A Pilot Randomized Controlled Trial of Motivation-Based Social Skills Group Treatment with Parent Training

作者：

Jane Shkel, Alicia Geng, Elise Pilchak, Maria Estefania Millan, Jessica M. Schwartzman, Rachel Schuck, Maria Victoria Bundang, Agatha Barnowski, Devon M. Slap, Sydney Stratford, Antonio Y. Hardan, Jennifer M. Phillips & Grace W. Gengoux

摘要：

Despite the popularity of social skills groups, there remains a need for empirical investigation of treatment effects, especially when targeting pivotal aspects of social functioning such as initiations to peers. The goal of the present study was to conduct a randomized controlled trial of a 12-week social intervention (SUCCESS), which combined an inclusive social group with a parent education program. Twenty-five 4- to 6-year-olds with Autism Spectrum Disorder (ASD) were randomized to SUCCESS (N = 11) or to treatment as usual (N = 14). Combining a peer group model with a parent training program, the SUCCESS intervention used naturalistic behavioral techniques (e.g., environmental arrangement, natural reinforcement) to increase social initiations to peers. After 12 weeks, children participating in the SUCCESS program made more frequent initiations to peers than children in the treatment-as-usual group, including more prompted and unprompted initiations to request. Additional gains in clinician-rated social functioning were observed in children randomized to SUCCESS, while differential treatment effects were not detected in parent-rated measures. However, lower baseline social motivation was associated with greater parent-reported initiation improvement. This study provides preliminary support for the efficacy of a naturalistic, behavioral social skills intervention to improve peer initiations for children with ASD. The findings suggest that using a motivation-based social skills group was effective in increasing both prompted and spontaneous initiations to peers, and highlights the need for further research into the role of baseline social motivation in predicting social skills treatment response.

尽管社交技能小组很受欢迎，但仍需要对治疗效果进行实证调查，尤其是在针对社会功能的关键方面时，例如对同伴的启蒙。本研究的目的是进行一项为期 12 周的社会干预 （SUCCESS） 的随机对照试验，该试验将包容性社会群体与家长教育计划相结合。25 名患有自闭症谱系障碍 （ASD） 的 4 至 6 岁儿童被随机分配到 SUCCESS （N = 11） 或常规治疗组 （N = 14）。SUCCESS干预将同伴群体模型与家长培训计划相结合，使用自然主义行为技术（例如，环境安排，自然强化）来增加对同伴的社交启蒙。12 周后，参与 SUCCESS 计划的儿童比常规治疗组的儿童更频繁地向同龄人发起，包括更多提示和无提示的请求。在随机分配到SUCCESS的儿童中观察到临床医生评定的社会功能有额外的增益，而在父母评定的措施中未检测到差异治疗效果。然而，较低的基线社会动机与父母报告的启动改善更大有关。本研究为自然主义、行为社交技能干预改善 ASD 儿童同伴启动的功效提供了初步支持。研究结果表明，使用基于动机的社交技能小组可有效增加对同龄人的提示和自发启动，并强调需要进一步研究基线社会动机在预测社交技能治疗反应中的作用。