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Meta-Analysis
. 2012 Jul 11;2012(7):CD008511.
doi: 10.1002/14651858.CD008511.pub2.

Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD)

Brian Reichow  1 , Amanda M Steiner, Fred Volkmar
Affiliations
Meta-Analysis

Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD)

Brian Reichow et al. Cochrane Database Syst Rev. .

Abstract

Background: Since autism was first described, major difficulties in social interaction have been a defining feature of individuals with autism spectrum disorders (ASD). Social skills groups are a common intervention for individuals with ASD. Although a frequently recommended practice, the few studies that have addressed the efficacy of social skills groups have shown mixed results.

Objectives: To determine the effectiveness of social skills groups for improving social competence, social communication, and quality of life for people with ASD who are six to 21 years of age.

Search methods: We searched the following databases in December 2011: CENTRAL (2011 Issue 4), MEDLINE (1948 to November Week 3, 2011), EMBASE (1980 to Week 50, 2011), PsycINFO (1887 to December Week 2, 2011), CINAHL (1937 to current), ERIC (1966 to current), Sociological Abstracts (1952 to current), OCLC WorldCat (12 December 2011), Social Science Citation Index (1970 to 16 December 2011), and the metaRegister of Controlled Trials (20 December 2011). We also searched the reference lists of published papers.

Selection criteria: Randomized control trials (RCTs) comparing treatment (social skills groups) with a control group who were not receiving the treatment for participants aged six to 21 years with ASD. The control group could be no intervention, wait list, or treatment as usual. Outcomes sought were standardized measures of social competence, social communication, quality of life, emotion recognition, and any other specific behaviors.

Data collection and analysis: Two review authors independently selected and appraised studies for inclusion and assessed the risk of bias in each included study. All outcome data were continuous and standardized mean difference effect sizes (ES) with small sample correction were calculated. We conducted random-effects meta-analysis where possible.

Main results: We included five RCTs evaluating the effects of social skills groups in 196 participants with ASD aged 6 to 21 years old. The results show there is some evidence that social skills groups improve overall social competence (ES = 0.47, 95% confidence interval (CI) 0.16 to 0.78, P = 0.003) and friendship quality (ES = 0.41, 95% CI 0.02 to 0.81, P = 0.04) for this population. No differences were found between treatment and control groups in relation to emotional recognition (ES = 0.34, 95% CI -0.20 to 0.88, P = 0.21) assessed in two studies or social communication as related to the understanding of idioms (ES = 0.05, 95% CI -0.63 to 0.72, P = 0.89), which was assessed in only one study. Two additional quality of life outcomes were evaluated, with results of single studies suggesting decreases in loneliness (ES = -0.66, 95% CI -1.15 to -0.17) but no effect on child or parental depression. No adverse events were reported.Given the nature of the intervention and the selected outcome measures, the risk of performance and detection bias are high. There is limited generalizability from the studies as they were all conducted in the US; they focused mainly on children aged 7 to 12, and the participants were all of average or above average intelligence.

Authors' conclusions: There is some evidence that social skills groups can improve social competence for some children and adolescents with ASD. More research is needed to draw more robust conclusions, especially with respect to improvements in quality of life.

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Conflict of interest statement

Brian Reichow ‐ receives royalties from book publication, honoraria from lectures on autism spectrum disorders, and has received funding from the US Department of Education, none of which supported or influenced my work on this review. Amanda M Steiner ‐ receives honoraria from lectures on autism spectrum disorders, and has received funding from the US National Institutes of Health, none of which supported or influenced my work on this review. Fred Volkmar ‐ receives royalties from book publication, honoraria from lectures on autism spectrum disorders, and has received funding from the US National Institutes of Health, none of which supported or influenced my work on this review.

Figures

1
1
Study flow diagram
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
4
4
Forest plot of social skills groups versus wait list control: Social competence (analysis 1.1)
5
5
Forest plot of social skills groups versus wait list control: Emotion recognition (analysis 3.1)
6
6
Forest plot of social skills groups versus wait list control: Quality of life ‐ friendship (analysis 4.2)
1.1
1.1. Analysis
Comparison 1 Social Competence, Outcome 1 Social Competence.
2.1
2.1. Analysis
Comparison 2 Social Communication, Outcome 1 Social Communication.
3.1
3.1. Analysis
Comparison 3 Emotion Recognition, Outcome 1 Emotion Recognition.
4.1
4.1. Analysis
Comparison 4 Quality of Life, Outcome 1 Loneliness.
4.2
4.2. Analysis
Comparison 4 Quality of Life, Outcome 2 Friendship.
4.3
4.3. Analysis
Comparison 4 Quality of Life, Outcome 3 Child Depression.
4.4
4.4. Analysis
Comparison 4 Quality of Life, Outcome 4 Maternal Depression.
See this image and copyright information in PMC

Comment in

References

References to studies included in this review

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References to studies excluded from this review

Baghdadli 2010 {published data only}
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