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Cutoffs for the Matson Evaluation of Social Skills with Youngsters-II (MESSY-II) for typically developing children and for children diagnosed with autism spectrum disorders
Research in Autism Spectrum Disorders 5 (2011) 798–802
Contents lists available at ScienceDirect
Research in Autism Spectrum Disorders Journal homepage: http://ees.elsevier.com/RASD/default.asp
Cutoffs for the Matson Evaluation of Social Skills with Youngsters-II (MESSY-II) for typically developing children and for children diagnosed with autism spectrum disorders Johnny L. Matson *, Alison M. Kozlowski, Daniene Neal, Julie A. Worley, Jill Fodstad Louisiana State University, United States
A R T I C L E I N F O
A B S T R A C T
Article history: Received 17 August 2010 Accepted 10 September 2010
The acquisition of social skills is an essential part of childhood and adolescent development. Due to its critical nature, assessment of appropriate and inappropriate social skills is necessary in order to determine whether or not deficits or excesses exist, thereby guiding treatment. The Matson Evaluation of Social Skills with Youngsters (MESSY) was developed for this purpose, and it has recently been renormed and revised. Beyond a general understanding of where strengths and weaknesses lie, it is important to also be able to identify clinically significant impairments versus those that may be observed as a normal part of development. This was accomplished with typically developing children to establish cutoffs for the revised scale, the MESSY-II. Additionally, a sample of children diagnosed with autism spectrum disorders were administered the MESSY-II and their cutoff scores were examined. ß 2010 Elsevier Ltd. All rights reserved.
Keywords: MESSY-II Social skills Children Adolescents ASD
1. Introduction Throughout childhood the acquirement of appropriate social skills, and likewise the management and treatment of inappropriate social skills, is seen as a core component of developmental growth and learning (Chan et al., 2009; Matson, Mahan, & Matson, 2009). A lack of appropriate social skills or excess of inappropriate social skills may have numerous consequences. Children and adolescents with such deficits may have difficulty obtaining and maintaining friendships, succeeding with academics, and fulfilling their social roles. Furthermore, social skills deficits are commonly associated with a variety of disorders including autism spectrum disorders (ASD; Matson, Dempsey, & Fodstad, 2009; Matson & Wilkins, 2007, 2008), fetal alcohol spectrum disorders (O’Connor et al., 2006), attention-deficit/hyperactivity disorder (Wehmeier, Schacht, & Barkley, 2010), and depression (Segrin, 2000), among others. Therefore, assessment of social skills is important for children and adolescents in order to identify problem areas for treatment and to evaluate progress during intervention. Despite the importance of social skills, relatively few measures focus solely on assessment of the strengths and weaknesses of these behaviors in children and adolescents. However, the Matson Evaluation of Social Skills with Youngsters (MESSY; Matson, 1988) is a rating scale that was specifically designed to assess both appropriate and inappropriate social skills in children and adolescents. The original scale was normed on 744 children between the ages of 4 and 18 and produced two factors—appropriate social skills and inappropriate assertiveness (Matson, Rotatori, & Helsel, 1983). The measure was found to possess good psychometric properties with strong internal consistency, strong test–retest reliability, and adequate convergent validity. The MESSY was later translated into several different languages and has been researched and applied to
* Corresponding author at: Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States. E-mail address: [email protected] (J.L. Matson). 1750-9467/$ – see front matter ß 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.rasd.2010.09.008
J.L. Matson et al. / Research in Autism Spectrum Disorders 5 (2011) 798–802
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many different populations including individuals with ASD, intellectual disability, hearing impairments, vision impairments, anxiety disorders, and depression (Matson & Wilkins, 2009). Recently, the MESSY’s psychometric properties and factor structure have been revisited using a new normative sample, resulting in a second edition of the scale, the MESSY-II (Matson, 2010). Using a sample of 885 typically developing children ages 2 through 16, the internal consistency of the measure was evaluated by dividing the participants into three age cohorts: 2- to 5-year olds, 6- to 9-year olds, and 10- to 16-year olds (Matson, Neal, Hess, Fodstad, et al., in press-a). Alpha coefficients indicated good internal consistency and ranged from .84 to .93 with the older age cohorts having greater alpha values, thereby suggesting that older children possess more consistent social skills. Matson and colleagues also explored the convergent and divergent validity of the scale using the same age cohorts. While both convergent and divergent validity ranged from good to strong, the authors do make note that the validity of the scale for younger children (i.e., 2- to 5-year olds) is less promising, most likely due to overall difficulty in measuring social skills in younger children related to variability seen in this age cohort. Finally, the factor structure of the MESSY-II was explored. An exploratory factor analysis yielded a threefactor solution with two factors related to inappropriate social skills (i.e., Hostile and Inappropriately Assertive/ Overconfident) and one factor consistent with appropriate social skills (i.e., Adaptive/Appropriate) (Matson, Neal, Worley, Kozlowski, et al., in press-b). With the MESSY having been renormed, yielding updated psychometric properties and a new factor structure, cutoffs for this revised scale are warranted. Therefore, the purpose of this paper was first to determine whether or not social skills among the three-factor structure differed by age cohort. Based on these results, cutoffs were established so that the measure could be administered to children and adolescents with the goal of determining whether or not significant social skills deficits were present along each factor. Finally, the MESSY-II scores of children with an autism spectrum disorder, a population distinctively known for possessing social skills deficits, were computed to examine the applicability of this scale for use in such populations. 