Autistic children ages 4-6 showed improved social skills after summer program conducted by UB’s Institute for Autism Research

BUFFALO, N.Y. – A summer intervention program for autistic children ages 4-6 with no intellectual disability significantly improved their social performance, according to a study by researchers at the Institute for Autism Research (IAR) at the University at Buffalo. It was published in Advances in Neurodevelopmental Disorders in July.

“Completion of our 5-week summerMAXyc program was associated with significant social, behavioral and autism symptom benefits for the children,” says Christopher J. Lopata, PsyD, co-author on the study and co-founder/co-director of the IAR with Marcus L. Thomeer, PhD; both are professors of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at UB. “Developing such foundational skills early in development sets the stage for development of more advanced skills later in childhood, adolescence and adulthood, thus leading to better long-term outcomes.”

Thomeer notes that while programs for autistic children with no intellectual disability ages 4-6 do exist, few provide intensive social programming. This population also tends to engage in significantly fewer group recreational activities in general than their peers without autism, further limiting social development opportunities.

“This constitutes a significant gap in social intervention development and service provision, which prompted our interest in developing such a program for this population,” he says. 

The intensive summerMAXyc program was conducted five-days-a-week over five weeks in the summer. The program follows a similar model to that of the IAR’s successful, evidence-based summerMAX program for older children, which has helped improve the social skills of hundreds of children since it began 23 years ago.

In the summerMAXyc program, each 6-hour day included 8 cycles of 30 minutes each, which began with 10 minutes of instruction in particular skills, such as having a conversation or accepting consequences, followed by a 20-minute cooperative activity.

According to the study, the children found that the program was fun and helped them learn skills and make new friends. Average child satisfaction was 14.9 out of a possible 15 with parent satisfaction at 69.8 out of a possible 70. Parents reported significant improvement in the children’s social skills, behaviors and autism symptoms.

There is broad consensus that earlier intervention is associated with better outcomes for autistic children. And parents are often the first to recognize the need.

“Parents reach out to us because their child has difficulty navigating the social world,” says Thomeer. “They describe their autistic children as wanting to have friends but not knowing what to do in social situations.”

Over the course of their child’s participation in summerMAXyc, Thomeer says, parents reported that other family members began to notice the child playing with others, not just playing alone. They also noticed that the child now makes eye contact, asks about others, plays games without getting upset and can recognize and understand different emotions.

According to Thomeer, a mother of one of the participants reported that her child not only noticed that she was frustrated about something, but also told her to “squeeze the orange,” a technique the children are taught where they squeeze an imaginary orange and take a deep breath in order to calm themselves down.

One of the study’s major strengths involved the use of objective observers to assess the children’s social performance. According to Lopata, parents are a critical source of information, however there is a risk of bias because they know that their children are in the intervention. Most social skills intervention studies for autistic children rely on parent ratings alone and therefore suffer from this limitation, he adds.

 “Our use of masked observers – trained individuals – eliminated that risk because they were unaware that the children received an intervention,” says Lopata.

The authors also note that the intervention was similarly successful in improving the children’s social performance and autism features regardless of the child’s age, IQ level, communication ability or level of diagnostic symptoms.

“There is widespread recognition in the field that no intervention will be effective for all autistic children and there is a significant need to determine which children are most likely to benefit from a specific intervention,” says Lopata. “Answering this question can help ensure that scarce resources are efficiently allocated and that children receiving a given intervention are most likely to benefit.”

The next step is to test the intervention in a large-scale randomized clinical trial with a control group, which would be a first for such a social intervention in this population.