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Sequence Learning in Minimally Verbal Children With ASD and the Beneficial Effect of Vestibular Stimulation / Gili KATZ-NAVE in Autism Research, 13-2 (February 2020)
[article]
Titre : Sequence Learning in Minimally Verbal Children With ASD and the Beneficial Effect of Vestibular Stimulation Type de document : Texte imprimé et/ou numérique Auteurs : Gili KATZ-NAVE, Auteur ; Yael ADINI, Auteur ; Orit E. HETZRONI, Auteur ; Yoram S. BONNEH, Auteur Article en page(s) : p.320-337 Langues : Anglais (eng) Mots-clés : SRT task minimally verbal ASD short learning sessions skill learning vestibular stimulation Index. décimale : PER Périodiques Résumé : People with autism spectrum disorder (ASD) and especially the minimally verbal, often fail to learn basic perceptual and motor skills. This deficit has been demonstrated in several studies, but the findings could have been due to the nonoptimal adaptation of the paradigms. In the current study, we sought to characterize the skill learning deficit in young minimally verbal children with ASD and explore ways for improvement. For this purpose, we used vestibular stimulation (VS) whose beneficial effects have been demonstrated in the typical population, but the data regarding ASD are limited. We trained 36 children ages 6-13 years, ASD (N = 18, 15 of them minimally verbal) and typical development (TD, N = 18), on a touch version of the visual-motor Serial-Reaction-Time sequence-learning task, in 10 short (few minutes) weekly practice sessions. A subgroup of children received VS prior to each training block. All the participants but two ASD children showed gradual median reaction time improvement with significant speed gains across the training period. The ASD children were overall slower (by ~250 msec). Importantly, those who received VS (n = 10) showed speed gains comparable to TD, which were larger (by ~100%) than the ASD controls, and partially sequence-specific. VS had no effect on the TD group. These results suggest that VS has a positive effect on learning in minimally verbal ASD children, which may have important therapeutic implications. Furthermore, contrary to some previous findings, minimally verbal children with ASD can acquire, in optimal conditions, procedural skills with few short training sessions, spread over weeks, and with a similar time course as non-ASD controls. Autism Res 2020, 13: 320-337. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Minimally verbal children with ASD who received specially adjusted learning conditions showed significant learning of a visual-motor sequence across 10 practice days. This learning was considerably improved with vestibular stimulation before each short learning session. This may have important practical implications in the education and treatment of ASD children. En ligne : http://dx.doi.org/10.1002/aur.2237 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=420
in Autism Research > 13-2 (February 2020) . - p.320-337[article] Sequence Learning in Minimally Verbal Children With ASD and the Beneficial Effect of Vestibular Stimulation [Texte imprimé et/ou numérique] / Gili KATZ-NAVE, Auteur ; Yael ADINI, Auteur ; Orit E. HETZRONI, Auteur ; Yoram S. BONNEH, Auteur . - p.320-337.