2. Methods 2.1. Participants For the first part of the study, a sample of 874 children was selected from a larger group of 1065 children whose parents or caregivers completed the MESSY-II. For the purposes of this part of the study, only children who were determined to be typically developing (i.e., no prior psychiatric condition, medical/genetic disorder, physical disability, intellectual disability, or developmental delay) via record review and/or parent report were retained. The sample was divided into three age cohorts, consistent with the reliability study of the MESSY-II (Matson, Neal, Hess, Fodstad, et al., in press-a): 2- to 5-year olds (n = 280; M = 3.86; SD = 1.01); 6- to 9-year olds (n = 305; M = 7.37; SD = 1.10); and 10- to 16-year olds (n = 289; M = 12.39; SD = 1.77). Breakdown of gender among the age cohorts was 51% male and 49% female for the 2- to 5-year olds, 39% male and 61% female for the 6- to 9-year olds, and 41% male and 59% female for the 10- to 16-year olds. The ethnic representation of the 2- to 5-year olds consisted of children who were Caucasian (81%), African American (12%), and Other (7%). The 6- to 9year old cohort included children who were Caucasian (83%), African American (6%), and Other (11%). Finally, the 10- to 16year old cohort consisted of children who were Caucasian (89%), African American (5%), and Other (6%). For the second part of the study, a sample of 86 children with an ASD were selected from a larger group of 1065 children whose parents or caregivers completed the MESSY-II. Diagnoses of ASD were obtained via an algorithm of International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10; World Health Organization [WHO], 1992) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR, American Psychological Association [APA], 2000) criteria. In addition, clinical histories, observations, and other standardized measures of ASD, such as the Autism Diagnostic Interview-Revised (ADI-R; Lord, Rutter, & LeCouteur, 1994), Childhood Autism Rating Scale (CARS; Schopler, Reichler, DeVellis, & Daly, 1980), and Checklist for Autism in Toddlers (CHAT; Baron-Cohen et al., 2000) were used along with clinical consultation with a licensed psychologist. Consistent with the first part of the study, the sample was divided into three age cohorts: 2- to 5-year olds (n = 26; M = 3.92; SD = 1.06); 6- to 9-year olds (n = 36; M = 7.36; SD = 1.18); and 10- to 16-year olds (n = 24; M = 12.33; SD = 1.86). Breakdown of gender among the age cohorts was 73% male and 27% female for the 2- to 5-year olds, 86% male and 14% female for the 6- to 9-year olds, and 88% male and 12% female for the 10- to 16-year olds. The ethnic representation of the 2- to 5-year olds consisted of children who were Caucasian (85%), African American (8%), and Other (7%). The 6- to 9-year old cohort included children who were Caucasian (86%), African American (6%), and Other (8%). Finally, the 10- to 16-year old cohort consisted of children who were Caucasian (79%), African American (8%), and Other (13%). 2.2. Measures 2.2.1. Matson Evaluation of Social Skills with Youngsters-II (MESSY-II; Matson, 2010) The MESSY-II is a social skills measure for a broad range of children, ages 2–16, based on observations of both appropriate and inappropriate social behaviors. The scale consists of a total of 57 items on a likert-type rating scale from 1 (‘‘not at all’’) to 5 (‘‘very much’’). The MESSY-II yields three factors: Hostile, Adaptive/Appropriate, and Inappropriate Assertiveness/Overconfident scales (Matson, Neal, Hess, Fodstad, et al., in press-a). Factor scores are obtained by
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summing the Likert rating for each item in the scale. A high score on the Hostile and/or Inappropriate Assertiveness/ Overconfident factors indicates the presence of poor social skills while a low score on the Adaptive/Appropriate factor indicates a lack of positive social skills. The MESSY-II reports a high degree of internal consistency with alpha coefficients of .84 for the 2- to 5-year olds, .93 for the 6- to 9-year olds, and .93 for the 10- to 16-year olds (Matson, Neal, Hess, Fodstad, et al., in press-a). Significant correlations between the MESSY-II and the adaptive subscales of the Behavior Assessment Scale for Children, Second Edition (BASC-2; Reynolds & Kamphaus, 2004) were found (Matson, Neal, Hess, Fodstad, et al., in press-a), indicating good to strong convergent validity. Furthermore, divergent validity was established by comparing the MESSY-II to the Autism Spectrum Disorders – Child Comorbidity (ASD-CC; Matson & Gonza´lez, 2007), resulting in non-significant correlations (Matson, Neal, Hess, Fodstad, et al., submitted for publication-a). 