Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study

Despite the psychosocial difficulties common among young adults with autism spectrum disorders (ASD), little to no evidence-based social skills interventions exist for this population. Using a randomized controlled trial (RCT) design, the current study tested the effectiveness of an evidence-based, caregiver-assisted social skills intervention known as PEERS for Young Adults with high-functioning young adults with ASD (ages 18-23) using self- and caregiver-report measures. Results revealed that treated young adults reported significantly less loneliness and improved social skills knowledge, while caregivers reported significant improvements in young adults' overall social skills, social responsiveness, empathy, and frequency of get-togethers. Results support the effectiveness of using this caregiver-assisted, manualized intervention for young adults with ASD.     

Peer-mediated social skills training program for young children with high-functioning autism

One of the most prevailing characteristics of children with autism is their deficit in social communication skills. The purpose of this study was to evaluate the effectiveness of a peer-mediated social skills training (SST) program combined with video feedback, positive reinforcement and token system in increasing social communication skills in young children with high-functioning autism. Four boys with high-functioning autism, ages 6-7 years, participated in the study. The social skills training, lasting 12 weeks, targeted six communication skills, selected after parent interviews and behavioral observation during a pre-training assessment period. One SST session was conducted each week, each session lasted 90min and had six structured activities. The training effectiveness was evaluated through direct observation of a structured interaction period, using an observational coding system. Improvement was observed in three out of four children, although individual differences among children were seen for changes in two global scales as well as subscales. These results suggest that the social skills training was effective in improving social communication skills for some children with high-functioning autism. Clinical and research implications and future directions for social skills training as well as this study's limitations are discussed.     

Adaptive Behavior Ratings Correlate With Symptomatology and IQ Among Individuals With High-Functioning Autism Spectrum Disorders

Caregiver report on the Adaptive Behavior Assessment System-II (ABAS) for 40 high-functioning individuals with Autism Spectrum Disorders (ASD) and 30 typically developing (TD) individuals matched for age, IQ, and sex ratio revealed global adaptive behavior deficits in ASD, with social skills impairments particularly prominent. Within the ASD group, adaptive communication skills were positively related to IQ while global adaptive functioning was negatively associated with autism symptomatology. Autistic behavior ratings related negatively to ABAS scores in the TD but not the ASD group. This investigation demonstrates: the utility of an adaptive functioning checklist for capturing impairments, even in high-functioning individuals with ASD; and that a relationship between social abilities and autism exists independently of intelligence.     

Brief Report: Individual Social-Multi-Modal Intervention for HFASD

This research is the first part of a 2-year cognitive-behavioral-ecological (CB-E) social skills training for high-functioning children with autism spectrum disorder (HFASD). Current study examined efficacy of an individual CB-E intervention in facilitating children’s dyadic interactions (immediately after treatment and 4 months later) and their social cognition capabilities (e.g., emotion understanding and recognition, social problem solving). Participants were 19 HFASD children aged 7 years and 7 months to 11 years and 6 months. Results demonstrated improvement in children’s social cognition and positive dyadic interaction and decrease in children’s low-level social interaction behavior. Long-term evaluation revealed maintenance of improvement. Progress in children’s cooperation, self-control, and assertiveness was reported by their teachers. Discussion focused on CB-E intervention efficacy in promoting integral social functioning for HF children with ASD.     

Abnormal Use of Facial Information in High-Functioning Autism

Altered visual exploration of faces likely contributes to social cognition deficits seen in autism. To investigate the relationship between face gaze and social cognition in autism, we measured both face gaze and how facial regions were actually used during emotion judgments from faces. Compared to IQ-matched healthy controls, nine high-functioning adults with autism failed to make use of information from the eye region of faces, instead relying primarily on information from the mouth. Face gaze accounted for the increased reliance on the mouth, and partially accounted for the deficit in using information from the eyes. These findings provide a novel quantitative assessment of how people with autism utilize information in faces when making social judgments.     

Brief Report: Feasibility of Social Cognition and Interaction Training for Adults with High Functioning Autism

The goal of this study was to evaluate the feasibility and utility of a group-based cognitive behavioral intervention to improve social-cognitive functioning in adults with high-functioning autism (HFA). We modified the treatment manual of a previously validated intervention, Social Cognition and Interaction Training (SCIT), for optimal use with HFA adults (SCIT-A). We then conducted a pilot study to compare SCIT-A (n = 6) to treatment as usual (TAU) (n = 5) for adults with HFA. Feasibility was supported; attendance was high (92%) and satisfaction reports were primarily positive. Participants in SCIT-A showed significant improvement in theory-of-mind skills and trend level improvements in social communication skills; TAU participants did not show these improvements. Findings indicate SCIT-A shows promise as an intervention for adults with HFA.     

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.     

