1
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Glad DM, Pardej SK, Olszewski E, Klein-Tasman BP. Feasibility and acceptability of a telehealth intervention for improving peer relationships for adolescents with neurofibromatosis type 1: a single-arm pilot study. J Pediatr Psychol 2024; 49:647-655. [PMID: 38908005 DOI: 10.1093/jpepsy/jsae050] [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: 11/18/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE Elevated rates of social difficulties are evident for children and adolescents with neurofibromatosis type 1 (NF1) but the effects of social skills interventions have not been investigated for this population. The Program for the Education and Enrichment of Relational Skills (PEERS®), a widely established social skills intervention in autism spectrum disorders with expansion to other conditions, was recently modified to be offered virtually. This study examined the feasibility and acceptability of this telehealth intervention. METHODS 27 adolescents with NF1 with social skills difficulties and at least 1 caregiver enrolled in the study. 19 of those participants (Mage = 14.21 years, SD = 1.63; 7 females; 79% White) completed PEERS® via telehealth in a single-arm pilot study. Dropout rates, attendance records, helpfulness of the curriculum topics and caregiver-reported acceptability, including ratings on the Treatment Acceptability Questionnaire, were examined. RESULTS Low study drop out (30% of enrolled participants; 14% of participants who began the intervention) and high attendance rates were observed. Caregivers found sessions related to common, everyday interactions most helpful. Adolescents indicated sessions related to having get-togethers and social nuances (e.g., humor) as most helpful. Caregiver ratings indicated acceptability of the intervention. CONCLUSIONS This investigation supported the feasibility and acceptability of telehealth PEERS®, a social skills intervention program, among adolescents with NF1 and their caregivers based on attendance patterns as well as appraisal of the curriculum and telehealth modality.
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Affiliation(s)
- Danielle M Glad
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - Ellen Olszewski
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
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2
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Harker SA, Baxter LC, Gallegos SM, Mitchell MM, Zerga L, Matthews NL, Braden BB. Adapting the PEERS ® for Young Adults Program for Autistic Adults across the Lifespan. Healthcare (Basel) 2024; 12:1586. [PMID: 39201145 PMCID: PMC11354006 DOI: 10.3390/healthcare12161586] [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] [Received: 03/30/2024] [Revised: 07/31/2024] [Accepted: 08/08/2024] [Indexed: 09/02/2024] Open
Abstract
The Program for the Education and Enrichment of Relational Skills (PEERS®) is an evidence-based intervention developed for autistic individuals to support social communication, peer interactions, independence, and interpersonal relationships. Despite a demonstrated effectiveness for young autistic individuals in the US and several other countries, PEERS has yet to be modified to support the needs of autistic adults across the lifespan. The present study describes how our team sought autistic voices to adapt PEERS for adults of any age. Specifically, we aimed to address the needs of middle-aged and older adults and adapt the curriculum to be more neurodiversity-affirming. Between two cohorts that completed the program consecutively, we evaluated the acceptability of the adapted PEERS program and made refinements based on feedback from autistic participants and their study partners. Results indicated that Cohort 2 reported higher satisfaction with the PEERS components and overall program than Cohort 1, suggesting effective refinement. We present a framework of adaptations that more specifically address the needs of middle-aged and older adults in a neurodiverse-affirming way compared to previous iterations. Our approach to implementing an adapted PEERS curriculum across the adult lifespan may serve as a model for improved clinical care and cultivate the acceptance of neurodiversity in the interpersonal domains of autistic adults' lives.
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Affiliation(s)
- Samantha A. Harker
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA;
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA;
| | | | - Stephen M. Gallegos
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA;
| | - Melissa M. Mitchell
- Southwest Autism Research and Resource Center, Phoenix, AZ 85006, USA; (M.M.M.); (L.Z.)
| | - Lillian Zerga
- Southwest Autism Research and Resource Center, Phoenix, AZ 85006, USA; (M.M.M.); (L.Z.)
| | - Nicole L. Matthews
- Southwest Autism Research and Resource Center, Phoenix, AZ 85006, USA; (M.M.M.); (L.Z.)
| | - B. Blair Braden
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA;
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3
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Moon J, Ke F. Effects of Adaptive Prompts in Virtual Reality-Based Social Skills Training for Children with Autism. J Autism Dev Disord 2024; 54:2826-2846. [PMID: 37246166 DOI: 10.1007/s10803-023-06021-7] [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] [Accepted: 05/19/2023] [Indexed: 05/30/2023]
Abstract
The purpose of this single-case experimental design (SCED) study is to investigate how adaptive prompts in virtual reality (VR)-based social skills training affect the social skills performance of autistic children. Adaptive prompts are driven by autistic children's emotional states. To integrate adaptive prompts in VR-based training, we conducted speech data mining and endorsed micro-adaptivity design. We recruited four autistic children (12-13 years) for the SCED study. We carried out alternating treatments design to evaluate the impacts of adaptive and non-adaptive prompting conditions throughout a series of VR-based social skills training sessions. Using mixed-method data collection and analyses, we found that adaptive prompts can foster autistic children's desirable social skills performance in VR-based training. Based on the study findings, we also describe design implications and limitations for future research.
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Affiliation(s)
- Jewoong Moon
- Department of Educational Leadership, Policy, and Technology Studies, The University of Alabama, Tuscaloosa, AL, USA.
| | - Fengfeng Ke
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
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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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5
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Patten KK, Murthi K, Onwumere DD, Skaletski EC, Little LM, Tomchek SD. Occupational Therapy Practice Guidelines for Autistic People Across the Lifespan. Am J Occup Ther 2024; 78:7803397010. [PMID: 38758762 DOI: 10.5014/ajot.2024.078301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
IMPORTANCE Occupational therapy practitioners need evidence to support interventions that promote subjective well-being among autistic people and their families through optimal engagement and participation in occupations. OBJECTIVE These Practice Guidelines are informed by systematic reviews to expand knowledge of interventions that promote access, inclusion, engagement, and optimal participation in occupations that are meaningful to autistic people. Our intent was to foster occupational therapy practitioners' clinical decision-making and reasoning when working with autistic people and their care partners. METHOD These Practice Guidelines were developed on the basis of four systematic reviews, supporting evidence and literature, along with continued revisions and integration through an iterative and collaborative process. RESULTS A total of 98 articles were included in the systematic reviews, which are the foundation for practice recommendations in these guidelines. Forty-eight of the systematic review articles were used to inform the clinical recommendations included in these Practice Guidelines. CONCLUSIONS AND RECOMMENDATIONS Strong to moderate evidence indicates the need for multidisciplinary, goal-oriented interventions to support autistic people in different contexts. Although there is only emerging evidence in the inclusion of autistic people's strengths, interests, and perspectives to guide occupational therapy interventions, such practices can enhance the delivery of neurodiversity-affirming and trauma-informed practices. In addition, evidence is needed to support participation in activities of daily living (ADLs) for autistic youths. We recommend the use of strengths-based language to describe autistic people and the use of environmental adaptations, care partner education, and coaching to enhance occupational therapy service delivery. Plain-Language Summary: The literature is sparse regarding neurodiversity-affirming and trauma-informed practices for autistic youths, as well as for participation in activities of daily living (ADLs). These Practice Guidelines provide new information on positive mental health development; self-determination; ADLs, instrumental ADLs, play, and leisure occupations for children, adolescents, and adults; person-centered planning for adolescents and adults; and rest and sleep. Information on health management is also provided. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel et al., 2021; Kenny et al., 2016). However, we respect the use of person-first language and have made a conscious decision to include research articles that have used this language.
