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Lao U, Li Y, Bai W, Wang Y, Li Y, Xie Y, Huang X, Zhu H, Zou X. Adaptation and Feasibility of the Mandarin Version of PEERS ® for Autistic Adolescents. J Autism Dev Disord 2024; 54:3387-3399. [PMID: 37480435 DOI: 10.1007/s10803-023-06056-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The Program for the Education and Enrichment of Relational Skills (PEERS®) is a group-based social skills training program for adolescents on the autism spectrum. Although the program has been shown to be effective in improving social skills in autistic adolescents, evidence of its effectiveness from the Mandarin-speaking Chinese population is sparse. The present study used a non-randomized, pre- and post-intervention research design to investigate the feasibility and cultural validity of the program, as well as examine the moderators of intervention outcomes. METHODS Thirty-three autistic adolescents with intelligence quotient above 70 (Mage = 13.57, SDage = 1.43; Male: Female 25:8) and their parents received 14 concurrent 90-minute sessions. Adolescents' autistic traits, challenging behaviors, emotional functioning, socio-cognitive process, social environment factors (school support), and caregivers' well-being were evaluated. RESULTS The findings suggest that with minor adjustments, the Mandarin version of PEERS® was generally acceptable and feasible for autistic adolescents and their parents. PEERS® may improve the social skills knowledge, reciprocal communication abilities, and emotional well-being of autistic adolescents. Also, participants with a higher level of school support, and parents with lower perceived subjective well-being at baseline may gain more benefits from PEERS®. The cultural adaptation and acceptability of the Mandarin Version of PEERS® were discussed. CONCLUSION This feasibility study (Chinese Clinical Trial Registry: ChiCTR2200061417, 2022-06-23, retrospectively registered) provides a basis for further randomized control trials of the Mandarin version of PEERS®.
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Affiliation(s)
- Uchong Lao
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Yan Li
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Wuxia Bai
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Yu Wang
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Yongmei Li
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Yixiang Xie
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Xiaoqian Huang
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China
| | - Huilin Zhu
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China.
| | - Xiaobing Zou
- Child Development and Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, 2693 Kai Chuang Avenue, Huangpu District, Guangzhou, 510530, China.
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Hsiao MN, Chien YL, Tai YM, Chen HM, Shih HH, Chen LW, Chen YY, Soong WT, Chiu YN, Tsai WC, Laugeson E, Tseng MH, Gau SSF. A preliminary randomized controlled study of the PEERS® program for Taiwanese autistic adolescents: The effectiveness on reducing school bullying and enhancing social function. Autism Res 2024; 17:1705-1720. [PMID: 39169699 DOI: 10.1002/aur.3213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/28/2024] [Indexed: 08/23/2024]
Abstract
Individuals with autism spectrum disorder (ASD) often experience lifelong social communication challenges and are more vulnerable to school bullying. Addressing their social difficulties and school bullying requires evidence-based interventions. PEERS® (Program for the Education and Enrichment of Relational Skills) was adapted and translated for Taiwanese adolescents. This randomized controlled study aimed to examine the effectiveness of the Taiwanese version of PEERS® in reducing school bullying and enhancing social function among autistic adolescents. Twenty-one autistic adolescents (mean age 14.29 ± 1.67 years; female n = 733.33%) were randomized to a treatment group (TG, n = 10) or a delayed treatment control group (DTG, n = 11). The outcome measures (school bullying, social challenges, social skills knowledge, and social skills performance) were assessed at baseline, post-treatment, and follow-up. The group and time interaction analyses revealed greater magnitudes of reduction in general school bullying (p < 0.001), victimization (p < 0.001), perpetration (p = 0.012), social challenges (p = 0.001), and peer conflicts (p < 0.001), and improvement in social knowledge (p < 0.001) in the TG group than the DTG group. The findings suggest that the PEERS® program tailored for Taiwanese adolescents is effective in reducing school bullying, decreasing social challenges, and enhancing social skills among autistic adolescents, with very large effect sizes (Cohen's d ranging from 1.19 to 2.88). Consequently, participation in the PEERS® program is recommended for adolescents with social difficulties to improve their social communication and interactions to offset school bullying and other social challenges related to adverse outcomes.
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Affiliation(s)
- Mei-Ni Hsiao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yueh-Ming Tai
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan
| | - Heng-Man Chen
- Foundation for Autistic Children and Adults in Taiwan, Taipei, Taiwan
| | - Hsien-Hsueh Shih
- Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Wei Chen
- Taiwan Proactive Early Intervention Association, Taipei, Taiwan
| | - Yu-Ying Chen
- Foundation for Autistic Children and Adults in Taiwan, Taipei, Taiwan
| | - Wei-Tsuen Soong
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Mei-Hui Tseng
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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Parenteau CI, Floyd J, Ankenman K, Glavin T, Charalel J, Lin E, Ence W, Kim YS, Bishop S, Zheng S. Efficacy of Community-Delivered PEERS® for Adolescents: Increases in Social Skills and Decreases in Social Anxiety and Loneliness. J Autism Dev Disord 2024:10.1007/s10803-024-06433-z. [PMID: 38884888 DOI: 10.1007/s10803-024-06433-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE PEERS® for Adolescents is an evidence-based social skills training program developed for individuals with autism spectrum disorder (ASD), which is now widely implemented by community providers in clinics and schools. However, majority of past efficacy studies on PEERS® were conducted in controlled research settings, with limited information about its effectiveness when delivered in the community. We sought to examine the effects of PEERS® on social functioning and mental health outcomes when delivered in an outpatient autism specialty clinic. METHODS Clinical data from 45 adolescents with social challenges (age range: 11-18 years old; 31.1% female assigned at birth) were extracted for secondary analyses. Paired t-tests were performed to examine the pre- to post-intervention changes in social and mental health outcomes. Correlations between pre- and post-change scores of outcome measures were examined. RESULTS Self-reported social skills knowledge, caregiver-reported social skills (measured by the Social Skills Improvement Systems) and the number of get-togethers hosted, increased significantly from pre- to post-intervention. Additionally, caregiver-reported anxiety and self-reported loneliness significantly decreased from pre- to post-intervention. Exploratory analyses showed that increases in caregiver-reported social skills were associated with decreases in self-reported loneliness. CONCLUSIONS Our findings provide evidence supporting the efficacy of PEERS® for improving social knowledge and skills of adolescents with social challenges when delivered in the community. The current study also showed the potential benefit of PEERS® for improving adolescent mental health.
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Affiliation(s)
- China I Parenteau
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Jessica Floyd
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Katy Ankenman
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Tara Glavin
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Julia Charalel
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Enjey Lin
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Whitney Ence
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Young Shin Kim
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA
| | - Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
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Gravholt CH, Andersen NH, Christin-Maitre S, Davis SM, Duijnhouwer A, Gawlik A, Maciel-Guerra AT, Gutmark-Little I, Fleischer K, Hong D, Klein KO, Prakash SK, Shankar RK, Sandberg DE, Sas TCJ, Skakkebæk A, Stochholm K, van der Velden JA, Backeljauw PF. Clinical practice guidelines for the care of girls and women with Turner syndrome. Eur J Endocrinol 2024; 190:G53-G151. [PMID: 38748847 DOI: 10.1093/ejendo/lvae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/19/2024] [Indexed: 06/16/2024]
Abstract
Turner syndrome (TS) affects 50 per 100 000 females. TS affects multiple organs through all stages of life, necessitating multidisciplinary care. This guideline extends previous ones and includes important new advances, within diagnostics and genetics, estrogen treatment, fertility, co-morbidities, and neurocognition and neuropsychology. Exploratory meetings were held in 2021 in Europe and United States culminating with a consensus meeting in Aarhus, Denmark in June 2023. Prior to this, eight groups addressed important areas in TS care: (1) diagnosis and genetics, (2) growth, (3) puberty and estrogen treatment, (4) cardiovascular health, (5) transition, (6) fertility assessment, monitoring, and counselling, (7) health surveillance for comorbidities throughout the lifespan, and (8) neurocognition and its implications for mental health and well-being. Each group produced proposals for the present guidelines, which were meticulously discussed by the entire group. Four pertinent questions were submitted for formal GRADE (Grading of Recommendations, Assessment, Development and Evaluation) evaluation with systematic review of the literature. The guidelines project was initiated by the European Society for Endocrinology and the Pediatric Endocrine Society, in collaboration with members from the European Society for Pediatric Endocrinology, the European Society of Human Reproduction and Embryology, the European Reference Network on Rare Endocrine Conditions, the Society for Endocrinology, and the European Society of Cardiology, Japanese Society for Pediatric Endocrinology, Australia and New Zealand Society for Pediatric Endocrinology and Diabetes, Latin American Society for Pediatric Endocrinology, Arab Society for Pediatric Endocrinology and Diabetes, and the Asia Pacific Pediatric Endocrine Society. Advocacy groups appointed representatives for pre-meeting discussions and the consensus meeting.
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Affiliation(s)
- Claus H Gravholt
- Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
| | - Niels H Andersen
- Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Sophie Christin-Maitre
- Endocrine and Reproductive Medicine Unit, Center of Rare Endocrine Diseases of Growth and Development (CMERCD), FIRENDO, Endo ERN Hôpital Saint-Antoine, Sorbonne University, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
| | - Shanlee M Davis
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, United States
- eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, CO 80045, United States
| | - Anthonie Duijnhouwer
- Department of Cardiology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Aneta Gawlik
- Departments of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Andrea T Maciel-Guerra
- Area of Medical Genetics, Department of Translational Medicine, School of Medical Sciences, State University of Campinas, 13083-888 São Paulo, Brazil
| | - Iris Gutmark-Little
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, United States
| | - Kathrin Fleischer
- Department of Reproductive Medicine, Nij Geertgen Center for Fertility, Ripseweg 9, 5424 SM Elsendorp, The Netherlands
| | - David Hong
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States
| | - Karen O Klein
- Rady Children's Hospital, University of California, San Diego, CA 92123, United States
| | - Siddharth K Prakash
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, United States
| | - Roopa Kanakatti Shankar
- Division of Endocrinology, Children's National Hospital, The George Washington University School of Medicine, Washington, DC 20010, United States
| | - David E Sandberg
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-2800, United States
- Division of Pediatric Psychology, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-2800, United States
| | - Theo C J Sas
- Department the Pediatric Endocrinology, Sophia Children's Hospital, Rotterdam 3015 CN, The Netherlands
- Department of Pediatrics, Centre for Pediatric and Adult Diabetes Care and Research, Rotterdam 3015 CN, The Netherlands
| | - Anne Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Kirstine Stochholm
- Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Center for Rare Diseases, Department of Pediatrics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Janielle A van der Velden
- Department of Pediatric Endocrinology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen 6500 HB, The Netherlands
| | - Philippe F Backeljauw
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, United States
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Afsharnejad B, Black MH, Falkmer M, Bölte S, Girdler S. The Methodological Quality and Intervention Fidelity of Randomised Controlled Trials Evaluating Social Skills Group Programs in Autistic Adolescents: A Systematic Review and Meta-analysis. J Autism Dev Disord 2024; 54:1281-1316. [PMID: 36681732 PMCID: PMC10981608 DOI: 10.1007/s10803-023-05893-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
A systematic review and meta-analysis were utilised to explore the methodological quality, program fidelity, and efficacy of social skills group programs (SSGPs) aiming to support autistic adolescents in navigating their everyday social worlds. The study evaluated the methodological quality and theoretical fidelity of studies, with a random effect meta-analysis conducted to summarise the overall efficacy of SSGP and its effect on social communication and interaction, behavioural/emotional challenges, adaptive functioning, and autism characteristics. Although findings from the 18 identified studies indicated an adjusted medium overall effect with these programs successfully supporting autistic adolescents' socialisation needs (g = 0. 60, p < 0.001), most studies demonstrated medium to low program fidelity despite their good methodological quality. Given the significant heterogeneity of SSGPs and variations in the design and measurement frameworks of efficacy studies, understanding the generalisability of the findings of this research is unclear.
