Establishment of Social Skills Training Group in Adolescents With Autism Spectrum Disorder and Effectiveness Analysis

NCT05341011 | Completed

• 1 other identifier: 201906022RIND
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Autism spectrum disorders (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, and the presence of restricted, repetitive behavior and interests. Their social relationships with peers may remain a challenge or even worsen for individuals with ASD throughout the school years and beyond. Adolescence may be a particularly difficult developmental period, as they may have greater motivation or desire to engage with peers but also have greater awareness of their social disability. Adolescents with ASD are reported to experience greater loneliness and mood disturbances, and have poorer friendship quality and social network status than their typically developing peers. Moreover, a growing body of literature indicating that students with ASD have increased risk at all kinds of bullying involvement. These findings underscore the importance of providing social skills training. One of the empirically supported intervention program that targets adolescents with ASD is the Program for the Education and Enrichment of Relational Skills (PEERS®). This is a parent-assisted, manualized social skills training program that addresses crucial areas of social functioning for adolescents. Psycho-education and cognitive-behavioral therapy techniques are employed to help adolescents develop ecologically valid skills for making and maintaining friendships. Moreover, caregiver attendance at the same time in the caregiver group was a mandatory component to enhance the child/s generalization of social skills. Adolescents with ASD and normal IQ will be recruit to attend the 14-week PEERS® group training together with a parent. The participants will be stratified by gender and randomized to a treatment (TX) group or delayed treatment control (DTC) group. A team member uninvolved in the program made the random allocation with random digit generated by computer. This study investigated the acceptability, feasibility and effectiveness of the Taiwanese adolescent PEERS® program.

Conditions

Autism Spectrum Disorder High-Functioning

Keywords

autism spectrum disorder; social skills training program; adolescents

Outcome Measures

Primary Outcomes (18)

• Test of Adolescents Social Skills Knowledge (TASSK)

  The TASSK consists of 26 items derived from the 13 didactic lessons in PEERS® to assess the specific social skills knowledge taught during the intervention. Adolescents were asked to read sentence stems and choose the best answer from two options to complete the sentence in each item. Each correct answer was awarded one point. Higher scores on this task reflected better knowledge of social etiquette, and the maximum possible score was 26. Previous studies on the PEERS® intervention have shown that the TASSK is sensitive to treatment effects. The original English Version was reported a coefficient alpha of 0.56, and the Chinese version (Shum et al., 2019) also obtained a ronbach's alpha of 0.50. The reliability of this measure was thus similar to those reported in previous studies.

  Baseline and Pre-Intervention

• Test of Adolescents Social Skills Knowledge (TASSK)

  The TASSK consists of 26 items derived from the 13 didactic lessons in PEERS® to assess the specific social skills knowledge taught during the intervention. Adolescents were asked to read sentence stems and choose the best answer from two options to complete the sentence in each item. Each correct answer was awarded one point. Higher scores on this task reflected better knowledge of social etiquette, and the maximum possible score was 26. Previous studies on the PEERS® intervention have shown that the TASSK is sensitive to treatment effects. The original English Version was reported a coefficient alpha of 0.56, and the Chinese version (Shum et al., 2019) also obtained a ronbach's alpha of 0.50. The reliability of this measure was thus similar to those reported in previous studies.

  During the Intervention

• Test of Adolescents Social Skills Knowledge (TASSK)

  The TASSK consists of 26 items derived from the 13 didactic lessons in PEERS® to assess the specific social skills knowledge taught during the intervention. Adolescents were asked to read sentence stems and choose the best answer from two options to complete the sentence in each item. Each correct answer was awarded one point. Higher scores on this task reflected better knowledge of social etiquette, and the maximum possible score was 26. Previous studies on the PEERS® intervention have shown that the TASSK is sensitive to treatment effects. The original English Version was reported a coefficient alpha of 0.56, and the Chinese version (Shum et al., 2019) also obtained a ronbach's alpha of 0.50. The reliability of this measure was thus similar to those reported in previous studies.

