The Efficacy of Social Skills Treatment for Children with Asperger Syndrome
Elder, Lisa M., Caterino, Linda C., Chao, Janet, Shacknai, Dina, De Simone, Gina, Education & Treatment of Children
Children with Asperger Syndrome present with significant social skills deficits, which may contribute to clinical problems such as anxiety, depression, and/or other behavioral disorders. This article provides a description of the nature of Asperger Syndrome and provides possible treatment interventions, specifically focusing on the efficacy of social skills programs in clinic and school populations.
Asperger Syndrome (AS) is a chronic condition that affects an individual's social, emotional, and adaptive functioning. Treatment is complex and multifaceted, and may be long term. While the treatment of Asperger Syndrome can include individual and family psychotherapy, psychopharmacology, special education, occupational therapy, and speech and language therapy, the focus of this article is on group Social Skills Training.
Difficulties in social skill acquisition and generalization are often the most significant challenge for children with AS. Socialization deficits can result in significant hardships including an inability to meet the demands of everyday life and difficulty fulfilling vocational and social relationship aspirations (Klin & Volkmar, 2003). Failure to intervene could result in symptoms of depression, anxiety, or behavior disorders (Barnhill, 2001). Social skills treatment is a well documented important intervention for children with AS (Attwood, 1998; 2000; 2003; Bock, 2001; Klin, Sparrow, Marans, Carter, & Volkmar, 2000; Kransy, Williams, Provencal, & Ozonoff, 2003; Myles & Simpson, 2001; Myles, 2003), although little empirical evidence exists to support this premise (Greenway, 2000; Gresham, Sugai, & Horner, 2001).
For the few studies that do exist there has been some suggestion that social skills treatment is effective. However, problems exist in creating and evaluating treatment interventions that are reliably effective and valid. Inclusionary and exclusionary criteria for the disorder are difficult to establish. For example, there is little clinical consensus on the diagnostic criteria for AS, with the exception of nomenclature from the Diagnostic and Statistical Manual of Mental Disorders, text revision (DSM-IV-TR) (American Psychiatric Association, 2000), and on the nature of how, and if, these disorders differ from Autistic Disorder (AD). There are also problems inherent in studying this type of special population, particularly due to the small numbers of individuals affected, which creates statistical problems for any empirical study. Instruments to evaluate outcome, as it pertains to a child's social skill ability, are also difficult to utilize due to the low sensitivity of these instruments to detect change and the lack of specificity to the area of social skill that the treatment may be targeting. Determining which social skill area to be addressed can also be challenging, as each child's functioning will vary. This paper will review Asperger Disorder, its characteristics and assessment, as well as research on social skills treatment for children with AS. It will also provide recommendations for future research and study.
In 1944, Hans Asperger identified a small group of children, adolescents, and adults who exhibited social peculiarities and socially isolative behavior, while appearing cognitively and linguistically typical (as cited in Myles & Simpson, 2002). In particular, he described four boys, ages six to 11 who had impairments in nonverbal communication, comprehension of affect, and behavioral and conduct problems. Wing (1981) later coined the term "Asperger Syndrome," adding other dimensions to Asperger's original observations and proposing that formal diagnostic criteria be developed to support the increasing number of clinical accounts.
An increasing number of individuals have been diagnosed with AS (Ehlers & Gillberg, 1993). …