STUDY DESIGN

1
PARENT-ASSISTED SOCIAL SKILLS TRAINING PROGRAM
FOR YOUNG ADULTS WITH AUTISM SPECTRUM
DISORDERS THE UCLA PEERS PROGRAM Alexander
Gantman, Psy.D. Elizabeth A. Laugeson,
Psy.D. UCLA Semel Institute for Neuroscience and
Human Behavior Funded by NIH T32 MH17140
(Leuchter, PI)
BACKGROUND
PARTICIPANTS
OVERVIEW OF INTERVENTION

• Inclusion criteria for this study are that all
  young adults must
• 1) Be between 18 to 22 years of age
• 2) Have an IQ Composite on the K-BIT-2 gt 70
• 3) Have a diagnosis of autism, Asperger's
  Disorder or PDD-NOS
• 4) Have social skill deficits as measured by a
  Vineland Adaptive Behavior Scale Second
  Edition, Socialization Standard Score below 1 SD
  (lt 85)
• 5) Be fluent in English
• 6) Have a caretaker who is a fluent speaker of
  English and who is willing to participate in the
  study
• Exclusion criteria for this study are that young
  adults have
• 1) A history of a diagnosis of major mental
  illness (e.g., schizophrenia, bipolar disorder)
• 2) A physical disability or a medical condition
  that would prevent participation in the group
  (i.e., prevent participation in outdoor
  activities)

Research on Autism Spectrum Disorders (ASD) has
been extensive in the child and adolescent
literature. Difficulties in social skills
acquisition and generalization are often the most
significant challenges for children and adults
with ASD. Among young adults, social deficits can
lead to significant impairment in daily living,
vocational skills, and social relationships (Klin
Volkmar, 2003). Such deficits may also lead to
symptoms of depression, anxiety, and/or behavior
disorders (Barnhill, 2001). Despite all we know
about these deficits and symptom clusters, there
is a tremendous void in the treatment research
which encompasses transitional youth/young adults
(ages 18-22). Only a few studies have examined
the difficulties these young adults endure during
this highly socially, emotionally, and physically
demanding period of their lives. Studies show
that the effects of social deficits are greatest
in adolescence and young adulthood (Tantam,
1991). This period encompasses school transition,
finding employment, building a social network,
increasing contributions to household
responsibilities, greater involvement in the
community, and the development of romantic
relationships (Collins et al., 2000 Stokes
Kaur, 2005 ). Research indicates that only about
15 percent of adults with ASD had friendships
with shared enjoyment, and even fewer adults were
married. It is suggested that lack of social
skills in young adults with ASD may lead to more
isolation, and thus a lack of personal and
romantic relationships, vocational difficulties,
and increased psychopathology such as higher
rates of depression and generalized anxiety,
possibly due to higher rates of victimization
(Shtayermman, 2007) Numerous studies have shown
that social skills are an important factor in
long term adjustment of individuals with ASD.
Consequently, improving social functioning in
young adults with ASD would be expected to also
have a positive impact on the psychosocial
functioning of these individuals. However, to
date there do not appear to be any evidence-based
treatment interventions focused on improving
social skills for young adults with ASD.

• Conversational skills trading information,
  rules for having a two-way
• conversation
• Electronic communication
• Entering and exiting conversations
• Appropriate use of humor
• Expanding social network
• Organizing social activities with friends
• How to handle social rejection
• Handling arguments and disagreements
• Dealing with peer pressure and exploitation
  (sex, drugs and alcohol, illegal
• activities)
• Dating etiquette

OUTCOME MEASURES
STUDY DESIGN

• Outcome Measures
• Young adult and caregiver reports of friendship
  quality, social skills
• knowledge, psychosocial functioning (i.e.,
  anxiety,
• loneliness, empathy)
• Caregiver reports of social functioning
• Independent rater reports of social functioning

• The purpose of this pilot study is to investigate
  the effectiveness of a 14-week caregiver-assisted
  social skills training program for young adults
  between 18-22 years of age with Aspergers
  Disorder, High Functioning Autism or Pervasive
  Developmental Disorder NOS
• The study will use a randomized delayed treatment
  control group design
• The intervention consists of 14-weekly 90-minute
  sessions delivered at The Help Group, a community
  mental health agency
• Young adults will attend small group sessions
  (n10)
• Caregivers will attend separate concurrent
  sessions that will instruct them on key features
  being taught to young adults
• Ecologically valid skills will be taught through
  didactic instruction, role-playing, behavioral
  rehearsal with performance feedback, and weekly
  caregiver-assisted socialization homework
  assignments
• The project will assess outcome at pre and post
  treatment

