Examining the Influence of Age on Social Skills Intervention Outcomes: Does Age Moderate Social Improvements in ASD?

Background: Although social skills interventions exist for children, adolescents, and adults with autism spectrum disorder (ASD; Palmen, Didden, & Lang, 2012; Reichow & Volkmar, 2010; White, Keonig, & Scahill, 2007), very few studies have examined the influence of age on the outcome of receiving such an intervention (e.g., Tse, Strulovitch, Tagalakis, Meng, & Fombonne, 2007). Literature demonstrates that ASD is a lifetime condition, that is, children do not “age out” of ASD symptomology. In both clinical and research domains, however, a small proportion of youth who receive intervention have been shown to experience “optimal outcome,” that is, amelioration of ASD symptoms to a non-clinical level (Fein et al., 2013). It may be that there are “ideal” times, or sensitive periods, during development when the receipt of a social skills intervention may be most helpful.

Objectives: The present study examined the relation between age and social knowledge and behavior among adolescents and young adults with ASD before and after receiving a well-validated social skills intervention, the Program for the Education and Enrichment of Relational Skills (PEERS^®). It was hypothesized that older age would be associated with better social knowledge prior to the intervention and that younger and older age would show less malleability across the intervention, both in terms of social knowledge and social behavior.

Methods: One-hundred seventy-nine adolescents and young adults with ASD aged 11-28 participated in this study (EXP = 88; WL = 91). Participants received the PEERS^® or PEERS^® for Young Adults intervention, corresponding with their age. Self-report or caregiver-report of social knowledge (TASSK/TYASSK), direct interactions (QSQ), and social behavior (SRS, SSIS) was collected before and after intervention.

Results: The EXP and WL groups did not differ by age t(177) = 1.42, p = .16. Pearson correlations were conducted to examine the relation between participant age and each of the social knowledge and behavior variables at both pre- and post-intervention. Results indicated positive associations between age and TASSK/TYASSK at both pre- (r = .48, p < .001; all participants) and post- (EXP: r = .24, p = .02; WL: r = .39, p < .001), as well as age and QSQ at pre- (r = .17, p = .02; all participants) but not post-; neither the SRS nor SSIS showed significant associations with age at either time point. Multiple linear regressions were employed to examine the potential moderating role of age in intervention outcome. Results indicated that there was no significant age by group interaction for any outcome measure.

Conclusions: Our hypotheses were partially supported. The current study provides some evidence that, while younger participants demonstrate lesser PEERS^® knowledge than their older counterparts, both before and after intervention, and have fewer direct social contacts prior to intervention, age itself does not appear to moderate intervention response. That is, seemingly regardless of age, adolescents and young adults benefit from the intervention.