  Immediately after the Intervention

• Test of Adolescents Social Skills Knowledge (TASSK)

  The TASSK consists of 26 items derived from the 13 didactic lessons in PEERS® to assess the specific social skills knowledge taught during the intervention. Adolescents were asked to read sentence stems and choose the best answer from two options to complete the sentence in each item. Each correct answer was awarded one point. Higher scores on this task reflected better knowledge of social etiquette, and the maximum possible score was 26. Previous studies on the PEERS® intervention have shown that the TASSK is sensitive to treatment effects. The original English Version was reported a coefficient alpha of 0.56, and the Chinese version (Shum et al., 2019) also obtained a ronbach's alpha of 0.50. The reliability of this measure was thus similar to those reported in previous studies.

  Change from Post-Intervention at 4 months

• Test of Adolescents Social Skills Knowledge (TASSK)

  The TASSK consists of 26 items derived from the 13 didactic lessons in PEERS® to assess the specific social skills knowledge taught during the intervention. Adolescents were asked to read sentence stems and choose the best answer from two options to complete the sentence in each item. Each correct answer was awarded one point. Higher scores on this task reflected better knowledge of social etiquette, and the maximum possible score was 26. Previous studies on the PEERS® intervention have shown that the TASSK is sensitive to treatment effects. The original English Version was reported a coefficient alpha of 0.56, and the Chinese version (Shum et al., 2019) also obtained a ronbach's alpha of 0.50. The reliability of this measure was thus similar to those reported in previous studies.

  Change from Post-Intervention at 8 months

• Test of Adolescents Social Skills Knowledge (TASSK)

  The TASSK consists of 26 items derived from the 13 didactic lessons in PEERS® to assess the specific social skills knowledge taught during the intervention. Adolescents were asked to read sentence stems and choose the best answer from two options to complete the sentence in each item. Each correct answer was awarded one point. Higher scores on this task reflected better knowledge of social etiquette, and the maximum possible score was 26. Previous studies on the PEERS® intervention have shown that the TASSK is sensitive to treatment effects. The original English Version was reported a coefficient alpha of 0.56, and the Chinese version (Shum et al., 2019) also obtained a ronbach's alpha of 0.50. The reliability of this measure was thus similar to those reported in previous studies.

  Change from Post-Intervention at 16 months

• Quality of Play Questionnaire (QPQ)

  The QPQ was adapted from Frankel and Mintz (2011) and included in the original treatment manual as QPQ-P (parent) and QPQ-A (adolescent). Parents and adolescents were asked to complete the questionnaire independently. There are 12 items in the questionnaire, 2 of which assess the frequency of get-togethers over the previous month, and the remaining 10 items gauge the level of conflict during the last hosted get-together. Items on the Conflict Scale, for instance, include "They/We criticized or teased each other". Higher scores on the Conflict Scale indicated more conflict observed during the last get-together.

  Baseline and Pre-Intervention

• Quality of Play Questionnaire (QPQ)

  The QPQ was adapted from Frankel and Mintz (2011) and included in the original treatment manual as QPQ-P (parent) and QPQ-A (adolescent). Parents and adolescents were asked to complete the questionnaire independently. There are 12 items in the questionnaire, 2 of which assess the frequency of get-togethers over the previous month, and the remaining 10 items gauge the level of conflict during the last hosted get-together. Items on the Conflict Scale, for instance, include "They/We criticized or teased each other". Higher scores on the Conflict Scale indicated more conflict observed during the last get-together.

  During the Intervention

• Quality of Play Questionnaire (QPQ)

  The QPQ was adapted from Frankel and Mintz (2011) and included in the original treatment manual as QPQ-P (parent) and QPQ-A (adolescent). Parents and adolescents were asked to complete the questionnaire independently. There are 12 items in the questionnaire, 2 of which assess the frequency of get-togethers over the previous month, and the remaining 10 items gauge the level of conflict during the last hosted get-together. Items on the Conflict Scale, for instance, include "They/We criticized or teased each other". Higher scores on the Conflict Scale indicated more conflict observed during the last get-together.