The ABC’s of Teaching Social Skills to Adolescents with Autism Spectrum Disorder in the Classroom: The UCLA PEERS ® Program

Social skills training is a common treatment method for adolescents with autism spectrum disorder (ASD), yet very few evidence-based interventions exist to improve social skills for high-functioning adolescents on the spectrum, and even fewer studies have examined the effectiveness of teaching social skills in the classroom. This study examines change in social functioning for adolescents with high-functioning ASD following the implementation of a school-based, teacher-facilitated social skills intervention known as Program for the Education and Enrichment of Relational Skills (PEERS ^® ). Seventy-three middle school students with ASD along with their parents and teachers participated in the study. Participants were assigned to the PEERS ^® treatment condition or an alternative social skills curriculum. Instruction was provided daily by classroom teachers and teacher aides for 14-weeks. Results reveal that in comparison to an active treatment control group, participants in the PEERS ^® treatment group significantly improved in social functioning in the areas of teacher-reported social responsiveness, social communication, social motivation, social awareness, and decreased autistic mannerisms, with a trend toward improved social cognition on the Social Responsiveness Scale. Adolescent self-reports indicate significant improvement in social skills knowledge and frequency of hosted and invited get-togethers with friends, and parent-reports suggest a decrease in teen social anxiety on the Social Anxiety Scale at a trend level. This research represents one of the few teacher-facilitated treatment intervention studies demonstrating effectiveness in improving the social skills of adolescents with ASD in the classroom: arguably the most natural social setting of all.     

The local,global, and neural aspects of visuospatial processing in autism spectrum disorders

Behavioral studies have documented a relative advantage in some aspects of visuospatial cognition in autism although it is not consistently found in higher functioning individuals with autism. The purpose of this functional neuroimaging study was to examine the neural activity in high functioning individuals with autism while they performed a block design task that systematically varied with regard to whether a global pattern was present. Participants were 14 adults with high-functioning autism and 14 age and IQ matched typical controls. The task was to identify a missing block in target figures which had either an obvious global shape or was an arbitrary array of blocks. Behavioral results showed intact, but not superior, performance in our participants with autism. A key group difference was that the participants with autism showed reliably greater activation in occipital and parietal regions in both tasks suggesting an increased reliance of the autism group on posterior brain areas to mediate visuospatial tasks. Thus, increased reliance on relatively posterior brain regions in itself may not guarantee superior performance as seen in the present study.     

An Intervention Program Targeting Daily Adaptive Skills Through Executive Function Training for Adults with Autism Spectrum Disorder: A Pilot Study

ObjectiveAdults with autism spectrum disorders (ASD) experience significant difficulties with executive functioning (EF) and related adaptive skills, yet the lack of interventions in South Korea targeting these areas has resulted in a heightened need to develop an evidence- based program. Therefore, we developed a novel intervention aiming to enhance everyday EF and daily adaptive skills in adults with high-functioning ASD and conducted a pilot study to evaluate the validity and feasibility of the program. MethodsA behavioral intervention of 10-weekly sessions was developed based on literature searches and focus group interviews. Seven adults with high-functioning ASD (mean age=20.29) participated in a single-group pilot trial. We used self and parent-report questionnaires as well as skills measured by assessment instruments to analyze differences before and after the intervention. ResultsSignificant improvements were shown in everyday EF, including time management, organization, self-restraint, and regulation of emotions. Additionally, results demonstrated an enhancement in adaptive functioning, especially in the subdomains of daily living skills. Analyses of parental outcomes only revealed a significant decrease in the scores of emotion regulation. ConclusionThe current study provides good evidence for the validity and feasibility of an intervention to improve everyday EF and adaptive skills in adults with ASD.     

Perceptions of popularity among a group of high-functioning adults with autism

The purpose of this study was to determine how a group of adults with autism perceived one another's interpersonal attributes and popularity. Five female and 11 male high-functioning autistic adults, 18–45 years old, participated in a social skills group together for several years. A sociogram and a questionnaire designed to determine perceptions of best looking, most athletic, and most humorous group members were administered to group members and nonhandicapped group leaders. Independent assessments of intelligence and empathy also were taken. Results indicated that perceived attractiveness and sense of humor were correlated with popularity, but group members' assessments of these attributes differed from those of the nonhandicapped group leaders. Differences between group members and group leaders responses and the implications of the results of the study for social skills training with high-functioning autistic adolescents and adults are discussed.     

Social Interaction Style of Children and Adolescents with High-Functioning Autism Spectrum Disorder

Qualitative differences in social interaction style exist within the autism spectrum. In this study we examined whether these differences are associated with (1) the severity of autistic symptoms and comorbid disruptive behavior problems, (2) the child’s psycho-social health, and (3) executive functioning and perspective taking skills. The social interaction style of 156 children and adolescents (6–19?years) with high-functioning autism spectrum disorder (HFASD) was determined with the Wing Subgroups Questionnaire. An active-but-odd social interaction style was positively associated with symptoms of autism, attention deficit and hyperactivity. Furthermore, an active-but-odd social interaction style was negatively associated with children’s psycho-social health and positively with executive functioning problems. Social interaction style explains part of the heterogeneity among children with HFASD.     

Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders

Anxiety is a commonly occurring psychiatric concern in adolescents with autism spectrum disorders (ASD). This pilot study examined the preliminary efficacy of a manual-based intervention targeting anxiety and social competence in four adolescents with high-functioning ASD. Anxiety and social functioning were assessed at baseline, midpoint, endpoint, and 6 months following treatment. Treatment consisted of cognitive-behavioral therapy, supplemented with parent education and group social skills training. The treatment program was effective in reducing anxiety in three of the four subjects and improving the social skills in all four subjects. Recommendations for the assessment and treatment of anxiety youth with ASD such as use of self-report measures to complement clinician and parent-reports and adaptations to traditional child-based CBT, are offered.     

Development of the Contextual Assessment of Social Skills (CASS): A Role Play Measure of Social Skill for Individuals with High-Functioning Autism

This study piloted a role play assessment of conversational skills for adolescents and young adults with high-functioning autism/Asperger syndrome (HFA/AS). Participants completed two semi-structured role plays, in which social context was manipulated by changing the confederate’s level of interest in the conversation. Participants’ social behavior was rated via a behavioral coding system, and performance was compared across contexts and groups. An interaction effect was found for several items, whereby control participants showed significant change across context, while participants with HFA/AS showed little or no change. Total change across contexts was significantly correlated with related social constructs and significantly predicted ASD. The findings are discussed in terms of the potential utility of the CASS in the evaluation of social skill.     

Autismus und soziale Kognition

Autism spectrum disorders (autism, Asperger's syndrome, high-functioning autism) are characterized by a common pattern of marked impairments in social interactions. Deficits have been described in face processing, facial emotion recognition, and social attribution ("theory of mind") or generally speaking in social cognition. Some studies have shown that these impairments are already detectable in early childhood, leading to the assumption that the underlying cause is an early disruption of neuronal development. Accordingly, neuroimaging data have revealed alterations of structure and function in the brains of autistic children, adolescents, and adults. The present review gives a systematic overview of the existing literature on functional imaging studies using experimental paradigms of social cognition, i.e. face discrimination, facial emotion recognition, and theory of mind in autistic disorders.     

The Friendship Questionnaire: An Investigation of Adults with Asperger Syndrome or High-Functioning Autism, and Normal Sex Differences

Friendship is an important part of normal social functioning, yet there are precious few instruments for measuring individual differences in this domain. In this article, we report a new selfreport questionnaire, the Friendship Questionnaire (FQ), for use with adults of normal intelligence. A high score on the FQ is achieved by the respondent reporting that they enjoy close, empathic, supportive, caring friendships that are important to them; that they like and are interested in people; and that they enjoy interacting with others for its own sake. The FQ has a maximum score of 135 and a minimum of zero. In Study 1, we carried out a study of n = 76 (27 males and 49 females) adults from a general population, to test for previously reported sex differences in friendships. This confirmed that women scored significantly higher than men. In Study 2, we employed the FQ with n = 68 adults (51 males, 17 females) with Asperger Syndrome or high-functioning autism to test the theory that autism is an extreme form of the male brain. The adults with Asperger Syndrome or high-functioning autism scored significantly lower on the FQ than both the male and female controls from Study 1. The FQ thus reveals both a sex difference in the style of friendship in the general population, and provides support for the extreme male brain theory of autism.     

Outcome in high-functioning adults with autism with and without early language delays: implications for the differentiation between autism and Asperger syndrome

The question of whether Asperger syndrome and high-functioning autism should be considered as the same or different conditions has been a source of debate and controversy over recent years. In the present study, 34 adults with autism who had shown early delays in language were compared with 42 individuals who were reported to have had no such delays, either in their use of words or phrases. All participants were at least 18 years of age, had a nonverbal IQ of 70 or above and met ADI-R criteria for age of onset, communication and social impairments, and stereotyped behaviors. Those in the language delay group were diagnosed as having high-functioning autism. The remainder were designated as having Asperger syndrome. The groups were matched for age, nonverbal IQ and gender. No significant differences were found between the groups either in their total ADI-R algorithm scores, or in their algorithm scores on individual domains. Social outcome ratings and ADI-R scores based on current functioning also failed to differentiate between the groups. Scores on tests of language comprehension and expression were also similar, but in both groups language abilities were well below chronological age level. The implications of these results with respect to the differences between Asperger syndrome and high-functioning autism are discussed. The poor performance on language tests also challenges the assumption that early language development in Asperger syndrome is essentially normal.     

A systematic review of social participation for adults with autism spectrum disorders: Support,social functioning,and quality of life

A systematic review of the literature was conducted to investigate what is currently known about support for social participation for adults with autism spectrum disorders (ASD). A computerized database search followed by hand searching was conducted to locate empirical studies published after 1995 in peer-reviewed journals that described social participation or social support for adults with ASD. 14 studies were identified, evaluated for strength of evidence, and organized into topical themes. These studies focused on support for social participation from two perspectives: social functioning and quality of life (QoL). Supporting social functioning and social participation is important, as this is one route through which individuals with ASD may be able to form relationships and establish natural support networks, which can in turn contribute to QoL. In addition, working to improve social skills is of key importance as social functioning heavily impacts outcomes in a variety of areas. Social participation, social functioning, and QoL for adults with ASD appear to be facilitated through informal social support from social networks, participation in social skills groups, and membership in support groups.