Child and Caregiver Social Behavior and Joint Attention Change following P.L.A.Y. Project Intervention

Autism is a complex, developmental disorder affecting approximately one in 110 children in the United States. Children with autism spectrum disorders demonstrate a variety of significant deficits, including social impairment. The limitations in social ability may be in part a product of limited joint attention development at an early age. Joint attention refers to the triadic attention between an individual, another person, and an object or event and has been shown to moderate the effectiveness of certain autism interventions. The P.L.A.Y. Project, developed by Dr. Richard Solomon, aims to train parents of children with autism to be their child\u27s own therapist by following the child\u27s lead and utilizing naturalistic learning opportunities to enhance the reinforcing value of social interaction. This study investigated whether five months of P.L.A.Y. intervention was effective in improving behaviors germane to joint attention development in caregivers and children with autism in comparison to a community standard control group. The relationship between caregiver and child joint attention behavior change also was explored. Thirty-two caregiver-child dyads were videotaped before and after a five-month period in which 14 received P.L.A.Y. Project intervention and 18 were assigned to a community standard control group. Results indicated that children in the P.L.A.Y. group made improvements in many domains, particularly in their frequency of children initiating and leading play sequences. However, these changes did not differ significantly from those made by children in the control group. Future studies should examine longer periods of P.L.A.Y. intervention for more accurate understanding of its benefits and a more comprehensive understanding of the interactive, dependent nature of the trajectory of joint attention development

Parent And Family Outcomes Of An Empirically Validated Social Skills Intervention For Adolescents With Autism Spectrum Disorders

Past research has indicated that raising a child with an Autism Spectrum Disorder (ASD) is associated with increased parenting stress, decreased parenting self-efficacy, and increased family distress. While ASD therapies often include significant parental involvement and are typically time-intensive and expensive, studies of ASD treatment have not widely evaluated the impact of treatment on caregivers or the family. There is evidence that successful long-term treatment outcomes are dependent on healthy systemic functioning, and thus it is important to understand how any particular treatment adjunctively affects parents and the family system. The Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson & Frankel, 2010) is a 14-week, manualized social skills intervention designed for adolescents with high-functioning Autism Spectrum Disorder. This study aimed to understand the impact of PEERS intervention on parenting stress, parenting self-efficacy, family distress, parent facilitation of teen autonomy, and parent-teen relational frustration, via a randomized, controlled trial. Comparison of an experimental group and waitlist control group from pre- to post-intervention via mixed between-within analysis of variance (ANOVA) suggested a significant group by time interaction effect indicative of a decrease in family chaos following PEERS intervention. In addition, parents in the experimental group demonstrated a significant increase in parenting self-efficacy from pre- to post-intervention. There were not significant main or interaction effects found for parenting stress, teen autonomy, or relational frustration. Additional analyses examined the relationships between parent and teen functioning. Overall, these findings highlight adjunctive benefits resulting from PEERS intervention and suggest the need for increased study of this promising program

Parent and Family Outcomes of PEERS: A Social Skills Intervention for Adolescents with Autism Spectrum Disorder

Raising a child with an Autism Spectrum Disorder (ASD) is associated with increased family chaos and parent distress. Successful long-term treatment outcomes are dependent on healthy systemic functioning, but the family impact of treatment is rarely evaluated. The Program for the Education and Enrichment of Relational Skills (PEERS) is a social skills intervention designed for adolescents with high-functioning ASD. This study assessed the impact of PEERS on family chaos, parenting stress, and parenting self-efficacy via a randomized, controlled trial. Results suggested beneficial effects for the experimental group in the domain of family chaos compared to the waitlist control, while parents in the PEERS experimental group also demonstrated increased parenting self-efficacy. These findings highlight adjunctive family system benefits of PEERS intervention and suggest the need for overall better understanding of parent and family outcomes of ASD interventions

Measuring the Plasticity of Social Approach: A Randomized Controlled Trial of the Effects of the PEERS Intervention on EEG Asymmetry in Adolescents with Autism Spectrum Disorders

This study examined whether the Program for the Education and Enrichment of Relational Skills (PEERS: Social skills for teenagers with developmental and autism spectrum disorders: The PEERS treatment manual, Routledge, New York, 2010a) affected neural function, via EEG asymmetry, in a randomized controlled trial of adolescents with Autism spectrum disorders (ASD) and a group of typically developing adolescents. Adolescents with ASD in PEERS shifted from right-hemisphere gamma-band EEG asymmetry before PEERS to left-hemisphere EEG asymmetry after PEERS, versus a waitlist ASD group. Left-hemisphere EEG asymmetry was associated with more social contacts and knowledge, and fewer symptoms of autism. Adolescents with ASD in PEERS no longer differed from typically developing adolescents in left-dominant EEG asymmetry at post-test. These findings are discussed via the Modifier Model of Autism (Mundy et al. in Res Pract Persons Severe Disabl 32(2):124, 2007), with emphasis on remediating isolation/withdrawal in ASD

The emerging role of rapid corticosteroid actions on excitatory and inhibitory synaptic signaling in the brain