  Immediately after the Intervention

• Quality of Play Questionnaire (QPQ)

  The QPQ was adapted from Frankel and Mintz (2011) and included in the original treatment manual as QPQ-P (parent) and QPQ-A (adolescent). Parents and adolescents were asked to complete the questionnaire independently. There are 12 items in the questionnaire, 2 of which assess the frequency of get-togethers over the previous month, and the remaining 10 items gauge the level of conflict during the last hosted get-together. Items on the Conflict Scale, for instance, include "They/We criticized or teased each other". Higher scores on the Conflict Scale indicated more conflict observed during the last get-together.

  Change from Post-Intervention at 4 months

• Quality of Play Questionnaire (QPQ)

  The QPQ was adapted from Frankel and Mintz (2011) and included in the original treatment manual as QPQ-P (parent) and QPQ-A (adolescent). Parents and adolescents were asked to complete the questionnaire independently. There are 12 items in the questionnaire, 2 of which assess the frequency of get-togethers over the previous month, and the remaining 10 items gauge the level of conflict during the last hosted get-together. Items on the Conflict Scale, for instance, include "They/We criticized or teased each other". Higher scores on the Conflict Scale indicated more conflict observed during the last get-together.

  Change from Post-Intervention at 8 months

• Quality of Play Questionnaire (QPQ)

  The QPQ was adapted from Frankel and Mintz (2011) and included in the original treatment manual as QPQ-P (parent) and QPQ-A (adolescent). Parents and adolescents were asked to complete the questionnaire independently. There are 12 items in the questionnaire, 2 of which assess the frequency of get-togethers over the previous month, and the remaining 10 items gauge the level of conflict during the last hosted get-together. Items on the Conflict Scale, for instance, include "They/We criticized or teased each other". Higher scores on the Conflict Scale indicated more conflict observed during the last get-together.

  Change from Post-Intervention at 16 months

• Chinese version of the School Bullying Experience Questionnaire (C-SBEQ)

  The self-reported C-SBEQ was used to evaluate participants' involvement in school bullying in recent months with 16 items answered on a Likert 4-point scale range with 0 indicating "never", 1 indicating "just a little", 2 indicating "often", and 3 indicating "all the time". This scale was composed of four 4-item subscales evaluating being a victim of passive bullying (items 1 to 4, including social exclusion, being called a mean nickname, and being spoken ill of), being a victim of active bullying (items 5 to 8, including being beaten up, being forced to do work, and having money, school supplies, and snacks taken away), being a perpetrator of passive bullying (items 9 to 12), and being a perpetrator of active bullying (items 13 to 16).

  Baseline and Pre-Intervention

• Chinese version of the School Bullying Experience Questionnaire (C-SBEQ)

  The self-reported C-SBEQ was used to evaluate participants' involvement in school bullying in recent months with 16 items answered on a Likert 4-point scale range with 0 indicating "never", 1 indicating "just a little", 2 indicating "often", and 3 indicating "all the time". This scale was composed of four 4-item subscales evaluating being a victim of passive bullying (items 1 to 4, including social exclusion, being called a mean nickname, and being spoken ill of), being a victim of active bullying (items 5 to 8, including being beaten up, being forced to do work, and having money, school supplies, and snacks taken away), being a perpetrator of passive bullying (items 9 to 12), and being a perpetrator of active bullying (items 13 to 16).

  During the Intervention

• Chinese version of the School Bullying Experience Questionnaire (C-SBEQ)

  The self-reported C-SBEQ was used to evaluate participants' involvement in school bullying in recent months with 16 items answered on a Likert 4-point scale range with 0 indicating "never", 1 indicating "just a little", 2 indicating "often", and 3 indicating "all the time". This scale was composed of four 4-item subscales evaluating being a victim of passive bullying (items 1 to 4, including social exclusion, being called a mean nickname, and being spoken ill of), being a victim of active bullying (items 5 to 8, including being beaten up, being forced to do work, and having money, school supplies, and snacks taken away), being a perpetrator of passive bullying (items 9 to 12), and being a perpetrator of active bullying (items 13 to 16).

