Raphael Chancel

Stephanie Miot

Florine Dellapiazza

Amaria Baghdadli

Group-based Educational Interventions in Young People with ASD without ID: A Systematic Review Focusing on the Transition to Adulthood

Aux membres du jury

Je remercie Madame le Professeur Amaria BAGHDADLI de me faire l'honneur de diriger mon travail de thèse et de m'avoir aidé dans son travail de rédaction et de recherche. Merci à vous également pour tout le soutien et la confiance que vous m'avez accordée. Merci également de m'avoir écouté quand j'étais en difficulté. Merci de me faire l'honneur d'être dans mon jury de thèse.

Merci pour votre gentillesse.

Merci à Madame le Docteur Stéphanie MIOT de nous avoir aidé dans a rédaction de ma thèse.

Et merci à toi de m'accompagner pour le Master 2. Merci pour ta gentillesse

Introduction

Rationnel

La prévalence des troubles du spectre de l'autisme (TSA) parmi les adultes est estimée à environ 1%, avec une grande hétérogénéité de fonctionnement intellectuel parmi les sujets. Durant les 20 dernières années, le nombre d'individus ayant un diagnostic de TSA a fortement augmenté et un grand nombre de ces personnes sont maintenant en transition vers l'âge adulte. Parmi cette population grandissante, la moitié, souvent dite « de haut niveau », possède des capacités intellectuelles normales.

Il est démontré que, parmi les patients présentant un TSA, la présence de capacités intellectuelles normales peut-être associée à des déficits adaptatifs significatifs et des comorbidités tel que l'anxiété ou la dépression, qui ont souvent un impact négatif sur la qualité de vie et le fonctionnement global.

La transition vers l'âge adulte est particulièrement complexe, à la fois en raison de la dépendance persistante des jeunes adultes avec TSA à leurs aidants familiaux et de la perte fréquente d'accès aux prestations sociales auxquelles ils avaient accès enfants et adolescents. Les jeunes personnes avec TSA ont des résultats sociaux, scolaires et professionnels moins bon que celles avec un développement

Introduction

Rationale

The prevalence of autism-spectrum disorder (ASD) among young adults is estimated to be approximately 1%, with a large range of coexisting heterogeneous intellectual functioning [START_REF] Brugha | Epidemiology of autism spectrum disorders in adults in the community in England[END_REF]. In the past 20 years, the number of individuals diagnosed with an ASD has dramatically increased, with many of them transitioning to adulthood [2]. Among this growing population, one half, often labeled as high functioning, have normal intellectual capabilities [START_REF] Postorino | Intellectual disability in Autism Spectrum Disorder: Investigation of prevalence in an Italian sample of children and adolescents[END_REF]. It is known that normal intellectual functioning can be associated with significant adaptive deficits and comorbid conditions in ASD, such as anxiety or ADHD, which often have negative effects on quality of life and outcome [START_REF] Hofvander | Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders[END_REF].

The transition to adulthood is particularly challenging, due to both the remaining dependence of young ASD adults on their caregivers and the frequent loss of the social support they received during childhood and adolescence [START_REF] Marsack-Topolewski | Impact of Caregiver Burden on Quality of Life for Parents of Adult Children With Autism Spectrum Disorder[END_REF]. Young people with ASD have worse vocational, social, and educational outcomes than those with typical development or other developmental disorders [START_REF] Anderson | Prevalence and correlates of postsecondary residential status among young adults with an autism spectrum disorder[END_REF][START_REF] Shattuck | Postsecondary education and employment among youth with an autism spectrum disorder[END_REF]. In addition, they are often unemployed and earn a lower median salary when they are employed [START_REF] Roux | Postsecondary employment experiences among young adults with an autism spectrum disorder[END_REF].

Finally, many young adults with ASD struggle with psychiatric comorbidities, such as depression and anxiety [START_REF] Eaves | Young adult outcome of autism spectrum disorders[END_REF], worsening even more their already low functional outcomes. These factors all contribute to difficulties in their achieving independence, socially, financially, and emotionally [START_REF] Eaves | Young adult outcome of autism spectrum disorders[END_REF].

