Program for the Education and Enrichment of Relationship Skills (PEERS®) for Adolescents

Note: The Program for the Education and Enrichment of Relationship Skills (PEERS®) for Adolescents program was not responsive to the CEBC's inquiry. The following information was obtained from publicly available sources.

About This Program

Target Population: Teens in middle school or high school who are interested in learning ways to help them make and keep friends including those with an autism spectrum disorder

Program Overview

Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents is a 14-week social skills intervention designed for motivated teens in middle school or high school who are interested in learning ways to help them make and keep friends. During each group session, teens are taught important social skills and are given the opportunity to practice these skills in session during real play activities (e.g., playing sports, board games, etc.).

Parents are taught how to assist their teens in making and keeping friends by providing feedback through coaching during weekly socialization homework assignments.

Logic Model

The program representative did not provide information about a Logic Model for Program for the Education and Enrichment of Relationship Skills (PEERS®) for Adolescents.

Manuals and Training

Publicly available information indicates there is a manual that describes how to deliver this program, and there is some training available for this program.
See contact info below.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Laugeson, E. A., Frankel, F., Mogil, C., & Dillon, A. R. (2009). Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(4), 596–606. https://doi.org/10.1007/s10803-008-0664-5

Type of Study: Randomized controlled trial
Number of Participants: 33

Population:

  • Age — 13–17 years (Mean=14.6 years)
  • Race/Ethnicity — 14 Caucasian, 6 Hispanic/Latino, 6 Mixed Ethnicities, 4 Asian, 3 African American, and 3 Middle Eastern
  • Gender — 28 Male and 5 Female
  • Status — Participants were teenagers with autism spectrum disorders (ASD).

Location/Institution: Regional Centers and schools throughout Southern California

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Program for the Education and Enrichment of Relational Skills (PEERS®) [now called Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents] in comparison with a matched delayed treatment control group, to improve friendship quality and social skills among teens with autism spectrum disorders. Participants were randomly assigned to one of two conditions: PEERS® or delayed treatment control group. Measures utilized include the Kaufman Brief Intelligence Test-Second Edition (KBIT-2), the Vineland Adaptive Behavior Scales-Second Edition (Vineland-II) Survey Form, the Social Skills Rating Scale (SSRS), the Quality of Play Questionnaire (QPQ), the Test of Adolescent Social Skills Knowledge (TASSK), and the Friendship Qualities Scale (FQS). Results indicate that in comparison with the delayed treatment control group, the PEERS® group significantly improved their knowledge of social skills, increased frequency of hosted get-togethers, and improved overall social skills as reported by parents. Possibly due to poor return rate of questionnaires, social skills improvement reported by teachers was not significant. Limitations include parent outcome may have been biased due to the parent involvement in the intervention; the durability of outcome was not measured after treatment ended; the diagnostic assessment was limited due to the lack of a standard measure of autistic symptomatology; although outcome on the SSRS-P was statistically significant, this instrument was not designed for the ASD population, and thus it may not sufficiently assess the specific social issues of this population; and lack of follow-up.

Length of controlled postintervention follow-up: None.

Laugeson, E. A., Frankel, F., Gantman, A., Dillon, A. R., & Mogil, C. (2012). Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program. Journal of Autism and Developmental Disorders, 42,1025–1036. https://doi.org/10.1007/s10803-011-1339-1

Type of Study: Randomized controlled trial
Number of Participants: 28

Population:

  • Age — 12–17 years of age (M=14.6 years)
  • Race/Ethnicity — 15 Caucasian, 6 Hispanic/Latino, 5 Other Ethnic Group, 4 Asian, and 1 African American
  • Gender — 23 Male and 5 Female
  • Status — Participants were middle school and high school adolescents with autism spectrum disorders (ASD).

Location/Institution: UCLA Parenting and Children's Friendship Program, the UCLA Autism Evaluation Clinic, and Regional Centers and schools throughout Southern California

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy and durability of the Program for the Education and Enrichment of Relational Skills (PEERS®) program for high-functioning adolescents with autism spectrum disorders (ASD) [now called Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents]. Participants were randomly assigned to one of two conditions: PEERS® or delayed treatment control group. Measures utilized include the Kaufman Brief Intelligence Test-Second Edition (KBIT-2), the Vineland Adaptive Behavior Scales-Second Edition, Survey Form (Vineland-II), the Social Skills Rating Scale (SSRS), the Quality of Play Questionnaire (QPQ), the Test of Adolescent Social Skills Knowledge (TASSK), and the Friendship Qualities Scale (FQS). Results indicate that teens receiving PEERS® significantly improved their social skills knowledge, social responsiveness, and overall social skills in the areas of social communication, social cognition, social awareness, social motivation, assertion, cooperation, and responsibility, while decreasing autistic mannerisms and increasing the frequency of peer interactions. Independent teacher ratings revealed significant improvement in social skills and assertion from pretest to follow-up assessment. Examination of durability of improvement revealed maintenance of gains in nearly all domains with additional treatment gains at a 14-week follow-up assessment. Limitations include lack of comprehensive diagnostic assessment, parent outcome may have been biased due to the parent involvement in the intervention, the generalizability of these findings is questionable given the small sample size, and the length of follow-up.

