Social skills classes produce lasting benefits for adults with autism

A social skills program for young adults with autism provides lasting benefits that include a steady growth in social connections, according to a new study in the Journal of Autism and Developmental Disorders.

The study – the largest controlled trial to track the effectiveness of such a program – evaluated a young adult version of the Program for the Education and Enrichment of Relational Skills, or PEERS. Previous research had demonstrated the effectiveness of PEERS programs for preschoolers and for adolescents. All three courses consist of 16 weekly, 90-minute sessions, with concurrent sessions for caregivers.

The study enrolled 22 participants, ages 18 to 24. All had autism without intellectual disability and significant difficulties in social situations. All had also expressed interest in taking the course.

During the study, half the participants completed the PEERS course, while the half were placed on a wait list. As part of the course, the participant’s parents or other caregivers received training on how to coach the participants outside of class.

The Program for the Education and Enrichment of Relational Skills (PEERS)

Conversation, humor and more

The group classes focused on conversational skills, appropriate use of humor and electronic communication, identifying sources of friends, entering and exiting conversations, organizing successful get-togethers and handling peer conflict and peer rejection. The course also included four sessions on dating etiquette.

During each class, trainers went over specific rules and steps of social behavior. They taught through lessons, role-play, rehearsal exercises and assignments to practice the skills in social settings outside of class.

“We’re not teaching what we think young people should do in social situations, but what we know actually works through research,” says senior researcher Elizabeth Laugeson. Dr. Laugeson is the founder and director of the PEERS Clinic at the University of California, Los Angeles.

For example, young people with autism are often advised to walk up and introduce themselves to others – a strategy that can come across as awkward.

Breaking skills into steps

“Most of us watch and listen to the conversation and figure out what [other people] are talking about,” Dr. Laugeson explains. “We do this by eavesdropping. But we don’t want to look like we’re eavesdropping…. The next step is to wait for a brief pause in the conversation and move closer. The final step is to join the conversation by saying something on topic.”

The PEERS training breaks down social skills in this stepwise manner.

Benefits 

The researchers evaluated the participants at the end of the 16-week course. Those who completed the classes had significantly greater improvements in social skills and frequency of social engagement, compared to the comparison group on the wait list. In addition, those who took the class had a significant decrease in autism symptoms related to social responsiveness.

Lasting gains and further improvement

The participants returned four months after the training ended for another evaluation. Those who had completed the course still showed significant gains in social skills and engagement.

What’s more, the researchers observed new improvements in social communication, assertion, responsibility and empathy. This may be due to continued coaching by the caregivers who participated in the study, the researchers propose.

“Our study offers encouraging findings that, through an evidence-based, caregiver-supported intervention, adults with autism can improve in ways that may help them be more successful in these aspects of their lives,” Dr. Laugeson says.

Although most people with autism struggle with social difficulties, few social skills interventions exist for young adults on the spectrum.

“It’s exciting to see a community-based treatment model using caregiver support to help improve social skills,” comments Kara Reagon, Autism Speaks associate director of dissemination science. “The results show adults can continue to learn complex social skills such as making and maintaining friendships, and managing conflict and rejection. More research on skill acquisition for social skills for with this age group is desperately needed.”

The researchers plan to publish a PEERS manual for young adults later this year. The PEERS Clinic already offers similar manuals for coaching adolescents and younger children.

PEERS trainings are available nationwide and in a dozen countries.