2.3. Procedures The participants for this investigation were recruited throughout the United States from a variety of clinic, community, and school settings via self or professional referral. Flyers describing the study and procedures for participation were disseminated at the aforementioned settings. Participants came from sites in California, Connecticut, Florida, Georgia, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, and Pennsylvania. The project was described as a study on the development of measures to assess the social and emotional behaviors of children and adolescents. As such, parents or legal guardians completed a battery of assessments which included, but was not limited to, a demographic questionnaire, an assessment of social skills in children and adolescents (i.e., MESSY-II), a measure of comorbid problems in children with ASD (i.e., ASD-CC), and a broad measure of clinical and adaptive functioning (i.e., BASC-2). This investigation was approved by the Louisiana State University Institutional Review Board and informed consent was obtained from parents or legal guardians. 2.4. Data analysis In order to investigate the appropriateness of developing cutoffs according to age cohorts, a MANOVA was utilized to test for significant differences between each total factor score of the MESSY-II (Hostile, Adaptive/Appropriate, and Inappropriately Assertive/Overconfident) and the age cohorts (2–5 years, 6–9 years, and 10–16 years). Next, a standard deviation method was utilized where clinical significance was defined as a score that was two standard deviations or more away from the mean (Jacobson & Truax, 1991). Therefore, the mean and standard deviation of the MESSY-II factors was calculated for each age cohort and used to compute the cutoff scores. Finally, to examine the utility of the new cutoff scores with an atypical population, MESSY-II mean factor scores from a sample of children diagnosed with ASD were computed. Missing data points were replaced with the mean for that particular item. No participant had more than five missing items. 3. Results 3.1. Typically developing group A MANOVA was computed with age cohort as the independent variable (i.e., 2- to 5-year olds, 6- to 9-year olds, and 10- to 16-year olds) and each of the three factors of the MESSY-II as dependent variables (i.e., Hostile, Adaptive/Appropriate, and Inappropriately Assertive/Overconfident). The purpose of the analysis was to determine if there were significant differences along the factors with respect to age cohorts. This analysis would help establish if separate cutoff scores for each cohort were necessary. The main effect for age cohort was significant, Wilks’ L = .012, F (3, 869) = 23,340, p = .000. Follow-up analyses of variance (ANOVAs) were run for all three factors. The ANOVAs were significant for all three factors: Hostile [F (2, 871) = 19.849, p = .000], Adaptive/Appropriate [F (2, 871) = 39.622, p = .000], and Inappropriately Assertive/Overconfident [F (2, 871) = 35.331, p = .000]. Tukey post-hoc tests revealed that on the Hostile factor the 2- to 5-year old age cohort (M = 38.37) significantly differed from the 6- to 9-year old age cohort (M = 43.94) and the 10- to 16-year old age cohort (M = 44.09). However, the 6- to 9-year old age cohort did not significantly differ from the 10- to 16-year old age cohort. On the Adaptive/ Appropriate factor, the 2- to 5-year old age cohort (M = 69.29) significantly differed from the 6- to 9-year old age cohort (M = 75.73) and the 10- to 16-year old age cohort (M = 76.18). However, the 6- to 9-year old age cohort did not significantly differ from the 10- to 16-year old age cohort. On the Inappropriately Assertive/Overconfident factor, the 2- to 5-year old age cohort (M = 32.30) did not significantly differ from the 6- to 9-year old age cohort (M = 31.35), but did significantly differ from the 10- to 16-year old age cohort (M = 27.38). Additionally, the 6- to 9-year old age cohort differed significantly from the 10to 16-year old age cohort. The mean and standard deviation for each of the three MESSY-II factors was calculated by age cohort for the typically developing sample. For the inappropriate social skills factors (i.e., Hostile and Inappropriately Assertive/Overconfident), scores that fell below one standard deviation above the mean were indicative of ‘no/minimal impairment,’ scores that fell between one standard deviation and two standard deviations above the mean were classified as ‘moderate impairment,’ and scores that fell two standard deviations or more above the mean were considered to be indicative of ‘severe impairment.’ For the appropriate social skills factor (i.e., Adaptive/Appropriate), scores that fell above one standard deviation below the mean were indicative of ‘no/minimal impairment,’ scores that fell between one standard and two standard deviations below the mean were considered indicative of ‘moderate impairment,’ and scores that fell two standard deviations or further below the
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J.L. Matson et al. / Research in Autism Spectrum Disorders 5 (2011) 798–802 Table 1 Factor means, standard deviations, and cutoffs for typically developing by age cohort. Age cohort
Factor
Mean
Standard deviation
No/minimal impairment
Moderate impairment
Severe impairment
2–5
Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident
38.37 69.29 32.30 49.94 75.73 31.35 44.09 76.18 27.39
9.70 10.06 7.58 14.03 10.06 8.52 12.75 10.88 5.91
0–47 60+ 0–39 0–57 67+ 0–39 0–56 66+ 0–32
48–57 50–59 40–47 58–71 57–66 40–48 57–69 55–65 33–38
58+ 0–49 48+ 72+ 0–56 49+ 70+ 0–54 39+
6–9
10–16
Table 2 Factor means and standard deviations for ASD by age cohort. Age cohort
Factor
Mean
Standard deviation
2–5
Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident
35.11 39.00 26.04 51.19 45.72 35.39 53.17 45.67 10.67
8.59 14.15 7.12 19.03 12.28 8.30 24.61 11.70 10.67
6–9
10–16
