A pilot study of social competence group training for adolescents with borderline intellectual functioning and emotional and behavioural problems (SCT-ABI)

A pilot study of social competence group training foradolescents with borderline intellectual functioning andemotional and behavioural problems (SCT-ABI)jir_1369 231..241

J. Nestler & L. Goldbeck

University Hospital Ulm, Child and Adolescent Psychiatry and Psychotherapy, Ulm, Germany

Abstract

Background Emotional and behavioural problemsas well as a lack of social competence are commonin adolescents with borderline intellectual function-ing and impair their social and vocational integra-tion. Group interventions specifically developed forthis target group are scarce and controlled evalua-tion studies are absent.Methods A cognitive–behavioural group training(Social Competence Training for Adolescents withBorderline Intelligence) was developed and its effec-tiveness was examined in students attending specialvocational schools. A total of 77 adolescents withborderline intelligence were randomised either tothe intervention (n = 40) or to the control group(n = 37). Outcome measures at post-treatment andat a 6-month follow-up comprised self-reports, car-egiver reports and behavioural observations.Results The adolescents in the intervention groupshowed temporally stable improvement in theirsocial competence, especially in social problemsolving (F = 17.6, P < 0.001) and attainment of indi-vidual behavioural goals in everyday life (self-reports: F = 15.9, P < 0.001; caregiver reports:F = 87.9, P < 0.001). Effects of the intervention on

other outcomes such as problem-solving compe-tence and skills performed in standardised roleplays were weak or absent.Conclusions Social Competence Training for Ado-lescents with Borderline Intelligence is a promisingtreatment for adolescents with borderline intellec-tual functioning and associated emotional/behavioural symptoms. Further studies examininglong-term effects on the participants’ social andvocational integration are needed.

Keywords adolescents, borderline intelligence,group intervention, randomised controlled trial,social competence training

Introduction

Borderline intelligence is one of the most frequentreasons for impaired development during adoles-cence and it is associated with the risk of persistentsocial maladaptation. According to the Diagnosticand Statistical Manual of Mental Disorders, 4thedition (APA 1994), borderline intelligence isdefined by a sub-average IQ level of less than 85

points, and it is differentiated from intellectual dis-ability (ID) (IQ � 70). Sturmey (2002) found thatpeople with borderline intelligence have anincreased risk of developing mental health

Correspondence: Miss Judith Nestler, Steinhoevelstr. 5 Ulm 89075,Germany (e-mail: [email protected]).

Journal of Intellectual Disability Research doi: 10.1111/j.1365-2788.2010.01369.x

volume 55 part 2 pp 231–241 february 2011231

© 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd

problems. They are characterised by school failurein the regular educational system and fail to enterthe job market (Opp 1992). Typical attributes com-prise also a retardation of social development and alack of social competence. Emotional, behaviouraland social problems, which occur about twice asmuch in people with ID compared with normalpeers (Deb & Bright 2001), significantly impair theyoung people’s social adaptation and integrationand constrain the attainment of important develop-mental tasks such as progressing from school toworking life, reaching autonomy and establishingstable relationships with peers and partners.

Social competence is defined as a multidimen-sional construct including emotional, behaviouraland cognitive components (Kanning, 2002, 2003).Within a sequence of social interactions, a personfirst perceives and analyses the situation (cognitivecompetence), then generates behavioural options(cognitive and emotional competence), executes thebehavioural action (behavioural competence/skills)and finally evaluates its consequences (cognitive/emotional competence) (Kanning 2002). Based onthis theoretical model, deficits in social competencecan occur in each of these domains.

In a meta-analysis, Kavale & Forness (1996)found that 75% of students with borderline intelli-gence show maladaptive social behaviours. Theyhave difficulties perceiving and discriminating emo-tions, processing social information, and utilisingproblem-solving strategies in interaction situations(Bauminger et al. 2005). Consequently, these ado-lescents are less accepted within their peer group(Frederickson & Furnham 2004) and are moreoften involved in peer conflicts (Wiener &Schneider 2002) compared with adolescents withnormal intellectual functioning (Grünke 2004).

