Social Skills Deficits Research Articles

Understanding the Effect Size of Peer-Mediated Academic Instruction: A Meta-Analysis

A deficit in social skills often makes teaching academics a second thought when instructing students with autism. Peer-mediated instruction has been well studied for increasing academic skills across various disabilities and social skills for students with autism spectrum disorder (ASD). The purpose of this study was to determine the effect size of peer-mediated academic instruction (PMAI) to increase academic skills for students with ASD. Results indicate studies demonstrate a weak to moderate effect when using PMAI to teach students with ASD. These results validate PMAI can be effective when teaching academic skills to students with ASD; however, more studies are needed to better understand for whom and under what conditions PMAI is most effective.

Anxiety and Social Skills Deficit levels among Children with Autism Spectrum Disorder in Nairobi, Kenya

This paper examines the severity level of anxiety and social skills deficits among children living with Autism among two schools in Nairobi County. Parents and teachers of 40 children and adolescents aged between 5-21 years old were used to conducting the assessment. Social skills deficits (SRS-2) and anxiety (CASI) questionnaires were used in data collection. The quasi-experimental study then involved a follow-up six months after data collection before conducting a statistical analysis. The results depict a significant decline in social skills represented by p=0.006 (95% C.I 4.97, 27.8). However, anxiety treatment was found to be not substantial even though the p-value = 0.002 was less than the significant level. The study concluded that the effect of ASD is real and can be treated. It requires being addressed as early as possible in the affected persons to allow them to achieve their full potential in life. The results provide essential insights into ASD and mental health. This paper adds to knowledge on ASD and anxiety and social skills and common comorbid disorders. The study recommended that the effect of ASD is real and can be treated. It requires being addressed as early as possible in the affected persons to allow them to achieve their full potential in life. The results provide essential insights into ASD and mental health.

The Relationship between Anxiety, Social Skills Deficit and Autism Spectrum Disorder among Autistic Children in Nairobi, Kenya.

This paper investigates the relationship between anxiety and social skills deficit and ASD in children living with autism. Focusing on Nairobi County in Kenya, the author engaged parents and teachers of 40 children and adolescents aged 5-21 years old. The study adopted a quasi-experimental design in two schools representing the experimental (n=20) and control (n=20) schools. Questionnaires were used for data collection. The intervention was done immediately after the baseline data was collected and followed up for six months. There was a significant decline in social skills deficits p=0.006 (95% C.I (4.97, 27.8)). In addition, remission of anxiety and social skills deficits is achievable by MASSI in children and adolescents with ASD in schools. The Social Responsiveness Scale (SRS-2) was used to measure the Autism Spectrum Disorder with scores ranging from 1- not accurate to 4 – almost always true. The indicator depicts reliable internal consistency of 0.90, with a higher score implying greater severity of the social deficit syndrome. The study found out that there was a correlation between the symptoms of anxiety and social skills deficits, anxiety problems in school-age children and adolescents and finally, social skills with ASD among the studied population. The study recommended that parents and caregivers of autistic children ought to adopt Skinner's contingency of reinforcement, address and support children's necessities having ASD and finally raising funds would enable the Ministry of Education to develop a curriculum that would address, prioritise and focus on the skill deficits most specific and appropriate to autism.

The Potential of Virtual Reality in Social Skills Training for Autism: Bridging the Gap Between Research and Adoption of Virtual Reality in Occupational Therapy Practice

Impairments in social functioning greatly hinder children and youth with autism spectrum disorder (ASD) from responding appropriately and adapting to various social situations. As a result, individuals with ASD get fewer opportunities for social inclusion, physical well-being, and forming interpersonal relationships. Virtual reality (VR) has been studied extensively in this area, where a large body of evidence shows that VR is a promising tool for social skills training (SST) in individuals with ASD. With the flexibility and projected effectiveness that VR offers, it can provide more opportunities to learn and practice strategies for recognizing daily challenges that involve forming social relationships and associated reasoning. This paper discusses the gap between the effectiveness of VR-based SST and its adoption in occupational therapy (OT) practice. There is a significant dearth of resources for the development of occupational therapists to effectively administer these interventions. Such resources that summarize empirically supported VR interventions to teach social skills to people with autism would be very valuable in training therapists who wish to employ them. Using theory-driven approaches, this paper intends to empower occupational therapists in becoming efficient and confident in using this technology for addressing social skills deficits in people with ASD.

