Impacting Real World Social Outcomes: An Examination of Changes in Social Engagement and Friendships Associated with START Program Participation

Background: Adolescents diagnosed with Autism Spectrum Disorder (ASD) frequently have difficulty making and sustaining friendships, which can lead to adverse consequences later in life (Mazurek, 2014). Group-based social skills interventions, have been shown to be effective in helping teens with ASD improve their performance on a variety of social skills (e.g. Laugeson et al., 2012; Vernon et. al., 2016). The ultimate aim of improving social competencies is to create a pathway towards meaningful change in the social lives of the participants; however, the extent to which program participation impacts real-life social success, such as making friends and engaging in social outings and activities on a regular basis, remains largely unknown.

Objectives: The purpose of the present study was to use self- and parent-report data collected in a randomized control trial of the Social Tools And Rules for Teens (START) intervention to provide insight into the impact of the program on real-life social outcomes. Specifically, the investigators sought to determine if participants and their parents independently endorsed increases in, (1) telephone contact with others, (2) extended and received invitations for get-togethers, (3) structured and unstructured social activities, and (4) number of friendships.

Methods: A randomized control trial (RCT) was conducted with 35 participants. Data were obtained from 16 participants in the treatment condition and 19 in the waitlist condition. Participants in the treatment condition (and later the waitlist group) engaged in a 20-week social skills group with a structured curriculum, covering a variety of key social skills including introductions and initiations, conversation skills, and higher order social skills such as sportsmanship, humor, and social media use. In addition to standardized measures and observational conversation skill data (reported elsewhere), all participants and their parents were asked to complete pre- and post-intervention surveys regarding frequency of phone communication, invitations for get-togethers, social activities, and reported friendships. Data were analyzed using a mixed group x time MANOVA with follow-up ANOVAs to identify specific survey items with significant differences.

Results: Results revealed a significant Time x Group interaction in the total number of friends reported by the adolescent participants (p = 0.025), as well as a trend in number of participant-reported invitations received (p = 0.067). Analyses also revealed a significant Time x Group interaction in parent reports of total number of friends (p = 0.001), as well as a trend for number of unstructured social activities (p = 0.084).

Conclusions: Results suggest that there were measurable real-world differences that occurred as a result of participation in the START intervention program. Most notably, an increase in the total number of friends reported by both the parents and adolescents suggest that the skills gained in the START program may generalize to other settings and result in meaningful change in the lives of these adolescents. Overall, the results suggest that the START program successfully targets social competence and motivation barriers that impede optimal social success in adolescence.