Group interventions are rarely designed to meetthe specific needs of adolescents with borderlineintellectual functioning, and studies investigatingtheir efficacy/effectiveness are absent (Roos &Petermann 2005).

This study reports the findings of a randomisedcontrolled trial (RCT) of a cognitive–behaviouralgroup training that was developed to meet thespecial needs of these adolescents. We hypothesisedthat the participants would show significant andpersistent improvements in social competence afterthe intervention and in a 6-month follow-up, com-

pared with adolescents who received only standardvocational training. We expected improvements inthree domains of social competence:• Cognitive components, e.g. social problemsolving and insight into the reciprocity of socialinteractions;• Skills/behavioural components, e.g. performingadaptive social behaviours; and• Emotional components, emotional stability, e.g.reduction of social anxiety.

Methods

Study design, subjects and implementation

The study was performed in collaboration with twoGerman special vocational training centres for ado-lescents with sub-average cognitive abilities. InGermany, adolescents with borderline intelligenceand persistent failure to gain a regular apprentice-ship or job may attend special vocational trainingcentres, which provide complete job training in dif-ferent occupations (e.g. cook, mechanic and baker).Each student is accompanied and supported bysocial workers (Opp 1992).

The study was designed as an RCT. Phase 1

included the baseline assessment of social compe-tence, randomisation to intervention or controlgroup and post-assessment of social competence.Phase 2 was a 6-month follow-up. The study designand procedures for obtaining informed consentwere approved by the Institutional Review Board atthe University Ulm. The study was registered athttp://www.clinicaltrials.gov (identification number:NCT00692081).

A consecutive sample of students was screenedfor elevated behavioural and emotional symptomsusing self-reports and caregiver reports. Sample-sizecalculation resulted in 2 ¥ 40 participants, based onthe condition of identifying between-group effectsizes (ES) of 0.40 in psychometric outcomes asreported by a recent meta-analysis (Roos & Peter-mann 2005). Of a total of 157 students, 77 adoles-cents met the following inclusion criteria for thestudy: a total symptom score above the average(T > 60) in at least one of the global scores,assessed by the Child Behaviour Checklist (CBCL/4-18, Achenbach 1991a) and/or the Youth SelfReport (YSR/11-18, Achenbach 1991b), as well as

232Journal of Intellectual Disability Research volume 55 part 2 february 2011

J. Nestler & L. Goldbeck • Social competence group training


the absence of a severe psychiatric illness such aspsychosis or major depression (as assessed by astructured clinical interview).

The 77 study participants were randomised eitherto the intervention group (n = 40) or to the controlgroup (n = 37) (see Fig. 1). All assessments ofoutcome variables were conducted by trained assis-tants. Four courses of the training programme werecarried out over a period of 1 year. Because of theproject’s limited resources, only the first wave ofparticipants (n = 40) could be reassessed 6 monthsafter the intervention.

The control group received the usual vocationaltraining programme. The adolescents obtained theregular education (major subjects, competenciesspecific to their particular future profession) andthe standard mentoring by social workers, compris-

ing half-year perspective interviews for the adoles-cents and their parents and individual counsellingon demand in cases of serious problems. The par-ticipants of the control group did not receive anyspecific group intervention or individual therapyduring the study.

Randomisation and masking

The randomised assignment to control and inter-vention group was carried out by extricatingnumbers, each representing one eligible participant,from a hat. The procedure was carried out stepwisefor each group of twenty participants, assigning 10

participants each to the control group and theintervention group. The evaluators of the role playswere blind for the individuals’ group condition.

randomised (n=77) (t1)

intervention group:

allocated to intervention: (n=40) received allocated intervention: (n=36) did not receive allocated intervention: (n=4) reasons: did not appear

post-treatment n=68 (t2)

intervention SCT-ABI

intervention group:

lost for follow-up (n= 3)reasons: school break-up, illdiscontinued intervention (be absent more than 3 sessions): (n=6) follow-up (t3)

(6 months)

intervention group:

lost for follow-up ( n= 2) reasons: illness

analysed t1: n=40, t2: n=30, t3: n=15

follow-up n=33 (of the

first two groups n=40)

control group:

allocated to control group: (n=37) excluded: (n=0)

control group:

lost for follow-up (n=6) reasons: school break-off, illness

control group: lost for follow-up (n=5) reasons: school break-up, refused

analysed t1: n=37, t2: n=31, t3: n=15

Excluded: n=80

did not meet inclusion criteria: n=73 refused to participate: n=5 other reasons: n=2 (school break-up: n=1, absent for training: n=1)

assessed for eligibility (n=157)

enrollment

Figure 1 CONSORT flow diagram.SCT-ABI, Social Competence Trainingfor Adolescents with BorderlineIntelligence.




