Journal of Autism and Developmental Disorders

, Volume 39, Issue 8, pp 1163–1172 | Cite as

Group Intervention to Promote Social Skills in School-age Children with Pervasive Developmental Disorders: Reconsidering Efficacy

  • Kathleen Koenig
  • Andres De Los Reyes
  • Domenic Cicchetti
  • Lawrence Scahill
  • Ami Klin
Original Paper


A consistent result in the evaluation of group-delivered intervention to promote social reciprocity in children with PDDs is that outcome data are inconclusive. Lack of robust evidence of efficacy confounds understanding of these interventions and their value to the field. It is conceivable that the construct of impaired social reciprocity in PDD presents unique circumstances that require special consideration when evaluating the evidence base. Social reciprocity and impairment in social functioning are complex constructs, which require a multi-dimensional, multi-method approach to intervention and measurement of gains. The existing paradigm for evaluating the evidence base of intervention may need modification to permit a more intricate analysis of the extant research, and increase the sophistication of future research.


Autism Pervasive developmental disorders Social skills training Evidence-based treatment Range of changes Group therapy 



We thank Fred Volkmar for his comments on this manuscript, and the participants in the Organization for Autism Research Convocation, Atlanta, 2008 for their comments as well. We thank Rebecca Pearlson for assistance with references.


