1. Reliability & Validity Objectives & Hypotheses
Pilot study of a peer-enacted role play measure of social skills for adolescents with high-functioning autism and Asperger syndrome
Author(s): A. B. Ratto1, D. L. Penn1, L. Turner-Brown2 and G. B. Mesibov3
UNC-Chapel Hill, Chapel Hill, NC: (1)Department of Psychology,(2)Neurodevelopmental Disorders Research Center (3)Psychiatry
Results
Introduction
Participants
Reliability & Validity
Social skills have been identified as a high priority target of treatment and research among adolescents with high-functioning autism (HFA) and Asperger’s syndrome (AS) (Krasny, Williams, Provencal, & Ozonoff, 2003). While numerous social skills interventions have been developed for this population, the development of externally valid social skills assessment measures has not proceeded at the same pace (Matson & Wilkins, 2007). During adolescence, social interactions become more difficult for individuals with HFA/AS as the social context shifts to an emphasis on casual conversations (Paul, 2003). One of the most critical skills in successful conversation is responding appropriately to verbal and nonverbal social cues (Turkstra, Ciccia, & Seaton, 2003). Role play measures allow for direct assessment of these critical social interaction skills. While role play measures have been successfully utilized to assess social skills in several clinical adolescent populations, a systematic role play measure of social skills has not been developed for ASD.
Change in CASS Total Score Across Context
Participant Perception of Social Interest
Participants were recruited from a social cognition intervention study for HFA/AS and from undergraduate psychology students at UNC-Chapel Hill.
Additional analyses were undertaken to examine the reliability and validity properties of the CASS. High inter-rater reliability was found, with an intraclass correlation (ICC) value of .81. The CASS also showed adequate internal consistency (α=.75). Pearson correlations were used to evaluate convergent and discriminant validity. Performance on the CASS was significantly positively correlated with both verbal IQ (r=.32, p<.04) and theory of mind (r=.47, p<.002) and unrelated to performance IQ (r=.006, ns).
Perceived Interest
Control
HFA/AS
Gender
M: 17 (85%)
F: 3 (15%)
Ethnicity
White: 18
Latino: 1
Asian: 1
Age
19.9 (1.2)
17.9 (1.4)*
Verbal IQ
115.8 (9.8)
109.1 (16.31)
Social Engagement
*Significant interaction effect: p<.006
Both groups accurately perceived that the confederate was less interested in the bored context, though the HFA/AS group was slightly impaired relative to typical controls.
*Significant interaction effect: p<.04. CASS scores reported as z-scores.
Typical participants responded appropriately to the bored context by increasing their engagement in the conversation, while participants with HFA/AS decreased their engagement in response to boredom.
*p<.0005
Conclusions
Methods
Measures
Cognitive ability: Wechsler Abbreviated Scales of Intelligence (WASI) (Wechsler, 1999)
Theory of Mind: The Awareness of Social Inference Test (TASIT) (McDonald, Flanagan, Rollins, & Kinch, 2003)
Piloted Measure
The Contextual Assessment of Social Skills (CASS)
Two semi-structured role play conversations enacted with two different confederates, creating 2 distinct contexts
Context 1: Interest
Context 2: Boredom
Following each role play, participants completed the Conversation Rating Scale, a Likert-scale rating of the participant’s perception of the confederate’s level of interest in the conversation
Behavioral Coding: Trained coders rated the participants’ social engagement behaviors in each role play. The level of change in participants’ social engagement behaviors across role plays were compared across groups. Specific behaviors included:
Questions
Topic Changes
Conversational Involvement
Quality of Rapport
These behaviors were summed and converted to a z-score to calculate the CASS Total Score, measuring social engagement.
The results of this pilot study indicate that the CASS has the potential to serve as a reliable and externally valid measure of social functioning for adolescents with HFA/AS. Interestingly, participants with HFA/AS seemed to have relatively intact social perception skills, but did not demonstrate appropriate changes in social behavior in response to changes in social context. The CASS may be useful in research investigating the link between social cognition and social behavior in HFA/AS.
Number of Questions Asked by Participant
Number of Topic Changes by Participant
Objectives & Hypotheses
The primary objective of this study was to pilot the Contextual Assessment of Social Skills (CASS), a peer-enacted role play measure of social skills for adolescents with HFA /AS, focused on the ability to respond appropriately to verbal and nonverbal social cues.
Hypothesis 1. Participants with HFA/AS will be impaired in the ability to perceive a change in social context, namely boredom, relative to typical controls.
Hypothesis 2. Typical participants will increase their social engagement in the conversation in response to boredom through increased questions, topic changes, and involvement, and will also show decreases in conversational rapport. The HFA/AS group will show minimal or no appropriate changes in behavior in response to boredom.
Literature Cited
*Interaction effect approached significance (p<.09)
Questions reported as raw score
*Interaction effect nonsignificant
Topic changes reported as raw score
Krasny, L., Williams, B. J., Provencal, S., & Ozonoff, S. (2003).
Social skills interventions for the autism spectrum: Essential
ingredients and a model curriculum. Child and Adolescent
Psychiatric Clinics of North America, 12,
Matson, J.L. & Wilkins, J. (2007). A critical review of assessment
targets and methods for social skills excesses and deficits for
children with autism spectrum disorders. Research in Autism
Spectrum Disorders, 1,
McDonald, S., Flanagan, S., Rollins, J., & Kinch, J. (2003). TASIT: A
new clinical tool for assessing social perception after traumatic
brain injury. Journal of Head Trauma Rehabilitation, 18,
Paul, R. (2003). Promoting social communication in high functioning
individuals with autistic spectrum disorders. Child and Adolescent
Psychiatric Clinics of North America, 12,
Turkstra, L.S., Dixon, T.M., Baker, K.K. (2004). Theory of mind and
social beliefs in adolescents with traumatic brain injury.
Neurorehabilitation, 19,
Wechsler, D. (1999). Manual for the Wechsler Abbreviated Scales of
Intelligence. San Antonio, TX: Psychological Corporation.
Conversational Involvement
Quality of Rapport
Acknowledgements
The collaboration of the Social Cognition Interaction Training for Adolescents with Autism (SCIT-A) study, conducted by D.L. Penn & L. Turner-Brown, is greatly appreciated. The study was funded in part by a grant from Autism Speaks, through collaboration with the SCIT-A study.
*Interaction effect nonsignificant
Conversational involvement report as Likert rating (Scale: 1 low – 7 high)
*Interaction effect significant (p<.001)
Conversational involvement report as Likert rating (Scale: 1 low – 7 high)
Note: All above analyses conducted using simultaneous linear regression.
Conflict of Interest: None