30688
Efficacy Study of a Social-Communication and Self-Regulation Intervention for School-Aged Children with Autism Spectrum Disorder: A Randomized Controlled Trial
The Growing, Learning, and Living with Autism (GoriLLA) group intervention is a blend of two widely used approaches: Structured TEACCHing (Klinger et al., 2006) and Social Thinking (Hendrix et al., 2013; Winner & Crooke, 2009). This intervention is designed to increase social-communication and self-regulation skills in children with ASD, and is parent-assisted to promote generalization of skills. Components of Social Thinking are commonly used for children with ASD, but lack an established evidence-base. In fact, very few RCTs have been conducted with this type of social-cognitive intervention package for young children and even fewer examining the role of parents.
Objectives:
This study aimed to examine the initial efficacy of the GoriLLA group intervention
Methods:
Participants were 17 1st and 2nd grade children with ASD (ages 6 to 9 years), and their parents. A randomized delayed treatment control group (DT) design was used with pre- and post-intervention assessments of parent and child intervention strategy knowledge and generalization of strategies as observed during a parent-child play interaction. Fidelity was monitored at each session. Two follow-up assessments were completed at 3 and 6 months post-intervention, corresponding to pretreatment and posttreatment assessments for the DT group.
Measures
The Child Observation Protocol (COP) is a semi-structured observational measure of child knowledge learned in the intervention. Internal consistency of the COP was fair to good (Cronbach’s alpha at pretest = .76; at posttest = .81). ICC for the total score was .97.
The Parent Report of Group Outcomes (PROGO) consists of 12 multiple choice questions tapping parent knowledge related to intervention concepts. Cronbach’s alpha at Time 1= .55, Time 2= .66.
The 3 Box Task (Brady-Smith et al., 1999; NICHD, 1999; Vandell, 1979) is a semi-structured parent-child play observation of social interaction skills. This task served as a measure of the generalization of strategies practiced in the groups to parent-child interactions.
Results:
Intervention fidelity was strong based on measures of attendance, adherence, clinician quality, and behavior management. Repeated measures ANOVAs revealed significant overall time by group effects for the PROGO, F(1,15) = 7.06, p ≤ .02, η2 = .32 and COP, F(1,15) = 6.90, p ≤ .02, η2 = .32, favoring the intervention group over the DT group. The effects of the intervention did not extend to parent-child interactions. All effect sizes were promising despite the small sample size (see Table 1). ANOVAs from the 3 to the 6 month follow-up assessments showed significant gains in the intervention group F(1,6) = 10.46, p <.02, but not the DT group F(1, 8) = 4.10, p < .10, although there was a trend toward replication of the effects of the GoriLLA Group intervention on the COP for the DT group (see Figure 1).
Conclusions:
Overall, the results of this study indicate that the GoriLLA Group intervention package is effective in teaching social-communication and self-regulation concept knowledge to children with ASD and their parents. Both parents and children demonstrated an increase in social-communication and self-regulation knowledge after participating in the intervention as compared to a control group.