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Affiliation(s)
- Kristie K Patten
- Kristie K. Patten, PhD, OT/L, FAOTA, is Counselor to the President and Professor, Department of Occupational Therapy, New York University, New York, NY
| | - Kavitha Murthi
- Kavitha Murthi, MSc(OT), FHEA(UK), OTR, is PhD Candidate, Department of Occupational Therapy, New York University, New York, NY
| | - Dora D Onwumere
- Dora D. Onwumere, MS, OTR/L, is PhD Candidate, Department of Occupational Therapy, New York University, New York, NY
| | - Emily C Skaletski
- Emily C. Skaletski, MOT, OTR/L, is PhD Candidate, Department of Kinesiology, University of Wisconsin-Madison
| | - Lauren M Little
- Lauren M. Little, PhD, OTR/L, FAOTA, is Associate Dean of Research, College of Health Sciences, and Associate Professor, Occupational Therapy, Rush University, Chicago, IL
| | - Scott D Tomchek
- Scott D. Tomchek, PhD, OTR/L, FAOTA, is Professor, Department of Pediatrics, Division of Developmental Behavioral Pediatrics, School of Medicine, University of Louisville, Louisville, KY
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Rosenau KA, Kim J, Cho ACB, Seltzer M, Ugueto AM, Weisz JR, Wood JJ. Meta-analysis of Psychotherapy for Autistic Youth. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01686-2. [PMID: 38580853 DOI: 10.1007/s10578-024-01686-2] [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] [Accepted: 02/17/2024] [Indexed: 04/07/2024]
Abstract
In order to provide more individualized support, it is imperative to further understand the effectiveness of different types of psychotherapy on the clinical areas of need common in autistic youth (Wood et al. in Behav Ther 46:83-95, 2015). Randomized controlled trials of psychotherapy for autistic youth were included if published in English, included random assignment to treatment or control group, required a previous diagnosis of autism, had a mean age of 6-17 years, and provided outcome measure data from both intervention and control groups. A total of 133 measures were coded across 29 studies and included 1464 participants with a mean age of 10.39 years (1.89). A small mean effect size (0.38,95% CI [0.26, 0.47]) was found overall, with the largest effects for cognitive behavioral therapies on autism-related clinical needs (0.81) and overall mental health (0.78). The results show the significant impact of psychotherapy interventions for autistic youth. Additional research should further assess the details of the most effective psychotherapies for each area of clinical need.
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Affiliation(s)
- Kashia A Rosenau
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
| | - Junok Kim
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
| | - An-Chuen Billy Cho
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
| | - Michael Seltzer
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
| | - Ana M Ugueto
- University of Texas Health Science Center at Houston, Houston, USA
| | | | - Jeffrey J Wood
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
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7
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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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8
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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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Glad DM, Pardej SK, Olszewski E, Klein-Tasman BP. Pilot study of the effectiveness of a telehealth group for improving peer relationships for adolescents with neurofibromatosis type 1. Orphanet J Rare Dis 2024; 19:115. [PMID: 38475852 DOI: 10.1186/s13023-024-03093-1] [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] [Received: 09/26/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Interventions for social difficulties have not been investigated in the neurofibromatosis type 1 (NF1) population despite observations of elevated rates of social difficulties. In this pilot study, the effectiveness of a 14-week telehealth PEERS® intervention with nineteen adolescents with NF1 (Mage=13.79 years, SD = 1.32) with social skills difficulties was examined. Measures of social outcomes were completed at three timepoints (before, immediately after, and at 14-week follow-up). RESULTS Caregiver-reported social-emotional skills, social impairment, caregiver-reported number of adolescent get-togethers, and teen social knowledge showed significant improvement following the intervention. CONCLUSIONS The PEERS® intervention is promising to support the social and friendship skills of adolescents with NF1 who have social difficulties.
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Affiliation(s)
- Danielle M Glad
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA.
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
| | - Ellen Olszewski
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
| | - Bonita P Klein-Tasman
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
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10
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Shkel J, Geng A, Pilchak E, Millan ME, Schwartzman JM, Schuck R, Bundang MV, Barnowski A, Slap DM, Stratford S, Hardan AY, Phillips JM, Gengoux GW. A Pilot Randomized Controlled Trial of Motivation-Based Social Skills Group Treatment with Parent Training. J Autism Dev Disord 2024:10.1007/s10803-024-06302-9. [PMID: 38446265 DOI: 10.1007/s10803-024-06302-9] [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: 02/19/2024] [Indexed: 03/07/2024]
Abstract
Despite the popularity of social skills groups, there remains a need for empirical investigation of treatment effects, especially when targeting pivotal aspects of social functioning such as initiations to peers. The goal of the present study was to conduct a randomized controlled trial of a 12-week social intervention (SUCCESS), which combined an inclusive social group with a parent education program. Twenty-five 4- to 6-year-olds with Autism Spectrum Disorder (ASD) were randomized to SUCCESS (N = 11) or to treatment as usual (N = 14). Combining a peer group model with a parent training program, the SUCCESS intervention used naturalistic behavioral techniques (e.g., environmental arrangement, natural reinforcement) to increase social initiations to peers. After 12 weeks, children participating in the SUCCESS program made more frequent initiations to peers than children in the treatment-as-usual group, including more prompted and unprompted initiations to request. Additional gains in clinician-rated social functioning were observed in children randomized to SUCCESS, while differential treatment effects were not detected in parent-rated measures. However, lower baseline social motivation was associated with greater parent-reported initiation improvement. This study provides preliminary support for the efficacy of a naturalistic, behavioral social skills intervention to improve peer initiations for children with ASD. The findings suggest that using a motivation-based social skills group was effective in increasing both prompted and spontaneous initiations to peers, and highlights the need for further research into the role of baseline social motivation in predicting social skills treatment response.
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Affiliation(s)
- Jane Shkel
- Stanford University School of Medicine, Stanford, USA
| | - Alicia Geng
- Stanford University School of Medicine, Stanford, USA
| | | | | | - Jessica M Schwartzman
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA
- Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, USA
| | - Rachel Schuck
- Stanford University School of Medicine, Stanford, USA
| | | | | | - Devon M Slap
- Stanford Medicine Children's Health, Stanford, USA
| | | | | | | | - Grace W Gengoux
- Stanford University School of Medicine, Stanford, USA.
- Department of Psychiatry & Behavioral Sciences, Division of Child & Adolescent Psychiatry, 401 Quarry Road, Stanford, CA, 94305-5719, USA.
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11
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Thompson BAD, Gilmore R, Barfoot J, Sakzewski L. A systematic review of the efficacy of group social skills interventions on social functioning and social participation in children with acquired brain injury or cerebral palsy. Child Care Health Dev 2024; 50:e13242. [PMID: 38528324 DOI: 10.1111/cch.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/15/2023] [Accepted: 02/08/2024] [Indexed: 03/27/2024]
Abstract
AIM The aim of this study was to evaluate the efficacy of Group social skills interventions (GSSIs) versus any comparator on social functioning in children aged 5-12 years with acquired brain injury or cerebral palsy. BACKGROUND GSSIs are an evidence-based approach to foster social skills development in children with autism spectrum disorder. Currently, limited literature exploring GSSIs in children with acquired brain injury and cerebral palsy is available. RESULTS MEDLINE, SCOPUS, Embase, CINAHL, Cochrane Library, PsycINFO, clinicaltrials.gov, ICTRP and ProQuest Dissertations and Theses were systematically searched. Study screening, risk-of-bias, Grading of Recommendations Assessment, Development and Evaluation and data extraction were performed in duplicate. Six studies were included in the narrative synthesis (one randomised controlled trial and five nonrandomised studies). Results indicate that GSSIs may increase children's social skills as measured on the Social Skills Rating System and Social Skills Questionnaire. Very low certainty evidence was found for improvements in social functioning and competence. CONCLUSIONS There is low certainty evidence that participation in GSSI may lead to gains in social functioning for children with acquired brain injury or cerebral palsy. Given the certainty of the evidence, these results must be interpreted with caution. Only one randomised controlled trial of GSSIs for children with acquired brain injury was identified, underscoring the need for additional high-quality studies.
