the science of making friends: the ucla peers program · the science of making friends: helping...

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The Science of Making Friends: The UCLA PEERS® Program

Overview of Workshop

•  Social deficits among teens and young adults with ASD

•  Consequences of peer rejection

•  Limitations of existing social skills programs

•  Effective methods of social skills instruction

•  PEERS curriculum strategies •  Summary of research findings •  Research directions •  Resources

Social Deficits Among Individuals with ASD

!  Poor social communication !  Problems with topic initiation !  Use repetitive themes

!  Perseverate on restricted interests !  Disregard the other person’s interests

!  One-sided conversations !  Elicit fewer extended responses !  Give fewer reciprocal responses !  Fail to identify common interests

!  Difficulty providing relevant information !  Make unexpected leaps in topics !  Pedantic style of speaking !  Poor speech prosody !  Highly verbose !  Difficulty interpreting verbal and nonverbal

social cues !  Voice tone !  Sarcasm !  Gestures !  Social touch

(Volkmar & Klin, 1998; Bauminger & Kasari, 2000; Orsmond, Krauss, & Seltzer, 2004; Koning & Magill-Evans, 2001; LeCouteur et al., 1989;

Marks, Schrader, Longaker, & Levine, 2000; Ghaziuddin & Gerstein, 1996; Twatchman-Cullen,

1998; Hemphill & Siperstein, 1990; Church, Alisanki, Amanullah, 2000; Constantino, 2005)

Photo of PEERS® courtesy of Associated Press

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Social Deficits Among Individuals with ASD

!  Poor social awareness !  Poor eye-contact !  Difficulty understanding social cues

and social landscape !  Poor social motivation

!  Less involvement in social activities !  Extra-curricular activities !  Clubs !  Sports

!  Lack of peer entry attempts !  Fewer social initiations

!  Poor social cognition !  Difficulty understanding the

perspectives of others !  Poor theory of mind !  Lack of cognitive empathy

(Volkmar & Klin, 1998; Bauminger & Kasari, 2000; Orsmond, Krauss, & Seltzer, 2004; Koning & Magill-Evans, 2001; LeCouteur et al.,

1989; Marks, Schrader, Longaker, & Levine, 2000; Ghaziuddin & Gerstein, 1996; Twatchman-Cullen, 1998; Hemphill & Siperstein,

1990; Church, Alisanki, Amanullah, 2000; Constantino, 2005)

Consequences of Social Deficits for Individuals with ASD

!  Social neglect and isolation !  Withdrawn !  Seen as shy by others !  Go unnoticed !  Not engaging others socially

!  Peer rejection !  Teased and bullied !  Unsuccessful attempts to socially

engage others !  Bad reputation

!  Peer conflict !  Arguments may result in

termination of friendship !  Lack of close reciprocal

friendships !  Poor friendship quality

(Volkmar & Klin, 1998; Bauminger & Kasari, 2000; Orsmond, Krauss, & Seltzer, 2004; Koning & Magill-Evans, 2001; LeCouteur et al., 1989; Marks, Schrader, Longaker, & Levine, 2000; Ghaziuddin & Gerstein,

1996; Twatchman-Cullen, 1998; Hemphill & Siperstein, 1990; Church, Alisanki, Amanullah, 2000)


Poor Quality of Friendships Among Individuals with ASD

•  Poor overall quality of friendships – Less companionship – Less help from

friends – Less security within

friendships •  Greater loneliness

(Bauminger & Kasari, 2000)

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Why Target Friendships?

Having one or two close friends:

•  Predicts later adjustment in life

•  Can buffer the impact of stressful life events

•  Correlates positively with: –  Self-esteem –  Independence

•  Correlates negatively with: –  Depression –  Anxiety

(Buhrmeister, 1990; Matson, Smiroldo, & Bamburg, 1998; Miller & Ingham, 1976)

Consequences of Peer Rejection

Peer rejection is one of the strongest predictors of:

•  Mental health problems –  Anxiety –  Depression

•  Juvenile delinquency

•  Early withdrawal from school

(Buhrmeister, 1990; Matson, Smiroldo, & Bamburg, 1998; Miller & Ingham, 1976)

Consequences of Peer Rejection

•  Depression •  Anxiety •  Loneliness •  Low self-esteem •  Substance abuse •  Poor academic

performance •  Suicidal ideation •  Suicide attempts

(Hawker & Boulton, 2000; Nansel et al., 2001; Buhrmeister, 1990; Matson, Smiroldo, & Bamburg,

