Social Conversational Improvements Associated with the Social Tools and Rules for Transitions (START for Young Adults with ASD) Program

Background: Young adults with autism spectrum disorder (ASD) often struggle with social communication and relationship formation (APA, 2013; Howlin, Moss, Savage, & Rutter, 2013). These challenges are significantly associated with poorer outcomes related to academic and vocational success, mental health, and quality of life (Zager & Alpern, 2010; Eaves & Ho, 2008). Unfortunately, support resources for adults with ASD are often limited, as is research on effective interventions to support adults with ASD in their social development. Targeted group socialization interventions may be a promising model for addressing social motivation, insight, and skill deficits for this growing population (Vernon, Miller, Ko, & Wu, 2016; Laugeson, Gantman, Kapp, Orenski, & Ellingsen, 2015). Within these intervention models, socially valid measurement of social skill performance is crucial, as program participation must yield observable social conversational improvements within everyday interactions to be clinically meaningful. Coding of live peer conversations may be a promising strategy for obtaining objective measurement of social gains (e.g. Vernon et al., 2016; Mitchell, Regehr, Reaume, & Feldman, 2010).

Objectives: The present study aims to determine whether participation in the START group leads to observable improvements in the use of key social communication skills during conversations with unfamiliar peers.

Methods: The Social Tools and Rules for Transitions (START) program is a 20-week peer-mediated socialization group intervention that combines experiential learning and instructional lessons, in addition to weekly social outings in the community that serve as “field work” settings to practice the targeted social strategies. A randomized clinical trial was used to assess the efficacy of this intervention with 28 adults with ASD, aged 18-25. Participants were randomly assigned to an immediate treatment or waitlist control group. At pre- and post-intervention, all participants completed two video-recorded 5-minute “get to know you” conversation probes with unfamiliar, untrained young adult peers who were unaware of study hypotheses and the diagnostic status of the participants. Videos were coded for both verbal (social inquiries made, conversational turn taking) and nonverbal social communication strategies (eye contact, directed facial expressions). 25% of all videos were coded by a second naïve rater to assess inter-rater reliability. Repeated measures ANOVAs were to determine whether the treatment group shows significant improvements over time, compared with the control group.

Results: Preliminary coded conversational data from a subset of the total trial cohort is indicative of significant increases in verbal and nonverbal social communication behaviors unique to the START participant group. Video coding and data analysis of the entire trial cohort will be completed by March 2019.

Conclusions: Preliminary data is indicative of live social conversational improvements in participants of the START program for young adults. Such data is indicative of an objective and observable enhancement of social functioning that can be applied to future peer interaction and relationship formation.