Efficacy of Community-Delivered PEERS�� for Adolescents: Increases in Social Skills and Decreases in Social Anxiety and Loneliness.
China I Parenteau, Jessica Floyd, Katy Ankenman, Tara Glavin, Julia Charalel, Enjey Lin, Whitney Ence, Young Shin Kim, Somer Bishop, Shuting Zheng
Author Information
China I Parenteau: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Jessica Floyd: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Katy Ankenman: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Tara Glavin: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Julia Charalel: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Enjey Lin: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Whitney Ence: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Young Shin Kim: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Somer Bishop: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA.
Shuting Zheng: Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 675 18th St., San Francisco, CA, 94107, USA. Shuting.zheng@ucsf.edu. ORCID
PURPOSE: PEERS�� for Adolescents is an evidence-based social skills training program developed for individuals with autism spectrum disorder (ASD), which is now widely implemented by community providers in clinics and schools. However, majority of past efficacy studies on PEERS�� were conducted in controlled research settings, with limited information about its effectiveness when delivered in the community. We sought to examine the effects of PEERS�� on social functioning and mental health outcomes when delivered in an outpatient autism specialty clinic. METHODS: Clinical data from 45 adolescents with social challenges (age range: 11-18 years old; 31.1% female assigned at birth) were extracted for secondary analyses. Paired t-tests were performed to examine the pre- to post-intervention changes in social and mental health outcomes. Correlations between pre- and post-change scores of outcome measures were examined. RESULTS: Self-reported social skills knowledge, caregiver-reported social skills (measured by the Social Skills Improvement Systems) and the number of get-togethers hosted, increased significantly from pre- to post-intervention. Additionally, caregiver-reported anxiety and self-reported loneliness significantly decreased from pre- to post-intervention. Exploratory analyses showed that increases in caregiver-reported social skills were associated with decreases in self-reported loneliness. CONCLUSIONS: Our findings provide evidence supporting the efficacy of PEERS�� for improving social knowledge and skills of adolescents with social challenges when delivered in the community. The current study also showed the potential benefit of PEERS�� for improving adolescent mental health.
Adams, R. E., Lampinen, L., Zheng, S., Sullivan, V., Taylor, J. L., & Bishop, S. L. (2023). Associations between social activities and depressive symptoms in adolescents and young adults with autism spectrum disorder: Testing the indirect effects of loneliness. Autism, 13623613231173859.
Asher, S. R., & Wheeler, V. A. (1985). Children���s loneliness: A comparison of rejected and neglected peer status. Journal of Consulting and Clinical Psychology, 53(4), 500���505.
[DOI: 10.1037/0022-006X.53.4.500]
Baczewski, L., & Kasari, C. (2021). Loneliness and associated mental health sequelae in individuals with autism spectrum disorder. In R. J. Coplan, J. C. Bowker, & L. J. Nelson (Eds.), The handbook of solitude: Psychological perspectives on social isolation, social withdrawal, and being alone (2nd ed., pp. 351���363). Wiley Blackwell.
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child & Adolescent Psychiatry, 36(4), 545���553.
[DOI: 10.1097/00004583-199704000-00018]
Cresswell, L., Hinch, R., & Cage, E. (2019). The experiences of peer relationships amongst autistic adolescents: A systematic review of the qualitative evidence. Research in Autism Spectrum Disorders, 61, 45���60.
[DOI: 10.1016/j.rasd.2019.01.003]
Crosby, J. W. (2011). Test review: FM Gresham & SN Elliott social skills improvement system rating scales. Minneapolis, MN: NCS Pearson, 2008. Journal of Psychoeducational Assessment, 29(3), 292���296.
[DOI: 10.1177/0734282910385806]
Estabillo, J. A., Moody, C. T., Poulhazan, S. J., Adery, L. H., Denluck, E. M., & Laugeson, E. A. (2022). Efficacy of PEERS�� for adolescents via telehealth delivery. Journal of Autism and Developmental Disorders, 52(12), 5232���5242.
[DOI: 10.1007/s10803-022-05580-5]
Factor, R. S., Moody, C. T., Sung, K. Y., & Laugeson, E. A. (2022). Improving social anxiety and social responsiveness in autism spectrum disorder through PEERS��. Evidence-Based Practice in Child and Adolescent Mental Health, 7(1), 142���159.
[DOI: 10.1080/23794925.2021.2013138]
Flanagan, D. P., Alfonso, V. C., Primavera, L. H., Povall, L., & Higgins, D. (1996). Convergent validity of the BASC and SSRS: Implications for social skills assessment. Psychology in the Schools, 33(1), 13���23.
[DOI: 10.1002/(SICI)1520-6807(199601)33]
Frankel, F., & Mintz, J. (2008). Measuring the quality of play dates. UCLA Parenting and Children���s Friendship Program, 300 Medical Plaza, Los Angeles.
Gresham, F. M., & Elliot, S. N. (2008). Social skills Improvement System: Rating scales. Pearson Assessments.
Hill, T. L., Gray, S. A., Baker, C. N., Boggs, K., Carey, E., Johnson, C., & Varela, E., R (2017). A pilot study examining the effectiveness of the PEERS�� program on social skills and anxiety in adolescents with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 29(5), 797���808.
