Adolescents' social interaction skills on social media versus in person and the correlations to well-being

INTRODUCTION

High-quality social interactions with peers could protect adolescents' mental health, resilience, and well-being. Assessing their social interaction skills (SIS) is essential to enhancing them. However, few instruments provide information about SIS in in-person and social media environments. The SIS Questionnaire (SISQ) was developed to fill this gap, spotlighting adolescents' viewpoints on SIS in both environments. This study aimed to describe the SISQ development and psychometric properties, differences in adolescents' SIS in both environments, and relationships between the adolescents' SIS and subjective well-being.

METHODS

A total of 214 typically developed adolescents aged 12-18 (M = 15.3 years, SD = 1.77; 61.2% girls) completed online questionnaires (demographic, SISQ, and Five Well-Being Index). We used exploratory factor analysis for construct validity, Cronbach's alpha for internal reliability, t-tests for differences in SIS, Cohen's d for effect sizes, and Pearson correlations and hierarchical regression for relationships between SIS and well-being.

RESULTS

The SISQ has content validity and a monofactorial scale construct validity with very good internal reliability. Participants rated their in-person SIS significantly higher than on social media, t(213) = -5.24, p < 0.001, d = 0.36, and the in-person environment as more important, t(213) = -11.57, p < 0.001, d = 0.79, than the social media environment. A significant correlation was found between both in-person SIS (r = 0.41, p < 0.001) and social media (r = 0.34, p < 0.01) and well-being.

CONCLUSION

The SISQ is a valid, reliable tool for assessing adolescents' SIS, essential to promoting these skills in this unique environment.

SPAN Website for Remote Intervention with Autistic Adolescents and Young Adults: Feasibility and Usability

Adolescents and young adults (AYA) with autism spectrum disorders (ASD) report less functional independence and social participation than their neurotypical peers. Remotely delivered interventions may allow autistic AYA to promote their independence, social participation, and wellbeing as they transition to adulthood. Social Participation and Navigation (SPAN) is a technology-based remotely delivered intervention initially developed for AYA with acquired brain injuries. The SPAN (website, application, and intervention manual) was modified to address the needs of AYA with autism (SPAN-ASD). This study examined the SPAN-ASD website and web application's feasibility and usability. Participants comprised 12 autistic AYA and 18 practitioners (all occupational therapists) with more than 1 year of experience in working with autistic AYA. All navigated the SPAN-ASD website and goal-management application. Practitioners completed the SPAN-ASD components and the Usefulness, Satisfaction, and Ease of Use questionnaires; AYA completed the System Usability Scale. The practitioners' average feasibility scores ranged from 4.30 to 4.68 (high); the overall usability score was 5.77 (good). The autistic AYA rated SPAN-ASD as a good, acceptable, and useful tool. Content analysis and item-level ratings indicated some needed improvements. Practitioners and autistic AYA perceived the SPAN-ASD website and application as highly feasible and usable, with excellent potential for technology-supported interventions.

Mind Sports: Exploring Motivation and Use of Cognitive Strategies in Bridge

The game of Bridge is one of the world's most widely played mind-sport games. A growing number of people consider it a meaningful leisure activity and are motivated to play. The aim of this study was to describe a sample of Bridge players in Israel in terms of demographics, player records, motivations, and cognitive strategies used to play Bridge and examine the associations between these variables. A sample of 488 Bridge players' completed an online demographic questionnaire, the Bridge Motivational Factors Checklist, and the Bridge Cognitive Strategies Questionnaire. Most players in the study were men with a mean age of 68.7 years and a Bridge player level between Vice Master and Senior Master. Most players play bridge because "bridge is a fun game". Strategy use that occurred in-game (versus pre- or postgame) obtained the highest mean score. Because Bridge is a strategy game that can be played from childhood to older adulthood, it is important to continue research to further understand the nature and different aspects of the cognitive strategy used among Bridge players and in other mind sports.

