Peers, play, and performance to build social salience in autistic youth: A multisite randomized clinical trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2023-07-01 Epub Date: 2023-05-18 DOI:10.1037/ccp0000821

Blythe A Corbett, Susan White, Matthew Lerner, Kristopher J Preacher, Mark E Klemencic, Grace Lee Simmons, Jennifer Pilkington, Philip Gable, Ayla Gioia, Alexandra P Key

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Abstract

Objective: Individuals with autism spectrum disorder (ASD) have significant impairment in social competence and reduced social salience. SENSE Theatre, a peer-mediated, theater-based intervention has demonstrated posttreatment gains in face memory and social communication. The multisite randomized clinical trial compared the Experimental (EXP; SENSE Theatre) to an Active Control Condition (ACC; Tackling Teenage Training, TTT) at pretest, posttest, and follow-up. It was hypothesized that the EXP group would demonstrate greater incidental face memory (IFM) and better social behavior (interaction with novel peers) and social functioning (social engagement in daily life) than the ACC group, and posttest IFM would mediate the treatment effect on follow-up social behavior and functioning.

Method: Two hundred ninety participants were randomized to EXP (N = 144) or ACC (N = 146). Per protocol sample (≥ 7/10 sessions) resulted in 207 autistic children 10-16 years. Event-related potentials measured IFM. Naive examiners measured social behavior (Vocal Expressiveness, Quality of Rapport, Social Anxiety) and functioning (Social Communication). Structural equation modeling was used to assess treatment effects.

Results: SENSE Theatre participants showed significantly better IFM (b = .874, p = .039) at posttest, and significant indirect effects on follow-up Vocal Expressiveness a × b = .064, with 90% CI [.014, .118] and Quality of Rapport a × b = .032, with 90% CI [.002, .087] through posttest IFM.

Conclusions: SENSE Theatre increases social salience as reflected by IFM, which in turn affected Vocal Expressiveness and Quality of Rapport. Results indicate that a neural mechanism supporting social cognition and driven by social salience is engaged by the treatment and has a generalized, indirect effect on clinically meaningful functional outcomes related to core symptoms of autism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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通过同伴、游戏和表演来培养自闭症青少年的社交突出感：多地点随机临床试验。

目的：自闭症谱系障碍（ASD）患者的社交能力严重受损，社交显著性降低。SENSE 剧院 "是一种以戏剧为基础、以同伴为中介的干预措施，治疗后，患者的面部记忆和社会交往能力均有所提高。这项多地点随机临床试验比较了实验组（EXP；SENSE 剧院）与积极对照组（ACC；解决青少年训练，TTT）在前测、后测和随访中的表现。假设 EXP 组会比 ACC 组表现出更强的偶然面孔记忆（IFM）、更好的社交行为（与新同学的互动）和社交功能（日常生活中的社交参与），并且测试后的 IFM 会调节治疗对后续社交行为和功能的影响：290名参与者被随机分配到EXP组（144人）或ACC组（146人）。207名10-16岁的自闭症儿童按方案抽样（≥7/10次）。事件相关电位测量 IFM。无知考官测量社交行为（声音表达能力、关系质量、社交焦虑）和功能（社交沟通）。采用结构方程模型评估治疗效果：结果：SENSE 戏剧参与者在测试后的 IFM 显著提高（b = .874，p = .039），并通过测试后的 IFM 对后续的 Vocal Expressiveness a × b = .064, with 90% CI [.014, .118] 和 Quality of Rapport a × b = .032, with 90% CI [.002, .087] 产生显著的间接影响：结论：SENSE 剧院通过 IFM 反映出社会显著性的增加，这反过来又影响了声乐表现力和关系质量。结果表明，通过治疗，一种支持社会认知并由社会显著性驱动的神经机制被调动起来，并对与自闭症核心症状相关的、具有临床意义的功能结果产生了普遍、间接的影响。(PsycInfo Database Record (c) 2023 APA, 版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.