Cultural Adaptation and Evaluation of the PEERS^® Program for Autistic Young Adults in Iran: A Mixed-Methods Study

This study evaluated the effectiveness of the Program for the Education and Enrichment of Relational Skills (PEERS^®) for young autistic adults in Iran and explored participant and caregiver experiences.

Twenty-one autistic males aged 18-30 were randomly assigned to either a 16-week program or a waitlist control group. Weekly group sessions were held for participants and their parents. Quantitative assessments were conducted at baseline, post-intervention, and 12-month follow-up using Farsi versions of validated scales measuring social functioning, empathy, loneliness, and social skills knowledge.

While no significant between-group differences were found in most outcome measures using repeated measures analyses, participants in the intervention group showed a statistically significant decrease in conflict scores reported by young adults (p = 0.026) and an increase in Test of Young Adult Social Skills Knowledge (TYASSK) (p = 0.008) after 16 weeks, which remained significant at 12 months (p = 0.046) based on paired t-tests. Focus groups identified several challenges in program implementation, including limited awareness of autism, resistance to homework, dense session content, and cultural barriers such as indirect communication norms and limited opportunities for social practice. However, participants reported meaningful improvements in confidence and social engagement. Families and therapists also expressed high satisfaction and a desire for follow-up sessions.

The findings suggest that PEERS^® is a culturally adaptable and positively received intervention for autistic young adults in Iran. The study emphasizes the importance of contextualizing interventions to local cultures and addressing the needs of underrepresented populations in autism research.