Effects of Transdiagnostic Versus ASD-Only Therapy Groups for Children with ASD

Background: Transdiagnostic approaches to social competence group interventions may best benefit children with ASD so that they learn to interact with children with disorders other than ASD. Weiss (2014) suggested that a transdiagnostic approach may be most efficacious for children with ASD because a disorder-specific approach may miss the underlying mechanisms that lead to co-occurring problems. Clarifying this issue may help inform both treatment and academic decisions, as parents and school administrators must determine whether a child with ASD should be placed in ‘mainstream’ or ASD-specific classrooms.

Objectives: The current study examines whether therapeutic effects are similar for a child with ASD whether they are in an ASD-only group or a transdiagnostic therapy group.

Methods: A sample of 45 children ages 7-12 years were enrolled in the Resilience Builder ProgramⓇ (RBP) intervention, a 14-week, manualized, group intervention for children with social competence and self-regulation challenges (Alvord, Zucker, & Grados, 2011). Treatment was completed at a private practice in Maryland. RBP is a cognitive behavior therapy (CBT) group program designed for children with social deficits. Two types of groups were conducted: a ‘mainstream’ group wherein a child with ASD was integrated into a group with children with diagnoses other than ASD, including social anxiety and ADHD, or a group comprised of only children with ASD. Group assignment was based on severity of social deficits and ASD symptoms. 24 children with ASD were enrolled in ‘mainstream’ groups (mean age = 9.83 ± 1.93 years; 75% male; 79% Caucasian) while 21 children with ASD were enrolled in ASD-only groups (mean age = 9.24 ± 1.58 years; 81% male; 62% Caucasian). Parents completed the Behavior Assessment System for Children (BASC-2; Reynolds & Kamphaus, 2004) pre- and post-therapy to evaluate treatment impact on social, emotional, and behavioral functioning. Change scores of select subscales of the BASC-2 from pre- to post-therapy were calculated to compare groups on treatment efficacy.

Results: Groups were not significantly different based on gender, race, age, or family income. Independent samples t-tests indicated no significant difference in change scores between groups on multiple domains, including Social Skills, t(29) = -.70, p = .224, Adaptive Skills, t(29) = -.46, p = .088, Developmental Social Disorders, t(29) = 1.02, p = .282, Internalizing Problems t(29) = -.44, p = .444 , and Externalizing Problems, t(29) = -.67, p = .461.

Conclusions: Change scores did not differ between the groups on multiple domains of functioning, including social skills, affect, and behavior. The results suggest that the efficacy of a resilience-based CBT group therapy may be comparable regardless of whether children with ASD are enrolled in transdiagnostic versus ASD-specific groups. This research may speak to the idea that it may be more beneficial to match children with ASD based on skill-level as opposed to diagnosis only.