A Randomized Controlled Trial of the Social Tools And Rules for Teens (START) Program: An Immersive Socialization Intervention for Adolescents with Autism Spectrum Disorder

Vernon, Ty; Miller, Amber R.; Ko, Jordan; Barrett, Amy; McGarry, Elizabeth

doi:10.1007/s10803-017-3380-1

Cited by 40 publications

(31 citation statements)

References 24 publications

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“…Improvement was determined by examining the recorded number of times the participant was using the skill in the past 5 weeks and also the facilitator's clinical judgment of whether it would be more beneficial to continue practicing the same skill or if another target skill was more pressing. Please see Vernon et al (2016) and Vernon et al (2018) for more details on target skills and self-management procedures.…”

Section: Methodsmentioning

confidence: 99%

“…Future methods for unobtrusively gathering social performance data from participants in everyday social settings (perhaps in home, school, and community environments) would be essential to thoroughly evaluate generalized improvements. Fortunately, there is some existing evidence of convergent social competence improvements in parent and self-report data from the START program, which offers some support for the generalization of improvements to other settings (Vernon et al, 2018).…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

“…Phases and content were checked off as they were covered and any deviations from the specified time frame were noted. A copy of this fidelity form can be obtained as a digital appendix in Vernon et al (2018). An analysis of these fidelity checklists indicated that procedures were correctly implemented 97.7% of the time.…”

Section: Fidelity Of Implementationmentioning

confidence: 99%

“…An initial pilot study investigation of six participants yielded encouraging improvements across a multitude of outcome measures, including parent-report survey measures, adolescent self-report survey measures, and coded observational data derived from video-recorded social conversations (Vernon et al, 2016). A randomized controlled trial (RCT) of the START program revealed significant improvements on parent and self-report survey measures unique to the treatment participants (Vernon et al, 2018). Specifically, participants receiving Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial the 20-week START program demonstrated significant gains in survey measures associated with autism symptom severity, social competency, and social motivation.…”

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confidence: 99%

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Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial

Miller

Vernon

2018

Autism

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There has been a significant increase in the development of interventions to improve the social competence and success of adolescents with autism spectrum disorder. The current investigation used direct observation and coding of social conversations as a rigorous method to further assess the efficacy of the Social Tools And Rules for Teens socialization intervention for adolescents with autism spectrum disorder in the context of a randomized controlled trial. A total of 35 adolescents with high-functioning autism spectrum disorder were randomized to either a treatment or waitlist control group. The 20-week group intervention took place once a week for 90 min per session. Brief video-recorded conversations between participants and unfamiliar, untrained peers were recorded at pre-and post-time points and coded for selected social behaviors (i.e. questions asked, positive facial expressions, and mutual engagement). Results revealed a significant Group × Time treatment effect for both questions asked and positive facial expressions. The findings support that the Social Tools And Rules for Teens intervention can positively impact specific, observable social behaviors through systematic coding of live social conversations within the context of a randomized controlled trial. This investigation is one of the first randomized controlled trials of a group socialization intervention to use systematic coding of live social conversations to assess social competence improvements.

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Section: Methodsmentioning

confidence: 99%

Section: Limitations and Future Directionsmentioning

confidence: 99%

Section: Fidelity Of Implementationmentioning

confidence: 99%

mentioning

confidence: 99%

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Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial

Miller

Vernon

2018

Autism

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“…A search of the current literature evaluating SSGTs for adolescents via randomized controlled trials (RCTs), identified a number of design and intervention limitations. Consistent design limitations included small sample sizes (9,(27)(28)(29)(30)(31), failing to employ blinded or external observer-report measurement of dependent variables (17,20,27,29,30,(32)(33)(34)(35), failing to describe the randomization processes (27, 29-31, 33, 34) or employ allocation concealment (17,20,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), limited application of intent-to-treat data analysis (17,(27)(28)(29)(30)(32)(33)(34)(35), a lack of clarity in regard to compliance with the Consolidated Standards of Reporting Trials (CONSORT) statement (20,27,29,30,35,36), and limited examples of mixed methods studies integrating quantitative and qualitative data collection methods and analysis in understanding the outcomes of interventions…”

Section: Social Skills Group Trainingmentioning

confidence: 99%

Afsharnejad

Falkmer

Black

et al. 2019

Preprint

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Background: Individuals diagnosed with Autism Spectrum Disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (i) replication of effects in additional clinical and cultural contexts, (ii) designs which employ active control groups, (iii) calculation of health economic benefits, (iv) identification of the optimal training duration, and (v) measurement of individual goal and quality of life outcomes. Method/design: With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12 to17 years (N=90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking program. Participants will attend both programs in groups of 6 to 8 adolescents, over 16 one and a half hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, and loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and health care costs. Discussion: The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigours evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.

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Social cognitive skills groups increase medial prefrontal cortex activity in children with autism spectrum disorder

et al. 2021

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Few studies have examined the neural mechanisms of change following social skills interventions for children with autism spectrum disorder (ASD). This study examined the neural effects of social cognitive skills groups during functional MRI (fMRI) tasks of irony comprehension and eye gaze processing in schoolaged children with ASD. Verbally fluent children (ages 8-11) were randomized to social cognitive skills groups or facilitated play comparison groups. Behavioral assessments and fMRI scans were obtained at baseline and endpoint (12 weeks). During fMRI, children completed two separate tasks to engage social cognition circuitry: comprehension of potentially ironic scenarios (n = 34) and viewing emotionally expressive faces with direct or averted gaze (n = 24). Whole-brain analyses were conducted to examine neural changes following treatment. Regression analyses were also conducted to explore the relationship between neural and behavioral changes. When comparing the two groups directly, the social cognitive skills group showed greater increases in activity in the medial prefrontal cortex (mPFC), implicated in theory of mind, relative to the comparison group for both irony comprehension and gaze processing tasks. Increased mPFC activity during the irony task was associated with improvement in social functioning on the Social Responsiveness Scale across both groups. Findings indicate that social cognitive skills interventions may increase activity in regions associated with social cognition and mentalizing abilities. Lay SummarySocial skills groups are a common intervention for school-aged children with ASD. However, few studies have examined the neural response to social skills groups in school-aged children with ASD. Here, we report on a study evaluating neural outcomes from an empirically supported social cognitive skills training curriculum using fMRI. This study seeks to understand the effects of targeting emotion recognition and theory of mind on the brain circuitry involved in social cognition in verbally fluent children ages 8-11. Results indicate increased neural activity in the mPFC, a region considered to be a central hub of the "social brain," in children randomized to social cognitive skills groups relative to a comparison group that received a high-quality, child-directed play approach. In addition, increased activation in the mPFC during an irony comprehension task was associated with gains in social functioning across both groups from pre-to post-treatment. This is the first fMRI study of social skills treatment outcomes following a randomized trial with an active treatment condition in school-aged children with ASD.

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A Randomized Controlled Trial of the Social Tools And Rules for Teens (START) Program: An Immersive Socialization Intervention for Adolescents with Autism Spectrum Disorder

Cited by 40 publications

References 24 publications

Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial

Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial

KONTAKT© in Australian Adolescents on the Autism Spectrum: Protocol of a Randomized Control Trial

Social cognitive skills groups increase medial prefrontal cortex activity in children with autism spectrum disorder

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