A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers?

Dekker, Vera; Nauta, Maaike H; Mulder, Erik J; Timmerman, Marieke E; de Bildt, Annelies

doi:10.1186/1471-244X-14-189

Table 1 Characteristics of published RCTs with control condition on SSTs in children with ASDs

From: A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers?

Auteur	N (INT/CON)	In-/exclusion criteria	Intervention	Follow-up	Outcome measures	Conclusion (pre/post treatment)
Frankel et al. (2010) [9]	76 randomized, 68 completed training (35/33)	ADOS/ADI-R ASD	Parent-assisted Children’s Friendship Training (CFT).	Only intervention group after 3 months	- Parent
		2^nd-5^th grade regular classroom	Parent-assisted Children’s Friendship Training (CFT).		○ QPQ (Ho, Gu, Con, Eng, Dis)	p < .0001 (Ho, Dis)
		VIQ > 60	12 weekly sessions of 60 minutes with concurrent sessions for child and parents. Class size was usually 10, with no more than 4 children with ASD.		○ SSRS social skills (As, SC)	p < .05 (SC)
		Knowing rules of board and school yard games			○ SSRS social skills (As, SC)	p < .05 (SC)
		Knowing rules of board and school yard games			○ SSRS problem behavior (In, Ex)	ns
		Able to switch topics in conversation			- Child
		Able to switch topics in conversation			○ PHS	p < .025
		Excl: psychotropic medication			○ The Loneliness Scale	p < .025
		Thought disorder			- Teacher
		Clinical seizure disorder, gross neurologic disease or other medical disorder			○ PEI (Wi, Ag)	ns
Laugeson et al. (2009) [8]	33 (17/16)	Clin dx ASD	Program for the Education and Enrichment of Relational Skills (PEERS).12 weekly sessions of 90 minutes with concurrent sessions for child and parents.	No	- Parent
		Age 13–17			○ SSRS social skills	p < .05
		IQ > 70			○ SSRS problem behavior	ns
		English fluency (child and parent)			○ QPQ (Ho, Gu, Con)	ns
		English fluency (child and parent)			- Teens
		Parent want to participate			○ QPQ (Ho, Gu, Con)	p < .025 (Ho)
		Parent want to participate			○ TASSK	p < .0001
		Social problems			○ FQS	p < .05
		Social problems			- Teacher (n = 13)
		Excl: history of major mental illness			○ SSRS social skills	ns
		Hearing, visual or physical impairments			○ SSRS problem behavior	ns
Koenig et al. (2010) [13]	44 (25/19)	Clin dx ASD	16 weekly sessions of 75 minutes; 4 to 5 children/2 peer/ 2 licensed clinicians.	No	- Parent
		ADOS/SCQ/PDD-BI score ASD			○ CGI – improvement	p = .001
		Age 8–11			○ SCI (PSI, SI)	ns
		IQ > 70
		Excl: need for different treatment
		ABC irritability > 18
		CSI clinically
Lopata et al. (2010) [21]	36 (18/18)	Clin dx HFASD	Summer training program.5 weeks intervention with Five daily 70-minute treatment cycles every day; 3 therapists/6 children.	No	- Parent
		Age 7–12			○ ASC	p = .006 d = .584
		Age 7–12			○ SRS	p = .003 d = .625
		IQ > 70			○ BASC-2-PRS – withdrawal	p < .001 d = 1.055
		VCI/PRI > 80			○ BASC-2-PRS – social skills	ns d = .365
		Expressive language score > 80			- Child
					○ SKA	p < .001 d = 1.272
					○ DANVA-2 (CF)	ns d = .532
Solomon et al. (2004) [16]	18 (9/9)	Clin dx ASD	The Social Adjustment Enhancement Curriculum.20 weekly sessions of 90 minutes with concurrent sessions for child and parents; 3 therapists/5 children.	No	- Child
		ADOS ASD, ADI-R AD			○ DANVA-2 (AF, CF)	p < .05 (AF, CF)
		Also met DSM-IV criteria of ASD based on a clinical interview			○ Strange Stories Task	ns
					○ Faux Pas Stories Task	ns
		Age 8–12			○ TOPS-ER	p < .05
		IQ > 75
		Able to pass first theory of mind task
		Excl: serious conduct problems
Yoo et al. (2014) [22]	55(28/27)	Clin dx ASD	The PEERS Treatment Manual.14 weekly sessions of 90 minutes with concurrent sessions for child and parents.	Only intervention group after 3 months	- Child	I	II	III
		Age 12–18			○ TASSK-R	p < .01	p < .01	p = .01
					○ QPQ (Gu, Con)	ns	ns	ns
					○ QPQ (Ho)	ns	ns	p = .04
		School 6^th grade elementary school to 3^rd grade high school			○ K-SSRS (As, Co, Em, SC, T)	ns	ns	ns
					○ CDI	p = .04	p = .03	ns
					○ STAIC-T	ns	ns	ns
					○ STAIC-S	ns	ns	ns
		Social difficulties			○ ADOS (lc-a, lc-t)	p = .01	p < .01	p < .01
		VIQ ≥ 65			○ ADOS (rsi-a, rsi-t)	p < .01	p < .01	p < .01
		VIQ ≥ 65			- Parents
		Substantial treatment motivation			○ SCQ	ns	ns	ns
					○ SRS	ns	ns	ns
					○ QPQ (Gu, Con)	ns	ns	ns
		No history of major mental illness			○ QPQ (Ho)	ns	p = .03	p = .03
		No current problems with aggressive behavior or severe oppositional tendency			○ ASDS (L, SI, BP, CA, SP)	ns	ns	ns
					○ K-CBCL An/dep	p = .03	ns	p = .02
					○ K-CBCL In	p = .02	ns	p = .03
		No hearing, visual, or physical disabilities preventing outdoor sport activities No clinically significant physical or neurological illnesses inhibiting treatment.			○ AHWA-VABS socialization	p < .01	p < .01	p < .01
					○ BDI (F, M)	ns	ns	ns
					○ STAI-T (F, M)	ns	ns	ns
					○ STAI-S (M)	p < .01	p = .01	p = .04
					○ STAI-S (F)	ns	ns	ns