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Affiliation(s)
- Bianca A D Thompson
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Rose Gilmore
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jacqui Barfoot
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
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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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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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14
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You XR, Gong XR, Guo MR, Ma BX. Cognitive behavioural therapy to improve social skills in children and adolescents with autism spectrum disorder: A meta-analysis of randomised controlled trials. J Affect Disord 2024; 344:8-17. [PMID: 37802322 DOI: 10.1016/j.jad.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is effective in treating various neurological and psychiatric diseases. It improves anxiety symptoms in children with autism spectrum disorder, gaining considerable empirical support. However, social skills results are mixed, leading to debate over its effectiveness, highlighting the need for further development. While the Social Responsiveness Scale (SRS) is a secondary indicator to measure anxiety symptoms, it primarily evaluates social skills, which are essential for rehabilitating children with autism. Therefore, evaluating social disorder improvement in children with autism is imperative. Social impairment is a core autism symptom. Therefore, we conducted a systematic review of randomised controlled trials assessing the effects of CBT on social skills in this population. METHODS We reviewed articles published in several databases through October 2022 and relevant reference lists. We used the standardised mean difference (SMD) as the main effect size indicator and focused on SRS metrics from baseline to endpoint. We analysed subgroups, heterogeneity, bias risk, and publication bias. RESULTS Our meta-analysis included 214 children from seven randomised controlled trials with nine datasets. Forest plot analysis shows CBT improved social skills in children with autism compared to controls. Subgroup analysis revealed parents' and teachers' SRS scores for children, SRS scores of CBT versus waitlist controls, and those of CBT versus non-waiting-list controls. LIMITATIONS Most randomised controlled CBT trials for children with autism have explored anxiety symptom improvement. Further, social skill assessment was a secondary outcome or not assessed. Thus, social skills data are insufficient. CONCLUSIONS CBT is effective in improving social impairment in children with autism. REGISTRATION This meta-analysis was registered with the International Prospective Register of Systematic Reviews (CRD42022363423).
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Affiliation(s)
- Xiao-Rui You
- Hebei University of Chinese Medicine, Hebei Province, Shijiazhuang, China
| | - Xing-Ruo Gong
- Hebei University of Chinese Medicine, Hebei Province, Shijiazhuang, China
| | - Mei-Ran Guo
- Hebei University of Chinese Medicine, Hebei Province, Shijiazhuang, China
| | - Bing-Xiang Ma
- The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Henan Province, Zhengzhou, China.
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15
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Corbett BA, Key AP, Klemencic ME, Muscatello RA, Jones D, Pilkington J, Burroughs C, Vandekar S. Investigating Social Competence in a Pilot Randomized Clinical Trial of a Theatre-Based Intervention Enhanced for Adults with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06214-0. [PMID: 38109034 PMCID: PMC11182891 DOI: 10.1007/s10803-023-06214-0] [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: 12/05/2023] [Indexed: 12/19/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by challenges in social competence that persist in adulthood, yet few treatment options exist. A pilot randomized clinical trial (RCT) of a peer-mediated, theatre-based intervention with established efficacy in youth with ASD was examined in autistic adults. The final sample consisted of forty-seven 18-to-40-year-old participants randomized to the experimental (EXP N = 23) or waitlist control (WLC N = 24) condition. A multimodal, social interdependent model was employed to examine social competence changes in brain (incidental face memory (IFM) using event-related potentials), cognition (Wechsler Memory Scale-III), behavior (Contextual Assessment of Social Skills) and function (Social Responsiveness Scale (SRS); Adaptive Behavior Assessment Scale (ABAS) Social Composite). Using analysis of covariance in which pretest was controlled in the model, posttest between-group differences were observed on IFM (p = 0.016, η2 = 0.139, d = 0.79) and several social and adaptive functional (SRS, ABAS) outcomes in social communication and interaction (SCI) (p = 0.019, η2 = 0.121, d = -00.45), communication (p = 0.044 η2 = 0.09, d = -00.31), and motivation (p = 0.001, η2 = 0.229, d = -0.79) domains. At two-month follow-up, gains in social motivation remained (p = 0.041, η2 = 0.100, d = -0.77). The results offer preliminary support for a unique theatre-based social skills intervention for autistic adults who have few treatment options to enhance social competence. The trial was pre-registered with ClinicalTrials.gov (Identifier: NCT04349644).
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA.
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark E Klemencic
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Dorita Jones
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Jennifer Pilkington
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Burroughs
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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Cordier R, Parsons L, Wilkes-Gillan S, Cook M, McCloskey-Martinez M, Graham P, Littlefair D, Kent C, Speyer R. Friendship interventions for children with neurodevelopmental needs: A systematic review and meta-analysis. PLoS One 2023; 18:e0295917. [PMID: 38096327 PMCID: PMC10721178 DOI: 10.1371/journal.pone.0295917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
RATIONALE Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships. OBJECTIVE To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD. METHOD Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials. RESULTS Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215). CONCLUSION Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship.
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Affiliation(s)
- Reinie Cordier
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
- Faculty of Health Sciences, Department of Health & Rehabilitation Sciences, University of Cape Town, University of Cape Town, Cape Town, South Africa
| | - Lauren Parsons
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Sarah Wilkes-Gillan
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Matthew Cook
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Matthew McCloskey-Martinez
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Pamela Graham
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - David Littlefair
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Cally Kent
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Renée Speyer
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
- Department Special Needs Education, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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17
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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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18
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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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Wright B, Kingsley E, Cooper C, Biggs K, Bursnall M, Wang HI, Chater T, Coates E, Teare MD, McKendrick K, Gomez de la Cuesta G, Barr A, Solaiman K, Packham A, Marshall D, Varley D, Nekooi R, Parrott S, Ali S, Gilbody S, Le Couteur A. Play brick therapy to aid the social skills of children and young people with autism spectrum disorder: the I-SOCIALISE cluster RCT. PUBLIC HEALTH RESEARCH 2023; 11:1-137. [PMID: 38095124 DOI: 10.3310/vgtr7431] [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] [Indexed: 12/18/2023] Open
Abstract
Background Social skills interventions are commonly recommended to help children and young people with autism spectrum disorder develop social skills, but some struggle to engage in these interventions. LEGO® (LEGO System A/S, Billund, Denmark) based therapy, a group social skills intervention, aims to be more interesting and engaging. Objective To evaluate the clinical effectiveness of LEGO® based therapy on the social and emotional skills of children and young people with autism spectrum disorder in school settings compared with usual support. Secondary objectives included evaluations of cost-effectiveness, acceptability and treatment fidelity. Design A cluster randomised controlled trial randomly allocating participating schools to either LEGO® based therapy and usual support or usual support only. Setting Mainstream schools in the north of England. Participants Children and young people (aged 7-15 years) with autism spectrum disorder, their parent/guardian, an associated teacher/teaching assistant and a facilitator teacher/teaching assistant (intervention schools only). Intervention Schools randomised to the intervention arm delivered 12 weekly sessions of LEGO® based therapy, which promotes collaborative play and encourages social problem-solving in groups of three children and young people with a facilitator (trained teacher or teaching assistant). Participants received usual support from school and community services. Participants in the control arm received usual support only. Research assistants and statisticians were blind to treatment allocation. Main outcome measure The social skills subscale of the Social Skills Improvement System (SSIS), completed by the children and young people's unblinded teacher pre randomisation and 20 weeks post randomisation. The SSIS social skills subscale measures social skills including social communication, co-operation, empathy, assertion, responsibility and self-control. Participants completed a number of other pre- and post-randomisation measures of emotional health, quality of life, loneliness, problem behaviours, academic competence, service resource utilisation and adverse events. Results A total of 250 children and young people from 98 schools were randomised: 127 to the intervention arm and 123 to the control arm. Intention-to-treat analysis of the main outcome measure showed a modest positive difference of 3.74 points (95% confidence interval -0.16 to 7.63 points, standardised effect size 0.18; p = 0.06) in favour of the intervention arm. Statistical significance increased in per-protocol analysis, with a modest positive difference (standardised effect size 0.21; p = 0.036). Cost-effectiveness of the intervention was found in reduced service use costs and a small increase in quality-adjusted life-years. Intervention fidelity and acceptability were positive. No intervention-related adverse events or effects were reported. Conclusions The primary and pre-planned sensitivity analysis of the primary outcome consistently showed a positive clinical difference, with modest standardised effect sizes of between 0.15 and 0.21. There were positive health economics and qualitative findings, corroborated by the difference between arms for the majority of secondary outcomes, which were not statistically significant but favoured the intervention arm. Post hoc additional analysis was exploratory and was not used in drawing this conclusion. Given the small positive change, LEGO® based therapy for children and young people with autism spectrum disorder in schools should be considered. Limitations The primary outcome measure was completed by an unblinded teacher (rather than by the facilitator). Future work The study team recommends future research into LEGO® based therapy, particularly in school environments. Trial registration This trial is registered as ISRCTN64852382. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/49/32) and is published in full in Public Health Research; Vol. 11, No. 12. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Barry Wright
