Short-term ASD-specific add-on group-based psychotherapy has shown postintervention efficacy with regard to parent-rated social responsiveness predominantly in male high-functioning children and adolescents with ASD. Future studies should implement blinded standardized observational measures of peer-related social interaction.

BackgroundGroup-based social skills training (SST) has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD). To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS) compared to treatment as usual (TAU). It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU.Methods/designThe SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres.DiscussionThis study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings.Trial registrationISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

Patienten mit Autismus-Spektrum-Störungen zeigen deutliche Einschränkungen der sozialen Interaktion und Kommunikation sowie stereotypes Verhalten und Sonderinteressen. Als therapeutische Methode der Wahl für Kinder und Jugendlichen mit durchschnittlichen kognitiven Fertigkeiten gelten autismusspezifische soziale Kompetenztrainings, anhand derer die beiden zentralen Bereiche der sozialen Interaktion und Kommunikation verbessert werden sollen. In der vorliegenden Studie wird der Effekt der neu entwickelten autismusspezifischen Gruppentherapie SOSTA-FRA auf die Verbesserung der sozialen Reaktivität im Elternurteil anhand einer Prä-Post-Studie untersucht. Zusätzlich werden globale Maße des Therapieerfolgs sowie Prozessvariablen bezogen auf die einzelnen Gruppentherapiesitzungen explorativ untersucht. Es zeigte sich ein mittlerer Effekt auf die Gesamt-SRS-Skala im Elternurteil. In der Selbstbeurteilung der Patienten zeigte sich eine gute Umsetzung selbst formulierter Therapieziele. Die SOSTA-FRA Gruppentherapie wird aktuell anhand einer multizentrischen randomisiert-kontrollierten Studie überprüft. Wenn der Effekt repliziert werden sollte, kann das Programm für die breite Anwendung in Kliniken, Praxen sowie spezialisierten Therapiezentren empfohlen werden.

Abnormalities in neurophysiological correlates of social perception are a well‐known feature of autism spectrum disorder (ASD). However, little is known if and how ASD specific behavioral interventions may affect neural processing in ASD. The aim of the current study was to investigate for the first time, whether the group‐based social skills training SOSTA‐FRA would elicit changes in neurophysiological correlates of social perception in high‐functioning ASD individuals aged 8–17 years. Event‐related potentials (ERPs) of a facial emotion recognition (FER) and a biological motion perception task were examined. ERPs were compared between a randomized intervention and a treatment as usual group at three time points (baseline, post‐intervention, and at 3 months follow‐up). A reduction of P100 amplitude in the right hemisphere and a trend toward reduced N200 latency in the biological motion task were found after the training only in the intervention group, whereas behavioral performance remained stable. Change in N200 latencies and parent‐rated social responsiveness showed small but statistically nonsignificant correlations. No changes were observed regarding FER. Results indicate that the intervention changed neural correlates of social perception in ASD. Especially neural correlates of biological motion perception, which is an important prerequisite for successful social interaction, were sensitive to change. ERPs of social perception tasks that are impaired in ASD can well be used to objectively measure neural processing improvement by behavioral intervention. Autism Res 2018, 11: 1376–1387. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary It is well known that people with autism spectrum disorder (ASD) process social information differently than other people and that these differences can also be seen in their brain activity. We also know that behavioral therapies, such as group‐based social skills trainings can help people with ASD improve their behavior. But it is unclear how therapy changes social processing in the brain. The aim of our study was therefore to examine how neural processing of social stimuli changed after behavioral intervention. Comparing a group of children and adolescents that received the group‐based social skills training SOSTA‐FRA to a control group we found that the neural processing of human motion became faster and involved less brain resources after the intervention, while behavioral performance remained stable. No changes were seen for the processing of emotional facial expressions. We recommend that future studies should also analyze changes in brain function as well as behavioral changes as a secondary therapy outcome parameter.