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Parent-Child Reciprocity and the Effectiveness of PEERS (ISR-PEERS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03354923
Recruitment Status : Active, not recruiting
First Posted : November 28, 2017
Last Update Posted : February 26, 2019
Sponsor:
Information provided by (Responsible Party):
Ofer Golan, Bar-Ilan University, Israel

Brief Summary:

Early adolescence marks a significant development in teens' social abilities, shifting from play to conversation-based activities, and having stronger and more intimate friendships. Parents contribute to this shift by practicing reciprocal social interaction with their teens.

For teens with Autism Spectrum Disorder (ASD) this shift in their peers' social abilities extends their characteristic social deficits even further. Social skills deficits in individuals with ASD are associated with poor adaptive functioning and increased psychopathology. Parents play a pivotal role in caring for and tutoring their children with ASD into adulthood. However, the effect parent-teen reciprocity has on the social skills of adolescents with ASD has not been tested. Furthermore, whereas parent-child reciprocity predicted intervention outcome in young children with ASD, no study has examined this effect in teens with ASD.

The proposed study aims to test these questions using the Program for the Education and Enrichment of Relational Skills (PEERS), an evidence-based parent-assisted social skills training program for teens with ASD.


Condition or disease Intervention/treatment Phase
Social Skills Parent-Child Relational Problem Behavioral: PEERS intervention Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 80 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Parent-Child Reciprocity and the Effectiveness of a Parent-Assisted Social Skills Training Program for Adolescents With Autism Spectrum Disorder
Study Start Date : January 2016
Actual Primary Completion Date : August 2018
Estimated Study Completion Date : August 2019

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: immediate intervention group
Immediate PEERS intervention
Behavioral: PEERS intervention
PEERS is a 14-week manualized social skills treatment program that targets the friendship skills of adolescents with ASD. In the Israeli adaptation of PEERS, two meeting were extended. An adolescents group will be held concurrently with the parents group in different rooms. Both groups will begin the session with homework review, followed by a didactic social skills lesson, utilizing the teaching methods of modeling and role-playing. In order to practice the newly learned social skills,a behavioral rehearsal interaction will be assigned in the adolescents group. Finally,Socialization homework assignments designed to address further mastery and generalization of newly learned skills within the natural social environment will be assigned too.

delayed intervention
delayed PEERS intervention to begin after experimental group
Behavioral: PEERS intervention
PEERS is a 14-week manualized social skills treatment program that targets the friendship skills of adolescents with ASD. In the Israeli adaptation of PEERS, two meeting were extended. An adolescents group will be held concurrently with the parents group in different rooms. Both groups will begin the session with homework review, followed by a didactic social skills lesson, utilizing the teaching methods of modeling and role-playing. In order to practice the newly learned social skills,a behavioral rehearsal interaction will be assigned in the adolescents group. Finally,Socialization homework assignments designed to address further mastery and generalization of newly learned skills within the natural social environment will be assigned too.




Primary Outcome Measures :
  1. Change from baseline Parent-Adolescent reciprocity paradigm at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    This paradigm is designed to test dyadic reciprocity between a parent and an adolescent. Adolescents will be observed in three 10-minute discussions (one positive, one support giving and one negative) with the parent who serves as their PEERS coach: In the positive discussion, parent and teen will be asked to plan a fun outing together. In the support giving the parent and child take turns and each tells the other something sad/disappointing that happened to him/her outside the relationship (with friends, boss, etc.) and the other gives support. After five minutes partners change roles. In the negative discussion they will be asked about a common conflict between them and negotiate it. The three discussions will be videotaped and coded using the Coding Interactive Behavior manual (Feldman, 1998). The CIB is a global rating system for social interactions that includes 52 codes rated on a scale of 1 to 5 which are aggregated into several composites

  2. Change from baseline Contextual Assessment of Social Skills at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The CASS is a live role-play assessment of conversational skills developed for adolescents with high-functioning ASD. Conversational skills are assessed via behavioral coding of two semi-structured role-plays (with an interested companion and with a bored companion) and scores on a conversation rating scale. Behaviors coded during the role plays include asking questions, topic changes, vocal expressiveness, gestures, positive affect, posture, kinesics arousal, social anxiety, involvement in the conversation, quality of rapport, and an overall score. Psychometric properties of the CASS are good, with mean internal consistency of .83 and mean inter-rater reliability of .68. The CASS was reported as a sensitive measure of change in an evaluation of a social skills program for young adults with ASD (White, Scarpa, Conner, Maddox, & Bonete, 2014).


