed between boys and girls in baseline scores on the above measures.

Results: In the male sample, both parent-report (t(23) = -5.385, p < .001) and boys’ self-report (t(11) = -5.358, p < .001) indicated a significant increase in social skills from pre- to post-CFT participation. By contrast, neither parents of girls (p = .074) nor girls themselves (p = .219) reported a significant change in social skills from pre- to post-CFT participation. A similar pattern emerged regarding ratings of social anxiety. While parents of boys reported a significant decrease in their child’s social anxiety from pre- to post-CFT participation, t(21) = 2.989, p = .007, parents of girls did not report a significant change in social anxiety (p = .871). Neither parents of boys (p = 1.000) nor parents of girls (p = .075) reported a significant change in how many play dates their child was invited to. However, while parents of boys reported no change in how many play dates their child hosted (p = .677), parents of girls reported a significant increase in how many play dates their child hosted, t(13) = -3.322, p = .006).

Conclusions: Prior to conducting this research, we found no data detailing specific outcomes of girls with ASD in CFT. Our results point to the need for more research on this topic.