Article

Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations.

Hershey Medical Center, Pennsylvania State Hershey College of Medicine, H073, 500 University Drive, Hershey, PA 17033, USA.
Journal of Autism and Developmental Disorders (Impact Factor: 3.34). 03/2008; 38(2):353-61. DOI: 10.1007/s10803-007-0402-4
Source: PubMed

ABSTRACT This paper reviews the literature examining social skills training (SST) programs for youth with AS/HFA, with an emphasis on critically evaluating efficacy and highlighting areas of future research. The review highlights the disparity between SST programs described in the extant literature, including lack of a universal definition of social skills, various levels of intensity and duration of treatment, divergent theoretical backgrounds, and variety in services provided in clinic or classroom settings. Overall, it is clear that, despite their widespread clinical use, empirical support for SST programs for children with AS/HFA is minimal at this time. Based on this critical review, a "roadmap" for future research, consistent with recommendations put forth by a leading group of autism researchers, is presented.

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    ABSTRACT: Autism Spectrum Disorder (ASD) is associated with social skills deficits and co-occurring mental health difficulties. ASD frequently co-occurs with Intellectual Disability (ID). There is scant literature exploring the association between social skills and mental health in children with ASD, with or without ID. Participants were 292 children aged six to 13 with ASD (217 without ID; 76 with Mild ID). Parents and teachers rated social skills and mental health using standardised questionnaires. Greater mental health difficulties were associated with greater social responsiveness difficulties and poorer social skills across the sample. Effect sizes were large. Social skills explained a significant proportion of the variance in mental health scores across the sample. The study has important implications for treatment and future research.
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    ABSTRACT: Résumé en anglais et en français Summary Background. First described in 1944 by Hans Asperger, Asperger syndrome (AS) is now considered in international diagnostic classifications as one of the pervasive developmental disorders (PDD) or autismspectrum disorders (ASD). The main symptoms of AS are severe impairment in social interaction and communication, and restricted interests, without significant delay in cognitive and language development. Its prevalence is not clearly established but might be around 0.26 per 1000. Symptoms of high-functioning autism (HFA), which is not an official diagnostic category, are quite similar. Children and adolescents with AS or HFA mostly have a social skills deficit, in connection with a lack of understanding concerning the rules governing social interactions. This deficit often leads to social isolation and peer rejection, which can alter their quality of life. Their lack of social skills can also have effects on success at school or work, integration among peers and mental health. According to recent guidelines of the French national authority for health (Haute autoritéde santé, HAS) about the special needs of persons with PDD, professionals have to develop evidence-based interventions, emphasizing social interactions and participation, as described by the international classification of functioning, disability and health (ICF): social and professional participation as well as participation in leisure activities, clubs and societies, etc. Objectives. To explore the studies that give evidence of the value of these social skills training groups, to review the methods and programs worked out in these groups, and to highlight the best general operating principles to be adopted and combined. Methods. Systematic searches of electronic databases, journals, and reference lists identified 12 studies published since 1984, involving social competence group interventions, led by psychotherapists who were trained in cognitive behavioral therapies (CBT), for children and adolescents from 6 to 18 years old with a diagnosis of AS or HFA. Results. According to these 12 studies, these interventions are useful and significantly effective. Adaptation of their contents and educational means to how children and adolescents with AS function is necessary to facilitate learning and decrease anxiety. Concerning the groups’ setting, most of these studies insist on the value of working with a small number of participants and creating a friendly, predictable and structured environment (even the progress of the sessions itself has to be structured). The programs’ contents should ally didactic teaching and training exercises, which should be diverse and adapted to the objectives. The techniques usually applied in CBT (role plays, modeling, problem-solving strategies, etc.), must be completed with strategies known to be appropriate for children and adolescents with ASD, such as social scenarios. Conclusions. Although new studies are necessary to assess the generalization and long-term efficacy of such approaches, this review confirms the advantages of the main methods of social skills training groups for children and adolescents with AS. It opens up perspectives to developing new programs of social skills training groups, integrating various approaches, dimensions and objectives, working on a long-term basis. Résumé Invalidant sur le plan social, le syndrome d’Asperger (SA) fait partie des troubles envahissants du développement (TED). Sa prévalence serait d’environ 0,26 pour 1000. Les enfants et adolescents avec SA présentent une altération sévère et prolongée des interactions sociales. La Haute autorité de santé (HAS) a indiqué récemment que des programmes portant sur les interactions sociales sont opportuns chez les personnes avec TED. Cette revue de littérature a pour objectifs de recenser les travaux évaluant l’intérêt des groupes d’entraînement aux habiletés sociales (GEHS) menés auprès d’enfants et d’adolescents avec SA par des thérapeutes formés, d’analyser leurs modalités d’intervention et d’en dégager des principes généraux pour faciliter le développement de ces interventions. La méthodologie a consisté à examiner les études sur ce thème, s’appuyant sur une méthodologie standardisée et publiées depuis 1984 dans des revues indexées dans Medline. D’après les résultats des 12 études retenues, ces méthodes apparaissent bénéfiques et significativement efficaces. Il se dégage quelques grands principes : nécessité d’adapter ces modalités aux spécificités de fonctionnement de ces jeunes ; petit nombre de participants ; cadre bienveillant, prévisible et structuré, contenu des séances alliant enseignement didactique et exercices d’entraînement, variables en fonction des objectifs fixés. Bien que de nouvelles études soient nécessaires afin d’é´valuer la généralisation des acquis et leur pérennité dans le temps, cette revue confirme l’intérêt des GEHS pour ces jeunes, de plus en plus intégrés et sollicités socialement. Elle dégage également des pistes pour la mise en place des GEHS les plus appropriés.
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