As a result, targeting interventions towards young people with ASD without an intellectual deficiency (ID) who are transitioning to adulthood is an urgent matter. The main aim must be to improve their general functioning and outcomes by offering them effective support during the critical developmental period of the beginning of adulthood, while also creating windows of opportunity. One obstacle to such a plan is that little research has been conducted on the transition to adulthood of people with ASD without ID. Thus, our knowledge about effective interventions for young ASD adults without ID is still limited. International guidelines (NICE Clinical guideline [CG142]) suggest that interventions should target adaptive functioning and empowerment and that specific attention must be paid to transitions. In clinical practice, group-based educational interventions have been used to help young ASD individuals to understand their symptoms and improve their social functioning [START_REF] Derosier | The Efficacy of a Social Skills Group Intervention for Improving Social Behaviors in Children with High Functioning Autism Spectrum Disorders[END_REF]. Many such interventions are cognitive-behavioral therapy (CBT)-based or use the principles of patient education (TPE) commonly used among people with chronic diseases (including mental health disorders) for a better awareness of their symptoms, training, and empowerment [START_REF] Merinder | Patient education in schizophrenia: a review[END_REF]. These strategies have been proven to be useful for a wide range of chronic conditions, such as diabetes [START_REF] Ellis | Diabetes patient education: a meta-analysis and meta-regression[END_REF], resulting in their being considered in France to be essential for building any personalized intervention plan for individuals with chronic diseases, including ASD [START_REF] Baghdadli | Education thérapeutique des parents d'enfant avec troubles du spectre autistique: Informer, former, accompagner[END_REF]. Thus, an important challenge is to validate the efficiency of such interventions before their generalization.

Objective

Here, we aimed to systematically review the efficiency of existing group-based educational intervention programs using psycho-education [14], cognitive remediation [START_REF] Galletly | An Overview of Cognitive Remediation Therapy for People with Severe Mental Illness[END_REF], CBT, acceptance and commitment therapy (ACT), social skills training (SST), or patient education [START_REF] Engers | Individual patient education for low back pain[END_REF] programs targeting the needs of young people with ASD without ID transitioning to adulthood.

Materials and Methods

Selection and Inclusion/Exclusion Criteria

We performed a literature search for articles published in English or French in PsycInfo-Esbco (Psycinfo, Eric, PsycARTICLES, Psychology and Behavioral Sciences Collection), PubMed, Web of Science (Web of Science TM Core Collection, KCI-Korean Journal Database, MEDLINE, SciELO Citation Index), and the Cochrane Library. The search was conducted in June 2019 and updated in January 2020, without limitation of the publication year. We followed the PRISMA standards, a 27item checklist, and a four-phase process, including the identification, screening, eligibility, and inclusion of studies [START_REF] Moher | Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement[END_REF]. The search equation was: (((((((((((psychoeducation) OR "patient education") OR "group intervention") OR "intervention group") OR "behavioral therapy") OR "Cognitive behavioral therapy") OR "Cognitive enhancement therapy")) OR ((transition) AND adulthood))) AND ((((((("ASD without intellectual disability") OR "autism without ID") OR "ASD without ID") OR "autism without intellectual disability") OR "autism spectrum disorder without This algorithm was applied to abstracts for PsycInfo-Esbco, all fields for PubMed, and title, abstract, and keywords for the Cochrane Library. Additionally, we searched the grey literature via Internet (Google and Google Scholar) using the same keywords as in the database search. The screening and selection process are presented in Fig. 1.

