Making the Connection: Randomized Controlled Trial of Social Skills at School for Children with Autism Spectrum Disorders
Reviewed by: Katelyn Selver, Rutgers University
Kasari, C., Rotheram-Fuller, E., Locke, J., & Gulsrud, A. (2012). Making the connection: Randomized controlled trial of social skills at school for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 53, 431-439.
Why research this topic?
The development and maintenance of peer relationships are important parts of a child’s success in academic and social environments. Individuals with ASD often have difficulty developing strong relationships with their peers due to their social skills deficits. Researchers have sought to develop interventions to teach individuals with autism to interact appropriately with their peers. Some models emphasize a peer-mediated approach, while other approaches involve direct social skills training and instruction either in a group or individual setting. Although social skills intervention has empirical and theoretical support, research has yet to directly compare the efficacy of different approaches to social skills training.
The present study compared two interventions for improving the social skills of high functioning children with autism spectrum disorders in general education classrooms. One intervention involved a peer-mediated approach (PEER) and the other involved a child-assisted approach (CHILD).
What did the researchers do?
The authors randomized 60 participants (6 females, 54 males), all with an autism diagnosis, to two levels of treatment. Thirty students were randomized to receive the CHILD intervention and 30 were randomized to receive the PEER intervention. Within these levels, 15 students were randomized to receive no treatment and 15 were randomized to receive both treatments. All interventions took place in children’s public schools.
Those participants who were randomized to the CHILD condition met with interventionists twice a week for 20-minute sessions for six weeks. The intervention began by identifying social skills to target. Once these skills were identified, instructors used didactic instruction and role-playing to teach the target skills. PEER interventionists aimed to increase appropriate and meaningful social interaction by teaching typical peers to interact with children with autism. Three typically developing children from the target child’s classroom were taught strategies for engaging individuals with social difficulties on the playground. Peer groups met for a total of 12, 20-minute sessions over a span of six weeks (2x per week). Typically developing peers were taught how to identify isolated children and engage them and how to lend social support via direct instruction, modeling, role-playing, and rehearsal. The authors measured the students’ prominence within their classroom social network, behavioral observation, and teacher perception of social skills to evaluate the effectiveness of intervention.
What did the researchers find?
Overall, results indicated that participants who received both the CHILD and the PEER interventions made the greatest gain in social network salience (SNS) with a large effect size. However, it seemed that the PEER intervention caused greater movement than the CHILD intervention toward a central role in the classroom social network in a shorter time period and that this improvement was maintained at the 12-week follow up. Participants assigned to the peer mediated intervention were more involved with their peers on the playground and scored higher on measures of teacher perception of social skills.
What do the results mean?
These results suggest that social skills interventions can be delivered effectively in public schools and with the involvement of typically developing models. The authors suggest that these school-based, peer-mediated interventions may be preferable to the two of the most common alternatives: conducting social skills training off-site (in a clinic setting) or assigning a one-to one aide to support students at school. Currently, the most common social skills interventions are one-to-one instruction with an adult and child-mediated. These results suggest that children may not generalize the social skills they learn in a one-on-one context with an adult to interactions with their peers. Several points are worth noting in regards to these findings. Reciprocal friendship ratings did not change from baseline to post-treatment. Although children exposed to the PEER mediated intervention were more likely to be nominated as a friend by their classmates after treatment, the participants themselves were unlikely to nominate their peers as friends. A similar phenomenon was observed when examining engagement on the playground. Although individuals randomized to the PEER intervention were less likely to engage in solitary play and more likely to be involved with their peers, no such gains were seen in students receiving the CHILD intervention alone. Both of these findings suggest that reciprocal friendships and playground engagement may be more complex skills that require a more intensive and specific intervention. However, the study indicates that short-term interventions can help children with autism join peer networks.
Selver, K. (2014). Research Synopsis of Kasari et al. (2012), Making the connection: Randomized controlled trial of social skills at school for children with Autism Spectrum Disorders. Science in Autism Treatment, 11(4), pp. 22-23