Social Participation and Navigation: Formative Evaluation of a Remote Intervention for Autistic Adolescents and Young Adults

Remote interventions can uniquely benefit and significantly increase the motivation/engagement of autistic adolescents and young adults (AYA) in intervention processes. The evidence-based, technology-based Social Participation and Navigation (SPAN), originally a remote intervention for AYA with traumatic brain injuries, shows great promise for autistic AYA. This formative evaluation aimed to inform SPAN adaptations for autistic AYA. Fifteen researcher and clinician stakeholders provided feedback and modification recommendations via a semistructured interview. Stakeholders described potential participants who might benefit, intervention goals, intervention delivery procedures, and additional program-content and technology suggestions, including original components to preserve or adjust. Findings provided a basis for developing a new SPAN-ASD website and intervention manual. The next steps include assessing website usability and feasibility and a pilot implementation study of SPAN-ASD with autistic AYA.

Telehealth Interventions to Promote Health and Behavior-Related Outcomes in Adolescents with Autism Spectrum Disorder

This systematic review examined the effectiveness in a hybrid telehealth model for adolescents with autism spectrum disorder (ASD), exploring the evidence base, methodology, and outcomes of health and behavior-related interventions for adolescents with ASD. The 11 included studies (a) were quantitative, (b) evaluated interventions delivered through a hybrid telehealth model (i.e., combined remote intervention with minimal in-person procedures), (c) measured health and behavior-related outcomes, and (d) considered adolescence as ages 12 through 25 years. The studies were a mixture of designs, methods, and outcome measures, and participant numbers were extremely low. Results demonstrated an overall lack of empirical evidence on the efficacy of hybrid-delivered interventions for adolescents with ASD, and more studies are needed to explore their effectiveness.

Work-Related Self-Efficacy and Illness Identity in Adults with Autism

Finding and retaining employment significantly challenges individuals with autism spectrum disorder (ASD). The employment rates of individuals with ASD are described as extremely low, barred by various environmental, occupational, and personal factors. Illness identity is how a person's health condition integrates with their identity and daily life and relates to self-esteem, employment, and quality of life. Adults with ASD may experience challenges developing positive identities within social and work environments, but illness identity has not been studied among this population. This study examines the autism identity of adults with ASD and the relationships to their self-reported work-related self-efficacy and quality of life. Seventeen participants aged 19-47 years diagnosed with ASD completed the Illness Identity Questionnaire, Work-Related Self-Efficacy Scale and World Health Organization Quality of Life Assessment. Participants reported significantly higher autism acceptance feelings. Negative feelings about living with autism were significantly correlated to lower work-related self-efficacy. Higher levels of enrichment feelings were significantly associated with a higher quality of life. These findings highlight the effect of illness identity on the work-related self-efficacy and quality of life among individuals with ASD. Allied health professionals and educators can assist these individuals in raising their awareness of how they perceive their autism, and in promoting its positive perception.

Illness Identity Perception and the Relationship to Health-Related Quality of Life Among Individuals With Autism Integrated in the Work World

Date Presented 04/01/2022

Illness identity is the perception people develop about themselves in relation to their health condition and how it integrates into their identity and daily life. Some individuals with autism negatively perceive their diagnosis and try to distance themselves from the autism label. That may affect their psychological and social quality of life. OTs have an essential role in promoting positive illness identity perception in this population.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Sonya Meyer

Role Perception of OTs in Education Systems as Affected by Self-Efficacy and Employability Skills

Date Presented 04/01/2022

This research examines an integrated conceptual model wherein self-efficacy explains OTs’ role perception with employability skills as mediator. Role perception is a vital component of understanding individuals’ concatenation in the workplace and combined expression of their psychological and socio-organizational dimensions. Thus, we assume high self-efficacy and employability skills may improve the role perception of OTs working in education systems.

Primary Author and Speaker: Yael Fogel

Additional Authors and Speakers: Liron Lamash

Hybrid Interventions to Promote Health-Related Outcomes in Adolescents With Autism Spectrum Disorder

Date Presented 04/01/2022

There is an increasing need for efficacious interventions to promote activities of daily living, social participation, academic and work skills, and well-being among adolescents with autism spectrum disorder (ASD). Therefore, we conducted a systematic review to characterize the evidence related to telehealth-delivered interventions for adolescents with ASD. Findings point to the need for increased research in this area.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Lauren Little, Liat Hen-Herbst

EASI Praxis Tests: Age Trends and Internal Consistency

IMPORTANCE

Ayres Sensory Integration® is an evidence-based practice that requires a comprehensive assessment before intervention. The Evaluation in Ayres Sensory Integration (EASI) is intended for this purpose, and psychometric data are needed to determine its validity and reliability.

