Social Skills Training Interventions Research Articles

Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness.

Evidence-based practices (EBPs) improve housing and health for persons who have experienced homelessness with serious mental illness (PEH-SMI) but are challenging to implement. We tested a strategy to support pilot implementation of a 12-session housing skills training intervention for PEH-SMI, tailored from effective social skills training interventions. We aimed to optimize the implementation strategy and intervention prior to an implementation trial. We provided training and technical assistance to nine providers to support pilot implementation of this intervention to six groups of PEH-SMI (n = 35) engaged in VA Greater Los Angeles' homeless services. We used scales and semi-structured interviews with 14 PEH-SMI and all interventionists to inform implementation strategy adaptations, identify factors that impacted implementation, and assess perceptions of the intervention. Attendance was tracked and we observed a random sample of each interventionist's groups to assess treatment fidelity. Interventionists perceived the implementation strategy and the intervention favorably. However, interventionists often lacked physical space, staff, and resources (e.g., computers) to conduct the intervention. Interventionists found the content valuable for participants and a few suggested that group engagement should be a prerequisite for obtaining housing services. PEH-SMI were interested in the intervention's content and receptive to the group-based format. Participants attended a mean of 4 ± 3/12 groups; all groups observed had acceptable fidelity. Problems with intervention retention were described, suggesting challenges maintaining group participation when participants transitioned between VA homeless services. To support the implementation of an EBP for PEH-SMI in homeless programs, these data suggest the value of training/technical assistance and strategies that enhance program-level buy-in to address resource concerns. Intervention adaptations, e.g., using a drop-in, open group format, in community-based settings that are easily accessible to PEH-SMI, may also increase adoption. This project was registered as "Improving Housing Outcomes for Homeless Veterans" Trial registration NCT03646149, registered 8/24/2018.

Penerapan Social Skills Training (SST) untuk Meningkatkan Social Skill Performance pada Anak

As social beings, everyone is required to be able to adjust in the social environment. But in fact, there are individuals who have difficulty adjusting because they have social skills deficits. Deficits of social skills can be measured using the social skills rating system (SSRS) which refers to the theory of Gresham and Elliott which explains that there are three aspects that can be used as a reference for measuring social skills, namely the ability to cooperate, assertive behavior, and the ability to control oneself. Based on these conditions, researchers conducted experimental research to determine the effectiveness of Social Skills Training (SST) as an effort to overcome social skill deficits owned by individuals. This study involved a 7-year-old boy who was studying at an elementary school. Based on the results of the SSRS measurement, the child has a deficit in social skills. The method used in this research is a single case experimental design (DEKT), with pre-test and post-test applied to the subject. The result is Social Skills. The training was able to improve the subject's social skills. The increase that occurred included all three aspects of social skills, namely the subject had shown the ability to work together with his peers, was able to convey what he wanted, thought, and felt, and was able to control himself when he was in an unpleasant situation. Overall, the subject's social skills after the SST intervention were in the high category.

Linking intervention experiences to child outcomes in a school‐based social skills training program

AbstractSmall group social skills training (SST) is recommended to improve the social behavior and peer relations of rejected children, but child responses vary. This study explored variation in intervention experiences that emerged in a large study of a school‐based SST program for peer‐rejected children and associations with program outcomes. One hundred and seven peer‐rejected elementary students (60% White, 15% Black, 22% Latinx, 3% Multi‐racial, and 65% male) were identified by classroom sociometrics and randomly assigned to a year‐long small group SST program. Normative classmates served as partners. Among the peer‐rejected targets of the intervention, those with relatively better pretreatment social skills received more SST sessions and were more positively engaged, whereas those with fewer social skills and more behavior problems experienced more negative peer responses during SST sessions and less collateral support from teachers and parents. Hierarchical regressions (controlling for pretreatment scores) revealed attenuated intervention benefits for children who received more negative peer responses during SST and less parent and teacher support. The findings suggest that, within a sample of peer‐rejected children, those with more severe skill deficits and elevated behavior problems at pretreatment have lower‐quality SST experiences that reduce intervention benefits, even when normative classmates serve as peer partners. These issues warrant careful attention in future SST intervention design and research.

Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders having a high influence on social interactions. The number of approved treatments and clinical trials for ADHD have increased markedly during the recent decade. This analytical review provides a quantitative overview of the existing pharmacological and non-pharmacological methods of ADHD treatments investigated in clinical trials during 1999-2021. A total of 695 interventional trials were manually assessed from clinicaltrial.gov with the search term « ADHD», and trial data has been used for analysis. A clear majority of the studies investigated non-pharmacological therapies (∼80%), including many behavioral options, such as social skills training, sleep and physical activity interventions, meditation and hypnotherapy. Devices, complementary and other alternative methods of ADHD treatment are also gaining attention. The pharmacological group accounts for ∼20% of all the studies. The most common drug classes include central nervous system stimulants (e.g., methylphenidate hydrochloride, lisdexamfetamine dimesylate, amphetamine sulfate, mixed amphetamine salts, a combination of dexmethylphenidate hydrochloride and serdexmethylphenidate chloride), selective noradrenaline reuptake inhibitors (atomoxetine, viloxazine), and alpha2 adrenergic receptor agonists (guanfacine hydrochloride, clonidine hydrochloride). Several studies investigated antidepressants (e.g., bupropion hydrochloride, vortioxetine), and atypical antipsychotics (e.g., quetiapine, aripiprazole) but these are yet not approved by the FDA for ADHD treatment. We discuss the quantitative trends in clinical trials and provide an overview of the new drug agents and non-pharmacological therapies, drug targets, and novel treatment options.

The Effect of Social Skills Training by Teacher on Mental Health of Female Primary School Students

Background: Social skills play an important role in children’s emotional health and well-being. Therefore, Social Skills Training (SST) of children is very important. Objective This study was to determine the effect of SST by teacher on mental health of female primary school students. Methods: This is a quasi-experimental study with a pre-test/post-test design conducted on 24 female primary school students (third grade) in Rasht, Iran in 2017-2018. Their parents and teachers completed questionnaires before and after SST intervention. The sessions were held during the school year. For SST of students, intervention was provided to their teacher who was in daily contact with them. Methods of cognitive behavioral skills and positive reinforcement were used for SST. The Strengths and Difficulties Questionnaire (SDQ) and the Matson Evaluation of Social Skills with Youngsters (MESSY) were used to assess mental health and social skills, respectively. Data were analyzed using statistical tests including Wilcoxon test and paired t-test in SPSS V.21 software. Results: The mean total score of MESSY decreased significantly from 225.54±13.65 to 219.12± 18.59 after the intervention (P=0.033). Among the subscales of SDQ, the mean of hyperactivity-attention deficit decreased only from 3.95±2.49 to 2.62±1.55 after the intervention, which was significant (P=0.020). Conclusion: The SST of female primary school students by the teacher do not lead to significant changes in their social skills and mental health.

Effect of interventions on activity and participation outcomes for adults with brain injury: a scoping review

ABSTRACT Objective To characterize the intervention elements associated with improvements in activity and participation outcomes for adults with brain injury. Data Sources PubMed and PsycINFO/Ovid. Study Selection We included RCTs that examined interventions for adults with acquired brain injury with an activity or participation outcome measure. Data Extraction We classified intervention elements and extracted effect sizes. We examined patterns of effect sizes associated with each intervention element based on time of follow-up and level of outcome (home versus community). Data Synthesis Thirty-nine articles were included. Outcomes focused on the performance of home and community activities. There was wide variation in effect sizes across all intervention elements, as well as by time and by outcome level (home versus community). Metacognitive interventions and daily life skills interventions showed the greatest promise for improving performance of home and community activities. Additionally, cognitive training interventions may play a role in improving home activity performance and social skills training interventions may play a role in community activity performance. Physical activity interventions showed the least promise for improving home and community activity performance. Conclusion This study highlights the importance of interventions that incorporate explicit strategies and task-specific training, rather than only addressing specific injury-related impairments.