Social workers and teachers, who were not part ofthe study team, however, could not be blind forthe group condition because of practical reasons;neither were the research assistants who deliveredthe questionnaires.

Intervention (the Social Competence Training forAdolescents with Borderline Intelligence)

Social Competence Training for Adolescents withBorderline Intelligence (SCT-ABI) was developedby the authors (for details see Table 1). The pro-gramme is conceived as a multidimensionalcognitive–behavioural treatment focusing on thethree domains (behavioural, cognitive, emotionalfactors) of social competence. The manual (Nestler& Goldbeck 2009) provides standardised instruc-tions, material for the training sessions (slides,worksheets) and handouts for the adolescents pro-vided at each session. The intervention groupobtained the usual vocational training and addition-ally, in groups of 10 adolescents, nine group ses-sions of SCT-ABI over a period of 3 months. Theparticipants in the intervention group did notreceive any other psychosocial treatment during thestudy investigation.

Implementation fidelity

The intervention is highly standardised in a detailedmanual (Nestler & Goldbeck 2009). Two therapists

(one psychologist/psychiatrist and one educator)were trained by the authors and performed theintervention together at both centres. These thera-pists were not involved in teaching the controlgroup. One author (JN) was present in the firstgroup cycle to supervise the trainers and to controlthe correctness of implementation. Treatment prac-ticability and fidelity were evaluated by the trainersusing a structured questionnaire after every unit.

Instruments

Social competence was assessed multidimensionalincluding emotional, behavioural and cognitivecomponents (Kanning 2002, 2003). Most instru-ments measuring social competence are not specifi-cally developed for adolescents with borderlineintellectual functioning. Therefore, analyses of reli-ability and validity were performed for the baselineassessment and only instruments with sufficientpsychometric properties were used (Nestler &Goldbeck 2010). Adolescents filled in all question-naires in the presence of a psychologist/psychiatristin order to avoid comprehension failures.

Behavioural outcomes

Behaviour in social situations was assessed by vid-eotaped role play behaviour. Three standardisedsocial problem situations developed by the authorshad to be solved by each adolescent interacting with

Table 1 Components of the Social Competence Training for Adolescents with Borderline Intelligence (SCT-ABI)

Main issues of SCT-ABI

Introduction(4 h)

Introduction, getting to know each other, awareness of social competence problems in everyday living, definitionof individual goal attainment

Unit 1 (2 h) Becoming acquainted with different styles of assertiveness behaviour, behaviour observation learning (model roleplay by therapists)

Unit 2 (2 h) Development of strategies for anger control and coping with provocation, role playsUnit 3 (2 h) Learning of conversation rules and behaviour strategies of interaction: attracting somebody’s sympathy,

maintaining conversationUnit 4 2(h) Role plays on attracting somebody’s sympathy, maintaining conversation and homework practice in everyday

livingUnit 5 (2 h) Learning of behaviour strategies: self-assertion, learning to say ‘no’ and maintaining relationshipsUnit 6 (2 h) Role plays on self-assertion and maintaining relationships, homework practice in everyday livingUnit 7 (2 h) Self-verbalisation (example by showing a film)

Thoughts, feelings and behaviour: handling of fear and depressive moodUnit 8 (3 h) Thoughts, feelings and behaviour: handling of fear and depressive mood, transfer to everyday living, evaluation




a trained research assistant, acting as an antagonistin the role play. The three situations represented thedomains ‘attracting somebody’s sympathy’, ‘main-taining a relationship’ and ‘self-assertiveness’.Trained evaluators, who were blind to the groupcondition, assessed skills (e.g. eye contact, loudnessof voice, posture) and problem-solving competence ineach of the situations using a standardised categori-cal rating system. Inter-rater reliability and internalconsistency for the different scales were satisfactory(ICC between 0.98 and 0.48, Cronbach’s a between0.99 and 0.65). The three ratings of problem-solving competence were summarised, and the sameprocedure was performed for the skills ratings.

