The Effect of Parenting Style on the Effectiveness of Parent-Mediated Social Skills Intervention for Adolescents with ASD

Background: Many evidence-based intervention programs for children and adolescents with ASD include a parent training component as part of the intervention. Involving parents, who can coach their children in various daily life contexts, has the potential of assisting in overcoming generalization difficulties that often characterize ASD (Koegel et al, 1992).

However, the effect that parenting style has on the effectiveness of parent-mediated interventions has scarcely been investigated among adolescents with ASD. This should be investigated, mostly because of the nature of parent-adolescent relationships in adolescents with ASD, whose parents continue to play a central role in their socialization during adolescence (Maljaars et al., 2014).

Objectives: The main aim of the current study was to examine how parenting style affects the effectiveness of the parent-mediated Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson & Frankel, 2010), a well-established evidence-based social skills program for adolescents with ASD.

Methods: Eighty two participants (9 females) aged 12-18 (M= 14.40, S.D=1.75), who were diagnosed with ASD without an intellectual disability (diagnosis validated using the ADOS-2, intelligence assessed using the Wechsler Intelligence Scales) were randomly assigned to an immediate treatment group (IT, n=40) or a waiting-list group (WL, n=42). Parenting style was coded using the parent-adolescent conflict paradigm from the Coding of Interactive Behavior protocol (CIB; Feldman, 1998) and was evaluated at baseline for both groups. Intervention outcomes were assessed using the ‘interested’ condition from the Contextual Assessment of Social Skills (CASS; Ratto et al., 2011) pre and post intervention (for the IT group) or pre and post a waiting period (for the WL group) . Both interactions were videotaped and coded by trained, independent and blind judges (with inter-rater reliability of .90 for CIB and 0.85 for CASS).

Results: A repeated measures ANOVA revealed a group by time interaction (F[1,74]=7.07, p<.01, η²=.09), showing improvements in social interaction abilities for adolescents in the IT but not in the WL group. In addition, a significant parenting style by group by time interaction (F[1,70]=4.62 p<.05, η²=.07), indicated that within the IT group, adolescents whose parents exhibited low levels of pre-intervention parental sensitivity, improved more than adolescents whose parents exhibited high levels of pre-intervention parental sensitivity. This was not found in the WL group. A regression analysis predicting Post-pre CASS difference scores in the IT group reached statistical significance (R²=0.36, F(2,32)=9.00, p<.001) and indicated that parents’ emotional containment was negatively associated (β=-1.27, p<.001), and parents’ supportive presence was positively associated (β=1.01, p<.01) with adolescents’ improvement on the outcome measure.

Conclusions: Our study provides valuable information about the extent to which parental style affects the ability of adolescents with ASD to benefit from a manualized parent-mediated intervention, and the nature of parenting practices that may promote or hinder adolescents’ intervention related progress. The PEERS protocol, which does not directly target parenting skills, seems to promote parents’ ability to socially coach their children, especially for parents who have difficulties in this area pre-intervention.