A unique treatment program at Canisius College offers hope to children with high-functioning autism spectrum disorders (Asperger's, high-functioning autism, and PDDNOS), which are characterized by lifelong impairments in social-communicative functioning and narrow and repetitive behaviors and interests.
Results of a randomized clinical trial found an innovative multi-component summer social development program to be effective in improving the social performance of children with high-functioning autism spectrum disorders. According to Christopher Lopata, PsyD and Marcus L. Thomeer, PhD, co-directors of the Institute for Autism Research at Canisius College and the study's lead authors, the findings of the clinical trial, published online in the Journal of Autism and Developmental Disorders (March 16, 2010) support and extend the findings of three previously published studies by this research team on the effectiveness of the manualized summer socialization program.
Following the 5-week program, children in the treatment group demonstrated significantly higher scores on child measures of non-literal language skills and knowledge of appropriate social behaviors, as well as significantly higher parent-rated social skills targeted by the program and significantly lower parent ratings of autism features and withdrawn behaviors compared to children in the control group. Secondary staff ratings corroborated the significant gains reported by parents. Parents, children, and staff also reported high levels of satisfaction with the program.
The general pattern of findings suggested that children in the treatment group improved significantly in their understanding of what social skills to use in a range of social situations and the specific elements of those skills, as well as in their ability to understand non-literal language. Ratings by parents and staff indicated that the children in the treatment group were also more likely to engage with others and use social skills targeted by the program (e.g., having a conversation, giving a compliment, recognizing another's feelings) compared to children who did not receive treatment.
"These findings are very promising, as they suggest that the children in the treatment group not only learned the skills but also used the skills to an extent that parents and staff clearly noticed a significant and meaningful change in the children's social performances," said Lopata. The significant reduction in autism-related features was also considered a major finding, as these features constitute long-term barriers to meaningful social relationships for these children.
"What is truly special about this program for children with high-functioning autism spectrum disorders is that children in the program do not view it as a 'treatment program' but rather an enjoyable summer camp," added Thomeer. "For many children in the program, this is their first successful social experience. Parents reported that their children really enjoyed participating though the program worked on the children's deficits and pushed them to develop social competencies."
A total of 36 children, ages 7-12 years participated in the clinical trial, with 18 randomly assigned to receive the summer program and 18 to a wait-list control condition. Children in the treatment were in groups of 6 children and 3 clinical staff. The summer program was conducted 5 days per week over 5 weeks and targeted core clinical and associated features of autism spectrum disorders including social skills, interpretation of non-literal language, face and emotion recognition, and interest expansion.
Treatment was provided during five, 70-minute treatment cycles each day using direct instruction, modeling, role-playing, and performance feedback. Each treatment cycle consisted of a 20-minute intensive skill building session followed by a 50-minute therapeutic activity designed to practice and reinforce target skills. A point system was used to reinforce positive social behaviors and reduce negative behaviors across the treatment day. Weekly parent education was also provided to educate parents on intervention strategies.
At present there are many available treatments for autism spectrum disorders that lack evidence or worse are ineffective. Lopata and Thomeer developed the manualized summer socialization program 8 years ago and, along with their team of researchers at the Institute for Autism Research-Canisius College, University at Buffalo-SUNY, and Summit Educational Resources, have evaluated its efficacy in a series of increasingly controlled studies. According to Lopata, "This clinical trial provides us with additional support that the program is effective in significantly reducing autism-related features and increasing the social performance of children with high-functioning autism spectrum disorders. We now need to continue this line of research to replicate the findings and further examine whether the treatment gains are sustained over time."
It is widely recognized that programs are needed that are manualized so effective treatment packages can be easily disseminated and used in community settings. "We are currently evaluating the manualized summer program in a community trial to see if the same gains that were achieved in the highly-controlled clinical trial can also be realized in a less controlled community program," said study co-author Jennifer A. Toomey, PhD, Coordinator of Research and Program Evaluation at Summit Educational Resources. "This will help us understand whether the intensive summer socialization program will be feasible and useful for practitioners in clinical settings"
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