1998; Miller & Ingham, 1976)

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Bullying and Peer Victimization Among Adolescents with ASD

•  Teens with ASD are NINE times more likely to experience peer victimization than “non-disabled” peers

•  94% of teens with ASD report experiencing some form of peer victimization in the previous year

•  Teens with ASD and comorbid ADHD are FOUR times more likely to engage in bullying behavior

–  Teens with ASD without ADHD do not differ from typically developing teens in rates of engaging in bullying behavior

(Olweus,1973,1993; Rose et al., 2009; Dinkes et al., 2006; Poteat & Espelage, 2007; Nansel et al., 2001; Espelage & Swearer, 2003;

Hawker & Boulton, 2000; Schwartz, 2010; Perry et al., 2001; Doren et al., 1996; Little, 2001, 2002; Montes & Halterman,

2007; van Roekel et al., 2010; Whitney et al., 1992, Martlew & Hodson, 1991; O’Moore & Hillery, 1989)

Risk Factors for Peer Rejection Among Adolescents with ASD

High Risk Factors: •  Less socially competent •  Fewer friendships

•  Less peer support

Protective Factors: •  Friendships are known to

protect against victimization (Olweus,1973,1993; Rose et al., 2009; Dinkes et al., 2006; Poteat & Espelage, 2007; Nansel et al., 2001; Espelage & Swearer, 2003;



Identifying Peer Rejected and Socially Neglected Individuals with

ASD !  Peer rejection

!  Teasing and bullying !  Bad reputations !  Actively seeking out peers !  ADHD, Mood disorders,

Impulse control disorders

!  Social neglect !  Isolated and withdrawn !  Ignored and unnoticed !  Actively avoiding peers !  Anxiety, Depression (Volkmar & Klin, 1998; Bauminger & Kasari, 2000; Orsmond, Krauss, &

Seltzer, 2004; Koning & Magill-Evans, 2001; LeCouteur et al., 1989; Marks, Schrader, Longaker, & Levine, 2000; Ghaziuddin & Gerstein,

1996; Twatchman-Cullen, 1998; Hemphill & Siperstein, 1990; Church, Alisanki, Amanullah, 2000)

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Categories of Peer Acceptance in Adolescence

The Science of Making Friends (Laugeson, 2013)

Transition to Young Adulthood

•  Functional profile for Young Adults with ASD –  75% no formal post-secondary

education –  More than 50% still living at home –  Only 16.8% of the total population in

the US with disabilities was employed in June 2014

–  Only 15% in a romantic relationship & only 25% report having a friend)

(US Bureau of Labor & Statistics, June 2014; Howlin & Moss, 2012)

Limitations of Social Skills Training

•  Do not use evidence-based curriculum

•  Fails to tailor teaching methods to shared strengths and weaknesses

•  Do not teach ecologically valid social skills

•  Do not include homework assignments

•  Skills do not generalize to other settings

•  Do not include parents and/or teachers in the treatment (Gresham, Sugai, & Horner, 2001; White, Keonig, & Scahill,

2007; DiSalvo & Oswald, 2002; Rogers, 2000; Rao, Beidel, Murray, 2008)

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PEERS® Program for the Education & Enrichment of Relational Skills

(Laugeson & Frankel, 2010)

•  Parent-assisted program •  Concurrent parent and teen sessions •  Addresses core deficits for ASD •  Focuses on friendship skills •  Teaches ecologically valid social skills •  14 week curriculum

–  90 minute weekly sessions •  Evidence-based:

–  Teens in middle and high school with ASD –  Young adults (18-24) with ASD –  Teens with ADHD –  Teens with FASD –  Teens with ID

PEERS® Program for the Education & Enrichment of Relational Skills

(Laugeson, 2014)

•  School curriculum •  Teacher-facilitated in the

classroom •  16-week program •  Daily lesson plans •  Focuses on friendship skills •  Strategies for handling peer

rejection/conflict •  Includes weekly comprehensive

parent handouts •  Evidence-based treatment for ASD

–  Middle school –  High school

The Science of Making Friends: Helping Socially Challenged Teens and Young Adults

(Laugeson, 2013)

