Abstract
Social competence training for adults with ASD were limited in comparison to intervention for children or adolescents. CBT-CSCA is a culturally-sensitive social competence training specially developed for adolescents in Hong Kong. With its demonstrated effectiveness, the current study outlined the adaptions of its adult version, CBT-CSCA (Adult) and examined its treatment effectiveness. Thirty-six adults (aged 18–29 years, with a FSIQ above 80) completed the intervention. Significant improvements were shown in overall social competence, from both self- and parent-report, and negative mood. Participants also reported satisfactory knowledge gain and confidence in applying content learnt after each session. The study provided evidence support to the applicability and effectiveness of social competence training for adults with ASD in the Chinese culture.
Similar content being viewed by others
References
Allison, C., Auyeung, B., & Baron-Cohen, S. (2012). Toward brief “red flags” for autism screening: The short autism spectrum quotient and the short quantitative checklist in 1000 cases and 3000 controls. Journal of the American Academy of Child and Adolescent Psychiatry, 51(2), 202–212.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Barnhill, G. P. (2007). Outcomes in adults with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 22, 116–126.
Baron-Cohen, S., Golan, O., Wheelwright, S., & Granader, Y. (2010). Emotion word comprehension from 4 to 16 years old: A developmental survey. Frontiers in Evolutionary Neuroscience, 2, 109.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17.
Berger, H. J. C., van Spaendonck, K. P. M., Horstink, M. W. I. M., Buytenhuijs, E. L., Lammers, P. W. J. M., & Cools, A. R. (1993). Cognitive shifting as a predictor of progress in social understanding in high-functioning adolescents with autism: A prospective study. Journal of Autism and Developmental Disorders, 23, 341–359.
Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463–472.
Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35(1), 79–89.
Cederlund, M., Hagberg, B., Billstedt, E., Gillberg, I. C., & Gillberg, C. (2008). Asperger syndrome and autism: A comparative longitudinal follow-up study more than 5 years after original diagnosis. Journal of Autism and Developmental Disorders, 38(1), 72–85.
Chan, R. W. S., Leung, C. N. W., Ng, D. C. Y., & Yau, S. S. W. (2018). Validating a culturally-sensitive social competence training programme for adolescents with ASD in a Chinese context: An initial investigation. Journal of Autism and Developmental Disorders, 48(2), 450–460.
Cheung, S. (2000). Psychometric properties of the Chinese version of the parental stress scale. Psychologia: An International Journal of Psychology in the Orient, 43, 253.
Eack, S. M., Greenwald, D. P., Hogarty, S. S., Bahorik, A. L., Litschge, M. Y., Mazefsky, C. A., et al. (2013). Cognitive enhancement therapy for adults with autism spectrum disorder: Results of an 18-month feasibility study. Journal of Autism and Developmental Disorders, 43(12), 2866–2877.
Geurts, H. M., Corbett, B., & Solomon, M. (2009). The paradox of cognitive flexibility in autism. Trends in Cognitive Sciences, 13, 74–82.
Golan, O., Baron-Cohen, S., & Hill, J. (2006). The Cambridge mindreading (CAM) face-voice battery: Testing complex emotion recognition in adults with and without Asperger syndrome. Journal of Autism and Developmental Disorders, 36(2), 169–183.
Golan, O., Sinai-Gavrilov, Y., & Baron-Cohen, S. (2015). The Cambridge mindreading face-voice battery for children (CAM-C): Complex emotion recognition in children with and without autism spectrum conditions. Molecular Autism, 6(1), 22.
Happé, F. G. (1993). Communicative competence and theory of mind in autism: A test of relevance theory. Cognition, 48(2), 101–119.
Happé, F., & Frith, U. (2006). The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36(1), 5–25.
Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.
Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45(2), 212–229.
Humphrey, N., & Symes, W. (2010). Perceptions of social support and experience of bullying among pupils with autistic spectrum disorders in mainstream secondary schools. European Journal of Special Needs Education, 25, 77–91.
Jackson, S. L., Hart, L., Brown, J. T., & Volkmar, F. R. (2018). Brief report: Self-reported academic, social, and mental health experiences of post-secondary students with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(3), 643–650.
Joshi, G., Wozniak, J., Petty, C., Martelon, M. K., Fried, R., Bolfek, A., ... & Caruso, J. (2013). Psychiatric comorbidity and functioning in a clinically referred population of adults with autism spectrum disorders: A comparative study. Journal of Autism and Developmental Disorders, 43(6), 1314–1325.
Laugeson, E. A., Gantman, A., Kapp, S. K., Orenski, K., & Ellingsen, R. (2015). A randomized controlled trial to improve social skills in young adults with autism spectrum disorder: The UCLA PEERS® program. Journal of Autism and Developmental Disorders, 45(12), 3978–3989.
Leung, C. (2015). The Construction and Validation of Short-Form, Chinese Autism Spectrum Quotient (Chinese-AQ-10) (Unpublished Master Dissertation). Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
Leung, T. Y. (2014). A psychometric study of the Chinese version of the multidimensional social competence scale (MSCS-C) on adolescents with autism spectrum disorder (ASD) in Hong Kong (Unpublished Master Dissertation). Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
Levy, A., & Perry, A. (2011). Outcomes in adolescents and adults with autism: A review of the literature. Research in Autism Spectrum Disorders, 5(4), 1271–1282.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.
Lugnegård, T., Hallerbäck, M. U., & Gillberg, C. (2011). Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Research in Developmental Disabilities, 32(5), 1910–1917.
Mehzabin, P., & Stokes, M. A. (2011). Self-assessed sexuality in young adults with high-functioning autism. Research in Autism Spectrum Disorders, 5, 614–621.