[DOI: 10.1007/s10882-017-9557-x]
Koukouriki, E., Athanasopoulou, E., & Andreoulakis, E. (2022). Feelings of loneliness and social dissatisfaction in siblings of children with autism spectrum disorders: The role of birth order and perceived social support. Journal of Autism and Developmental Disorders, 52(11), 4722���4738.
[DOI: 10.1007/s10803-021-05308-x]
La Greca, A. M., & Lopez, N. (1998). Social anxiety among adolescents: Linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26(2), 83���94.
[DOI: 10.1023/A]
Laugeson, E. A., & Frankel, F. (Eds.). (2010). Test of adolescent social skills knowledge, mental status checklist. The PEERS�� treatment manual. Routledge.
Laugeson, E. A., & Frankel, F. (2011). Social skills for teenagers with developmental and autism spectrum disorders: The PEERS�� treatment manual. Routledge.
Laugeson, E. A., Frankel, F., Gantman, A., Dillon, A. R., & Mogil, C. (2012). Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program. Journal of Autism and Developmental Disorders, 42, 1025���1036.
[DOI: 10.1007/s10803-011-1339-1]
Marchica, L., & D���Amico, M. (2016). Examining the efficacy of an adapted version of the UCLA PEERS�� program with Canadian adolescents. Journal of Education & Social Policy, 3(4), 54���65.
Matthews, N. L., Orr, B. C., Warriner, K., DeCarlo, M., Sorensen, M., Laflin, J., & Smith, C. J. (2018). Exploring the effectiveness of a peer-mediated model of the PEERS curriculum: A pilot randomized control trial. Journal of Autism and Developmental Disorders, 48(7), 2458���2475. https://doi.org/10.1007/s10803-018-3504-2 .
[DOI: 10.1007/s10803-018-3504-2]
Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455���470.
[DOI: 10.1016/S0005-7967(97)10031-6]
Menezes, M., Harkins, C., Robinson, M. F., & Mazurek, M. O. (2020). Treatment of depression in individuals with autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 78, 101639.
[DOI: 10.1016/j.rasd.2020.101639]
Nader, D., Dunlop, B., Tomaszewski, B., Sam, A. M., Hume, K., Aljuaid, M., & Odom, S. L. (2023). Exploratory factor analysis of the social skills improvement system (SSIS) for autistic children: Implications for use and educational placement. Research in Autism Spectrum Disorders, 104, 102144.
[DOI: 10.1016/j.rasd.2023.102144]
Odom, S. L., Hall, L. J., & Suhrheinrich, J. (2020). Implementation science, behavior analysis, and supporting evidence-based practices for individuals with autism. European Journal of Behavior Analysis, 21(1), 55���73.
[DOI: 10.1080/15021149.2019.1641952]
Rasmussen, E. E., Shannon, K. L., & Pitchford, B. (2022). Adolescents��� disclosure of mental illness to parents: Preferences and barriers. Health Communication, 37(3), 346���355.
[DOI: 10.1080/10410236.2020.1839201]
Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior Assessment System for children: Second edition. AGS.
Schiltz, H. K., McVey, A. J., Dolan, B. K., Willar, K. S., Pleiss, S., Karst, J. S., & Van Hecke, A. V. (2018). Changes in depressive symptoms among adolescents with ASD completing the PEERS�� social skills intervention. Journal of Autism and Developmental Disorders, 48, 834���843.
[DOI: 10.1007/s10803-017-3396-6]
Schiltz, H. K., McVey, A. J., Wozniak, D., Haendel, B., Stanley, A. D., Arias, R., & Van Hecke, A., A. V (2021). The role of loneliness as a mediator between autism features and mental health among autistic young adults. Autism, 25(2), 545���555.
[DOI: 10.1177/1362361320967789]
Schohl, K. A., Van Hecke, A. V., Carson, A. M., Dolan, B., Karst, J., & Stevens, S. (2014). A replication and extension of the PEERS intervention: Examining effects on social skills and social anxiety in adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(3), 532���545.
[DOI: 10.1007/s10803-013-1900-1]
Shum, K. K. M., Cho, W. K., Lam, L. M. O., Laugeson, E. A., Wong, W. S., & Law, L. S. (2019). Learning how to make friends for Chinese adolescents with autism spectrum disorder: A randomized controlled trial of the Hong Kong Chinese version of the PEERS�� intervention. Journal of Autism and Developmental Disorders, 49, 527���541.
[DOI: 10.1007/s10803-018-3728-1]
Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland Adaptive Behavior scales: Second edition (Vineland II), survey interview Form/Caregiver rating form. Pearson Assessments.
Yoo, H. J., Bahn, G., Cho, I. H., Kim, E. K., Kim, J. H., Min, J. W., & Laugeson, E. A. (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.
[DOI: 10.1002/aur.1354]
Zeedyk, S. M., Cohen, S. R., Eisenhower, A., & Blacher, J. (2016). Perceived social competence and loneliness among young children with ASD: Child, parent and teacher reports. Journal of Autism and Developmental Disorders, 46, 436���449.
[DOI: 10.1007/s10803-015-2575-6]
Zheng, S., Kim, H., Salzman, E., Ankenman, K., & Bent, S. (2021). Improving social knowledge and skills among adolescents with autism: Systematic review and meta-analysis of UCLA PEERS�� for adolescents. Journal of Autism and Developmental Disorders, 51(12), 4488���4503.
[DOI: 10.1007/s10803-021-04885-1]