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Affiliation(s)
- Bahareh Afsharnejad
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.
| | - Melissa H Black
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Marita Falkmer
- School of Education and Communication, CHILD, Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden
| | - Sven Bölte
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- School of Allied Health, University of Western Australia, Perth, WA, Australia
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Fatta LM, Bianchi D, Laugeson EA, Veytsman E, Romano G, Laghi F, Scattoni ML. Enhancing social outcomes in autistic youth: Assessing the impact of PEERS® booster sessions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 147:104698. [PMID: 38401194 DOI: 10.1016/j.ridd.2024.104698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND The Program for the Education and Enrichment of Relational Skills (PEERS®) is a social skills training program for autistic adolescents and those facing social challenges. Its efficacy has been established worldwide, including in Italy. Although booster interventions are a potentially valuable strategy to maintain improvements over time, there is currently no research on the efficacy of providing booster sessions of PEERS® following the traditional treatment. AIMS This study aims to evaluate the efficacy of PEERS® Booster sessions in a sample who had previously participated in a traditional PEERS® Adolescent program. METHODS AND PROCEDURES A longitudinal non-randomized study was conducted involving 21 autistic adolescents, divided into the treatment group undergoing PEERS® Booster sessions and the control group without it. OUTCOMES AND RESULTS The study evaluated the primary outcomes (social abilities) and secondary outcomes (co-occurrences, executive functions) at two-time points (pre- and post-treatment). No significant differences were found between groups on baseline measures and primary outcomes. However, there were significant group differences between pre- and post-treatment on primary outcomes (social awareness and social communication) and secondary outcomes (externalizing problems). CONCLUSIONS AND IMPLICATIONS The efficacy of the PEERS® Booster Sessions shows promise and clinical implications were also discussed.
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Affiliation(s)
- Laura Maria Fatta
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy.
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | | | | | | | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Gilmore R, Ziviani J, McIntyre S, Goodman S, Tyack Z, Sakzewski L. Exploring caregiver and participant experiences of the Program for the Education and Enrichment of Relational Skills (PEERS ®) for youth with acquired brain injury and cerebral palsy. Disabil Rehabil 2024; 46:515-523. [PMID: 36661096 DOI: 10.1080/09638288.2023.2167008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/06/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE This study explored the experience of adolescents with brain injuries and their caregivers who participated in the Program for the Education and Enrichment of Relational Skills (PEERS®) in Australia. MATERIALS AND METHODS Twenty-seven adolescents and 31 caregivers, who completed the PEERS® intervention as part of an RCT, contributed to focus groups following the 14-week program. Semi-structed interviews guided focus groups. An interpretive description methodology was used to understand participants' experiences in the program and suggestions for improvements. RESULTS Thematic analysis led to the development of five themes. "Challenging families and meeting expectations" explored the challenge and worth of participating. "Learnt new skills" highlighted skills and strategies gained and methods used to achieve these. "Connecting, belonging and understanding that's our normal" represented the value placed on the group experience. "Confidence in knowing and doing" reflected the changes in everyday social experiences and "Where to from here?" provided many suggestions for adaptation to improve practice. CONCLUSION After taking part in the PEERS® social skills group intervention, most adolescents with brain injury and their caregivers perceived improvement in their social participation and had suggestions for improving the group experience. Some adolescents didn't enjoy the program.IMPLICATIONS FOR REHABILITATIONOffering adolescents with brain injury and their caregivers the opportunity to participate in a group social skills intervention is an important part of paediatric rehabilitation.Participants of group social skills interventions are likely to perceive improvements in their everyday social functioning following completion.Considering strategies to enhance engagement in the group is expected to be important for outcomes.Participants of group social skills programs may need additional support and adjustments to balance the demands of the intervention with other everyday family and school tasks and requirements.
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Affiliation(s)
- Rose Gilmore
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Australia
- Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, Brisbane, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
| | - Sarah Goodman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Australia
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Lee JD, Kang VY, Terol AK, Joo S. Examining the Efficacy of Culturally Responsive Interventions for Autistic Children and Their Families: A Meta-Analysis. J Autism Dev Disord 2024:10.1007/s10803-023-06212-2. [PMID: 38246962 PMCID: PMC11260274 DOI: 10.1007/s10803-023-06212-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/23/2024]
Abstract
Culturally responsive interventions for autistic children and their families have been developed and implemented to address issues related to limited representation, inequities, and disparities in access to care of minoritized families in research. Currently available reviews are relatively limited in scope or do not synthesize interventions specifically. Therefore, we conducted a meta-analysis to synthesize autism intervention literature that specifically targeted autistic individuals and their family members from minoritized backgrounds, such as immigrant families. We used four databases to identify studies that used culturally responsive interventions with minoritized autistic children and their families. An article was included if it included empirical intervention data using an experimental design. A total of 354 studies were initially screened, and 24 studies were included. Effect sizes of these studies were extracted across two levels (i.e., child and family levels). Data from group design studies were extracted manually, and data from single-case design studies were extracted using a web-based tool. We used design-comparable standardized effect sizes to compare across both designs. The analysis revealed a large, positive, and significant overall effect size across culturally responsive interventions. Specifically, social-communication and mental health outcomes yielded significant effects at the child level. Additionally, parents' mental health and fidelity of strategy implementation also yielded significant results. Our results suggest that culturally responsive interventions yield comparable outcomes to unadapted, original interventions. Future research should examine the distinction between the effect of cultural adaptation and the efficacy of the intervention itself.
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Affiliation(s)
- James D Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6901 Sand Point Ave NE, Seattle, WA, 98115, USA.
| | - Veronica Y Kang
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, USA
| | - Adriana Kaori Terol
- Department of Special Education, University of Illinois Urbana-Champaign, Champaign, USA
| | - Sean Joo
- Department of Educational Psychology, University of Kansas, Lawrence, USA
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Kim SI, Jang SY, Kim T, Kim B, Jeong D, Noh T, Jeong M, Hall K, Kim M, Yoo HJ, Han K, Hong H, Kim JG. Promoting Self-Efficacy of Individuals With Autism in Practicing Social Skills in the Workplace Using Virtual Reality and Physiological Sensors: Mixed Methods Study. JMIR Form Res 2024; 8:e52157. [PMID: 38206652 PMCID: PMC10811570 DOI: 10.2196/52157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Individuals with autism often experience heightened anxiety in workplace environments because of challenges in communication and sensory overload. As these experiences can result in negative self-image, promoting their self-efficacy in the workplace is crucial. Virtual reality (VR) systems have emerged as promising tools for enhancing the self-efficacy of individuals with autism in navigating social scenarios, aiding in the identification of anxiety-inducing situations, and preparing for real-world interactions. However, there is limited research exploring the potential of VR to enhance self-efficacy by facilitating an understanding of emotional and physiological states during social skills practice. OBJECTIVE This study aims to develop and evaluate a VR system that enabled users to experience simulated work-related social scenarios and reflect on their behavioral and physiological data through data visualizations. We intended to investigate how these data, combined with the simulations, can support individuals with autism in building their self-efficacy in social skills. METHODS We developed WorkplaceVR, a comprehensive VR system designed for engagement in simulated work-related social scenarios, supplemented with data-driven reflections of users' behavioral and physiological responses. A within-subject deployment study was subsequently conducted with 14 young adults with autism to examine WorkplaceVR's feasibility. A mixed methods approach was used, compassing pre- and postsystem use assessments of participants' self-efficacy perceptions. RESULTS The study results revealed WorkplaceVR's effectiveness in enhancing social skills and self-efficacy among individuals with autism. First, participants exhibited a statistically significant increase in perceived self-efficacy following their engagement with the VR system (P=.02). Second, thematic analysis of the interview data confirmed that the VR system and reflections on the data fostered increased self-awareness among participants about social situations that trigger their anxiety, as well as the behaviors they exhibit during anxious moments. This increased self-awareness prompted the participants to recollect their related experiences in the real world and articulate anxiety management strategies. Furthermore, the insights uncovered motivated participants to engage in self-advocacy, as they wanted to share the insights with others. CONCLUSIONS This study highlights the potential of VR simulations enriched with physiological and behavioral sensing as a valuable tool for augmenting self-efficacy in workplace social interactions for individuals with autism. Data reflection facilitated by physiological sensors helped participants with autism become more self-aware of their emotions and behaviors, advocate for their characteristics, and develop positive self-beliefs.
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Affiliation(s)
- Sung-In Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Bundang, Republic of Korea
| | - So-Youn Jang
- Georgia Institute of Technology, Atlanta, GA, United States
| | - Taewan Kim
- Department of Industrial Design, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Bogoan Kim
- Department of Data Science, Hanyang University, Seoul, Republic of Korea
| | - Dayoung Jeong
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Taehyung Noh
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Mingon Jeong
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Kaely Hall
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Meelim Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, United States
- The Design Lab, University of California San Diego, San Diego, CA, United States
- Center for Wireless & Population Health Systems Calit2's Qualcomm Institute, University of California San Diego, San Diego, CA, United States
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyungsik Han
- Department of Data Science, Hanyang University, Seoul, Republic of Korea
- Department of Artificial Intelligence, Hanyang University, Seoul, Republic of Korea
| | - Hwajung Hong
- Department of Industrial Design, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Jennifer G Kim
- Georgia Institute of Technology, Atlanta, GA, United States
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Fatta LM, Laugeson EA, Bianchi D, Laghi F, Scattoni ML. Program for the Education and Enrichment of Relational Skills (PEERS ®) for Italy: A Randomized Controlled Trial of a Social Skills Intervention for Autistic Adolescents. J Autism Dev Disord 2024:10.1007/s10803-023-06211-3. [PMID: 38190054 DOI: 10.1007/s10803-023-06211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
The Program for the Education and Enrichment of Relational Skills (PEERS®) is an intervention targeting social skills for autistic adolescents and those with other social challenges. The efficacy of the PEERS® on adolescents has been extensively explored but the program has not been validated in Italy. In the present study, we adapted PEERS® to Italian culture and evaluated its efficacy in an Italian sample. A Randomized Controlled Trial was conducted, analyzing the results of 37 autistic adolescents who were randomly assigned to two groups: experimental group (TG) and waitlist group (WL). The primary outcomes (social abilities) and secondary outcomes (co-occurring conditions, executive functions) were assessed at four time points. No differences were found at pre-treatment between groups on baseline measures and primary outcomes. At post-treatment, significant group differences emerged in primary outcomes (social knowledge and social performance) and secondary outcomes (emotion regulation). The groups' results pooled together (TG + WL) confirmed the findings at post-treatment and showed further changes in primary outcomes (global social competence and social cognition) and secondary outcomes (externalizing problems, emotive and behavioral total problems, functional problems related to depressive symptoms). The improvements were maintained at a 3-month follow-up, except for global social competence and social cognition. Additionally, new results emerged regarding internalizing problems and global executive functioning. The efficacy of the Italian version of PEERS® was ascertained on primary and secondary outcomes. Innovative findings on emotion regulation, behavioral problems, and depression symptoms also emerged.Clinical trial registration information Program for the Education and Enrichment of Relational Skills (PEERS®) for Italy. An RCT's Study on Social Skills Intervention for Adolescents with Autism Spectrum Disorder (ASD). URL: http://clinicaltrials.gov . TRN: NCT05473104. Release Date: July 21, 2022.
