Parent-Assisted Social Skills Training to Improve Friendships in Teens with Autism Spectrum Disorders Laugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2008) Powered by www.RedOffice.com

Background Inclusion Increase social interaction complexity* Decrease nonsocial activity* Lonelier, poor quality friendships** Isolation, rejection, bullying*** (*Sigman & Ruskin, 1999; **Capps et al., 1996; **Bauminger &Kasari, 2000, *** Tse et al., 2007)

Background Typical Teens vs. Teens with ASDs Typical Teens: Best Friends By 4th grade* Aids resilience to life events** Aids self esteem*** Aids social competence & social problem solving**** Neg correlated with anxiety and depression*** Teens with ASDs Missing out on these experiences Need extra support and instruction (*Fankel, 1996; *McGuire & Weisz, 1982; **Miller & Ingham, 1976; ***Buhrmester, 1990, ****Nelson & Aboud, 1985)

Background Previous Research Exceptions: Mostly children Lower functioning range Not formally tested (social competence) Exceptions: Ozonoff and Miller (1995) Tse et al (2007) Ozonoff and Miller HFA adolescents basic interactional and conversational skills; infer mental states Tse & colleaues 13-18 year olds; no control group

Out-Patient Social Skills Program PEERS intervention content Adapted from Children's Friendship Training Evidence base: ADHD, Fetal Alcohol Spectrum, children with ASD (Frankel & Myatt, 2003), (O'Connor et. al., 2006), (Frankel & Myatt, 2007)Small Group Format Small Group Format Parent instruction Separate concurrent sessions

Current Study PEERS intervention content: Evidence base practices Didactic instruction, role playing, modeling, behavioral rehearsal, coaching with performance feedback, weekly socialization assignments with consistent homework review Social etiquette Social situations with accompanying rules & steps Teens provided instruction in steps Parents provided information to supervise

Targeted Skills Conversation Peer entry and exit Friendship networks Expanding & developing Bullying, teasing, arguments Good sportsmanship Good host Changing reputations

Participants Teens (n = 33) 13-17 years of age, mean 14.6 Male (28), Female (5) Diagnosis of ASD HFA, Asperger's, PDD-NOS Caucasian (14), Hispanic/Latino (6), African American (3), Asian (4), Middle Eastern (3), Mixed ethnicity (3) Regular Ed (17), Special Ed (8), Pull out (2), Home-school (3), other Ed (3). Participants were randomly assigned to either the Treatment or the Delayed Treatment Group

Outcome Measures Test of Adolescent Social Skills Knowledge TASSK Teen 22 items, Sentence stems with 2 choices Knowledge of teen social skills (TASSK; Laugeson and Frankel, 2006) Friendship Qualities Scale 23 yes/no questions regarding their best friend(ship) (FQS; Bukowski et al, 1994)

TASSK Example Items The goal of a conversation is to Make the other person like you Find common interests One of the rules for having a two way conversation is To be an interviewer Do not be an interviewer If you try to join a conversation and the people ignore you: Move on Speak louder so they can hear you

Friendship Qualities Scale Yes / No Questions Think of Best Friend My friend and I spend all of our free time together

Outcome Measures Social Skills Rating Scale Parent & Teacher 38 item questionnaire, never, sometimes, very often Social skills scale, problem behavior scale (SSRS: Gresham and Elliott, 1990) The Quality of Play Questionnaire Parent & Teen 12 item questionnaire, frequency of get-togethers & conflict Hosted & invited get-togethers (QPQ; Frankel and Mintz, 2008)

SSRS Info and Sample Items Social Skills Cooperation Follows your direction Assertion Invites others to join in activities Responsibility Requests permission before leaving the house Self Control Responds appropriately when pushed or hit Problem Behaviors Externalizing Fights with others Internalizing Is easily embarrassed Hyperactivity Acts impulsively ** Likert Never Sometimes Always

The Quality of Play Questionnaire Frequency of play dates Number of Dates invited vs. hosted Level of conflict Criticized or teased each other

Treatment Completely manualized & delivered over 12 weeks Students Reciprocity in conversation Diminishing importance of rejecting peer group Reversing negative reputations Instruction to promote get-togethers Competence with teasing, bullying, conflicts Didactic lessons Modeling, Role-playing, Performance feedback Homework assigned

Treatment Parents Teen and Parents reunited Review of homework assignments Troubleshoot homework problems Instruction to help teen overcome homework problems Teen and Parents reunited Teens deliver review for parents Homework finalized

Quick Recap Random Assignment Treatment & Delayed Treatment Group Demographic information gathered Pre-test outcome measures gathered Teens, Parents, Teachers Treatment Post-test outcome measures gathered

Results Non-Significant Differences at Baseline Between Treatment Group and Delayed Treatment Groups

Results Statistically Significant scores for Pre and Post- test outcome variables for Treatment and Delayed Treatment

Discussion Findings Limitations Knowledge of social etiquette Hosted get-togethers Quality of friendships Parent report of overall social skills Limitations Bias in Parent Report? Increase Teacher report Need Maintenance Data Would have liked ADOS or ADI-R SSRS not designed for ASD

Thank you ! TA McDonald Integrated Autism Education, Treatment, and Leadership Wendy Machalicek Colleen Moore