Over the past two decades, there has been increasing evidence for the importance of rapid-onset actions of corticosteroid hormones in the brain. Here, we highlight the distinct rapid corticosteroid actions that regulate excitatory and inhibitory synaptic transmission in the hypothalamus, the hippocampus, basolateral amygdala, and prefrontal cortex. The receptors that mediate rapid corticosteroid actions are located at or close to the plasma membrane, though many of the receptor characteristics remain unresolved. Rapid-onset corticosteroid effects play a role in fast neuroendocrine feedback as well as in higher brain functions, including increased aggression and anxiety, and impaired memory retrieval. The rapid non-genomic corticosteroid actions precede and complement slow-onset, long-lasting transcriptional actions of the steroids. Both rapid and slow corticosteroid actions appear to be indispensable to adapt to a continuously changing environment, and their imbalance can increase an individual's susceptibility to psychopathology

Brief Report: Assessment of Intervention Effects on In Vivo Peer Interactions in Adolescents with Autism Spectrum Disorder (ASD)

This study aimed to evaluate the effectiveness of a randomized controlled trial of a social skills intervention, the Program for the Education and Enrichment of Relational Skills (PEERS: Laugeson et al. in J Autism Dev Disord 39(4): 596–606, 2009), by coding digitally recorded social interactions between adolescent participants with ASD and a typically developing adolescent confederate. Adolescent participants engaged in a 10-min peer interaction at pre- and post-treatment. Interactions were coded using the Contextual Assessment of Social Skills (Ratto et al. in J Autism Dev Disord 41(9): 1277–1286, 2010). Participants who completed PEERS demonstrated significantly improved vocal expressiveness, as well as a trend toward improved overall quality of rapport, whereas participants in the waitlist group exhibited worse performance on these domains. The degree of this change was related to knowledge gained in PEERS

Brief Report: Does Gender Matter in Intervention for ASD? Examining the Impact of the PEERS® Social Skills Intervention on Social Behavior Among Females with ASD

A paucity of research has been conducted to examine the effect of social skills intervention on females with ASD. Females with ASD may have more difficulty developing meaningful friendships than males, as the social climate can be more complex (Archer, Coyne, Personality and Social Psychology Review 9(3):212–230, 2005). This study examined whether treatment response among females differed from males. One hundred and seventy-seven adolescents and young adults with ASD (N = 177) participated in this study. When analyzed by group, no significant differences by gender emerged: PEERS® knowledge (TASSK/TYASSK, p = .494), direct interactions (QSQ, p = .762), or social responsiveness (SRS, p = .689; SSIS-RS, p = .482). Thus, females and males with ASD respond similarly to the PEERS® intervention

Changes in Depressive Symptoms Among Adolescents with ASD Completing the PEERS® Social Skills Intervention

Depression is a common concern among people with autism spectrum disorder (ASD) and is often associated with social skills and relationship challenges. The present data, from a randomized controlled trial, examined the effect of PEERS® on self-reported depressive symptoms via the Children’s Depression Inventory (CDI) among 49 adolescents with ASD. Findings revealed that many CDI subscale scores declined (p’s \u3c 0.05) and were related to direct social contact on the Quality of Socialization Questionnaire at posttest (p’s \u3c 0.05). Exploratory analyses uncovered that suicidality was less evident following PEERS®. Findings support the notion that social functioning and depression may be intimately intertwined in ASD; therefore, bolstering social skills in ASD may positively influence other domains of functioning, including mental health

Examining the Links Between Challenging Behaviors in Youth with ASD and Parental Stress, Mental Health, and Involvement: Applying an Adaptation of the Family Stress Model to Families of Youth with ASD

Raising a child with autism spectrum disorder (ASD) poses unique challenges that may impact parents’ mental health and parenting experiences. The current study analyzed self-report data from 77 parents of youth with ASD. A serial multiple mediation model revealed that parenting stress (SIPA) and parental mental health (BAI and BDI-II) appears to be impacted by challenging adolescent behaviors (SSIS-PBs) and, in turn, affect parental involvement (PRQ), controlling for social skills (SSIS-SSs). Further, the study explored the malleability of parents’ mental health over the course of a social skills intervention, and provides modest evidence that parent depressive symptoms decline across intervention. This study illustrates the importance of considering the entire family system in research on youth with ASD

Social Difficulties in Youth with Autism With and Without Anxiety and ADHD Symptoms

Social difficulties inherent to autism spectrum disorder are often linked with co‐occurring symptoms of anxiety and attention deficit hyperactivity disorder (ADHD). The present study sought to examine the relation between such co‐occurring symptoms and social challenges. Parents of adolescents with autism (N = 113) reported upon social challenges via the social responsiveness scale (SRS) and anxiety and ADHD symptomatology via the Child Behavior Checklist. Results revealed differences in SRS scores across co‐occurring symptom subgroups (Anxiety, ADHD, Both, Neither)—namely, adolescents with autism and anxiety as well as those with autism, anxiety, and ADHD showed greater scores on the SRS than the other groups. Implications for research and clinical practice are discussed and recommendations are offered. Lay Summary Anxiety and attention deficit hyperactivity disorder (ADHD) symptoms are related to greater social challenges for adolescents with autism spectrum disorder. The present study found that autism with anxiety and autism with anxiety and ADHD, was related to greater social difficulties than autism alone. Findings provide further support for the intertwined nature of anxiety and ADHD symptoms in autism. What this may mean for research and clinical practice is considered and recommendations are suggested