mean were determined to be indicative of ‘severe impairment.’ All factor means, standard deviations, and cutoffs according to age cohort are presented in Table 1. 3.2. ASD Group Lastly, the mean score for each of the three MESSY-II factors was calculated by age cohort for a sample of children diagnosed with an ASD. On average, children diagnosed with ASD across all three age cohorts were found to fall within the no/minimal impairment category for the Hostile and Inappropriately Assertive/Overconfident factors, suggesting no excesses of inappropriate social skills. Conversely, on the Adaptive/Appropriate factor all three age cohorts averaged within the severe impairment range, thereby suggesting a significant impairment with respect to appropriate social skills. All factor means and standard deviations for the ASD group according to age cohort are presented in Table 2. 4. Discussion Impairments in social skills are a defining aspect of developmental disabilities, and deficits in these skills can affect the ability of children, adolescents, and adults to progress in other areas across the spectrum of development. Furthermore, social deficits are major risk factors for challenging behaviors (Farmer & Aman, 2009; Tenneij, Didden, Stolker, & Koot, 2009), and similarly, they can compound problems of psychopathology (Brim, Townsend, DeQuinzio, & Poulson, 2009; Matson, ´ skarsdo´ttir, & Gillberg, 2009; Rose, Bramham, Young, Paliokostas, & Dempsey, & Rivet, 2009; Niklasson, Rasmussen, O Xenitidis, 2009). For these and other reasons, the development of measures of social skills is very important (Matson & Boisjoli, 2009a, 2009b; Matson & Dempsey, 2009; van den Hazel, Didden, & Korzilius, 2009). Factor cutoff scores were established for typically developing children and adolescents on the MESSY-II. These scores differed to some degree across age cohorts. What these data suggest is the need to develop normative data by specific cohorts on social skills measures as was done in the current study. A trend in scale development in clinical psychology and psychiatry has been the development of more specific and tailored assessment instruments. These trends are driven by greater knowledge about childhood development and psychopathology (Matson & Boisjoli, 2009a, 2009b; Matson & Fodstad, 2009; Matson, Wilkins, Sevin, et al., 2009; Wilkins & Matson, 2009). The data in the present study further underscore this trend. Similarly, differences were noted between the typically developing children and adolescents compared to the ASD groups on the Adaptive/Appropriate factor. This finding supports the utility of the MESSY-II for assessing and monitoring appropriate social skills in this population characteristically known to display social skills deficits. Furthermore, this demonstrates the validity of using this scale with typically developing children and adolescent populations since individuals possessing social skills deficits (i.e., those diagnosed with ASD) were found to score above the scale’s cutoff as would be predicted. The lack of significant differences between the groups on the inappropriate social skills factors (i.e., Hostile and
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Inappropriately Assertive/Overconfident) proposes that although children diagnosed with ASD may display deficits in appropriate social skills, they do not appear to possess excesses with respect to inappropriate social skills. The MESSY-II presents with strong psychometric properties. In addition, cutoff scores have been determined according to age cohorts, allowing for the examination of social skills in younger and older children and adolescents. This measure is not only useful during initial assessments of deficits or excesses in social skills, but it can also be used as a measure to monitor treatment progress over time. References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author. Baron-Cohen, S., Wheelwright, S., Cox, A., Baird, G., Charman, T., Swettenham, J., & Doehring, P. (2000). The early identification of autism: The checklist for autism in toddlers (CHAT). 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Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. Matson, J. L. (1988). The Matson evaluation of social skills with youngsters (MESSY). www.disabilityconsultants.org. Matson, J. L. (2010). The Matson evaluation of social skills with youngsters-II (MESSY-II). Baton Rouge, LA: Disability Consultants, LLC. Matson, J. L., & Boisjoli, J. A. (2009a). An overview of developments in research on persons with intellectual disabilities. Research in Developmental Disabilities, 30, 587–591. Matson, J. L., & Boisjoli, J. A. (2009b). The token economy for children with intellectual disability and/or autism: A review. Research in Developmental Disabilities, 30, 240–248. Matson, J. L., & Dempsey, T. (2009c). The nature and treatment of compulsions, obsessions, and rituals in people with developmental disabilities. Research in Developmental Disabilities, 30, 603–611. Matson, J. L., & Fodstad, J. C. (2009d). The treatment of food selectivity and other feeding problems in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3, 455–461. Matson, J. L., & Gonza´lez, M. L. (2007). Autism spectrum disorders – comorbidity – child version. www.disabilityconsultants.org. Matson, J. L., & Wilkins, J. (2007b). A critical review of assessment targets and methods for social skills excesses and deficits for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 1, 28–37. Matson, J. L., & Wilkins, J. (2008). Nosology and diagnosis of Asperger’s syndrome. Research in Autism Spectrum Disorders, 2, 288–300. Matson, J. L., & Wilkins, J. (2009e). Psychometric testing methods for children’s social skills. Research in Developmental