A new research and treatment program is giving children with Asperger’s Disorder (AD) and their parents good reason to be optimistic. Asperger’s Disorder is a high functioning form of autism characterized by a lack of social skills, the inability to recognize emotions in others and narrow, often obsessive interests.
The intervention, called the “Connections Research and Treatment Program” is lead by members of the Autism Spectrum Disorders Research Consortium. Researchers are evaluating the effectiveness of a cognitive-behavioral treatment program on the social behaviors of six – 13 year old children with Asperger’s Disorder.
“Our preliminary research indicates that children with Asperger’s Disorder, who participated in Connections, showed significant improvement in social skills based on parent and staff reports,” said Robert E. Nida, PhD, associate professor of education. “In addition, many of the parents reported a significant improvement in adaptability and reduction in unusual behavior for their children.”
The findings are important because the diagnosis of Asperger’s Disorder is so new (the American Psychiatric Association officially recognized AD in 1994), there is a distinct lack of sound, empirical research and proven treatment options. And although social skills interventions are commonly recommended for children with AD, at present little is know about the efficacy of such interventions with this population.
Unlike children with more severe forms of autism, those with Asperger’s Disorder have good verbal skills (although poor pragmatic language skills), average or above average intelligence and appear to develop normally in early childhood. Indications of the disorder emerge in first and second grade, generally at the same time more complex play emerges. Most children diagnosed with Asperger’s lack the social skills that enable them to participate fully in play and other social situations.
This is where the Connections Program intervenes.
The program facilitates the social development and communicative skills of AD children, through the use of highly structured and targeted activities. Children attend the six-week program for six hours a day, five days a week. Even though the program is extensive, the activities are designed to engage the children and hold their interest.
Each day is composed of four, 70-minute treatment cycles. Each cycle includes 20 minutes of intensive social skill instruction based on Skillstreaming. Skillstreaming was developed by the late Syracuse University Professor Arnold Goldstein, PhD, and involved instruction, modeling, role-playing and feedback. The last 50 minutes of each treatment cycle consists of a therapeutic activity in which the children practice social skills and emotion recognition, or work on expanding their interests.
The program is designed to teach a wide range of social skills that progress from concrete skills to more abstract skills. For example, to address the inability to associate facial expressions with particular emotions, the children are asked to name an emotion, draw the facial expression associated with that emotion, and then talk about how that emotion can make a person feel physically. To reinforce this skill, students watch the popular children’s movie Willie Wonka and the Chocolate Factory, because the characters in the film exhibit a wide array of facial expressions. A Connections counselor pauses the movie at critical points and asks the children to explain what the character is feeling, how they know what the character is feeling and how that character might be feeling physically.
The idea is to teach the appropriate social skill, provide opportunities to practice that skill and set up contexts that they have to exhibit those social skills. “According to preliminary findings, the program is working to positively change the behaviors of the children in their day-to-day lives,” said Nida.
Results were based on parent and staff reports based on a pretest-posttest design. Parents and staff completed behavioral rating scales (i.e., Behavioral Assessment System for Children, Second Edition) at the beginning and end of the six-week treatment program. The results showed a significant increase in social skill ratings that appeared to also have social significance outside the program, and after the summer program ended.
Evidence of social significance was reflected in anecdotal reports by parents. For example, many parents reported that their children had been invited to participate in a range of social activities such as visiting a peer’s house and attending a peer’s party. Such events were reported by many of the parents to be absent or rare prior to the program.
In addition, anecdotal reports suggested that children in the program were more socially aware of and attentive to peers, utilizing many of the skills taught during the program, including introducing oneself, initiating and ending a conversation, discussing another’s interests, and establishing and maintaining appropriate eye contact.
In addition to social skills improvements, parents also reported a significant improvement in their children’s adaptability. This reflected improved ability to change tasks, share possessions, adapt to changes in routine and adapt to changes in the environment.
“The preliminary results of the study appear to provide tentative support for interventions that incorporate cognitive-behavior strategies targeting social skills deficits for children with AD,” said Nida.
Source: Canisius College