•  Parent book •  Friendship skills •  Handling peer

rejection and conflict •  Parent section

–  Narrative lessons –  Social coaching tips

•  Teen and young adult chapter summaries

•  Chapter exercises •  Companion DVD •  Mobile App: FriendMaker

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Evidence-Based Methods for Teaching Social Skills

!  Small class format !  Didactic lessons

!  Concrete rules and steps of social etiquette !  Ecologically valid social skills

!  Role-play demonstrations !  Model social behavior !  Appropriate and inappropriate

demonstrations !  Behavioral rehearsal exercises

!  Practice with coaching !  Homework assignments

!  Practice in natural social settings !  Helps generalize skills

!  Parent and/or teacher coaching

(Matson, 1984; Davies & Rogers, 1985; Fleming & Fleming, 1982; Mesibov, 1984; Gresham, Sugai, & Horner, 2001; Gralinski &

Kopp, 1993; Rubin & Sloman, 1984, Frankel & Myatt, 2003; Rao, Beidel, & Murray, 2008; Laugeson et al., 2008)

Photo of PEERS courtesy of Associated Press

Development of PEERS®

Rules and Steps of Social Behavior

!  Ecologically valid social skills !  DO’s

!  Common social errors committed by those with ASD !  DON’Ts

!  Create rules around ecologically valid skills and common social errors

!  Break steps down into concrete parts


Overview of Teen PEERS® Curriculum

!  Conversational skills !  Trading information !  Finding common interests !  Having a reciprocal two-way

conversation !  Non-verbal communication

!  Electronic communication !  Voicemail, email, IM, text

messaging, social networking sites

!  Online safety !  Choosing appropriate friends

!  Identifying a peer group / crowd !  Identifying extracurricular

activities

(Laugeson & Frankel, 2010; Laugeson, 2013; Laugeson, 2014)


[Topics in WHITE will be covered in workshop]

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!  Appropriate use of humor !  Paying attention to humor

feedback !  Peer entry strategies

!  Starting individual conversations !  Entering group conversations

!  Peer exit strategies !  Exiting conversations

!  Good sportsmanship !  Playing nicely during games and

sports !  Get-togethers

!  Being a good host or guest during get-togethers with friends





!  Peer conflict !  Handling arguments with friends

!  Peer rejection !  Handling teasing !  Utilizing embarrassing feedback !  Handling physical bullying !  Managing rumors and gossip !  Minimizing cyber bullying !  Changing a bad reputation

!  Graduation !  Where to go from here !  Graduation party & ceremony




Overview of Young Adult Didactic Lessons

!  Starting conversations and trading information * !  Maintaining conversations and trading information * !  Finding a source of friends * !  Electronic communication !  Appropriate use of humor !  Peer entry !  Peer exiting (three types) * !  Get-togethers !  Dating etiquette (four sessions) * !  Handling arguments and disagreements !  Handling direct bullying * !  Handling indirect bullying * * Different from teen groups

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Daily Lesson Format

Mondays • Homework Review

Tuesdays • Didactic Lesson • Role Play

Wednesdays • Lesson Review • Role Play • Behavioral Rehearsal • Homework Assignment • Distribute parent handout

Thursdays & Fridays

• Didactic Summary • Teen Activity • Homework Assignment

Weekly Lesson Format

!  Homework review (30 min) !  Troubleshoot homework

problems !  Individualize treatment

!  Didactic instruction (30 min) !  Concrete rules / steps for social

etiquette !  Role-play / modeling

!  Socialization activity (30 min) !  Behavioral rehearsal for teens !  Performance feedback through

coaching

PEERS® for Preschoolers Curriculum

•  Listening and following directions •  Meeting and greeting friends

–  Asking and using names –  Saying hi and bye

•  Sharing and giving a turn •  Asking for a turn •  Keeping cool

–  Emotion regulation •  Being a good sport •  Showing and telling during play

–  Sustaining play –  Commenting (e.g., “Watch me!” or

“Look at this!”)

