Promoting social skill use and generalization in children with autism spectrum disorder

Social skills training is a frequently utilized intervention for addressing social deficits of children with autism spectrum disorder (ASD). The current study investigated the effects of the Superheroes Social Skills program, a social skills training program consisting of multiple evidence-based practices, in promoting accurate demonstration of target social skills in both a training and generalized setting. Three children with ASD between the ages of 10 and 14 attended 10 social skills training sessions over five weeks, with social skills lessons targeting participation, conversation, perspective taking, and problem solving skills. A multiple probe design across behaviors and replicated across participants was utilized to evaluate accurate demonstration of target social skills. Results suggest improvement in skill accuracy in both the training and generalization settings. Indirect secondary measures of participant social functioning and parental stress were also collected and suggest improvements associated with social skills training.     

A review of treatments for deficits in social skills and self-help skills in autism spectrum disorder

Deficits in social skills and self-help skills present significant challenges for individuals diagnosed with autism spectrum disorders (ASD). Much research in Applied Behavior Analysis (ABA) has been devoted to treatments for deficits in social skills and there exist a number of extensive reviews on the research in this area. Some research has also been conducted in the treatment of self-help skills although no comprehensive reviews of this research have been conducted. A combined acquisition of social and self-help kills is required by individuals diagnosed with ASD for successful independent living in society. The current literature review provides a comprehensive investigation and examination of studies focused on interventions for deficits in social skills or self-help skills in those with ASD. Twenty-two studies that met the inclusion criteria were chosen. Studies were categorised based on intervention. Key studies were defined as studies that added something novel to the literature, rather than replicating previous research. Each study was then evaluated on a number of aspects. All studies showed positive outcomes. Strengths, limitations and future recommendations are discussed.     

A pilot randomised controlled trial of a group based social skills intervention for adults with autism spectrum disorder

BackgroundSocial skills training is commonly used for children and adolescents with ASD. There are few studies considering its efficacy in adults and those that exist usually compare it to standard treatment, as opposed to controlling for non-specific improvements that may result from receiving an intervention. We conducted a pilot study to investigate whether social skills training is more effective than non-specific support for adults with ASD.Methods19 adults with ASD were randomised to either social skills training or non-specific social interaction groups for 16 weeks. The Reading the Mind in the Eyes and Reading the Mind in the Voice Tasks were used to assess social cognition while the Social Responsiveness Scale (SRS-2) and the Weiss Functional Impairment Rating Scale (WFIRS-S) were used to measure real-life change pre- and post-treatment.ResultsTaken together, both groups improved across the course of the study on the ‘Eyes’ task (p = 0.049), SRS-2 (p = 0.03) and WFIRS-S (p = 0.053). However, there were no significant differences between the groups. There was some trend-level evidence that the social skills group improved more on the tests of social cognition (p ≤ 0.1 for group x time interaction). This was not the case for the SRS-2 (p = 0.25) and for the WFIRS-S there was a trend for the social interaction group to show greater improvements (p = 0.07).ConclusionsThis study did not show clear evidence of benefit from social skills training compared to facilitated social interaction, although larger studies are required to draw firm conclusions about efficacy.     

Correlates of social functioning in autism spectrum disorder: The role of social cognition

BackgroundIndividuals with autism spectrum disorder (ASD) experience marked challenges with social function by definition, but few modifiable predictors of social functioning in ASD have been identified in extant research. This study hypothesized that deficits in social cognition and motor function may help to explain poor social functioning in individuals with ASD.MethodCross-sectional data from 108 individuals with ASD and without intellectual disability ages 9 through 27.5 were used to assess the relationship between social cognition and motor function, and social functioning.ResultsResults of hierarchical multiple regression analyses revealed that greater social cognition, but not motor function, was significantly associated with better social functioning when controlling for sex, age, and intelligence quotient. Post-hoc analyses revealed that better performance on second-order false belief tasks was associated with higher levels of socially adaptive behavior and lower levels of social problems.ConclusionsOur findings support the development and testing of interventions that target social cognition in order to improve social functioning in individuals with ASD. Interventions that teach generalizable skills to help people with ASD better understand social situations and develop competency in advanced perspective taking have the potential to create more durable change because their effects can be applied to a wide and varied set of situations and not simply a prescribed set of rehearsed situations.     

