1. PSYCHOSOCIAL TREATMENT EFFECTS OF THE PEERS SOCIAL SKILLS INTERVENTION FOR YOUNG ADULTS WITH AUTISM SPECTRUM DISORDERS Alexander Gantman, Steven K. Kapp, Kaely Orenski & Elizabeth A. Laugeson UCLA Semel Institute for Neuroscience and Human Behavior Conflict of Interest: The authors have been funded by NIH T32 (MH17140, Leuchter PI) and Organization for Autism Research (20093336, Gantman PI) Research on Autism Spectrum Disorders (ASD) has been extensive in the child and adolescent literature. Difficulties in social skills acquisition and generalization are often the most significant challenges for both children and adults with ASD. Among young adults, social deficits can lead to significant impairment in daily living, vocational skills, and social relationships (Klin & Volkmar, 2003; Roy, 2009) and psychological well being (Hofvander, 2009). Such deficits may also lead to symptoms of depression, anxiety, and/or behavior disorders (Barnhill, 200; Hofvander, 2009). Despite all we know about these deficits and symptom clusters, there is a tremendous void in the treatment research which encompasses transitional youth and young adults with ASD. Only a few studies have examined the difficulties these young adults endure during this highly socially, emotionally, and physically demanding period of their lives; yet, research suggests that the effects of social deficits are greatest in adolescence and young adulthood (Tantam, 1991). This period encompasses school transition, finding employment, building a social network, increasing contributions to household responsibilities, greater involvement in the community, and the development of romantic relationships. Research reveals that only about 15 percent of adults with ASD have friendships with shared enjoyment, and even fewer adults are married (Howlin et al., 2004; Hofvadner, 2009). It is suggested that lack of social skills in young adults with ASD may lead to more isolation and thus a lack of personal and romantic relationships, vocational difficulties, and increased psychopathology, such as higher rates of depression and generalized anxiety (Hofvadner, 2009), possibly due to higher rates of victimization. Numerous studies have shown that social skills are an important factor in long term adjustment of individuals with ASD. Consequently, improving social functioning in young adults with ASD would be expected to also have a positive impact on the psychosocial functioning of these individuals. However, to date there do not appear to be any evidence-based treatment interventions focused on improving social skills for young adults with ASD. The purpose of the current study was to investigate the effectiveness of a caregiver-assisted social skills intervention for young adults with ASD. Conversational skills Nonverbal communication Electronic communication Entering and exiting conversations Appropriate use of humor Choosing appropriate peer groups The purpose of this study was to investigate the effectiveness of PEERS for Young Adults, a 14-week caregiver-assisted social skills training program for transitional youth between 18-23 years of age with Asperger’s Disorder, High Functioning Autism or Pervasive Developmental Disorder NOS. The intervention was adapted for use with transitional youth from a pre-existing evidence-based social skills intervention known as PEERS (Program for the Education and Enrichment of Relational Skills), developed at UCLA by Laugeson & Frankel (2010). The study used a randomized delayed treatment control group design. The intervention consisted of fourteen 90-minute sessions, delivered once a week over the course of 14-weeks at The Help Group community mental health agency. Young adults with ASD attended small group sessions with other peers with similar social delays. Caregivers attended separate concurrent sessions that instructed them on key features of the young adult intervention and methods for supporting the development of skill acquisition through social coaching. Ecologically valid skills were taught through didactic instruction, role-playing, behavioral rehearsal with performance feedback, and weekly caregiver-assisted socialization homework assignments. The project assessed outcomes at pre- and post-test looking at caregiver-reported social skills, social skills knowledge, social responsiveness, empathy, frequency of social get-togethers, and family/friendship/romantic loneliness. Findings suggest that the use of PEERS for Young Adults, a caregiver-assisted manualized social skills intervention for young adults with ASD, is effective in improving social skills. An overall improvement in social skills was reported by caregivers in the treatment group as compared to the delayed controls. Results from caregiver reports also suggest that young adults’ social responsivity significantly increased and socially relevant ASD symptoms significantly decreased by the end of the treatment. Similarly, empathic abilities and emotional awareness, which are thought to function as a marker of ASD symptoms, improved at the end of treatment. Social skills knowledge as well as the frequency of invited and hosted get-togethers significantly improved. Finally, young adults reported a significant decrease in loneliness as a result of the intervention. Thus, PEERS for Young Adults appears to be effective in improving social skills and the development of social relationships; a much needed intervention for young adults with ASD. References: Barnhill, G. P. (2001). Social attribution and depression in adolescents with Asperger Syndrome. Focus on Autism and other Developmental Disabilities, 16, 46–54. Hofvander, B., Delorme, R., Chaste, P., Nyde´n, A., Wentz, E., Stahlberg, O., et al. (2009). Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry, 9, 1-9. Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome in children with Autism. Journal of Child Psychology and Psychiatry, 45, 212–29. Klin, A., & Volkmar, F., R. (2003). Asperger Syndrome: Diagnosis and external validity. Child and Adolescent Clinics of North America, 12(1), 1-13. Laugeson, E.A. & Frankel, F. (2010). Social skills training for teenagers with developmental and autism spectrum disorders: The PEERS Treatment Manual. New York, NY: Routledge. Tantam, D. (1991). Asperger’s syndrome in adulthood. In U. Frith (Ed.) Autism and Asperger syndrome pp.147–83). Cambridge: Cambridge University Press. Inclusion criteria for this study were that all young adults must: 1) Be between 18 to 23 years of age. 2) Have an IQ Composite on the K-BIT-2 > 70. 3) Have a previous diagnosis of autism, Asperger's Disorder or PDD-NOS. 4) Have social deficits as defined by a Vineland Adaptive Behavior Scale – Second Edition (VABS-II) Socialization Standard Score below 1 SD (< 85). 5) Be fluent in English. 6) Have a caretaker who is a fluent English speaker and who is willing to participate in the study. Exclusion criteria for this study were that young adults could not have a: 1) History of a diagnosis of major mental illness (e.g., schizophrenia, bipolar disorder). 2) Physical disability or a medical condition that would prevent them from participating in the group. BACKGROUND PARTICIPANTS STUDY DESIGN OVERVIEW OF TREATMENT RESULTS DISCUSSION Having successful get-togethers Being a good sport Handling teasing and bullying Handling disagreements Handling peer pressure Dating etiquette MEASURES Caregiver Measures: Social Skills Rating System (SSRS) Social Responsiveness Scale (SRS) Empathy Quotient (EQ) Quality of Socialization Questionnaire (QSQ) Young Adult Measures: Test of Young Adult Social Skills Knowledge (TYASSK) Social and Emotional Loneliness Scale for Adults (SELSA) Difficulties in Emotion Regulation Scale (DERS)