Randomized Comparative Trial of a Social Cognitive Skills Group for Children With Autism Spectrum Disorder

Soorya, Latha; Siper, Paige M.; Beck, Todd; Soffes, Sarah; Halpern, Danielle; Gorenstein, Michelle; Kolevzon, Alexander; Buxbaum, Joseph D.; Wang, A. Ting

doi:10.1016/j.jaac.2014.12.005

Cited by 63 publications

(70 citation statements)

References 38 publications

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“…The week 11 results reported by Minshawi et al demonstrating decreased SRS total scores in both treatment groups but not between group treatment effects align with previous reports of substantial immediate impact of social skills training in youth with ASD [2]. In this follow-up study, we show enhanced durability of treatment response in those subjects who received weekly DCS, a novel finding considering previous studies indicating lack of treatment durability following social skills intervention in ASD [4]. In this analysis, DCS appears to support maintenance of social skills gains made during short-term group therapy compared to placebo.…”

Section: Discussionsupporting

confidence: 90%

“…Social skills training explicitly targets this core deficit and is widely implemented in ASD treatment [2]. Adolescent social skills groups consistently demonstrate immediate improvements in social and communication skills in participants during treatment; however, participants tend to show limited sustained treatment response over longer term follow-up [2–4]. …”

Section: Introductionmentioning

confidence: 99%

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d-Cycloserine enhances durability of social skills training in autism spectrum disorder

et al. 2017

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Background d-Cycloserine (DCS) enhances extinction learning across species, but it has proven challenging to identify consistent benefit of DCS when added to therapeutic interventions. We conducted a placebo-controlled trial of DCS to potentiate social skills training in autism spectrum disorder (ASD) but found substantial improvement in both the DCS and placebo groups at the conclusion of active treatment. Here, we assess the impact of DCS 11 weeks following active treatment to evaluate the impact of DCS on treatment response durability.MethodsStudy participants included 60 outpatient youth with ASD, ages 5–11 years, all with IQ above 70, and significantly impaired social functioning who completed a 10-week active treatment phase during which they received weekly single doses of 50 mg of DCS or placebo administered 30 min prior to group social skills training. Following the 10-week active treatment phase, blinded follow-up assessments occurred at week 11 and week 22. The primary outcome measure for our durability of treatment evaluation was the parent-rated social responsiveness scale (SRS) total raw score at week 22.ResultsAnalysis of the SRS total raw score demonstrated significant decrease for the DCS group compared to the placebo group (p = 0.042) indicating greater maintenance of treatment effect in the DCS group. DCS was well tolerated, with irritability being the most frequently reported adverse effect in both groups.ConclusionsThe findings of this study suggest that DCS may help youth with ASD to maintain skills gained during sort-term social skills training. Larger-scale studies with longer follow-up will be necessary to further understand the long-term impact of DCS paired with structured social skills training.Trial registrationClinicalTrials.gov, NCT01086475

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

d-Cycloserine enhances durability of social skills training in autism spectrum disorder

et al. 2017

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“…With regards to treatment research, the RMET is widely used as treatment outcome measure, particularly for drug manipulations (i.e. oxytocin) or behavioral interventions targeting social skills and social cognition (e.g., [32][33][34][35] ). All of this prior work utilizes an analytic strategy of computing RMET summary scores across all items and then onto potentially sub-optimal omnibus case-control comparisons which mask the presence of nested subgroups within ASC.…”

Section: Discussionmentioning

confidence: 99%

“…The RMET is widely used as a core instrument for assessing difficulties in the social cognitive domain of understanding other minds, and its prominence has even warranted its listing as a core instrument in this domain within the NIMH RDoC (http://1.usa.gov/1Qs6MdI). The RMET is also widely utilized as a treatment outcome measure (e.g., [32][33][34][35]. Given that inconsistency exists behind findings from mentalizing-based treatments for ASC 36 and the tacit understanding that heterogeneity in treatment response is highly likely, it is critical to further our understanding of how mentalizing heterogeneity manifests in ASC, particularly on the RMET, and whether such insights can help in better trial design and/or in individualizing interpretations about who may benefit from such treatments.…”

