Rationale: Social skills interventions, including social skills groups are sometimes used to treat the social impairments of higher-functioning children with ASD (hfASD; without intellectual disability). Despite the recognized need for such treatments, few children with hfASD receive social interventions and, when they do, they are most often too short in duration and/or lack intensity. Although reviews of studies of social interventions delivered in university/clinic settings for this population have suggested some positive impacts, the benefits rarely translate to school settings. Efforts to develop and implement school social interventions have been hindered by barriers in the school environment during the school day (e.g., focus on academic priorities [over social skills], lack of resources, staffing, and training, and limited time). As such, there is a need for feasible and effective social interventions that can be delivered by non-professional (paraprofessional) school staff in school settings, including after-school programs. An innovative program such as this takes advantage of existing resources and programs, substantially expands access to social treatment, improves paraprofessionals’ skills, and minimizes the burden on school staff during the school day. Including typically developing peers who are already attending the after-school program also provides the opportunity for children with hfASD to develop relationships with peers in the same school.

FY21 Area of Interest to Be Addressed: This project addresses the need for “behavioral, cognitive… therapies for ASD core symptoms” (p. 3).

Impact of Project Results on Field of ASD Research: Given the critical need for social interventions for children with hfASD, results of the project may impact the field of ASD research in several ways. Assuming evidence supporting feasibility and initial efficacy, the project will represent a low-cost model for increasing access to social intervention for children with hfASD (as schools have access to all children with hfASD). The project will also illustrate how to utilize existing programming (after school) and staff (paraprofessionals) as a vehicle for delivery of social interventions for hfASD; specifically, how to integrate social interventions into existing programs. The model also includes a manualized procedure for training paraprofessional to accurately deliver the social intervention. Last, the project includes a simplified instructional/teaching protocol and easy to implement game/activity (lesson) plans that increase feasibility and sustainability of an intervention following the study (as intervention complexity affects ongoing use). All of these factors may affect future intervention development efforts.

Impact on Short- and Long-Term Outcomes for Children with hfASD: This project has the potential to immediately improve the social functioning and core symptoms of children with hfASD. This is critical, given the chronic and long-term nature of their symptoms and impairments. Increasing social skills and social knowledge in childhood addresses the most debilitating aspect of the disorder that affects everyday functioning. Beyond the immediate improvements, increasing social skills and social knowledge in childhood may also make the children more responsive to future social and vocational programming, thus improving long-term outcomes.

Impact on Short- and Long-Term Outcomes for Paraprofessionals: This project has the potential to immediately improve the therapeutic/clinical skills of the paraprofessionals delivering the intervention. The training protocol establishes competency of the paraprofessional intervention agents, thus ensuring short-term improvements in their skills. Establishing such skills may make the paraprofessionals more effective in learning and administering other interventions for children with hfASD or other clinical disorders.

How the Results Will Translate into Clinical Applications: The protocol to be tested is a social treatment and it will be studied as a clinical application. Evidence of feasibility and initial efficacy will support ongoing testing in a large-scale RCT, which will ultimately determine its efficacy.