|Increasing Social Performance of Children With Autism Spectrum Disorders via Randomized Clinical Trials and Manualized Protocols
|Monday, May 31, 2010
|9:00 AM–10:20 AM
|Area: AUT/DDA; Domain: Applied Behavior Analysis
|Chair: Stephen R. Anderson (Summit Educational Resources)
|CE Instructor: Dana Reinecke, Ph.D.
|Abstract: There is a significant need for comprehensive social interventions for children with autism spectrum disorders (ASD), yet highly-controlled studies are scarce. Recent reviews of social treatment studies have identified a number of weaknesses including small samples and lack of random assignment, control groups, treatment manuals, and fidelity measures. A NIMH working group proposed a four-phase model to serve as a guide for conducting psychosocial intervention research. The four phases progress from development and systematic testing of new techniques, to manualized protocols, to randomized clinical trials, and finally community-based effectiveness studies. Following this four phase model, researcher from Summit Educational Resources, Canisius College and the University at Buffalo have developed and tested manualized protocols designed to increase social performance of children with ASDs. The research team has conducted four studies including (1) two RCTs of a manualized summer socialization program for children with HFASDs (RCT and replication RCT), (2) a RCT of a manualized social skills curriculum for more severely impaired center-based children with autism, (3) a pilot study teaching emotion recognition(ER) to children with HFASDs, and (4) a RCT of the manualized summer socialization program with ER instruction. This symposium will report outcomes for these studies.
|Randomized Clinical Trials of a Manualized Social Treatment for High-Functioning Autism Spectrum Disorders
|Christopher Lopata (Institute for Autism Research at Canisius College), MARCUS LUCAS THOMEER (Institute for Autism Research at Canisius College), Martin Volker (University at Buffalo), Jennifer Toomey (Summit Educational Resources)
|Abstract: Two randomized clinical trials (RCTs) examined the efficacy of a manualized social intervention for children with high-functioning autism spectrum disorders (HFASD). Each RCT included 36 children ages 7-12 diagnosed with a HFASD. Participants were randomly assigned to the treatment or wait-list control condition. Treatment included intensive instruction and therapeutic activities targeting social skills, face-emotion recognition, interest expansion, and interpretation of non-literal language. A response-cost behavioral program was applied to reduce problem behaviors and foster acquisition and maintenance of social skills. Pre-post efficacy measures were administered; results of the repeated measures ANOVAs/ANCOVAs for the initial RCT indicated significant treatment gains for 14 of the 17 outcome measures. These findings were replicated in the replication RCT. Standardized effect size estimates in both RCTs were generally medium to large for the treatment groups. Both studies reported high parent, child, and staff satisfaction and treatment fidelity was > 94%. Results of the initial and replication RCTs strongly supported the validity of the intervention for improving social functioning of children with HFASDs.
|Evaluation of a Manualized Social Skills Curriculum for 72 Center-Based Children With Autism and Related Disorders
|Marcus Lucas Thomeer (Institute for Autism Research at Canisius College), JENNIFER TOOMEY (Summit Educational Resources), Rebekah Lindamer (Summit Educational Resources), Christopher Lopata (Institute for Autism Research at Canisius College), Stephen R. Anderson (Summit Educational Resources), Christin A. Crossman (Summit Educational Resources), Martin Volker (University at Buffalo)
|Abstract: This study evaluated a manualized social skills curriculum (MSSC) for 72 lower-functioning children, ages 5-12 years, with autism and related disorders. Implementation of treatment was staggered across three 6-month intervals allowing for waitlist controls in the first two 6-month intervals. Treatment consisted of daily direct instruction in two of six skill sets followed by three 10-15 minute sessions conducted during the school day which allowed each student to practice skill(s) taught. Children in the waitlist conditions received social intervention as it was typically offered in their school programming (i.e., “business as usual”). Stratified random cluster sampling was used to assign classrooms. Teacher and parent ratings were collected prior to and at the end of each treatment interval. All ratings were analyzed using repeated measures ANOVAs. Direct observations of participants in both structured and unstructured settings were collected at predetermined points throughout the study. Findings and implications for research and practice will be discussed.
|Pilot Evaluation of a Manualized Protocol to Teach Emotion Recognition in Children With High-Functioning Autism Spectrum Disorders
|Marcus Lucas Thomeer (Institute for Autism Research at Canisius College), Jonathan D. Rodgers (University at Buffalo), CHRISTIN A. CROSSMAN (Summit Educational Resources), Jennifer Toomey (Summit Educational Resources), Christopher Lopata (Institute for Autism Research at Canisius College), Martin Volker (University at Buffalo), Rebekah Lindamer (Summit Educational Resources)
|Abstract: Impairment in social communication is a central characteristic of high-functioning children with autism spectrum disorders including deficits in recognizing basic and complex emotions in facial expressions, disorganized scanning of faces, and reduced attention to core facial features. While research is limited, attempts to increase emotion recognition of children with high-functioning autism spectrum disorders (HFASD) using traditional instructional techniques have produced mixed results. Computer-based interventions have been proposed as a way to increase emotion recognition. This pilot study evaluated a manualized administration of Mind Reading (MR) for its effect on emotion recognition and social behaviors of 11 children with HFASDs, as well as its overall feasibility. Following 12 sessions of MR over 7 weeks, emotion recognition and display skills were rated significantly higher than pretest. Significant reductions were also found on ratings of problem social behaviors (i.e., autism-associated symptoms) on a standardized rating scale. Assessment of feasibility (i.e., fidelity and satisfaction) indicated high levels of treatment fidelity and high levels of parent and child satisfaction. Effect size estimates were medium to large for scales on which significant changes were observed. Implications for future studies are proposed.
|Randomized Clinical Trial Teaching Emotion Recognition to Children With High-Functioning Autism Spectrum Disorders in a Manualized Summer Program
|Christopher Lopata (Institute for Autism Research at Canisius College), Marcus Lucas Thomeer (Institute for Autism Research at Canisius College), JONATHAN D. RODGERS (University at Buffalo), Christin A. Crossman (Summit Educational Resources), Rachael Smith (University at Buffalo), Gaetano Gullo (University at Buffalo), Jennifer Toomey (Summit Educational Resources), Martin Volker (University at Buffalo)
|Abstract: One technique for teaching decoding skills and emotion recognition is the mind reading (MR) interactive software program. Two recently conducted uncontrolled studies found MR produced significant increases in decoding of facial and vocal emotions for children with high-functioning autism spectrum disorders (HFASD). This current RCT included 24 children ages 7-12 with a HFASD. Participants were randomly assigned to the treatment (MR + Manualized Summer Program) or control condition (Manualized Summer Program Only). All participants were participating in a manualized five-week summer social development program that included intensive instruction and therapeutic activities targeting three core areas: social skills, interest expansion, and interpretation of non-literal language. Additionally all children’s prosocial and inappropriate social behaviors were monitored via a response cost system. Children in the MR condition received 17 ½ hours of instruction using the MR program. Control children practiced previously learned social skills while the other children received MR instruction. Pre-post staff, parent and child data is being analyzed via repeated measures ANOVAs. Results of satisfaction ratings and treatment fidelity will also be reported. Results, implications, and limitations will be discussed.