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Affiliation(s)
- Laura Maria Fatta
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | | | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
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11
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Tawankanjanachot N, Truesdale M, Orachon P, Kidd L. Social skills interventions for Thai adolescents with Autism Spectrum Disorder (ASD): a qualitative study of the perceptions and experiences of Thai adolescents, their caregivers and healthcare professionals. Int J Ment Health Syst 2024; 18:1. [PMID: 38167087 PMCID: PMC10763348 DOI: 10.1186/s13033-023-00617-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Social skills interventions (SSIs) are effective for enhancing social skills and decreasing mental health problems in adolescents with autism spectrum disorder (ASD). However, these interventions have been designed and their effectiveness has been established in Western countries. Lack of culturally acceptable SSIs for Asian nations is a possible barrier to implementing effective and tailored interventions that address the unique requirements of ASD individuals across countries and cultures. This study aims to explore the needs and preferences of adolescents with ASD, their caregivers, and healthcare professionals (HPs) in Thailand regarding the components, delivery formats, and cultural adaptation required for an outpatient-based social skills intervention. METHODS Qualitative data was collected via three focus groups of HPs (n = 20) and 24 paired interviews with adolescents with ASD and their caregivers from a child psychiatric hospital in Thailand. Purposive sampling was employed, and thematic analysis was used to analyse the data. RESULTS Nine themes emerged from the data generated by HPs, and seven from adolescents with ASD and their caregivers. SSIs for Thai adolescents with ASD and their caregivers should emphasise specific social skills training and assess the abilities of adolescents as required. Incorporating various learning strategies is important. Parental involvement is essential and provides knowledge of an adolescent's symptoms and coaching skills, which are best used to support their adolescents. Cultural considerations include the need for social knowledge of Thai culture, promoting assertiveness and praising parents' abilities, implementing a programme in time to not interrupt academic achievement, and renaming a programme from social skills intervention to social communication intervention. Barriers to implementing a programme included HPs' need for specialised training and education and decreased workload. Also, the caregivers' and adolescents' stigma reduced attendance in a programme. Increased extra compensation and relocation days off are provided as policy support for staff who deliver the intervention. CONCLUSION The results suggest that SSIs for Thai adolescents with ASD should be tailored to meet the needs for specific knowledge, skills, and parental collaboration as coaches for their adolescents. Additionally, it should incorporate Thai culture. It is necessary to consider staff knowledge, workload, and stigma in order to reduce barriers to implementation in practice.
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Affiliation(s)
- Nadlada Tawankanjanachot
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow, G12 9LL, UK.
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Maria Truesdale
- School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 0XH, UK
| | - Pornpun Orachon
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health, Ministry of Public Health, Samut Prakan, 10270, Thailand
| | - Lisa Kidd
- School of Health & Life Sciences, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, G4 OBA, UK
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12
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Son JW, Nam SH. Basic Management Strategies by Life Cycle for Treatment of the Persons With Autism Spectrum Disorder. Soa Chongsonyon Chongsin Uihak 2024; 35:22-28. [PMID: 38204737 PMCID: PMC10774562 DOI: 10.5765/jkacap.230011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/14/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
Interventions for targeted symptoms are important when setting treatment strategies for individuals with autism spectrum disorder (ASD) and developmental disabilities. Especially, the goal should be to achieve individual "niche construction" by allowing them to select and adjust an environment where they can demonstrate their special characteristics and strengths. In addition, these choices should vary depending on the stage of development of each person with ASD and developmental disabilities. It is necessary to establish a detailed and systematic plan for diagnosis and treatment necessary for infants and toddlers, school placement in school age, and employment or self-reliance in adult transition period to establish customized treatment strategies that fit the individual level of people with ASD and developmental disabilities.
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Affiliation(s)
- Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Seok-Hyun Nam
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Korea
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13
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Kose S, Turer F, Inal Kaleli I, Calik Senturk HN, Ozuysal Uyar DH, Bildik T. The Relationship Between Social Skills and Sensory Profile, Emotion Regulation, and Empathizing/Systemizing in Adolescents on the Autism Spectrum. J Autism Dev Disord 2023:10.1007/s10803-023-06190-5. [PMID: 38127185 DOI: 10.1007/s10803-023-06190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
This study aims to evaluate the relationship between social skills and sensory features, emotion regulation, and empathy in adolescents on the autism spectrum. One hundred and twenty-three adolescents were included in the study (50 autistic, 73 typically developing-TD adolescents). The participants filled out the Adolescent/Adult Sensory Profile (AASP) and Emotion Regulation Questionnaire. Parents of the participants completed the Child Empathy and Systemizing Quotient (EQ-C/SQ-C) and Autism-Social Skills Profile (ASSP) scales. Social reciprocity, social participation/avoidance, ASSP total scores, empathy and systemizing scores were lower, and detrimental social behaviors, low registration sensory profile scores were higher in the autism spectrum group. While a difference between genders was observed in sensory sensitivity, sensation avoiding, low registration quadrants and empathy scores, no gender and group interaction was found in any domain. Social skill total scores were correlated to sensation seeking and low registration sensory features, empathy, systemizing, and reappraisal emotion regulation scores. A hierarchical multiple linear regression analysis was conducted controlling for group and gender, sensation seeking (p = .032, β = 0.138), low registration (p = .012, β = - 0.215) of the AASP, and empathy (p < .001, β = 0.555) and systemizing (p = .033, β = 0.138) scores of the EQ/SQ-C was found to significantly predict social skill total scores. Although emotional regulation strategies may play a role, sensory processing features and empathy and systemizing skills seem to be the more significant contributors to social skills during adolescence. Interventions targeting sensory processing and especially improving empathy and systematization skills may positively affect social skills in adolescents on the autism spectrum.
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Affiliation(s)
- Sezen Kose
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Furkan Turer
- Department of Child and Adolescent Psychiatry, Corlu State Hospital, Tekirdag, Turkey.
| | - Ipek Inal Kaleli
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hilal Nur Calik Senturk
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Damla Hazal Ozuysal Uyar
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
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14
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Antezana L, Albright J, Scarpa A, Richey JA, Laugeson EA, Factor RS. PEERS® for Preschoolers preliminary outcomes and predictors of treatment response. J Autism Dev Disord 2023; 53:4671-4684. [PMID: 36103076 PMCID: PMC10011023 DOI: 10.1007/s10803-022-05724-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2022] [Indexed: 11/28/2022]
Abstract
PEERS® for Preschoolers (P4P) is a social skills group program for young autistic children and their caregivers, which provides everyday tools for interacting and communicating with others. Twenty-two caregiver-child dyads participated and completed pre-treatment, post-treatment, and follow-up measures (4-16 weeks after). Using single-subject analyses to examine social skills, 60% demonstrated post-treatment improvement, and 53.85% demonstrated follow-up improvement. Regarding a secondary outcome of behavioral difficulties, 33.33% demonstrated post-treatment reduction, and 7.69% demonstrated follow-up reduction. Using regressions, autistic traits predicted outcomes; fewer social communication difficulties predicted both greater social skills and fewer behavioral difficulties at post-treatment, while fewer repetitive behaviors predicted fewer post-treatment and follow-up behavioral difficulties. These results preliminarily demonstrate the benefits of P4P and how autistic traits may impact P4P outcomes.
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Affiliation(s)
- Ligia Antezana
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA.
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Jordan Albright
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
| | - John A Richey
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Reina S Factor
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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15
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Płatos M, Wojaczek K, Laugeson EA. Effects of Social Skills Training for Adolescents on the Autism Spectrum: a Randomized Controlled Trial of the Polish Adaptation of the PEERS® Intervention via Hybrid and In-Person Delivery. J Autism Dev Disord 2023; 53:4132-4146. [PMID: 36001196 PMCID: PMC9399988 DOI: 10.1007/s10803-022-05714-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 12/19/2022]
Abstract
The study examined the efficacy of the Polish adaptation of the PEERS® curriculum for adolescents on the autism spectrum. Twenty-nine adolescents (aged 11-16) were randomized into a Treatment and a Waitlist Control Group. Due to COVID-19-related restrictions, the Treatment Group received part of the intervention online (in hybrid mode). Results showed large effects of PEERS® increasing the teens' social skills, knowledge about social skills, and the number of get-togethers with peers. Most of the effects were maintained over a six-month follow-up period. There was no impact of the delivery mode on the treatment effects. The study demonstrates the feasibility and efficacy of the Polish adaptation of PEERS® and encourages future research on the online/hybrid delivery of Social Skills Training.
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Affiliation(s)
- Mateusz Płatos
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 01-909, Warsaw, Poland.
- Association for Social Innovation "Mary and Max", Marszałkowska 84/92/201, 00-514, Warsaw, Poland.
| | - Kinga Wojaczek
- Association for Social Innovation "Mary and Max", Marszałkowska 84/92/201, 00-514, Warsaw, Poland
| | - Elizabeth A Laugeson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, 90095-6967, Los Angeles, CA, USA
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16
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Cheng WM, Smith TB, Butler M, Taylor TM, Clayton D. Effects of Parent-Implemented Interventions on Outcomes of Children with Autism: A Meta-Analysis. J Autism Dev Disord 2023; 53:4147-4163. [PMID: 35996037 PMCID: PMC10539413 DOI: 10.1007/s10803-022-05688-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/11/2022]
Abstract
Children with autism spectrum disorder (ASD) have been shown to benefit from parent-implemented interventions (PIIs). This meta-analysis improved on prior reviews of PIIs by evaluating RCTs and multiple potential moderators, including indicators of research quality. Fifty-one effect sizes averaged moderately strong overall benefits of PIIs (g = 0.553), with studies having lower risk of research bias yielding lower estimates (g = 0.47). Parent and observer ratings yielded similar averaged estimates for positive behavior/social skills (g = 0.603), language/communication (g = 0.545), maladaptive behavior (g = 0.519), and to a lesser extent, adaptive behavior/life skills (g = 0.239). No other study, intervention, or participant characteristic moderated outcomes. PIIs with children with ASD tend to be effective across a variety of circumstances.
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Affiliation(s)
- Wai Man Cheng
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA.
| | - Timothy B Smith
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA.
| | - Marshall Butler
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| | - Tina M Taylor
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| | - Devan Clayton
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
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17
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Yu Z, Zhang P, Tao C, Lu L, Tang C. Efficacy of nonpharmacological interventions targeting social function in children and adults with autism spectrum disorder: A systematic review and meta-analysis. PLoS One 2023; 18:e0291720. [PMID: 37725597 PMCID: PMC10508624 DOI: 10.1371/journal.pone.0291720] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/14/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND AND AIMS This paper aimed to evaluate the use of nonpharmacological interventions for the management of autism spectrum disorder (ASD). The effects of acupuncture and behavioural therapy, two nonpharmalogical interventions, on social function in ASD patients are still controversial. This meta-analysis investigated the impact of these two treatments and compared their effects. METHODS Seven electronic databases were systematically searched to identify randomized controlled trials (RCTs) on the use of acupuncture or behavioural therapy for ASD. A meta-analysis was carried out using Review Manager 5.4 software. Continuous data are reported as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). An assessment of methodological quality using the Cochrane risk-of-bias (ROB) tool for trials was carried out. The Grading of Recommendation Assessment, Development, and Evaluation (GRADE) was applied to evaluate the quality (certainty) of evidence for results regarding social function indicators. RESULTS Thirty RCTs on acupuncture and 36 on behavioural therapy were included. Compared with the control condition, body acupuncture (SMD: 0.76, 95% CI: [0.52, 1.01]; low certainty), modern acupuncture technology (SMD: 0.84, 95% CI: [0.32, 1.35]; low certainty), cognitive behavioural therapy (SMD: 0.42, 95% CI: [0.26, 0.58]; high certainty), the Denver model (SMD: 0.61, 95% CI: [0.23, 0.99]; moderate certainty) and social skills training (SMD: 0.56, 95% CI: [0.41, 0.71]; moderate certainty) improved social functioning. CONCLUSION Behavioural therapies (such as CBT, the Denver model, social skills training), improved the social functioning of patients with ASD in the short and long term, as supported by high- and moderate-quality evidence. Acupuncture (including scalp acupuncture, body acupuncture and use of modern acupuncture technology) also improved social functioning, as supported by low- and very low-quality evidence. More high-quality evidence is needed to confirm the effect of acupoint catgut embedding and Early Intensive Behavioural Intervention (EIBI).
