Improving Social Anxiety and Social Responsiveness in Autism Spectrum Disorder through PEERS®

ABSTRACT

Autistic individuals often experience anxiety at higher rates than typically developing individuals, which could worsen social impairment. While anxiety is highly linked to social skills, social anxiety symptoms have not often been investigated within the context of social skills interventions. The present study compared changes in social anxiety and social responsiveness in 154 adolescents and young adults on the autism spectrum participating in the Program for the Education and Enrichment of Relational Skills (PEERS®) social skills intervention. Results indicate that social anxiety symptoms significantly improved following treatment for both adolescents and young adults. Although young adults reported higher levels of anxiety overall, age group did not moderate social anxiety outcome, with both groups demonstrating comparable social anxiety improvements following treatment. Further, greater improvements in social responsiveness following PEERS® were associated with greater reductions in social anxiety symptoms. We also examined reporter agreement (e.g., self- and caregiver-reports), which indicated these reports were largely consistent, though correlations between adolescent and caregiver-report increased from pre- to post-treatment. Findings suggest that social skills interventions may play a critical role in the reduction of mental health symptoms, such as anxiety symptoms, for autistic adolescents and young adults.

Acknowledgments

The authors would like to thank the UCLA PEERS® Clinic for access to resources and running groups, all of the group leaders and coordinators who helped run the PEERS® groups, and Research Assistants who helped enter and score the data. Finally, we would like to thank all families who participated, without whom we would not be able to conduct this important work.

Disclosure statement

Dr. Laugeson receives royalties from Routledge for sales of the PEERS® treatment manual. The other authors have no conflicts of interest to disclose.

Notes

¹ Many self-advocates from the autism community (Bury et al., 2020) prefer identity first language (e.g., autistic children) or language describing the individual (e.g., on the spectrum). Therefore, this language will be utilized throughout the present manuscript.

² Due to the nested nature of participants clustered within multiple treatment groups, we also conducted analyses using multilevel modeling. The multilevel models produced the same pattern of results as single level models. Further, the design effects of our primary outcome variables were all less than 2, a commonly used threshold, above which indicates need for multilevel models to account for within-group variability (Muthén & Satorra, 1995; Peugh, 2010). Given these findings, single level models were utilized and reported for parsimony.