30584
Implementation of Social Skill Group Training Kontakt in Children and Adolescents with ASD and Psychiatric Co-Morbidity in Regular Clinical Settings
Evidence-based treatments for children with ASD and psychiatric co-morbidity have long been missing, though widely needed. KONTAKT is a social skills group training (SSGT) treatment for children and adolescents with ASD. A previous pragmatic randomized controlled multicenter trial of SSGT KONTAKT showed small to moderate effects in social skills for participants. The aim of this study was to implement SSGT KONTAKT at Swedish Child and Youth Psychiatric Clinics (BUP) in Stockholm, Sweden.
Objectives:
To investigate the outcome effect on psychiatric comorbidity anxiety (A) and depression (D), of SSGT KONTAKT in children and adolescents with ASD during implementation of the treatment in regular clinical setting (BUP).
The hypothesis was that children and youths with ASD and psychiatric co-morbidity will show a decrease in depression and anxiety after attending SSGT KONTAKT.
Methods:
A total of 35 children/adolescents aged 9-17 years (7 female/28 male) participated in 5 groups at two different units and submitted the primary outcome measure of Becks Youth Inventory (BYI) scales of Anxiety and Depression, at baseline and post-treatment. The secondary outcome measures were the parent-rated Social Responsiveness Scale (SRS) that measures social skills and communication difficulties, and Adaptive Behavior Assessment System II (ABAS-II), a scale of adaptive functioning that indexes real-word abilities and disabilities. The OSU Autism Clinical Global Impression (CGI) and Developmental Disabilities Children’s Global Assessment Scale (DD-CGAS) were used as clinician rated secondary outcome measures to assess global functioning and clinical severity.
Results:
No treatment effects were found on the primary outcome Becks Youth Inventory Anxiety scale and Depression scale (BYI A p>1.0000; 95% CI, BYI D p=0.2521; 95% CI). Secondary outcomes indicated small to moderate effects on social responsiveness and adaptive behavior (SRS p<0.0001; 95% CI, ABAS-II p=0.0239; 95% CI.). The largest effect was seen on clinicians' rating of global functioning and clinical severity (CGI: p<0.0001; 95% CI, DD-CGAS p=0.0006; 95% CI).
Conclusions:
The results from previous studies of SSGT KONTAKT concerning parents' and clinicians' ratings of social skills, adaptive functioning, and clinical severity are confirmed when implementing the treatment in regular clinical settings. More research is needed to evaluate and implement treatments of patients with ASD with psychiatric comorbidity. Becks Youth Inventory, a widely used scale to measure psychiatric conditions in children and youth at Child and Youth Psychiatric Clinics (BUP) in Stockholm, Sweden, is not appropriate for patients with ASD.