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Affiliation(s)
- Zhili Yu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Peiming Zhang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Chenyang Tao
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Liming Lu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
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Lee JH, Lee TS, Yoo SY, Lee SW, Jang JH, Choi YJ, Park YR. Metaverse-based social skills training programme for children with autism spectrum disorder to improve social interaction ability: an open-label, single-centre, randomised controlled pilot trial. EClinicalMedicine 2023; 61:102072. [PMID: 37483546 PMCID: PMC10359727 DOI: 10.1016/j.eclinm.2023.102072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is characterised by abnormalities in social interactions and restricted and repetitive behaviors. Children with high-functioning ASD (HFASD), lack social communication skills, do not interact with others, and lack peer relationships. We aimed to develop, and evaluate the feasibility of, a metaverse-based programme to enhance the social skills of children with HFASD. Methods This open-label, single-centre, pilot parallel randomised controlled trial (RCT) was conducted on boys aged 7-12 years with HFASD. Children were recruited from a treatment centre for children with HFASD in Korea or by self-referral through online community webpages for the parents of children with HFASD. Participants were randomly assigned (1:1) by a blinded researcher to receive either four weeks of a metaverse-based social skills training programme or a control group. Randomisation was stratified by age (children aged 7-9 and 10-12 years) using permuted blocks (block size 4). The metaverse-based social skills training programme was delivered via the metaverse platforms (Roblox) and Zoom. Children in the intervention group completed the metaverse-based social skills training programme at home for four weeks. The intervention consisted of four sessions, one session per week, for 60 min each. The control group did not receive any interventions. The primary outcome measure was the median change in the Social Responsiveness Scale-2 (SRS-2) scores from pre-to post-intervention. SRS-2 is an assessment tool used to confirm the effectiveness of social interactions. Higher scores indicate lower social functioning. The trial is registered with CRIS Registration Number; KCT0006859. Findings Between February 14, 2022, and March 31, 2022, 20 participants were enrolled. Overall, 15 children (median [Interquartile range (IQR)] age, intervention group: 9.0 [8.0-10.0]; control group: 8.5 [8.0-10.0]) participated in the programme. The intervention group included nine participants (60%), and the control group included six participants (40%). The SRS-2 total scores for the intervention group decreased from baseline 96.0 (IQR: 74.0-112.0) to post-intervention 85.0 (IQR: 84.0-103.0). The group median difference in SRS-2 scores between the intervention and control groups was 11.5 (95% CI: 8.5-14.0), with a further reduction in the intervention group. Similar trends were seen for social cognition (group median difference, 95% CI: 2.0, 1.0-4.0), social communication (group median difference, 95% CI: 2.0, 1.0-4.0), and autistic mannerism (group median difference, 95% CI: 4.0, 1.0-5.0). There were no adverse events related to study participation. Interpretation The findings of this feasibility study suggest that children with HFASD can potentially be familiarised, through metaverse-based programmes, with real-life social situations to improve sociality and reduce emotional and behavioural problems. Such interventions could be delivered at home and possibly be extended to target groups that have difficulty in interacting with peers offline. Funding The Institute of Information & Communications Technology Planning & Evaluation grant, via the Ministry of Science and ICT of the South Korean Government.
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Affiliation(s)
- Joo Hyun Lee
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae Seon Lee
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea
- Center for Medical Education, Graduate School of Medicine, Nagoya University, Japan
| | - Su Young Yoo
- DoBrain Co., Ltd., Seoul, South Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Seung Woo Lee
- Graduate School of Information and Communication Technology, Ajou University, Suwon, South Korea
| | - Ji Hye Jang
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
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Kim YR, Song DY, Bong G, Han JH, Kim JH, Yoo HJ. Clinical characteristics of comorbid tic disorders in autism spectrum disorder: exploratory analysis. Child Adolesc Psychiatry Ment Health 2023; 17:71. [PMID: 37309007 DOI: 10.1186/s13034-023-00625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The frequency, clinical characteristics, and associated symptoms of comorbid tic disorders in individuals with autism spectrum disorder (ASD) remain unclear. METHODS We included subsets of individuals from a larger genetic study who were diagnosed with ASD (n = 679; age: 4-18 years) and completed the Yale Global Tic Severity Scale (YGTSS) questionnaire. Based on the YGTSS score, the individuals were divided into two groups: ASD only (n = 554) and ASD with tics (n = 125). Individuals were assessed using the verbal and non-verbal intelligence quotient (IQ), Vineland Adaptive Behavior Scale (VABS-2), Social Responsiveness Scale-2 (SRS-2), Child Behavior Checklists (CBCL), and Yale-Brown Obsessive-Compulsive Scale (YBOCS), followed by between-group comparisons. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 26. RESULTS Tic symptoms were observed in 125 (18.4%) participants; among them, most participants presented both motor and vocal tics (n = 40, 40.0%). The ASD with tics group had a significantly higher average age and full-scale IQ score than the ASD only group. After adjusting for age, the ASD with tics group had significantly higher scores in the SRS-2, CBCL, and YBOCS subdomains than the ASD only group. Furthermore, all variables except the non-verbal IQ and VABS-2 scores were positively correlated with the YGTSS total score. Finally, the proportion of tic symptoms was significantly higher among individuals with a higher IQ score (≥ 70). CONCLUSIONS The IQ score was positively correlated with the proportion of tic symptoms among individuals with ASD. Moreover, the severity of the core and comorbid symptoms of ASD was associated with the occurrence and severity of tic disorders. Our findings suggest the need for appropriate clinical interventions for individuals with ASD. Trial registration This study retrospectively registered participants.
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Affiliation(s)
- Ye Rim Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, 82 Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam, 13620, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Da-Yea Song
- Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Guiyoung Bong
- Department of Psychiatry, Seoul National University Bundang Hospital, 82 Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam, 13620, Republic of Korea
| | - Jae Hyun Han
- Department of Psychiatry, Seoul National University Bundang Hospital, 82 Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam, 13620, Republic of Korea
| | - Joo-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, 82 Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam, 13620, Republic of Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, 82 Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam, 13620, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Veytsman E, Baker E, Martin AM, Choy T, Blacher J, Stavropoulos K. Perceived and Observed Treatment Gains Following PEERS: A Preliminary Study with Latinx Adolescents with ASD. J Autism Dev Disord 2023; 53:1175-1188. [PMID: 35157167 PMCID: PMC8852879 DOI: 10.1007/s10803-022-05463-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
The Program for the Education and Enrichment of Relational Skills (PEERS) social skills intervention has demonstrated effectiveness for adolescents with autism spectrum disorder (ASD). However, studies have been limited by a lack of objective outcome measures and an underrepresentation of Latinx families. This pilot study extends the PEERS literature by utilizing an observational measure of conversational skills (Contextual Assessment of Social Skills; CASS) with a diverse sample of 13 adolescents with ASD (with parent groups conducted in English and Spanish simultaneously) and a control group of 11 neurotypical adolescents. Consistent with previous research, adolescents with ASD and their parents perceived improvements in social functioning following intervention, which were maintained four months later and corroborated by improvements in conversational skills.
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Affiliation(s)
- Elina Veytsman
- Graduate School of Education, University of California, 1207 Sproul Hall, Riverside, CA, 92521, USA.
| | - Elizabeth Baker
- Graduate School of Education, University of California, 1207 Sproul Hall, Riverside, CA, 92521, USA
| | - Ann Marie Martin
- Graduate School of Education, University of California, 1207 Sproul Hall, Riverside, CA, 92521, USA
| | - Tricia Choy
- Graduate School of Education, University of California, 1207 Sproul Hall, Riverside, CA, 92521, USA
| | - Jan Blacher
- Graduate School of Education, University of California, 1207 Sproul Hall, Riverside, CA, 92521, USA
| | - Katherine Stavropoulos
- Graduate School of Education, University of California, 1207 Sproul Hall, Riverside, CA, 92521, USA
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21
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Honan I, Sharp N, McIntyre S, Smithers‐Sheedy H, Balde I, Quinn K, Morgan M, Rothery S, Butchers T, Laugeson E. Program evaluation of an adapted PEERS® social skills program in young adults with autism spectrum disorder and/or mild intellectual impairment and social skills difficulties. J Eval Clin Pract 2023; 29:126-135. [PMID: 35927973 PMCID: PMC10946497 DOI: 10.1111/jep.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Social challenges are common for young adults with autism spectrum disorder (ASD) and/or mild intellectual impairment, yet few evidence-based interventions exist to address these challenges. PEERS®, the Program for the Education and Enrichment of Relational Skills, has been shown to be effective in improving the social skills of young adults with ASD; however, it requires a significant time commitment for parents of young adults. As such, this mixed-methods study aimed to investigate the experiences of young adults, parents and PEERS® social coaches participating in an adapted PEERS® program, and to evaluate its acceptability and efficacy. METHOD Young adults with ASD and/or mild intellectual impairment participated in a 16-week PEERS® program. Parents and PEERS® social coaches attended fewer, condensed sessions, where they learnt program content to support the young adults' social skill development at home and in the community. Focus groups were conducted post intervention. Quantitative pre-post assessment using the Social and Emotional Loneliness Scale for Adults, the Test of Young Adult Social Skills Knowledge, and Quality of Socialization Questionnaire-Young Adults was completed by young adults. The Social Responsiveness Scale Second Edition was completed by young adults and their parents. RESULT Qualitative results revealed that, taken together, young adults, parents and PEERS® social coaches all felt that the adapted PEERS® program was 'challenging, but worth it'. The program was acceptable with a 93% attendance rate across all sessions. Whilst young adults' perceptions of their own social functioning did not change post-intervention, their knowledge of social skills content improved significantly (p < 0.05). Parent perceptions of young adults' social responsiveness also improved (p < 0.05). CONCLUSIONS Social skill knowledge, social responsiveness, and social engagement improved significantly following the completion of the adapted PEERS® program. It was deemed acceptable and worthwhile by young adults, their parents and PEERS® social coaches.
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Affiliation(s)
- Ingrid Honan
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Nicole Sharp
- School of Health Sciences and Translational Health Research InstituteWestern Sydney UniversityPenrith SouthNew South WalesAustralia
| | - Sarah McIntyre
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Hayley Smithers‐Sheedy
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Isabelle Balde
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten Quinn
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Marita Morgan
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Sophie Rothery
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Teigan Butchers
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Elizabeth A. Laugeson
- Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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22
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Chien YL, Tsai WC, Chen WH, Yang CL, Gau SSF, Soong WT, Laugeson E, Chiu YN. Effectiveness, durability, and clinical correlates of the PEERS social skills intervention in young adults with autism spectrum disorder: the first evidence outside North America. Psychol Med 2023; 53:966-976. [PMID: 34247667 DOI: 10.1017/s0033291721002385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite the fact that social deficits among individuals with autism spectrum disorder (ASD) are lifelong and impact many aspects of personal functioning, evidence-based programs for social skills training were not available until recently. The Program for the Education and Enrichment of Relational Skills (PEERS®) has been shown to effectively improve social skills for adolescents on the spectrum across different social cultures. However, the effectiveness for young adults beyond North America has yet to be examined. This study aimed to investigate the effectiveness of the PEERS intervention in Taiwanese young adults with ASD, and examine its durability and clinical correlates. METHODS We recruited 82 cognitively-able young adults with ASD, randomized to the PEERS treatment or treatment-as-usual. RESULTS Following treatment, significant improvement was found in aspects of social deficits, autism severity, social interaction anxiety, empathy, and social skills knowledge either by self-report or coach-report. Additionally, communicative behaviors rated by observers improved throughout the sessions, showing a trend toward more appropriate eye contact, gestures, facial expression during conversation, and appropriate maintenance of conversation and reciprocity. Most effects maintained at 3-month and 6-month follow-ups. The improvement of social deficits was positively correlated with baseline severity, while gains in social skills knowledge were positively correlated with IQ. The improvement of social deficits, autism severity, and empathy were positively correlated with each other. CONCLUSION Overall, the PEERS intervention appears to effectively improve social functioning in Taiwanese young adults with ASD. Improvement of social response and knowledge may be predicted by baseline severity and intelligence respectively.
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Affiliation(s)
- Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Hao Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Liang Yang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Tsuen Soong
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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Wichers RH, van der Wouw LC, Brouwer ME, Lok A, Bockting CLH. Psychotherapy for co-occurring symptoms of depression, anxiety and obsessive-compulsive disorder in children and adults with autism spectrum disorder: a systematic review and meta-analysis. Psychol Med 2023; 53:17-33. [PMID: 36404645 DOI: 10.1017/s0033291722003415] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Individuals with autism spectrum disorder (ASD) struggle accessing psychotherapy services for comorbidities, including anxiety-, depressive- and obsessive-compulsive disorders (OCD). Apart from cognitive behavioural therapy (CBT) for anxiety in children with ASD, it is unclear whether psychotherapy is effective for these comorbid disorders.We therefore systematically reviewed any form of psychotherapy for co-occurring symptoms of anxiety, depression and OCD in individuals with ASD.Database searches were conducted until February 2022 using EMBASE, PsycINFO and PubMed. Randomised controlled trials (RCT) were included investigating any form of psychotherapy for symptoms of anxiety, depression and OCD in individuals with ASD. Summary data were extracted, and random-effects meta-analyses were conducted.For CBT 26 RCTs (n = 1251), and for social skills training (SST) 11 RCTs (n = 475) met criteria for inclusion. Pooled effect sizes indicated a moderate reduction of anxiety in children (g = -0.70) and a small reduction of depressive symptoms in adults (g = -0.39). For SST overall effect sizes were small for reduction of anxiety in children (g = -0.35) and adults (g = -0.34) and moderate for reduction of depressive symptoms in children (g = -0.50). Risk of bias was high in 18, moderate in 16 and low in 3 RCTs.Our results provide new and age-specific evidence that: (1) CBT is effective for reducing anxiety in children and to a lesser extent for depressive symptoms in adults with ASD; and (2) social skills interventions are effective for reducing anxiety in children and adults and for depressive symptoms in children with ASD.
