Teaching Autistic Teens to Make Friends

During the first week of class, the teens' eyes were downcast, their responses were mumbled and eye contact was almost nonexistent. By Week 12, though, these same kids were talkative, responsive and engaged.

That's the result of a special class designed at UCLA to help teens with autism spectrum disorders (ASD) learn to interact appropriately with their peers. ASD includes a range of pervasive developmental disorders characterized by problems with communication and socialization; it's estimated that one in 150 children born in the United States has some form of ASD.

In a study appearing in the April edition of the Journal of Autism and Developmental Disorders, UCLA clinical instructor of psychiatry Elizabeth Laugeson and colleagues report that in comparison with a control group, the treatment group taking the class significantly improved their overall social skills and interactions with their peers.

"Although, typically, developing teens often learn basic social rules through observation of peer behavior and specific instruction from parents," Laugeson said, "adolescents with autism spectrum disorders often require further instruction.

"It's hard enough to be a teenager," she said, "but it's harder still for adolescents with autism because they typically lack the ability to pick up on all the social cues most of us take for granted — things like body language, hand gestures and facial expressions, along with speech inflections like warmth, sarcasm or hostility.

"Lack of these basic social skills may lead to rejection, isolation or bullying from their peers. And sadly, that isolation can carry into their adult life."
Laugeson and her colleagues developed the class, called PEERS (Program for the Education and Enrichment of Relational Skills), to give high-functioning teens with ASD a set of specific social skills.

"How do you have a successful get-together with someone? How do you go up to a group of teens and join their conversation? What do you say as a comeback when someone teases you? Without these core social skills, it becomes very difficult for teenagers to make and keep friends," Laugeson said.

In the study, 33 teens with ASD — 28 males and five females — attended the PEERS classes. All the participants had a previous diagnosis of high-functioning autism, Asperger's Disorder or Pervasive Developmental Disorder–Not Otherwise Specified (PDD-NOS). The teens met once a week for 12 weeks; each session lasted 90 minutes. Instruction was conducted in a small-group format, with seven to 10 teens, using established strategies for teaching social skills to adolescents with ASD.

Parents were also required to attend separate, concurrent sessions where they were provided direct instruction and guidance to support their child's development.

"Parental involvement was mandatory and important," said Laugeson, who is also associate director of the UCLA Parenting and Children's Friendship Program and director of the Help Group–UCLA Autism Research Alliance. "Other research has shown us that parent involvement can have significant positive effects upon children's friendships, both in terms of direct instruction and supervision, as well as supporting a child's development of an appropriate peer network."