Improvement in Social Communication Skills Following the PEERS® for Preschoolers Intervention
Objectives: To develop and test a time-limited SSI for young children with ASD with average cognitive abilities. Multiple components which were previously found to bolster treatment gains were included, including active parent education and training, play-based group format, multimodal teaching strategies, and teaching of concrete skills for friendship building. In addition to studying treatment efficacy, predictors of treatment gains were investigated.
Methods: An open-trial (Study 1) and a randomized-controlled trial (Study 2) were completed. Study 1 included 5 children with ASD (mean age = 5.28 years); Study 2 included 11 children with ASD (mean age = 4.89 years). Methods across studies were similar. The PEERS® for Preschoolers intervention is a parent-assisted social skills treatment program that met once weekly over the course of 16 weeks. Each session was 90 minutes; parents and children attended separate and joint concurrent sessions that focused on key strategies for friendship development and maintenance. At baseline, the KBIT-2 and VABS-2 were collected. At baseline and post-treatment, the QPQ, SSiS, SRS-2 and ADOS-2 were collected. Select measures will be discussed here.
Results: Study1: Parent-reported SRS-2 Total Scores decreased by 9.00 T-score points (p=.158, d=.776), indicating a strong trend with a medium/large effect overall. Parent-reported SSiS Social Skills scores increased by 5.40 Standard Score (SS) points (p=.633, d =.132) and SSiS Problem Behavior scores decreased by 2.20 SS points (p=.782, d=.231); effect sizes were small. Study2: Parent-reported SRS-2 Total Scores decreased by 9.45 T-score points (p=.001, d=1.40), indicating a clinically and statistically significant improvement with a large effect size. From pre-to post-treatment, there was a significant decrease in parent-reported SSiS Problem Behavior scores (-5.90 SS points, p=.032, d=.803, large effect). There was a strong trend toward a significant improvement in parent-reported SSiS Social Skills. Predictors of treatment gains: Across studies, treatment gains were independent of baseline KBIT-2, VABS-2, and ADOS-2 comparison scores. Treatment gains on the SSiS Social Skills domain were predicted by baseline SSiS Social Skills scores (r=.531; p=.042, r2=.282). No predictors were identified for improvements in SSiS Problem Behaviors or SRS-2 Total Scores.
Conclusions: Though results should be interpreted with some caution and are limited due to small sample sizes, they suggest social growth and a decrease in problematic behaviors following the PEERS® for Preschoolers intervention. Treatment gains are largely independent of baseline functioning, indicating that the program is likely to be beneficial for many young children with ASD.