Sustainable Social Gains after Completion of a Group Socialization Program for ASD: Confluence Among Parent Survey, Self-Report Survey, Peer Conversation, Social Impression Rating, and Real-World Social Metric Measures
Objectives: The objective of the current investigation is to examine follow-up data collected 20 weeks after participants had completed the Social Tools And Rules for Teens (START) program for evidence of sustained social competence gains.
Methods: Participants consisted of 35 adolescents with ASD (ages 12-17) who enrolled in an RCT of the START program and were randomly assigned to treatment or waitlist groups. The START program is a 20-week experiential socialization intervention consisting of peer facilitators, free socialization periods, interactive topic discussions, structured social activities, and individual check-in and check-out sessions. At pre, post, and 20-week follow-up time points, participants and their parents completed a comprehensive set of social measures, including parent survey measures (Social Skills Improvement System, Social Responsiveness Scale-2, Social Motivation & Competency Scale), adolescent self-report measures (SSIS, SMCS), two video-recorded 5-minute conversations with untrained peers, and reports of real-world social metrics. Trained research assistants systematically coded all peer conversations for a variety of key social behaviors (i.e. questions asked, speaking/listening ratio, eye contact, facial expressions, engagement). Additionally, multiple peers provided a composite social impression rating after reviewing randomized participant videos.
Results: Repeated measure ANOVA procedures were used to compare pre, post, and follow-up data for all described measures. Participation in the START program was associated with significant increases across social competence measures from pre- to post-intervention time points (p-values < 0.01) with medium to large effect sizes. Across most measures, there were no significant differences between post- and follow-up data, which was reflective of sustainable social gains. Cases of significant post- to follow-up differences were actually due to continued improvements in social functioning even though START participation had ended.
Conclusions: In targeted efforts to improve the social competence of individuals with ASD, the sustainability and social validity of post-intervention gains are arguably the most important metrics of a program’s efficacy. Significant gains in social competence are irrelevant if they do not generalize to everyday peer interactions or persist after a program has concluded. The results of this START efficacy trial are indicative of sustainable, comprehensive social improvements reflected in a confluence of parent, peer, self-report, and observational social gains.