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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. (2015). The Secret Agent Society social-emotional skills training program for children with Autism Spectrum Disorders. The Australian Clinical Psychologist, 1(2), 27-29.

Beaumont, R., Hinton, S., and Sofronoff. (2018). The Secret Agent Society: Upskilling Teachers in the Delivery of a Game-Based Social Skills Youth Program. In D. Mentor (Ed.). Computer Mediated Learning for Workforce Development (pp 22-40). Hershey, PA: IGI Global. ISBN: 978152254110

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

Beaumont, R., Rotolone, C., & Sofronoff, K. (2015). The Secret Agent Society social skills program for children with High-Functioning Autism Spectrum Disorders: A comparison of two school variants. Psychology in the Schools, 52(4), 390-402. DOI: 10.1002/pits.21831

Beaumont, R, Smith-Merry, J., Costley, D., Howlin, P., Sofronoff, K., Roberts, J……Einfeld, S. (2019). Implementation, evaluation and maintenance of a social emotional skills training program for children with an Autism Spectrum Disorder in a specialist school setting. International Journal of Special Education, 34(1), 95-108.

Beaumont, R., & Sofronoff, K. (2008). A multi-component social skills intervention for children with Asperger syndrome: The Junior Detective Training Program. Journal of Child Psychology and Psychiatry, 49(7), 743-753.

Beaumont, R., Walker, H., Weiss, J., & Sofronoff, K. (2021). Randomized controlled trial of a video gaming‑based social skills program for children on the Autism Spectrum. Journal of Autism and Developmental Disorders, 51, 3637-3650. https://doi.org/10.1007/s10803-020-04801-z

Costley, D., Baldwin, S., Clark, T., Howlin, P., Taffe, J. R., Beaumont, R., … Sofronoff, K. (2020). The Association Between Parent Engagement and Child Outcomes in Social Skills Training Programs : Discovering the Secret Agent Society in Partnership. Australasian Journal of Special and Inclusive Education, 44(1), 46–59. https://doi.org/10.1017/jsi.2020.2

Cullen, A.M. (2016). Emotion and social problem solving using the secret agent society computer game with a pupil with an autism spectrum disorder in an Irish mainstream school setting. LEARN, 38, 86-94.

Einfeld, S.L., Beaumont, R., Clark, T., Clarke, K.S., Costley, D., Gray, K.M…Howlin, P. (2018). School-based social skills training for young people with autism spectrum disorders. Journal of Intellectual and Developmental Disability, 43(1), 29-39.

Gasparro, S., Bennett, S., Wyka, K., Temkin-Yu, A., Damianides, A., Beaumont, R. (2023). The Effect of the Secret Agent Society Group Program on Parent-Teacher Agreement Regarding Children’s Social Emotional Functioning. Behavioral Sciences 2023, 13, 322.

Lee, V., Roudbarani, F., Tablon Modica, P., Pouyandeh, A., & Weiss, J. A. (2022). Adaptation of Cognitive Behavior Therapy for Autistic Children During the Pandemic: A Mixed-Methods Program Evaluation. Evidence-Based Practice in Child and Adolescent Mental Health7(1), 76–93. https://doi.org/10.1080/23794925.2021.1941432

MacEvilly, D., Maguire, K., Brosnan, G., Gaffny, L. (2024). Enhancing children’s emotional regulation and social communication through group intervention – evidence of impact in an Irish outpatient Child and Adolescent Mental Health Service. Child Language Teaching and Therapy, 1-21. DOI: 10.1177/02656590241228424

MacEvilly, D., & Brosnan, G. (2020). Adapting an emotional regulation and social communication skills group programme to teletherapy, in response to the COVID-19 pandemic. Irish Journal of Psychological Medicine, 1-21. https://doi.org/10.1017/ipm.2020.109

Maughan, A. L., & Weiss, J. A. (2017). Parental Outcomes Following Participation in Cognitive Behavior Therapy for Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(10), 3166+.

Mootz, C. A., Lemelman, A., Giordano, J., Winter, J., & Beaumont, R. (2022). Brief Report: Feasibility of Delivering the Secret Agent Society Group Social Skills Program via Telehealth During COVID-19: A Pilot Exploration. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-022-05591-2

Sauvé, S., O’Haire, C., Hall, H., Lane, C & Hudson, B. (2018). Adapting a social skills intervention for children with autism within an urban specialty community clinic. Evidence-Based Practice in Child and Adolescent Mental Health. DOI: 10.1080/23794925.2018.1483214

Sofronoff, K., Silva, J., & Beaumont, R. (2017). The Secret Agent Society social-emotional skills program for children with High- Functioning Autism Spectrum Disorder: A parent-directed trial. Focus on Autism and Other Developmental Disabilities, 32(1), 55-70. DOI: 10.1177/1088357615583467

Tan, Y.L., Mazzucchelli, T.G., & Beaumont, R. (2015). An evaluation of individually delivered Secret Agent Society social skills program for children with High-Functioning Autism Spectrum Disorders: A pilot study. Behaviour Change, 32(3), 159-174. doi 10.1017/bec.2015.7

Temkin, A. B., Beaumont, R., Wkya, K., Hariton, J. R., Flye, B. L., Sheridan, E., … Bennett, S. M. (2022). Secret Agent Society: A Randomized Controlled Trial of a Transdiagnostic Youth Social Skills Group Treatment. Research on Child and Adolescent Psychopathology. https://doi.org/10.1007/s10802-022-00919-z

Thomson, K., Burnham Riosa, P., & Weiss, J. (2015). Brief report of preliminary outcomes of an emotion regulation intervention for children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45(1), 3487-3495.

Weiss, J., Thomson, K., Burnham Riosa, P., Albaum, C., Chan, V., Maughan, A., Tablon, P., & Black, K (2018). A randomized waitlist- controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism. Journal of Child Psychology and Psychiatry, 59(11), 1180-1191. DOI:10.1111/jcpp.12915

Zengegui, E., Beaumont, R., Chiu, A.W., Schild, J., & Bennett, S.M. (2020). Evaluating Clinical outcomes in practice settings: Beyond the limits of grant funded clinical research. Professional Psychology: Research and Practice, 51(2), 145-155. DOI: 10.1037/pro0000276