Randomized Clinical Trial Replication of a Psychosocial Treatment for Children with High‐Functioning Autism Spectrum Disorders

Abstract

This replication randomized clinical trial examined the efficacy of a comprehensive psychosocial intervention for children aged 7 to 12 years with high‐functioning autism spectrum disorders (HFASDs). Participants were randomly assigned to treatment or wait‐list conditions. Treatment included instruction and therapeutic activities targeting social skills, face‐emotion recognition, interest expansion, and interpretation of non‐literal language. A response‐cost program was used to reduce problem behaviors and increase skills acquisition. Significant treatment effects were found for five of seven primary outcome measures (parent ratings and direct child measures). Secondary measures (i.e., staff ratings) corroborated gains reported by parents. Children maintained social gains 2 to 3 months post‐treatment. High levels of parent, child, and staff satisfaction were found, along with high levels of treatment fidelity. Standardized effect size estimates were predominantly in the medium and large ranges for significant outcome variables.

RCT examining the effect of treatment intensity for a psychosocial treatment for high-functioning children with ASD

“…These fidelity and satisfaction ratings were consistent with prior studies of summerMAX (Lopata et al, 2010;Thomeer et al, 2012) and suggested that reducing treatment intensity did not affect program feasibility. For staff clinicians, this finding was particularly important as staff effort toward accurate treatment implementation can be affected by their perception of the protocol (Bellini, Peters, Benner, & Hopf, 2007).…”

“…The lack of significant improvement on the DANVA-2 Child Faces test is similar to the previous RCTs of the summerMAX program. The inconsistent and weak effects on the DANVA-2 in this and prior studies of the summerMAX program (Lopata et al, 2008(Lopata et al, , 2010Thomeer et al, 2012) may indicate poor measure sensitivity or a reduced treatment effect on decoding skills. Ongoing research may benefit from examination of alternate measures of decoding skills and/or a modification of the face-emotion decoding treatment component of the Standards for v 2 : small = .01, medium = .08, and large = .18 (Cumming, 2012).…”

“…Fidelity of implementation was high (!94%), as were parent, child, and staff satisfaction ratings. In the replication RCT (Thomeer et al, 2012) summerMAX was assessed with 35 new children, ages 7-12 years with HFASD randomly assigned to the treatment or waitlist control. At posttest, five of the seven primary outcome measures were significant and favored the treatment group (i.e., child skills in interpreting non-literal language and knowledge of target skills; and parent ratings of target social skills, ASD symptoms, and broad social skills).…”

RCT of mind reading as a component of a psychosocial treatment for high-functioning children with ASD

“…are used to increase skills acquisition and reduce ASD symptoms and behavior problems, and weekly parent training is provided (see Section 2.3). Five studies have evaluated the efficacy of the program including two RCTs (for a summary of the treatment trials, see Lopata et al, 2013 also Thomeer et al, 2012). These studies have consistently found the treatment produced significant gains in the children's social cognition (i.e., knowledge of social responses and component steps for targeted skills) and understanding of non-literal language, and in parent and staff ratings of targeted social skills, ASD symptoms, and broader social skills.…”

A Systematic Review of Social Communication and Interaction Interventions for Patients with Autism Spectrum Disorder

“…Our search identified two additional trials of comparable interventions (52,53), which were published after the final search in the review by Reichow and colleagues (11). In a trial from the United States (52), a total of 35 children were randomized to social skills group training or to being waitlisted.…”