REFERENCES
PRELIMINARY STUDIES
Barnhill, G. P. (2001). Social attribution and
depression in adolescents with Aspergers
Disorder. Focus on Autism and other
Developmental Disabilities, 16, 4654. Collins,
D., Davis, M., Vander Stoep, A. (2000).
Transition, a time of developmental and
institutional clashes. In H. B. Clark M.
Davis (Eds.), Transition to adulthood A
resource for young people with emotional or
behavioral difficulties (pp. 327), Baltimore,
MD Brookes. Klin, A. Volkmar, F., R. (2003).
Aspergers Disorder Diagnosis and external
validity. Child and Adolescent Clinics of North
America, 12(1), 1-13. Laugeson, E. A., Frankel,
F., Gantman, A., Dillon, A. R., Mogil C.
(2008). Evidence-Based Friendship Training for
Adolescents with Autism Spectrum Disorders A
Replication Study of the UCLA PEERS Program. 
Invited paper at the Autism 2008 AWARES Online
Conference, Wales, UK. Laugeson, E. A., Mogil, C.
E., Dillon, A. R., Frankel, F. (2009). 
Parent-assisted social skills training to
improve friendships in teens with autism spectrum
disorders. Journal of Autism and Developmental
Disorders 39(4), 596-606. Shtayermman, O. (2007).
Peer victimization in adolescents and young
adults diagnosed with Aspergers Disorder A
link to depressive symptomatology, anxiety
symptomatology and suicidal ideation. Issues in
Comprehensive Pediatric Nursing, 30(3),
87-107. Stokes, M., Kaur, A. (2005). High
functioning autism and sexuality A parental
perspective. Autism, 9(3), 263286. Tantam, D.
(1991). Aspergers Disorder in adulthood. In U.
Frith (Ed.) Autism and Aspergers Disorder
(pp.14783). Cambridge Cambridge University
Press. For more information please visit our
website http//www.semel.ucla.edu/socialskills/ o
r contact us at agantman_at_mednet.ucla.edu
In two recent clinical trials investigating the
efficacy of a parent-assisted manualized social
skills intervention for teens with ASD, known as
PEERS (Program for the Education and Enrichment
of Relational Skills), findings revealed
significant improvement in social functioning
among adolescents (Laugeson et al., 2008
Laugeson et al., 2009 see Table 1). In
comparison with a delayed treatment control
group, the treatment group significantly improved
their social skills knowledge, improved the
quality of their friendships, increased the
frequency of hosted get-togethers with peers, and
improved their overall social skills as reported
by parents (Laugeson et al., 2009) moreover,
these social skills gains were maintained at a
three-month follow-up assessment (Laugeson et
al., 2008).

STRUCTURE OF THE SESSIONS

• Young Adult Sessions
• Review of homework from the previous week
  troubleshoot homework problems
• Didactic presentation of social skills lessons
• Behavioral rehearsal with performance feedback
  from coaches
• Reunification with caregivers and young adults
  to negotiate homework assignment
• Caregiver Sessions
• Review of homework from the previous week
  troubleshoot homework problems
• Didactic presentation of the young adult social
  skills lesson
• Assign socialization homework for the coming
  week
• Reunification with caregivers and young adults
  to negotiate homework assignment

Table 1. Mean Pre- and Post-Treatment Scores for
Statistically Significant Outcome Variables for
Treatment and Delayed Treatment Control Groups
(Standard Deviations are in Parentheses). _______
__________________________________________________
______________ Variable Group Treatment
Delayed Treatment Control n 17 n
16 Pre Post Pre Post plt Teen
measures TASSK 13.3 (2.4) 19.6 (1.4) 12.6
(3.6) 13.3 (3.8) .001 QPQ Host 1.1 (1.4)
3.2 (2.2) 0.6 (0.9) 1.1 (1.3)
.025 FQS 16.8 (3.4) 17.2 (4.0) 18.1(3.9)
16.6 (4.6) .05 Parent Measure SSRS Social
Skills 80.2 (8.8) 89.7 (12.1) 77.9 (12.1)
79.8 (11.7) .05