- Hull York Medical School, University of York, York, UK
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Ellen Kingsley
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katie Biggs
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Matthew Bursnall
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Han-I Wang
- Hull York Medical School, University of York, York, UK
| | - Tim Chater
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Coates
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - M Dawn Teare
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Kirsty McKendrick
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Amy Barr
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Kiera Solaiman
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anna Packham
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | | | - Roshanak Nekooi
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Steve Parrott
- Hull York Medical School, University of York, York, UK
| | - Shehzad Ali
- Hull York Medical School, University of York, York, UK
| | - Simon Gilbody
- Hull York Medical School, University of York, York, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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20
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Gates JA, McNair ML, Richards JK, Lerner MD. Social Knowledge & Performance in Autism: A Critical Review & Recommendations. Clin Child Fam Psychol Rev 2023; 26:665-689. [PMID: 37544969 PMCID: PMC10613329 DOI: 10.1007/s10567-023-00449-0] [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: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Autistic social challenges have long been assumed to arise from a lack of social knowledge ("not knowing what to do"), which has undergirded theory and practice in assessment, treatment, and education. However, emerging evidence suggests these differences may be better accounted for by difficulties with social performance ("doing what they may know"). This distinction has important implications for research, practice, policy, and community support of autistic people. This review examines the theoretical and clinical implications and empirical status of the knowledge-performance distinction in autism. Current evidence suggests that social knowledge deficits are neither definitional nor reliably related to outcomes in autism. Prioritizing social knowledge, then, may produce unanticipated, problematic consequences in terms of accuracy of assessment, intervention effectiveness, and promotion of stigma. It may also yield unrealistic expectations around the value of knowledge for autistic people and their families, yielding important ethical considerations. Conversely, recent evidence highlights performance-related factors as being especially promising for better modeling and addressing social challenges in autism. Prioritizing performance, then, may offer new directions for assessment, substantially different intervention opportunities, and novel methods of inclusion and affirmation. This review touches upon each of these domains and implications, integrates these developments with broader models of social competence in youth, and provides direction for future research and practice regarding social competence in autism.
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Affiliation(s)
| | | | | | - Matthew D Lerner
- Stony Brook University, Stony Brook, USA.
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
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21
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Arnardóttir ÁÁ, Guðmundsdóttir LÁ, Hannesdóttir DK, Halldórsson F, Auðardóttir H, Sveinbjörnsdóttir B. A Pilot Study on the FEST program - Friendship and Emotional Skills Training for Children on the Autism Spectrum. J Autism Dev Disord 2023:10.1007/s10803-023-06099-z. [PMID: 37642875 DOI: 10.1007/s10803-023-06099-z] [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: 08/04/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Social skills difficulties among children on the autism spectrum can impede social, emotional, and academic development, especially with increasing age and social demands. This pilot study examined the efficacy of a 5-week skill-building program for children on the autism spectrum. Although effective social skills programs are available for adolescents with autism spectrum disorder (ASD), very few programs are explicitly intended for 10-12-year-old children. METHODS This pilot study examined the efficacy of the 9-session Friendship and Emotional Skills Training (FEST Program) for children with ASD without intellectual disability. Participants were 22 children randomly assigned to the FEST Program or a delayed intervention control group. Eleven children (boys = 8; girls = 3) received the FEST Program in two separate groups, and 11 were wait-listed for a delayed intervention. Parents, teachers, and the children answered questionnaires at baseline, post-intervention, and a 3-month follow-up. RESULTS Upon completing the FEST Program (post-intervention), parents reported an increase in overall social skills (on the Social Skills Rating System - SSRS) and a reduction on the Autistic Mannerisms factor (on the Social Responsiveness Scale - SRS) compared to the control group. These changes were also maintained at the 3-month follow-up. The children's assessment also showed a significant increase in assertion (on the SSRS) post-intervention. Teachers also reported a significant reduction on the Autistic Mannerisms factor at the 3-month follow-up. CONCLUSION The findings suggest that the FEST Program shows some promising results as one possibility for supporting children with ASD and their families in everyday life.
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Affiliation(s)
- Ágústa Á Arnardóttir
- The National Agency for Children and Families (Barna- og fjölskyldustofa), Reykjavik, Iceland.
| | - Laufey Á Guðmundsdóttir
- Children´s Mental Health Center for the Primary Health Care of the Capital Area (Gedheilsumistod barna Heilsugaeslu hofudborgarsvaedisins), Reykjavik, Iceland
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Dagmar Kr Hannesdóttir
- Children´s Mental Health Center for the Primary Health Care of the Capital Area (Gedheilsumistod barna Heilsugaeslu hofudborgarsvaedisins), Reykjavik, Iceland
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | - Freyr Halldórsson
- Department of Business Administration, Reykjavik University, Reykjavik, Iceland
| | - Helga Auðardóttir
- SOL clinic - Psychological and medical services for families, Kopavogur, Iceland
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22
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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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23
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Libster N, Knox A, Engin S, Geschwind D, Parish-Morris J, Kasari C. Sex differences in friendships and loneliness in autistic and non-autistic children across development. Mol Autism 2023; 14:9. [PMID: 36829214 PMCID: PMC9960478 DOI: 10.1186/s13229-023-00542-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/10/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Autistic children have been shown to have less complete definitions of friendships and higher levels of loneliness than their non-autistic peers. However, no known studies have explored sex differences in autistic children's understanding of friendships and reported loneliness across development. Autistic girls demonstrate higher levels of social motivation than autistic boys and appear to "fit in" with their peers, but they often have difficulty recognizing reciprocal friendships during middle childhood. As autistic girls develop a more complex understanding of friendship during adolescence, they may begin to redefine their friendships and experience heightened loneliness. Here, we explored how autistic and non-autistic boys and girls define the meaning of friendship and report feelings of loneliness across development. We also examined their perceptions of friendships and loneliness. METHODS This mixed-methods study analyzed the transcribed clinical evaluations of 58 autistic children (29 girls) matched to 42 non-autistic children (21 girls) on age and IQ. Transcripts were coded for four categories that children used to define friendships-personality, companionship, dependability, and intimacy-and for reported loneliness. We then compared these codes across diagnosis, sex, and age. Content analyses were further implemented to gain a more holistic understanding of children's perceptions of friendships and loneliness. RESULTS Girls, regardless of diagnosis, were more likely than boys to refer to personality when defining the meaning of friendship, and the likelihood of referring to dependability and intimacy increased with age. Most children reported having at least one friend, though some autistic adolescents reported not having friends or were uncertain whether they had friends. While autistic and non-autistic boys and girls were equally likely to report feeling lonely at times, several autistic girls and boys reported being frequently lonely. LIMITATIONS This study was a secondary data analysis. The standardized set of questions on the ADOS limited the amount of information that children provided about their friendships and perceptions of loneliness. CONCLUSION As with non-autistic children, autistic children acquire a more complex understanding of friendship throughout development. However, as children begin to prioritize dependability and intimacy in friendships, autistic adolescents may have difficulty developing friendships characterized by these constructs. Furthermore, the quantity and/or quality of autistic children's friendships may not be sufficient to alleviate loneliness.
