Social skills training

Social skills training (SST) is a group program that aims to support social communication and interaction, often through role-play, modeling, peer mediation or group activities.¹ It is often targeted at autistic children, and adults may also be offered it after diagnosis.¹ The curricula teach social rules held to be necessary for social competence.² Most programs work on how the autistic person treats other people: starting conversations, keeping up a back-and-forth, sharing enjoyment and working out what others want.²

The best-known program is PEERS, short for the Program for the Education and Enrichment of Relational Skills. It is a caregiver-assisted group course, developed at the University of California, Los Angeles, that teaches rules for making and keeping friends.³ A second program, KONTAKT, is a manualized social skills group training used and evaluated in Sweden.⁴

In a Swedish trial, 296 children and adolescents aged 8 to 17 who had autism and no intellectual disability were assigned at random either to KONTAKT or to their usual care.⁴ In an exploratory look at whether the program worked better for some children, the effects on the main measure appeared only in parent ratings, for the older children and for the girls; the teachers who rated the children without knowing their group saw no effect. The trial also reported moderate gains in adaptive functioning and in how clinicians rated the children, and its authors call the overall effects modest and inconsistent.⁴

Two later trials compared the social skills group with another social group. In the first, 90 autistic adolescents aged 12 to 17, most of them boys, who spoke and had IQs above 70 were assigned at random to KONTAKT or to a group cooking program of the same length. Both groups made large progress toward social goals they had chosen themselves, and the KONTAKT group made a little more progress on those goals.⁵ In the second, 84 autistic children aged 8 to 12 were assigned at random to KONTAKT or to a social art group. Both improved, and the two groups did not differ on the main measure; the KONTAKT children enjoyed the sessions more, and the only outcome that favored KONTAKT was the quality of their friendships.⁶

PEERS has also been tested in adolescents. A randomized trial of the program, run by its developers, reported that the teenagers improved on social skills and social knowledge and interacted with peers more often, with most gains still there 14 weeks later; teachers who rated them independently saw improvement in social skills and assertion.⁷ A Polish version, tested with 29 adolescents aged 11 to 16, found large gains that mostly held at six months, and lists a developer of the program among its authors.⁸

Pooled across studies, the gains are small to moderate. A meta-analysis of PEERS alone, 31 studies, reported gains in social-skills knowledge and in the ability to apply social skills, and found that caregivers and teachers rated the results differently.⁹ A meta-analysis of 17 studies of children aged 3 to 18 reported small to moderate gains, but pooling the four studies that measured social responsiveness found no significant difference between the training group and the control group.¹⁰ A further meta-analysis of randomized trials alone, 25 studies whose participants averaged 13 years old and were 80% male, reported a moderate change in social responsiveness, the measure of how well a child responds to social approaches; that figure describes change within each group over the trial rather than a difference between the program and a comparison, so it says less than it appears to.¹¹

Social skills training is also offered to autistic adults, usually through programs adapted from the children's versions. The two randomized trials of PEERS for young adults were run by the program's developers at UCLA. In the first, a small pilot, the adults reported less loneliness and better knowledge of social skills.¹² In the second, 22 young adults aged 18 to 24 were assigned at random to the program or to a delayed-treatment group, and those who took part reported better social skills and social engagement, with most of the gains holding at 16 weeks.³ Both trials compared the program with waiting rather than with another treatment.^12,3

Pooled across the adult trials, the picture is similar. A meta-analysis of five randomized trials, 145 adults in all, reported large effects on social responsiveness as rated by parents, and warned that the evidence is of moderate quality and the effects may be inflated; no trial used an active comparison.¹³ A wider meta-analysis of interventions for autistic adults of all kinds, 35 studies and 1,631 adults, most of them compared with usual care or a waiting list, found small to moderate effects on social cognition, mental health and quality of life, and no significant effect on behavior, thinking skills, daily living or employment. Its findings are not specific to social skills training.¹⁴

On campus, one program adapts PEERS for college students. In a small study that did not assign people at random, six autistic students and five non-autistic partners took part; the students reported better social reciprocity, social-skills knowledge rose in both groups, and two of the six students showed reliable change.¹⁵

The dispute is whether social skills training helps autistic people or teaches them to hide who they are. Whether it works is argued over, so the parts below say what the studies do and do not support.