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Affiliation(s)
- Robert H Wichers
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Lisa C van der Wouw
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Marlies E Brouwer
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Anja Lok
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Claudi L H Bockting
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
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24
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Son C, Yoo HJ, Kim JH, Oh M. Mood and Emotional Changes After PEERS ® Program in Parents of Young Adults With Autism Spectrum Disorder. Soa Chongsonyon Chongsin Uihak 2023; 34:30-36. [PMID: 36636495 PMCID: PMC9815999 DOI: 10.5765/jkacap.220023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 01/05/2023] Open
Abstract
Objectives This study examined the changes in anxiety and depressive symptoms in the parents of Korean adults with autism spectrum disorder (ASD) after participating in the Korean version of the Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS®-YA-K). Methods Forty-six parents were enrolled (mean age 54.7 years; 22 fathers and 24 mothers), of whom 27 participated in the PEERS®- YA-K as social coaches. Participants completed self-report scales, including the Test of Young Adult Social Skills Knowledge (TYASSK), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Symptom Check-List-90-R (SCL-90-R). The scales were administered three times: before and after the 16-week program and 4 months after the program ended. Differences between participant variables at pretreatment, post-treatment, and follow-up were analyzed using paired-sample t-tests. Results Participants showed a significant improvement in their social skills knowledge (TYASSK) (p<0.01). There was a significant improvement in the BAI and BDI scores of parents with severe depressive and anxiety symptoms at the baseline (p<0.05). Paternal paranoia and maternal hostility results also significantly improved on the SCL-90-R. Conclusion This study suggests that PEERS®-YA-K can reduce parental anxiety and depressive symptoms. To the best of our knowledge, this is the first to compare the degree of depression and anxiety after PEERS®-YA-K in parents of adults with ASD.
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Affiliation(s)
- Chansoo Son
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea,Seoul National University College of Medicine, Seoul, Korea
| | - Joo-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Miae Oh
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, Korea,Address for correspondence: Miae Oh, Department of Psychiatry, Kyung Hee University Hospital, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: +82-2-958-8551, Fax: +82-2-957-1997, E-mail:
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Hua Y, Zhao Q, Shen J, Liu Y, Zheng L, Zhang M. Program for education and enrichment of relational skills (PEERS) training for social skills and depressed mood intervention in young adult with depression: Study protocol for a randomized controlled trial. Front Psychiatry 2022; 13:993124. [PMID: 36172511 PMCID: PMC9510920 DOI: 10.3389/fpsyt.2022.993124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Depression is a common psychiatric disorder characterized by persistent low mood, reduced interest, and slowed thinking. Young adults are the main first-onset group for depression in all categories of the population. Program for education and enrichment of relational skills (PEERS) training, a program for the Education and Enrichment of Relational Skills, has been used in Europe and America for people with various types of social disorders with good results. A Chinese adaptation of the PEERS training program may be a new approach to help youth with depression return to society as soon as possible. This study aimed to construct and optimize a social skills training program for Chinese young adults with depression and to validate the impact of the program. Materials and methods and analysis The aim of this trial protocol is to evaluate the efficacy of the localized PEERS training program on social competence, depressed mood in a Chinese young adult population with depression. The primary outcome will be a change in self-reported depressive symptoms from baseline to week 3 post-randomization to week 6 post-randomization measured using the Liebowitz social anxiety scale (LSAS). Secondary outcomes include the rate of decline in severe social anxiety, the Social Avoidance and Distress Scale (SAD), the Social Self-Efficacy Scale (PSSE), and the Hamilton Depression Scale (HAMD-17). Data for each assessment will be collected at baseline, week 3 of the trial, and week 6 of the trial. Ethics and dissemination Ethics approval was obtained from the Hospital Ethics Committee. Findings will be disseminated through scientific journals, conferences, and university courses. Trial registration number [http://www.chictr.org.cn/], identifier [ChiCTR2100046050].
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26
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Agarwal R, Wuyke G, Sharma U, Burke SL, Howard M, Li T, Sanchez M, Bastida E. Stress and Anxiety Among Parents of Transition-Aged Children with Autism Spectrum Disorder: a Systematic Review of Interventions and Scales. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022; 11:1-23. [PMID: 36065251 PMCID: PMC9434067 DOI: 10.1007/s40489-022-00340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 08/12/2022] [Indexed: 11/06/2022]
Abstract
The period between adolescence to young adulthood can be stressful for parents of transition-aged children (14 to 22 years old) with autism spectrum disorder. A systematic review was undertaken to examine if existing interventions address the unique parental stressors of this phase and if the scales used to measure parental stress and anxiety are suitable for this group. Of the 9813 studies screened, only 13 studies met the inclusion criteria. Findings indicated that interventions focused on mindfulness, social functioning, or multiple components, of which only two addressed the transition period and only three specifically targeted parents of this age group. Moreover, of the six scales which assessed stress or anxiety, none were designed for these parents. Findings highlight the urgent need for more suitable scales and targeted interventions.
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Affiliation(s)
- Rumi Agarwal
- FIU Embrace, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Gabriella Wuyke
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Utsav Sharma
- College of Liberal Arts and Sciences, University of Florida, Gainesville, FL 32611 USA
| | - Shanna L. Burke
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Melissa Howard
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Elena Bastida
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
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Bullying experiences and mothers’ responses to bullying of children with autism spectrum disorder. DISCOVER PSYCHOLOGY 2022. [PMCID: PMC9376894 DOI: 10.1007/s44202-022-00045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the fact that children with disabilities generally have been shown to be at a greater risk of bullying, which include physical attacks and threats, being picked on and teased and verbal abuse, there is still a need to understand bullying of children with autism spectrum disorder (ASD) and the strategies used by parents to support them in tackling this issue. This study aims to investigate the type and level of occurrence of bullying and parental support for children aged five with ASD who suffer from bullying. This study used both quantitative and qualitative analysis; a questionnaire, distributed to mothers of children with ASD, adopted from the Bullying for ASD Survey developed by Chen and Schwartz (Focus Autism Other Dev Disabil 27(4):200–212, 2012) measured types and frequency of bullying and parental support. An open-ended question was added to the survey to enable parents to write about the ways in which their child was bullied and the ways in which they supported their child. The results showed that while children suffered from all types of bullying, especially being picked on, being excluded and called names. Parental support showed a higher prevalence of involving peers and teachers for the prevention of bullying as well as avoiding strategies which included avoiding bullies and none of the mothers encouraged their children to stand up to bullies.
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Gilmore R, Ziviani J, Chatfield MD, Goodman S, Sakzewski L. Social skills group training in adolescents with disabilities: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 125:104218. [PMID: 35306461 DOI: 10.1016/j.ridd.2022.104218] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Group social skills interventions (GSSIs) are offered to youth with Autism Spectrum Disorder (ASD) to improve social functioning. This systematic review focused on the adolescent population, including a wider range of disabilities. AIMS To evaluate effectiveness of GSSIs at improving social functioning in adolescents with congenital, acquired or developmental disabilities. METHODS AND PROCEDURES Databases, trial registries and dissertations were systematically searched and a meta-analysis of randomized controlled trials conducted. Study screening, risk-of-bias assessment and Grading of Recommendations Assessment, Development and Evaluation were completed. OUTCOMES AND RESULTS Sixteen studies (n = 1119), 15 with adolescents with ASD and one with brain tumor survivors, revealed GSSIs reduced social impairment on the Social Responsiveness Scale (mean difference (MD) 9.68, 95% CI 5.63-13.73; P < 0.001), increased social skills on the Social Skill Improvement System Rating Scales (SMD 0.38, 95% CI 0.10-0.65; P = 0.007), and improved adolescent social knowledge on the Test of Adolescent Social Skills (MD 7.43 points, 95% CI 5.36-9.50; P < 0.001). CONCLUSIONS AND IMPLICATIONS There is moderate certainty evidence that GSSIs improve social responsiveness, social skills and knowledge, and low certainty of evidence to improve social participation for adolescents with ASD. High quality randomized studies are required to inform clinical practice with adolescents with other disabilities. WHAT THIS PAPER ADDS Current evidence for group social skills interventions (GSSIs) is for adolescents with autism (ASD). GSSIs likely improve social knowledge and reduce impairments in adolescents with ASD, however the effect of GSSIs on social participation is not well understood. Only one randomized trial investigated GSSIs in another population of adolescents, highlighting the need for more high-quality studies including adolescents with other disabilities.
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Affiliation(s)
- Rose Gilmore
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia; Queensland Children's Hospital, 501 Stanley Street, South Brisbane, Queensland 4101, Australia.
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia
| | - Mark D Chatfield
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Sarah Goodman
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Leanne Sakzewski
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
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Utilizing the Child Behavior Checklist (CBCL) as an Autism Spectrum Disorder Preliminary Screener and Outcome Measure for the PEERS® Intervention for Autistic Adolescents. J Autism Dev Disord 2022; 52:2061-2074. [PMID: 34052960 PMCID: PMC9926906 DOI: 10.1007/s10803-021-05103-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 12/27/2022]
Abstract
Exploration of potential preliminary screeners, and examination of social intervention outcomes for effects on comorbid symptoms is imperative. The Child Behavior Checklist (CBCL; Achenbach & Rescorla, Achenbach and Rescorla, Manual for the ASEBA school-age forms & profiles, University of Vermont, Research Center for Children, Youth & Families, 2001) provides a potential ASD screener and intervention outcome evaluation. This study had two aims: (1) to examine CBCL scales scores as a potential ASD screener; (2) to investigate PEERS® outcomes via the CBCL for Autistic adolescents. Results indicated elevated scores on four CBCL scales in the ASD groups, contrasted to a typically-developing group. Furthermore, decreases in the two CBCL scales for adolescents that received the intervention were found. Findings support prior research indicating a unique CBCL elevation pattern as a potential screener for ASD, and provide additional support for the efficaciousness of PEERS®.
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Idris S, van Pelt BJ, Jagersma G, Duvekot J, Maras A, van der Ende J, van Haren N, Greaves-Lord K. A randomized controlled trial to examine the effectiveness of the Dutch version of the Program for the Education and Enrichment of Relational Skills (PEERS®). BMC Psychiatry 2022; 22:293. [PMID: 35459118 PMCID: PMC9034592 DOI: 10.1186/s12888-022-03913-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 03/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study examines the effectiveness of the culturally adapted Dutch version of The Program for the Education and Enrichment of Relational Skills (PEERS®), utilizing a randomized control trial (RCT) with an active treatment control condition. METHODS 106 adolescents with ASD, aged 12-18 years, were randomly assigned to one of two group interventions: the experimental condition (PEERS®; n = 54) or the active treatment control condition (Regulation, Organization and Autonomy Didactics; ROAD; n = 52). Effects of interventions on social skills were primarily assessed using an observational measure (CASS - Contextual Assessment Social Skills). Secondary indices of social skills were self, parent and teacher reported questionnaire data (i.e., Social Responsiveness Scale; SRS, and Social Skills Improvement System; SSIS). Treatment satisfaction was also obtained from adolescents and their parents. RESULTS Results on the observational measure of social skills revealed improvements in positive affect, overall quality of rapport, as well as starting and ending a conversation, irrespective of condition. Compared to ROAD, PEERS® participants showed increased overall self-reported social skills (SSIS). Parent reports showed decreased overall social skill impairment (SRS) as well as improved social communication (SSIS subscale), with significantly more progress in the PEERS® group. Furthermore, parents of adolescents in the PEERS® group were significantly more satisfied with the intervention (M = 8.20, SD = 1.46) than parents of adolescents in the ROAD group (M = 7.52, SD = 1.45). The self-reported treatment satisfaction of adolescents did not differ between conditions. Teacher data showed decreased social skill impairment as measured with the SRS, irrespective of condition. CONCLUSIONS This study reveals promising indications that the Dutch version of PEERS® enhances social skills in adolescents with ASD. Yet, further research is needed into how effectiveness can be optimized. TRIAL REGISTRATION Dutch trail register NTR6255 (NL6117) 08/02/2017 https://www.trialregister.nl/trial/6117.