Recommendations for Social Skills End Points for Clinical Trials in Neurofibromatosis Type 1.

To review parent-report social skills measures to identify and recommend consensus outcomes for use in clinical trials of social deficit in children and adolescents (ages 6-18 years) with neurofibromatosis type 1 (NF1). Searches were conducted via PubMed and ClinicalTrials.gov to identity social skills outcome measures with English language versions used in clinical trials in the past 5 years with populations with known social skills deficits, including attention-deficit/hyperactivity disorder and autism spectrum disorder (ASD). Measures were rated by the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) Neurocognitive Committee on patient characteristics, use in published studies, domains assessed, availability of standard scores, psychometric properties, and feasibility to determine their appropriateness for use in NF1 clinical trials. Two measures were ultimately recommended by the committee: the Social Responsiveness Scale-2 (SRS-2) and the Social Skills Improvement System-Rating Scale (SSIS-RS). Each of the 2 measures assesses different aspects of social functioning. The SSIS-RS is appropriate for studies focused on broader social functioning; the SRS-2 is best for studies targeting problematic social behaviors associated with ASD. Researchers will need to consider the goals of their study when choosing a measure, and specific recommendations for their use are provided.

ТІРЕК-ҚИМЫЛ АППАРАТЫ ЗАҚЫМДАЛҒАН ЖЕТКІНШЕК БАЛАЛАРҒА САНДЫҚ БІЛІМ БЕРУДЕГІ АРТЫҚШЫЛЫҚТАР

Online technologies offer many positive social and behavioral opportunities for students with special needs and allow you to develop correctional and developmental programs in accordance with the age and individual characteristics of children, their state of mental and somatic health. Children with special educational needs, such as those with musculoskeletal disorders, often experience significant deficits in social reciprocity and communication skills, but these children are very sensitive to technology.

Microbiota and Microglia Interactions in ASD.

Autism spectrum disorders (ASD) are serious, highly variable neurodevelopmental disorders, commonly characterized by the manifestation of specific behavioral abnormalities, such as stereotypic behaviors and deficits in social skills, including communication. Although the neurobiological basis for ASD has attracted attention in recent decades, the role of microglial cells, which are the main resident myeloid cell population in the brain, is still controversial and underexplored. Microglia play several fundamental roles in orchestrating brain development and homeostasis. As such, alterations in the intrinsic functions of these cells could be one of the driving forces responsible for the development of various neurodevelopmental disorders, including ASD. Microglia are highly sensitive to environmental cues. Amongst the environmental factors known to influence their intrinsic functions, the gut microbiota has emerged as a central player, controlling both microglial maturation and activation. Strikingly, there is now compelling data suggesting that the intestinal microbiota can play a causative role in driving the behavioural changes associated with ASD. Not only is intestinal dysbiosis commonly reported in ASD patients, but therapies targeting the microbiome can markedly alleviate behavioral symptoms. Here we explore the emerging mechanisms by which altered microglial functions could contribute to several major etiological factors of ASD. We then demonstrate how pre- and postnatal environmental stimuli can modulate microglial cell phenotype and function, underpinning the notion that reciprocal interactions between microglia and intestinal microbes could play a crucial role in ASD aetiology.

Genetic and cytogenetic screening of autistic spectrum disorder: Genotype-phenotype profiles

Autism, a pervasive developmental disorder typically characterized by repetitive behaviour, social skills deficit (or a deficit in social communication), speech and language impairments. Our prime focus is to analyze the clinical features and phenotypical behavioural changes using the diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM IV-TR), and locating the biomarkers associated with specific autistic characters using karyotyping and fluorescence in situ hybridization (FISH) techniques. The prevalence rate of the neurexin 1 (NRXN1) gene polymorphism was also assessed in the current study. The study group involved 196 samples with 98 autistics, and equal age-matched (±2) controls based on their birth order and carrier. The participants include 35.2% males (n = 69) and 14.8% females (n = 29). The autistic and control participants were categorized based on their ages as group I (<12 yrs) with n = 62; males n = 41 (20.9%); females n = 21 (10.7%) and group II (≥12 yrs)-n = 36; males n = 28 (14.2%); females n = 08 (4.08%). Karyotyping was done for autism participants (n = 98) and the results showed that 90% of autistic participants were either the only child or the first child with a low perception and frequency in both the groups. Subsequently, we carried out the FISH assay on participants (n = 37) with higher DSM-IV TR score (≥30). Only 30 FISH tests were negative for subtelomeric deletions with NRXN1 polymorphism genotypic frequency as 62.50%, 25% and 25% for A/A, A/G and G/G genotype respectively. Our study suggests the link between a haplotype with clinical signs of autism for the single nucleotide sequence (SNP rs9636391) and links autistic characters and gene among autistic children according to their birth order, age and gender in India.