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PEERS® for Preschoolers Curriculum

•  Asking a friend to play –  Initiating play

•  Joining a game –  Peer entry

•  Playing something different –  Transitioning between activities

•  Helping friends and asking for help •  Body boundaries •  Using an inside voice •  Final review

PEERS® for Preschoolers: Child Session Format

1.  Puppet-facilitated didactic lesson (20 minutes) –  Concrete rules and steps –  Role play and modeling –  Behavioral rehearsal with puppets

2.  Socialization activities 1 (40 minutes) –  Two group behavioral rehearsal activities

with performance feedback 3.  Parent coached play (20 minutes)

–  In vivo performance feedback to parents during mock play dates

4.  Wrap up (10 minutes) –  Review lesson and homework assignments –  Obtain rewards

PEERS® for Preschoolers: Parent Session Format

1.  Homework review (40 minutes) –  Troubleshoot use of skills –  Individualize treatment

2.  Didactic lesson (20 minutes) –  Parent lesson –  Review child lesson –  Prepare for parent coached play activity

3.  Parent coached play (20 minutes) –  In vivo performance feedback to parents

during mock play dates 4.  Wrap up (10 minutes)

–  Review lesson and homework assignments

–  Obtain rewards

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PEERS® Evidence-Base

PEERS® Research Snapshot: Parent-Assisted for Teens with ASD

(Laugeson, Frankel, Gantman, Dillon, & Mogil 2012)

(p < .01)

(p < .01)

(p < .01)

PEERS® Research Snapshot: 14-week Follow-up with

Parent-Assisted for Teens with ASD (Laugeson, Frankel, Gantman, Dillon, & Mogil 2012)

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Parent Report Teacher Report

PEERS® Research Snapshot: New Findings at 14-week Follow-up with

Parent-Assisted for Teens with ASD (Laugeson, Frankel, Gantman, Dillon, & Mogil 2012)

PEERS® Research Snapshot: School-Based Curriculum for Teens with ASD

(Laugeson, Ellingsen, Sanderson, Tucci, & Bates 2014)

(p < .01)



(p < .03) (p < .03)

(p < .03) (p < .02)

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(p < .01)

(p < .02)

(p < .06, trend) (p < .01)

PEERS® Research Snapshot: Caregiver-Assisted for Young Adults with ASD

(Laugeson, Gantman, Kapp, Orenski, & Ellingsen 2015)



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PEERS® Research Snapshot: Long-term Follow-up Study

(Mandelberg, Laugeson, Cunningham, Ellingsen, Bates, & Frankel 2013)

•  Data was collected 1-5 years post-treatment –  T1 – Pre-test –  T2 – Post-test –  T3 – 1-5 year follow-up

•  53 of 82 potential subjects –  64% response rate

•  No significant differences between participants and non-participants at baseline

•  Mean age at follow-up: –  17.5 years old –  11.4 grade level

•  Mean time to follow-up: –  29 months

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PEERS® for Preschoolers: Randomized Controlled Trial with Parent Assistance

(Laugeson, Park, Bolourian, & Sanderson, 2015)

Baseline/ Pre-treatment Eligibility Assessments

Random assignment

Immediate Treatment (n = 8)

16-week PEERS® for Preschoolers Intervention

Post-treatment Assessments

Delayed Treatment Control (n =11)

16-week Waiting Period

Baseline 2 / Pre-treatment 2 Assessments

16-week PEERS® for Preschoolers Intervention

Post-treatment Assessments

Child Baseline Assessments

Measure Mean (SD)

Cognitive Functioning: KBIT-2 Crystallized (Verbal) IQ 97.8 (15.6) Fluid (Nonverbal) IQ 96.6 (17.7) IQ Composite 97.0 (17.8)

Adaptive Functioning: Vineland-II Communication 103.0 (18.3) Daily Living Skills 96.6 (13.0) Socialization 75.0 (20.8) Motor Skills 90.2 (18.1) Adaptive Behavior Composite 89.6 (18.2)

Standard scores: M = 100, SD = 15 (No significant differences between treatment and waitlist participants)

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Treatment Outcome Measures

•  Child Behavioral Measure •  Autism Diagnostic Observation Scale, Second Edition (ADOS-2: Lord et al.,

2012)

•  Parent Measures •  Social Responsiveness Scale, Second Edition (SRS-2: Constantino, 2012) •  Social Skills Improvement System (SSIS: Gresham & Elliott, 2008) •  Quality of Play Questionnaire (QPQ: Frankel & Mintz, 2010)

Preliminary Results: Autism Diagnostic Observation Scale - 2

Minimal to No

Low

Moderate

Moderate

Higher scores indicate more autism-related symptoms

p<.05

Moderate Range

Mild Range

Preliminary Results: Social Responsiveness Scale - 2

Higher scores indicate more social impairment

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Average Range

Preliminary Results: Social Skills Improvement Scale

Higher scores indicate better social skills

Preliminary Results: Social Skills Improvement Scale

Average range

Higher scores indicate more problem behaviors

Preliminary Results: Quality of Play Questionnaire

Number of play dates in the past month

p<.05

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Summary of Findings

•  Difference scores (DS) were calculated to examine changes in social functioning following treatment

