The Italian validation of the Social Skills Program PEERS® in autistic adolescents: a randomized controlled trial during COVID-19

Background. Social difficulties are a lifespan characteristic of autism (ASD), targeted by preschoolers and children’s interventions while lacking evidence in adolescence. The Program for the Education and Enrichment of Relational Skills (PEERS®) is a recognized parent-assisted program on social skills, but there is no validated adaptation in Italy. Objectives. A two-arm RCT to evaluate the effectiveness of the PEERS® was conducted. Methods. Thirty-seven ASD adolescents (Level 1) were randomly assigned to two groups: experimental (TG), attending training immediately, and the delayed treatment (WL), which participated after 14 weeks. Evaluation on primary (social abilities) and secondary outcomes (co-occurring conditions, executive functions) was performed at four-time points. Due to COVID-19, PEERS® it was delivered via telehealth and questionnaires to multi-informant assessors (adolescents, parents, and blinded teachers) were administered. Results. No differences were found at T0 between TG and WL in baseline characteristics and primary outcomes. Significant group differences emerged between T0 vs. T1 on primary (TASSK-R; QSQ-Social Initiative Scale parent and adolescent’s versions) and secondary outcomes (BRIEF-2 Emotion Regulation Index). To test additional treatment-related effects, we evaluated the changes in the overall group (TG+WL) among pre- and post-intervention and follow-up. Further changes emerged in secondary outcomes (BRIEF-2 Global Executive Composite Score; CBCL-Youth; internalizing, externalizing, total problems; CDI-2 Functional Problems), maintained at a 3-months follow-up. Conclusions. The efficacy of the Italian validation of PEERS® was ascertained on primary and secondary outcomes. Innovative findings on emotion regulation and depression symptoms have also emerged. Future studies should confirm the PEERS’ efficacy in community settings.