Additionally, the adolescents and social workersfilled in 5-point goal attainment scales (The List ofIndividual Symptoms for Therapy Evaluation, Mat-tejat & Remschmidt 2001). Five stages of individualbehavioural goal attainment (e.g. stay calm if some-body criticises the adolescent) were defined beforethe training. At the end of the training and at thefollow-up assessment, goal attainment was evaluatedby adolescents and the social workers responsiblefor them.

Teachers, vocational trainers and social workersfilled in the observational category system AKI(observational category system of socially compe-tent, aggressive and passive behaviour) (Petermann& Petermann 2003), which assesses three aspects ofsocial behaviour (socially competent, aggressive andpassive behaviour) over 12 categories on 5-pointrating scales (Cronbach’s a between 0.73 and 0.87).The ratings for each study participant were sum-marised as individual total scores.

Cognitive outcomes

Social problem-solving competence was assessed bythe hamet2 module 3 (Dietrich et al. 2001), a com-puterised tool developed especially for measuringvocational social competencies of adolescents withborderline intelligence. Adolescents have to respondto eight standardised social conflict situations takenfrom working life (e.g. customer complaint). Theverbal descriptions of problem solving are rated byindependent evaluators on 5-point rating scales.Cronbach’s a of the global score at baseline assess-ment was 0.57. In spite of its moderate reliability,the instrument was included, because it was the

only available instrument especially developed forour target group.

Additionally, adolescents in the interventiongroup filled in a self-constructed nine-questionsocial knowledge questionnaire during the first and lastunit of the programme to assess their knowledgegain. The answers were coded according to theiraccuracy, with either 0.5 or 1 point. Consistencyanalysis for the sum score showed satisfying results(mean = 3.34, SD = 1.97, span = 7, oblique = 0.061,Cronbach’s a = 0.75), and the item difficulties werebetween 0.12 and 0.50 (mean 0.38).

Emotional outcomes

Social anxiety was assessed by the U-questionnaire(Ullrich & Muynck 2001), a German questionnairemostly used for evaluations of social training pro-grammes.The questionnaire has six scales (internalconsistencies according to the authors of the ques-tionnaire between 0.91 and 0.95, test–retest reliabil-ity between r = 0.85 and 0.71).We used only the twoscales failure anxiety and contact anxiety because thesewere the only scales with satisfying consistencyscores in our sample (Cronbach’s a = 0.85 and 0.83).

Social competence relating to peer groups wasmeasured with the Teenage Inventory of SocialSkills (TISS-D) (Inderbitzen & Foster 1992,German version Pössel & Häußler 2004). Thisquestionnaire comprises 28 gender-specific itemsdivided into the scales negative behaviour and positivebehaviour related to other adolescents (a = 0.86 and0.85, test–retest reliability r = 0.89).

Engagement in treatment

All 77 study participants (see Fig. 1) completed thebaseline assessment (t1). Nine participants (three inthe intervention group, six in the control group)were lost for the second measurement at the end ofthe intervention (t2), because they were absentbecause of long-term illness or had terminated theirvocational training. Adolescents, who did not com-plete the intervention (n = 4) or missed more thanthree sessions (n = 6), were not included in theanalyses.

Follow-up assessment was completed by 33 of 40

eligible participants (five adolescents from thecontrol group and two from the intervention groupwere lost at follow-up).




Statistical analyses

Statistical analyses were performed using the soft-ware program spss for windows version 12.0. Therewere no systematic missing values in specific itemsacross all instruments. Missing data were replacedby mean values of the other items if less than one-third of raw scores were missing. Otherwise, thescale score was excluded from analyses. The ran-domisation check was carried out with c2 tests andt-tests for independent samples.

