LAUSR

Abstract Background Group social skills programs for autism spectrum disorder (ASD) have been shown to improve social skills knowledge and parent and teacher survey ratings, but have been limited by a lack of directly observed measures of social skills in unstructured settings. Methods The goal of this study was to examine the feasibility of using a novel, directly observed measure (“game day”) to monitor changes in social skills in students with ASD participating in a 16-week, school-based social skills program (Program for the Education and Enrichment of Relational Skills - PEERS). Game day occurred once a month and consisted of the instructor placing a set of board games in the room and then leaving. Videos of the game day sessions were rated by three reviewers (blinded to the video sequence) using a modified version of the Contextual Assessment of Social Skills (CASS). Results Six students (age range 13–22, 5 male) enrolled and completed all PEERS instruction and 5 monthly game day sessions. Reviewers were able to complete ratings for all scale items except frequency of initiations and responses. The remaining nine CASS items were used to generate a summary score for each child; the mean score improved from 38.5 to 43.6 (p = 0.011). Validated surveys also showed statistically significant improvements in social skills knowledge, problem behaviors, and ASD behaviors. Conclusions This study provides initial evidence that a directly observed measure detects changes in social competence in ASD and may provide a broader assessment of social ability.