McVey, A. J., Dolan, B. K., Willar, K. S., Pleiss, S., Karst, J. S., Casnar, C. L. .. Vaughn VanHecke, A. (2016). A replication and extension of the PEERS® for Young Adults social skills intervention: Examining effects on social skills and social anxiety in young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(12), 3739-3754.
Reviewed by Tristram Smith, PhD
ASAT Board of Directors
Why research this topic?
Individuals with autism spectrum disorder (ASD) show significant deficits in social cognition such as recognizing mental states in others, reading social cues, and empathizing. These deficits interfere with social interactions and ongoing peer relationships, which may lead to feelings of loneliness. Although starting in childhood, the deficits extend into adulthood. However, most research on social skills intervention has focused on children. One program, the Program for the Education and Enrichment of Relational Skills (PEERS®) for Young Adults developed by Gantman, Kapp, Orenski and Laugeson (2012) has some empirical support for improving social skills in young adults with ASD, but, until now, all research has been conducted within the UCLA clinic where the intervention originated. The current authors set out to conduct an independent evaluation of the effects of the PEERS® for Young Adults on social skills and social anxiety in young adults on the spectrum.
What did the researchers do?
Fifty-six participants were included in the study. Participants were required to have a diagnosis of ASD confirmed through the Autism Diagnostic Observation Schedule, be between the ages of 18 and 28, have a parent report of social difficulties, speak English and have parents who speak English, and be free of a comorbid psychiatric diagnosis. Participants were randomly assigned to either an experimental or waitlist group. Intervention for the experimental group consisted of 90-minute sessions, once per week, for 16 weeks of the PEERS® for Young Adults as outlined in the treatment manual developed at UCLA. Trained graduate students served as group leaders and trained undergraduate students served as assistants. Intervention sessions consisted of small group didactic instruction, roleplays, behavioral rehearsal, coaching and practice through social skills homework. Topics included having appropriate conversations, choosing friends, communicating via social media, handling arguments, and coping with bullying or teasing. Parents of participants also received intervention in separate sessions. At entry into the study and again after the experimental group completed intervention, participants and parents in the experimental and waitlist groups completed rating scales to assess social skills, social cognition, empathy, loneliness and social anxiety.
What did the researchers find?
Following intervention, the PEERS® for Young Adults surpassed the waitlist group on measures of social skills, social responsiveness, understanding of social concepts, empathy, and problem behaviors. Unfortunately, improvements in rates of loneliness were not obtained, possibly because rates were already low prior to treatment. Despite not being directly targeted by PEERS® for Young Adults, significant decreases in self-rated social anxiety were obtained post intervention. Although not directly studied, the authors discuss several possible reasons for the improvement in anxiety.
What are the strengths and limitations of this study?
This study was the first known independent replication of treatment effects of the PEERS® for Young Adults. Supporting past results, the authors reported improvements in social skills, social cognition, empathy and peer interactions in young adults with ASD as assessed through parent and self-ratings. In addition, it was the first study to show reductions in social anxiety using PEERS® for Young Adults. The study used a strong experimental design, used multiple measures of outcome, and ensured adherence to the PEERS® manual by trained clinicians. The authors do, however, highlight several limitations to their work. First is the lack of diversity of their sample. Participants were mostly male, Caucasian young adults. A second limitation is the lack of third party, independent raters. Pre and post ratings were all conducted by participants and parents who were not blind to treatment. Third, the study would have been improved if a direct measure of social behavior was used in place of, or in combination with, rating scales. A final limitation was the absence of a longterm follow-up.
What do the results mean?
The current study helps fill the need for empirically supported social skills treatment programs for young adults with ASD. PEERS® for Young Adults improved social skills, social knowledge and social anxiety in a group of these adults.
Citation for this article:
Smith, T. (2018). Research review: A replication and extension of the PEERS® for Young Adults social skills intervention: Examining effects on social skills and social anxiety in young adults with autism spectrum disorder. Science in Autism Treatment, 15(3), 16-17.
