Abstract | Summary | Original Article

Social Skills Training for Adolescents with Asperger Syndrome and High-Functioning Autism.

Tse J, Strulovitch J, Tagalakis V, Meng L, Fombonne E.

Journal of Autism and Developmental Disorders. 2007; 37:1960-1968.

Question: Was a social skills training programme effective in aiding adolescents with Asperger Syndrome and High-Functioning Autism to improve their social skills and problem behaviours?

Background: Adolescence is a time when social interactions are of growing importance and the need to fit in becomes paramount.  Teenagers with Asperger syndrome (AS) or high functioning autism (HFA) are at disadvantage because of social skills deficits. Their problems making and keeping friends, and being subjected to rejection or bullying at school and in the community, can put them at high risk for depression and anxiety.

Design: This was a pre-post study of a social skills training program.

Setting: a university-based clinic.

Participants: Forty-six teenagers (age range 13-18), with a diagnosis of either AS or HFA and their parents took part.  Two participants did not complete the program. 

Intervention: The intervention consisted of 12 weekly 90-minute, after-school groups of 7 to 8 adolescents with AS or HFA. The groups were led by a social worker, psychologist, and a psychiatric resident. The social skills training exercises were adapted mainly from the book, “Skillstreaming the Adolescent” (Goldstein & McGinnis, 2000). Prior to the program, the teenagers and their parents were interviewed about their goals and expectations to ensure that the groups could meet their expectations.

Main Outcome Measures: Parents completed the Social Responsiveness Scale, the Aberrant Behavior Checklist and the Nisonger Child Behavior Rating Form. In two of the groups, the teenaged participants filled out an anonymous questionnaire about whether they liked the group, if they thought their skills had improved, and what they liked best and least about the groups, and their suggestions for future groups.

Main Results: Complete data were available for 32 of the 44 participants. There were significant improvements on the Social Responsiveness Scale and on the Nisonger Child Behavior Rating Form, indicating that the program had positive effects on social skills and problem behaviours. Parents reported that the skills learned in the group were also used in other social settings. The adolescent participants reported greater improvement in their skills and behaviour than their parents did. There were also improvements in the ability to control emotions and level of anxiety, tendency to isolate themselves, stereotypies, and self-injurious behaviours. Hyperactivity and conduct problems were the least likely to improve.

Conclusion: The study showed that social skills in teenagers with AS and HFA might improve through participation in a social skills training program in a fairly short time. Parent and child participants both reported that the skills learned were used in other social situations. There are limitations to this study: it had a small sample size and was not a randomized controlled trial (RCT),  but it did use standardized tests to measure the target deficits and changes in them. It provided “real world” evidence that social skills training programs can make a difference to teenagers with AS and HFA, improving their social competence and overall confidence. An RCT is now needed.

Tse J, Strulovitch J, Tagalakis V, Meng L, Fombonne E. Social Skills Training for Adolescents with Asperger Syndrome and High-Functioning Autism. Journal of autism and Developmental Disorders. 2007; 37:1960-1968.