•  Preliminary findings from paired sample t-tests of the open trial reveal a significant:

–  Decrease in autism symptoms on the ADOS-2 from a moderate range to a low range (p<.05)

–  Improvement in social responsiveness on SRS T-scores in the areas of: •  Social communication (DS=5.1; p<.05) •  Social awareness (DS=6.2; p<.05) •  Social motivation (DS=6.5; p<.05) •  Decreased repetitive behaviors / restricted interests (DS=7.3; p<.05)

–  Improvement in overall social skills on the SSIS (DS=4.9; p<.05) –  Decreased problem behaviors on the SSIS (DS=4.7; p<.05) –  Increased frequency of play dates on the QPQ (p<.05).

•  No other statistically significant changes were observed across the outcome measures

PEERS® Evidence-Base: Parent-Assistance with Teens and Adults

PEERS® Evidence-Base: Replication Studies with Teens

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UCLA PEERS® Research Partners •  Seoul National University (South Korea)

–  Randomized controlled trial (Yoo et al. 2014) –  Teens with ASD –  Korean manual published in 2013

•  University of Calgary (Canada) –  Adolescents and adults with ASD

•  Cal Tech –  Pre-post comparison of biomarkers –  Predictors of treatment outcome

•  Erasmus University (Holland) –  Randomized controlled (Yulius Academy) –  Teens with ASD –  Dutch manual in preparation

•  Bar Ilan University (Israel) –  Manual translated into Hebrew –  Randomized controlled trial –  Teens with ASD

•  Marquette University –  Replication study – social anxiety and parenting

stress (Schohl et al. 2013; Karst et al. 2014) –  EEG – first biomarker of treatment outcome

(Van Hecke et al. 2013)

Current Research: PEERS® Virtual Coach

Organization for Autism Research (Laugeson, PI)

•  High-functioning adolescents with ASD

•  N = 36 •  Test the effectiveness of a “virtual coach” using a mobile application (FriendMaker)

•  Compare three groups: –  PEERS parent-assisted

treatment as usual –  PEERS parent-assisted with

virtual coach –  Delayed treatment control

Future Research

ACCEPTED

•  PEERS dissemination project in the schools for teens with ASD

PROPOSED

•  PEERS for Teens with Intellectual Disabilities

•  Club PEERS –  Maintenance program with booster

sessions •  Camp PEERS •  PEERS for Dating •  PEERS for Careers

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UCLA PEERS Groups

Clinical Example: Preschool

QUESTION:

What do most parents tell preschoolers to do to join a game?

Clinical Examples

QUESTION:

What are common social errors committed by teens with ASD when talking to others?

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Bad Role-Play: Conversational Skills

The Science of Making Friends DVD and Mobile App (Laugeson, 2013)

Common Conversational Error: Conversation Hogging

!  One-sided conversations !  Elicit fewer extended responses

from others !  Fail to identify common interests

!  Use repetitive themes !  Perseverate on personal interests !  Disregard the other person’s

interests

!  Rule: Don’t be a conversation hog


Perspective Taking Questions: Conversation Hogging

•  What was that like for Ben?

•  What did Ben think of Alex?

•  Will Ben want to talk to Alex again?


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Common Conversational Error: Interviewing

!  Ask a series of unrelated questions

!  Make unexpected leaps in topics

!  Difficulty providing personal information

!  One-sided conversations !  Give fewer reciprocal responses !  Fail to identify common interests

!  Rule: Don’t be an interviewer (Laugeson & Frankel, 2010; Laugeson, 2013;

Laugeson, 2014)

Perspective Taking Questions: Interviewing





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Common Conversational Error: Policing

!  Poor social cognition !  Difficulty predicting social world

!  Dichotomous thinking !  Black-and-white thinking

!  Rule-driven !  Notice rule violations !  Feel compelled to point out

rule violations

!  Rule: Don’t police


Perspective Taking Questions: Policing





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Common Conversational Error: Getting Too Personal

!  Poor social cognition !  Difficulty taking on the

perspectives of others !  Difficulty picking up on social

cues !  Ask personal questions of

others !  Share too much information

!  Rule: Don’t get too personal (Laugeson & Frankel, 2010; Laugeson, 2013;

Laugeson, 2014)

Perspective Taking Questions: Getting Too Personal





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Perspective Taking Questions: Speaking Too Loudly







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Perspective Taking Questions: Speaking Too Quietly





Common Conversational Errors: Volume Control Issues

!  Speaking too loudly !  ADHD !  Mood disorder

!  Speaking too softly !  Anxiety !  Depression

!  Rule: Use good volume control

(Laugeson & Frankel, 2010; Laugeson, 2013; Laugeson, 2014



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Perspective Taking Questions: Standing Too Close

•  What was that like for Mary?