Factors associated with quality of life in individuals with autism spectrum disorders: A review of literature

This review study was conducted to synthesize the existing research on the level of quality of life (QoL) in individuals with autism spectrum disorders (ASD) and the factors associated with their QoL. A total of 16 studies were included for this review. This study found that (a) the majority of the individuals with ASD had poor QoL; (b) behavior problems and leisure activities were associated with the QoL of the majority of adults with ASD; (c) autism severity, age, behavior problems, social skills, adaptive behavior, education, and comorbid psychiatric conditions were associated with the QoL of the majority of children with ASD. These findings may provide critical information to parents/caregivers of individuals with ASD and practitioners providing services to them.     

Mixed martial arts training improves social skills and lessens problem behaviors in boys with Autism Spectrum Disorder

BackgroundDifficulties with social functioning are a defining core characteristic among children with Autism Spectrum Disorder (ASD). Fortunately, adaptive social skills can be acquired. Physical exercise has gained interest among researchers as a practical way to improve social functioning in children with ASD. The present study evaluated the effectiveness of a Mixed Martial Arts (MMA) intervention for improving social skills and lessening problematic social behaviors in school-aged boys with ASD.MethodThirty-four boys and girls (n = 28 boys, 6 girls) with ASD were randomly assigned to either a community-based MMA intervention or a Waitlist Control (WLC) condition. Randomization resulted in an intervention group of all boys. Assessments of child functioning were conducted pre- and post-intervention. The 26-session MMA intervention consisted of learning and practicing increasingly challenging motor movements in a structured class with ASD and typically-developing peers. The WLC group did not participate in any intervention between pre- and post-test. Measures of implementation fidelity were included.ResultsResults indicated significant interactions between group and predicted social functioning over time. Compared to the control group, parents of boys with ASD in the martial arts group reported significantly higher positive social behaviors and significantly lower negative social behaviors between pre- and post-test.ConclusionsThe results of this study increase our understanding of the benefits of martial arts training for boys with ASD within a community setting. Practical implications highlight the importance of providing a social component with physical exercise, helping to address the physical needs of children with ASD and perhaps conferring social benefits as well.     

Social Participation Among Young Adults with an Autism Spectrum Disorder

Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.     

Social communication effects of peer-mediated recess intervention for children with autism

Children with ASD face enormous challenges in the area of social functioning. Research has shown that impairments in social functioning distinguish this population from both typically developing children and children with disabilities. This study incorporated several evidence-based social skills-teaching procedures (i.e., direct instruction, priming, prompting, peer-mediation, contingent reinforcement, and token economies) directly in the recess setting to increase appropriate social behaviors for four children with ASD (ages 6–8). Elements of peer networks and pivotal response training (two types of social skills intervention packages in the literature) were included. Results showed significant increases in social communication between focus children and their peers, as well as generalization of skills to non-intervention recesses.     

Group cognitive behaviour therapy (CBT) for social interaction anxiety in adults with autism spectrum disorders (ASD)

BackgroundGroup social skills interventions (SSI) are partially effective for addressing the communication and social interaction impairments experienced by individuals with autism spectrum disorders (ASD). Social anxiety has been found to be a moderating mechanism for SSI in young people with ASD. Comparatively few studies have investigated the effectiveness of SSI in the adult ASD population, and none so far have investigated group approaches incorporating SSI and anxiety management techniques.MethodThe present study describes the design and evaluation of a non-randomised single-arm, 11 week group interaction anxiety and social skills intervention, piloted on three occasions during routine clinical practice at an adult ASD service. The intervention was informed by a cognitive behaviour therapy (CBT) framework. Eighteen cognitively-able adult males with ASD attended. Outcome measures were completed pre- and post-intervention.ResultsSelf-reported social anxiety improved (p = 0.01, d = 0.65). Low mood, general anxiety and functioning did not change significantly (p > 0.05, d < 0.20). Qualitative feedback indicated that participants found the intervention to be acceptable and useful for improving social knowledge and coping strategies, and reducing avoidance behaviours. Attrition was low (n = 2).ConclusionsThese results suggest that integrating SSI and anxiety management techniques in a group format is acceptable to adults with ASD, and can reduce symptoms of social anxiety. Whether SSI enhance social skills in adults requires further investigation. In clinical practice, consideration should be given to augmenting SSI with CBT techniques designed to target concurrent symptoms of social anxiety.     