Langues : Anglais (eng)
in Autism Research > 13-2 (February 2020) . - p.320-337
Mots-clés : SRT task minimally verbal ASD short learning sessions skill learning vestibular stimulation Index. décimale : PER Périodiques Résumé : People with autism spectrum disorder (ASD) and especially the minimally verbal, often fail to learn basic perceptual and motor skills. This deficit has been demonstrated in several studies, but the findings could have been due to the nonoptimal adaptation of the paradigms. In the current study, we sought to characterize the skill learning deficit in young minimally verbal children with ASD and explore ways for improvement. For this purpose, we used vestibular stimulation (VS) whose beneficial effects have been demonstrated in the typical population, but the data regarding ASD are limited. We trained 36 children ages 6-13 years, ASD (N = 18, 15 of them minimally verbal) and typical development (TD, N = 18), on a touch version of the visual-motor Serial-Reaction-Time sequence-learning task, in 10 short (few minutes) weekly practice sessions. A subgroup of children received VS prior to each training block. All the participants but two ASD children showed gradual median reaction time improvement with significant speed gains across the training period. The ASD children were overall slower (by ~250 msec). Importantly, those who received VS (n = 10) showed speed gains comparable to TD, which were larger (by ~100%) than the ASD controls, and partially sequence-specific. VS had no effect on the TD group. These results suggest that VS has a positive effect on learning in minimally verbal ASD children, which may have important therapeutic implications. Furthermore, contrary to some previous findings, minimally verbal children with ASD can acquire, in optimal conditions, procedural skills with few short training sessions, spread over weeks, and with a similar time course as non-ASD controls. Autism Res 2020, 13: 320-337. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Minimally verbal children with ASD who received specially adjusted learning conditions showed significant learning of a visual-motor sequence across 10 practice days. This learning was considerably improved with vestibular stimulation before each short learning session. This may have important practical implications in the education and treatment of ASD children. En ligne : http://dx.doi.org/10.1002/aur.2237 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=420 Learning of skilled movements via imitation in ASD / Danielle MCAULIFFE in Autism Research, 13-5 (May 2020)
[article]
Titre : Learning of skilled movements via imitation in ASD Type de document : Texte imprimé et/ou numérique Auteurs : Danielle MCAULIFFE, Auteur ; Yi ZHAO, Auteur ; Ajay S. PILLAI, Auteur ; Katarina AMENT, Auteur ; Jack ADAMEK, Auteur ; Brian S. CAFFO, Auteur ; Stewart H. MOSTOFSKY, Auteur ; Joshua B. EWEN, Auteur Article en page(s) : p.777-784 Langues : Anglais (eng) Mots-clés : autism dyspraxia imitation learning motor control skill learning Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) consists of altered performance of a range of skills, including social/communicative and motor skills. It is unclear whether this altered performance results from atypical acquisition or learning of the skills or from atypical "online" performance of the skills. Atypicalities of skilled actions that require both motor and cognitive resources, such as abnormal gesturing, are highly prevalent in ASD and are easier to study in a laboratory context than are social/communicative skills. Imitation has long been known to be impaired in ASD; because learning via imitation is a prime method by which humans acquire skills, we tested the hypothesis that children with ASD show alterations in learning novel gestures via imitation. Eighteen participants with ASD and IQ > 80, ages 8-12.9 years, and 19 typically developing peers performed a task in which they watched a video of a model performing a novel, meaningless arm/hand gesture and copied the gesture. Each gesture video/copy sequence was repeated 4-6 times. Eight gestures were analyzed. Examination of learning trajectories revealed that while children with ASD made nearly as much progress in learning from repetition 1 to repetition 4, the shape of the learning curves differed. Causal modeling demonstrated the shape of the learning curve influenced both the performance of overlearned gestures and autism severity, suggesting that it is in the index of learning mechanisms relevant both to motor skills and to autism core features. Autism Res 2020, 13: 777-784.. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Imitation is a route by which humans learn a wide range of skills, naturally and in therapies. Imitation is known to be altered in autism spectrum disorder (ASD), but learning via imitation has not been rigorously examined. We found that the shape of the learning curve is altered in ASD, in a way that has a significant impact both on measures of autism severity and of other motor skills. En ligne : http://dx.doi.org/10.1002/aur.2253 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422
in Autism Research > 13-5 (May 2020) . - p.777-784[article] Learning of skilled movements via imitation in ASD [Texte imprimé et/ou numérique] / Danielle MCAULIFFE, Auteur ; Yi ZHAO, Auteur ; Ajay S. PILLAI, Auteur ; Katarina AMENT, Auteur ; Jack ADAMEK, Auteur ; Brian S. CAFFO, Auteur ; Stewart H. MOSTOFSKY, Auteur ; Joshua B. EWEN, Auteur . - p.777-784.