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Affiliation(s)
- Natalie Libster
- grid.19006.3e0000 0000 9632 6718Department of Education, UCLA, 457 Portola Plaza, Los Angeles, CA 90024 USA
- grid.19006.3e0000 0000 9632 6718Center for Autism Research and Treatment, Semel Institute for Neuroscience, UCLA, 760 Westwood Plaza, Los Angeles, CA 90024 USA
| | - Azia Knox
- grid.239552.a0000 0001 0680 8770Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Selin Engin
- grid.19006.3e0000 0000 9632 6718Center for Autism Research and Treatment, Semel Institute for Neuroscience, UCLA, 760 Westwood Plaza, Los Angeles, CA 90024 USA
| | - Daniel Geschwind
- grid.19006.3e0000 0000 9632 6718Center for Autism Research and Treatment, Semel Institute for Neuroscience, UCLA, 760 Westwood Plaza, Los Angeles, CA 90024 USA
- grid.19006.3e0000 0000 9632 6718David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, Los Angeles, CA 90024 USA
| | - Julia Parish-Morris
- grid.239552.a0000 0001 0680 8770Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
- grid.25879.310000 0004 1936 8972Department of Psychology, University of Pennsylvania, 3720 Walnut St, Philadelphia, PA 19104 USA
| | - Connie Kasari
- grid.19006.3e0000 0000 9632 6718Department of Education, UCLA, 457 Portola Plaza, Los Angeles, CA 90024 USA
- grid.19006.3e0000 0000 9632 6718Center for Autism Research and Treatment, Semel Institute for Neuroscience, UCLA, 760 Westwood Plaza, Los Angeles, CA 90024 USA
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24
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Liu TL, Chen YL, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Chou WJ, Yen CF. Adolescent-Caregiver Agreement Regarding the School Bullying and Cyberbullying Involvement Experiences of Adolescents with Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3733. [PMID: 36834428 PMCID: PMC9961965 DOI: 10.3390/ijerph20043733] [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: 01/11/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
School bullying and cyberbullying victimization and perpetration are prevalent in adolescents with autism spectrum disorder (AASD). However, the levels of adolescent-caregiver agreement regarding the bullying involvement of AASD and the factors associated with these levels remain to be evaluated. In the present study, we evaluated the levels of adolescent-caregiver agreement on the school bullying and cyberbullying involvement experiences of AASD and the factors associated with the levels of agreement. This study included 219 dyads of AASD and their caregivers. The school bullying and cyberbullying involvement experiences of the participating AASD were assessed using the School Bullying Experience Questionnaire and the Cyberbullying Experiences Questionnaire, respectively. Attention-deficit/hyperactivity disorder, oppositional defiant disorder (ODD), depressive and anxiety symptoms, and autistic social impairment were also assessed. AASD and their caregivers had poor to fair levels of agreement regarding the school bullying and cyberbullying victimization and perpetration experiences of AASD. Severe inattention, hyperactivity-impulsivity, ODD, depressive and anxiety symptoms, and autistic social impairment were associated with high levels of adolescent-caregiver agreement. When assessing the bullying involvement experiences of AASD, mental health professionals should obtain information from multiple sources. In addition, the factors influencing the levels of agreement should be considered.
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Affiliation(s)
- Tai-Ling Liu
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Lung Chen
- Department of Psychology, Asia University, Taichung 41354, Taiwan
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98105, USA
| | - Hsing-Chang Ni
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Chiao-Fan Lin
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Hsiang-Lin Chan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Yi-Hsuan Hsieh
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Liang-Jen Wang
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Kaohsiung Medical Center, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Min-Jing Lee
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Wen-Jiun Chou
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Kaohsiung Medical Center, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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25
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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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26
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Cleary M, West S, Mclean L. From 'Refrigerator Mothers' to Empowered Advocates: The Evolution of the Autism Parent. Issues Ment Health Nurs 2023; 44:64-70. [PMID: 36049183 DOI: 10.1080/01612840.2022.2115594] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A historical perspective offers a chance to reflect on unfolding narratives. The emergence of the diagnosis of autism attracted some positions of blame for "refrigerator mothers". With ensuing neuroscience and developmental research and more nuanced biopsychosocial models, this gave way to notions of strong neurological contributions to the disorder and the positive role of parents supporting the regulation of their child. The notion of co-regulation then emerges with collective agency by parents to offer advocacy and support for those with ASD and their parents and an important role in educating society around the needs and value of those with ASD.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Loyola Mclean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW, Australia.,Royal North Shore Hospital, Sydney, NSW, Australia.,Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, NSW, Australia.,Western Clinical School, The University of Sydney, Camperdown, NSW, Australia
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27
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Dean M, Chang YC, Shih W, Orlich F, Kasari C. Social engagement and loneliness in school-age autistic girls and boys. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231170973. [PMID: 37129160 PMCID: PMC10159247 DOI: 10.1177/17455057231170973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES This study examines the relationship between social engagement and loneliness in female and male autistic children and adolescents in school-based social settings. Secondary aims sought to explore the emergence of loneliness across different age groups and differences in social engagement and loneliness between genders. METHODS This study conducted an analysis of previously collected data from two multi-site randomized control trials. This study included 58 autistic students (29 females, 29 males) between the ages 6 through 18 years. Female and male participants were matched on age and intelligence quotient. Concurrent mixed methods were used to examine participants' social engagement and loneliness. RESULTS Findings revealed a significant relationship between joint engagement and loneliness, such that autistic students reported more loneliness when they were mutually engaged with social groups than when they were isolated or alone. Positive correlations between joint engage and loneliness were identified in elementary-age girls and secondary-age boys, suggesting that being mutually engaged with peers leads to increased loneliness. Negative correlations between parallel and loneliness identified in secondary-age boys suggested that boys in close proximity to peers felt less lonely than boys who were mutually engaged with peers. Qualitative analysis of social behaviors indicated that elementary girls and secondary boys were more likely to be mutually engaged or in close proximity to activities, but they had difficulty sustaining this engagement throughout the entire social period. Secondary girls and elementary boys, on the other hand, were more likely to be solitary and less likely to engage with peer groups. CONCLUSION Study findings highlight the relationship between social engagement and loneliness in school-based autistic populations, and that more engagement itself can lead to more loneliness for younger girls and older boys. The influence of age and gender on engagement and loneliness highlights a need to tailor social interventions to leverage existing social strengths.
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Affiliation(s)
- Michelle Dean
- California State University (CSU)
Channel Islands, Camarillo, CA, USA
| | - Ya-Chih Chang
- California State University (CSU), Los
Angeles, Los Angeles, CA, USA
| | - Wendy Shih
- Center for Autism Research &
Treatment, UCLA Semel Institute, Los Angeles, CA, USA
| | - Felice Orlich
- Seattle Children’s Autism Center (CAC),
Seattle, WA, USA
| | - Connie Kasari
- Center for Autism Research &
Treatment, UCLA Semel Institute, Los Angeles, CA, USA
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28
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Adler EJ, Schiltz HK, Glad DM, Lehman SA, Pardej SK, Stanley RE, Van Hecke AV. Brief Report: A Pilot Study Examining the Effects of PEERS® for Adolescents Telehealth for Autistic Adolescents. J Autism Dev Disord 2022; 52:5491-5499. [PMID: 35870099 PMCID: PMC9308371 DOI: 10.1007/s10803-022-05666-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/09/2022]
Abstract
The COVID-19 pandemic sparked a worldwide transition to providing online services overnight, highlighting the urgent need for empirically supported telehealth interventions. The current study examined the effects of PEERS® for Adolescents Telehealth, an adaptation from the original social skills intervention developed for in-person provision, among 22 autistic adolescents and their caregivers. To evaluate the intervention, caregivers completed questionnaires assessing core autistic features and frequency of get-togethers. Adolescents completed questionnaires measuring social knowledge and frequency of get-togethers. Improvements in social skills knowledge, increased get-togethers, and decreased core autistic symptoms were evident. Preliminary results suggest PEERS® for Adolescents Telehealth improves social competence, as found for the in-person version. Further research exploring the equivalence of telehealth to in-person social skills intervention is recommended.
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Affiliation(s)
- Elyse J Adler
- Department of Psychology, Marquette University, Milwaukee, WI, USA.
| | - Hillary K Schiltz
- Department of Psychology, Marquette University, Milwaukee, WI, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Danielle M Glad
- Department of Psychology, University of Wisconsin, Milwaukee, WI, USA
| | - Sarah A Lehman
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin, Milwaukee, WI, USA
| | - Rachel E Stanley
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Amy V Van Hecke
- Department of Psychology, Marquette University, Milwaukee, WI, USA
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29
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Offermans JE, de Bruin EI, van Steensel FJ. Examining an individualized, group-based social skills training using a mixed-methods design: A feasibility study. Clin Child Psychol Psychiatry 2022:13591045221137195. [PMID: 36314352 DOI: 10.1177/13591045221137195] [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] [Indexed: 11/16/2022]
Abstract
Tailoring treatments to individual needs may be beneficial for treatment adherence and treatment effects. However, individualizing a group-based Social Skills Training (SST) may be complicated. Therefore, in this feasibility study, we examined outcomes after engagement in an individualized SST provided to 33 children aged 7-11 years (M = 9.39, SD = 1.09; 13 girls), who were referred to a mental health care center for various psychosocial problems. To analyze outcomes, we combined a top-down (including researcher-chosen measures: Questionnaires on pro-social, socially inadequate, and problem behavior) and a bottom-up (including participant-driven measures: Ratings of personal goals and evaluation reports) approach and used a mixed-methods design. After the SST, personal goals and pro-social behavior increased (large and small effects respectively). Also, socially inadequate behavior and problem behavior decreased (both small effects). Evaluation reports mainly showed improvements in social responsiveness, emotion regulation, and internalizing problems. At the same time, however, most parents also reported limitations (e.g., a lack of generalization). Altogether, we can conclude that (1) tailoring a group-based SST to the individual needs of children, as well as measuring progress on personal goals, is feasible and (2) mixed-method designs to study intervention effectiveness should be encouraged.
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Affiliation(s)
- Julia E Offermans
- Academic Treatment Center for Parents and Children, UvA Minds, Amsterdam, Netherlands.,Research Institute of Child Development and Education, 1234University of Amsterdam, Amsterdam, Netherlands
| | - Esther I de Bruin
- Academic Treatment Center for Parents and Children, UvA Minds, Amsterdam, Netherlands.,Research Institute of Child Development and Education, 1234University of Amsterdam, Amsterdam, Netherlands
| | - Francisca Ja van Steensel
- Research Institute of Child Development and Education, 1234University of Amsterdam, Amsterdam, Netherlands
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30
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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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31
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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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Tomfohrde O, Hudock RL, Kremer KB, Fatiha N, Weiler L. Fostering social connectedness among adolescents and adults with autism: A qualitative analysis. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Olivia Tomfohrde
- Department of Family Social Science University of Minnesota—Twin Cities Minneapolis Minnesota USA
| | - Rebekah L. Hudock
- Department of Pediatrics University of Minnesota—Twin Cities Minneapolis Minnesota USA
| | - Kalli B. Kremer
- College of Biological Sciences University of Minnesota—Twin Cities Minneapolis Minnesota USA
| | - Nusroon Fatiha
- Department of Family Social Science University of Minnesota—Twin Cities Minneapolis Minnesota USA
| | - Lindsey Weiler
- Department of Family Social Science University of Minnesota—Twin Cities Minneapolis Minnesota USA
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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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Gilmore R, Ziviani J, Mcintyre S, Smithers Sheedy H, Hilton N, Williams T, Chatfield MD, Laugeson E, Sakzewski L, Quinn K, Balde I. Program for the Education and Enrichment of Relational Skills for adolescents with an acquired brain injury: A randomized controlled trial. Dev Med Child Neurol 2022; 64:771-779. [PMID: 35092016 DOI: 10.1111/dmcn.15144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/10/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
AIM To test the efficacy of a group social skills intervention on social functioning in adolescents with a brain injury. METHOD Thirty-six adolescents (mean age 14y, SD 1y 8mo, age range 12y 1mo-16y 3mo; 17 females) with acquired brain injury (ABI; ≥12mo postintervention; n=19) or cerebral palsy (n=17) were randomly allocated to the Program for the Education in Enrichment of Relational Skills (PEERS) or usual care. The primary outcome was the Social Skills Improvement System-Rating Scales (SSIS-RS). Secondary outcomes were scores derived from the Test of Adolescent Social Skills Knowledge-Revised (TASSK-R), Social Responsiveness Scale, Second Edition, and Quality of Socialization Questionnaire. Between-group differences postintervention and at the 26-week retention time point were compared using linear mixed modelling for continuous outcomes and Poisson regression for count data. RESULTS There were no between-group differences on the primary outcome (SSIS-RS). Regarding the secondary outcomes, the PEERS-exposed group achieved significantly greater improvements on the TASSK-R (mean difference [MD]=6.8, 95% confidence interval [CI]=4.8-8.8, p<0.001), which were maintained at the 26-week retention time point (MD=8.1, 95% CI=6.0-10.2, p<0.001). PEERS was also associated with a significant increase in parent-reported invited get-togethers at 26 weeks (incidence rate ratio=4.0, 95% CI=1.0-16.0, p=0.05). INTERPRETATION Adolescents with brain injury who completed the PEERS learned and retained social knowledge and increased social participation.
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Affiliation(s)
- Rose Gilmore
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia.,Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola Hilton
- Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Tracey Williams
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Mark D Chatfield
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Estabillo JA, Moody CT, Poulhazan SJ, Adery LH, Denluck EM, Laugeson EA. Efficacy of PEERS® for Adolescents via Telehealth Delivery. J Autism Dev Disord 2022; 52:5232-5242. [PMID: 35624224 PMCID: PMC9137447 DOI: 10.1007/s10803-022-05580-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 11/16/2022]
Abstract
PEERS® for Adolescents is an evidence-based social skills intervention for autistic youth and adolescents with other social challenges. The efficacy and effectiveness of PEERS® are well established; however, limited data on PEERS® via telehealth delivery exist. The current study aimed to examine the efficacy of PEERS® for Adolescents via telehealth and compare outcomes between telehealth and in-person modalities. Thirty-one adolescents (Mage = 13.77, SD = 2.14) participated in telehealth groups, and outcomes were compared with 212 adolescents (Mage = 14.02, SD = 2.00) from in-person groups. Findings demonstrate PEERS® for Adolescents via telehealth results in significant improvements in social skills knowledge, social responsiveness, overall social skills and problem behaviors, and social engagement. Telehealth outcomes are relatively equivalent to in-person delivery.
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Affiliation(s)
- Jasper A Estabillo
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA. .,Department of Psychology, University of California, Los Angeles, CA, USA.
| | - Christine T Moody
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Solene J Poulhazan
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Laura H Adery
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Elizabeth M Denluck
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,College of Education School Psychology Program, University of Oregon, Eugene, OR, USA
| | - Elizabeth A Laugeson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
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A Distance-Delivered Social Skills Program for Young Adults with Williams Syndrome: Evaluating Feasibility and Preliminary Efficacy. J Autism Dev Disord 2022; 52:5162-5176. [PMID: 35575839 PMCID: PMC9109668 DOI: 10.1007/s10803-022-05501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Adults with Williams syndrome (WS) display hypersocial behaviors and experience social skills deficits. To improve social outcomes, we evaluated the feasibility, acceptability, and preliminary efficacy of an 8-week distance-delivered social skills program for adults with WS. Sessions were offered twice a week for 90 min. Twenty-four adults with WS were assigned to an intervention or waitlist control group. Outcomes were assessed through interviews and surveys with adults with WS, parents, and facilitators. The intervention was rated as acceptable and feasible by all. Parents rated adults with WS as displaying significant improvements in social skills; yet ratings by adults with WS did not change. Adults also displayed increased social skills knowledge following participation. Implications for practice and future research are discussed.