Two case study evaluations of an arts-based social skills intervention for adolescents with childhood brain disorder

Objective: Arts-based programmes have been shown to be useful for individuals with disturbances in cognitive and behavioural functioning. The current case studies examined the feasibility and effectiveness of a theatre skills training programme to facilitate social skills and participation for adolescents with childhood brain disorder.

Methods: A case study approach was used with two adolescent participants. Focus groups were conducted immediately post-intervention, while a battery of quantitative measures were administered pre- and post-treatment, as well as 8 months post-treatment.

Results: Perceived and documented improvements in social skills and participation were observed from pre- to post-intervention and at follow-up.

Conclusion: Results support the use of an arts-based intervention for youth with brain injuries to facilitate social skills and participation. Findings also highlight the need for more sensitive measures of these skills for youth with childhood brain disorder, who may have impaired awareness of their abilities and/or impairments in memory and language comprehension.     

Alexithymia, social support and health problems

This article presents three studies examining whether alexithymia is associated with less perceived and network social support, whether such relationships are accounted for by reduced social skills associated with alexithymia, and whether limited social support links alexithymia to health problems. The relationships between alexithymia (Toronto Alexithymia Scale), social variables, and physical health and depression were examined in both healthy young adults and patients. Alexithymia (especially deficits in identifying and communicating feelings) was related to less perceived support, fewer close relationships, and less social skill; the social skills deficit accounted fully for the association between alexithymia and a smaller social network. Additionally, alexithymia was related to both somatic complaints and depression, but social support generally was not. It is concluded that alexithymia is associated with reduced perceived and network social support, that these associations are likely due to alexithymia-related deficiencies in social skills, but that reduced social support does not account for the relationship between alexithymia and health problems.     

Social Competence Intervention Program (SCIP): A pilot study of a creative drama program for youth with social difficulties

This study explored the effects of participation in the Social Competence Intervention Program (SCIP), an innovative creative drama-based group intervention, of children diagnosed with autism spectrum disorder (ASD), nonverbal learning disability (NLD) and/or attention deficit hyperactivity disorder (ADHD). Eighteen participants in SCIP were compared to a clinical control group of 16 on changes in measures of social perception, social competence, and naturalistic observed social behavior. Hierarchical multiple regression model was used for all primary quantitative analyses. Interviews were conducted post-treatment to provide qualitative data. The treatment group showed significant improvement in key domains of observed social behavior in a natural setting compared to the clinical control group. Parents and children in the SCIP condition reported multiple positive changes in social functioning. These findings provide preliminary support for the use of a creative drama program for children with social competence deficits related to social perception problems.     

COVID-19 pandemic effects in people with Autism Spectrum Disorder and their caregivers: Evaluation of social distancing and lockdown impact on mental health and general status

Among the difficulties associated with Autism Spectrum Disorder (ASD) are those related to adaptation to changes and new situations, as well as anxious-depressive symptoms frequently related to excessive environmental requirements. The main objective of this research is to study the psychological impact of the lockdown due to the social emergency situation (COVID-19) in children/adolescents and adults diagnosed with ASD. Participants were 37 caregivers of children/adolescents with ASD, also 35 ASD adults and 32 informants. Evaluation was conducted through a web survey system and included standardized clinical questionnaires (CBCL and SCL-90-R), which were compared with results before lockdown start, and a brief self-reported survey addressing the subjective perception of changes in daily functioning areas. The results revealed a reduction of psychopathological symptoms in both age groups, but only reaching statistical significance in the adult group, except for Somatization, Anxiety, and Obsessive-Compulsive domains. ASD severity Level 2 showed greater improvement after lockdown onset in the children/adolescent group when compared to ASD Level 1 participants. Younger adults (18–25 yoa) reported greater improvement than older adults (=>25 yoa). Survey results indicate an improvement of feeding quality and a reduction in the number of social initiations during the lockdown. Adult ASD participants perceived a decrease in stress levels after the lockdown onset, whereas caregivers reported higher stress levels at the same point in both age groups. Limitations included the small number of participants and a heterogeneous evaluation window between measures. Pyschopathological status after two months of social distancing and lockdown seems to improve in ASD young adult population.     

