Randomized comparative trial of a social cognitive skills group for children with autism spectrum disorder

Abstract

Objective: This study evaluated the efficacy of a targeted social skills training group in school-aged children with autism spectrum disorder (ASD). The intervention, Seaver-NETT (Nonverbal communication, Emotion recognition, and Theory of mind Training), is a 12-session cognitive-behavioral intervention (CBI) for verbal, school-aged children targeting ASD-specific social behavioral impairments.

Method: Sixty-nine children with ASD, 8 to 11 years of age, with verbal IQs greater than 70, participated in a randomized comparative trial to examine the efficacy of NETT relative to a facilitated play group. Treatment outcomes included caregiver reports of social behavior and neuropsychological assessments of social cognition conducted by blinded raters. Outcomes were collected at baseline, endpoint, and 3 months posttreatment.

Results: Significant improvements were found on social behavior outcomes such as nonverbal communication, empathic responding, and social relations in the NETT condition relative to the active control at endpoint. Verbal IQ moderated the interaction effect on social behavior, with higher verbal IQ associated with improvements in the CBI condition. No significant improvements were found on social cognitive outcomes. No significant group differences were found at 3-month follow-up conducted with approximately half the sample (n = 34).

Conclusion: These data indicate that targeted CBI social skills groups such as NETT improve social communication deficits in verbal, school-aged children with ASD. The moderating effects of high verbal IQ suggest a need to consider participant and treatment characteristics associated with outcomes in future studies. Clinical trial registration information-Neural and Behavioral Outcomes of Social Skills Groups in Children With Autism Spectrum Disorder; https://ichgcp.net/clinical-trials-registry/NCT01190917" title="See in ClinicalTrials.gov">NCT01190917.

Keywords: autism; cognitive behavioral intervention; social cognition; social communication; social skills groups.

Conflict of interest statement

Disclosure: Dr. Soorya has received research funding from Autism Speaks, the Brain and Behavior Research Foundation, and the Brinson Foundation. She has served as a consultant to University of North Carolina-Chapel Hill, the Mount Sinai School of Medicine, and Coronado Biosciences. She has received royalties from Hogrefe Publishing. Dr. Weinger has received research funding from Autism Speaks. Dr. Gorenstein has received funding from the UJA Federation of New York. Dr. Halpern has received funding from the UJA Federation of New York. Dr. Kolevzon has received research funding from the National Institutes of Health, Autism Science Foundation, Seaver Foundation, Hoffman-La Roche, Neuren Pharmaceuticals, and Synapdx. Dr. Buxbaum has received research funding from NIMH, the National Institute on Aging, and Sage Bionetworks. He has served as an advisory board member for the Brain and Behavior Research Foundation, the Hussman Foundation, the Phelan-McDermid Syndrome Foundation, and the Autism Science Foundation. He is an editor for Molecular Autism and receives royalties from the Biomed Central Publishing Group. He is also an editor for Elsevier, The Neuroscience of Autism Spectrum Disorders, and Oxford University Press, Neurobiology of Mental Illness. He retains intellectual property rights for IGF1 in Shank3 IP, PTSD Risk Assessment, and Autism Genetics/Treatment. Dr. Wang has received research funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Mr. Beck and Ms. Soffes report no biomedical financial interests or potential conflicts of interest.

Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Consolidated Standards of Reporting Trials (CONSORT) diagram.

Figure 2

A. Improvement in social behavior impairments. Note: Interaction effect for Nonverbal communication, Emotion recognition, and Theory of mind Training (NETT) relative to active treatment control showing mean social behavior composite score and standard error (SE) at baseline, endpoint, and follow-up. B. Verbal IQ moderates improvement for NETT. Note: Change in social behavior composite (z score and SE) is shown at the 25th and 75th percentiles of verbal IQ (verbal IQ = 85 and 106, respectively).