Length of controlled postintervention follow-up: 14 weeks.

Laugeson, E. A., Ellingsen, R., Sanderson, J., Tucci, L., & Bates, S. (2014). The ABC's of teaching social skills to adolescents with autism spectrum disorder in the classroom: The UCLA PEERS® program. Journal of Autism and Developmental Disorders, 44(9), 2244–2256. https://doi.org/10.1007/s10803-014-2108-8

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 81

Population:

  • Age — Teachers: 29–59 years (Mean=27 years); Children: 12–14 years (Mean=13 years)
  • Race/Ethnicity — Teachers: 50% Caucasian, 25% Asian American, 13% Hispanic/Latino, and 13% African American; Children: 69% Caucasian, 14% Hispanic/Latino, 5% African American, 4% Asian American, 4% Middle Eastern, and 4% Unknown
  • Gender — Teachers: 87% Female; Children: 88% Male and 12% Female
  • Status — Participants were middle school students with autism spectrum disorders (ASD) along with their parents and teachers.

Location/Institution: Village Glen Middle School

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine change in social functioning for adolescents with high-functioning autism spectrum disorders (ASD) following the implementation of a school-based, teacher-facilitated social skills intervention known as Program for the Education and Enrichment of Relational Skills (PEERS®). Participants were assigned to the PEERS® treatment condition or an alternative social skills curriculum. Measures utilized include the Social Responsiveness Scale (SRS), the Social Skills Rating Scale (SSRS), the Quality of Play Questionnaire (QPQ), the Social Anxiety Scale (SAS), the Friendship Qualities Scale (FQS), the Piers-Harris Self-Concept Scale-Second Edition (PHS-2), and the Test of Adolescent Social Skills Knowledge (TASSK). Results indicate that in comparison to an active treatment control group, participants in the PEERS® treatment group significantly improved in social functioning in the areas of teacher-reported social responsiveness, social communication, social motivation, social awareness, and decreased autistic mannerisms, with a trend toward improved social cognition on the Social Responsiveness Scale. Adolescent self-reports indicate significant improvement in social skills knowledge and frequency of hosted and invited get-togethers with friends, and parent-reports suggest a decrease in teen social anxiety on the Social Anxiety Scale at a trend level. Limitations include lack of a randomized control trial (RCT) design, lack of comprehensive diagnostic assessment, lack of knowledge regarding the benefit of parent participation in the intervention, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Schohl, K. A., Van Hecke, A. V., Carson, A. M., Dolan, B., Karst, J., & Stevens, S. (2014). A replication and extension of the PEERS intervention: Examining effects on social skills and social anxiety in adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(3), 532–545. https://doi.org/10.1007/s10803-013-1900-1

Type of Study: Randomized controlled trial
Number of Participants: 58

Population:

  • Age — 11–16 years (Mean=13.65 years)
  • Race/Ethnicity — 52 Caucasian, 3 African American, 2 Unknown, and 1 Asian
  • Gender — 47 Male and 11 Female
  • Status — Participants were adolescents with autism spectrum disorders (ASD).

Location/Institution: A medium-sized Midwestern city

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the Program for the Education and Enrichment of Relational Skills (PEERS®) for improving social skills and social anxiety. Participants were randomly assigned to one of two conditions, either PEERS® or the waitlist control group (WL). Measures utilized include the Kaufman Brief Intelligence Test-Second Edition (KBIT-2), the Autism Diagnostic Observation Schedule-Generic (ADOS-G), the Vineland Adaptive Behavior Scales-Second Edition (Vineland-II) Survey Form, the Test of Adolescent Social Skills Knowledge (TASSK), the Quality of Socialization Questionnaire (QSQ), the Friendship Qualities Scale (FQS), the Social Interaction Anxiety Scale (SIAS), the Social Responsiveness Scale (SRS), the Social Skills Rating System (SSRS), and the Adolescent Mental Status Checklist. Results indicate that in comparison to the WL group, the PEERS® group significantly improved their knowledge of PEERS® concepts and friendship skills, increased their number of get-togethers, and decreased their levels of social anxiety, core autistic symptoms, and problem behaviors from pre-to-post PEERS®. Limitations include lack of generalizability due to the sample including mostly males who were Caucasian, possible parent rating bias due to the parent involvement in the intervention, a large amount of missing teacher data, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Yoo, H. J., Bahn, G., Cho, I. H., Kim, E. K., Kim, J. H., Min, J. W., Lee, W. H., Seo, J. S., Jun, S. S., Bong, G., Cho, S., Shin, M. S., Kim, B. N., Kim, J. W., Park, S., & Laugeson, E. A. (2014). A randomized controlled trial of the Korean version of the PEERS® parent-assisted social skills training program for teens with ASD. Autism Research, 7(1), 145–161. https://doi.org/10.1002/aur.1354