Family influences on social and play outcomes among children with ASD during middle childhood

Using data drawn from a longitudinal study of families of children with autism spectrum disorders (ASD), I examined the concurrent and prospective impact of two family factors, marital quality and maternal expressed emotion (EE) on five indicators of parent-reported child social functioning (number of peers in the child's play network, child participation in unstructured group play, and the extent to which group play was characterized by play interaction, disruption, and disconnection). Controlling for child autism symptom severity, regression analyses indicated martial quality and maternal EE to be significant cross-sectional predictors of number of playmates and group play participation. In addition, marital quality was found to mediate the relationship between symptom severity and both play outcomes. Despite these significant cross-sectional effects, initial analyses revealed no significant longitudinal family effects on play outcomes. Subsequent analyses focusing specifically on the prediction of substantial change in child social functioning over time, however, did find increased play disconnection to be significantly linked to heightened levels of maternal EE, suggesting that familial influences may play a role in hindering improvement in some aspects of social functioning among mid-aged children with ASD. Study implications and limitations are discussed.     

Quality of life: A case-controlled long-term follow-up study,comparing young high-functioning adults with autism spectrum disorders with adults with other psychiatric disorders diagnosed in childhood

Background

Long term outcome in childhood autism spectrum disorders (ASD) was evaluated by studying quality of life (QoL) in young adulthood in comparison to the outcome of other child psychiatric disorders.

Methods

In this follow-up study, objective and subjective QoL of 169 high-functioning (IQ > 70) adults with ASD (19 to 30 years) was contrasted with QoL data of age matched adults diagnosed with attention deficit/hyperactivity disorder (N = 85), disruptive behaviour disorders (N = 83), and affective disorders (N = 85) during childhood. The mean follow-up period of the ASD patients was 13.9 years. Objective QoL included marital status, living arrangements, level of education, employment, and usage of mental health care. Subjective QoL included satisfaction concerning living arrangements, work or education, physical condition, partner relationship, social relationships, state of mind, and future perspective.

Results

QoL was more compromised in adults diagnosed with ASD in childhood than in adults with other psychiatric disorders in childhood. A relatively large proportion of the adults with ASD were single, few lived with a partner or a family and many of them were institutionalized. Adults with ASD had lower educational levels, relatively few had paid employment and many were social security recipients, as compared to the other psychiatric patients. In case the adults with ASD used medication, 47% used anti-psychotics. Regarding the subjective QoL, the adults with ASD were less satisfied about their work or education, partner relationship, and future perspective than the other groups. Even when highly educated adults with ASD were compared to highly educated adults diagnosed with other childhood disorders, the QoL appeared to be more disadvantageous in adults with ASD.

Conclusion

Many studies have shown that QoL is threatened in psychiatric patients, but findings of this study indicate that young high-functioning adults diagnosed with ASD in childhood are at relatively high risk for poor QoL compared to other childhood psychiatric disorders.     

Self-esteem,social support,and life satisfaction in Chinese parents of children with autism spectrum disorder

PurposeThe current study examined self-esteem, social support, and life satisfaction in Chinese parents of children with autism spectrum disorder (ASD), and observed the mediation effects of social support on the relationship between self-esteem and life satisfaction.MethodsWe compared 118 Chinese parents of children with ASD to 122 demographic-matched parents of typically developing children on measures of self-esteem, social support, and life satisfaction using the Rosenberg Self-Esteem Scale (SES), Multidimensional Scale of Perceived Social Support (MSPSS), and Satisfaction with Life Scale (SWLS), respectively.ResultsParents of children with ASD scored significantly lower on self-esteem, social support, and life satisfaction than the controls (ps < 0.01), and social support partly mediated the relationship between self-esteem and life satisfaction in both groups. Hierarchical regressions indicated that after controlling for demographic variables, social support and self-esteem were significant predictors of life satisfaction in both groups but explained more variance in life satisfaction for the parents of children with ASD.ConclusionsSocial support and self-esteem play a more important role in life satisfaction for parents of children with ASD than those of typically developing children. Life satisfaction is positively related to higher household income, higher self-esteem, and stronger social support for parents. Self-esteem is likely to be associated with greater life satisfaction by means of greater social support. Future research and interventions should focus on fostering a more positive climate of social support for ASD families in China.     

