Long-term social skills group training for children and adolescents with autism spectrum disorder: a randomized controlled trial

Ulf Jonsson, Nora Choque Olsson, Christina Coco, Anders Görling, Oskar Flygare, Anna Råde, Qi Chen, Steve Berggren, Kristiina Tammimies, Sven Bölte, Ulf Jonsson, Nora Choque Olsson, Christina Coco, Anders Görling, Oskar Flygare, Anna Råde, Qi Chen, Steve Berggren, Kristiina Tammimies, Sven Bölte

Abstract

Social skills group training (SSGT) is widely used for intellectually able children and adolescents with autism spectrum disorder (ASD). Previous studies indicate small to moderate effects on social communication capacities. The duration of most available programs is relatively short, and extended training might lead to further improvement. This randomized controlled trial compared an extended 24-week version of the SSGT program KONTAKT with standard care. The weekly sessions gradually shifted in content from acquisition of new skills to real-world application of the acquired skills. A total of 50 participants with ASD (15 females; 35 males) aged 8-17 years were included. The study was conducted at two child and adolescent psychiatry outpatient units in Sweden. The primary outcome was the Social Responsiveness Scale-Second Edition (SRS-2) rated by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and at 3-months follow-up. Parent-rated SRS-2 scores indicated large effects posttreatment [- 19.2; 95% CI - 29.9 to - 8.5; p < .001, effect size (ES) = 0.76], which were maintained at follow-up (- 20.7; 95% CI - 31.7 to - 9.7; p < .0001, ES = 0.82). These estimates indicate substantially larger improvement than previously reported for shorter SSGT. However, the effects on teacher-rated SRS-2 and most secondary outcomes did not reach statistical significance. Our results suggest added benefits of extended SSGT training, implying that service providers might reach better results by optimizing the delivery of SSGT.

Keywords: Autism; Group training; Long-term; Neurodevelopmental disorder; Social skills.

Conflict of interest statement

Conflict of interest

Sven Bölte receives royalties for the German and Swedish KONTAKT manuals from Hogrefe Publishers. Sven Bölte discloses that he has in the last 5 years acted as an author, consultant or lecturer for Shire, Medice, Roche, Eli Lilly, Prima Psychiatry, GLGroup, System Analytic, Kompetento, Expo Medica, and Prophase. He receives royalties for text books and diagnostic tools from Huber/Hogrefe, Kohlhammer and UTB. The other authors declare that they have no conflict of interest.

Ethical standards

The study was approved by the Ethical Review Board in Stockholm (2012/385- 31/4) and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from each participant and/or parent or legal guardian after the study’s aims and procedures had been fully explained.

Figures

Fig. 1
Fig. 1
CONSORT Flow Diagram. *The number of participants assessed refer to parent-rated outcome measures
Fig. 2
Fig. 2
Least square means and 95% confidence intervals for parent- and teacher-rated Social Responsiveness Scale–Second Edition (SRS-2) scores at baseline, posttreatment and 3-month follow-up; significant time by group interactions are indicated by p-values

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Source: PubMed

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