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Affiliation(s)
- Sakinah Idris
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, 68100, Batu Caves, Selangor, Malaysia
| | - Bjorn Jaime van Pelt
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
- Yulius Organization for Mental Health, Burg. De Raadtsingel 93c, 3311 JG, Dordrecht, The Netherlands
| | - Gabrine Jagersma
- GGZ Rivierduinen Children and Youth, Institute for Mental Health, Leiden, The Netherlands
| | - Jorieke Duvekot
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - Athanasios Maras
- Yulius Organization for Mental Health, Burg. De Raadtsingel 93c, 3311 JG, Dordrecht, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - Neeltje van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.
- Yulius Organization for Mental Health, Burg. De Raadtsingel 93c, 3311 JG, Dordrecht, The Netherlands.
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, Groningen, The Netherlands.
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, The Netherlands.
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Jolliffe R, Adams D, Simpson K. Trait Anxiety in Individuals on the Autism Spectrum: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00308-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractAlthough anxiety is commonly researched in autism, the focus has predominantly been on anxiety disorders and not upon general levels of anxiousness or trait anxiety. This review summarises research investigating trait anxiety in autism. Systematic searches yielded 1099 records, with 23 studies meeting inclusion criteria. Study participants were mainly males from Western countries, with no representation of older adults or individuals with intellectual disability. All articles used self-report questionnaire trait anxiety measures. Anxiety measure psychometric details were absent in most studies, with 21 using subjective measures that are not validated for use in autism. Results showed higher trait anxiety scores in autism versus control groups, and correlations between trait anxiety scores and other study outcomes.
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Factor RS, Rea HM, Dahiya AV, Albright J, Ollendick TH, Laugeson EA, Scarpa A. An Initial Pilot Study Examining Child Social Skills, Caregiver Styles, and Family Functioning in the PEERS® for Preschoolers Program for Young Autistic Children and their Caregivers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 121:104152. [PMID: 34942441 DOI: 10.1016/j.ridd.2021.104152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and worsen as the child matures. Though many interventions for young children exist, few specifically target social skills and involve caregivers. AIMS This pilot study examined PEERS® for Preschoolers, focusing on temporal change in child social skills, caregiver style, and family functioning in the context of a caregiver-assisted social skills intervention. This extension of the PEERS® program builds on the success of the intervention for older children, presenting skills in a developmentally appropriate manner to young autistic children and their caregivers. METHODS AND PROCEDURES The present pilot study used a non-concurrent multiple baseline design to examine the above variables with 15 autistic children (Mage = 4.87, SD = 1.25; 11 boys). Children and caregivers participated in PEERS® for Preschoolers groups, with each group randomly assigned three different baseline periods (1.5, 2, or 2.5 weeks) before beginning. OUTCOMES AND RESULTS Simulation Modeling Analysis (SMA) revealed concurrent improvements in social and caregiving skills, with subsequent changes in family functioning occurring over the course of this 16-session intervention. CONCLUSIONS AND IMPLICATIONS Future research will need to examine mechanisms of change in PEERS® for Preschoolers for children and caregivers. WHAT THIS PAPER ADDS There is a dearth of research that specifically examines social skills interventions for young autistic children that incorporates caregivers and examines family functioning as well. This paper is one of the first to evaluate the PEERS® for Preschoolers (P4P) intervention by: 1) exploring changes in child social skills, caregiver efficacy, and family functioning, and 2) analyzing the sequence of improvements in the aforementioned variables to measure systematic change. This pilot study presents results using appropriate methodology for a small sample size of children and caregivers. Results suggested concurrent improvements in social and caregiving skills and subsequent changes in family functioning. These can be built upon for further research on the PEERS® for Preschoolers intervention. This study supports PEERS® for Preschoolers as a feasible intervention that likely contributes to improvements for the child, caregiver in their relationship with their child and parenting styles in general, as well as functioning of the entire family. In sum, this work is essential to furthering the provision of a much needed service of social skills interventions for young autistic children.
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Affiliation(s)
- Reina S Factor
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States; Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States.
| | - Hannah M Rea
- Research in Autism and the Brain Lab, University of Washington, CHDD Box 357920, Seattle, WA 98195, United States
| | - Angela V Dahiya
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Jordan Albright
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Thomas H Ollendick
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
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Lee J, Lee TS, Lee S, Jang J, Yoo S, Choi Y, Park YR. Development and Application of Metaverse-based Social Skills Training Program for Children with Autism Spectrum Disorder to Improve Social Interaction: Protocol for a Randomized Controlled Trial (Preprint). JMIR Res Protoc 2021; 11:e35960. [PMID: 35675112 PMCID: PMC9218883 DOI: 10.2196/35960] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 04/04/2022] [Accepted: 04/22/2022] [Indexed: 01/29/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is characterized by abnormalities in social communication and limited and repetitive behavioral patterns. Children with ASD who lack social communication skills will eventually not interact with others and will lack peer relationships when compared to ordinary people. Thus, it is necessary to develop a program to improve social communication abilities using digital technology in people with ASD. Objective We intend to develop and apply a metaverse-based child social skills training program aimed at improving the social interaction abilities of children with ASD aged 7-12 years. We plan to compare and analyze the biometric information collected through wearable devices when applying the metaverse-based social skills training program to evaluate emotional changes in children with ASD in stressful situations. Methods This parallel randomized controlled study will be conducted on children aged 7-12 years diagnosed with ASD. A metaverse-based social skills training program using digital technology will be administered to children who voluntarily wish to participate in the research with consent from their legal guardians. The treatment group will participate in the metaverse-based social skills training program developed by this research team once a week for 60 minutes per session for 4 weeks. The control group will not intervene during the experiment. The treatment group will use wearable devices during the experiment to collect real-time biometric information. Results The study is expected to recruit and enroll participants in March 2022. After registering the participants, the study will be conducted from March 2022 to May 2022. This research will be jointly conducted by Yonsei University and Dobrain Co Ltd. Children participating in the program will use the internet-based platform. Conclusions The metaverse-based Program for the Education and Enrichment of Relational Skills (PEERS) will be effective in improving the social skills of children with ASD, similar to the offline PEERS program. The metaverse-based PEERS program offers excellent accessibility and is inexpensive because it can be administered at home; thus, it is expected to be effective in many children with ASD. If a method can be applied to detect children's emotional changes early using biometric information collected through wearable devices, then emotional changes such as anxiety and anger can be alleviated in advance, thus reducing issues in children with ASD. Trial Registration Clinical Research Information Service KCT0006859; https://tinyurl.com/4r3k7cmj International Registered Report Identifier (IRRID) PRR1-10.2196/35960
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Affiliation(s)
- JooHyun Lee
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Seon Lee
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - SeungWoo Lee
- Graduate School of Information and Communication Technology, Ajou University, Suwon, Republic of Korea
| | - JiHye Jang
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - YeJin Choi
- DoBrain Co, Ltd, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yamada M, Sekine M, Tatsuse T. Pathological gaming and its association with lifestyle, irritability, and school and family environments among Japanese elementary school children. J Epidemiol 2021. [PMID: 34744101 DOI: 10.2188/jea.je20210365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pathological gaming (PG) has emerged as one of the major public health concerns worldwide. We aimed to assess PG and its associated factors among elementary school children in Japan. METHODS We conducted a school-based observational study in Toyama, Japan in 2018. Totally, 13,413 children in the 4th-6th grades (mean age, 10.5 years) participated in the study. We distributed questionnaires and inquired about their lifestyle, irritability, and school and family environments. Referring to criteria of gaming disorder in the International Statistical Classification of Disease (ICD-11), we asked about three core symptoms: impaired control over gaming, increasing priority given to gaming over other activities, and continuation of gaming despite the negative consequences. Children who had all three criteria in the questionnaire were defined as PG. RESULTS The response rate was 97.6% and 11,826 children were included in our analyses (88.2%). The prevalence of PG was 5.6% (7.8% in boys, 3.2% in girls). Besides sex, PG was significantly associated with lifestyles including skipping breakfast (odds ratio, OR=1.33; 95% confidence interval, CI: 1.05-1.68), physical inactivity (OR=2.23; 95% CI: 1.63-3.05 for rare), late bed time (OR=2.52; 95% CI: 1.96-3.25 for ≥11 p.m), frequent irritability (OR=1.89; 95% CI: 1.47-2.43), frequent feeling of school avoidance (OR=1.92; 95% CI: 1.49-2.46), fewer close friends (OR=1.30; 95% CI: 1.08-1.56 for some), low academic performance (OR=1.53; 95% CI: 1.13-2.08), no child-parental interaction (OR=1.34; 95% CI: 1.02-1.75), and no rules at home (OR=1.21; 95% CI: 1.02-1.43). CONCLUSION Unhealthy lifestyles, irritability, and low functioning in school and family environments were associated with PG. Besides having a healthy lifestyle, parental involvement appears to be an essential countermeasure for PG in children.
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Affiliation(s)
- Masaaki Yamada
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama
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MacKenzie KT, Eack SM. Interventions to Improve Outcomes for Parents of Children with Autism Spectrum Disorder: A Meta-Analysis. J Autism Dev Disord 2021; 52:2859-2883. [PMID: 34189683 DOI: 10.1007/s10803-021-05164-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
This meta-analysis examines the impact of parent interventions on outcomes for parents of children with ASD. A systematic review of the literature produced 37 studies that met inclusion criteria. Random-effects models revealed small but significant impacts of intervention on parental outcomes, primarily in parenting confidence and mental health. No improvements were observed in caregiving burden, family adjustment, physical health, or stress. Significant heterogeneity was observed; however, no moderation effects were detected for intervention or sample characteristics. These findings suggest parent interventions improve parenting confidence and, to a lesser degree, mental health. More work is needed to develop interventions that address a wider range of outcomes for parents of children with ASD. Limitations and implications for future research are discussed.
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Affiliation(s)
- Kristen T MacKenzie
- School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.
| | - Shaun M Eack
- School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.,Department of Psychiatry, School of Medicine, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
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36
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Kerr-Gaffney J, Mason L, Jones E, Hayward H, Harrison A, Murphy D, Tchanturia K. Autistic Traits Mediate Reductions in Social Attention in Adults with Anorexia Nervosa. J Autism Dev Disord 2021; 51:2077-2090. [PMID: 32910314 PMCID: PMC8124046 DOI: 10.1007/s10803-020-04686-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Anorexia nervosa (AN) is associated with difficulties in social and emotional functioning. A significant proportion of individuals with AN show autistic traits, which may influence social attention. This study examined attention to faces and facial features in AN, recovered AN (REC), and healthy controls, as well as relationships with comorbid psychopathology. One hundred and forty-eight participants' eye movements were tracked while watching a naturalistic social scene. Anxiety, depression, alexithymia, and autistic traits were assessed via self-report questionnaires. Participants with AN spent significantly less time looking at faces compared to REC and controls; patterns of attention to individual facial features did not differ across groups. Autistic traits mediated the relationship between group and time spent looking at faces.