Langues : Anglais (eng)
in Autism Research > 13-5 (May 2020) . - p.777-784
Mots-clés : autism dyspraxia imitation learning motor control skill learning Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) consists of altered performance of a range of skills, including social/communicative and motor skills. It is unclear whether this altered performance results from atypical acquisition or learning of the skills or from atypical "online" performance of the skills. Atypicalities of skilled actions that require both motor and cognitive resources, such as abnormal gesturing, are highly prevalent in ASD and are easier to study in a laboratory context than are social/communicative skills. Imitation has long been known to be impaired in ASD; because learning via imitation is a prime method by which humans acquire skills, we tested the hypothesis that children with ASD show alterations in learning novel gestures via imitation. Eighteen participants with ASD and IQ > 80, ages 8-12.9 years, and 19 typically developing peers performed a task in which they watched a video of a model performing a novel, meaningless arm/hand gesture and copied the gesture. Each gesture video/copy sequence was repeated 4-6 times. Eight gestures were analyzed. Examination of learning trajectories revealed that while children with ASD made nearly as much progress in learning from repetition 1 to repetition 4, the shape of the learning curves differed. Causal modeling demonstrated the shape of the learning curve influenced both the performance of overlearned gestures and autism severity, suggesting that it is in the index of learning mechanisms relevant both to motor skills and to autism core features. Autism Res 2020, 13: 777-784.. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Imitation is a route by which humans learn a wide range of skills, naturally and in therapies. Imitation is known to be altered in autism spectrum disorder (ASD), but learning via imitation has not been rigorously examined. We found that the shape of the learning curve is altered in ASD, in a way that has a significant impact both on measures of autism severity and of other motor skills. En ligne : http://dx.doi.org/10.1002/aur.2253 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 Savant syndrome has a distinct psychological profile in autism / J. E. A. HUGHES in Molecular Autism, 9 (2018)
[article]
Titre : Savant syndrome has a distinct psychological profile in autism Type de document : Texte imprimé et/ou numérique Auteurs : J. E. A. HUGHES, Auteur ; J. WARD, Auteur ; E. GRUFFYDD, Auteur ; Simon BARON-COHEN, Auteur ; P. SMITH, Auteur ; Carrie ALLISON, Auteur ; J. SIMNER, Auteur Article en page(s) : 53p. Langues : Anglais (eng) Mots-clés : Autism spectrum conditions Cognition Perception Savant syndrome Sensory processing Skill learning Talent Ethics Committee at the University of Sussex. Informed consent was gained from all individual participants.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Index. décimale : PER Périodiques Résumé : Background: Savant syndrome is a condition where prodigious talent can co-occur with developmental conditions such as autism spectrum conditions (autism). It is not yet clear why some autistic people develop savant skills while others do not. Methods: We tested three groups of adults: autistic individuals who have savant skills, autistic individuals without savant skills, and typical controls without autism or savant syndrome. In experiment 1, we investigated the cognitive and behavioural profiles of these three groups by asking participants to complete a battery of self-report measures of sensory sensitivity, obsessional behaviours, cognitive styles, and broader autism-related traits including social communication and systemising. In experiment 2, we investigated how our three groups learned a novel savant skill-calendar calculation. Results: Heightened sensory sensitivity, obsessional behaviours, technical/spatial abilities, and systemising were all key aspects in defining the savant profile distinct from autism alone, along with a different approach to task learning. Conclusions: These results reveal a unique cognitive and behavioural profile in autistic adults with savant syndrome that is distinct from autistic adults without a savant skill. En ligne : https://dx.doi.org/10.1186/s13229-018-0237-1 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371
in Molecular Autism > 9 (2018) . - 53p.[article] Savant syndrome has a distinct psychological profile in autism [Texte imprimé et/ou numérique] / J. E. A. HUGHES, Auteur ; J. WARD, Auteur ; E. GRUFFYDD, Auteur ; Simon BARON-COHEN, Auteur ; P. SMITH, Auteur ; Carrie ALLISON, Auteur ; J. SIMNER, Auteur . - 53p.
Langues : Anglais (eng)
in Molecular Autism > 9 (2018) . - 53p.