Type of Study: Randomized controlled trial
Number of Participants: 47

Population:

  • Age — Parents: 46–47 years; Children: 12–18 years
  • Race/Ethnicity — Parents: 100% Korean; Children: 100% Korean
  • Gender — Parents: 99% Female; Children: Not specified
  • Status — Participants included teens with a diagnosis of ASD and a verbal intelligence quotient (IQ) greater than or equal to 65.

Location/Institution: Korea

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the feasibility and treatment efficacy of a Korean version of Program for the Education and Enrichment of Relational Skills (PEERS®) for enhancing social skills in adolescents and young adults with autism spectrum disorders (ASD). Participants were randomly assigned to a treatment group (TG) or delayed treatment control group (CG). Measures utilized include the Autism Diagnostic Observation Schedule-Generic (ADOS-G), the Korean version of the Vineland Adaptive Behavior Scale (EHWA-VABS), the Test of Adolescent Social Skills Knowledge (TASSK), the Quality of Socialization Questionnaire (QSQ), the Social Communication Questionnaire (SCQ), the Social Responsiveness Scale (SRS), the Korean version of the Social Skills Rating System (K-SSRS), the Child Depression Inventory (CDI), the State and Trait Anxiety Inventory for Children (STAIC-T and STAIC-S), the Korean version of the Child Behavior Checklist (K-CBCL), the Beck Depression Inventory (BDI,) and the State and Trait Anxiety Inventory (STAI-T and STAI-S). Results indicate that the TG showed significant improvement in communication and social interaction domain scores on the Autism Diagnostic Observation Schedule interpersonal relationship and play/leisure time on the subdomain scores of the Korean version of the Vineland Adaptive Behavior Scale; social skills knowledge total scores on the Test of Adolescent Social Skills Knowledge-Revised; and decreased depressive symptoms on the Child Depression Inventory following treatment. Analyses of parental outcomes reveal a significant decrease in maternal state anxiety in the TG after controlling for potential confounding variables. Despite cultural and linguistic differences, the PEERS® social skills intervention appears to be efficacious for teens with ASD in Korea with modest cultural adjustment. Participants receiving the PEERS® treatment showed significant improvement in social skills knowledge, interpersonal skills, and play/leisure skills, as well as a decrease in depressive symptoms and ASD symptoms. Limitations include lack of direct observation data of teens at the 3-month follow-up, ADOS-G administration was only partially blinded because of the timing of testing among groups, lack of ratings from a third party (e.g., teachers), lack of treatment acceptability measures for the participants and their families, and length of follow-up.

Length of controlled postintervention follow-up: 3 months.

Matthews, N. L., Orr, B. C., Warriner, K., DeCarlo, M., Sorensen, M., Laflin, J., & Smith, C. J. (2018). Exploring the effectiveness of a peer-mediated model of the PEERS curriculum: A pilot randomized control trial. Journal of Autism and Developmental Disorders, 48(7), 2458–2475. https://doi.org/10.1007/s10803-018-3504-2

Type of Study: Randomized controlled trial
Number of Participants: 47

Population:

  • Age — Parents: 46–47 years; Children: 13–17 years
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were high school teens with autism spectrum disorder (ASD).