SELF-CONCEPT AS CORRELATE OF INTERPERSONAL RELATIONSHIP AMONG INSCHOOL ADOLESCENTS IN KWARA STATE, NIGERIA

The formation of self-concept and interpersonal relationship are pivotal to the developmental tasks of adolescence. In view of this, this study investigated the self-concept and interpersonal relationship of in-school adolescents in Ilorin metropolis, Kwara State. The correlation research design was employed for the study. The proportionate sampling technique was used to select 200 respondents who participated in the study. Data were collected using a self-designed instrument entitled “Self-Concept and Interpersonal Relationship Questionnaires” (SCIRQ); with a Cronbach Alpha reliability index of 0.78. The data collected were analyzed using percentage and Pearson’s (r) correlation statistic and all hypotheses were tested at 0.05 alpha level. The findings of the study revealed that there is a significant positive relationship between emotional (Cal. r = 0.29; p < 0.05), physical (Cal. r = 0.34; p < 0.05) and social self-concepts (Cal. r = 0.43; p < 0.05) and interpersonal relationship among secondary school students in Kwara State; while a negative correlation was found between academic self-concept (Cal. r = -0.31; p < 0.05) and interpersonal relationship among the respondents. Based on the findings of the study, it was recommended that school counsellors, parents and other stakeholders in the education sector should enhance adolescents’ interpersonal relationship by strengthening their physical, social and emotional self-concepts through relevant social skills training and counseling interventions.

Integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training for Negative Symptoms of Psychosis: Effects in a Pilot Randomized Controlled Trial.

Negative symptoms and cognitive impairment in schizophrenia (SZ) remain unmet treatment needs as they are highly prevalent, associated with poor functional outcomes, and resistant to pharmacologic treatment. The current pilot randomized controlled trial examined the efficacy of an integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training (CBSST-CCT) intervention compared to Goal-focused Supportive Contact (SC) on negative symptoms and cognitive performance. Fifty-five adults with SZ or schizoaffective disorder with moderate-to-severe negative symptoms were randomized to receive 25 twice-weekly, 1-h manualized group sessions (12.5 weeks total duration) of either CBSST-CCT or SC delivered by master's level clinicians in five community settings. Assessments of negative symptom severity (primary outcomes) and neuropsychological performance, functional capacity, social skills performance, and self-reported functional ability/everyday functioning, psychiatric symptom severity, and motivation (secondary outcomes) were administered at baseline, mid-treatment, post-treatment, and 6-month follow-up. Mixed-effects models using baseline, mid-treatment, and post-treatment data demonstrated significant CBSST-CCT-associated effects on negative symptom severity, as assessed by the Scale for the Assessment of Negative Symptoms (p = .049, r = 0.22), with improvements in diminished motivation driving this effect (p = .037, r = 0.24). The CBSST-CCT group also demonstrated improved verbal learning compared to SC participants (p = .026, r = 0.36). The effects of CBSST-CCT appeared to be durable at 6-month follow-up. CBSST-CCT improved negative symptom severity and verbal learning in high-negative-symptom individuals relative to SC. CBSST-CCT warrants larger investigations to examine its efficacy in treating negative symptoms, along with other symptoms, cognition, and, ultimately, real-world functional outcomes. Clinical Trial registration number NCT02170051.

Validation of the Perceived Empathic and Social Self-Efficacy Scale: A Brief Report

Perceived empathic and social self-efficacy are required to strengthen interpersonal relationships and receive social support, which are crucial for community participation, employment, and job retention of people with disabilities. This study investigated the factor structure and related psychometric properties of an instrument used to measure these two constructs among people with disabilities. Results confirmed the two-factor measurement structure, the Perceived Empathic Self-Efficacy and the Perceived Social Self-Efficacy factors. This scale can be used by rehabilitation professionals to assess vocational rehabilitation (VR) consumers’ perceived levels of empathic and social self-efficacy. It can also be used by researchers as an outcome measure to evaluate the effectiveness of social skills training interventions for VR consumers.

A pilot study of a brief inpatient social-skills training for young adults with psychosis.

Objective: Psychotic disorders are serious illnesses that are most amenable to early intervention. Though inpatient units are typically the first care setting for young people with psychosis, almost all early intervention work has been limited to outpatient settings. Social difficulties are a core feature of psychotic illnesses, and despite need for empirically supported social-skills treatments there are few interventions intended specifically for the developmental phase during which psychosis manifests (i.e., late teenage to early adult years). Method: Our group implemented an adapted social-skills training intervention (SST) designed for young adults on a psychiatric inpatient unit. Nineteen young adult inpatients (aged 18-35) with psychosis participated. Psychiatric symptoms and aspects of social functioning, including reported social self-efficacy and performance on social skills role-plays, were assessed before and after SST participation. Results: Preliminary data demonstrate improvements in both self-report and performance-based measures of social functioning after SST participation. Conclusions and Implications for Practice: These findings, though preliminary, support additional, larger-scale investigations of this SST among young adults with psychosis. Further, multidisciplinary collaborations are valuable in providing specialized care for young adults with psychosis who are receiving inpatient psychiatric care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychosocial Interventions for Adults With Schizophrenia: An Overview and Update of Systematic Reviews.

