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Predicting Treatment Outcomes of a Teacher-Facilitated Social Skills Intervention for Adolescents with Autism: The School-Based UCLA PEERS Program Mary Goodarzi, Yasamine Bolourian, Lindsay Henry, Ruth Ellingsen, Lara Tucci, Shannon Bates, and Elizabeth Laugeson
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Predicting Treatment Outcomes of a Teacher-Facilitated Social Skills Intervention for Adolescents with Autism: The School-Based UCLA PEERS Program Mary Goodarzi, Yasamine Bolourian, Lindsay Henry, Ruth Ellingsen, Lara Tucci, Shannon Bates, and Elizabeth Laugeson UCLA Semel Institute for Neuroscience and Human Behavior The Help Group- UCLA Autism Research Alliance Funded by the Nathan and Lily Shapell Foundation BACKGROUND RESULTS MEASURES • Adolescents with Autism Spectrum Disorders (ASD) present with an array of social deficits including poor social communication, poor social cognition, and difficulty developing and maintaining meaningful relationships (Reichow & Volkmar, 2010). • Social skills training during adolescence is critical, yet few evidence-based programs exist (White, Koenig, Scahill, 2007). • PEERS (Laugeson & Frankel, 2010) is one of the few empirically supported social skills intervention for high-functioning teenagers with ASD using parent-mediated strategies (Laugeson et al., 2009; Laugeson et al., 2011). • Although parental involvement in social skills training has established efficacy, not all parents are able to participate in treatment. Therefore, providing social skills instruction in the classroom may prove to be a more inclusive approach. • While PEERS has demonstrated efficacy in improving social skills using parent-mediated methods, the effectiveness of PEERS in the classroom using teacher-facilitation is unknown. • The current study seeks to identify factors associated with predicting positive treatment outcomes using a school-based teacher-facilitated PEERS intervention in the classroom. Social Cognition, Social Responsiveness, & Social Communication before PEERS • Outcome data was collected at pre- and post-treatment to include: • Social Responsiveness Scale- Teacher Report (SRS-T: Constanino & Gruber, 2005) • Social Skills Rating System- Teacher Report (SSRS-T: Gresham & Elliot, 1990) STRUCTURE OF THE SESSIONS • Day One: Teens report on the results of their homework assignment from the previous week, while teachers troubleshoot any problems that may have arisen. • Day Two: Teacher facilitated didactic presentation, which includes role-playing demonstrations of the targeted social skills. • Day Three: Review of previously learned social skill with a role-playing demonstration, followed by a behavioral rehearsal with performance feedback and coaching from teachers and teaching assistants, concluding with a homework assignment to generalize the skill outside of the classroom setting. • Days Four and Five: Socialization activities are conducted in which • the teens practice the skills taught during the didactic lesson in a • more naturalistic environment, while receiving performance feedback • through coaching. • Improvement in social skills was measured by calculating the difference between pre-and post-intervention Social Skills Total Scores on the SSRS-T. • Baseline scores on the SRS-T reflecting better Social Cognition predict improvement in social skills on the SSRS-T (p<.05). • Baseline scores on the SRS-T reflecting better Social Responsiveness and Social Communication predicted improvement in social skills at a trend level on the SSRS-T (p<.10). DISCUSSION • According to teacher-report, teens exhibiting greater impairment in social cognition pre-intervention demonstrated greater improvement in their social functioning at the end of treatment. • Teacher-reports also suggest teens exhibiting greater impairment in overall social responsiveness and social communication prior to treatment, may demonstrate greater improvement in their social functioning post-intervention. • Teacher-reports of teen social awareness, social motivation, and autistic mannerisms did not predict change in social skills post-treatment. PARTICIPANTS • Participants were recruited from The Help Group Village Glen Middle School, a nonpublic school for adolescents with ASD: • N=73 middle school students diagnosed with ASD • Grade: M=8th grade; SD=0.50; Range=7th to 8th grade • Age: M=12; SD=0.67; Range=12 to 14 years of age • Gender: 90% male, 10% female • Ethnicity: Caucasian 69% (n=50); Hispanic 14% (n=10); African American 5% (n=4); Asian American 4% (n=3); Middle Eastern 4% (n=3); Other 4% (n=3) DESCRIPTION OF SOCIAL SKILLS LESSONS • How to use appropriate conversational skills • How to find common interests by trading information • How to appropriately use electronic communication • How to appropriately use humor • How to choose appropriate friends • How to enter and exit conversations between peers • How to be a good host during get-togethers • How to be a good sport • How to handle rejection, teasing, and physical bullying • How to handle arguments and disagreements • How to handle rumors and gossip • How to change a bad reputation REFERENCES Constantino, J. & Gruber, C. (2005). Social Responsiveness Scale. Western Psychological Services: Torrance, CA. Gresham, F.M. & Elliott, S.N. (1990). Social Skills Rating System. American Guidance Service: Circle Pines, MN. Laugeson, E.& Frankel, F.(2010).Social Skills for Teenagers with Developmental and Autism Spectrum Disorders: The PEERS Treatment Manual. New York: Brunner-Routledge. Laugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2009). Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 596-606. Laugeson, E. A., Frankel, F., Gantman, A., Dillon, A. R., & Mogil, C. (2011). Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program. Journal of Autism and Developmental Disorders. Advance online publication. DOI: 10.1007/s10803-011-1339-1. Reichow, B. & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40, 149-166. White, S. W., Keonig, K., & Scahill, L. (2007). Social skills development in children with autism spectrum disorders: A review of the intervention research. Journal of Autism and Developmental Disorders, 37, 1858-1868. METHODS • The PEERS Treatment Manual was adapted for the classroom setting to incorporate teachers as facilitators of the lessons. • Teachers and Teaching Assistants were trained on the PEERS curriculum and received weekly supervision from research staff. • The curriculum was implemented over one school semester. • 14 social skills lessons were conducted daily in classrooms for 30 minutes at a time. • Predictors of treatment outcome were examined using standardized measures of social functioning. For additional information please contact: Mary Goodarzi at peersclinic@ucla.edu or (310) 26-PEERS Visit the PEERS website at www.semel.ucla.edu/peers