OBJECTIVE

To evaluate the internal consistency of four EASI Praxis tests and their validity as developmental measures.

DESIGN

Cross-sectional developmental design.

SETTING

Participants' homes.

PARTICIPANTS

Typically developing children and young adolescents, ages 6 to 12 yr (N = 234). Outcomes and Measures: We analyzed four EASI Praxis tests using Cronbach's α, Pearson correlation coefficients, and one-way analysis of variance to explore internal consistency and developmental trends.

RESULTS

The findings indicate moderate to high internal consistency for all tests. Significant correlations between age and praxis scores indicate that the EASI Praxis tests are sensitive to developmental changes.

CONCLUSIONS AND RELEVANCE

Occupational therapists can have confidence in the internal consistency and sensitivity to developmental changes of these praxis scores through early adolescence. What This Article Adds: Occupational therapists administering EASI Praxis tests can have confidence that they consistently measure praxis ability and are sensitive to developmental changes across ages 6 to 12 yr. The results suggest that praxis continues to develop into early adolescence, and adolescents may benefit from assessment and intervention targeting praxis ability.

Time Organization Patterns of Adolescents: Agreement between Self- Report and Parent Report

AIMS

Occupational therapy services include measurement and promotion of time organization as important for adolescents' daily life management and well-being into adulthood. This study examined the internal consistency reliability of the Time Organization and Participation Scale (TOPS) among adolescents and their parents, associations between time organization and age, gender differences in time organization, and agreement levels between adolescents' and parents' perceptions of time-organization abilities.

METHODS

Seventy-five adolescents with typical development and their parents completed the TOPS self-report and parent versions.

RESULTS

Both TOPS versions showed high internal consistency (.80-.94). No significant correlations were found between age and time-organization patterns. Girls self-reported significantly more emotional response following disorganization in time. Parents' total scores explained 52.1% of the variance in their children's total scores.

CONCLUSIONS

Adolescence, a critical transitional period of preparing for independent adult life, involves a continual interaction between person, occupation, and environment while using skills to organize in time. The TOPS's self- and parent-reports are reliable and can raise awareness of time-organization deficiencies in daily activities and emotional consequences. The use of the TOPS to assess adolescents' time-organization abilities can inform intervention design to help adolescents develop an awareness of their time use and foster their daily performance.

Role Perception of Occupational Therapists in Education Systems: Self-Efficacy and Employability Skills

Although the main framework for occupational therapy includes delivery of services in educational institutions with students with disabilities, little is known about how the occupational therapists perceive their role in this specific system. This research examines an integrated conceptual model wherein self-efficacy explains the occupational therapists' role perception with employability skills as a mediator. Participants, 147 occupational therapists working in educational systems, completed an online demographic questionnaire, the Perception Questionnaire for Occupational Therapists in the Education System, General Self-Efficacy Questionnaire, and Employability Key Questionnaire. The proposed model was analyzed by the structural equation model (SEM) using AMOS software. The SEM provided excellent goodness of fit indices, χ 2(24) = 40.49; p = .019; NFI = .93; CFI = .97; RMSEA = .07; SRMR = .05, and explained 40% of the variance in role perception. These findings highlight employability skills as the primary contributor that affects occupational therapists' role perception. Self-efficacy and employment skills influence how occupational therapists working in education systems perceive their roles; thus, employment skills should be included in professional training and development courses. This study has implications for occupational therapists working on the education system to understand the meaningful effects of employability skills as critical to developing and improving their role perception.

Daily Routine and Autonomy (DRA) Questionnaire Among Adolescents With Autism Spectrum Disorder

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

Adolescents with autism spectrum disorder (ASD) show poor independence in daily activities. The self-report Daily Routine and Autonomy Questionnaire (DRA) identifies adolescents' actual versus desired independence in daily routines and promotes setting and achieving goals. This research assesses the DRA with adolescents with ASD. Results indicate moderate to high internal reliability and significantly higher desire for independence than independence level, indicating potential goals they can set.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Naomi Josman

Collapse

Relationship Between Professional Identity and Role Perception of OTs Working in Education Systems

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

OTs are integral in education settings, but their inability to define their role and differences between the educational and therapeutic cultures challenge their professional identity development. Reliable and valid tools to assess the role perceptions and professional identity of OTs in education systems indicate that teamwork is the most influential factor in OTs' positive professional identity.

