Social Skills Training for Children and Adolescents With Autism Spectrum Disorder: A Randomized Controlled Trial

Abstract

Social Skills Group Training ("KONTAKT") for Children and Adolescent With High-functioning Autism Spectrum Disorders; https://clinicaltrials.gov/; NCT01854346.

KONTAKT© in Australian Adolescents on the Autism Spectrum: Protocol of a Randomized Control Trial

“…It has been argued that underpinning the core challenges of ASD is a paucity of social understanding (13,14). Social skills training, that is overtly teaching social skills, has been proposed as one means of ameliorating the difficulties of adolescents with ASD (15) with evidence showing a positive impact on social skills (16)(17)(18), anxiety (9,19,20), and family quality of life (21). It is likely that participating in social skills training early in life will lessen and possibly even prevent social difficulties later in life (22).…”

“…While social skills training interventions can be delivered to individuals or groups, the group context has many apparent benefits for adolescents with ASD, including providing an in-vivo and immediate context for practicing learnt skills and the opportunity for positive interactions with peers (7). Social skills group training (SSGT) interventions for adolescents diagnosed with ASD are commonly delivered in small groups of 4 to 9 participants (16,17,20,(23)(24)(25) with intellectual quotients (IQs) of > 70, and led by one to three SSGT facilitators (15,19). Sessions aim to teach a range of skills promoting social communication and interaction skills, covering topics such as emotion recognition, assertion, initiation, interpretation of verbal and non-verbal cues, conflict management, coping strategies, selfcontrol, cooperation, developing and maintaining a relationship, and strategies for handling bullying, rumours and gossip (19,24,26).…”

“…A search of the current literature evaluating SSGTs for adolescents via randomized controlled trials (RCTs), identified a number of design and intervention limitations. Consistent design limitations included small sample sizes (9,(27)(28)(29)(30)(31), failing to employ blinded or external observer-report measurement of dependent variables (17,20,27,29,30,(32)(33)(34)(35), failing to describe the randomization processes (27, 29-31, 33, 34) or employ allocation concealment (17,20,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), limited application of intent-to-treat data analysis (17,(27)(28)(29)(30)(32)(33)(34)(35), a lack of clarity in regard to compliance with the Consolidated Standards of Reporting Trials (CONSORT) statement (20,27,29,30,35,36), and limited examples of mixed methods studies integrating quantitative and qualitative data collection methods and analysis in understanding the outcomes of interventions (17) (Additional fil...…”

“…A range of identified intervention shortcomings included limited consideration or incorporation of adolescents' personal goals (20, 27-31, 33, 34, 36), outcomes largely measured by parent proxy report (17,28,29,31,32,35,36), inadequate tailoring of interventions to individual activity preferences (20,29,30,(33)(34)(35)(36), failing to consider the relationship between intervention dosage (that is the number of sessions) and outcomes (20,(27)(28)(29)(30)(31)(33)(34)(35)(36), the absence of cost analysis (17,20,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) and limited reporting of adverse events during the intervention period (20, 27-30, 32-34, 36) (Additional file 1). While comparison groups varied considerably, most examined the efficacy of SSGT interventions relative to usual care waitlist control groups, with limited description of what interventions and therapies were received by comparison groups.…”

“…The perceived benefits of SSGT interventions from the perspective of the adolescents themselves in achieving their personally meaningful social goals has yet to be rigorously evaluated. While it is likely that researchers have been reluctant to focus on adolescent determined personally meaningful outcomes, given the inherent difficulty adolescents with ASD experience in self-reporting their own and perceiving other's emotional states (37,38), there is a clear over reliance on parent proxy reports in research evaluating the efficacy of SSGT programs (9,17,24,35). This is of particular concern given the level of discrepancy between adolescent self-report and parent proxy report ratings in the domains of emotional and social functioning (39).…”