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Affiliation(s)
- Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AZ, UK.
| | - Luke Mason
- Centre for Brain & Cognitive Development, Birkbeck, University of London, London, UK
| | - Emily Jones
- Centre for Brain & Cognitive Development, Birkbeck, University of London, London, UK
| | - Hannah Hayward
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Amy Harrison
- Department of Psychology and Human Development, University College London, London, UK
- Psychological Medicine Clinical Academic Group, National Eating Disorders Service, South London and Maudsley NHS Trust, London, UK
| | - Declan Murphy
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AZ, UK
- Psychological Medicine Clinical Academic Group, National Eating Disorders Service, South London and Maudsley NHS Trust, London, UK
- Department of Psychology, Ilia State University, Tbilisi, GA, USA
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Kim SY, Kim YA, Song DY, Bong G, Kim JM, Kim JH, Yoo HJ. State and Trait Anxiety of Adolescents with Autism Spectrum Disorders. Psychiatry Investig 2021; 18:257-265. [PMID: 33735545 PMCID: PMC8016686 DOI: 10.30773/pi.2020.0328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/18/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study examined how state and trait anxiety of adolescents with autism spectrum disorders (ASD) are associated with their demographic characteristics, repetitive and restricted behaviors (RRBs), and internalizing and externalizing problem behaviors. METHODS A total of 96 participants with ASD (mean age=14.30 years; 91 males) completed a battery of tests including the State/Trait Anxiety Inventory (STAI), the Autism Diagnostic Interview-Revised, the Social Responsiveness Scale (SRS), and a cognitive test measuring intelligence quotient (IQ). Participants' parents completed the Child Behavior Checklist (CBCL). Pearson's correlations among age, IQ, two subscales of the STAI (i.e., STAIS and STAIT, measuring self-reported state and trait anxiety, respectively), and the Anxiety subscale of CBCL (i.e., CBCL-Anxiety, measuring parent-reported trait anxiety) were computed. Subsequently, Pearson's correlations were computed among the three anxiety measures, RRBs, and problem behaviors, while controlling for participants' age and IQ. RESULTS The STAIS and CBCL-Anxiety were both significantly correlated with higher age, sensory sensitivity, depressive symptoms, somatic complaints, and aggressive behaviors. All three anxiety variables were significantly and positively correlated with total SRS RRB scores. Additionally, the STAIS and STAIT were significantly associated with more severe Compulsion/Adherence behaviors, and the CBCL-Anxiety was also significantly associated with more severe Rule-breaking Behaviors. CONCLUSION Self-reported state anxiety showed association patterns similar to those of parent-reported trait anxiety. Future studies investigating the precise operationalization of different anxiety instruments are needed to accurately measure the anxiety of adolescents with ASD.
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Affiliation(s)
- So Yoon Kim
- Department of Teacher Education, Duksung Women's University, Seoul, Republic of Korea
| | - Young Ah Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Da-Yea Song
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Guiyoung Bong
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong-Myeong Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joo Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Afsharnejad B, Falkmer M, Black MH, Alach T, Lenhard F, Fridell A, Coco C, Milne K, Chen NTM, Bölte S, Girdler S. Cross-Cultural Adaptation to Australia of the KONTAKT© Social Skills Group Training Program for Youth with Autism Spectrum Disorder: A Feasibility Study. J Autism Dev Disord 2021; 50:4297-4316. [PMID: 32270385 DOI: 10.1007/s10803-020-04477-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study investigated the feasibility and cultural validity of KONTAKT©, a manualised social skills group training, in improving the social functioning of adolescents with autism spectrum disorder (ASD). KONTAKT© was delivered to 17 adolescents (mage = 14.09, SDage = 1.43; 70% male) with ASD over sixteen 90 min sessions. A pre-test post-test design evaluated changes in personally meaningful social goals, symptom severity, quality of life, interpersonal efficacy, social anxiety, loneliness, and facial emotion recognition at pre, post and 3 months follow-up. Focus groups were conducted post intervention. Findings indicate that KONTAKT© may support Australian adolescents with ASD in achieving their personally meaningful social goals. This study resulted in finalisation of KONTAKT© in preparation for evaluation of its efficacy in a randomised controlled trial (Australian New Zealand Clinical Registry (ANZCTR): ACTRN12617001117303, ClinicalTrials.gov: NCT03294668).
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Affiliation(s)
- Bahareh Afsharnejad
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
| | - Marita Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.,CHILD, Swedish Institute for Disability Research, School of Education and Communication, Jönköping University, Jönköping, Sweden
| | - Melissa H Black
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
| | - Tasha Alach
- Autism Association of Western Australia, Perth, WA, Australia
| | - Fabian Lenhard
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden
| | - Anna Fridell
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Christina Coco
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Kelly Milne
- Autism Association of Western Australia, Perth, WA, Australia
| | - Nigel T M Chen
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
| | - Sven Bölte
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.,Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden
| | - Sonya Girdler
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia. .,Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.
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Zheng S, Kim H, Salzman E, Ankenman K, Bent S. Improving Social Knowledge and Skills among Adolescents with Autism: Systematic Review and Meta-Analysis of UCLA PEERS® for Adolescents. J Autism Dev Disord 2021; 51:4488-4503. [PMID: 33512626 DOI: 10.1007/s10803-021-04885-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 12/18/2022]
Abstract
UCLA PEERS® for Adolescents is a widely applied program among a number of social skills training programs developed over the years. We synthesized current research evidence on the PEERS program to evaluate the treatment effect on four commonly used outcome measures. 12 studies met inclusion criteria for the review and nine met the criteria for meta-analysis. Results showed moderate to large pooled effects across measures and informants in favor of the PEERS program, with the largest effect seen in social knowledge improvement and the smallest effect in the frequency of get-togethers. The heterogeneity of effects across studies were examined and the limitations of the current evidence were discussed.
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Affiliation(s)
- Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA.
| | - Hosanna Kim
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Emma Salzman
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Katy Ankenman
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Stephen Bent
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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40
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Oh M, Laugeson E, Kim JH, Lee K, Kim J, Lee S, Lim B, Cha S, Bong G, Yoon NH, Bahn GH, Yoo HJ. A Randomized Controlled Trial of the Korean Version of the Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS®-YA-K) With Autism Spectrum Disorder: A Pilot Study. Front Psychiatry 2021; 12:730448. [PMID: 34690837 PMCID: PMC8526555 DOI: 10.3389/fpsyt.2021.730448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
Evidence-based social skills interventions for young adults are limited, despite social difficulties in autism spectrum disorder (ASD) persisting after transition to adulthood. The Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS®-YA) is an evidence-based intervention found to be effective in improving relational skills in young adults with ASD. To translate the original American version of the PEERS®-YA treatment manual into Korean, intensive interviews were performed. Based on results from interviews, several rules of dating etiquette and social activities were modified to be culturally sensitive and linguistically appropriate. Next, young adults diagnosed with ASD (18-35 years of age; IQ > 70) and their social coaches were recruited for the randomized controlled trial (RCT). Participants were randomly assigned either to a treatment group (TG; n = 19) or a delayed treatment group (DTG; n = 18). In the analysis of group differences in the TG and DTG, social skills knowledge was improved. The within group analyses showed positive effects of improving social skills knowledge on reducing depression and anxiety symptoms. After modest cultural adaptations focusing on dating and social activities, the implementation of the PEERS®-YA-K was found feasible for the Korean community. This is one of only a few cross-cultural validation trials establishing evidence-based treatment in young adults with ASD. Clinical Trial Registration: This trial was registered at ClinicalTrials.gov, identifier: NCT03310775.
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Affiliation(s)
- Miae Oh
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, South Korea
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Joo-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyungah Lee
- Department of Special Education, Dankook University, Yongin, South Korea
| | - Jeeyun Kim
- Maeumddrak Clinical Psychology Center, Seoul, South Korea
| | - SeungHa Lee
- Institute of Education, University College London, London, United Kingdom
| | - Bora Lim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seyoung Cha
- Smile Together Foundation, Seongnam, South Korea
| | - Guiyoung Bong
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nan-He Yoon
- Division of Social Welfare and Health Administration, Wonkwang University, Iksan, South Korea
| | - Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, South Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
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Abstract
Social skills training programs for individuals with autism spectrum disorder are effective in improving social competence, although effects are frequently not robust across all outcomes measured. When aggregating across the social skills training programs with the strongest evidence, common elements can be identified in both the treatment delivery method and the social skills content targeted. However, social skills training programs continue to remain limited in their generalizability and scope. Existing research has primarily tested programs designed for school-aged children with autism spectrum disorder, who have average or above average intellectual functioning.
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Schiltz HK, McVey AJ, Dolan Wozniak B, Haendel AD, Stanley R, Arias A, Gordon N, Van Hecke AV. The role of loneliness as a mediator between autism features and mental health among autistic young adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:545-555. [PMID: 33126822 DOI: 10.1177/1362361320967789] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Autistic adults commonly experience mental health concerns including social anxiety and depression, which can have negative effects on their quality of life. It is not completely clear, however, why rates of mental health concerns are so high. Some evidence suggests that social connectedness might play a key role. The goal of this study was to explore links between loneliness, mental health concerns, autism features, and social contact among autistic adults and test whether the links between mental health with autism features and social contact can be explained by loneliness. Researchers in this study collected data using questionnaires completed by 69 autistic young adults. Autistic adults who reported more autism features also reported more social and family loneliness, higher levels of social anxiety and depression, and fewer initiated social contacts. In addition, adults with more social contact initiations were likely to report lower levels of social and family loneliness and social anxiety but not depression. Results showed that the link from social engagement and autism features to social anxiety and depression symptoms could be mostly explained by loneliness. The results of this study expand previous findings by illustrating one factor (loneliness) that might be responsible for the high rates of mental health concerns among adults on the autism spectrum. These findings highlight the importance of studying factors related to mental health concerns among autistic adults and ways to best support social connectedness for the mental well-being of autistic young adults.
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Affiliation(s)
| | - Alana J McVey
- Marquette University, USA.,University of California, Los Angeles, USA
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Tseng A, Biagianti B, Francis SM, Conelea CA, Jacob S. Social Cognitive Interventions for Adolescents with Autism Spectrum Disorders: A Systematic Review. J Affect Disord 2020; 274:199-204. [PMID: 32469804 PMCID: PMC7430499 DOI: 10.1016/j.jad.2020.05.134] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/18/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Autism spectrum disorder (ASD), a heterogeneous neurodevelopmental disorder, impacts social experience and functioning throughout the lifespan. Although the postnatal phase of neuroplasticity has been a focus for early interventions in ASD, a second critical period in adolescence has emerged as a promising target for experience-dependent remediation. Interventions addressing the multidimensional construct of social cognition have also shown potential as a therapeutic approach. Yet, to date, evidence-based social cognitive interventions (SCIs) designed for adolescents with ASD are still lacking. In this review, we aim to survey and synthesize the extant literature on SCIs for adolescents with ASD in order to inform next steps for treatment research. METHODS Using the PRISMA guidelines, we limited our queries to peer-reviewed, English-language journal articles describing SCI trials for adolescents with ASD using a randomized controlled design. RESULTS Eighteen articles in total met our inclusion/exclusion criteria. We present and discuss these trials using the non-exclusive categories of group-based social skills interventions, experiential-based interventions, and computer-assisted interventions. LIMITATIONS To ensure a focus on adolescence, we excluded trials with teen-age participants if mean subject age was not between 12-18 years. Also, given the variability across studies in outcome measures, study designs, samples, and effect sizes, findings were incommensurable. CONCLUSIONS Several reviewed SCIs reported post-treatment improvements in varied domains but findings were inconsistent. Further investigations of existing and novel interventions are warranted; attention to assessing and improving long-term skill transfer is essential. Technology-assisted augmentations may improve treatment efficacy and ecological validity of therapeutic gains.
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Affiliation(s)
- Angela Tseng
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Bruno Biagianti
- Department of R&D, Posit Science Corporation, San Francisco, CA, USA; Department of Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Sunday M. Francis
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Christine A. Conelea
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Suma Jacob
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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Rabin SJ, Laugeson EA, Mor-Snir I, Golan O. An Israeli RCT of PEERS®: Intervention Effectiveness and the Predictive Value of Parental Sensitivity. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:933-949. [PMID: 32780594 DOI: 10.1080/15374416.2020.1796681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES A Randomized Controlled Trial was conducted to evaluate the effectiveness of the Hebrew adaptation of the Program for the Education and Enrichment of Relational Skills (PEERS®), a parent-assisted intervention. Parental sensitivity (PS), measured in conflict and support contexts, was assessed as a predictor of adolescents' intervention-related outcomes. DESIGN Eighty-two Hebrew-speaking adolescents (9 females), aged 12-17 years, and their parents (62 mothers), were randomly allocated into immediate intervention (II; n = 40) or delayed intervention control (DI; n = 42) groups. Participants were tested at three time-points (Pre-Post-Follow Up for II, Pre-Pre-Post for DI). Outcome measures included behavioral assessments of adolescents' social communication (SC), a social-skills knowledge test, and self, parent, and teacher reported questionnaires. PS was assessed using support and conflict parent-adolescent interactions. Repeated measures ANOVAs were used to assess intervention effectiveness. SEM was used to examine PS pre- and post-intervention as predictors of adolescents' immediate and follow-up outcomes. RESULTS The II group improved on adolescents' measured SC and social knowledge, on parent-(but not teacher-) reported social skills, and on self-reported empathy. Gains maintained at follow-up. The DI group showed similar gains following their intervention. Adolescents' intervention-related SC gains were negatively predicted by pre-intervention PS, and positively predicted by intervention-related PS changes in the support context. Pre-intervention PS in the conflict context positively predicted adolescent SC at follow-up. CONCLUSIONS The Hebrew-adapted PEERS® is an effective intervention for adolescents with ASD. PS plays an important role in the promotion of SC in adolescents with ASD and should receive clinical attention.