Primary Author and Speaker: Yael Fogel

Additional Authors and Speakers: Liron Lamash

Collapse

Illness Identity and the Relationship With Participation and Quality of Life Among Adolescents With Celiac Disease

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

Celiac disease is a chronic condition, treated by a strict lifelong gluten-free diet. Adolescents need to gain independence and assume responsibility for self-managing their diet while participating in daily food-related activities. Maintaining health, well-being, and quality of life and developing self- and illness identity are central developmental tasks during adolescence. OTs have an important role in addressing and promoting health management needs.

Primary Author and Speaker: Sonya Meyer

Additional Authors and Speakers: Liron Lamash

Metacognitive Model to Promote Independence Among Adolescents With Autism Spectrum Disorder: Implementation of a Shopping Task in the Community

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

A metacognitive model was developed based on functional cognition and the existing literature, with the aim of promoting independence in everyday functioning among individuals with autism spectrum disorder (ASD). This study examines an application of the proposed model among adolescents with ASD, in the context of conducting a shopping errand in the community. Results show evidence of significantly greater improvement for the group receiving the functional cognitive intervention in comparison with the control group.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Naomi Josman

Role Perception and Professional Identity of Occupational Therapists Working in Education Systems: Perception du rôle et identité professionnelle des ergothérapeutes qui travaillent dans les systèmes scolaires

BACKGROUND.

Occupational therapists, especially those in education systems, are challenged to define their professional roles and identities.

PURPOSE.

This research evaluated the Role-Perception Questionnaire for Occupational Therapists in the Education System's (RP-OT) psychometric properties, the Professional Identity Scale (PIS) internal consistency among occupational therapists, and relationships among role perception, professional identity, and demographic characteristics.

METHOD.

A sample of 147 occupational therapists in education systems completed the RP-OT and PIS. We conducted exploratory factor analysis and calculated Cronbach alpha to evaluate the RP-OT and PIS psychometric properties. Relationships were examined using Pearson correlation.

FINDINGS.

The RP-OT was found reliable and valid, with medium-to-strong correlations among role perception, professional identity, and demographics. Teamwork in the education system was the major predictor (82%) of professional identity.

IMPLICATIONS.

Teamwork is part of the professional role of occupational therapists in the education system and a significant component for developing their positive professional-identity perception.

Illness Identity in Adolescents With Celiac Disease

OBJECTIVES

The aim was to examine the reliability and validity of the Illness Identity Questionnaire (IIQ) among adolescents with celiac disease (CD), to describe their illness identity characteristics, and to examine relationships between illness identity and self-reported participation in food-related activities and quality of life.

METHODS

Adolescents with CD (n = 91) were recruited for this cross-sectional study via social media interest groups. Participants completed online questionnaires: the IIQ, the CD Children's Activities Chart (CD-Chart), and the Pediatric Quality of Life Inventory (PedsQL).

RESULTS

Internal reliability was established for IIQ items (α = 0.87) and for its 4 components (α = 0.75--0.90). The positive components (acceptance, enrichment) significantly differed from the negative components (rejection, engulfment), t(90) = 11.45, P < 0.001, d = 1.98. Feelings were more positive (M = 3.48, SD = 0.67) than negative (M = 2.06, SD = 0.76). The total IIQ was positively associated with the CD-Chart amount of activities (r = 0.30, P < 0.01) and enjoyment (r = 0.34, P < 0.001) and with the PedsQL social scale (r = 0.53, P < 0.001).

CONCLUSIONS

The IIQ established acceptable reliability and validity. In all, the adolescents with CD exhibited an illness identity profile that was more positive and adaptive than negative. The IIQ can contribute to understanding the developmental status of illness identity during the critical transition process from adolescence to adulthood.

Organization in Time Among Adolescents: Is There an Adolescent–Parent Agreement, and What About Gender Differences?

