Peers, Play, and Performance to Build Social Salience in Autistic Youth: A Multisite Randomized Clinical Trial
Abstract
Objective: Individuals with autism spectrum disorder (ASD) have significant impairment in social competence and reduced social salience. SENSE Theatre®, a peer-mediated, theatre-based intervention has demonstrated post-treatment 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: 290 participants were randomized to EXP (N=144) or ACC (N=146). Per protocol sample (≥ 7/10 sessions) resulted in 207 autistic children 10-to-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:…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 290 participants or records.
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