  1. Achenbach, T. (2006). As others see us: Clinical and research implications of cross-informant correlations for psychopathology. Current Directions in Psychological Science, 15(2), 94–98. doi: 10.1111/j.0963-7214.2006.00414.x.CrossRefGoogle Scholar
  2. Baldwin, S., Murray, D., & Shadish, W. (2005). Empirically supported treatments or type I errors? Problems with the analysis of data from group-administered treatments. Journal of Consulting and Clinical Psychology, 73, 924–935. doi: 10.1037/0022-006X.73.5.924.PubMedCrossRefGoogle Scholar
  3. Barnhill, G., Tapscott-Cook, K., Tebbenkamp, K., & Smith Myles, B. (2002). The effectiveness of social skills targeting nonverbal communication for adolescents with Asperger syndrome and related pervasive development delays. Focus on Autism and Other Developmental Disabilities, 17, 112–118. doi: 10.1177/10883576020170020601.CrossRefGoogle Scholar
  4. Baron-Cohen, S., Tager-Flusberg, H., & Cohen, D. (2000). Understanding other minds: Perspectives from cognitive neuroscience. New York: Oxford University Press.Google Scholar
  5. Barry, T. D., Klinger, G., Lee, J. M., Palardy, N., Gilmore, T., & Bodin, S. D. (2003). Examining the effectiveness of an outpatient clinic-based social skills group for high-functioning children with autism. Journal of Autism and Developmental Disorders, 33, 685–701. doi: 10.1023/B:JADD.0000006004.86556.e0.PubMedCrossRefGoogle Scholar
  6. Bauminger, N. (2002). The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: Intervention outcomes. Journal of Autism and Developmental Disorders, 32, 283–298. doi: 10.1023/A:1016378718278.PubMedCrossRefGoogle Scholar
  7. Beelman, A., Phingsten, U., & Loesel, F. (1994). Effects of training social competence in children: A meta-analysis of recent evaluation studies. Journal of Clinical Child Psychology, 23, 260–271. doi: 10.1207/s15374424jccp2303_4.CrossRefGoogle Scholar
  8. Begeer, S., Koot, H., Rieffe, C., Terwogt, M., & Stegge, H. (2008). Emotional competence in children with autism: Diagnostic criteria and empirical evidence. Developmental Review, 28(3), 342–369. doi: 10.1016/j.dr.2007.09.001.CrossRefGoogle Scholar
  9. Boker, S. (2001). Differential structural equation modeling of intraindividual variability. In L. M. Collins & A. G. Sayer (Eds.), New methods for the analysis of change (pp. 3–28). Washington DC: American Psychological Association.Google Scholar
  10. Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716. doi: 10.1146/annurev.psych.52.1.685.PubMedCrossRefGoogle Scholar
  11. Concato, J. (2004). Observational versus experimental studies: What’s the evidence for a hierarchy? NeuroRx: The Journal of the American Society for Experimental NeuroTherapeutics, 1, 341–347.Google Scholar
  12. Concato, J., Shah, N., & Horwitz, R. (2000). Randomized, controlled trials, observational studies, and the hierarchy of research designs. The New England Journal of Medicine, 342(25), 1887–1892. doi: 10.1056/NEJM200006223422507.PubMedCrossRefGoogle Scholar
  13. Curran, P., & Bollan, K. (2001). The best of both worlds: Combining autoregressive and latent curve models. In L. M. Collins & A. G. Sayer (Eds.), New methods for the analysis of change (pp. 105–136). Washington DC: American Psychological Association.Google Scholar
  14. De los Reyes, A., & Kazdin, A. (2005). Informant discrepancies” in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131(4), 483–509. doi: 10.1037/0033-2909.131.4.483.PubMedCrossRefGoogle Scholar
  15. De los Reyes, A., & Kazdin, A. (2006). Conceptualizing changes in behavior in intervention research: The range of possible changes model. Psychological Review, 113, 554–583. doi: 10.1037/0033-295X.113.3.554.PubMedCrossRefGoogle Scholar
  16. Golan, O., & Baron-Cohen, S. (2006). Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology, 18, 591–617. doi: 10.1017/S0954579406060305.PubMedCrossRefGoogle Scholar
  17. Grice, J., Jackson, B., & McDaniel, B. (2006). Bridging the nomothetic-ideographic divide: A follow up study. Journal of Personality, 74, 1191–1218. doi: 10.1111/j.1467-6494.2006.00407.x.PubMedCrossRefGoogle Scholar
  18. Gueorguieva, R., & Krystal, J. (2004). Move over ANOVA: Progress in analyzing repeated-measures data and its reflection in the Archives of General Psychiatry. Archives of General Psychiatry, 61, 310–317. doi: 10.1001/archpsyc.61.3.310.PubMedCrossRefGoogle Scholar
  19. Jacobson, N., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. doi: 10.1037/0022-006X.59.1.12.PubMedCrossRefGoogle Scholar
  20. Klin, A. (2000). Attributing social meaning to ambiguous visual stimuli in higher-functioning autism and Asperger syndrome: The social attribution task. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41(7), 831–846. doi: 10.1111/1469-7610.00671.CrossRefGoogle Scholar
  21. Klin, A., Jones, W., Shultz, R., & Volkmar, F. (2003). The enactive mind, or from actions to cognition: Lessons from autism. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 358(1430), 345–360. doi: 10.1098/rstb.2002.1202.PubMedCrossRefGoogle Scholar
  22. Koegel, L., & Koegel, R. (1995). Current issues in autism; learning and cognition in autism. New York: Plenum Press.Google Scholar
  23. Koenig, K., White, S., Pachler, M., Lewis, L. M., Pachler, M., Klin, A., & Scahill, L. (in press). Promoting social skill development in children with pervasive developmental disorders: A feasibility and efficacy study. Journal of Contemporary Psychotherapy.Google Scholar
  24. Konstantareas, M., & Stewart, K. (2006). Affect regulation and temperament in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 36(2), 143–154. doi: 10.1007/s10803-005-0051-4.PubMedCrossRefGoogle Scholar
  25. Kraemer, H., Measelle, J., Ablow, J., Essex, M., Boyce, W., & Kupfer, D. (2003). A new approach to integrating data from multiple informants in psychiatric assessment and research: Mixing and matching contexts and perspectives. The American Journal of Psychiatry, 160, 1566–1577. doi: 10.1176/appi.ajp.160.9.1566.PubMedCrossRefGoogle Scholar
  26. Lipsey, M., & Wilson, D. (1993). The efficacy of psychological, educational and behavioral treatments: Confirmation from meta-analysis. The American Psychologist, 48, 1181–1209. doi: 10.1037/0003-066X.48.12.1181.PubMedCrossRefGoogle Scholar
  27. Lord, C., Wagner, A., Rogers, S., Szatmari, P., Aman, M., Charman, T., et al. (2005). Challenges in evaluating psychological interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 14, 395–404.Google Scholar