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Bush H, Rapp JT, Nuhu N. A Pilot Study Exploring Social Validity Ratings of Social Profiles for College Students. Dev Neurorehabil 2022; 25:263-273. [PMID: 34866530 DOI: 10.1080/17518423.2021.2011460] [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] [Indexed: 10/19/2022]
Abstract
Nuhu and Rapp identified three profiles undergraduates displayed during social interactions. We evaluated the social validity of these three profiles in two studies. In Study 1 we presented video exemplars of speakers representing each profile to undergraduate participants and asked them to rate the speaker in respect to various statements. Results showed that one profile was rated significantly different than the other two profiles on all but one statement. In Study 2 we further evaluated the role of eye contact in the profile that participants rated differently in Study 1. Results from Study 2 showed that a speaker engaging in low eye contact was rated lower than a speaker engaging in either a validated or high level of eye contact. Likewise, participants with self-reported high social competency provided more negative ratings of a speaker who displayed low eye contact than participants with self-reported Moderate and Low social competency.
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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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Factor RS, Rea HM, Laugeson EA, Scarpa A. Examining Feasibility and Outcomes of the PEERS® for Preschoolers Program. J Autism Dev Disord 2022; 53:1821-1833. [PMID: 35267147 DOI: 10.1007/s10803-022-05502-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and often worsen. There is a paucity of evidence-based interventions explicitly targeting social skill development for young children with ASD and few actively integrate caregivers. The PEERS® program, an evidence-based caregiver-assisted social skills program, was extended for young children with ASD (i.e., PEERS® for Preschoolers (P4P)). This pilot study expands upon initial results by examining the feasibility of a briefer intervention period and the effectiveness in improving child social skills among 15 children with ASD. Results suggest P4P recruitment, participant retention, and implementation are feasible across clinicians and sites. Further, P4P appears to improve social skills, maintained post-intervention. Future research might examine mechanisms that lead to results.
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Affiliation(s)
- Reina S Factor
- Department of Psychology, Virginia Tech 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA. .,Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA, 24061, USA. .,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA, 90095, USA.
| | - Hannah M Rea
- Research in Autism and the Brain Lab, University of Washington, CHDD Box 357920, Seattle, WA, 98195, USA
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA, 90095, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA.,Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA, 24061, USA
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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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Factor RS, Glass L, Baertschi D, Laugeson EA. Remote PEERS ® for preschoolers: A pilot parent-mediated social skills intervention for young children with social challenges over telehealth. Front Psychiatry 2022; 13:1008485. [PMID: 36523874 PMCID: PMC9745198 DOI: 10.3389/fpsyt.2022.1008485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Social differences characteristic of autism spectrum disorder (ASD) and other developmental disabilities are evident in early childhood and are associated with later difficulties. Unfortunately, there is a paucity of evidence-based interventions explicitly targeting social skills development for young children, few actively integrate parents and caregivers, and even fewer have remote models. The importance of providing accessible, tailored services for families in the wake of the COVID-19 pandemic, prompted the creation of a parent-mediated telehealth version of Program for the Education and Enrichment of Relational Skills (PEERS®) for Preschoolers (P4P), a pre-existing, evidence-based social skills intervention for children 4-6 years focused on making and keeping friends. METHOD This methodological paper documents the implementation, feasibility, and satisfaction of a novel telehealth group-based delivery of P4P. RESULTS Qualitative results indicate acceptable feasibility and satisfaction. Additionally, following completion there was an increase in parental confidence in social coaching and increased use of child social skills. DISCUSSION Future work will evaluate quantitative outcomes and comparisons between delivery methods (e.g., telehealth vs. in-person).
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Affiliation(s)
- Reina S Factor
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Leila Glass
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Daliah Baertschi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Elizabeth A Laugeson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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King G, Keenan S. Solution-Focused Coaching for Friendship in Pediatric Rehabilitation: A Case Study of Goal Attainment, Client Engagement, and Coach Stances. Phys Occup Ther Pediatr 2022; 42:154-171. [PMID: 34266361 DOI: 10.1080/01942638.2021.1947435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS To examine goal attainment, engagement, and the stances used by coaches providing a solution-focused coaching intervention (SFC-peds) for young people with cerebral palsy pursuing friendship goals. METHODS The case study involved two clients with cerebral palsy (a young child and his mother, and a youth) and their service providers. An interpretive descriptive approach was used to analyze quantitative and qualitative data. Friendship goal attainment was assessed by the Canadian Occupational Performance Measure and goal attainment scaling, and client engagement was assessed using the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version. Information from post-intervention client interviews was used to identify coach stances and relationships with client engagement. RESULTS Participants met their friendship goals and were considered to be highly engaged by their coaches. Four coach stances were identified: Respectful Inquiry, a Strengths Presupposition, Implementation Curiosity, and Inspiring Commitment. These stances, and aligned tactics, engaged clients on affective, cognitive, and behavioral levels, and impacted the client's stance toward their goal. CONCLUSIONS SFC-peds appears to be an effective and engaging approach for young people with disabilities working on friendship goals. The findings illustrate how the coach's stances and tactics engage clients, thus impacting the client's own stances toward change.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Sarah Keenan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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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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Darling SJ, Goods M, Ryan NP, Chisholm AK, Haebich K, Payne JM. Behavioral Intervention for Social Challenges in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2021; 175:e213982. [PMID: 34661613 PMCID: PMC8524357 DOI: 10.1001/jamapediatrics.2021.3982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022]
Abstract
Importance Social deficits are a common and disabling feature of many pediatric disorders; however, whether behavioral interventions are associated with benefits for children and adolescents with social deficits is poorly understood. Objective To assess whether behavioral interventions in children and adolescents with neurodevelopmental or mental health disorders are associated with improvements in social function and social cognition, and whether patient, intervention, and methodological characteristics moderate the association. Data Sources For this systematic review and meta-analysis, the PsycINFO, MEDLINE, and PubMed electronic databases were searched in December 2020 for randomized clinical trials published from database inception to December 1, 2020, including terms related to neurodevelopmental or mental health disorders, social behavior, randomized clinical trials, and children and adolescents. Data were analyzed in January 2021. Study Selection Randomized clinical trials that enrolled participants aged 4 to 17 years with social deficits and examined the efficacy of a clinician-administered behavioral intervention targeting social functioning or social cognition were included. A total of 9314 records were identified, 78 full texts were assessed for eligibility, and 33 articles were included in the study; 31 of these reported social function outcomes and 12 reported social cognition outcomes. Data Extraction and Synthesis Articles were reviewed using the Cochrane Risk of Bias Assessment for randomized clinical trials. Data were independently extracted and pooled using a weighted random-effects model. Main Outcomes and Measures The main outcome was the association of behavioral intervention with social function and social cognition. Hedges g was used to measure the standardized mean difference between intervention and control groups. Standardized effect sizes were calculated for the intervention group vs the comparison group for each trial. Results A total of 31 trials including 2131 participants (1711 [80%] male; 420 [20%] female; mean [SD] age, 10.8 [2.2] years) with neurodevelopmental or mental health disorders (autism spectrum disorder [ASD] [n = 23], attention-deficit/hyperactivity disorder [n = 4], other conditions associated with social deficits [n = 4]) were analyzed to examine differences in social function between the intervention and control groups. Significantly greater gains in social function were found among participants who received an intervention than among the control groups (Hedges g, 0.61; 95% CI, 0.40-0.83; P < .001). The type of control condition (wait list vs active control vs treatment as usual) was a significant moderator of effect size (Q2, 7.11; P = .03). Twelve studies including 487 individuals with ASD (48 [10%] female; 439 [90%] male; mean [SD] age, 10.4 [1.7] years) were analyzed to examine differences in social cognition between intervention and control groups. The overall mean weighted effect was significant (Hedges g, 0.67; 95% CI, 0.39-0.96; P < .001), indicating the treatment groups had better performance on social cognitive tasks. Conclusions and Relevance In this systematic review and meta-analysis, significantly greater gains in social function and social cognition were reported among children and adolescents who received behavioral interventions for social deficits compared with participants receiving the control conditions. These findings suggest that children and adolescents with social deficits might benefit from social skills training regardless of their specific neurodevelopmental or mental health diagnosis.