Miller, M., & Ingham, J. (1976). Friends, confidants and symptoms. Social Psychiatry, 11(2), 51–58.
Mitchell, P., Saltmarsh, R., & Russell, H. (1997). Overly literal interpretations of speech in autism: Understanding that messages arise from minds. Journal of Child Psychology and Psychiatry, 38(6), 685–691.
NICE. (2013). Autism spectrum disorder in adults: Diagnosis and management, CG 142. England: NICE.
Orsmond, G. L., Krauss, M. W., & Selzter, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism and Developmental Disorders, 34, 245–256.
Oswald, T. M., Winder-Patel, B., Ruder, S., Xing, G., Stahmer, A., & Solomon, M. (2018). A pilot randomized controlled trial of the ACCESS program: A group intervention to improve social, adaptive functioning, stress coping, and self-determination outcomes in young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(5), 1742–1760.
Parsons, S., & Mitchell, P. (1999). What children with autism understand about thoughts and thought bubbles. Autism, 3, 17–38.
Pennington, B. F., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51–87.
Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 60–69.
Poon, W. K. V. (2011). Evaluation of the Psychometric Properties of the Chinese Version of Autism-Spectrum Quotient (AQ-Adult-C) (Unpublished Master Dissertation). Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
Reichow, B., Barton, E. E., Boyd, B. A., & Hume, K. (2012). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Systematic Review. https://doi.org/10.1002/14651858.CD009260.pub2.
Reichow, B., & Volkmar, R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40(2), 149–166.
Seltzer, M. M., Shattuck, P., Abbeduto, L., & Greenberg, J. S. (2004). Trajectory of development in adolescents and adults with autism. Mental Retardation and Developmental Disabilities Research Reviews, 10(4), 234–247.
Shamay-Tsoory, S. G. (2008). Recognition of ‘fortune of others’ emotions in Asperger syndrome and high functioning autism. Journal of Autism and Developmental Disorders, 38(8), 1451–1461.
Shu, D. (2011). Evaluation of the Psychometric Properties of the Parent-Report Chinese Version of Autism-Spectrum Quotient (AQ-Adult-C) (Unpublished Doctoral Dissertation). Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
South, M., Ozonoff, S., & McMahon, W. M. (2007). The relationship between executive functioning, central coherence, and repetitive behaviors in the high-functioning autism spectrum. Autism, 11, 437–451.
Spain, D., & Blainey, S. H. (2015). Group social skills interventions for adults with high-functioning autism spectrum disorders: A systematic review. Autism, 19(7), 874–886.
Stokes, M., Newton, N., & Kaur, A. (2007). Stalking, and social and romantic functioning among adolescents and adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(10), 1969-1986.
Tantam, D. (2003). The challenge of adolescents and adults with Asperger syndrome. Child and Adolescent Psychiatric Clinics of North America, 12, 143–163.
Taouk, M. L., Lovibond, P. F., & Laube, R. (2001). Psychometric properties of a Chinese version of the short Depression Anxiety Stress Scales (DASS21). Sydney: Report for New South Wales Transcultural Mental Health Centre, Cumberland Hospital.
Turner-Brown, L. M., Perry, T. D., Dichter, G. S., Bodfish, J. W., & Penn, D. L. (2008). Brief report: Feasibility of social cognition and interaction training for adults with high functioning autism. Journal of Autism and Developmental Disorders, 38(9), 1777–1784.
Williams, D. M., Nicholson, T., & Grainger, C. (2018). The self‐reference effect on perception: Undiminished in adults with autism and no relation to autism traits. Autism Research, 11(2), 331–341.
Yager, J., & Iarocci, G. (2013). The development of the multidimensional social competence scale: A standardized measure of social competence in autism spectrum disorders. Autism Research, 6(6), 631–641.
Yerys, B. E., Wallace, G. L., Harrison, B., Celano, M. J., Giedd, J. N., & Kenworthy, L. E. (2009). Set-shifting in children with autism spectrum disorders: Reversal shifting deficits on the Intradimensional/Extradimensional Shift Test correlate with repetitive behaviors. Autism, 13(5), 523–538.
Yi, L., Fan, Y., Li, J., Huang, D., Wang, X., Tan, W., et al. (2014). Distrust and retaliatory deception in children with autism spectrum disorder. Research in Autism Spectrum Disorders, 8(12), 1741–1755.
Yoo, H. J., Bahn, G., Cho, I. H., Kim, E. K., Kim, J. H., Min, J. W., ... & Cho, S. (2014). A randomized controlled trial of the Korean version of the PEERS® parent-assisted social skills training program for teens with ASD. Autism Research, 7(1), 145–161.
Acknowledgments
The authors would like to acknowledge the Hong Kong Jockey Club Charities Trust for its financial support to the Jockey Club iREACH Social Competence Development and Employment Support Center, New Life Psychiatric Rehabilitation Association. We would also like to thank Fan Mui Ying, Joe Chan, Doris Huang, Chris Lam and other colleagues for their valuable assistance on this study. We are grateful to the participants and families who participated.
Author information
Authors and Affiliations
Contributions
RC conceived of the study, participated in its design and coordination. CL & MY developed the intervention protocol under the supervision of RC. HT wrote the first draft under the supervision of CL. CL & RC revised and finalized the manuscript.
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Leung, C.N.W., Chan, R.W.S., Yeung, M.Y.C. et al. Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self- and Parent-Report. J Autism Dev Disord 49, 3440–3452 (2019). https://doi.org/10.1007/s10803-019-04066-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-019-04066-1