The authors of this systematic review (SR) sought to provide evidence for effects of commonly used psychosocial interventions on several outcomes among adults with schizophrenia. MEDLINE, the Cochrane Library, and PsycINFO databases were searched through July 2020. Eligible studies were SRs and trials of at least 12 weeks duration and with ≥50 participants that compared psychosocial interventions with treatment as usual among adults with schizophrenia. Study design, year, setting, country, sample size, eligibility criteria, population, clinical and intervention characteristics, results, and funding source were extracted, along with quality criteria. The evidence was evaluated on quality and strength of evidence stratified by intervention area and outcome, according to the Evidence-Based Practice Centers Methods Guide of the Agency for Healthcare Research and Quality. Nine SRs and 30 trials (N=23,921 patients) in 11 intervention areas were included. Trials were mostly of fair quality and had low-to-moderate strength of evidence. Compared with treatment as usual, most psychosocial interventions were more effective in improving intervention-targeted outcomes, including core illness symptoms. Compared with treatment as usual, assertive community treatment, cognitive-behavioral therapy (CBT), family interventions, psychoeducation, social skills training, supported employment, and early interventions for first-episode psychosis (FEP) improved various functional outcomes. CBT and early interventions for FEP improved quality of life. Family interventions, psychoeducation, illness self-management, and early interventions for FEP reduced relapse. Compared with treatment as usual, most psychosocial interventions improved functional outcomes, quality of life, and core illness symptoms, and several reduced relapse frequency among adults with schizophrenia.

Antibullying Interventions for Autistic Students: A Systematic Review

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. As part of the school health team, OTs should implement antibullying interventions, because bullying has a significant impact on students' participation in school occupations. The purpose of this systematic review was to examine interventions to reduce school bullying of students with autism. Social–emotional learning and social skills training interventions were found to be the most effective in decreasing bullying. Primary Author and Speaker: Janet Njelesani Additional Authors and Speakers: Christina M. Samaan

The efficacy of social skills training in the treatment of schizophrenia

IntroductionSocial cognition and skill deficits have been largely documented in subjects with schizophrenia (SCZs), and have a strong influence on the functional outcome of these subjects. Different behavioural interventions have been developed to target and improve social skills in SCZs. For instance, the Social Skills Training (SST) focuses on improving communication skills and assertiveness to facilitate disease management, independent living and real-life functioning of SCZs. SST seems also to have an impact on negative symptoms and social cognition.ObjectivesThe study aims to evaluate the effectiveness of SST in improving social cognition and negative symptoms in SCZs.MethodsThe sample included 8 chronic SCZs (age between 18 and 60), who completed 6 months of SST. The intervention consisted of two weekly group sessions of 2 hours each. We assessed psychopathology, neurocognition, real-life functioning, functional capacity and social cognition at baseline and after training. Paired samples t-tests were performed to evaluate the differences of the variables considered after completing the treatment.ResultsSignificant improvements in negative symptoms (p<.05), social cognition (p<.05), functional capacity (p<.001), activities of daily living (p<.001) and interpersonal relationships (p<.011) were found.ConclusionsThe present findings suggest that SST might ameliorate social cognition and negative symptoms which are generally not influenced by antipsychotic treatment. The integration of pharmacological and SST interventions might have an impact on major determinants of poor real-life functioning in SCZs.