The articles were read by two authors (AB and RC) and selected if they were consistent with the following inclusion criteria: the papers had to 1) be an original study documenting educational group-based intervention for people with ASD, which could include their families but not be targeted primarily towards them, including psycho-education (which can be defined as a systematic didactic and psychotherapeutic intervention that aims to inform patients and relatives on a psychiatric disorder and improve their ability to cope with the illness) [14], patient education (which was defined as a systematic experience in which a combination or a variety of methods are used, possibly including the provision of information, advice, and behavioral modification techniques, that influence the way the patient experiences and perceives his illness and/or his knowledge and health behavior, aiming to improve, maintain, or learn how to cope with a condition, usually a chronic one) [START_REF] Engers | Individual patient education for low back pain[END_REF], cognitive remediation (which refers to nonpharmacological methods of improving cognitive function in people with severe mental disorders) [START_REF] Galletly | An Overview of Cognitive Remediation Therapy for People with Severe Mental Illness[END_REF], SST, ACT, or CBT focused primarily on AS core signs or associated psychiatric comorbidities (anxiety disorders, emotional dysregulation, depression); 2) study the effect of group-based intervention; 3) have a participant sample with a mean age between 13 and 26 years at study entry and a mean IQ over 70; 4) have a participant sample in which at least 50% of the participants had a diagnosis of an AS, including autism, ASD, atypical autism, Asperger Syndrome, or PDD-NOS (pervasive developmental disorder-not otherwise specified), according to ICD-10, DSM-IV, or DSM-5 criteria. Finally, papers were required to 5) have a minimum sample size of 10 participants.

The exclusion criteria were: 1) papers in which the chronological age, diagnosis, and/or intellectual level of their participants were not reported and 2) systematic reviews or meta-analyses.

Data Extraction

Two authors (RC, AB) read abstracts and selected them if they were broadly consistent with the inclusion criteria. If consensus was not reached, the abstracts were set aside for further evaluation.

Then, these authors reviewed the full-text articles of selected abstracts against the inclusion criteria.

Data were extracted from the full-text articles and reviewed, with regular discussions to ensure consistency. Data extraction from the full text was organized into the following sections:

Data Analysis

The quality rating was made independently by the two authors (RC, FD) according to the PEDro Checklist [START_REF] Maher | Reliability of the PEDro scale for rating quality of randomized controlled trials[END_REF], which is a scale used to measure the methodological quality of clinical trials. In cases of disagreement, the authors reached a consensus through discussion. The scale contains 11 items, each assessing a different source of bias. The 11 items are: (1) whether eligibility criteria were specified (selection bias), (2) whether subjects were randomly allocated to groups, (3) whether allocation was concealed, (4) whether the groups were similar at baseline concerning the most important prognostic indicators, (5) whether there was blinding of all subjects, (6) whether there was blinding of all therapists who administered the therapy, [START_REF] Shattuck | Postsecondary education and employment among youth with an autism spectrum disorder[END_REF] whether there was blinding of all assessors who measured at least one key outcome, ( 8) measures of at least one key outcome were obtained from more than 85% of the subjects initially allocated to groups, (9) whether all subjects for whom outcome measures were available received the treatment or control condition as allocated or, where this was not the case, data for at least one key outcome was analyzed by intention to treat, [START_REF] Derosier | The Efficacy of a Social Skills Group Intervention for Improving Social Behaviors in Children with High Functioning Autism Spectrum Disorders[END_REF] whether the results of between-group statistical comparisons are reported for at least one key outcome, and finally, [START_REF] Merinder | Patient education in schizophrenia: a review[END_REF] whether the study provides both point measures and measures of variability for at least one key outcome.

Studies scoring 9-11 on the PEDro scale were considered to be of excellent methodological quality. Scores ranging from 6 to 8 were considered to be of good quality, whereas studies scoring 4 or 5 were considered to be of fair quality and those scoring below 4 of poor quality.

Results

Study Selection

Of the 159 articles that were identified, 99 were rejected at abstract review and 60 available full texts were assessed. Among them, 43 did not meet the inclusion criteria, mainly in terms of age, IQ, small sample size, or because they targeted individual-based interventions. Finally, 17 papers were selected, comprising 16 studies. Searching the grey literature led us to include four additional studies.

Of the 21 articles selected, one focused on a leisure program, eight on SST programs, three on cognitive remediation, seven on CBT, one on ACT, and one mixed all of them. Overall, 14 studies were randomized control trials (RCTs) and seven used other experimental designs.