  Immediately after the Intervention

• Chinese version of the School Bullying Experience Questionnaire (C-SBEQ)

  The self-reported C-SBEQ was used to evaluate participants' involvement in school bullying in recent months with 16 items answered on a Likert 4-point scale range with 0 indicating "never", 1 indicating "just a little", 2 indicating "often", and 3 indicating "all the time". This scale was composed of four 4-item subscales evaluating being a victim of passive bullying (items 1 to 4, including social exclusion, being called a mean nickname, and being spoken ill of), being a victim of active bullying (items 5 to 8, including being beaten up, being forced to do work, and having money, school supplies, and snacks taken away), being a perpetrator of passive bullying (items 9 to 12), and being a perpetrator of active bullying (items 13 to 16).

  Change from Post-Intervention at 4 months

• Chinese version of the School Bullying Experience Questionnaire (C-SBEQ)

  The self-reported C-SBEQ was used to evaluate participants' involvement in school bullying in recent months with 16 items answered on a Likert 4-point scale range with 0 indicating "never", 1 indicating "just a little", 2 indicating "often", and 3 indicating "all the time". This scale was composed of four 4-item subscales evaluating being a victim of passive bullying (items 1 to 4, including social exclusion, being called a mean nickname, and being spoken ill of), being a victim of active bullying (items 5 to 8, including being beaten up, being forced to do work, and having money, school supplies, and snacks taken away), being a perpetrator of passive bullying (items 9 to 12), and being a perpetrator of active bullying (items 13 to 16).

  Change from Post-Intervention at 8 months

• Chinese version of the School Bullying Experience Questionnaire (C-SBEQ)

  The self-reported C-SBEQ was used to evaluate participants' involvement in school bullying in recent months with 16 items answered on a Likert 4-point scale range with 0 indicating "never", 1 indicating "just a little", 2 indicating "often", and 3 indicating "all the time". This scale was composed of four 4-item subscales evaluating being a victim of passive bullying (items 1 to 4, including social exclusion, being called a mean nickname, and being spoken ill of), being a victim of active bullying (items 5 to 8, including being beaten up, being forced to do work, and having money, school supplies, and snacks taken away), being a perpetrator of passive bullying (items 9 to 12), and being a perpetrator of active bullying (items 13 to 16).

  Change from Post-Intervention at 16 months

Secondary Outcomes (16)

• Swanson, Nolan, and Pelham, version IV (SNAP-IV)

  Baseline and Pre-Intervention, immediate Post-Intervention, and the 4th-, 8th- and 16th-month follow-up

• Social Adjustment Inventory for Children and Adolescents (SAICA)

  Baseline and Pre-Intervention, immediate Post-Intervention, and the 4th-, 8th- and 16th-month follow-up

• Empathy Quotient (EQ)

  Baseline and Pre-Intervention, immediate Post-Intervention, and the 4th-, 8th- and 16th-month follow-up

• Friendship Questionnaire (FQ)

  Baseline and Pre-Intervention, immediate Post-Intervention, and the 4th-, 8th- and 16th-month follow-up

• Friendship Quality Scale (FQS)

  Baseline and Pre-Intervention, immediate Post-Intervention, and the 4th-, 8th- and 16th-month follow-up

Study Arms (2)

Treatment (TX) Group

EXPERIMENTAL

The TX group received 14 weeks of the PEERS® intervention immediately following a baseline assessment,

Behavioral: PEERS® Social Skills Training

Delayed Treatment Control (DTC) Group

EXPERIMENTAL

The DTC group received the same intervention after a 14-week waiting period. Parents and teens attended concurrent sessions held in separate rooms.

Behavioral: PEERS® Social Skills Training

Interventions

PEERS® Social Skills Training BEHAVIORAL

The PEERS® consisted of 14 weekly 90-min didactic sessions. Adolescents and their parents attended separate concurrent sessions. Each session began with a review of the homework assignment from the previous week and allowed time for troubleshooting problems encountered in completing the behavioral assignment. This was followed by a didactic lesson on the weekly topic. Didactic lessons included content related to various social skills and peer interactions. Parents attendance was a mandatory component of PEERS® intervention. Parents were expected to enhance generalization of social skills through in vivo social coaching in natural social settings and increase homework compliance as well as practice of newly learned social skills. A 10-min reunification between adolescents and caregivers was arranged at the end of each session to review the skills taught in the session and assign corresponding homework for the next session.