Comparing social skill profiles of children with autism spectrum disorders versus children with attention deficit hyperactivity disorder: Where the deficits lie

Marked socialization impairment is evident in both individuals with autism spectrum disorders (ASD) and individuals with attention deficit/hyperactivity disorder (ADHD). The current study utilizes the Matson Evaluation of Social Skills for Youngsters-II (MESSY-II) to explore similarities and discrepancies in the social skill profiles of children with ASD and children with ADHD ages 6–9 years old and 10–16 years old. Children with ASD and children with ADHD were both found to be significantly deficient in social skills compared to atypically developing peers without an Axis I or Axis II diagnosis; however, specific skill deficits vary between the groups. In particular, children with ASD exhibited a lack of adaptive social skills whereas children with ADHD demonstrated social skill knowledge but an increased level of maladaptive social behavior. The trends of socialization impairment over time were also found to differ in children with ASD versus children with ADHD. While children with ASD remained at similar levels of adaptive social skill impairment over age groups, children with ADHD were found to become more socially impaired in more areas over time. The distinct patterns and trends of social skill deficit found in children with ASD and children with ADHD can inform treatments targeted toward the specific deficits observed within each disorder.     

Self-determination, social abilities and the quality of life of people with intellectual disability

Background The international literature has documented that self‐determination is impacted by environmental factors, including living or work settings; and by intraindividual factors, including intelligence level, age, gender, social skills and adaptive behaviour. In addition, self‐determination has been correlated with improved quality of life (QoL). This study sought to contribute to the growing literature base in this area by examining the relationship among and between personal characteristics, self‐determination, social abilities and the environmental living situations of people with intellectual disabilities (ID). Methods The study involved 141 people with ID residing in Italy. Healthcare professionals and social workers who had known participants for at least 1 year completed measures of self‐determination, QoL and social skills. Analysis of variance was conducted to verify whether different levels of intellectual impairment were associated with different degrees of the dependent variables. The Pearson product–moment correlation was used to examine any relationships among dependent variables and IQ scores. Finally, discriminant function analysis was used to examine the degree to which IQ score, age, self‐determination and social abilities predicted membership in groups that were formed based on living arrangement, and on QoL status (high vs. low). Results The anova determined, as expected, that participants with more severe ID showed the lowest levels of self‐determination, QoL and social abilities. Discriminant function analysis showed that (a) individuals attending day centres were distinguished from those living in institutions in that they were younger and showed greater autonomy of choice and self‐determination in their daily activities; (b) basic social skills and IQ score predicted membership in the high or low QoL groups; and (c) the IQ score predicted membership in the high or low self‐determination groups. A manova conducted to examine gender‐ and age‐level differences on self‐determination found gender differences; women had higher self‐determination scores than men. Conclusions These findings contribute to an emerging knowledge base pertaining to the role of intraindividual and environmental factors in self‐determination and QoL. In general, the study replicated findings pertaining to the relative contribution of intelligence to self‐determination and QoL, added information about the potential contribution of social abilities, and pointed to the potentially important role of opportunities to make choices as a particularly important aspect of becoming more self‐determined, at least in the context of residential settings.     

Characteristics of social skills for adults with intellectual disability,autism and PDD-NOS

Social skills deficits and excesses are defining characteristics of intellectual disability (ID). Despite this, there is an unfortunate lack of research on the patterns and profiles of social behavior, particularly with adults who are severely intellectually disabled. This paper provides an analysis of social skill patterns for adults living in residential programs in the southeastern United States using the Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER) as the dependent variable. A diagnosis of an autism spectrum disorder (ASD) was associated with more serious social disability. Items that were most commonly noted as problematic for individuals with ASD included preferring to be alone, avoiding eye contact, and exhibiting peculiar or odd mannerisms. Additionally, the presence of blindness and motoric impairment was associated with a higher degree of social skills impairment. The implications of these data for assessment, treatment, and future research are discussed.     

The quality of life of parents of children with autism spectrum disorder: A systematic review

BackgroundPrevious research has raised concerns about the quality of life (QoL) of parents of children with autism spectrum disorder (ASD). A better understanding of parental QoL can inform clinicians and policymakers and lead to improved outcomes for both parents and children.AimsThis review aimed to systematically examine studies measuring the QoL among parents of children with ASD (<18 years) and to investigate its parental, child-related and contextual associated factors.MethodologyAn electronic database search was conducted using Medline, Psycinfo, Embase, CINAHL, Biosis, ASSIA, Social Services Abstracts, Sociological Abstracts and Open grey.ResultsThis review indicated poorer QoL among parents of children with ASD compared to parents of typically developing children or to population norms. Variables associated with lower parental QoL within this group included child behavioural difficulties, unemployment, being a mother and lack of social support.ConclusionThis review verified previous reports on lower QoL among parents of children with ASD and highlighted potential areas of support. Implications for future research, policy and practice are discussed.