Therapies for Children With Autism Spectrum Disorders

Content of the literature. We located 16 unique papers addressing social skills interventions.
This number includes two sets of papers with possibly overlapping samples evaluating a
Skillstreaming intervention 135,136 and a cognitive-behavioral-ecological social skills
approach. 137,138 The ages of children studied ranged from 4-16 years old. Twelve studies focused
exclusively on higher functioning children or included language and/or cognitive requirements
among their eligibility criteria. 135-146 Three studies provided individual treatment to
children, 137,145,147 three used a combination of individual and small group formats, 138,146,148 and
nine employed a small group format only. 135,136,139-144,149 In addition, five interventions included
some form of parent training or involvement as an adjunct to child treatment. 137,139,141,144,146 For
the 14 studies with prospective designs, the total amount of training provided ranged from 6.7
hours to 180 hours. Table 10 summarizes additional details.
Among studies of social skills interventions, seven were fair quality and nine were poor.
Summary of the literature. Three RCTs 139,141,146 (Table 11) evaluated social skills interventions
targeting high functioning children with ASDs using a format that involved training for both
children and their parents. The criteria for determining whether a child was high functioning and
therefore eligible to participate varied by study, but at a minimum the child had to have a verbal
IQ above 60. Different outcome measures were used across the samples, making direct
comparisons difficult.
The Children’s Friendship Training 141 program involves children with and without ASDs,
and uses didactic instruction on rules of social behavior; modeling, coached behavioral rehearsal,
and performance feedback during treatment sessions; rehearsal at home; homework assignments;
and coaching by parents during play dates with a peer. Children were randomly assigned to
receive Children’s Friendship Training either immediately or 12 weeks later (Delayed Treatment
Control group). Treatment was conducted in 60-minute small parallel group sessions for parents
and children, and lasted 12 weeks.
Immediately following treatment, the Children’s Friendship Training group showed
significant improvements in social behavior and social cognition compared with the Delayed
Treatment Control group. Children in the treatment group also spent less time during the play
date engaged in minimally socially interactive activities (such as watching television) compared
with the delayed treatment group (p