Self-esteem, family connectedness and social skills on academic performance of students with hearing impairment in Ibadan, Nigeria

Introduction: Extant and indigenous literature have shown that students with hearing impairment are found to be below their hearing counterparts in the area of academic and their poor academic performance most times, it is traced to lack of communication, paying little or no attention to other factors. Purpose: This study therefore investigated factors such as self-esteem, family connectedness and social skills as determinants of academic performance of students with hearing impairment in Ibadan Oyo State, Nigeria. Design: Descriptive survey research design was adopted in the study. A total of fifty two students with hearing impairment were selected through simple random sampling technique for the study. Purposive sampling technique was used to select three integrated schools in Ibadan. Four instruments were validated and used to collect relevant data. Three research questions were raised to guide the study. Data collected were subjected to a descriptive and inferential statistics. Results: The study found that there was positive multiple correlation (R = 0.572) among self-esteem, social skills deficits and family connectedness on academic performance. All these factors in this order of magnitude: family connectedness (r = 0.426, p &lt;0.05); self-esteem (r = 0.419, p&lt; 0.05), and social skills deficits (r = 0.138, p&lt; 0.05) predicted academic performance of students with hearing impairment. Recommendations: It was therefore recommended that school counselors should provide direct service to parents, classroom teachers, school community and students with hearing impairment on the roles these factors play on the academic performance of students with hearing impairment.

The Social Referencing Observation Scale (SoROS) for children: Scale development and reliability

AbstractThe Social Referencing Observational Scale (SoROS) is being developed to measure and detect deficits in social referencing skills in children between 2.6 and 5.0 years of age. This study is the first in the sequence, describing the first phases of development. First, three different scenarios designed to evoke social referencing behaviors were selected. We called the scenarios Fear, Pain, and Joy. In the pilot study, social referencing in 60 typical children was scored. Based on the data from the pilot study, the scoring system was refined and another 204 children were tested. We report descriptive data on social referencing in typical children across age and gender. Our main finding was that all children showed social referencing in that they first looked for cues in another person as for how to behave, and second behaved accordingly. This was the case across all three tested scenarios. Inter‐rater reliability for individual scoring behaviors in all three scenarios was good to high. The descriptive data for how typical children behave in these scenarios can provide the basis for detecting deficits in social referencing and for planning interventions.

Klinefelter Syndrome and Turner Syndrome.

1. Carole Samango-Sprouse, EdD*,†,‡ 2. Sophia Q. Song, BA‡ 3. Angela E. Lin, MD§ 4. Cynthia M. Powell, MD¶ 5. Andrea L. Gropman, MD*,** 1. *George Washington University, Washington, DC 2. †Florida International University, Miami, FL 3. ‡Department of Research, The Focus Foundation, Davidsonville, MD 4. §Massachusetts General Hospital for Children, Boston, MA 5. ¶University of North Carolina at Chapel Hill, Chapel Hill, NC 6. **Children’s National Medical Center, Washington, DC Sex chromosome aneuploidy (SCA) syndromes refer to disorders with an abnormality of sex chromosome number. The most common are Klinefelter syndrome (KS), resulting from the gain of an X chromosome in males, and Turner syndrome (TS), reflecting the loss of an X chromosome or the presence of a structurally different X chromosome in females. Whereas most patients with KS have nonmosaic 47,XXY, only 40% of women with TS have 45,X; the remainder have a variety of mosaicisms. The syndromes also contrast in that males with KS are characteristically tall, whereas females with TS are typically short unless they receive hormonal treatment. Despite efforts to increase awareness, KS and TS are often underdiagnosed, leading to delayed care. Only 25% of men with KS are ever diagnosed, with fewer than 10% detected prenatally, and with a median age of 27 years for those identified later in life. For TS, the median age at diagnosis is 6.6 years. Although not exclusively, optimal neurocognitive outcomes depend on the timing of diagnosis and access to early targeted treatment, so fortunately the recent development of noninvasive prenatal screening is increasing the early identification of these disorders dramatically. Pediatricians should be aware of signs that allow for early detection, and the importance of prompt referral for testing and therapy. KS occurs in 1 in 660 live births, representing the most common SCA. Affected males have androgen deficiency, which affects endocrine, central nervous system, and neurodevelopmental function. Characteristics include increased height, clinodactyly of the fifth finger, pes planus, and hypogonadism manifesting as …