Effect of social skills training on interpersonal interactions of children with autism: an interventional research

Autism is a neuro-developmental disorder typically appears prior to the age of three years, and seriously limits the normal development of children. However, there is a wide variety of effective intervention programs and strategies designed to help children with autism. Hence, this research aimed to see the effect of social skills training on interpersonal interaction of children with autism. Using pre-post equivalent experimental and control group design, data were collected from a sample of eight children using Autism Social Skills Profile Rating Scale before and after the implementation of social skills training. Data were analyzed through frequency, percentage, mean, standard deviation, and independent samples t-test. The pre-intervention assessment revealed that participants of the experimental and the control groups did not significantly differ but both groups scored below half on the total scale point and almost one-third of the maximum score on social reciprocity and social participation sub-scales. The result of the intervention also indicated that children in both groups demonstrated positive changes in their overall social skills including the sub-scales. However, it was found out that the experimental group has greater mean scores as compared to the control group on total scale, social participation and social reciprocity subscales. But the increment on detrimental social behaviors subscale in the experimental group was with a decreasing rate. Based on this finding, it can be concluded that social skills training intervention improves social skills of children with autism. Therefore, it is recommended that further intensive and comprehensive intervention is very critical to more improve the social skills of children with autism.

Psychological interventions on fetal alcohol spectrum disorder across the life span

Fetal alcohol spectrum disorder (FASD) is the leading known and preventable cause of intellectual disability in the western world, affecting up to 1-5% of the population. It is considered an underdiagnosed and undertreated disorder, with few psychological interventions with empirical evidence. To review all the studies published to date on the psychological treatment of FASD throughout life. A bibliographic search was carried out using the MEDLINE, PsychINFO, PubMed and Cochrane Library databases using the terms 'fetal alcohol syndrome disorder' AND 'cognitive behavioral intervention' OR 'psychological intervention' OR 'psychological treatment' OR 'therapy' OR 'psychotherapy'. The review included published works which evaluate the efficacy of psychological treatments for these patients. Twenty published studies met the inclusion criteria. The treatments were classified according to the type of intervention: emotional and behavioral regulation, social skills training and family interventions for patients with FASD. The results indicate that psychological treatments focused on emotional and behavioral regulation, social skills training and family interventions are the most evidenced treatments for these patients. These treatments are based on cognitive-behavioral principles and include school-age children. However, more research is needed on psychological interventions for adults with FASD. Despite the progress in psychological interventions for FASD, the research still reflects highlighted limitations.

Reducing negative symptoms in schizophrenia: Feasibility and acceptability of a combined cognitive-behavioral social skills training and compensatory cognitive training intervention

The current study examined the feasibility and acceptability of an integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training (CBSST-CCT) intervention compared with Goal-Focused Supportive Contact (SC) in a pilot randomized controlled trial for people with schizophrenia with high negative symptom severity. The sample included 55 participants from five community settings; masters-level study clinicians delivered interventions on-site. Participants completed assessments of cognitive, functional, and psychiatric symptoms at baseline, mid-treatment, post-treatment (12.5 weeks), and 6-month follow-up. Enrollment goals were not initially met, necessitating the addition of a fifth site; however, all groups and assessments were completed on-site. Study procedures were acceptable, as evidenced by 100% enrollment and completion of baseline assessments following informed consent; however, over 1/3rd of participants dropped out. No modifications were necessary to the intervention procedures and CBSST-CCT fidelity ratings were acceptable. The intervention was deemed acceptable among participants who attended ≥1 session, as evidenced by similar attendance rates in CBSST-CCT compared to SC. Among CBSST-CCT participants, lower positive symptoms were significantly associated with better attendance. Overall, we found mixed evidence for the feasibility and acceptability of the CBSST-CCT protocol in people with schizophrenia with high negative symptoms. Challenges are highlighted and recommendations for future investigations are provided.

Psychosocial therapy in psychiatry : Update of the DGPPN-S3 guidelines "Psychosocial therapies for severe mental illnesses"

Severe mental illnesses are often associated with substantial impairments of psychosocial functioning and ahigh risk of social exclusion. Along with somatic and psychotherapeutic treatment approaches, psychosocial interventions are an integral component of treatment. Psychosocial therapies aim to improve participation and enable patients to live self-determined lives as far as possible. This paper provides an overview of the structure and recommendations of the German S3guidelines "Psychosocial therapies for severe mental illnesses" of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN). In the DGPPN S3 guidelines psychosocial therapies are systematically described for the first time and recommendations are formulated on the basis of asystematic processing of scientific evidence and a formalized consensus process. The evidence-based and consensus-based guidelines formulate atotal of 33recommendations and 12statements. For many psychosocial interventions there is abroad evidence base. In the field of individual interventions psychoeducation, social skills training and health-promoting interventions have been given the highest recommendation strength(A). In the field of system level interventions, team-based, multiprofessional community psychiatric approaches, supported employment and self-determined housing with mobile support (supported housing) are given A level recommendations. For other interventions, the current evidence base is less robust. The successful implementation of guidelines depends not only on the quality but also on the dissemination. Therefore, in addition to the treatment guidelines ashort version, apatient version and awaiting room version were developed.