Secondary Outcome Measures :
  1. Change from baseline Social Responsiveness Scale at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The SRS is a 65-item rating scale measuring the severity of autism spectrum symptoms as they occur in natural social settings. Completed by parents and teachers, it is appropriate for use with children from 4 to 18 years of age. Scales include social awareness, social information processing, capacity for reciprocal social communication, social anxiety/avoidance, and autistic preoccupations and traits. The SRS has been shown to be sensitive to changes in social functioning among children with ASD (Wood et al., 2009). Internal consistency for SRS scales varies between 0.91-0.97, test-retest reliability 0.84-0.97 and interrater reliability 0.74-0.95 (Bolte, Poustka, & Constantino, 2008).

  2. Change from baseline The Social Skills Improvement System at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The SSIS is a standardized rating scale that assesses global social competence for children 3 to 18 years. Designed to assess social skills change after treatment, it utilizes a multi-informant approach, allowing parents, teachers, and students to evaluate target social behaviors including communication, cooperation, assertion, responsibility, empathy, engagement, and self-control. Targeted problem behaviors include externalizing behaviors and bullying. Internal consistency for the SSIS ranges from .92 to .97, test-retest reliability from .77 to .87, inter-rater reliability from .50 to .68.

  3. Change from baseline Friendship Qualities Scale [ Time Frame: Day 0, 4 months and 8 months ]
    The FQS is an adolescent self-report measure of the quality of best friendships. It is composed of 23-items on a scale of 0-4. The items fall into five categories: Closeness, Companionship, Conflict, Helpfulness, and Security. The FQS has good internal consistency, with alpha coefficients ranging between .71 and .86 across all five categories.

  4. Change from baseline Quality of Play Questionnaire at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The QPQ is a measure completed by adolescents (QPQ-A) and parents (QPQ-P) in which the quality of the adolescent's last get-together and the frequency of weekly get-togethers with peers are assessed. The scales on the QPQ have been shown to discriminate individuals referred to social skills training from a general community sample using a cut point of > 3.5 on the Conflict Scale and a cut point of < 2.5 on the frequencies of get-togethers.

  5. Change from baseline Test of Adolescent Social Skills Knowledge at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The TAASK is a criterion referenced measure designed to assess adolescent knowledge of the specific social skills taught during the PEERS treatment. Two items are derived from each of the PEERS didactic lessons making a total of 26 forced-choice items.

  6. Change from baseline Vineland Adaptive Behaviors Scales II at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The VABS II is a parent interview regarding a child communication, social, motor and daily living skills based on the report of primary caregivers from which a standardized composite score of adaptive function is calculated.

  7. Change from baseline Loneliness and Social Dissatisfaction Questionnaire at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The LSDQ is a 24-item, standardized self-report measure that assesses global feelings of loneliness and social adequacy and inadequacy. It has been validated with typically developing youth, as well as youth with intellectual disabilities and learning disabilities.

  8. Change from baseline Beck Depression Inventory II at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The BDI-II is a 21 items self-administered questionnaire consisting of 21 items that assess the severity of symptoms and attitudes related to depression. The questionnaire identifies the presence and severity of symptoms consistent with the criteria of the DSM-V. The sum of the scores obtained in each item results in a total score when 14-19 is considered as mild, 20-28 moderate and 29-63 is considered as severe symptoms of depression.

  9. Change from baseline Autism Spectrum Quotient at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The AQ is 50 item, self-reported questionnaire measuring the degree to which an adult with normal intelligence has the traits associated with the autistic spectrum. The cut of score which indicates the person has clinically significant levels of autistic traits is 32 or more. The AQ is a well-known screening instrument for autism spectrum disorder

  10. Change from baseline Empathy Quotient at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    The EQ is a 60 item, valid self-assessment questionnaire measuring empathy levels in adults with normal intelligence. The scales of EQ are 0-80 with the cut off score of 30. The EQ is used as a screening instrument for autism spectrum disorder.