Disabilities, 30, 249–274. Matson, J. L., Rotatori, A. F., & Helsel, W. J. (1983). Development of a rating scale to measure social skills in children: The Matson evaluation of social skills with youngsters (MESSY). Behaviour Research Therapy, 21, 335–340. Matson, J. L., Dempsey, T., & Fodstad, J. C. (2009a). The effect of autism spectrum disorders on adaptive independent living skills in adults with severe intellectual disability. Research in Developmental Disabilities, 30, 1203–1211. Matson, J. L., Dempsey, T., & Rivet, T. T. (2009b). The interrelationship of psychopathology symptoms on social skills in adults with autism or PDD-NOS and intellectual disability. Journal of Developmental and Physical Disabilities, 21, 39–55. Matson, J. L., Mahan, S., & Matson, J. L. (2009c). Parent training: A review of methods for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3, 868–875. Matson, J. L., Wilkins, J., Sevin, J. A., Knight, C., Boisjoli, J. A., & Sharp, B. (2009d). 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A controlled social skills training for children with fetal alcohol spectrum disorders. Journal of Consulting and Clinical Psychology, 74, 639–648. Reynolds, C. R., & Kamphaus, R. W. (2004). Manual: Behavior assessment system for children (2nd ed.). Circle Pines, MN: American Guidance Service. Rose, E., Bramham, J., Young, S., Paliokostas, E., & Xenitidis, K. (2009). Neuropsychological characteristics of adults with comorbid ADHD and borderline/mild intellectual disability. Research in Developmental Disabilities, 30, 496–502. Schopler, E., Reichler, R. J., DeVellis, R. F., & Daly, K. (1980). Toward objective classification of childhood autism: Childhood autism rating scale (CARS). Journal of Autism and Developmental Disorders, 10, 91–103. Segrin, C. (2000). Social skills deficits associated with depression. Clinical Psychology Review, 20, 379–403. Tenneij, N. H., Didden, R., Stolker, J. J., & Koot, H. M. (2009). 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Contents lists available at ScienceDirect
Research in Autism Spectrum Disorders Journal homepage: http://ees.elsevier.com/RASD/default.asp
Cutoffs for the Matson Evaluation of Social Skills with Youngsters-II (MESSY-II) for typically developing children and for children diagnosed with autism spectrum disorders Johnny L. Matson *, Alison M. Kozlowski, Daniene Neal, Julie A. Worley, Jill Fodstad Louisiana State University, United States
A R T I C L E I N F O
A B S T R A C T
Article history: Received 17 August 2010 Accepted 10 September 2010
The acquisition of social skills is an essential part of childhood and adolescent development. Due to its critical nature, assessment of appropriate and inappropriate social skills is necessary in order to determine whether or not deficits or excesses exist, thereby guiding treatment. The Matson Evaluation of Social Skills with Youngsters (MESSY) was developed for this purpose, and it has recently been renormed and revised. Beyond a general understanding of where strengths and weaknesses lie, it is important to also be able to identify clinically significant impairments versus those that may be observed as a normal part of development. This was accomplished with typically developing children to establish cutoffs for the revised scale, the MESSY-II. Additionally, a sample of children diagnosed with autism spectrum disorders were administered the MESSY-II and their cutoff scores were examined. ß 2010 Elsevier Ltd. All rights reserved.
Keywords: MESSY-II Social skills Children Adolescents ASD
1. Introduction Throughout childhood the acquirement of appropriate social skills, and likewise the management and treatment of inappropriate social skills, is seen as a core component of developmental growth and learning (Chan et al., 2009; Matson, Mahan, & Matson, 2009). A lack of appropriate social skills or excess of inappropriate social skills may have numerous consequences. Children and adolescents with such deficits may have difficulty obtaining and maintaining friendships, succeeding with academics, and fulfilling their social roles. Furthermore, social skills deficits are commonly associated with a variety of disorders including autism spectrum disorders (ASD; Matson, Dempsey, & Fodstad, 2009; Matson & Wilkins, 2007, 2008), fetal alcohol spectrum disorders (O’Connor et al., 2006), attention-deficit/hyperactivity disorder (Wehmeier, Schacht, & Barkley, 2010), and depression (Segrin, 2000), among others. Therefore, assessment of social skills is important for children and adolescents in order to identify problem areas for treatment and to evaluate progress during intervention. Despite the importance of social skills, relatively few measures focus solely on assessment of the strengths and weaknesses of these behaviors in children and adolescents. However, the Matson Evaluation of Social Skills with Youngsters (MESSY; Matson, 1988) is a rating scale that was specifically designed to assess both appropriate and inappropriate social skills in children and adolescents. The original scale was normed on 744 children between the ages of 4 and 18 and produced two factors—appropriate social skills and inappropriate assertiveness (Matson, Rotatori, & Helsel, 1983). The measure was found to possess good psychometric properties with strong internal consistency, strong test–retest reliability, and adequate convergent validity. The MESSY was later translated into several different languages and has been researched and applied to
* Corresponding author at: Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States. E-mail address: [email protected] (J.L. Matson). 1750-9467/$ – see front matter ß 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.rasd.2010.09.008