Date Presented 03/27/20

Adolescents divide their time among occupation domains essential for developing daily life management and well-being into adulthood. The Time Organization and Participation Scale (TOPS) assesses self-perception and emotional implications of time-organization abilities. This study’s results present TOPS’s internal reliability for adolescents and their parents and identify gender-related differences. Time organization should be considered for assessing and developing interventions among adolescents.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Sara Rosenblum

Contributing Authors: Tsameret Ricon

Comparison of Community Participation Patterns of Israeli Adolescents With and Without Autism Spectrum Disorder (ASD)

Date Presented 03/26/20

Community participation promotes quality of life and transition to adulthood for adolescents with ASD. This study describes community participation and environmental barriers to and supports of adolescents with ASD compared to typically developing peers using the Participation and Environment Measure—Children and Youth. Results can inform intervention, resource allocation, and policy decisions to best meet the needs of adolescents with ASD.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Gary Bedell

Contributing Authors: Naomi Josman

Metacognitive Model to Promote Independence Among Adolescents With Autism Spectrum Disorder (ASD): Implementation of a Shopping Task in the Community

Date Presented 03/27/20

A metacognitive model was developed based on functional cognition and the existing literature, with the aim of promoting independence in everyday functioning among individuals with ASD. This study examines an application of the proposed model among adolescents with ASD, in the context of conducting a shopping errand in the community. Results show evidence of significantly greater improvement for the group receiving the functional cognitive intervention in comparison to the control group.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Naomi Josman

Full-information factor analysis of the Daily Routine and Autonomy (DRA) questionnaire among adolescents with autism spectrum disorder

INTRODUCTION

Adolescents with autism spectrum disorder (ASD) show poor independence in daily activities. Unlike existing instruments, the innovative self-report Daily Routine and Autonomy questionnaire (DRA) addresses their level of and desire for independence in activities throughout a full daily routine. This study describes the DRA development, explores its psychometric properties and internal consistency reliability using full-information factor analysis (FIFA), and identifies levels of and desire for independence among adolescents with ASD.

METHODS

Seventy-two Israeli adolescents with ASD (58 boys and 14 girls) aged 11-19 years (M = 14.59, SD = 1.61) completed the DRA. Statistical analyses were performed using SPSS and R. Internal consistency reliability, FIFA, Spearman's correlations, t-tests, and Wilcoxon signed-rank were conducted to assess relationships and differences between the DRA parts.

RESULTS

The FIFA revealed three factors with high sum-of-squared loadings (4.09-5.13). Of the 31 DRA items, 28 had factor loadings higher than 0.35 and were retained in the study questionnaire. The DRA had moderate-to-high internal reliability for factors (α = 0.65-0.84) and total scores (α = 0.86-0.90). Participants showed partial independence in most daily activities, with high desire for independence in social and leisure activities. Significant gaps in half of the DRA items indicate the participants' desire for independence was significantly higher than their independence level.

CONCLUSION

The DRA provides crucial information about levels of and desire for autonomy that can be used to promote participation of adolescents with ASD in setting their own goals for independent living.

A metacognitive intervention model to promote independence among individuals with autism spectrum disorder: Implementation on a shopping task in the community

Adolescents with autism spectrum disorder show low independence levels and difficulty performing complex daily activities. The many intervention approaches for these individuals include deconstructing complex activities into basic components, processing and practicing tasks, and developing compensation strategies. The aim of this study was to examine the effectiveness of a short-term metacognitive intervention combined with virtual supermarket practice to improve the independent implementation of a shopping task among adolescents with autism spectrum disorder. The study included 56 adolescents with autism spectrum disorder, of whom 33 performed the metacognitive intervention and 23 served as controls. Outcome measures included assessments of cognitive and metacognitive functions and a performance-based evaluation of a shopping task in the natural environment. Compared to the control group, the intervention group experienced significant improvement in accuracy and efficiency while performing a shopping task. In addition, the executive functions domain was found to be the main predictor of accuracy and efficiency in performing the shopping task. These findings indicate the short-term metacognitive intervention, reinforced by a technology-based training programme, may effectively enhance the independent execution of a shopping task by adolescents with autism spectrum disorder and expand their potential participation in the community.

Participation patterns of adolescents with autism spectrum disorder compared to their peers: Parents’ perspectives

Introduction

Although participation is an important outcome of rehabilitation interventions and a critical indicator of quality of life, few studies have focused on the participation patterns of adolescents with autism spectrum disorder in their daily activities or the environmental factors that influence such participation. This study aims to describe the participation characteristics of adolescents with autism spectrum disorder compared with typically developing peers in home, school and community and to identify supporting or hindering environmental features.

