Online social interaction skill group for adolescents on the autism spectrum: Preliminary outcomes of the START Connections program

Abstract

Background

Promising social skill interventions have emerged to target socialization vulnerabilities of autistic adolescents, but there remains a critical need for effective dissemination of these programs to improve service access. The Social Tools And Rules for Teens (START) Program is a group-based intervention program for increasing social motivation while enhancing social communication skill use.

Method

The current study aimed to evaluate START Connections, an online adaptation of the original START model. We (1) assessed the preliminary efficacy, feasibility, and acceptability of START Connections, and (2) compared its outcomes to a prior in-person START clinical trial. Participants were 41 autistic adolescents aged 11–16 and their parent. Each bi-weekly START Connections session consisted of a check-in, socialization time, group discussion and practice of social topics, group activity, and check-out.

Results

Attendance for the program was high and teens endorsed high levels of enjoyment and skill improvement. Analysis of treatment gains yielded evidence of increased emotion regulation, social skills, and social motivation. Improvements in behaviorally coded target skills were observed for many participants during naturalistic conversations. An analytical comparison revealed a comparable trend in outcomes between START Connections and in-person START groups for social challenges, self-reported social skill use, and social motivation and competence.

Conclusion

Overall, these pilot outcomes are extremely promising and suggest that the START Connections model is feasible and has the potential to improve social communication and emotion regulation in autistic teens. These results warrant a follow-up, RCT investigation evaluating the unique benefits of in-person versus online START Programs.