Increasing the appropriate demonstration of affectionate behavior, in children with Asperger syndrome, high functioning autism, and PDD-NOS: A randomized controlled trial

• Program to teach affectionate behavior developed specifically for children with AS.
• Used to improve understanding of friendship skills.
• Randomized controlled trial.
• Improved demonstration of appropriate affectionate behavior.

Individuals with Asperger syndrome (AS) can have difficulty understanding, receiving and expressing appropriate affectionate behavior (Attwood, 2007). The purpose of the current study was to further evaluate the effectiveness of a cognitive–behavioral intervention program aimed at improving affectionate communication and friendship skills in children with AS. The pilot study of this program (Sofronoff, Eloff, Sheffield, & Attwood, 2011) was extended in the current study in a randomized controlled trial. Fifty-eight children with AS (aged 7–12 years) participated in the program and were randomly assigned to the intervention (n = 29) or waitlist (n = 29) condition. Parent-report measures indicated that, relative to the waitlist group, children in the intervention group showed significantly greater improvements in the overall appropriateness of their affectionate behavior to others after the program. Specifically, improvements were reported in the appropriate expression of affection to others and this finding was maintained at three-month follow-up. Parent-report measures further demonstrated significant improvements in children's communication of empathy to others at follow-up. Children's understanding of the purpose of affection approached significance. Overall, this study indicates that children with AS can be taught to interact more appropriately. The limitations and suggestions for future research are discussed.