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SAS Evidence
How effective is Secret Agent Society?
Multiple University and community trials including four randomised controlled trials (RCTs) have shown SAS to be effective in improving children’s emotion regulation and social skills when delivered in clinic, school and telehealth contexts.
Results from the initial clinic-based RCT of the SAS Small Group program (formerly called the Junior Detective Training Program) showed 76 per cent of children aged 8 to 12 years with Asperger’s Syndrome who had clinically significant delays in social functioning improved to showing social skills within the range of typically developing children. Improvements in social skills and emotional regulation occurred across home and school and were maintained 5-months after the program ended.
An independent evaluation of the SAS Small Group program conducted in Autism Spectrum Australia (ASPECT) Satellite Classes across five NSW school districts showed that SAS led to improvements in the emotional regulation and social skills of autistic students, with gains maintained one year after the program ended. Results showed that supplementing the school curriculum with SAS led to significantly greater gains in students’ social-emotional functioning than the standard curriculum alone, with SAS shown to be equally effective irrespective of students’ socio-economic status, verbal comprehension level, gender, or age (between 8 and 14 years). This three-year evaluation involved collaboration between ASPECT and academics from the University of Sydney, University of Queensland, Monash University, Griffith University, Westmead Children’s Hospital and King’s College (London).
A pilot evaluation conducted at the University of Queensland demonstrated the effectiveness of the SAS Small Group program for children who had social-emotional challenges, but who were not on the autism spectrum. This trial included students with learning difficulties, ADHD, anxiety disorders and those who had not been formally diagnosed with a psychological disorder. SAS was as effective for these children as for those with an ASD (as demonstrated in previous trials), with significant improvements in children’s emotional-regulation skills, anxiety levels and social functioning shown.
Multiple sites across the world have conducted community implementation projects to demonstrate the benefits of using the SAS Small Group program in local clinical, disability and education services. These include the National Educational Psychology Service in Ireland, Geneva Centre for Autism in Canada, the Children’s Hospital Los Angeles, Buffalo School Districts in USA and Weill Cornell Medicine, New York Presbyterian Hospital, USA, Lucena Clinic in Ireland, Alfred Health in Australia, and both York and Carleton Universities in Canada.
An Australian-based trial of SAS was conducted in mainstream schools comparing the effectiveness of a variant of the SAS Small Group program to the educator-led use of the SAS Computer Game Pack. Results showed that both interventions led to improvements in the emotional regulation and social skills of autistic students, although the small group intervention led to greater gains. The Small Group Program participants also displayed reductions in child anxiety, improvements in student behaviour and enhanced parent and teacher self-efficacy.
A multi-clinic RCT conducted at Weill Cornell Medicine, New York Presbyterian Hospital demonstrated the SAS Small Group program to be more effective than treatment as usual in improving the emotion regulation and social skills of children with ASD, ADHD, anxiety disorders, or any combination of these conditions, with improvements maintained at 6-month follow-up. SAS Small Group was shown to be equally effective regardless of the number and type of diagnoses that children in the trial presented with. Additional research evaluations within child mental health and developmental disability services are currently underway or being prepared for publication by research teams based in Dublin, Ireland, Melbourne, Australia, and York University, Canada.
Gender Effects on Program Outcomes
Findings from several trials described above have shown SAS to be equally effective, regardless of children’s gender. The SAS Small Group Program materials have been updated over time to improve gender diversity and neutrality across graphics, activities, and specific program content in response to feedback from children, parents and professionals.
Individual Delivery
Preliminary evaluations and RCTs of face-to-face individual delivery variants of the SAS Small Group Program resources in Australia and Canada have also shown positive findings for improving the emotion regulation and/or social skills of children with ASDs.
Telehealth and Remote Learning
Telehealth parent coaching variants of SAS have been evaluated through randomised control trials at the University of Queensland. Parents were supported by a trained SAS Facilitator via phone/web link, to deliver either a variant of the SAS Small Group Program or the SAS Computer Game Pack, with results showing improvements in the emotion regulation and social skills of children on the autism spectrum. The group program variant also improved children’s behaviour and parents’ self-efficacy. A pilot project conducted by the Center for Autism and Developing Brain, New York Presbyterian Hospital, USA and a community-based applied research trial led by York University, Canada, support the feasibility and acceptability of the SAS Small Group Program when delivered via telehealth.
Children of Different Ages and Intelligence
Results from the ASPECT Satellite Class Trial and the initial clinic-based randomised controlled trial described above showed SAS to be equally effective irrespective of a child’s age (8-14 years in the ASPECT Trial; 8-12 years in the clinic trial) or IQ (a small number of students had mild to moderate intellectual impairments in the ASPECT Trial; all had an IQ at least within the average range in the clinic trial). Updates to the SAS Small Group overtime include more simplified language and facilitator tips for tailoring to lower levels of intellectual functioning and/or learning difficulties.
References
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Beaumont, R., Pearson, R., and Sofronoff, K. (2019). A novel intervention for child peer relationship difficulties: The Secret Agent Society, Journal of Child and Family Studies, 28(11), 3075-3090. DOI: 10.1007/s10826-019-01485-7
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