Location/Institution: A nonprofit autism center

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare the effectiveness of a peer-mediated Program for the Education and Enrichment of Relational Skills (PEERS®) model [now called Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents], characterized by a 1-to-1 ratio of typically developing (TD) adolescents to adolescents with autism spectrum disorder (ASD), to the traditional PEERS® curriculum, and a delayed treatment control group (DTC). Participants were randomly assigned to a traditional PEERS® curriculum, a peer-mediated PEERS curriculum, or to a delayed treatment control group. Measures utilized include the Kaufman Brief Intelligence Test-Second Edition (KBIT-2), the Social Responsiveness Scale (SRS), the Social Skills Improvement System (SSIS), the Hosted and Invited Get-Togethers, the parent and adolescent version of the Quality of Socialization Questionnaire (QSQ-P and QSQ-A), the Test of Adolescent Social Skills Knowledge (TASSK), the Social Interaction Anxiety Scale (SIAS), the Revised UCLA Loneliness Scale (R-UCLA), the Social Distance Scale, and the Autism Knowledge Questionnaire (AKQ). Results indicate a modest advantage in social skills knowledge and social functioning for participants in the peer-mediated PEERS® curriculum relative to traditional PEERS®, and gains in social skills knowledge, social functioning, and reductions in loneliness were maintained in one or both treatment groups at a 4-month follow-up. Typically developing peer mentors showed improvements in social skills knowledge, and marginal improvements in autism knowledge and loneliness. Limitations include the small sample size, findings may not generalize to more diverse populations, and length of follow-up.

Length of controlled postintervention follow-up: 4 months.

Shum, K. K.-M., Cho, W. K., Lam, L. M. O., Laugeson, E. A., Wong, W. S., & Law, L. S. K. (2019). Learning how to make friends for Chinese adolescents with autism spectrum disorder: A randomized controlled trial of the Hong Kong Chinese version of the PEERS® intervention. Journal of Autism and Developmental Disorders, 49(2), 527–541. https://doi.org/10.1007/s10803-018-3728-1

Type of Study: Randomized controlled trial
Number of Participants: 72

Population:

  • Age — Parents: Not specified; Children: 11–15 years (Mean=13.5)
  • Race/Ethnicity — Parents: 100% Chinese; Children: 100% Chinese
  • Gender — Parents: Not specified; Children: 79% Male and 21% Female
  • Status — Participants were adolescents with high-functioning autism spectrum disorders (ASD).

Location/Institution: Hong Kong

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the treatment efficacy of Program for the Education and Enrichment of Relational Skills (PEERS) among Chinese adolescents with autism spectrum disorder (ASD) in Hong Kong. Participants were randomly assigned to a treatment or waitlist control group. Measures utilized include the Wechsler Intelligence Scale for Children-Fourth Edition [Hong Kong] (WISC-IV[HK]), the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the Test of Adolescent Social Skills Knowledge (TASSK), the Quality of Socialization Questionnaire (QSQ), the Social Responsiveness Scale, Second Edition (SRS-2) School-Age Form (Hong Kong Chinese version), the Adaptive Behavior Assessment System, Second Edition (ABAS–II), and the Adolescent Social Behavior Scale (ASBS). Results indicate that PEERS® significantly improved social skills knowledge and social functioning and reduced autistic mannerisms. Treatment outcomes were maintained for 3 months after training and replicated in the control group after delayed treatment. Limitations include sample size, lack of generalizability due to ethnicity of population, and poor return rate of surveys from teachers and study participants.

Length of controlled postintervention follow-up: 3 months.

Matthews, N. L., Laflin, J., Orr, B. C., Warriner, K., DeCarlo, M., & Smith, C. J. (2020). Brief report: Effectiveness of an accelerated version of the PEERS® social skills intervention for adolescents. Journal of Autism and Developmental Disorders, 50, 2201–2207.https://doi.org/10.1007/s10803-019-03939-9

Type of Study: Randomized controlled trial
Number of Participants: 63

Population:

  • Age — Mean=15.10–15.45 years
  • Race/Ethnicity — 73% Caucasian, 18% Hispanic, and 9% African American
  • Gender — 81% Male
  • Status — Participants were students with autism spectrum disorder (ASD) or cognitive deficits (intellectual disabilities or borderline intellectual functioning).

Location/Institution: A private school in a large metropolitan area

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare outcomes of an accelerated version of Program for the Education and Enrichment of Relational Skills (PEERS®) or the traditional PEERS® program [now called Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents]. Participants were randomly assigned to an accelerated version of PEERS® that met twice weekly for 7 weeks or the traditional PEERS® program that met once weekly for 14 weeks. Measures utilized include the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), the Kaufman Brief Intelligence Test-Second Edition (KBIT-2), the Vineland Adaptive Behavior Scales Survey (Vineland-II) Interview Form, the Test of Adolescent Social Skills Knowledge (TASSK), the Quality of Socialization Questionnaire (QSQ), the Social Responsiveness Scale-Second Edition (SRS-2), and the Social Skills Improvement System (SSIS). Results indicate the accelerated PEERS® group demonstrated improvements consistent with previous research on the program, and treatment response did not differ significantly between the accelerated PEERS® and traditional PEERS® groups. Limitations include the small sample size, the sample was predominantly Caucasian and middle- to upper-middle class, and the lack of follow-up.