The Feasibility of Taekwondo for Addressing Social Interaction and Social Participation in Children

Background: Children with autism spectrum disorder (ASD) often experience physical, social, and emotional barriers that impact participation in extracurricular activities, such as taekwondo. Engaging in taekwondo may provide opportunities for advancing social abilities as well as developing health-promoting behaviors and routines. Therefore, the purpose of this feasibility study was to explore the effectiveness of using a form of martial arts, taekwondo, as an intervention to promote social participation in everyday life. Method: A mixed-methods design was used. Three children between 7 and 8 years of age who met the ASD criteria participated in a 7-week taekwondo program. The children engaged in interviews before and after the program. The parents completed the Autism Social Skills Profile-2 (ASSP-2) and completed pre and post interviews. Results: Four themes emerged from the qualitative data: social interactions, physical abilities, community barriers and supports, and intervention feasibility. Overall, the qualitative data highlighted the children’s increased confidence with social interaction, interests in exploring activities, and program satisfaction. Although not statistically significant, the ASSP-2 scores increased for each child after participation in the program. Conclusion: This study suggests that taekwondo may promote self-confidence in social and physical abilities, leisure exploration, and participation in children with social interaction skills deficits.

Developing Social Skills of Children With Autism Spectrum Disorder for Physical Activity Using a Movement-Based Program

The motor and social skill difficulties experienced by many children with autism spectrum disorder (ASD) can create challenges when participating in age appropriate physical activity contexts. Although behavioral interventions can increase the general social communicative skills of children with ASD, often the skills targeted are not relevant to physical activity contexts. Thus, this pilot study utilized a movement-based intervention program to support children with ASD in learning both social and movement skills that are relevant to physical activity contexts. Nineteen children with ASD with a mean age of 9.3 (±3.0) years participated in this program for 8 weeks, twice a week, at a recreation center as an afterschool activity. Six object control skills were selected and tested before and after the intervention because these gross motor skills were considered to elicit human interactions and place demands on social skills. Ten social skills were selected, aligned to each program context, taught, and evaluated. This intervention resulted in significant improvements in object-control skills for the participants. Additionally, there were significantly more participants who demonstrated improvements in their performance of the target social skills than who did not demonstrate improvements. These preliminary findings provide support for the feasibility of developing interventions that address social skill deficits in the context of physically active settings for children with ASD.

Developing Social Skills and Social Competence in Children with Autism

Social development is one of the most critical developmental areas for human beings. Deficits in social skills may negatively impact several essential domains including academic achievement, interpersonal relationships, behavior, mental health, and adult life outcome. Individuals with autism present with core deficits in social skills. Without supports and effective interventions to enhance social skills, children with autism often struggle to obtain social competence, and may experience challenges in the school, home, and community settings. With effective interventions, children with autism can learn essential social skills that can help to mitigate deficits and strengthen social competence. After a brief review of various theories of social development, this article seeks to present the constructs of social competence, social skills, and adaptive skills in relatable and clear language for educators. Finally, the article will review several evidence-based interventions designed to enhance social skills.

The effectiveness and adverse effects of D-cycloserine compared with placebo on social and communication skills in individuals with autism spectrum disorder.