Delayed Treatment Control (DTC) Group; Treatment (TX) Group

Eligibility Criteria

• Age: 12 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Teens:
• currently enrolled in school
• clinical diagnosis of Autism Spectrum Disorder (ASD)
• experiencing social difficulties
• scored ≧ 26 on the caregiver-reported Autism Spectrum Quotient (AQ)
• verbal fluency in Chinese
• with a full-scale IQ \> 70 on WAIS-IV
• with motivation to participate in the intervention
• Parents:
• verbal fluency in Chinese
• with motivation to participate in the intervention

You may not qualify if:

• major mental illness
• sever visual or hearing impairment

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

National Taiwan University Hospital

Taipei, Taiwan

Location

Related Publications (7)

• Laugeson EA, Frankel F, Gantman A, Dillon AR, Mogil C. Evidence-based social skills training for adolescents with autism spectrum disorders: the UCLA PEERS program. J Autism Dev Disord. 2012 Jun;42(6):1025-36. doi: 10.1007/s10803-011-1339-1.

  PMID: 21858588 BACKGROUND

• Laugeson EA, Frankel F, Mogil C, Dillon AR. Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders. J Autism Dev Disord. 2009 Apr;39(4):596-606. doi: 10.1007/s10803-008-0664-5. Epub 2008 Nov 18.

  PMID: 19015968 BACKGROUND

• Rao PA, Beidel DC, Murray MJ. Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations. J Autism Dev Disord. 2008 Feb;38(2):353-61. doi: 10.1007/s10803-007-0402-4. Epub 2007 Jul 20.

  PMID: 17641962 BACKGROUND

• Schroeder JH, Cappadocia MC, Bebko JM, Pepler DJ, Weiss JA. Shedding light on a pervasive problem: a review of research on bullying experiences among children with autism spectrum disorders. J Autism Dev Disord. 2014 Jul;44(7):1520-34. doi: 10.1007/s10803-013-2011-8.

  PMID: 24464616 BACKGROUND

• Andanson J, Pourre F, Maffre T, Raynaud JP. [Social skills training groups for children and adolescents with Asperger syndrome: A review]. Arch Pediatr. 2011 May;18(5):589-96. doi: 10.1016/j.arcped.2011.02.019. Epub 2011 Apr 1. French.

  PMID: 21458972 BACKGROUND

• Yoo HJ, Bahn G, Cho IH, Kim EK, Kim JH, Min JW, Lee WH, Seo JS, Jun SS, Bong G, Cho S, Shin MS, Kim BN, Kim JW, Park S, Laugeson EA. A randomized controlled trial of the Korean version of the PEERS((R)) parent-assisted social skills training program for teens with ASD. Autism Res. 2014 Feb;7(1):145-61. doi: 10.1002/aur.1354. Epub 2014 Jan 9.

  PMID: 24408892 BACKGROUND

• Hsiao MN, Chien YL, Tai YM, Chen HM, Shih HH, Chen LW, Chen YY, Soong WT, Chiu YN, Tsai WC, Laugeson E, Tseng MH, Gau SS. A preliminary randomized controlled study of the PEERS(R) program for Taiwanese autistic adolescents: The effectiveness on reducing school bullying and enhancing social function. Autism Res. 2024 Aug;17(8):1705-1720. doi: 10.1002/aur.3213.

  PMID: 39169699 DERIVED

MeSH Terms

Conditions

Autism Spectrum Disorder

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Mei-Ni Hsiao, MA

  National Taiwan University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 31, 2022
• First Posted: April 22, 2022
• Study Start: August 2, 2019
• Primary Completion: August 17, 2021
• Study Completion: October 26, 2023
• Last Updated: October 27, 2023

Record last verified: 2023-08

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)