To evaluate the intervention efficacy of integrated group social skills training on social ability in school-age patients with high-functioning ASD, so as to provide a reference for improving social skills in children with high-functioning ASD.

From January 2021 to December 2023, 62 children aged 7-12 with high-functioning ASD who visited the Children's Psychiatry Outpatient Department of the Affiliated Kangning Hospital of Ningbo University were recruited, and were randomly divided into a training (n=31) and a control group (n=31) by a random number table method. The training group received a 20-week structured group social training program (mental interpretation courses and social courses), while the control group received only conventional treatment. Chinese version of Griffith Empathy Measure Parent Ratings (GEM-PR) and Social Response Scale (SRS) were used to assess the symptoms of social deficits before and after treatment. Emotional face recognition tasks and eye movement trajectories were used to test the characteristics of social visual attention in children with ASD. Group comparison was conducted using t-test and Mann-Whitney U test.

At baseline, there were no significant differences in GEM-PR score (t=-1.20 to -0.81), SRS score (t=-0.36-1.75), emotional face recognition accuracy and reaction time (t=-0.58-1.85), and eye movement trajectory (U/t=-1.63-0.29) between the two group (P>0.05). After intervention, the total GEM-PR score and empathic cognitive factor score of training group [18.00(10.00, 24.00), 9.00(8.00, 13.00)] were significantly higher than those of the control group [12.00(-1.00, 18.00), 2.00(-2.00, 7.00)], and the total SRS score and social cognition, social perception, social communication, social motivation (73.23±14.20, 16.16±2.72, 6.58±2.50, 24.29±5.61, 9.52±3.73) were significantly lower than those of the control group (95.26±15.29, 19.90±2.84, 12.58±2.49, 31.94±6.38, 13.74±4.81) (U/t=-2.38, -4.59; -5.88, -5.29, -9.47, -5.01, -3.87, P < 0.05). The overall correct rate of emotional face recognition and the correct rate of angry, fearful and neutral faces recognition in the training group [(81.55±6.62)%, (76.86±12.06)%, (79.61±12.42)%, (94.27±6.26)%] were significantly higher than the control group [(70.55±13.82)%, (62.82±18.77)%, (67.18±18.85)%, (79.60±20.05)%], and the average reaction time [(2 226.70±274.43)ms] was lower than the control group [(2 417.27±324.10)ms] (t=4.00, 3.50, 3.07, 3.89, -2.42, P < 0.05). The time to first eye gaze [764.74 (748.64, 793.73) ms] in the training group was significantly lower than that in the control group [810.92 (782.86, 877.42) ms], and the proportion of moderate-to-high intensity attention area in the face [(37.37±1.27)%] was significantly higher than that in the control group [(30.34±1.23)%] (U/t=3.44, 8.89, P < 0.05).

Integrated group social training can significantly improve the social communication and empathy ability of high-functioning ASD children, increase active attention and recognition ability of faces, and improve mental development of children with ASD.