Mots-clés : Autism spectrum conditions Cognition Perception Savant syndrome Sensory processing Skill learning Talent Ethics Committee at the University of Sussex. Informed consent was gained from all individual participants.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Index. décimale : PER Périodiques Résumé : Background: Savant syndrome is a condition where prodigious talent can co-occur with developmental conditions such as autism spectrum conditions (autism). It is not yet clear why some autistic people develop savant skills while others do not. Methods: We tested three groups of adults: autistic individuals who have savant skills, autistic individuals without savant skills, and typical controls without autism or savant syndrome. In experiment 1, we investigated the cognitive and behavioural profiles of these three groups by asking participants to complete a battery of self-report measures of sensory sensitivity, obsessional behaviours, cognitive styles, and broader autism-related traits including social communication and systemising. In experiment 2, we investigated how our three groups learned a novel savant skill-calendar calculation. Results: Heightened sensory sensitivity, obsessional behaviours, technical/spatial abilities, and systemising were all key aspects in defining the savant profile distinct from autism alone, along with a different approach to task learning. Conclusions: These results reveal a unique cognitive and behavioural profile in autistic adults with savant syndrome that is distinct from autistic adults without a savant skill. En ligne : https://dx.doi.org/10.1186/s13229-018-0237-1 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371 Beyond intervention into daily life: A systematic review of generalisation following social communication interventions for young children with autism / Sophie CARRUTHERS in Autism Research, 13-4 (April 2020)
[article]
Titre : Beyond intervention into daily life: A systematic review of generalisation following social communication interventions for young children with autism Type de document : Texte imprimé et/ou numérique Auteurs : Sophie CARRUTHERS, Auteur ; Andrew PICKLES, Auteur ; Vicky SLONIMS, Auteur ; Patricia HOWLIN, Auteur ; Tony CHARMAN, Auteur Article en page(s) : p.506-522 Langues : Anglais (eng) Mots-clés : autism generalization intervention research learning skill learning social communication Index. décimale : PER Périodiques Résumé : Researchers have generally considered autistic individuals to have difficulties generalising learned skills across novel contexts. Successful generalisation is necessary for an intervention to have benefits in everyday life beyond the original learning environment. We conducted a systematic review of randomised controlled trials of early social communication interventions for children with autism in order to explore generalisation and its measurement. We identified nine RCTs that provided evidence of initial target learning and measured generalisation, of which eight demonstrated at least some successful generalisation across people, settings, and/or activities. The findings did not support the widely reported generalisation 'difficulties' associated with autism. However, generalisation was not consistent across all skills within studies, and one study found no generalisation despite evidence for initial target learning within the intervention context. In general, there are few methodologically sound social communication intervention studies exploring generalisation in autism and no consensus on how it should be measured. In particular, failure to demonstrate initial learning of target skills within the intervention setting and an absence of formal mediation analyses of the hypothesised mechanisms limit current research. We outline a framework within which measurement of generalisation can be considered for use in future trials. To maximise the effectiveness of interventions, the field needs to gain a better understanding of the nature of generalisation among autistic individuals and what additional strategies may further enhance learning. Autism Res 2020, 13: 506-522. (c) 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: It is generally considered that autistic individuals experience difficulties applying things they have learned in one context into different settings (e.g. from school to home). This is important to consider for intervention studies. Our review does not support a complete lack of generalisation but instead suggests that after early social communication intervention, autistic children can transfer some skills to new contexts. Overall, there is limited research in this area and further work is needed. En ligne : http://dx.doi.org/10.1002/aur.2264 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=421
in Autism Research > 13-4 (April 2020) . - p.506-522[article] Beyond intervention into daily life: A systematic review of generalisation following social communication interventions for young children with autism [Texte imprimé et/ou numérique] / Sophie CARRUTHERS, Auteur ; Andrew PICKLES, Auteur ; Vicky SLONIMS, Auteur ; Patricia HOWLIN, Auteur ; Tony CHARMAN, Auteur . - p.506-522.