•  What did Mary think of Yasamine?

•  Will Mary want to talk to Yasamine again?




Perspective Taking Questions: Standing Too Far Away





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Common Conversational Errors: Body Boundary Issues

!  Standing too close !  ADHD !  Mood disorder

!  Standing too far away !  OCD !  Anxiety !  Depression

!  Rule: Use good body boundaries (arm’s length away) (Laugeson & Frankel, 2010; Laugeson, 2013;

Laugeson, 2014)



Perspective Taking Questions: Too Little Eye Contact





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Perspective Taking Questions: Too Much Eye Contact





Common Conversational Errors: Poor Eye Contact

!  Very little eye contact !  Appear disinterested

!  Too much eye contact !  Intrusive !  Uncomfortable

!  Rule: Use good eye contact


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PEERS® Conversational Skills

!  Trade information !  Ask the person about himself or

herself !  Answer your own question !  Find a common interest !  Share the conversation !  Ask open-ended questions !  Ask follow-up questions !  Don’t be repetitive !  Listen to your friend !  Be a little more serious when first

getting to know someone (Laugeson & Frankel, 2010; Laugeson, 2013;

Laugeson, 2014)

Clinical Example: Entering Group Conversations

QUESTIONS:

What are most children and teens told to do to meet new people?

What do children and teens with ASD often do to meet new people? The Science of Making Friends DVD and Mobile App

(Laugeson, 2013)

Bad Role-Play: Entering Group Conversations

Perspective Taking Questions:

•  What was that like for the group?

•  What did the group think of Yasamine?

•  Will the group want to talk to Yasamine again? The Science of Making Friends DVD and Mobile App

(Laugeson, 2013)

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PEERS® Steps for Entering Group Conversations

1.  Watch / Listen !  Watch from a distance

!  Using a prop is helpful !  Listen for the topic !  Identify common interests !  Make periodic eye contact !  Watch to see if you know

someone !  Make sure they’re talking nicely

2.  Wait !  Wait for a pause in the

conversation 3.  Move closer

!  Arm’s length away 4.  Join the Topic

!  Make a comment or ask a question that is ON TOPIC


Good Role-Play: Entering Group Conversations


•  What was that like for the group?

•  What did the group think of Yasamine?

•  Will the group want to talk to Yasamine again?


Clinical Example: Assessing Interest

QUESTION:

Do most children and teens with ASD know when they are accepted or not accepted into a conversation?

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PEERS® Assessing Interest During Conversational Entry

!  Verbal signs: !  Are they talking to you? !  Good: Talking nicely, asking you

questions !  Bad: Giving short answers, not

asking you questions !  Eye contact:

!  Are the looking at you? !  Good: Smiling, nodding, making eye

contact !  Bad: Look confused, making faces,

rolling eyes, no eye contact !  Body language:

!  Are they facing you? !  Good: OPEN the circle, turn toward

you !  Bad: CLOSE the circle, give the cold

shoulder, turn away


Defining Bullying

•  Subtype of aggression •  Negative actions directed at a

student or groups of students that are either:

–  Repetitive –  Chronic –  Characterized by power

imbalance

•  Bullying behaviors take on a variety of forms including:

–  Physical –  Verbal –  Relational (rumor spreading,

social exclusion) –  Electronic (cyber bullying)

(Olweus,1973,1993; Rose et al., 2009; Dinkes et al., 2006; Poteat & Espelage, 2007; Nansel et al., 2001; Espelage & Swearer, 2003;



Clinical Example: Teasing

QUESTIONS:

What are most children and teens told to do in response to teasing?

What do most children and teens with ASD do in response to teasing?

