Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis

Abstract

Group-based social skills interventions (GSSIs) are widely used for treating social competence among youth with autism spectrum disorder (ASD), but their efficacy is unclear. Previous meta-analysis of the literature on well-designed trials of GSSIs is limited in size and scope, collapsing across highly heterogeneous sources (parents; youths; teachers; observers; behavioral tasks). The current meta-analysis of randomized control trials (RCTs) was conducted to ascertain overall effectiveness of GSSIs and differences by reporting sources. Nineteen RCTs met inclusion criteria. Results show that overall positive aggregate effects were medium (g = 0.51, p < 0.001). Effects were large for self-report (g = 0.92, p < 0.001), medium for task-based measures (g = 0.58, p < 0.001), small for parent- and observer-report (g = 0.47 and 0.40, respectively, p < 0.001), and nonsignificant for teacher-report (p = 0.11). Moderation analyses of self-report revealed the effect was wholly attributable to youth reporting that they learned about skilled social behaviors (social knowledge; g = 1.15, p < 0.01), but not that they enacted them (social performance; g = 0.28, p = 0.31). Social skills interventions presently appear modestly effective for youth with ASD, but may not generalize to school settings or self-reported social behavior.

Defining behavioral components of social functioning in adults with autism spectrum disorder as targets for treatment

“…However, concerns have been raised about the generalizability of social skills training in a clinical setting to daily functioning in the community. Increased focus on practicing social skills in various contexts and community settings (“programming for generalization”) may maximize the impact of social skills training on real-world functioning (Gates, Kang, & Lerner, 2017). …”

Psychometric Evaluation of Social Cognitive Measures for Adults with Autism

“…In schizophrenia, poor social cognitive ability predicts social skills and daily living skill ability, suggesting social cognition is an important area to target in treatments [Pinkham, Harvey, & Penn, ]. Social cognitive challenges may also relate to difficulties with social functioning for adults with ASD [Sasson et al, ], but training programs developed to target social cognition in ASD have shown inconsistent effects [Bishop‐Fitzpatrick, Minshew, & Eack, ] and often result in only modest improvements that do not generalize well to real‐world functioning [Gates, Kang, & Lerner, ]. The inconsistency and limited efficacy of these programs may occur in part because of the variable ways social cognition is operationalized and measured across treatment and research studies with ASD adults [Kliemann & Adolphs, ].…”

Social cognition as a predictor of functional and social skills in autistic adults without intellectual disability

“…Because autistic adults without intellectual disability often perform poorly on measures of social cognition [Morrison et al, 2019;Velikonja, Fett, & Velthorst, 2019], including in the areas of social attention [Pelphrey et al, 2002;Sasson et al, 2007], affect recognition [Eack, Mazefsky, & Minshew, 2015], and advanced theory of mind [Baron-Cohen, Jolliffe, Mortimore, & Robertson, 1997], programs often focus on social cognition and explicitly teach strategies for improving performance Kandalaft, Didehbani, Krawczyk, Allen, & Chapman, 2013;Koegel, Ashbaugh, Navab, & Koegel, 2016;Turner-Brown, Perry, Dichter, Bodfish, & Penn, 2008]. Indeed, these programs often do improve performance on specific tasks [Bishop-Fitzpatrick, Minshew, & Eack, 2014;Kandalaft et al, 2013;Koegel et al, 2016], and confer other benefits like increasing knowledge about social skills [Gates, Kang, & Lerner, 2017] and facilitating friendship development when a peer group component is included [Spain & Blainey, 2015]. Unfortunately, such success has largely not generalized to broader real-world improvement in social and functional outcomes [Bottema-Beutel, Park, & Kim, 2018;Gates et al, 2017].…”

“…Indeed, these programs often do improve performance on specific tasks [Bishop-Fitzpatrick, Minshew, & Eack, 2014;Kandalaft et al, 2013;Koegel et al, 2016], and confer other benefits like increasing knowledge about social skills [Gates, Kang, & Lerner, 2017] and facilitating friendship development when a peer group component is included [Spain & Blainey, 2015]. Unfortunately, such success has largely not generalized to broader real-world improvement in social and functional outcomes [Bottema-Beutel, Park, & Kim, 2018;Gates et al, 2017].…”