Improving Social Skills in Adolescents with Autism Spectrum Disorders:

1. Improving Social Skills in Adolescents with Autism Spectrum Disorders: The Adaptation of the UCLA PEERS Program into a School-Based Teacher-Assisted Intervention Ruth Ellingsen, Elizabeth Laugeson, Psy.D., Jennifer Sanderson, M.S., Jin Lee, M.A., Amanda Lenvin, Jennifer McNamara, M.A., and Fred Frankel, Ph.D., ABPP UCLA Semel Institute for Neuroscience & Human Behavior Funded by the Nathan and Lily Shapell Foundation, Friends of the Semel Institute, and the Semel Scholar Award (Laugeson, PI) Study Design Background Benefits of School Setting PEERS Curriculum • Social skills are taught in a naturalistic setting. • Teens are familiar with the setting, which enhances overall comfort. • Teens are exposed to peers with similar interests who attend their school. Thus, the teens’ social networks in the school environment are further developed. • Provides the opportunity for repetition of instruction from teachers through the use of teachable moments. • Further promotes generalization of skills to the school environment. Week 1: Conversation Skills I: Trading Information Week 2: Conversation Skills II: Two-Way Conversations Week 3: Electronic Communication Week 4: Choosing Appropriate Friends Week 5: Peer Entry Strategies Week 6: Peer Exit Strategies Week 7: Get-Togethers (Being a Good Host or Guest) Week 8: Good Sportsmanship Week 9: Handling Teasing and Embarrassing Feedback Week 10: Handling Bullying and Bad Reputations Week 11: Handling Arguments and Disagreements Week 12: Graduation • Teens with Autism Spectrum Disorders (ASD) typically display deficits in social skills, committing infractions of rules of social etiquette that often lead to negative reputations, peer rejection, social isolation, withdrawal, and loneliness. • Very few social skills intervention studies have taken place in the classroom, arguably one of the more naturalistic social settings of all. Previous studies have also typically failed to include teachers as interventionists, perhaps underutilizing the powerful impact of school-based treatment. • Previous research indicates that UCLA’s Program for the Education and Enrichment of Relational Skills (PEERS) results in the improvement of social functioning in teens with ASD (Laugeson et al., 2009). • More specifically, teens who completed the PEERS intervention demonstrated significant improvement in overall social skills, enhanced knowledge of social etiquette, hosted significantly more get-togethers, and endorsed better quality of friendships post-treatment. • This research is being conducted under the auspices ofThe Help Group – UCLA Autism Research Alliance. • Participants recruited from six middle school and high school classrooms at the Village Glen School, a nonpublic school serving adolescents with ASD. • Teachers randomly assigned to the treatment (PEERS) or active treatment control condition. • Teachers in the treatment condition (PEERS) trained and supervised in the intervention. • All participants receive daily social skills instruction for 30 minutes a day in the classroom. • Active Treatment Control group: Typical Village Glen school-based social skills scope and sequence • Treatment group: Teacher-facilitated PEERS intervention • Pre and post assessment of social functioning measured. Previous Studies References Homework Assignments • Baxter, A. (1997). The power of friendship. Journal on Developmental Disabilities, 5(2), 112-117. • Buhremeister, D. (1990). Intimacy of friendship, interpersonal competence, and adjustment during preadolescence and adolescence. Child Development, 61, 1101-1111. • Gralinski, J. H., & Kopp, C. (1993). Everyday rules for behavior: Mother’s requests to young children. Developmental Psychology, 29, 573-584. • Laugeson, E. A. & Frankel, F. (2006). Program for the Education and Enrichment of Relational Skills (PEERS). Unpublished manuscript, UCLA Semel Institute for Neuroscience and Human Behavior. • Laugeson, E. A., Mogil, C., Dillon, A., Frankel, F. (2009). Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(4), 596-606. • Matson, J. L., Smiroldo, B. B., & Bamburg, J.W. (1998). The relationship of social skills to psychopathology for individuals with severe or profound mental retardation. Journal of Intellectual & Developmental Disability, 23(2), 137-146. • Miller, P. M., & Ingham, J. G. (1976). Friends, confidants, and symptoms. Social Psychiatry, 11, 51-58. • Pfiffner, L. J., & McBurnett, K. (1997). Social skills training with parent generalization: Treatment effects for children with attention deficit disorder. Journal of Consulting and Clinical Psychology, 65(5) 749-757. • Rubin, Z., & Sloman, J. (1984). In: Beyond the Dyad. Lewis, M. ed. New York: Plenum Press, 223-250. • In-group telephone call • Out-of-group telephone call • Practice trading information with parents and peers • Join a new extracurricular activity to expand social network • Practice peer entry into a conversation with a new group of peers • Host and/or attend get-togethers with friends • Practice handling peer rejection when relevant • OVERVIEW OF INTERVENTION: • Key elements of the intervention taught didactically through instruction of simple rules of social etiquette. • Social skills are modeled through role-playing exercises modeled by teachers. • Students rehearse newly learned skills in the classroom, receiving performance feedback from teachers. • Students required to complete weekly in vivo socialization homework assignments to practice skills. • Parents receive weekly handouts to assist with the generalization of skills. Table 1. Mean Pre- and Post-Treatment Scores for Statistically Significant Outcome Variables for Treatment and Delayed Treatment Control Groups (Standard Deviations are in Parentheses). Variable Group_________________________________________________ p Treatment Delayed Treatment Control (n = 17) (n = 16) _________________________ ___________________________ Pre Post Pre Post p < _____________________________________________________________________________________ Teen measures: TASSK 13.3 (2.4) 19.6 (1.4) 12.6 (3.6) 13.3 (3.8) 0.001 QPQ Host 1.1 (1.4) 3.2 (2.2) 0.6 (0.9) 1.1 (1.3) 0.025 FQS 16.8 (3.4) 17.2 (4.0) 18.1 (3.9) 16.6 (4.6) 0.05 Parent measures: SSRS social skills 80.2 (8.8) 89.7 (12.1) 77.9 (12.1) 79.8 (11.7) 0.05 Participants Outcome Measures Contact Information • N = 60 • Treatment group (n = 30) • Active Treatment Control group (n = 30) TEEN MEASURES • Test of Adolescent Social Skills Knowledge • Social Anxiety Scale for Adolescents • Friendship Qualities Scale • Quality of Socialization Questionnaire—Adolescent For additional information please contact: Ruth Ellingsen at Rellingsen@mednet.ucla.edu or visit the Parenting & Children’s Friendship Program website at http://www.semel.ucla.edu/socialskills/ Research Objective Village Glen Demographics 76% male • Examine the effectiveness of a school-based teacher- facilitated social skills intervention for middle school and high school adolescents with ASD. TEACHER MEASURES • Social Skills Rating System—Teacher • Social Responsiveness Scale—Teacher Report PARENT MEASURES • Social Skills Rating System—Parent • Social Responsiveness Scale—Parent Report • Quality of Socialization Questionnaire—Parent