The analyses of the endpoints were carried outby repeated measures analyses of variance withgroup as independent factor. First, two time points(pre-post treatment) were included with all studyparticipants who completed the study. An additionalanalysis was carried out for three time points basedon those participants who completed all threeassessments, including the follow-up assessment.Changes between adjacent measurement timepoints were analysed by paired t-tests. Significancelevel for all inferential statistical analyses wasadjusted for multiple tests by Bonferroni correction.

Exploratory subgroup analyses were performed todetermine the moderating effect of the level of cog-nitive functioning on treatment outcome by dividingthe sample into two groups split by the median IQof 80.

Because of the pilot character of our study and toevaluate the potential of the intervention, we analy-sed only those participants who finished the studyby protocol. Additionally, intent-to-treat (ITT)analyses were performed, including participantswho dropped out of the study by last operationcarried forward. To evaluate the magnitude ofeffects in the different outcome variables, Cohen’sbetween-group ES were determined. An ES >0.30

was considered to be a small effect, >0.50 mediumand >0.80 a large effect (Cohen 1988).

Results

Sample description

The mean age of the 77 participants was 17 years(range: 15 to 22, SD = 1.3), and 64% were male.The mean IQ was 80 (SD = 8.8, range: 65–104).Surprisingly, 10 participants had an IQ < 70 and 20

adolescents an IQ > 85, the remaining 47 had an IQ

of between 85 and 70 measured by standardised IQtests. There were no statistically significant differ-ences between intervention and control group onany of the socio-demographic variables or baselinevalues of outcome variables (Table 2).

Treatment fidelity

In total, 37 of 40 adolescents received SCT-ABI. Inthe session feedback sheets, the therapists judgedthe standard of the lessons to be at the appropriatelevel and confirmed that lessons were carried outaccording with the treatment manual.

Treatment outcome

Table 3 demonstrates the descriptive results and ES.Table 4 shows the results of the anovars for thedifferent dimensions of social competence at base-line and at the end of treatment.

Behavioural outcomes

The results of the anovars (Table 4) showed neithersignificant main effects of time or group nor aninteraction effect for problem-solving competence inrole play. There was a small ES (ES = 0.34) infavour of the intervention group. For the skillsassessed by role play, a significant main effect oftime occurred.

Analyses of the goal attainment ratings provided byadolescents and social workers demonstrated signifi-cant main effects of group and time as well as aninteraction effect. Both groups showed significantindividual goal attainment, but the interventiongroup performed significantly better than thecontrol group. The effect in favour of the interven-tion group was large (ES = 2.09 by adolescents’,ES = 2.43 by social workers’ ratings).

Neither significant main effects nor an interactioneffect of group and time occurred in the AKI scalesaggressive and passive behaviour, but there was a sig-nificant effect of time on the scale competent behav-iour. There was also a small ES for the latter scale(ES = 0.30) in favour of the intervention group.

Cognitive outcomes

The anovar for the total score of hamet2 revealed asignificant main effect of time and a significant




interaction effect. Students across both groupsshowed an improvement of problem-solving compe-tence and the intervention group showed signifi-cantly more improvement than the control group(ES = 1.27).

There was a significant improvement of knowl-edge as measured by the social knowledge questionnairebetween the first (M = 4.22; SD = 2.20) and last unit(M = 6.12; SD = 1.92) (t = -5.08, P < 0.001).

Emotional outcomes

There were neither significant main effects nor aninteraction effect for failure anxiety. In the scalecontact anxiety, there was a significant effect of time,

whereby both groups decreased. There were no sig-nificant effects of group or interaction. However, inthis variable there was a small ES in favour of theintervention group (ES = 0.30).

Social competence relating to peers measuredwith the TISS-D showed neither a significant mainnor an interaction effect. A small negative ES of theintervention on the scale negative behaviour(ES = -0.35) was found.