Langues : Anglais (eng)
in Autism Research > 13-4 (April 2020) . - p.506-522
Mots-clés : autism generalization intervention research learning skill learning social communication Index. décimale : PER Périodiques Résumé : Researchers have generally considered autistic individuals to have difficulties generalising learned skills across novel contexts. Successful generalisation is necessary for an intervention to have benefits in everyday life beyond the original learning environment. We conducted a systematic review of randomised controlled trials of early social communication interventions for children with autism in order to explore generalisation and its measurement. We identified nine RCTs that provided evidence of initial target learning and measured generalisation, of which eight demonstrated at least some successful generalisation across people, settings, and/or activities. The findings did not support the widely reported generalisation 'difficulties' associated with autism. However, generalisation was not consistent across all skills within studies, and one study found no generalisation despite evidence for initial target learning within the intervention context. In general, there are few methodologically sound social communication intervention studies exploring generalisation in autism and no consensus on how it should be measured. In particular, failure to demonstrate initial learning of target skills within the intervention setting and an absence of formal mediation analyses of the hypothesised mechanisms limit current research. We outline a framework within which measurement of generalisation can be considered for use in future trials. To maximise the effectiveness of interventions, the field needs to gain a better understanding of the nature of generalisation among autistic individuals and what additional strategies may further enhance learning. Autism Res 2020, 13: 506-522. (c) 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: It is generally considered that autistic individuals experience difficulties applying things they have learned in one context into different settings (e.g. from school to home). This is important to consider for intervention studies. Our review does not support a complete lack of generalisation but instead suggests that after early social communication intervention, autistic children can transfer some skills to new contexts. Overall, there is limited research in this area and further work is needed. En ligne : http://dx.doi.org/10.1002/aur.2264 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=421 A randomized controlled trial evaluating the Hebrew adaptation of the PEERS((R)) intervention: Behavioral and questionnaire-based outcomes / S. J. RABIN in Autism Research, 11-8 (August 2018)
[article]
Titre : A randomized controlled trial evaluating the Hebrew adaptation of the PEERS((R)) intervention: Behavioral and questionnaire-based outcomes Type de document : Texte imprimé et/ou numérique Auteurs : S. J. RABIN, Auteur ; S. ISRAEL-YAACOV, Auteur ; E. A. LAUGESON, Auteur ; I. MOR-SNIR, Auteur ; O. GOLAN, Auteur Article en page(s) : p.1187-1200 Langues : Anglais (eng) Mots-clés : adolescents clinical trials intervention - behavioral skill learning social cognition treatment research Index. décimale : PER Périodiques Résumé : Social interaction deficits form a core characteristic of ASD that is commonly targeted through social-skill groups. The Program for the Education and Enrichment of Relational Skills (PEERS((R)) ) is a well-established parent-assisted intervention for adolescents, which addresses key areas of social functioning. PEERS((R)) has been mainly studied in North-America and its evaluations were mostly questionnaire based. The aim of the current study was to test the effectiveness of the adapted and translated Hebrew version of the PEERS((R)) intervention in a randomized controlled trial, using behavioral measures of peer interaction, in addition to self, parent, and teacher reports. Forty-one participants with ASD and no intellectual impairment, aged 12-17 years, were randomly assigned to an immediate intervention or a delayed-intervention group. All participants were assessed before and after the immediate intervention, and again at follow up, after the delayed intervention took place. Results revealed intervention-related behavioral improvements on adolescents' engagement, question-asking, and physical arousal. Parental reports indicated improved social skills, and reduced ASD symptoms. Adolescents reported on more social encounters, greater empathy, and scored higher on social-skill knowledge. Most of these effects maintained at a 16-week follow-up. Teacher reports' yielded effects only on pre-post intervention analysis. Adolescents' improvement on behavioral engagement predicted parent-reported social skills improvement. Our findings support the effectiveness of the adapted Hebrew version of PEERS((R)) for adolescents with ASD, through significant behavioral and questionnaire-based outcomes, which maintained at follow-up. Autism Res 2018, 11: 1187-1200. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Social-skills groups, which facilitate key social deficits characteristic of ASD, are a popular intervention for adolescents with ASD. Indeed, many treatment protocols have been published, and some have also been research validated. However, there have been inconsistent findings regarding the effectiveness of different protocols, in addition to limited findings of improvement beyond questionnaire reports. This study evaluated the Hebrew adaptation of the PEERS((R)) intervention, a 16-weeks long program, which involves the parents as their adolescents' social coaches. Following the intervention, adolescents improved their social-skills, participated more in social encounters, reported greater empathy, and demonstrated higher social-skill knowledge. A live play-role assessment with an unfamiliar peer indicated that adolescents showed greater involvement, asked more questions and were more physically relaxed during the conversation. Improvements maintained 16 weeks after the intervention was completed. En ligne : http://dx.doi.org/10.1002/aur.1974 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=369
in Autism Research > 11-8 (August 2018) . - p.1187-1200[article] A randomized controlled trial evaluating the Hebrew adaptation of the PEERS((R)) intervention: Behavioral and questionnaire-based outcomes [Texte imprimé et/ou numérique] / S. J. RABIN, Auteur ; S. ISRAEL-YAACOV, Auteur ; E. A. LAUGESON, Auteur ; I. MOR-SNIR, Auteur ; O. GOLAN, Auteur . - p.1187-1200.
Langues : Anglais (eng)
in Autism Research > 11-8 (August 2018) . - p.1187-1200
Mots-clés : adolescents clinical trials intervention - behavioral skill learning social cognition treatment research Index. décimale : PER Périodiques Résumé : Social interaction deficits form a core characteristic of ASD that is commonly targeted through social-skill groups. The Program for the Education and Enrichment of Relational Skills (PEERS((R)) ) is a well-established parent-assisted intervention for adolescents, which addresses key areas of social functioning. PEERS((R)) has been mainly studied in North-America and its evaluations were mostly questionnaire based. The aim of the current study was to test the effectiveness of the adapted and translated Hebrew version of the PEERS((R)) intervention in a randomized controlled trial, using behavioral measures of peer interaction, in addition to self, parent, and teacher reports. Forty-one participants with ASD and no intellectual impairment, aged 12-17 years, were randomly assigned to an immediate intervention or a delayed-intervention group. All participants were assessed before and after the immediate intervention, and again at follow up, after the delayed intervention took place. Results revealed intervention-related behavioral improvements on adolescents' engagement, question-asking, and physical arousal. Parental reports indicated improved social skills, and reduced ASD symptoms. Adolescents reported on more social encounters, greater empathy, and scored higher on social-skill knowledge. Most of these effects maintained at a 16-week follow-up. Teacher reports' yielded effects only on pre-post intervention analysis. Adolescents' improvement on behavioral engagement predicted parent-reported social skills improvement. Our findings support the effectiveness of the adapted Hebrew version of PEERS((R)) for adolescents with ASD, through significant behavioral and questionnaire-based outcomes, which maintained at follow-up. Autism Res 2018, 11: 1187-1200. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Social-skills groups, which facilitate key social deficits characteristic of ASD, are a popular intervention for adolescents with ASD. Indeed, many treatment protocols have been published, and some have also been research validated. However, there have been inconsistent findings regarding the effectiveness of different protocols, in addition to limited findings of improvement beyond questionnaire reports. This study evaluated the Hebrew adaptation of the PEERS((R)) intervention, a 16-weeks long program, which involves the parents as their adolescents' social coaches. Following the intervention, adolescents improved their social-skills, participated more in social encounters, reported greater empathy, and demonstrated higher social-skill knowledge. A live play-role assessment with an unfamiliar peer indicated that adolescents showed greater involvement, asked more questions and were more physically relaxed during the conversation. Improvements maintained 16 weeks after the intervention was completed. En ligne : http://dx.doi.org/10.1002/aur.1974 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=369