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Rules for Handling Teasing

!  Do not walk away, ignore the person, or tell an adult

!  Don’t show you’re upset or tease back !  Act like what the person said did not

bother you !  Provide a SHORT COMEBACK that

shows what the person said was lame: !  Whatever! !  Anyway… !  So what? !  Big deal! !  Who cares? !  Yeah and? !  And your point is? !  Am I supposed to care? !  Is that supposed to be funny? !  (Shrug shoulders) !  (Roll eyes)

!  Then walk away or remove yourself


Male Role-Play: Handling Teasing


•  What was that like for Alex?

•  What did Alex think of Ben?

•  Will Alex want to tease Ben again?


Female Role-Play: Handling Teasing


•  What was that like for Yasamine?

•  What did Yasamine think of Lara?

•  Will Yasamine want to tease Lara again?


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Clinical Example: Physical Bullying

QUESTIONS:

What are most teens told to do in response to physical bullying?

What do most teens with ASD do in response to physical bullying?

Avoiding Physical Bullying !  Avoid the bully

!  Stay out of reach of the bully !  If the bully can’t find you, he can’t bully you

!  Plan your route !  Lay low when the bully is around

!  Don’t draw attention to yourself !  If the bully doesn’t notice you, he won’t bully you

!  Don’t provoke the bully !  Don’t use the strategies for teasing with the bully

!  Don’t tease the bully !  Don’t police the bully

!  Don’t tell on the bully for minor offenses !  Discretely tell an adult if someone is in danger

!  Don’t try to make friends with the bully !  Hang out with other teens

!  Bullies like to pick on teens who are by themselves

!  Stay near adults when the bully is around !  Get help from an adult


Clinical Example: Cyber Bullying

QUESTIONS:

What are most teens told to do in response to cyber bullying?

What do cyber bullies want their victims to do?

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Addressing Cyber Bullying

!  Don’t feed the trolls !  Don’t react !  Have friends stick up for you !  Lay low online !  Block the bully !  Save the evidence !  Get help from supportive adults !  Report cyber bullying to the

proper authorities !  Webmasters !  Service providers !  School !  Law enforcement (extreme cases)


Clinical Example: Rumors and Gossip

QUESTIONS:

What do most adults tell children and teens to do when they are the target of rumors and gossip?

What is the natural response to someone spreading a rumor about you?

PEERS® Handling Rumors & Gossip

How to avoid being the target of gossip:

• Avoid being friends with gossips • Don’t being enemies with the gossips • Be as neutral as possible with the gossips • Don’t spread rumors or gossip about people


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PEERS® Handling Rumors & Gossip What to do if you’re the target of gossip: • Every instinct we have is WRONG • Don’t try to disprove the gossip • Don’t show that you’re upset • Don’t confront the source of the gossip • Avoid the source of the gossip • Act amazed anyone would BELIEVE or CARE about the gossip

–  “I can’t believe anyone would believe that.”

–  “Can you believe anyone cares about that?”

(Laugeson & Frankel, 2010; Laugeson, 2013; Laugeson,

2014)

PEERS® Handling Rumors & Gossip

Spread the rumor about yourself: 1. Find a supportive friend 2. Find an audience 3. Acknowledge the rumor

–  “Did you hear this rumor….” 4. Act amazed anyone would BELIEVE or CARE about the rumor

–  “I can’t believe anyone believes that.” –  “People are so gullible.” –  “People need to find something interesting to talk about.” –  “People need to get a life.”

5. Repeat with other friends (Laugeson & Frankel, 2010; Laugeson, 2013;

Laugeson, 2014)

Bad Role-Play: Handling Rumors and Gossip


•  What was that like for Lara?

•  What did Lara think of Yasamine?

•  Will Lara want to spread the rumor?


39

Good Role-Play: Handling Rumors and Gossip


•  What was that like for Lara?

•  What did Lara think of Yasamine?

•  Will Lara want to spread the rumor?


Clinical Example: Letting Someone Know You Like Them

QUESTIONS:

What are most people with autism told to do to let someone know they like them romantically?

What do people with autism often do to let someone know they like them?