  11. Change from baseline Parenting Stress Index Short Form at 4 and 8 months [ Time Frame: Day 0, 4 months and 8 months ]
    . The PSI/SF is a 36 item, self-reported questionnaire for parents measuring the levels of stress in the parent-child relationship and identifies the presence of dysfunctional parenting. This instrument has 4 subscales: Defensive responsive, Parental Distress, Parent-Child Dysfunctional Interaction and Difficult Child. Child and Parent domains combine to form the Total Stress Scale.



Information from the National Library of Medicine

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Ages Eligible for Study:   12 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Capable and willing to provide informed assent
  • Diagnosed with ASD (high functioning)
  • IQ > 80

Exclusion Criteria:

  • Intellectual Disability
  • History of significant head injury or neurological illness
  • Current diagnosis of substance dependence

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03354923


Locations
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Israel
Bar Ilan University
Ramat Gan, Israel, 5290002
Sponsors and Collaborators
Bar-Ilan University, Israel
Investigators
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Principal Investigator: Irit Mor, MD Association for Children at Risk
Publications of Results:
Feldman, R. (1998). Coding interactive behavior. Unpublished Manual, 1-54.
Gresham, F., & Elliott, S. (2008). Social skills improvement system (SSIS) rating scales. Bloomington, MN: Pearson.
Sparrow, S., Cicchetti, D., & Balla, D. (2005). Vineland Adaptive Behavior Scales (2nd ed.). Minneapolis, MN.
Asher, S. R., Hymel, S., & Renshaw, P. D. (1984). Loneliness in Children. Child Development, 55(4), 1456.
Beck, A. T., Steer, R. A., & Brown, G. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
Abidin, R. R. (1990). Parenting stress index-short form. Charlottesville, VA: Pediatric Psychology Press.
Laugeson, E. A., & Frankel, F. (unpublished). Test of adolescent social skills knowledge—revised. (Available from UCLA Parenting and Children's Friendship Program, 300 Medical Plaza, Los Angeles, CA 90095, USA).

Other Publications:
Soenens, B., Vansteenkiste, M., Smits, I., Lowet, K., & Goossens, L. (2007). The role of intrusive parenting in the relationship between peer management strategies and peer affiliation. Journal of Applied Developmental Psychology, 28(3), 239-249.
McElhaney, K. B., Allen, J. P., Stephenson, J. C., & Hare, A. L. (2009). Attachment and Autonomy during Adolescence. In Handbook of Adolescent Psychology. Hoboken, NJ, USA: John Wiley & Sons, Inc.
Russell, A., Pettit, G. S., & Mize, J. (1998). Horizontal Qualities in Parent-Child Relationships: Parallels with and Possible Consequences for Children's Peer Relationships. Developmental Review, 18(3), 313-352
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association.
Howlin, P. (2004). Autism and Asperger syndrome: Preparing for adulthood. London: Routledge.
Gerhardt, P. F., & Lainer, I. (2011). Addressing the Needs of Adolescents and Adults with Autism: A Crisis on the Horizon. Journal of Contemporary Psychotherapy, 41(1), 37-45.
Fong, L., Wilgosh, L., & Sobsey, D. (1993). The Experience of Parenting an Adolescent with Autism. International Journal of Disability, Development and Education, 40(2), 105-113.
Cappadocia, M. C., & Weiss, J. A. (2011). Review of social skills training groups for youth with Asperger Syndrome and High Functioning Autism. Research in Autism Spectrum Disorders, 5(1), 70-78.
Mandelberg, J., Laugeson, E. A., Cunningham, T. D., Ellingsen, R., Bates, S., & Frankel, F. (2014). Long-Term Treatment Outcomes for Parent-Assisted Social Skills Training for Adolescents with Autism Spectrum Disorders: The UCLA PEERS Program. Journal of Mental Health Research in Intellectual Disabilities, 7(1), 45-73

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Responsible Party: Ofer Golan, Prof. Ofer Golan, Bar-Ilan University, Israel
ClinicalTrials.gov Identifier: NCT03354923    
Other Study ID Numbers: BIU121216
First Posted: November 28, 2017    Key Record Dates
Last Update Posted: February 26, 2019
Last Verified: February 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided