A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers?

Erik J Mulder,Vera Dekker,Marieke E Timmerman,Annelies de Bildt,Maaike H Nauta

doi:10.1186/1471-244x-14-189

Abstract

BackgroundSocial skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills. Despite the fact that SSTs are often applied in clinical practice, the evidence for the effectiveness of these trainings for children with ASD is inconclusive. Moreover, long term outcome and generalization of learned skills are little evaluated. Additionally, there is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life. We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life.Method/DesignIn a randomized controlled trial (RCT) with three conditions, 120 participants with ASD at the end of primary school (10–12 years of calendar age) have been randomized to SST, SST-PTI (SST with Parent & Teacher Involvement), or care-as-usual. The SST consists of 18 group sessions of 1.5 hours for the children. In the SST-PTI condition, parents additionally participate in 8 parent sessions and parents and teachers are actively involved in homework assignments. Assessment takes place at three moments: before and immediately after the intervention period and at 6 months follow-up. Primary outcome is socialization, as an aspect of adaptive functioning. Secondary outcomes focus on specific social skills children learn during SST and on more general social skills pertaining to home and community settings from a multi-informant perspective. Additionally, possible predictors of treatment outcome will be assessed.DiscussionThe current study is an RCT study evaluating SST in a large sample of Dutch children with ASD in a specific age range (10–12 years). Strengths of the study are the use of one manualized protocol, application of standardized and internationally used rating instruments, use of multiple raters, investigation of generalization of learned skills to daily life, and the evaluation of efficacy in the longer term by follow-up measures at 6 months after the end of training.Trial registrationNTR2405

Highlights

Social skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills
Strengths of the study are the use of one manualized protocol, application of standardized and internationally used rating instruments, use of multiple raters, investigation of generalization of learned skills to daily life, and the evaluation of efficacy in the longer term by follow-up measures at 6 months after the end of training
ASDs typically emerge during young childhood and they persist throughout the lifespan

Summary

Introduction

Social skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills. There is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life. We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life. The symptoms are seen as a continuum, ranging from mild to severe expression [3] This revised perspective on ASDs reflects empirical research into the underlying factors for ASDs [3] and is in line with clinical presentation in daily practice. The prevalence of ASDs is estimated at 1 per 150 children and adolescents [5], with the ratio of boys to girls being 4:1

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