ABC, Aberrant Behavior Checklist; AD, Autism Disorder; ADI-R, Autism Diagnostic Interview-Revised; ADOS, Autism Diagnostic Observation Schedule (lc-a, language and communication algorithm; lc-t, language and communication total; rsi-a, reciprocal social interaction algorithm; rsi-t, reciprocal social interaction total); AHWA-VABS, Korean Version of the Vineland Adaptive Behavior Scale); ASC, Adapted Skillstreaming Checklist; ASD, Autism Spectrum Disorder; ASDS, Asperger Syndrome Diagnostic Scale (L, Language; SI, Social Interaction; BP, Behavioral Problems; CA, Cognitive Ability; SP, Sensorimotor Problems); BASC-2-PRS, Behavior Assessment System for Children, Second Edition-Parent Rating Scales; BDI, Beck Depression Inventory (F, Father; M, Mother); CASL, Comprehensive Assessment of Spoken Language; CDI, Child Depression Inventory; CGI, Clinical Global Impressions Scale; Clin dx, clinical diagnosis; CON, Control condition; CSI, Children’s Symptom Inventory; DANVA-2, Diagnostic Analysis of Nonverbal Accuracy-2 (AF, Adult Facial Expression; CF, Child Facial Expression); Excl, exclusion criteria; FQS, Friendship Qualities Scale; HFASD, High-Functioning Autism Spectrum Disorder; INT, Intervention; K-CBCL, Korean Version of the Child Behavior Checklist (An/dep, anxiety/depression; In, Internalizing problems); K-SSRS, Korean Version of the Social Skills Rating System (As, Assertion; Co, Cooperation; Em, Empathy; SC, Self-Control; T, Total score); PDD-BI, Pervasive Developmental Disorders: behavior Inventory; PEI, The Pupil Evaluation Inventory (Wi, Withdrawal; Ag, Agression); PHS, Piers-Harris Self-Concept Scale; PRI, Perceptual Reasoning Index; PSS, Parent Satisfaction Survey; QPQ, Quality of Play Questionnaire (Con, Conflict ; Dis, Disengage; Eng, Engage; Gu, Guest; Ho, Host); SCI, Social Competence Inventory (PSI, Pro-Social Index; SI, Social Initiation Index); SCQ, Social Communication Questionnaire; SKA, Skillstreaming Knowledge Assessment; SRS, Social Responsiveness Scale; SSRS, Social Skills Rating System (As, Assertion; SC, Self-Control; In, Internalizing behavior; Ex, Externalizing behavior); STAI, State and Trait Anxiety Inventory (T, Trait; S, State; M, Mother; F, Father); STAIC, State and Trait Anxiety Inventory for Children (T, Trait; S, State; M, Mother; F, Father); TASSK, Test of Adolescent Social Skills Knowlegde; TASSK-R, Test of Adolescent Social Skills Knowledge-Revised; TOPS-ER, Test of Problem Solving-Elementary Revised; VCI, Verbal Comprehension Index; VIQ, Verbal IQ; I, no covariates are controlled; II, controlled teen’s age, sex, IQ and medication as covariates; III, controlled socioeconomic status, maternal education, and age as well as teen’s age, sex, IQ and medication as covariates.

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