The Use of Social Stories to Reduce Negative Affect and Improve Satisfaction in Adults Attending an ASD Assessment
The Use of Social Stories to Reduce Negative Affect and Improve Satisfaction in Adults Attending an ASD Assessment
Many people with Autism Spectrum Disorder (ASD) find the unpredictability of social
 situations emotionally distressing. It is likely that attending a diagnostic assessment is no
 exception. Social Stories are short stories that describe a social situation so that people
 know what to expect. They are written in a way that is accessible to people with ASD. This
 study will explore whether a Social Story written about a diagnostic assessment can reduce
 the associated emotional distress and increase people's satisfaction with the process. If so,
 they could be a simple way that services can better cater for their clients' needs.
An invitation to participate in the study will be included with every appointment letter sent
 out by the host site(s) whilst recruitment is active. The invitation will invite participants
 to visit a website (hosted by Qualtrics) where they will be provided with information about
 the study and asked if they would like to provide informed consent to participate. If consent
 is given, they will be asked to complete an online version of the Positive and Negative
 Affect Schedule (PANAS; time 1). Contact information will also be requested at this point.

 Participants will then be randomly allocated to either an experimental group or to a control
 group. Participants in the experimental group will read a Social Story about what to expect
 from their assessment; participants in the control group will read the standard information
 the host service sends out about what to expect from their assessment. Participants will be
 blinded to which group they are in.

 If the participants choose to supply a mobile telephone number and email address, an SMS text
 message and/or email reminder will be sent out one week prior to their assessment and again
 on the morning of the assessment. These reminders will include hyperlinks to the information
 about what to expect and will remind them to complete the PANAS once they arrive at their
 appointment.

 On arrival at their assessment (time 2), participants will complete a paper copy of the PANAS
 questionnaire and will be asked for demographic information. Participants will also be asked
 to rate the extent that the information they read prior to attending the assessment has
 helped them to know what to expect thus far. Paper copies of the questionnaire will be left
 in the waiting area with instructions to hand them into staff once complete.

 One week following their assessment (time 3), participants will receive another SMS/email
 which will include a hyperlink to a post-assessment survey that will ask participants to rate
 their satisfaction with the assessment and whether they received a diagnosis of ASD.
 Participants who do not complete this questionnaire after one week will be contacted one
 final time. All participants will be sent a debriefing sheet.

 Hypotheses

 1. Compared with participants who read standard, non-social information prior to attending
 an assessment for ASD, participants who read a Social Story will report, on average,
 less of an increase in negative affect when attending their assessment, as measured by
 the negative subscale of the PANAS.

 2. Participants who read a Social Story prior to attending an assessment for ASD will
 report, on average, higher satisfaction (measured via a 5 point Likert scale) with the
 assessment than participants who read standard, non-social information.

 3. Compared with participants who read standard, non-social information prior to attending
 an assessment for ASD, participants who read a Social Story will report, on average,
 that the assessment was more predictable (measured via a 5 point Likert scale).

 Data Analysis

 1. Comparison of means using a 2 (group; SS, control) X 2 (time; time 1, time 2) mixed
 ANOVA (repeated measures on the time factor). Dependent variable = PANAS score.

 Comparison of means using an independent t-test at time 2. Independent variable = group
 (2 levels; SS and control). Dependent variable = PANAS score.

 Descriptive statistics.

 2. Comparison of means using the Mann-Whitney U test at time 3. Independent variable =
 group (2 levels; SS and control). Dependent variable = satisfaction score.

 Descriptive statistics.

 3. Descriptive statistics.
Inclusion Criteria:

 -  People who are awaiting an ASD assessment at the host site.

 -  People who have never visited the site before.

 Exclusion Criteria:

 -  People who do not receive a diagnosis of ASD following the study will not be included
 in the inferential statistical analysis. However, they will still be participants in
 the study and their data will be reported descriptively.