Abstract

BackgroundGroup social skills programs for autism spectrum disorder (ASD) have been shown to improve social skills knowledge and parent and teacher survey ratings, but have been limited by a lack of directly observed measures of social skills in unstructured settings. MethodsThe goal of this study was to examine the feasibility of using a novel, directly observed measure (“game day”) to monitor changes in social skills in students with ASD participating in a 16-week, school-based social skills program (Program for the Education and Enrichment of Relational Skills - PEERS). Game day occurred once a month and consisted of the instructor placing a set of board games in the room and then leaving. Videos of the game day sessions were rated by three reviewers (blinded to the video sequence) using a modified version of the Contextual Assessment of Social Skills (CASS). ResultsSix students (age range 13–22, 5 male) enrolled and completed all PEERS instruction and 5 monthly game day sessions. Reviewers were able to complete ratings for all scale items except frequency of initiations and responses. The remaining nine CASS items were used to generate a summary score for each child; the mean score improved from 38.5 to 43.6 (p = 0.011). Validated surveys also showed statistically significant improvements in social skills knowledge, problem behaviors, and ASD behaviors. ConclusionsThis study provides initial evidence that a directly observed measure detects changes in social competence in ASD and may provide a broader assessment of social ability.

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