Results at 6-months follow-up

A total of 30 participants could be included for theanalyses of follow-up results 6 months after theintervention (see Fig. 1). The mean age of these

Table 2 Baseline characteristics of subjects

Demographic characteristicsVariable Groups IG (n) CG (n) c2 pGender Male 22 28 3.61 0.06

female 18 9Study centre Ulm 20 19 0.01 0.91

Ravensburg 20 18Nationality German 28 28 0.31 0.58

Other 12 9IG M CG M t (d.f.) P

Intelligence – 81.5 79.2 -1.14 (75) 0.26Age – 17.83 17.73 -0.33 (75) 0.74Baseline measurement of social competence

IG CG t (d.f.) PM (SD) M (SD)

Problem-solving competence (role play) 3.58 3.49 -0.24 (75) 0.38(1.51) (1.79)

Skills (role play) 9.83 9.59 -0.28 (66) 0.78(2.99) (4.08

AKI aggressive behaviour 3.11 3.60 0.71 (68) 0.48(2.94) (2.81)

AKI competent behaviour 9.85 9.57 -0.35 (68) 0.73(3.56) (2.86)

AKI passive behaviour 4.57 4.41 -0.30 (68) 0.77(1.99) (2.40)

Problem solving (hamet2) total score 7.36 7.47 0.16 (73) 0.87(3.14) (3.03)

U-questionnaire failure anxiety 29.03 28.19 -1.27 (75) 0.21(13.88) (12.66)

U-questionnaire contact anxiety 28.10 24.65 -1.18 (75) 0.24(13.39) (12.18)

TISS positive social behaviour 55.30 51.86 -1.12 (75) 0.27(13.89) (12.89)

TISS negative behaviour 28.43 30.30 0.90 (75) 0.37(8.99) (9.33)

AKI, observational category system of socially competent, aggressive and passive behaviour; n, number of persons; IG, intervention group;CG, control group; c2, chi-squared after Pearson; M, mean; SD, standard deviation.




participants was 17.9 years (range: 16 to 21,SD = 1.1), and 68% were male. The mean IQ was78 (SD = 9.6, range: 65–104). Seven participantshad an IQ < 70 and five adolescents an IQ > 85; therest had an IQ of between 85 and 70. There wereno statistically significant differences betweenfollow-up intervention and control group on base-line values of the outcome variables or socio-demographic variables (besides significant moremale adolescents in the follow-up control groupthan in the follow-up intervention group). Long-term effects of the training resemble the results ofthe pre-post analysis (see Table 5).

Intent-to-treat analyses

We repeated all analyses at post-intervention and atthe 6-months follow-up by applying ITT analyses

and received consistent results, with a tendencytowards slightly smaller ES.

Discussion

The aim of this RCT was to evaluate a multi-modalsocial competence training designed for the specialneeds of adolescents with borderline intelligence(SCT-ABI).

The results demonstrate that SCT-ABI has somepotential to reduce individual problem behaviour, toshape pro-social behaviour and to provide generali-sation of the acquired competent behaviour ontoeveryday life. Further, it has positive effects on thecognitive dimension of social competence. However,the results for observable social problem-solvingbehaviour, social skills and aggressive behaviour

Table 3 Descriptive statistics and effectsizes of behavioural, cognitive andemotional measurements of socialcompetence pre and post intervention

Instruments/scales(scale range)

t1 t2

EScorrM SD M SD

Instruments measuring behavioural components of social competenceProblem-solving competence (role play)

(range: -3–6)IG 3.41 1.45 3.93 1.16 0.34CG 3.61 2.01 3.64 1.42

Skills (role play)(range: 0–24)

IG 9.31 3.26 11.90 0.80 0.01CG 9.54 4.31 12.11 0.81

Goal attainment adolescents(range: -1–3)

IG 0 0.00 2.59 0.73 2.09CG 0 0.00 1.13 0.67

Goal attainment social workers(range: -1–3)

IG 0 0.00 2.52 1.15 2.43CG 0 0.00 0.74 0.77

AKI aggressive behaviour(range: 0–16)

IG 2.37 2.30 2.39 2.07 0.22CG 3.88 2.85 3.24 2.57

AKI competent behaviour(range: 0–20)

IG 9.66 3.67 11.88 3.57 0.30CG 9.73 2.92 10.99 2.68

AKI passive behaviour(range: 0–12)

IG 4.51 2.21 3.69 1.64 0.01CG 4.04 2.24 3.18 2.77

Instruments measuring cognitive components of social competenceProblem solving (hamet2) total score

(range: -8–16)IG 7.90 3.01 11.38 2.38 1.27CG 7.50 3.01 7.70 2.83

Instruments measuring emotional components of social competenceU-questionnaire failure anxiety