J.L. Matson et al. / Research in Autism Spectrum Disorders 5 (2011) 798–802
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many different populations including individuals with ASD, intellectual disability, hearing impairments, vision impairments, anxiety disorders, and depression (Matson & Wilkins, 2009). Recently, the MESSY’s psychometric properties and factor structure have been revisited using a new normative sample, resulting in a second edition of the scale, the MESSY-II (Matson, 2010). Using a sample of 885 typically developing children ages 2 through 16, the internal consistency of the measure was evaluated by dividing the participants into three age cohorts: 2- to 5-year olds, 6- to 9-year olds, and 10- to 16-year olds (Matson, Neal, Hess, Fodstad, et al., in press-a). Alpha coefficients indicated good internal consistency and ranged from .84 to .93 with the older age cohorts having greater alpha values, thereby suggesting that older children possess more consistent social skills. Matson and colleagues also explored the convergent and divergent validity of the scale using the same age cohorts. While both convergent and divergent validity ranged from good to strong, the authors do make note that the validity of the scale for younger children (i.e., 2- to 5-year olds) is less promising, most likely due to overall difficulty in measuring social skills in younger children related to variability seen in this age cohort. Finally, the factor structure of the MESSY-II was explored. An exploratory factor analysis yielded a threefactor solution with two factors related to inappropriate social skills (i.e., Hostile and Inappropriately Assertive/ Overconfident) and one factor consistent with appropriate social skills (i.e., Adaptive/Appropriate) (Matson, Neal, Worley, Kozlowski, et al., in press-b). With the MESSY having been renormed, yielding updated psychometric properties and a new factor structure, cutoffs for this revised scale are warranted. Therefore, the purpose of this paper was first to determine whether or not social skills among the three-factor structure differed by age cohort. Based on these results, cutoffs were established so that the measure could be administered to children and adolescents with the goal of determining whether or not significant social skills deficits were present along each factor. Finally, the MESSY-II scores of children with an autism spectrum disorder, a population distinctively known for possessing social skills deficits, were computed to examine the applicability of this scale for use in such populations. 2. Methods 2.1. Participants For the first part of the study, a sample of 874 children was selected from a larger group of 1065 children whose parents or caregivers completed the MESSY-II. For the purposes of this part of the study, only children who were determined to be typically developing (i.e., no prior psychiatric condition, medical/genetic disorder, physical disability, intellectual disability, or developmental delay) via record review and/or parent report were retained. The sample was divided into three age cohorts, consistent with the reliability study of the MESSY-II (Matson, Neal, Hess, Fodstad, et al., in press-a): 2- to 5-year olds (n = 280; M = 3.86; SD = 1.01); 6- to 9-year olds (n = 305; M = 7.37; SD = 1.10); and 10- to 16-year olds (n = 289; M = 12.39; SD = 1.77). Breakdown of gender among the age cohorts was 51% male and 49% female for the 2- to 5-year olds, 39% male and 61% female for the 6- to 9-year olds, and 41% male and 59% female for the 10- to 16-year olds. The ethnic representation of the 2- to 5-year olds consisted of children who were Caucasian (81%), African American (12%), and Other (7%). The 6- to 9year old cohort included children who were Caucasian (83%), African American (6%), and Other (11%). Finally, the 10- to 16year old cohort consisted of children who were Caucasian (89%), African American (5%), and Other (6%). For the second part of the study, a sample of 86 children with an ASD were selected from a larger group of 1065 children whose parents or caregivers completed the MESSY-II. Diagnoses of ASD were obtained via an algorithm of International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10; World Health Organization [WHO], 1992) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR, American Psychological Association [APA], 2000) criteria. In addition, clinical histories, observations, and other standardized measures of ASD, such as the Autism Diagnostic Interview-Revised (ADI-R; Lord, Rutter, & LeCouteur, 1994), Childhood Autism Rating Scale (CARS; Schopler, Reichler, DeVellis, & Daly, 1980), and Checklist for Autism in Toddlers (CHAT; Baron-Cohen et al., 2000) were used along with clinical consultation with a licensed psychologist. Consistent with the first part of the study, the sample was divided into three age cohorts: 2- to 5-year olds (n = 26; M = 3.92; SD = 1.06); 6- to 9-year olds (n = 36; M = 7.36; SD = 1.18); and 10- to 16-year olds (n = 24; M = 12.33; SD = 1.86). Breakdown of gender among the age cohorts was 73% male and 27% female for the 2- to 5-year olds, 86% male and 14% female for the 6- to 9-year olds, and 88% male and 12% female for the 10- to 16-year olds. The ethnic representation of the 2- to 5-year olds consisted of children who were Caucasian (85%), African American (8%), and Other (7%). The 6- to 9-year old cohort included children who were Caucasian (86%), African American (6%), and Other (8%). Finally, the 10- to 16-year old cohort consisted of children who were Caucasian (79%), African American (8%), and Other (13%). 2.2. Measures 2.2.1. Matson Evaluation of Social Skills with Youngsters-II (MESSY-II; Matson, 2010) The MESSY-II is a social skills measure for a broad range of children, ages 2–16, based on observations of both appropriate and inappropriate social behaviors. The scale consists of a total of 57 items on a likert-type rating scale from 1 (‘‘not at all’’) to 5 (‘‘very much’’). The MESSY-II yields three factors: Hostile, Adaptive/Appropriate, and Inappropriate Assertiveness/Overconfident scales (Matson, Neal, Hess, Fodstad, et al., in press-a). Factor scores are obtained by