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confidence: 99%

Unsupervised data-driven stratification of mentalizing heterogeneity in autism

Lombardo

Lai

Auyeung

et al. 2015

Preprint

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Individuals affected by autism spectrum conditions (ASC) are considerably heterogeneous. Novel approaches are needed to parse this heterogeneity to enhance precision in clinical and translational research. Applying a clustering approach taken from genomics and systems biology on two large independent cognitive datasets of adults with and without ASC (n = 694; n = 249), we find replicable evidence for 5 discrete ASC subgroups that are highly differentiated in item-level performance on an explicit mentalizing task tapping ability to read complex emotion and mental states from the eye region of the face (Reading the Mind in the Eyes Test; RMET). Three subgroups comprising 45-62% of ASC adults show evidence for large impairments (Cohen's d = −1.03 to −11.21), while other subgroups are effectively unimpaired. These findings delineate robust natural subdivisions within the ASC population that may allow for more individualized inferences and accelerate research towards precision medicine goals.Autism spectrum conditions (ASC) are currently defined by consensus behavioral criteria of difficulties in social-communication and restricted repetitive behaviors. Although the population is subsumed under a single unitary diagnostic label, variability between affected individuals is considerable 1 . This diversity or 'heterogeneity' inherent within ASC can be seen at multiple levels, from a myriad of different etiological mechanisms 2 , developmental trajectories 3,4 , sex/gender 5 , clinical comorbidities 6 , cognitive/behavioral features (e.g., language development 7 ), and the list could go on 8 . Accordingly, many in the field now subscribe to the idea that there is not just one 'autism' , but rather multiple 'autisms' 9,10 . Given these rich theoretical ideas about the complexity manifesting behind unitary clinical diagnostic labels like 'autism' , it seems like a natural extension of logic that research would follow along such ideas. However, the opposite occurs a majority of the time, whereby clinical and translational research is done utilizing case-control comparison methodology that treats autism as one omnibus group and makes comparison to a matched 'control' or 'comparison' group. While the standard case-control

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“…A recent study in ASD adolescents found that combined poor performance on several social cognition tasks (ToM tasks, emotion-recognition tasks, and anthropomorphic animations) was collectively associated with elevated SRS score (64). Some ASD studies have further found that parent/caregiver report of real-world social behaviors are better measures of treatmentrelated changes in social outcomes than are social cognition tasks, which suggests that these tasks may be measuring more nuanced social cognition skills such as ToM or attribution of intentions compared to every-day reciprocal social behaviors assessed by the SRS (65,66). Hence, it is possible that the types of social concerns endorsed on the SRS (e.g., eye contact, odd behaviors, preference for being alone, ritualistic behaviors) may not relate as closely as we originally hypothesized to the TASIT's measurement of nuanced social cognition skills such as lie and sarcasm detection.…”

Section: Discussionmentioning

confidence: 99%

Social Cognition in 22q11.2 Deletion Syndrome and Idiopathic Developmental Neuropsychiatric Disorders

Jalal

Nair

Lin

et al. 2020

Preprint

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KEYWORDS 2 22q11.2 deletion, social cognition, neurocognition, psychosis, autism spectrum disorder 3 Abstract Background 22q11.2 deletion syndrome (22q11DS) is a common recurrent neurogenetic condition associated with elevated risk for developmental neuropsychiatric disorders and intellectual disability. Children and adults with 22q11DS often exhibit marked social impairment as well as neurocognitive deficits, and have elevated rates of both autism spectrum disorder (ASD) and psychosis. However, the relationship between the basic processes of social cognition and cognitive ability has not been well studied in 22q11DS. Here, we examined differences in social cognition in 22q11DS, relative to multiple groups of idiopathic neuropsychiatric disorders, and typically developing healthy controls (HC). Additionally, we examined differences in intellectual functioning and its relationship to social cognitive abilities.Finally, we examined the relationship between social cognitive abilities and real-world social behavior. MethodsWe examined social cognition and intellectual functioning in 306 participants (mean age = 16.63+/-4.59; % female = 44.8%): sixty-eight with 22q11DS, 49 youth with first episode psychosis (FEP), 48 at clinical high-risk (CHR) for psychosis, 24 participants with ASD, and 117 HC. Social cognition was assessed using The Awareness of Social Inference Test (TASIT), while reciprocal social behavior was assessed via parent/caregiver ratings on the Social Responsiveness Scale (SRS).Participants were also administered the Wechsler Abbreviated Scale of Intelligence, 2 nd edition (WASI-II) to assess intellectual functioning. ResultsThe 22q11DS group exhibited significantly lower social cognitive abilities compared to all other groups, even after controlling for intellectual functioning. Significant positive correlations were found between social cognition, as measured by the TASIT, and IQ across groups. In contrast, no significant relationships were found between TASIT and real-world social behavior (SRS) for any group. ConclusionsOur findings indicate social cognitive deficits are more prominent in 22q11DS than idiopathic neuropsychiatric conditions across the age range, even after adjusting for global intellectual function. the most common recurrent contiguous gene deletion syndrome, estimated to occur in about 1 in 4000 live births (2). It typically results from a de novo deletion, although 10% of cases are familial (3,4). 22q11DS is associated with a range of developmental anomalies (5). The most frequently associated medical comorbidities include congenital heart defects, facial dysmorphology such as palatal defects, immunodeficiency, velopharyngeal insufficiency, and hypocalcemia (2, 6).Individuals with 22q11DS often present with developmental delays, as well as broad cognitive impairment (6). In most individuals with 22q11DS, Full Scale IQ falls within the borderline to low average range (M = 72.41, SD = ± 13.72; 7). A range of associated cognitive deficits have also been noted in individuals with 22q11...

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Randomized Comparative Trial of a Social Cognitive Skills Group for Children With Autism Spectrum Disorder

Cited by 63 publications

References 38 publications

d-Cycloserine enhances durability of social skills training in autism spectrum disorder

d-Cycloserine enhances durability of social skills training in autism spectrum disorder

Unsupervised data-driven stratification of mentalizing heterogeneity in autism

Social Cognition in 22q11.2 Deletion Syndrome and Idiopathic Developmental Neuropsychiatric Disorders

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