  28. Mackay, T., Knott, F., & Dunlop, A. (2007). Developing social interaction and understanding in individuals with autism spectrum disorder: A group work intervention. Journal of Intellectual & Developmental Disability, 32, 279–290. doi: 10.1080/13668250701689280.CrossRefGoogle Scholar
  29. Matson, J., Matson, M., & Rivit, T. (2007). Social skills treatments for children with autism spectrum disorders: An overview. Behavior Modification, 31(5), 682–707. doi: 10.1177/0145445507301650.PubMedCrossRefGoogle Scholar
  30. Morrison, L., Kamps, D., Garcia, J., & Parker, D. (2001). Peer mediation and monitoring strategies to improve initiations and social skills for students with autism. Journal of Positive Behavior Interventions, 3(4), 237–250. doi: 10.1177/109830070100300405.CrossRefGoogle Scholar
  31. Offit, P. (2008). Autism’s false prophets: Bad science, risky medicine, and the search for a cure. New York: Columbia University Press.Google Scholar
  32. Ozonoff, S., & Miller, J. (1995). Teaching theory of mind: A new approach to social skills training for individuals with autism. Journal of Autism and Developmental Disorders, 25, 415–433. doi: 10.1007/BF02179376.PubMedCrossRefGoogle Scholar
  33. Paul, R., Shriberg, L. D., McSweeny, J., Cicchetti, D., Klin, A., & Volkmar, F. (2005). Perception and production of prosody by speakers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 35(6), 861–869. doi: 10.1007/s10803-005-0031-8.PubMedCrossRefGoogle Scholar
  34. Provencal, S. (2003). The efficacy of a social skills training program for adolescents with autism spectrum disorders. Unpublished doctoral dissertation, University of Utah.Google Scholar
  35. Quinn, M., Kavale, K., Mather, S., Rutherford, R., & Forness, S. (1999). A meta-analysis of social skill interventions for students with emotional or behavioral disorders. Journal of Emotional and Behavioral Disorders, 7(1), 54–65. doi: 10.1177/106342669900700106.CrossRefGoogle Scholar
  36. Rao, P., Beidel, D., & Murray, M. (2008). Social skills interventions for children with Asperger’s syndrome or high-functioning autism: A review and recommendations. Journal of Autism and Developmental Disorders, 38, 353–361. doi: 10.1007/s10803-007-0402-4.PubMedCrossRefGoogle Scholar
  37. Rogers, S., & Vismara, L. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child and Adolescent Psychology, 37(1), 8–38. doi: 10.1080/15374410701817808.PubMedCrossRefGoogle Scholar
  38. Sansosti, F., & Powell-Smith, K. (2006). Using social stories to improve the social behavior of children with Asperger syndrome. Journal of Positive Behavior Interventions, 8(1), 43–57. doi: 10.1177/10983007060080010601.CrossRefGoogle Scholar
  39. Sayer, A., & Cumsille, P. (2001). Second-order latent growth models. In L. M. Collins & A. G. Sayer (Eds.), New methods for the analysis of change (pp. 177–200). Washington DC: American Psychological Association.Google Scholar
  40. Schneider, B. (1992). Didactic methods for enhancing children’s peer relations: A quantitative review. Clinical Psychology Review, 12, 363–382. doi: 10.1016/0272-7358(92)90142-U.CrossRefGoogle Scholar
  41. Schriebman, L. (2000). Intensive behavioral/psychoeducational treatments for autism: Research needs and future directions. Journal of Autism and Developmental Disorders, 30(5), 373–378. doi: 10.1023/A:1005535120023.CrossRefGoogle Scholar
  42. Schultz, R., Grelotti, D., Klin, A., Kleinman, J., Van Der Gaag, C., Marois, R., et al. (2003). The role of the fusiform face area in social cognition: Implications for the pathobiology of autism. Philosophical transactions of the royal society B-Biolgical Sciences, 358(1430), 415–427.CrossRefGoogle Scholar
  43. Smith, T., Scahill, L., Dawson, G., Guthrie, D., Lord, C., Odom, S., et al. (2007). Designing research studies on psychosocial interventions in autism. Journal of Autism and Developmental Disorders, 37, 354–366. doi: 10.1007/s10803-006-0173-3.PubMedCrossRefGoogle Scholar
  44. Solomon, M., Goodlin-Jones, B., & Anders, T. (2004). A social adjustment enhancement intervention for high functioning autism, Asperger’s syndrome, and pervasive developmental disorder NOS. Journal of Autism and Developmental Disorders, 34, 649–668. doi: 10.1007/s10803-004-5286-y.PubMedCrossRefGoogle Scholar
  45. Spence, S. (2003). Social skills training with children and young people: Theory, evidence and practice. Child and Adolescent Mental Health, 8(2), 84–96. doi: 10.1111/1475-3588.00051.CrossRefGoogle Scholar
  46. Tager-Flusberg, H., Paul, R., & Lord, C. (2003). Language and communication in autism. In F. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders, vol. 1: Diagnosis, development, neurobiology, and behavior (3rd ed., pp. 335–364). Hoboken, NJ, US: Wiley.Google Scholar
  47. Tse, J., Strulovitch, J., Tagalakis, V., Meng, L., & Fombonne, E. (2007). Social skills training for adolescents with Asperger syndrome and high functioning autism. Journal of Autism and Developmental Disorders (serial online).Google Scholar
  48. Volkmar, F., Paul, R., Klin, A., & Cohen, D. (2005). Handbook of autism and the pervasive developmental disorders. New York: Wiley.Google Scholar
  49. Wadman, M. (2008). Stalled trial for autism highlights dilemma of alternative treatments. Nature, 253, 259. doi: 10.1038/454259a.CrossRefGoogle Scholar
  50. Wang, D., & Bakhai, A. (2006). Clinical trials: A practical guide to design, analysis, and reporting. London: Remedica.Google Scholar
  51. Webb, B., Miller, S., Pierce, T., Strawser, S., & Jones, W. P. (2004). Effects of social skill instruction for high-functioning adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19(1), 53–62. doi: 10.1177/10883576040190010701.CrossRefGoogle Scholar
  52. White, S., Koenig, K., & Scahill, L. (2007). Social skills development in children with autism spectrum disorders: A review of the intervention research. Journal of Autism and Developmental Disorders, 37, 1858–1868. doi: 10.1007/s10803-006-0320-x.CrossRefGoogle Scholar
  53. Yang, N., Schaller, J., Huang, T., Wang, M., & Tsai, S. (2003). Enhancing appropriate social behaviors for children with autism in general education classrooms: An analysis of six cases. Education and Training in Developmental Disabilities, 38, 405–441.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Kathleen Koenig
    • 1
  • Andres De Los Reyes
    • 2
  • Domenic Cicchetti
    • 1
  • Lawrence Scahill
    • 1
  • Ami Klin
    • 1
  1. 1.Yale Child Study CenterYale University School of MedicineNew HavenUSA
  2. 2.Department of PsychologyUniversity of MarylandCollege ParkUSA

Personalised recommendations