Feasibility and Preliminary Effectiveness of the Arabic Version of the Program for the Education and Enrichment of Relational Skills (Peers-AA) for Autistic Adolescents in Saudi Arabia.

Abstract

Autism spectrum disorder is a neurodevelopmental condition characterized by significant deficits in social skills that impact youths' academic, adaptive, and psychological functioning. Social skills deficits are imperative targets for interventions. This pilot study explored the feasibility and preliminary effectiveness of the translated and culturally adapted Arabic version of the UCLA PEERS^® among autistic adolescents (ages 11-17) in Saudi Arabia. The study utilized a quasi-experimental design, collected pre-, post-, and three-month follow-up data, and used focus group discussion and a prospective cohort study with pre- and postintervention assessments. Feasibility was assessed based on subjective methods: recruitment, retention, attendance rate, comprehension of the translated material, and homework completion. Effectiveness was evaluated based on postintervention and three-month follow-up interval changes in scores on three outcome measures: the Social Responsiveness Scale, Second Edition, Child Behavior Checklist, QSQ, and Test of Adolescent Social Skills Knowledge. Written informed consent was obtained from caregivers, and oral assent was obtained from the study participants. These initial findings support the feasibility and preliminary effectiveness of the PEERS-AA. The outcomes suggested significant improvement in the subjects' social skills and knowledge of social etiquette, as reported by the adolescents and their parents, with improvements retained at the three-month follow-up. However, there was no reported improvement in the number of get-togethers, which was likely explained by COVID-19 pandemic restrictions and culture-related considerations. This study represents the first cross-cultural validation trial of an established evidence-based social skills intervention for autistic adolescents in an Arabic-speaking country. The PEERS-AA manual's feasibility and preliminary effectiveness indicate its promising applicability for interventions and research. Further research to evaluate the generalizability and long-term effectiveness of the PEERS-AA program is needed.