A description of the interventions is presented in Table 2.

Risk of Bias Assessment

We examined the risk of bias according to the PEDro scale (Table 2). Overall, two studies were scored as excellent, 12 as good, five as fair, and one as poor. No study blinded the intervention to both patients and therapists and only six blinded the assessors.

Primary and Secondary Outcomes

On average, studies used four to five scales (from three to six) as their outcomes. These scales can be divided into 13 categories as follows: social skills/self-determination skills, adaptive and global functioning, work capabilities, neuro or social cognition, knowledge about asd, severity of asd, selfesteem, depression/anxiety, quality of life, therapeutic adherence and alliance, leisure capabilities, inattention, hyperactivity and impulsivity, and broad psychiatric measures. More details on the scales used can be found in Supplemental Data 1.

Descriptive Synthesis of Interventions

Social-Skills Training

Eight studies assessed the efficacy of SST programs [START_REF] Bonete | Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study[END_REF][START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF][START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF][START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF][START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF][START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF][START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF].

Assessed Interventions: Four studies assessed [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF][START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF][START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: the UCLA PEERS program[END_REF][START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF] the efficacy of UCLA PEERS, a group-based caregiver-assisted intervention developed by Laugeson et al., 2012 [26]. Two evaluated the original program designed for teenagers [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF][START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: the UCLA PEERS program[END_REF], whereas the other two evaluated a version adapted for young adults [START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF][START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF]. One study [START_REF] Bonete | Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study[END_REF] evaluated SCI-Labor, an interpersonal problemsolving skills training group for adolescents and adults with Asperger Syndrome. One study assessed [START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF] START, a socialization intervention that blends experiential and instructional components with an emphasis on motivational elements and active involvement from participants and peer models.

Another study [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF] evaluated a group-based social skills intervention targeting three crucial functional domains: social communication, self-determination, and working with others. Finally, one study [START_REF] Herbrecht | Pilot evaluation of the Frankfurt Social Skills Training for children and adolescents with autism spectrum disorder[END_REF] assessed KONTAKT (Frankfurt SST), which focuses on learning to initiate conversation, understanding social rules and relationships, identification and interpretation of verbal and non-verbal social signals, problem-solving, coping strategies, and improvement of self-confidence in a group setting.

Sessions: UCLA PEERS comprised 14 to 16 weekly 90-min sessions, depending on the version.

SCI-Labor consisted of 10 weekly 75-min sessions. START comprised 20 weekly sessions. The intervention of Nadig et al. [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF] consisted of 10 weekly sessions. Finally, KONTAKT consisted of seven to 29 sessions, once to twice a week, according to the participants' age: adolescents had sessions twice a week for a total of seven ("experienced adolescent") or 15 ("naïve adolescent'') sessions, whereas children had sessions once a week for a total of 29 ("naïve children") sessions.

Target Population and Diagnostic Criteria:

The two studies assessing the efficacy of UCLA PEERS for young adults [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF][START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF] recruited participants with a diagnosis of ASD without ID ascertained by healthcare professionals and the two studies [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF][START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF] that assessed UCLA PEERS for adolescents targeted adolescents with a diagnosis of ASD without ID ascertained by a healthcare professional [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF] or ADOS [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF]. [27] did not include any control condition, instead opting for a pre-post comparison.

Primary Outcomes: The primary outcomes for both the studies of Gantman et al. [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF] and