(range: 0–75)IG 29.6 14.14 24.40 15.83 0.21CG 23.4 11.63 20.48 12.99

U-questionnaire contact anxiety(range: 0–75)

IG 28.7 13.92 22.23 16.02 0.30CG 23.1 12.21 20.32 14.46

TISS positive social behaviour(range: 14–84)

IG 55.4 14.32 53.66 14.05 0.22CG 52.2 12.58 53.54 13.60

TISS negative behaviour(range:14–84)

IG 26.9 8.13 28.70 9.92 0.35K 30.6 10.05 29.13 9.54

AKI, observational category system of socially competent, aggressive and passive behaviour;IG, intervention group (n = 31); CG, control group (n = 30); M, mean; SD, standard devia-tion, EScorr, corrected effect size t1–t2.




show no significant effects of the intervention.Thus, the programme has differential effectsdepending on the domain of social competence.

Considering other evaluation studies (e.g. Kavale& Mostert 2004) of social competence trainingsfor adolescents with borderline intellectual func-tioning found in the mean small ES (ES = 0.21,range: -0.67 to 1.19) and a lack of effect sustain-ability and generalisation of newly establishedbehaviour to daily life, the findings of the SCT-ABI evaluation seem promising. However, becauseof several methodical limitations, our resultsshould be interpreted cautiously and consideredpreliminary.

Limitations

Treatment fidelity was given, but the sample sizeof the study was quite small, so the limited statis-tical power has to be considered. Because of theonly partial involvement of study participants (halfof calculation demand), the results of thefollow-up assessment have to be considered verypreliminary. Dropouts occurred in both groups

(intervention/control) because of school brake-off,illness or refusal to participate. Some adolescentsmissed more than three sessions of the trainingand were consequently excluded from the analyses.The participants of the study were recruited inonly two centres; therefore, the generalisation toother populations and treatment settings might belimited. Teachers, research assistants and socialworkers were not blind to the study condition,so the results of their ratings might have beenbiased.

Implications

Considering the preliminary character of ourstudy, multi-centre studies with larger samples andin different settings such as youth welfare institu-tions should to be carried out to replicate thefindings and to allow responder analyses by sub-group. Variations of the programme might considera higher dosage of the intervention and moreefforts to generalise the training effects onto theadolescents’ daily working life. The intervention

Table 4 Results of the variance analyses with repeated measurement (t1, t2) for behavioural, cognitive and emotional factors of socialcompetence measurements

Instruments/scales

Main effect Main effect Interaction effectTime (d.f. = 1) Group (d.f. = 1) Time ¥ group (d.f. = 1)

F P F P F P

Instruments measuring behavioural components of social competenceProblem-solving competence (role play) 1.44 0.235 0.02 0.888 1.09 0.300Skills (role play) 22.46 <0.001 0.06 0.815 0.00 0.989Goal attainment adolescents 420.62 <0.001 64.71 <0.000 15.91 <0.001Goal attainment social workers 296.09 <0.001 87.85 <0.000 87.86 <0.001AKI aggressive behaviour 1.03 0.316 3.69 0.061 1.17 0.284AKI competent behaviour 16.67 <0.001 0.26 0.611 1.29 0.262AKI passive behaviour 9.15 0.004 0.77 0.385 0.004 0.950Instruments measuring cognitive components of social competenceProblem solving (hamet2) total score 22.09 <0.001 10.56 0.002 17.55 <0.001Instruments measuring emotional components of social competenceU-questionnaire failure anxiety 9.65 0.003 2.39 0.127 0.76 0.387U-questionnaire contact anxiety 17.83 <0.001 1.22 0.274 2.75 0.103TISS positive behaviour 0.017 0.896 0.25 0.619 0.99 0.324TISS negative behaviour 0.026 0.872 0.80 0.373 2.91 0.093

Intervention group (n = 31), control group (n = 30), Bonferroni correction for multiple tests.AKI, observational category system of socially competent, aggressive and passive behaviour.




programme was positively received and most ofthe adolescents were satisfied. Meanwhile, SCT-ABI has been successfully implemented in theregular practice of the two vocational trainingcentres, underlining the feasibility and usefulnessof the programme. Our intervention programme isan example of a programme in accordance withthe current policy of the German Ministry ofLabour, aiming to implement support programmesfor disadvantaged adolescents. This policy complieswith article 24 of the Convention on the Rights ofPersons with Disabilities, stating that disabled ado-lescents have the right for integration and inclu-sion into the educational and social system (Officeof the United Nations High Commissioner forHuman Rights 2010) and state assistance isrequired to achieve this goal.

