A randomized controlled trial to examine the effectiveness of the Dutch version of the Program for the Education and Enrichment of Relational Skills (PEERS®)

Sakinah Idris*, Bjorn Jaime van Pelt, Gabrine Jagersma, Jorieke Duvekot, Athanasios Maras, Jan van der Ende, Neeltje van Haren, Kirstin Greaves-Lord

*Corresponding author for this work

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Background: This study examines the effectiveness of the culturally adapted Dutch version of The Program for the Education and Enrichment of Relational Skills (PEERS®), utilizing a randomized control trial (RCT) with an active treatment control condition. Methods: 106 adolescents with ASD, aged 12–18 years, were randomly assigned to one of two group interventions: the experimental condition (PEERS®; n = 54) or the active treatment control condition (Regulation, Organization and Autonomy Didactics; ROAD; n = 52). Effects of interventions on social skills were primarily assessed using an observational measure (CASS – Contextual Assessment Social Skills). Secondary indices of social skills were self, parent and teacher reported questionnaire data (i.e., Social Responsiveness Scale; SRS, and Social Skills Improvement System; SSIS). Treatment satisfaction was also obtained from adolescents and their parents. Results: Results on the observational measure of social skills revealed improvements in positive affect, overall quality of rapport, as well as starting and ending a conversation, irrespective of condition. Compared to ROAD, PEERS® participants showed increased overall self-reported social skills (SSIS). Parent reports showed decreased overall social skill impairment (SRS) as well as improved social communication (SSIS subscale), with significantly more progress in the PEERS® group. Furthermore, parents of adolescents in the PEERS® group were significantly more satisfied with the intervention (M = 8.20, SD = 1.46) than parents of adolescents in the ROAD group (M = 7.52, SD = 1.45). The self-reported treatment satisfaction of adolescents did not differ between conditions. Teacher data showed decreased social skill impairment as measured with the SRS, irrespective of condition. Conclusions: This study reveals promising indications that the Dutch version of PEERS® enhances social skills in adolescents with ASD. Yet, further research is needed into how effectiveness can be optimized.

Original languageEnglish
Article number293
JournalBMC Psychiatry
Issue number1
Early online date22 Apr 2022
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information:
We would like to thank all the participants, their parents and teachers who took part in this study, as well as the students who helped during data collection (Femke ten Hoeven, Isaura Lotte, Denise Heupers, Ties van Gemert, Iris van de Merwe, Suzan de Haan ? van Dijk, Marret Fortuin, Cindy van der Hout, Simone Tuk, Amber Hendriks, Esther Keijzer, Harmen Turkstra, Anne-Jet Heerema, Ilse Betten, Laura Spieker, Benjamin de Graaff, and Romi Mol) and our confederates for their constructive roles as conversation partners (Mats van Dijk, Julia Wubs, Jo?l Wubs, Isabel van Beek, Jo?lle Loekabino, Isha Bechou, Nils Jansen, Stijn van Pamelen, Elena Trienekens, Thijmen Koenraad & Rutger Maase). We thank Ad van der Sijde for his dedicated believe in implementing PEERS ? in the Dutch mental health care system. We are very grateful for the contributions of Elizabeth Laugeson in training our staff and supportive feedback in carrying out the intervention. Our gratitude goes out to all the PEERS ? and ROAD trainers as well as clinicians who made it possible to carry out the study, by providing high quality care for our participants. Hereby thanking (in random order): Anneke Louwerse, Leonie de Weerdt, Evelien Sorensen, Magda den Breejen, Marieke Wubs, Annelies de Vos, Annemarie Huson, Frieda Boudesteijn, Manda Hoogeveen, Eva van den Berg, Annelein Koot, Bianca Segeren, Rachna Huijssoon, Janneke Eijgelaar, Vera Dolfing, Sietske Wakker, Ineke Hartsuiker and Ilona Visser and all other clinical and supportive staff of Yulius, Erasmus MC, de Jutters, Boba and Jonx for making this study possible. And Carlijn Zoetmulder for coordinating the RCT within the Jutters, Dr. Inge van Balkom for facilitating implementation at Jonx. Finally, a special thanks to Susan White for her advisory role in the design of the study.

Funding Information:
The study is supported and funded by a Dutch philanthropic foundation that is committed to improving current diagnostics, training, and treatment in adolescents and (young) adults with autism. The Foundation has had no influence in the design of the study, data collection, analysis or interpretation of data, publication of results or writing this manuscript.

Publisher Copyright:
© 2022, The Author(s).


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