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summing the Likert rating for each item in the scale. A high score on the Hostile and/or Inappropriate Assertiveness/ Overconfident factors indicates the presence of poor social skills while a low score on the Adaptive/Appropriate factor indicates a lack of positive social skills. The MESSY-II reports a high degree of internal consistency with alpha coefficients of .84 for the 2- to 5-year olds, .93 for the 6- to 9-year olds, and .93 for the 10- to 16-year olds (Matson, Neal, Hess, Fodstad, et al., in press-a). Significant correlations between the MESSY-II and the adaptive subscales of the Behavior Assessment Scale for Children, Second Edition (BASC-2; Reynolds & Kamphaus, 2004) were found (Matson, Neal, Hess, Fodstad, et al., in press-a), indicating good to strong convergent validity. Furthermore, divergent validity was established by comparing the MESSY-II to the Autism Spectrum Disorders – Child Comorbidity (ASD-CC; Matson & Gonza´lez, 2007), resulting in non-significant correlations (Matson, Neal, Hess, Fodstad, et al., submitted for publication-a). 2.3. Procedures The participants for this investigation were recruited throughout the United States from a variety of clinic, community, and school settings via self or professional referral. Flyers describing the study and procedures for participation were disseminated at the aforementioned settings. Participants came from sites in California, Connecticut, Florida, Georgia, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, and Pennsylvania. The project was described as a study on the development of measures to assess the social and emotional behaviors of children and adolescents. As such, parents or legal guardians completed a battery of assessments which included, but was not limited to, a demographic questionnaire, an assessment of social skills in children and adolescents (i.e., MESSY-II), a measure of comorbid problems in children with ASD (i.e., ASD-CC), and a broad measure of clinical and adaptive functioning (i.e., BASC-2). This investigation was approved by the Louisiana State University Institutional Review Board and informed consent was obtained from parents or legal guardians. 2.4. Data analysis In order to investigate the appropriateness of developing cutoffs according to age cohorts, a MANOVA was utilized to test for significant differences between each total factor score of the MESSY-II (Hostile, Adaptive/Appropriate, and Inappropriately Assertive/Overconfident) and the age cohorts (2–5 years, 6–9 years, and 10–16 years). Next, a standard deviation method was utilized where clinical significance was defined as a score that was two standard deviations or more away from the mean (Jacobson & Truax, 1991). Therefore, the mean and standard deviation of the MESSY-II factors was calculated for each age cohort and used to compute the cutoff scores. Finally, to examine the utility of the new cutoff scores with an atypical population, MESSY-II mean factor scores from a sample of children diagnosed with ASD were computed. Missing data points were replaced with the mean for that particular item. No participant had more than five missing items. 3. Results 3.1. Typically developing group A MANOVA was computed with age cohort as the independent variable (i.e., 2- to 5-year olds, 6- to 9-year olds, and 10- to 16-year olds) and each of the three factors of the MESSY-II as dependent variables (i.e., Hostile, Adaptive/Appropriate, and Inappropriately Assertive/Overconfident). The purpose of the analysis was to determine if there were significant differences along the factors with respect to age cohorts. This analysis would help establish if separate cutoff scores for each cohort were necessary. The main effect for age cohort was significant, Wilks’ L = .012, F (3, 869) = 23,340, p = .000. Follow-up analyses of variance (ANOVAs) were run for all three factors. The ANOVAs were significant for all three factors: Hostile [F (2, 871) = 19.849, p = .000], Adaptive/Appropriate [F (2, 871) = 39.622, p = .000], and Inappropriately Assertive/Overconfident [F (2, 871) = 35.331, p = .000]. Tukey post-hoc tests revealed that on the Hostile factor the 2- to 5-year old age cohort (M = 38.37) significantly differed from the 6- to 9-year old age cohort (M = 43.94) and the 10- to 16-year old age cohort (M = 44.09). However, the 6- to 9-year old age cohort did not significantly differ from the 10- to 16-year old age cohort. On the Adaptive/ Appropriate factor, the 2- to 5-year old age cohort (M = 69.29) significantly differed from the 6- to 9-year old age cohort (M = 75.73) and the 10- to 16-year old age cohort (M = 76.18). However, the 6- to 9-year old age cohort did not significantly differ from the 10- to 16-year old age cohort. On the Inappropriately Assertive/Overconfident factor, the 2- to 5-year old age cohort (M = 32.30) did not significantly differ from the 6- to 9-year old age cohort (M = 31.35), but did significantly differ from the 10- to 16-year old age cohort (M = 27.38). Additionally, the 6- to 9-year old age cohort differed significantly from the 10to 16-year old age cohort. The mean and standard deviation for each of the three MESSY-II factors was calculated by age cohort for the typically developing sample. For the inappropriate social skills factors (i.e., Hostile and Inappropriately Assertive/Overconfident), scores that fell below one standard deviation above the mean were indicative of ‘no/minimal impairment,’ scores that fell between one standard deviation and two standard deviations above the mean were classified as ‘moderate impairment,’ and scores that fell two standard deviations or more above the mean were considered to be indicative of ‘severe impairment.’ For the appropriate social skills factor (i.e., Adaptive/Appropriate), scores that fell above one standard deviation below the mean were indicative of ‘no/minimal impairment,’ scores that fell between one standard and two standard deviations below the mean were considered indicative of ‘moderate impairment,’ and scores that fell two standard deviations or further below the
