Evaluating Change in Social Skills in High-Functioning Adults With Autism Spectrum Disorder Using a Laboratory-Based Observational Measure

Despite the impact of social disability on the lives of people with Autism Spectrum Disorders (ASDs), we know little about how to assess clinical improvement in this domain. This is a preliminary study of the potential utility and sensitivity of a novel observational rating system, the Contextual Assessment of Social Skills (CASS), as a treatment outcome measure with cognitively unimpaired adults with ASD. Five cognitively unimpaired adults with ASD completed the CASS, before and after a group social skills intervention. Based on ratings made by evaluators masked to assessment (pre-treatment or post-treatment), reliable change indices were computed to assess improvement. Four participants demonstrated significant improvement in conversational involvement, two initiated significantly more topic changes, and one asked more questions. Laboratory-based observational measures, such as the CASS, may be useful in clinical trials for adults with ASD, though further evaluation with larger samples is required.