What is not disputed. The programs teach social rules in a group, and their trials mostly report how well participants perform social skills, or how "socially responsive" a parent or the participant rates them. Whether that performance makes people's lives better is a separate question, and the trials often measure one without the other.

What the studies show. No trial has measured whether social skills training increases masking. No study found as of October 2026 has tested it. The closest evidence comes from a different treatment: in 71 autistic adults who took an eight-week cognitive behavioral therapy group for social anxiety, a measure of camouflaging did not rise, and the people whose anxiety fell most showed the largest falls in camouflaging. That study had no comparison group, and the link between anxiety and masking in it is a correlation, not an effect of the treatment.¹⁶ In interviews, some autistic adults described negative experiences of the training and said that using social skills that felt inauthentic could lead them to mask.¹

Who holds which view. Some researchers argue the taught rules do not match what research on social interaction shows, and that following them can work against a person's authenticity and add to stigma; Kristen Bottema-Beutel and colleagues made that argument in 2018.² Autistic writers make a sharper version, describing the training as a course in masking (see below and Why people mask). The programs' developers present the training as effective, and the UCLA team that runs PEERS reports gains in its trials.³ In one set of interviews, 18 autistic young adults said they wanted to build social skills and to improve their self-advocacy, but also to keep their own identity and choose when to adapt rather than be trained to fit in.¹⁷

What would settle it. A randomized trial with an active comparison, measuring masking, authenticity and mental health alongside social skills, with its outcomes fixed in advance and its design made with autistic people, would show whether the training helps participants on their own terms or mainly teaches them to perform. No such trial was found as of October 2026.

The critique of social skills training rests on an idea from research: that misunderstandings between autistic and non-autistic people run both ways, so the difficulty sits in the interaction rather than in the autistic person alone. The full account of that research is in Double empathy.¹⁸

What autistic people say supports the idea. In two online focus groups, 23 Italian autistic adults, none with an intellectual disability, described the difficulty of reading non-autistic people as matched by the difficulty non-autistic people have in reading them.¹⁹ The same theme runs through the interviews about social skills training, where some adults asked for the training to fall on non-autistic people instead, teaching them how to socialize with autistic people.¹ A group of clinicians and researchers has taken that further, proposing communication partner training that works with the autistic adult and their non-autistic partner together and changes the setting, rather than only the autistic person.²⁰

Most social-skills work with children happens at school. A systematic review of 56 school-based programs for including autistic pupils in mainstream schools found that the programs made school activities easier to reach, but did not necessarily improve the give-and-take and friendship between autistic pupils and their peers.²¹ Few of the studies changed the physical environment, and the review argues for shifting attention from the individual child's social skills to the setting around them.²¹

Many autistic writers describe social skills training as a course in appearing non-autistic. Devon Price calls the standard programs a list of "the normative qualities we supposedly lack", from making eye contact to filtering out "oversharing", and writes that by the end "Autistics are expected to ... mask".^c1 Orion Kelly, an autistic writer and parent, describes watching his son's therapy and finds that "some early intervention therapies are pure acting classes teaching Autistic kids how to play the role of a neurotypical person".^c2 Price also lists what the programs target: starting conversations, keeping up a back-and-forth, sharing enjoyment and working out what others are interested in, none of which asks what the autistic person needs.^c1

Other writers make a simpler point about which skills matter and who should change. Luke Beardon, an autistic writer and trainer, writes that "the notion that you lack social skills is abhorrent to me", and that skills that suit the non-autistic majority, such as eye contact, should not be forced on anyone.^c3