Social skills group training in children with autism spectrum disorder: a randomized controlled trial

Abstract

In 122 high-functioning children with autism spectrum disorder (ASD; 9–13 years; 19 girls), we investigated the effectiveness of a 15-session social skills group training (SST) with and without parent and teacher involvement (PTI) in a randomized controlled trial with three conditions: SST ( n = 47), SST–PTI ( n = 51), and care-as-usual (CAU, n = 24). Hierarchical linear modeling was used for immediate and 6-month follow-up analyses. Measures were administered before randomization (blind), post-treatment and at follow-up (not blind). Trial registration: Dutch Trial Register; http://www.trialregister.nl ; NTR2405. At post-treatment, children in both SSTs had improved significantly more than CAU on the primary outcome, Vineland Socialization (SST: Cohen’s d = 0.39; 95% CI − 2.23 to 3.11 and SST–PTI: d = 0.43; 95% CI − 2.19 to 3.15) and on the secondary outcome parent-SSRS “Cooperation” (SST: d = 0.43; 95% CI − 0.23 to 1.15 and SST–PTI: d = 0.45; 95% CI − 0.21 to 1.17), with no difference between post-treatment and follow-up. Additionally, children in SST–PTI improved significantly more on the teacher-SSRS than in CAU [“Cooperation” d =0.42 (95% CI − 0.33 to 1.13); “Assertion” d =0.34 (95% CI − 0.39 to 1.11); “Self-Control” d =0.61 (95% CI − 0.08 to 1.34)] and in SST [“Cooperation” d =0.34 (95% CI − 0.37 to 1.05); “Self-Control” d =0.59 (95% CI − 0.13 to 1.32)]. The current study corroborates earlier findings in smaller samples and wider age ranges, with small but statistically significant effects of SST for high-functioning pre-adolescent children with ASD. Parental and teacher involvement intensified treatment, yet did not yield an additional effect relative to SST for children only, as reported by parents. 6 months after training, no further improvement or decline was found. Electronic supplementary material The online version of this article (10.1007/s00787-018-1205-1) contains supplementary material, which is available to authorized users.

Application of Latent Class Analysis to Identify Subgroups of Children with Autism Spectrum Disorders who Benefit from Social Skills Training

“…That is, more children in this subgroup participated in SST without parent and teacher involvement than in SST with such involvement. In the comparison between the three conditions of the RCT that the current paper was based on, we found no difference across all participants between the effect of SSTs with or without parent and teacher involvement compared to CAU reported by parents (Dekker et al 2019). Yet, taking into account individual differences, the current study indicates that no formal parent and teacher involvement negatively affects outcome on SST for those children with poor social communicative skills and high perceived difficulty of these skills as reported by parents at start.…”

“…The study was based on data from an RCT on the effectiveness of group SST with and without parental and teacher involvement, with three conditions: Social Skills Training (SST; n = 47), Social Skills Training with Parent and Teacher Involvement (SST-PTI; n = 51) and CAU (n = 24) (Dekker et al 2014(Dekker et al , 2019. From September 2010 through September 2013, training groups had started (September and February), data collection therefore started in May 2010 (first pre test) and ended in October 2014 (last follow-up measurement).…”

“…This involvement was added to advance the generalization of social skills to situations beyond the training. 21.6 (11.5) 2-54 SNAP-IV-P ADHD inattention a 12.6 (6.6) 1-26 ADHD hyperactivity/impulsivity a 9.3 (5.8) 0-27 A more comprehensive description of the SST and SST-PTI can be found elsewhere (Dekker et al 2014(Dekker et al , 2019.…”

“…With the current study we aimed to increase the insight into patterns of response to SST of children with ASD, and their relation with multiple characteristics. Therefore, we applied a Latent Class Analysis (LCA) to a randomized controlled trial (RCT) dataset on the effectiveness of group SST with and without parental and teacher involvement, compared to each other and to care as usual (CAU) (Efficacy of Social skills Training In Autism [ESTIA]; Dekker et al 2019). The RCT was conducted in 122 high-functioning pre-adolescents with ASD, and involved pre, post, and six months follow-up measures in all conditions (Dekker et al 2014(Dekker et al , 2019.…”

Social Skills Training for Autism Spectrum Disorder: a Meta-analysis of In-person and Technological Interventions

“…The majority of the included studies fell within the Some Risk-of-Bias category and evidence of bias was also evident at the study-level through funnel plot analysis (Borenstein et al 2009). Notably, the three largest studies (Choque Olsson et al 2017;Dekker et al 2019;Freitag et al 2016) had relatively smaller effects, though they demonstrated the highest precision, resulting in an asymmetric funnel plot. This suggests that the magnitude of the overall effect may be positively biased and that further studies with similarly large samples should be conducted in order to gain more accurate and precise estimates of the overall effects.…”