Examining the Treatment Efficacy of PEERS in Japan: Improving Social Skills Among Adolescents with Autism Spectrum Disorder.

The groups were assigned by school schedule, not randomised, so differences between them could have affected the results. Only 28 adolescents were studied, with 14 in each group, so the findings are imprecise. Parents were part of the treatment and reported many outcomes, and the interviewer was on the study team, so expectations may have influenced scores. Some scores improved during the waiting period, including communication and interpersonal relationship scores, so not every change can be attributed to treatment. The analysis of get-togethers and the analysis of how many participants crossed clinical cutoffs combined the treated and waiting groups, so those results lacked a control comparison. Baseline social-skills knowledge differed between groups, and the authors adjusted some analyses for this, but it still complicates interpretation. The sample required motivation, verbal IQ above 70, no major mental illness, no disruptive behaviour, and ability to attend sessions, so results may not apply to adolescents who cannot meet these criteria. Only 10 of 28 participants received the ADOS-2 diagnostic assessment. Treatment fidelity was checked by viewing sessions, but no quantitative fidelity data were collected.

The study was funded by Sasagawa Scientific Research Grant from the Japan Science Society. The last author is a developer of PEERS and the TASSK assessment, confirmed Japanese versions of the TASSK and QPQ, and gave permission for the QPQ adaptation.

Do not conclude that PEERS alone caused the improvements. Adolescents were assigned by school schedule rather than randomised, parents knew the treatment and reported many outcomes, the interviewer was on the study team, and some analyses combined treated and waiting participants without a control comparison.