PEERS® Social Skill: Letting Someone Know You Like Them

•  Speak to a mutual friend –  Ask if the person is dating

anyone –  Ask if the person might be

interested in you –  Ask if they think the person

might go out with you –  Causally mention that you like

them

•  Show interest in the person –  Trade information –  Find common interests

40


•  Flirt with them

1.  Make eye contact 2.  Give a slight smile

•  Not a big smile •  No teeth

3.  Look away 4.  Repeat


•  Give compliments

–  GENERAL compliments ONLY if you know them well

•  Example: “You’re so smart!” –  SPECIFIC compliments for

people you don’t know well •  Example: “That was really

interesting!” –  Avoid too many physical

compliments –  Physical compliments should

be from the neck-up

PEERS® Social Skill: Asking Someone on a Date

BEFORE ASKING THEM OUT:

• Figure out their dating status • Let them know you like them • Flirt with them • Trade information multiple times • Find common interests

41

PEERS® Social Skill: Asking Someone on a Date

1.  Trade information 2.  Mention your common interests 3.  Ask what they’re doing at some

general time (e.g., this weekend) 4.  Assess their interest 5.  Use common interests as a cover

story for going out 6.  If interested:

–  Choose a day and general time –  Exchange contact information

7.  Contact them to finalize plans 8.  If NOT interested:

1.  Keep your cool 2.  Casually say, “Okay” 3.  Change the subject Video courtesy of www.wrongplanet.net

Acknowledgements Funding Support

NIMH U54-MH-068172 (Sigman, PI) NIH T32 MH17140 (Leuchter, PI) Nathan & Lilly Shapell Foundation (Laugeson, PI) Semel Scholar Award (Laugeson, PI) Friends of the Semel Institute (Laugeson, PI) Organization for Autism Research (Gantman, PI) Shapell & Guerin Family Foundation (Laugeson, PI) Organization for Autism Research (Laugeson, PI) Lang Family Foundation (Laugeson, PI)

Research Collaborators

Fred Frankel, Ph.D., ABPP (co-developer) Andrew Leuchter, M.D. (post-doc mentor) Alex Gantman, Psy.D. Catherine Mogil, Psy.D. Helena Johnson, Ph.D. Josh Mandelberg, M.D. Mina Park, Ph.D. Enjey Lin, Ph.D. Jilly Chang, Ph.D. Jennifer Sanderson, Psy.D.

Administrative Support

Yasamine Bolourian, M.A. Jessica Hopkins Shannon Bates, M.A. Lara Tucci, M.A. Ashley R. Dillon, Ph.D. Ruth Ellingsen, M.A. Clare Gorospe Jessie Sanchez Elina Veytsman James Yang

THG Research Assistants Maria Kriv Stephen Kapp, Ph.D. Kaely Orenski, Psy.D. Georgia Yu, M.A. Dali Tung Jan Stolpe Dawn Mitchell, M.A. Rosanna Rivero, M.A. Mary Goodarzi, M.A. Alex Friedman Sarah Bohlman, M.A. Lindsay Henry, M.A. Summer Vilkins Maile Adolphson Horn, M.A. Michelle Jackson, M.A. Sarah Taylor, M.A. Melissa Wasserman, M.A. Lindsey Hughes, M.A. Ellie Mellon Daniel Janulaitis, M.A. Rohini Bagrodia Kathryn Fitzpatrick Tiana Bayrami, M.A. Jason Tinero Elizabeth Shipley, M.A. Khadija Noorbhai Catherine Wallace Marlene Cabrera Renee Doe Alexandra Walsh Marina Avetisian Maria Pizzano Eugene Kutasevich Maricella Campuzano Leijing Zhang

UCLA Research Assistants Jin Lee, Psy.D. Amanda Lenvin Cordelia Ross Kristine McGlennen Jeff Rudie Natalie Colich Dana Lieberman, M.A. Siena Whitham, M.A. Allison Vreeland Lucy Vo Chloe Koeffler Alea Baron, M.A. Laura Knoll, M.A. Ahoo Karimian, M.A. Kathleen Jorgenson, M.A. Rebecca Fountain, M.A. Erin Cornack, M.A. Emily Chen, M.A. Kandyse Christopher Devi Beck-Pancer Ben Schwartman, Ph.D. Elan Javanfard, M.A. Meredith Kalies, M.A. Meagan Cronin, M.A. Lyndsay Brooks, M.A. David Diaz, M.A. Cecilia Costa, M.A. Crystal Ferrendelli, M.A. Erin Santos, M.A. Danielle Missler, M.A. Cara Lam Fernanda Samaia Tony Abuyo Angela Dahiya Jennifer Majdick

www.semel.ucla.edu/peers/ [email protected]

310-26-PEERS Facebook & Twitter: UCLA PEERS

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