Trauma‐focused counselling and social effectiveness skills training interventions on impaired psychological functioning of internally displaced adolescents in Nigeria

AbstractTrauma‐focused counselling (T‐FC) and social effectiveness skills training (SEST) were used on impaired psychological functioning of early adolescents in IDP Camps in Nigeria. The factorial quasi‐experimental design was adopted. While the cluster sampling technique was used to select 60 participants from the IDP camps and were randomly assigned to T‐FC (20), SEST (20) and control (20) groups, the Kessler Psychological Distress Scale (α = .81) was used to screen the participants for impaired psychological functioning and adolescents' psychosocial functioning inventory scale (α = .90) was used for data collection. Analysis of covariance was used for data analysis. The two interventions significantly improved psychological functioning of displaced adolescents that was impaired [F(2,57) = 239.29; partial ῆ2 = 0.89]. It was concluded that T‐FC and SEST were found to be potent on impaired psychological functioning of adolescents in internally displaced camps in North‐Central Nigeria.

The Effectiveness of Social Skills Training on Aggression and Impulsive among Kindergartens Children

Introduction: Social interaction is an inevitable technique and resource of children's mental development, and children learn how to interact with others. The purpose of this study was to determine the effectiveness of social skills training on aggression and impulsive among kindergartens children in Tehran in 2017-2018. Materials & Methods: The study was a quasi-experimental design with a pre-test and post-test were selected by simple random sampling to compare a group of experiments (N= 7) with control (N = 7) groups. In this study, the statistical population in Tehran kindergartens in 2017-18 consisted of all children aged 4 to 6 years. The intervention was conducted 10 sessions in 60-minute after pre-test and then the results were evaluated in two stages of pre-test and post-test by Matson's Social Skills Questionnaire and finally, after about one month the data were collected. Data were analyzed by using SPSSver.22 software. Results: According to the descriptive findings, the age range of 4 to 6 years with mean age of 5.5 years. The mean and SD scores of aggression and impulsive behaviors in the experimental and the control group were 24.14± 6.24 and 26.17±8.11, respectively. The mean scores of aggression and impulsive behaviors in the experimental group increased from 26.71 to 28.17 in the post-test. The standard deviation of these scores is 6.47 and 7.54, respectively. So that, the test did not show a significant difference at a level of p< 0.05. Conclusion: Considering the use of social skills training interventions, it did not show a significant difference between aggression and impulsive in kindergartens children. Therefore, it is necessary to teach methods along with other psychotherapeutic to reduce aggression and impulsive behaviors among kindergartens children.

Experiences of social interaction in young women with Turner syndrome: A qualitative study

Turner Syndrome (TS; 45,X) is a sex chromosome aneuploidy associated with deficits in social interaction, for which clinical care guidelines have recently recommended trialling a social skills training intervention. The present study aimed to gather preliminary evidence to support a training programme for young women. Semi-structured interviews and psychometric questionnaires about social ability were administered to young women with TS aged 16 to 25 years old (n=17) and their parents (n=20). Interview transcripts were analysed using thematic analysis. Although young women with TS experienced a "wide range of social competencies," they attributed social challenges to "personal and contextual factors." The magnitude of these challenges to social integration intensified during adolescence. They felt increasingly "out of sync" with their peers. They also considered their social abilities to be better than their parents did; on a scale of autistic traits (rated by parents), half had mild to severe autistic traits. Most expressed interest in taking part in a social skills programme. Young women with TS are aware they experience difficulties in social communication, and they express interest in improving their social skills. Accordingly, social skills training during adolescence would be welcomed by them and their families. Any intervention should take account of their feelings of social dislocation arising from hearing difficulties together with limited recognition, and slow processing, of social cues.