Length of controlled postintervention follow-up: None.

Yamada, T., Miura, Y., Oi, M., Akatsuka, N., Tanaka, K., Tsukidate, N., Yamamoto, T., Okuno, H., Nakanishi, M., Taniike, M., Mohri, I., & Laugeson, E. A. (2020). Examining the treatment efficacy of PEERS in Japan: Improving social skills among adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50, 976–997. https://doi.org/10.1007/s10803-019-04325-1

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 28

Population:

  • Age — Mean=13–13.17 years
  • Race/Ethnicity — Children: 100% Japanese
  • Gender — 19 Male and 9 Female
  • Status — Participants were elementary and middle school adolescents students with autism spectrum disorder (ASD).

Location/Institution: Japan

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of the Japanese version of the Program for the Education and Enrichment of Relational Skills (PEERS®) [now called Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents], which focuses on improving social functioning through making friends and maintaining good relationships for adolescents with autism spectrum disorder (ASD) without intellectual disabilities. Participants were assigned to PEERS® or to a waitlist control. Measures utilized include the Japanese versions of all of the following measures: the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), the Social Communication Questionnaire (SCQ), the Test of Adolescent Social Skills Knowledge (TASSK), the Quality of Play Questionnaire-Adolescent (QPQ-A), the Quality of Play Questionnaire-Parent (QPQ-P), the Vineland Adaptive Behavior Scales-Second Edition (VABS-2), the Child Behavior Checklist (CBCL), and the Depression Self-Rating Scale for Children (DSRS-C). Results indicate that with linguistic and cultural modifications, PEERS® is effective in improving social functioning for adolescents with ASD in Japan. Positive results were found specifically in the areas of socialization, communication, knowledge of social skills, autistic mannerisms, and behavioral and emotional problems. In addition, most treatment gains were maintained at a 3-month follow-up assessment. Limitations include nonrandomization of participants, the small sample size, the lack of blinded assessments, lack of generalizability due to ethnicity of the population, and the length of follow-up.

Length of controlled postintervention follow-up: 3 months.

Veytsman, E., Baker, E., Martin, A. M., Choy, T., Blacher, J., & Stavropoulos, K. (2023). Perceived and observed treatment gains following PEERS: A preliminary study with Latinx adolescents with ASD. Journal of Autism and Developmental Disorders, 53(3), 1175–1188. https://doi.org/10.1007/s10803-022-05463-9

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 17

Population:

  • Age — ASD Group: Mean=14.2 years; Neurotypical (TD) Group: Mean=13.1 years
  • Race/Ethnicity — 100% Latino
  • Gender — ASD Group: 77% Male; TD Group: 82% Male
  • Status — Participants were Latinx adolescents diagnosed with ASD or were neurotypical.

Location/Institution: California

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of the Program for the Education and Enrichment of Relational Skills (PEERS®) [now called Program for the Education and Enrichment of Relational Skills (PEERS®) for Adolescents] on Latinx families. Participants were attendees of the PEERS group or members of the non-treatment control group. Measures utilized include the Autism Diagnostic Observation Schedule, 2nd edition (ADOS 2), Wechsler Abbreviated Scale of Intelligence (WASI II), Social Skills Improvement System (SSIS), Social Responsiveness Scale, 2nd Edition (SRS 2), Piers Harris Self Concept Scale Second Edition (PH 2), Quality of Socialization Questionnaire (QSQ), Friendship Quality Scale (FQS), Test of Adolescent Social Skills Knowledge—Revised (TASSK R), Contextual Assessment of Social Skills (CASS), Social Interaction Anxiety Scale (SIAS), and the Loneliness and Social Dissatisfaction Questionnaire (LSDQ). Results indicate that adolescents with ASD and their parents perceived improvements in social functioning following the intervention, which were maintained four months later and corroborated by improvements in conversational skills. Limitations include small sample size, lack of randomization, and follow-ups being changed from in-person to virtual for the second cohort of participants due to the COVID-19 pandemic.

Length of controlled postintervention follow-up: 4 months.

Additional References

No reference materials are currently available for Program for the Education and Enrichment of Relationship Skills (PEERS®) for Adolescents.

Contact Information

UCLA PEERS Clinic
Website: www.semel.ucla.edu/peers
Email:
Phone: (310) 267-3377

Date Research Evidence Last Reviewed by CEBC: March 2024

Date Program Content Last Reviewed by Program Staff: February 2024

Date Program Originally Loaded onto CEBC: June 2021