Acknowledgements

We thank all participating adolescents and the stafffrom the vocational training centres Ulm andRavensburg for supporting our project, and thesponsor Berufsbildungswerk Adolf Aich gGmbH,Stiftung Liebenau for funding this study. No otherpotential conflicts of interest relevant to this articleexist.

ReferencesAchenbach T. M. (1991a) Manual of the Child Behaviour

Checklist/4-18. University of Vermont, Department ofPsychiatry, Burlington.

Achenbach T. M. (1991b) Manual for theYouth Self-Report.University of Vermont, Department of Psychiatry,Burlington.

Table 5 Descriptive statistics and effect sizes of the behavioural, cognitive and emotional measurements of social competence at t1, t2 and t3

Instruments/scales(scale range) G M t1 SD M t2 SD M t3 SD EScorr

Instruments measuring behavioural components of social competenceProblem-solving competence (role play)

(range: -3 – 6)IG 3.36 1.50 4.27 1.01 4.09 1.58 0.54CG 3.07 2.09 3.29 1.64 2.79 2.05

Skills (role play)(range: 0–24)

IG 8.64 2.94 12.00 3.58 13.18 3.37 0.99CG 9.31 4.63 11.69 5.04 10.77 2.55

Goal attaeinment adolescents(range: -1–3)

IG 0.00 0.00 2.62 0.65 2.54 0.78 1.66CG 0.00 0.00 1.21 0.58 1.29 0.73

Goal attainment social workers(range: -1–3)

IG 0.00 0.00 2.47 0.64 1.60 1.12 1.18CG 0.00 0.00 0.80 0.68 0.40 0.91

AKI aggressive behaviour(range: 0–16)

IG 2.84 1.97 3.03 2.41 3.65 2.45 0.51CG 4.00 3.32 3.04 3.13 3.40 2.81

AKI competent behaviour(range: 0–20)

IG 8.20 3.51 10.35 3.31 10.17 3.48 1.31CG 9.64 3.11 10.10 2.01 7.27 3.17

AKI passive behaviour(range: 0–12)

IG 4.14 2.38 3.39 1.72 4.55 2.13 0.41CG 4.57 1.93 4.43 2.72 4.09 2.25

Instruments measuring cognitive components of social competenceProblem solving (hamet2) total score

(range: -8–16)IG 7.73 4.17 10.09 2.77 11.91 2.34 0.95CG 6.47 2.92 6.73 2.76 7.93 3.45

Instruments measuring emotional components of social competenceU-questionnaire failure anxiety

(range: 0–75)IG 34.21 12.81 26.71 15.11 29.36 15.42 0.35CG 24.27 8.89 22.47 9.20 22.20 9.52

U-questionnaire contact anxiety(range: 0–75)

IG 32.79 13.00 24.86 14.45 25.43 14.21 0.48CG 25.07 10.51 23.47 12.27 22.93 13.56

TISS positive social behaviour(range: 14–84)

IG 56.25 10.01 49.92 16.07 54.25 15.04 0.59CG 52.00 10.73 51.33 13.57 56.83 14.36

TISS negative behaviour(range: 14–84)

IG 27.21 6.71 29.43 10.25 31.36 11.76 0.33CG 32.73 9.52 32.53 9.93 35.60 13.19

AKI, observational category system of socially competent, aggressive and passive behaviour; IG, intervention group (n = 15); CG, controlgroup (n = 15); M, mean; SD, standard deviation, EScorr, corrected effect size t1–t3.




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Accepted 30 November 2010




Documents

A pilot study of social competence group training for adolescents with borderline intellectual functioning and emotional and behavioural problems (SCT-ABI)