Symptoms of autism spectrum disorder (ASD) have been associated, in part, with the dysfunction of N-methyl-D-aspartate (NMDA) glutamate receptors at excitatory synapses and glutamate abnormalities. Medications related to glutamatergic neurotransmission, such as D-cycloserine - which is a partial agonist of the NMDA glutamate receptor - are potential treatment options for the core features of ASD. However, the potential effect of D-cycloserine on the social and communication skills deficits of individuals with ASD has not been thoroughly explored and no systematic reviews of the evidence have been conducted. To assess the efficacy and adverse effects of D-cycloserine compared with placebo for social and communication skills in individuals with ASD. In November 2020, we searched CENTRAL, MEDLINE, Embase, six other databases and two trials registers. We also searched the reference lists of relevant publications and contacted the authors of the included study, Minshawi 2016, to identify any additional studies.In addition,we contacted pharmaceutical companies, searched manufacturers' websites and sources ofreports of adverse events. SELECTION CRITERIA: All randomised controlled trials (RCTs) of any duration and dose of D-cycloserine, with or without adjunct treatment, compared to placebo in individuals with ASD. Two review authors independently selected studies for inclusion, extracted relevant data, assessed the risk of bias, graded the certainty of the evidence using the GRADE approach, and analysed and evaluated the data. We provide a narrative report of the findings as only one study is included in this review. We included a single RCT (Minshawi 2016) funded by the United States Department of Defense. It was conducted attwo sites in the USA: Indiana University School of Medicine and Cincinnati Children's Hospital Medical Centre. In the included study, 67 children with ASD aged between 5 and 11 years were randomised to receive either 10 weeks (10 doses) of (50 mg) D-cycloserine plus social skills training, or placebo plus social skills training. Randomisation was carried out1:1 between D-cycloserine and placebo arms, and outcome measures were recorded at one-week post-treatment.The 'risk of bias' assessment for the included study was low for five domains and unclear for two domains. The study (67 participants) reportedlow certainty evidence of little to no differencebetween the two groups for alloutcomes measured at one week post-treatment:social interactionimpairment (mean difference (MD) 3.61 (assessed with theSocial Responsiveness Scale), 95% confidence interval (CI) -5.60 to 12.82); social communication impairment(MD -1.08 (measured using the inappropriate speech subscale of the Aberrant Behavior Checklist (ABC)), 95% CI -2.34 to 0.18); restricted, repetitive, stereotyped patterns of behaviour (MD 0.12 (measured by the ABC stereotypy subscale), 95% CI -1.71 to 1.95); serious adverse events (risk ratio (RR) 1.11, 95% CI 0.94 to 1.31); non-core symptoms of ASD(RR 0.97 (measured by the Clinical Global Impression-Improvementscale), 95% CI 0.49 to 1.93); andtolerability of D-cycloserine(RR 0.32 (assessed by thenumber of dropouts), 95% CI 0.01 to 7.68). AUTHORS' CONCLUSIONS: We are unable to conclude with certainty whether D-cycloserine is effective for individuals with ASD. This review included low certainty data from only one study with methodological issues and imprecision. The added value of this review compared to the included study is we assessed the risk of bias and evaluated the certainty of evidence using the GRADE approach. Moreover, if we find new trials in future updates of this review, we could potentially pool the data, which may either strengthen or decrease the evidence for our findings.

Association of screen time with parent-reported cognitive delay in preschool children of Kerala, India

BackgroundScreen use is increasing rapidly among preschool children and excess screen use in these children has been associated with cognitive side effects and speech delay. We undertook this study to estimate the risk associated with screen time in children, parental supervision, and parent-reported cognitive development among preschool children aged 2–5 years.MethodsA cross-sectional study was done between July 2019 and January 2020 involving parents of all students aged 2–5 years, attending 2 kindergarten schools in Thiruvalla using a self-administered questionnaire. Parents also used the Werner David Development pictorial scale (WDDPS), a screening tool to report cognitive development. The schools were sampled based on convenience.ResultsOf the 189 children included in the study, 89.4% had excess screen use (> 1 h per day) and the average use was 2.14 h. 45.0% of parents supervised screen use inconsistently (self-reported). Meal-time screen use (OR 3.8, 95% CI 1.3–10.8), receiving screen on demand (OR 3.7, 95% CI 1.2–11.3), and using devices other than computers (OR 6.5, 95% CI 1.6–26.8) were significantly associated with excess screen use in pre-school children. Similarly, those children with inconsistently supervised screen time were significantly more likely to have suspected deficits in attention (OR 3.2, 95% CI 1.3–8.2), intelligence (OR 4.1, 95% CI 1.3–13.3), and social skills (OR 15.3, 95% CI 1.9–121.2), compared to children whose screen use was consistently supervised.ConclusionScreen time in the majority of preschool children is above the recommended limits, and inconsistent supervision by parents was seen in almost half of the study participants. Inconsistently supervised screen time is associated with suspected cognitive delays in children.