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Affiliation(s)
- Simone J. Darling
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Marquelle Goods
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Nicholas P. Ryan
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Anita K. Chisholm
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kristina Haebich
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan M. Payne
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Akrami L, Malekpour M, Faramarzi S, Abedi A. Effect of training program on sexual knowledge and social skills of adolescents with high-functioning autism in puberty. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-07-2020-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Autism spectrum disorder (ASD) refers to a group of complex neurodevelopmental disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. Puberty is an important period for teenagers with ASD. The purpose of this study was to investigate the effect of educational program on increasing social skills (SS) and sexual knowledge (SK) in adolescent boys with high-functioning autism (HFA) disorder.
Design/methodology/approach
This study was conducted using a single-subject design. Participants were three boys diagnosed with HFA disorder, selected using purposive sampling. The social skills improvement system scale and the sexual knowledge questionnaire were used to measure SS and SK. The training program consisted of 49 sessions.
Findings
Results showed that, given the comparison of scores before and after the intervention, the training program was effective in improving SS and SK.
Originality/value
With regard to the importance of puberty, training programs for parents and adolescents play an effective role in increasing SS and SK of adolescents with HFA disorder.
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Baker E, Veytsman E, Choy T, Blacher J, Stavropoulos KKM. Investigating Changes in Reward-Related Neural Correlates After PEERS Intervention in Adolescents With ASD: Preliminary Evidence of a "Precision Medicine" Approach. Front Psychiatry 2021; 12:742280. [PMID: 34803765 PMCID: PMC8595219 DOI: 10.3389/fpsyt.2021.742280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/12/2021] [Indexed: 01/16/2023] Open
Abstract
Background: The Social Motivation Hypothesis proposes that individuals with autism spectrum disorder (ASD) experience social interactions as less rewarding than their neurotypical (TD) peers, which may lead to reduced social initiation. Existing studies of the brain's reward system in individuals with ASD report varied findings for anticipation of and response to social rewards. Given discrepant findings, the anticipation of and response to social rewards should be further evaluated, particularly in the context of intervention outcome. We hypothesized that individual characteristics may help predict neural changes from pre- to post-intervention. Methods: Thirteen adolescents with ASD received the Program for the Education and Enrichment of Relational Skills (PEERS) intervention for 16 weeks; reward-related EEG was collected before and after intervention. Fourteen TD adolescents were tested at two timepoints but did not receive intervention. Event-related potentials were calculated to measure anticipation of (stimulus-preceding negativity; SPN) and response to (reward-related positivity; RewP) social and non-social rewards. Additionally, measures of social responsiveness, social skills, and intervention-engagement were collected. Group differences were analyzed as well as individual differences using prediction models. Result: Parent-reported social responsiveness and social skills improved in adolescents with ASD after participation in PEERS. ASD adolescents displayed marginally decreased anticipation of social rewards at post-intervention compared to pre-intervention. Regression models demonstrated that older adolescents and those with lower parent-reported social motivation prior to participation in PEERS displayed marginally increased social reward anticipation (more robust SPN) from pre- to post-intervention. Participants who displayed more parent-reported social motivation before intervention and were more actively engaged in the PEERS intervention evidenced increased social reward processing (more robust RewP) from pre- to post-intervention. Conclusion: Findings suggest that there may be differences in saliency between wanting/anticipating social rewards vs. liking/responding to social rewards in individuals with ASD. Our findings support the hypothesis that identification of individual differences may predict which adolescents are poised to benefit the most from particular interventions. As such, reported findings set the stage for the advancement of "precision medicine." This investigation is a critical step forward in our ability to understand and predict individual response to interventions in individuals with ASD.
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Affiliation(s)
- Elizabeth Baker
- School of Education, University of California, Riverside, Riverside, CA, United States
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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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Luckhardt C, Boxhoorn S, Schütz M, Fann N, Freitag CM. Brain stimulation by tDCS as treatment option in Autism Spectrum Disorder-A systematic literature review. PROGRESS IN BRAIN RESEARCH 2021; 264:233-257. [PMID: 34167658 DOI: 10.1016/bs.pbr.2021.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and interaction as well as stereotypical and repetitive behavior. Transcranial direct current stimulation (tDCS) has been proposed as a new intervention method in ASD with the potential to improve cognitive, motor and social communication abilities by targeting specific underlying neuronal alterations. Here, we report results of a systematic literature review on tDCS effects on EEG and behavioral outcomes, and discuss tDCS as treatment option for ASD. PsychInfo, PubMed, ScienceDirect, Web of Science, https://clinicaltrials.gov and the German Clinical Trials Register (Deutsches Register Klinischer Studien) were searched systematically for randomized, sham-controlled clinical trials of tDCS in individuals with ASD, and information regarding study designs and relevant results was extracted. Six eligible studies were identified. The dorsolateral prefrontal cortex (DLPFC) was targeted in four trials, with core ASD symptoms and working memory as outcome measures. One study targeted the primary motor cortex (M1) with motor skills as outcome, and one study targeted the temporoparietal junction (TPJ) with social communication skills as outcome measure. Comparison of the implemented study designs showed high methodological variability between studies regarding stimulation parameters, trial design and outcome measures. Study results indicate initial support for improved cognitive and social communication skills in ASD following tDCS stimulation. However, systematic and comparison studies on the best combination of stimulation intensity, duration, location as well as task related stimulation are necessary, before results can be translated into routine clinical application.
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Affiliation(s)
- Christina Luckhardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Sara Boxhoorn
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Magdalena Schütz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Nikola Fann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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Wolstencroft J, Kerry E, Denyer H, Watkins A, Mandy W, Skuse D. New approaches to social skills training: Blended group interventions for girls with social communication difficulties. Autism Res 2021; 14:1061-1072. [PMID: 33694323 DOI: 10.1002/aur.2495] [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] [Received: 08/03/2020] [Accepted: 02/21/2021] [Indexed: 12/12/2022]
Abstract
Social skills group interventions are increasing popular for children with social communication disorders but there is little evidence of their acceptability or effectiveness when delivered online. We report a feasibility study that adapted the Program for Education and Enrichment of Relational Skills (PEERS) to provide an intensive 8 week online delivery to female adolescents, blended with some face-to-face group meetings. A systematic multiple-case series design with case tracking was developed, comprising a 3-month baseline, a 2-month intervention and a 3-month follow-up period. Seven adolescents with Turner Syndrome and social communication difficulties (17-20 years) took part, together with their parents. Acceptability and feasibility were assessed by means of qualitative feedback and attendance rates. Changes in social adaptation were tracked using measures of social knowledge, social behaviour and autistic symptoms, plus anxiety and self-esteem. Attendance rates were consistently high and there were no dropouts. Qualitative feedback indicated the online format was acceptable to both the participants and their families. Objective outcome measures showed significant gains in social knowledge and improved social initiations from measures made during the pre-intervention baseline. This proof-of-principle pilot study demonstrated blended social skills interventions are both feasible and acceptable to adolescent females with social communication difficulties. LAY SUMMARY: Social skills groups are increasingly popular for children with social communication disorders, but there is little evidence for their use online. Psychological treatments that require weekly face-to-face sessions for both children and their parents are associated with practical difficulties, disrupting family life and school commitments. Our study, is the first to use a blended online and face-to-face social skills training program for adolescent girls with social communication difficulties. We showed that this new approach to treatment was acceptable to families and has a positive and significant impact on participant's social performance and social knowledge. This new treatment approach may increase the accessibility of treatment for adolescents and young adults, especially those with social communication difficulties. Autism Res 2021, 14: 1061-1072. © 2021 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals LLC.
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Affiliation(s)
- Jeanne Wolstencroft
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Eleanor Kerry
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Hayley Denyer
- King's College London, Social Genetic and Developmental Psychiatry Centre, London, London, UK
| | | | - William Mandy
- Faculty of Brain Sciences, Division of Psychology and Language Sciences, University College London, London, UK
| | - David Skuse
- Great Ormond Street Institute of Child Health, University College London, London, UK
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