Social skills group training in children with autism spectrum disorder: a randomized controlled trial

In 122 high-functioning children with autism spectrum disorder (ASD; 9-13years; 19 girls), we investigated the effectiveness of a 15-session social skills group training (SST) with and without parent and teacher involvement (PTI) in a randomized controlled trial with three conditions: SST (n=47), SST-PTI (n=51), and care-as-usual (CAU, n=24). Hierarchical linear modeling was used for immediate and 6-month follow-up analyses. Measures were administered before randomization (blind), post-treatment and at follow-up (not blind). Trial registration: Dutch Trial Register; http://www.trialregister.nl; NTR2405. At post-treatment, children in both SSTs had improved significantly more than CAU on the primary outcome, Vineland Socialization (SST: Cohen's d=0.39; 95% CI -2.23 to 3.11 and SST-PTI: d=0.43; 95% CI -2.19 to 3.15) and on the secondary outcome parent-SSRS Cooperation (SST: d=0.43; 95% CI -0.23 to 1.15 and SST-PTI: d=0.45; 95% CI -0.21 to 1.17), with no difference between post-treatment and follow-up. Additionally, children in SST-PTI improved significantly more on the teacher-SSRS than in CAU [Cooperation d=0.42 (95% CI -0.33 to 1.13); Assertion d=0.34 (95% CI -0.39 to 1.11); Self-Control d=0.61 (95% CI -0.08 to 1.34)] and in SST [Cooperation d=0.34 (95% CI -0.37 to 1.05); Self-Control d=0.59 (95% CI -0.13 to 1.32)]. The current study corroborates earlier findings in smaller samples and wider age ranges, with small but statistically significant effects of SST for high-functioning pre-adolescent children with ASD. Parental and teacher involvement intensified treatment, yet did not yield an additional effect relative to SST for children only, as reported by parents. 6months after training, no further improvement or decline was found.