Method

The Participation and Environment Measure for Children and Youth was administered to 59 parents of adolescents ( M = 14.51 years) with autism spectrum disorder and a control group of 188 parents of typically developing adolescents in Israel, and the results were compared.

Results

Adolescents with autism spectrum disorder showed lower participation levels at home and school, and much lower levels in the community, preferring solitary activities that involve technology. Their typically developing peers participated in more activities that involved social interaction skill. In addition, parents of adolescents with autism spectrum disorder rated more environmental factors as barriers in all environments.

Conclusion

Participation gaps between adolescents with autism spectrum disorder and their typically developing peers should be considered when developing interventions, allocating services and creating policies to meet the unique needs of adolescents with autism spectrum disorder.

Daily Routine and Autonomy: Identifying Independence and Desire for Autonomy in Daily Activities Among Adolescents With Autism Spectrum Disorder

Date Presented 4/19/2018

Adolescents with autism spectrum disorder show poor independence in daily activities compared with their peers. Daily Routine and Autonomy is an innovative self-report questionnaire that assesses their independence abilities and desire for autonomy. This study examined its reliability and validity.

Primary Author and Speaker: Liron Lamash

Contributing Authors: Naomi Josman

The Test of Grocery Shopping Skills and Its Correlation to Metacognition Among Adolescents With Autism Spectrum Disorder

Date Presented 4/20/2018

Adolescents with autism spectrum disorder show impairments in metacognitive abilities and low independence in daily activities. This study examined correlations between the Test of Grocery Shopping Skills and WebNeuro. It is vital to evaluate metacognitive skills in the context of daily activities among this population.

Primary Author and Speaker: Liron Lamash

Contributing Authors: Naomi Josman

Using Multitouch Collaboration Technology to Enhance Social Interaction of Children with High-Functioning Autism

AIMS

Children with high-functioning Autism Spectrum Disorder (HFASD) have major difficulties in social communication skills, which may impact their performance and participation in everyday life. The goal of this study was to examine whether the StoryTable, an intervention paradigm based on a collaborative narrative, multitouch tabletop interface, enhanced social interaction for children with HFASD, and to determine whether the acquired abilities were transferred to behaviors during other tasks.

METHODS

Fourteen boys with HFASD, aged 7-12 years, participated in a 3-week, 11-session intervention. Social interactions during two nonintervention tasks were videotaped at three points in time, one prior to the intervention (pre), a second immediately following the intervention (post) and a third three weeks after the intervention (follow-up). The video-recorded files were coded using the Friendship Observation Scale to ascertain the frequencies of positive and negative social interactions and collaborative play. Differences in these behaviors were tested for significance using nonparametric statistical tests.

RESULTS

There were significantly higher rates of positive social interactions and collaborative play, and lower rates of negative social interactions following the intervention suggesting generalization of the social skills learned during the intervention. Improvement was maintained when tested three weeks later.

CONCLUSION

These findings provide support for the use of collaborative technology-based interventions within educational settings to enhance social interaction of children with HFASD.

To enforce or not to enforce? The use of collaborative interfaces to promote social skills in children with high functioning autism spectrum disorder

The goal of this stud was to examine whether a technological touch activated Collaborative Puzzle Game (CPG) increased positive social behaviors in children with high functioning autism spectrum disorder (HFASD). The CPG involved construction of a virtual puzzle by selecting and dragging pieces into the solution area on a touch screen table. The target picture was presented on the top of the screen. Six dyads of children with HFASD (aged 8-11 years) engaged in the CPG in a Free Play (FP) mode in which partners could independently move puzzle pieces versus in an Enforced Collaboration (EC) mode in which partners could only move puzzle pieces together. Videos of the dames were coded for the frequencies of positive and negative social interaction, affect, play, and autistic behaviors. Parents completed the Social Responsiveness Scale (SRS). Wilcoxon Signed-ranks tests indicated that children with HFASD showed significantly higher frequencies of positive social interaction and collaborative play in the EC versus FP modes but there were no differences in negative social behaviors. Differences in social behaviors between partners during the puzzle games were not significant; however there were differences within pair in the severity of social deficits as assessed by the SRS questionnaire. The CPG in an EC mode was effective in promoting positive social interaction by requiring children to work together towards a mutual goal. However, the increased challenge in this mode, particularly for children with lower social-communication skills, suggests the need for establishing selection criteria and mediation steps for such interventions.