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Factor
Mean
Standard deviation
No/minimal impairment
Moderate impairment
Severe impairment
2–5
Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident
38.37 69.29 32.30 49.94 75.73 31.35 44.09 76.18 27.39
9.70 10.06 7.58 14.03 10.06 8.52 12.75 10.88 5.91
0–47 60+ 0–39 0–57 67+ 0–39 0–56 66+ 0–32
48–57 50–59 40–47 58–71 57–66 40–48 57–69 55–65 33–38
58+ 0–49 48+ 72+ 0–56 49+ 70+ 0–54 39+
6–9
10–16
Table 2 Factor means and standard deviations for ASD by age cohort. Age cohort
Factor
Mean
Standard deviation
2–5
Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident Hostile Adaptive/Appropriate Inappropriately Assertive/Overconfident
35.11 39.00 26.04 51.19 45.72 35.39 53.17 45.67 10.67
8.59 14.15 7.12 19.03 12.28 8.30 24.61 11.70 10.67
6–9
10–16
mean were determined to be indicative of ‘severe impairment.’ All factor means, standard deviations, and cutoffs according to age cohort are presented in Table 1. 3.2. ASD Group Lastly, the mean score for each of the three MESSY-II factors was calculated by age cohort for a sample of children diagnosed with an ASD. On average, children diagnosed with ASD across all three age cohorts were found to fall within the no/minimal impairment category for the Hostile and Inappropriately Assertive/Overconfident factors, suggesting no excesses of inappropriate social skills. Conversely, on the Adaptive/Appropriate factor all three age cohorts averaged within the severe impairment range, thereby suggesting a significant impairment with respect to appropriate social skills. All factor means and standard deviations for the ASD group according to age cohort are presented in Table 2. 4. Discussion Impairments in social skills are a defining aspect of developmental disabilities, and deficits in these skills can affect the ability of children, adolescents, and adults to progress in other areas across the spectrum of development. Furthermore, social deficits are major risk factors for challenging behaviors (Farmer & Aman, 2009; Tenneij, Didden, Stolker, & Koot, 2009), and similarly, they can compound problems of psychopathology (Brim, Townsend, DeQuinzio, & Poulson, 2009; Matson, ´ skarsdo´ttir, & Gillberg, 2009; Rose, Bramham, Young, Paliokostas, & Dempsey, & Rivet, 2009; Niklasson, Rasmussen, O Xenitidis, 2009). For these and other reasons, the development of measures of social skills is very important (Matson & Boisjoli, 2009a, 2009b; Matson & Dempsey, 2009; van den Hazel, Didden, & Korzilius, 2009). Factor cutoff scores were established for typically developing children and adolescents on the MESSY-II. These scores differed to some degree across age cohorts. What these data suggest is the need to develop normative data by specific cohorts on social skills measures as was done in the current study. A trend in scale development in clinical psychology and psychiatry has been the development of more specific and tailored assessment instruments. These trends are driven by greater knowledge about childhood development and psychopathology (Matson & Boisjoli, 2009a, 2009b; Matson & Fodstad, 2009; Matson, Wilkins, Sevin, et al., 2009; Wilkins & Matson, 2009). The data in the present study further underscore this trend. Similarly, differences were noted between the typically developing children and adolescents compared to the ASD groups on the Adaptive/Appropriate factor. This finding supports the utility of the MESSY-II for assessing and monitoring appropriate social skills in this population characteristically known to display social skills deficits. Furthermore, this demonstrates the validity of using this scale with typically developing children and adolescent populations since individuals possessing social skills deficits (i.e., those diagnosed with ASD) were found to score above the scale’s cutoff as would be predicted. The lack of significant differences between the groups on the inappropriate social skills factors (i.e., Hostile and
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Inappropriately Assertive/Overconfident) proposes that although children diagnosed with ASD may display deficits in appropriate social skills, they do not appear to possess excesses with respect to inappropriate social skills. The MESSY-II presents with strong psychometric properties. In addition, cutoff scores have been determined according to age cohorts, allowing for the examination of social skills in younger and older children and adolescents. This measure is not only useful during initial assessments of deficits or excesses in social skills, but it can also be used as a measure to monitor treatment progress over time. References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author. Baron-Cohen, S., Wheelwright, S., Cox, A., Baird, G., Charman, T., Swettenham, J., & Doehring, P. (2000). The early identification of autism: The checklist for autism in toddlers (CHAT). 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