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Affiliation(s)
- S J Rabin
- Department of Psychology, Bar-Ilan University
| | - E A Laugeson
- UCLA PEERS® Clinic, Semel Institute for Neuroscience and Human Behavior, UCLA
| | - I Mor-Snir
- The Autism Treatment and Research Center, Association for Children at Risk
| | - O Golan
- Department of Psychology, Bar-Ilan University.,The Autism Treatment and Research Center, Association for Children at Risk.,Autism Research Centre, Department of Psychiatry, University of Cambridge
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Yamada T, Miura Y, Oi M, Akatsuka N, Tanaka K, Tsukidate N, Yamamoto T, Okuno H, Nakanishi M, Taniike M, Mohri I, Laugeson EA. Examining the Treatment Efficacy of PEERS in Japan: Improving Social Skills Among Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:976-997. [PMID: 31823217 PMCID: PMC7010628 DOI: 10.1007/s10803-019-04325-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study examines the efficacy of the Japanese version of the Program for the Education and Enrichment of Relational Skills (PEERS), which focuses on improving social functioning through making friends and maintaining good relationships for adolescents with autism spectrum disorder (ASD) without intellectual disabilities. Originally developed in the United States, PEERS is one of the few evidence-based social skills training programs for youth with ASD. The present study shows that with linguistic and cultural modifications, PEERS is effective in improving social functioning for adolescents with ASD in Japan. Positive results were found specifically in the areas of socialization, communication, knowledge of social skills, autistic mannerisms, and behavioral and emotional problems. In addition, most treatment gains were maintained at a 3-month follow-up assessment. These findings suggest that the Japanese version of PEERS is beneficial across multiple socio-emotional and behavioral domains for adolescents with ASD.
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Affiliation(s)
- Tomoko Yamada
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 13-1-D Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Yui Miura
- Ehime University, 3 Bukyo, Mastuyama, Ehime, 790-8577, Japan
| | - Manabu Oi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 13-1-D Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Nozomi Akatsuka
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 13-1-D Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kazumi Tanaka
- Hirakata Board of Education, 1-1-1 Kurumazuka, Hirakata, Osaka, 573-1159, Japan
| | - Naotake Tsukidate
- Yamanashi Eiwa College, 888 Yokone, Kofu, Yamanashi, 400-8555, Japan
| | - Tomoka Yamamoto
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiroko Okuno
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Mariko Nakanishi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ikuko Mohri
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Ste.48-243B, Los Angeles, CA, 90024, USA
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46
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Hillman K, Dix K, Ahmed K, Lietz P, Trevitt J, O'Grady E, Uljarević M, Vivanti G, Hedley D. Interventions for anxiety in mainstream school-aged children with autism spectrum disorder: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1086. [PMID: 37131419 PMCID: PMC8356281 DOI: 10.1002/cl2.1086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Kylie Hillman
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Katherine Dix
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Kashfee Ahmed
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Petra Lietz
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Jenny Trevitt
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Elizabeth O'Grady
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Mirko Uljarević
- Division of Child and Adolescent Psychiatry, Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of MedicineStanford UniversityPalo AltoCalifornia
| | - Giacomo Vivanti
- A. J. Drexel Autism InstituteDornsife School of Public Health, Drexel UniversityPhiladelphiaPennsylvania
| | - Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health and EngineeringLaTrobe UniversityBundooraVictoriaAustralia
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47
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van Pelt BJ, Idris S, Jagersma G, Duvekot J, Maras A, van der Ende J, van Haren NEM, Greaves-Lord K. The ACCEPT-study: design of an RCT with an active treatment control condition to study the effectiveness of the Dutch version of PEERS® for adolescents with autism spectrum disorder. BMC Psychiatry 2020; 20:274. [PMID: 32487179 PMCID: PMC7268391 DOI: 10.1186/s12888-020-02650-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 05/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Social skills interventions are commonly deployed for adolescents with autism spectrum disorder (ASD). Because effective and appropriate social skills are determined by cultural factors that differ throughout the world, the effectiveness of these interventions relies on a good cultural fit. Therefore, the ACCEPT study examines the effectiveness of the Dutch Program for the Education and Enrichment of Relational Skills (PEERS®) social skills intervention. METHODS/DESIGN This study is a two-arm parallel group randomized controlled trial (RCT) in which adolescents are randomly assigned (after baseline assessment) to one of two group interventions (PEERS® vs. active control condition). In total, 150 adolescents are to be included, with multi-informant involvement of their parents and teachers. The ACCEPT study uses an active control condition (puberty psychoeducation group training, focussing on social-emotional development) and explores possible moderators and mediators in improving social skills. The primary outcome measure is the Contextual Assessment of Social Skills (CASS). The CASS assesses social skills performance in a face to face social interaction with an unfamiliar, typically developing peer, making this a valuable instrument to assess the social conversational skills targeted in PEERS®. In addition, to obtain a complete picture of social skills, self-, parent- and teacher-reported social skills are assessed using the Social Skills improvement System (SSiS-RS) and Social Responsiveness Scale (SRS-2). Secondary outcome measures (i.e. explorative mediators) include social knowledge, social cognition, social anxiety, social contacts and feelings of parenting competency of caregivers. Moreover, demographic and diagnostic measures are assessed as potential moderators of treatment effectiveness. Assessments of adolescents, parents, and teachers take place at baseline (week 0), intermediate (week 7), post intervention (week 14), and at follow-up (week 28). CONCLUSION This is the first RCT on the effectiveness of the PEERS® parent-assisted curriculum which includes an active control condition. The outcome of social skills is assessed using observational assessments and multi-informant questionnaires. Additionally, factors related to social learning are assessed at several time points, which will enable us to explore potential mediators and moderators of treatment effect. TRAIL REGISTRATION Dutch trail register NTR6255 (NL6117). Registered February 8th, 2017 - retrospectively registered.
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Affiliation(s)
- B J van Pelt
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Wytemaweg 8, 3015, CN, Rotterdam, The Netherlands.
- Yulius Organization for Mental Health, Burg, De Raadtsingel 93c, 3311, JG, Dordrecht, The Netherlands.
| | - S Idris
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Wytemaweg 8, 3015, CN, Rotterdam, The Netherlands
- Department of Psychiatry, Clinical Psychology Unit, Faculty of Medicine, Universiti Teknologi MARA, 68100 Batu Caves, Shah Alam, Selangor, Malaysia
| | - G Jagersma
- Yulius Organization for Mental Health, Burg, De Raadtsingel 93c, 3311, JG, Dordrecht, The Netherlands
| | - J Duvekot
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Wytemaweg 8, 3015, CN, Rotterdam, The Netherlands
| | - A Maras
- Yulius Organization for Mental Health, Burg, De Raadtsingel 93c, 3311, JG, Dordrecht, The Netherlands
| | - J van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Wytemaweg 8, 3015, CN, Rotterdam, The Netherlands
| | - N E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Wytemaweg 8, 3015, CN, Rotterdam, The Netherlands
| | - K Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Wytemaweg 8, 3015, CN, Rotterdam, The Netherlands
- Yulius Organization for Mental Health, Burg, De Raadtsingel 93c, 3311, JG, Dordrecht, The Netherlands
- Autism Team Northern-Netherlands, Jonx, department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute Groningen, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
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48
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Kerr-Gaffney J, Mason L, Jones E, Hayward H, Ahmad J, Harrison A, Loth E, Murphy D, Tchanturia K. Emotion Recognition Abilities in Adults with Anorexia Nervosa are Associated with Autistic Traits. J Clin Med 2020; 9:E1057. [PMID: 32276387 PMCID: PMC7230901 DOI: 10.3390/jcm9041057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 02/06/2023] Open
Abstract
Difficulties in socio-emotional functioning are proposed to contribute to the development and maintenance of anorexia nervosa (AN). This study aimed to examine emotion recognition abilities in individuals in the acute and recovered stages of AN compared to healthy controls (HCs). A second aim was to examine whether attention to faces and comorbid psychopathology predicted emotion recognition abilities. The films expressions task was administered to 148 participants (46 AN, 51 recovered AN, 51 HC) to assess emotion recognition, during which attention to faces was recorded using eye-tracking. Comorbid psychopathology was assessed using self-report questionnaires and the Autism Diagnostic Observation Schedule-2nd edition (ADOS-2). No significant differences in emotion recognition abilities or attention to faces were found between groups. However, individuals with a lifetime history of AN who scored above the clinical cut-off on the ADOS-2 displayed poorer emotion recognition performance than those scoring below cut-off and HCs. ADOS-2 scores significantly predicted emotion recognition abilities while controlling for group membership and intelligence. Difficulties in emotion recognition appear to be associated with high autism spectrum disorder (ASD) traits, rather than a feature of AN. Whether individuals with AN and high ASD traits may require different treatment strategies or adaptations is a question for future research.
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Affiliation(s)
- Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK;
| | - Luke Mason
- Centre for Brain & Cognitive Development, Birkbeck, University of London, London WC1E 7JL, UK
| | - Emily Jones
- Centre for Brain & Cognitive Development, Birkbeck, University of London, London WC1E 7JL, UK
| | - Hannah Hayward
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Jumana Ahmad
- School of Human Sciences, University of Greenwich, London SE10 9LS, UK
| | - Amy Harrison
- Department of Psychology and Human Development, University College London, London WC1H 0AA, UK
- South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London SE5 8AZ, UK
| | - Eva Loth
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Declan Murphy
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK;
- South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London SE5 8AZ, UK
- Department of Psychology, Ilia State University, Tbilisi 0162, Georgia
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49
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Moody CT, Laugeson EA. Social Skills Training in Autism Spectrum Disorder Across the Lifespan. Child Adolesc Psychiatr Clin N Am 2020; 29:359-371. [PMID: 32169267 DOI: 10.1016/j.chc.2019.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Social skills training programs for individuals with autism spectrum disorder are effective in improving social competence, although effects are frequently not robust across all outcomes measured. When aggregating across the social skills training programs with the strongest evidence, common elements can be identified in both the treatment delivery method and the social skills content targeted. However, social skills training programs continue to remain limited in their generalizability and scope. Existing research has primarily tested programs designed for school-aged children with autism spectrum disorder, who have average or above average intellectual functioning.
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50
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Afsharnejad B, Falkmer M, Black MH, Alach T, Lenhard F, Fridell A, Coco C, Milne K, Chen NTM, Bölte S, Girdler S. KONTAKT© for Australian adolescents on the autism spectrum: protocol of a randomized control trial. Trials 2019; 20:687. [PMID: 31815642 PMCID: PMC6902510 DOI: 10.1186/s13063-019-3721-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 09/13/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes. METHOD/DESIGN With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs. DISCUSSION The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.
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Affiliation(s)
- Bahareh Afsharnejad
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
| | - Marita Falkmer
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
- CHILD, Swedish Institute for Disability Research, School of Education and Communication, Jönköping University, Gjuterigatan, Sweden
| | - Melissa H. Black
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
| | - Tasha Alach
- Autism Association of Western Australia, Perth, WA Australia
| | - Fabian Lenhard
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Anna Fridell
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Christina Coco
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Kelly Milne
- Autism Association of Western Australia, Perth, WA Australia
| | - Nigel T. M. Chen
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
| | - Sven Bölte
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Sonya Girdler
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
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