Background: Turner Syndrome (TS) is a sex chromosome aneuploidy (45,X) associated with social skill difficulties. The 2016 Cincinnati clinical care guidelines recommend that the Program for the Education and Enrichment of Relational Skills (PEERS) social skills intervention is piloted. PEERS has previously been used in face-to-face interventions with male adolescents with autism spectrum conditions. This pilot project will be the first to examine the feasibility and acceptability of the PEERS protocol online.
Methods: The PEERS consists of 14 weekly lessons and runs two concurrent groups; one for the young women and one for parents. The young person lessons are structured to provide didactic instruction as well as social skill rehearsal. PEERS has been modified to be delivered primarily online. Face-to-face sessions took place at the start, middle and end of the program. All other sessions were conducted online using Adobe Connect Meetings.
Participants were screened using the Strengths and Difficulties Questionnaire (SDQ) Peer scale to measure deficits in social performance (parent report) and the PEERS screening interview assessed motivation to improve social competence (young person and parent).
The pilot used an uncontrolled study design with multiple-case tracking. The primary outcome measure (Social Competence with Peers; SCP) assessed social performance at 9 time-points (3x pre-pilot, 3x during pilot, 3x post-pilot). Secondary outcome measures assessed pre-post changes in social knowledge, anxiety, self-esteem and autistic symptomatology using standardised questionnaire, and evaluated intervention acceptability.
Results: PEERS was piloted with 7 young women with TS aged 17-20 with a verbal IQ above 70. At baseline participants scored in the abnormal range on the SDQ peers scale (t(6)=4.66, P=0.003) compared to female population norms and were highly motivated to improve their daughter's social functioning.
After the intervention social performance was significantly improved on the SCP by parent report (P=0.045; δ=0.64). Gains were maintained at follow up. Significant improvements were observed in social knowledge (P<0.0001; δ=4.25) and autistic symptomatology (P=0.036; δ=0.46). No significant changes were found in standardised self-report measures of anxiety and self-esteem.
Adherence to the intervention was high (>86%) and 100% of participants rated PEERS as 'very helpful' and reported improvements in the young person's social ability.
Discussion: The young women and their parents were highly motivated to improve their daughter's social functioning. Online administration will substantially broaden the accessibility of social skills interventions in a cost-effective way to more young women with TS and other rare genetic disorders.
19 Sep 2019 - 21 Sep 2019