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Social Skills Interventions for Adolescents with Level 1 Autism Spectrum Disorder: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Forfatter(e)
Narzisi, A., Sesso, G., Fabbri-Destro, M., Berloffa, S., Fantozzi, P., Muccio, R., Bruzzi, G., Scatigna, S., Valente, E., Viglione, V., Milone, A., Cortese, S., Masi, G.
År
2024
DOI
10.36131/cnfioritieditore20240302
Tidsskrift
Clinical Neuropsychiatry
Volum
21
Sider
169-181
Kategori(er)
Atferdsproblemer, antisosial atferd og atferdsforstyrrelser Depresjon og nedstemthet (inkl. både vansker og lidelse) Angst og engstelighet (inkl. både vansker og lidelse) Autismespekter Sosiale ferdigheter (inkl. vennerelasjoner)
Tiltakstype(r)
Habilitering/rehabilitering (inkl. fysioterapi)
Abstract

Objective

Evidence on the efficacy of social skills training for adolescents with Level 1 Autism Spectrum Disorder (ASD) is unclear.

Method

We searched Pubmed, Scopus, and Web of Science until July 27th, 2023, for randomized controlled trials (RCTs) of social skills training for pre-adolescents and adolescents (aged 9-18) with Level 1 ASD. We then pooled data on efficacy from individual RCTs by conducting multivariate mixed-effects meta-analyses in R. We estimated possible bias in the retained RCTs using the RoB2 tool.

Results

We retained 36 RCTs (encompassing 2796 participants), including 18 RCTs comparing an experimental treatment to a waiting list, and 18 RCTs comparing it to standard care/control treatment. Meta-analyses showed that experimental treatments were significantly more efficacious than waiting list or standard care/ control treatments in improving social skills (SMD = 0.3745; 95%CI = [0.2396; 0.5093]), as well as reducing behavioral symptoms (0.3154;0.1783, 0.4525) and anxious/depressive symptoms (0.2780; 0.0432, 0.5128). However, for some outcomes there was significant heterogeneity across studies and evidence of publication bias. Subgroup analyses and meta-regressions did not identify any specific clinical or demographic factors as significant predictors of outcome. The most common risk of bias across studies was related to deviations from intended interventions and measurement of the outcomes.

Conclusions

At the group level, social skills training for adolescents with Level 1 ASD is efficacious, with small-to-moderate effect size. Future research should focus on personalized medicine approaches, aimed at tailoring interventions to specific characteristics of adolescents with Level 1 ASD.