Could early diagnosis and rehabilitation of Auditory Processing Disorder in schizophrenia have a positive effect on cognition?

Deficits in social skills are common among people with psychosis and may contribute to the severity of the stigmatization they experience. The aim of the present research was to shed light on the mechanisms through which lack of interpersonal competence may lead to an increased exposure to stigma by investigating the mediating effects of social network and social support.A sample of 207 patients diagnosed with psychotic disorders was recruited for the study. The pattern of relationships between interpersonal competence, social network, social support and experienced stigma was analyzed using path modeling.The level of interpersonal competence was found to be directly negatively related to the intensity of experienced stigma (β = −0.20, SE = 0.08; P < 0.05) and directly positively related to the scope of social network (β = 0.36, SE = 0.08, P < 0.01) and social support (β = 0.36, SE = 0.08, P < 0.01). The analysis of mediation pathways between interpersonal competence and stigma experiences revealed significant indirect effect through social support (βIND = −0.08, 95% CI: −0.16 to −0.02) and sequential effect through social network and social support (βIND = −0.03, 95% CI: −0.06 to −0.01). The indirect pathway from interpersonal competence to stigma via social network alone turned out to be non-significant.The findings indicate that poor interpersonal competence may increase the extent of the stigma experienced by people with psychotic illness both directly and indirectly, with social support being the key mediator. Since interpersonal competence, social network and social support are potentially modifiable factors, they should be considered as possible targets of anti-stigma interventions.

Estudio de caso: Timidez en la adolescencia

The research presented below is a clinical case of a 16-year-old adolescent who displays shy&nbsp;behavior, lacking social skills, Attention Deficit Disorder, and family problems. This study&nbsp;aims to identify the factors that influence the development of shy behavior, as well as social&nbsp;skills; through psychological tests, personal and family history, and interviews completed to the&nbsp;examinee, which has been possible to argue about the various factors that have influenced and&nbsp;are still perceived in respect of the shy behavior and social skills deficit found in the examinee.&nbsp;Once the comprehensive assessment was conducted, a therapeutic process based on cognitive&nbsp;behavioral therapy began, focused on the recognition of emotions, identification of thoughts,&nbsp;differentiation in the recognition between thought, emotion and behavior, cognitive restructuring,&nbsp;symbolic modeling and relaxation training.

Enhancing Social Initiations Using Naturalistic Behavioral Intervention: Outcomes from a Randomized Controlled Trial for Children with Autism.

Deficits in social skills are common in children with Autism Spectrum Disorder (ASD), and there is an urgent need for effective social skills interventions, especially for improving interactions with typically developing peers. This study examined the effects of a naturalistic behavioral social skills intervention in improving social initiations to peers through a randomized controlled trial. Analyses of multimethod, multi-informant measures indicated that children in the active group (SIMI) demonstrated greater improvement in the types of initiations which were systematically prompted and reinforced during treatment (i.e., behavior regulation). Generalization to joint attention and social interaction initiation types, as well as collateral gains in broader social functioning on clinician- and parent-rated standardized measures were also observed.

Social Media Use in Emerging Adults: Investigating the Relationship With Social Media Addiction and Social Behavior

In the 21st century, use of online communication has skyrocketed, and this is particularly true for young people who have grown up in the age of the smartphone. In the world of online communication, adolescents and young adults especially seem to gravitate toward social media. The present study examined a mediational model wherein social media use in emerging adults predicts social media addiction through altered social behaviors, including face-to-face interactions, communication apprehension, and social skill deficits. More than 100 undergraduate students reported on their social media use and social behaviors via an online questionnaire. Contrary to expectations, social media use was only significantly correlated with social skills deficits, r(108) = .204, p = .017, and social media addiction, r(108) = .495, p &lt; .001. Face-to-face interactions, communication apprehension, and social skills deficits did not function as mediators of the relationship between social media use and addiction and had no significant correlations with social media addiction. A modified mediation model is proposed, wherein impoverished face-to-face behavior and communication apprehension predict social skills deficits and those deficits predict social media addiction only when social media use is high.