Social Skills Therapy Groups – Evaluating the Behavioral and Neural Impact for Children with Autism Spectrum Disorders

Social dysfunction is the central, unifying feature of autism spectrum disorders (ASD) and perhaps also the most debilitating. Impairments in socialization persist in individuals with ASD regardless of age or language level and are likely to impact quality of life variables, such as employment and companionship. Improvement in social functioning is widely considered to be a crucial target for intervention. Even so, there are very few controlled studies of treatments that focus specifically on social skills. Much of the current literature describes comprehensive treatment plans and applied behavior analytic approaches geared toward increasing language and basic skills deficits found in young, primarily nonverbal children with ASD. Little is known about effective strategies for improving socialization in older, high-functioning children with ASD.

In clinical practice, several models of social skills interventions have been applied to verbally fluent children with autism that address a range of social deficits, from basic, (e.g. emotion recognition) to more complex (e.g. “theory of mind,” the ability to understand the mental states of others). Models of intervention include cognitive behavioral therapy (CBT); play therapies based in psychodynamic theories and/or the floortime model; comprehensive packages such as the Relationship Development Intervention (RDI); and eclectic approaches that draw from several theoretical orientations. In addition to variations in the model of intervention, variability in the modality and location of interventions also exist. Modalities may include traditional outpatient group therapy models, computerized programs (e.g. face or emotion training programs), individual therapy, push-in social skills in classrooms, peer-facilitated models, and board games.

Despite the availability of an array of intervention approaches, little is known about the efficacy of these approaches because few treatments targeting social skills have been manualized and subject to controlled investigations. A study currently in progress at the Seaver and New York Autism Center of Excellence by Drs. Wang and Soorya is one step towards developing the empirical support needed to advance therapeutic interventions for socialization skills in children with ASD. The study, funded by Autism Speaks, is evaluating short-term outcomes associated with two forms of commonly used social skills therapies: CBT and play therapy. Each 12-week group is focused on children 8-11 years of age with ASD and fluent verbal skills and includes a separate, concurrent therapy group for parents.

Importantly, the study utilizes manualized protocols for both CBT and play therapy as well as a randomized, controlled design, which provides basic elements of experimental control in order to evaluate potential changes. This pilot study is assessing a broad array of potential outcomes including effects on emotional perception, changes in social behavior at home and school, and changes in brain activity during social information processing (measured by functional magnetic resonance imaging). Through the randomized methodology and manualized treatment protocols, the study seeks to provide preliminary data on the nature of potential benefits from CBT and play therapy groups and develop hypotheses regarding the neural mechanisms responsible for potential changes.

The demand for providing socialization interventions for children with ASD has led to a proliferation of clinical interventions; often with strong support from families and therapists but unfortunately with limited data to support their use. Data from this study may serve as an initial step in understanding the effects of commonly used socialization programs for high functioning children with ASD. Many other studies are also underway at the Seaver and New York Autism Center of Excellence where we are dedicated to discovering the biological causes of autism and to developing breakthrough treatments.

The Seaver Center is under the direction of Dr. Joseph Buxbaum, the G. Harold and Leila Y. Mathers Research Professor of Psychiatry, Neuroscience, Genetics and Genomic Sciences at Mount Sinai School of Medicine.

The Research Program at the Seaver Center is a collaborative effort that offers an integrated series of research studies in innovative treatments, genetics, and brain imaging. All services in research studies are provided without charge to eligible participants and include gold standard diagnostic assessments such as the Autism Diagnostic Observation Schedule (ADOS), the Autism Diagnostic Interview (ADI), and neuropsychological testing.

The Clinical Program offers Assessment & Evaluation Services, including diagnostic testing, neuropsychological testing, academic testing, and psychiatric evaluations. In addition, we offer comprehensive Treatment Services, including medication management, social skills groups, parent training sessions, cognitive behavior therapy, and a sibling support program. As part of our commitment to education and community care, we also have a Community Outreach & Training Program that provides lectures and workshops to parent groups, agencies, and schools. We also host an annual conference to address current scientific trends and discoveries.

For more information about Research and Clinical Programs at the Seaver and New York Autism Center of Excellence, please contact: Jessica Kiarashi – jessica.kiarashi@mssm.edu, 212-241-7098.

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