title: Social Skills Training for Adolescents With Autism Spectrum Disorder Using Facebook (Project Rex Connect): A Survey Study.
abstract: BACKGROUND
  Adolescents with autism spectrum disorder (ASD) spend more time using electronic screen media than neurotypical peers; preliminary evidence suggests that computer-assisted or Web-based interventions may be beneficial for social skills acquisition. The current generation of adolescents accesses the Internet through computers or phones almost daily, and Facebook is the most frequently used social media platform among teenagers. This is the first research study to explore the use of Facebook as a therapeutic tool for adolescents with ASD.
  
  
  OBJECTIVE
  To study the feasibility and clinical impact of using a Web-based social platform in combination with social skills training for adolescents with ASD.
  
  
  METHODS
  This pilot study enrolled 6 participants (all males; mean age 14.1 years) in an online social skills training group using Facebook. Data was collected on the participants' social and behavioral functioning at the start and conclusion of the intervention. Outcome measures included the Social Responsiveness Scale-2, the Social Skills Improvement System Rating Scale, and the Project Rex Parent Survey. Participants were surveyed at the conclusion of the intervention regarding their experience.
  
  
  RESULTS
  No statistically significant differences in measurable outcomes were observed. However, the online addition of Facebook was well received by participants and their parents. The Facebook intervention was able to be executed with a careful privacy protocol in place and at minimal safety risk to participants.
  
  
  CONCLUSIONS
  The utilization of Facebook to facilitate delivery of social skills training for adolescents with ASD appears to be feasible, although the clinical impact of such an addition is still unclear. It is important to note that social difficulties of participants persisted with the addition of the online platform and participants still required assistance to engage with peers in an online environment. A Web-based intervention such as the one utilized in this study has the potential to reach a mass number of patients with ASD and could address disparities in access to in-person treatment services. However, the complexity and evolving nature of Facebook's website and privacy settings leads to a number of unique online safety concerns that may limit its clinical utility. Issues encountered in our study support the development of an alternative and closed Web-based social platform designed specifically for the target audience with ASD; this platform could be a safer and more easily moderated setting for aiding in social skills development. Despite a small sample size with no statistically significant improvements of target symptoms, the use of electronic screen media as a therapeutic tool for adolescents with ASD is still a promising area of research warranting further investigation. Our study helps inform future obstacles regarding feasibility and safety.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
authors.forename: McLeod Frampton
authors.identifier: http://orcid.org/0000-0001-7567-1835
authors.initials: MF
authors.lastname: Gwynette
authors.affiliation: Brown University, Providence, RI, United States.
authors.forename: Danielle
authors.identifier: http://orcid.org/0000-0001-7837-9776
authors.initials: D
authors.lastname: Morriss
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
authors.forename: Nancy
authors.identifier: http://orcid.org/0000-0003-3779-1048
authors.initials: N
authors.lastname: Warren
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
authors.forename: James
authors.identifier: http://orcid.org/0000-0002-5908-6094
authors.initials: J
authors.lastname: Truelove
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
authors.forename: Jennifer
authors.identifier: http://orcid.org/0000-0002-0818-5412
authors.initials: J
authors.lastname: Warthen
authors.affiliation: Department of Psychology, Loyola University of Maryland, Baltimore, MD, United States.
authors.forename: Charles Paul
authors.identifier: http://orcid.org/0000-0001-7526-4121
authors.initials: CP
authors.lastname: Ross
authors.affiliation: College of Charleston, Charleston, SC, United States.
authors.forename: George
authors.identifier: http://orcid.org/0000-0002-1377-7842
authors.initials: G
authors.lastname: Mood
authors.affiliation: Clemson University, Clemson, SC, United States.
authors.forename: Charlotte Anne
authors.identifier: http://orcid.org/0000-0003-3212-1678
authors.initials: CA
authors.lastname: Snook
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.|Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, United States.|Ralph H. Johnson VAMC, Charleston, SC, United States.
authors.forename: Jeffrey
authors.identifier: http://orcid.org/0000-0001-5761-8125
authors.initials: J
authors.lastname: Borckardt
keywords: autism; social media; social skills