Laugeson et al. [START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF] were severity of ASD measured by the SRS [START_REF] Constantino | Social Responsiveness Scale: SRS-2 Software Kit[END_REF] and social skills measured by the SSRS [29]. Gantman et al. [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF] also assessed loneliness, measured by the SELSA [30]. Laugeson et al. [START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF] also assessed empathy, measured by the EQ (a measure of ASD severity) [START_REF] Baron-Cohen | The Empathy Quotient: An Investigation of Adults with Asperger Syndrome or High Functioning Autism, and Normal Sex Differences[END_REF], involvement in social get togethers, measured by the QSQ (a measure of social skills) [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF], and young adults' knowledge about autism, measured by the TYASSK [START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF]. Common primary outcomes for both the studies of Laugeson et al. [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: the UCLA PEERS program[END_REF] and Rabin et al. [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF] were severity of ASD, measured by the SRS [START_REF] Constantino | Social Responsiveness Scale: SRS-2 Software Kit[END_REF],

and knowledge about ASD, measured by the TASSK [START_REF] Laugeson | Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders[END_REF] or TASSK-R [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: the UCLA PEERS program[END_REF]. Laugeson et al. [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF] also measured social skills using the SSRS [29] and the frequency of hosted and invited get-togethers, measured by the QPQ [START_REF] Frankel | A Randomized Controlled Study of Parent-assisted Children's Friendship Training with Children having Autism Spectrum Disorders[END_REF]. Rabin et al. [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF] also measured conversational skills by the CASS [START_REF] Ratto | Development of the contextual assessment of social skills (CASS): A role play measure of social skill for individuals with high-functioning autism[END_REF],

loneliness by the LSDQ [START_REF] Asher | Loneliness in children[END_REF], empathy by the EQ [START_REF] Baron-Cohen | The Empathy Quotient: An Investigation of Adults with Asperger Syndrome or High Functioning Autism, and Normal Sex Differences[END_REF], the frequency of hosted and invited gettogethers by the QSQ [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF], and global social competence by the SSIS [START_REF] Gresham | Social skills improvement system: Rating scales manual[END_REF]. In the trial of Bonete et al. [START_REF] Bonete | Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study[END_REF], the primary outcomes were interpersonal problem-solving skills, measured by the ESCI [37],

adaptive functioning, measured by the VABS-II [START_REF] Sparrow | Vineland Adaptive Behavior Scales[END_REF], and work capabilities, measured by the O-AFP [START_REF] Wiedl | The Osnabruck Work Capabilities Profile (O-AFP) for persons with psychiatric illness: concept, development, and testing in schizophrenic patients[END_REF]. As the primary outcomes, Ko et al. [START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF] used three scales specifically developed for the study with no previous validation: questions asked (defined as the percentage of questions asked by the participant during conversation), positive facial expressions (defined as the percentage of time the participant displayed positive facial expressions), and mutual engagement (defined as the percentage of intervals in which both individuals contributed equally in a back-and-forth manner). Nadig et al.

[24] used three primary outcomes: quality of life measured by the QoL-Q-A [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF], self-determination measured by the SDS of the ARC [START_REF] Wehmeyer | The Arc's self-determination scale (adolescent version)[END_REF], and social skills measured by the SPST [41,[START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF]. Finally, Herbrecht et al. [START_REF] Herbrecht | Pilot evaluation of the Frankfurt Social Skills Training for children and adolescents with autism spectrum disorder[END_REF] used a total of seven primary outcomes: the DCL [START_REF] Döpfner | A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children[END_REF], which is a measure of the severity of ASD, the GAS [43], which is a measure of global functioning, the CGB [START_REF] Bölte | Checkliste zur Beurteilung von Gruppenfertigkeiten[END_REF], which is a measure of social skills, the PIA-CV-mini [START_REF] Bölte | Eltern-Kurzinterview zur Erfassung autistischen Verhaltens[END_REF], which is also a measure of the severity of ASD, the SKS [START_REF] Bölte | Soziale Kompetenzskala (SKS)[END_REF], which is another measure of social skills, the FaBel [START_REF] Stein | The development of an impact-on-family scale: preliminary findings[END_REF], which is a measure of the family burden caused by a mentally ill offspring, and finally, the FEG [START_REF] Bölte | Fragebogen zur Erfassung des Gruppenverhaltens[END_REF], which is a measure of social skills at school.

Main results: Laugeson et al. [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF] found a significant group x time interaction for the SRS, SSRS, QPQ, and TASSK-R, thus demonstrating efficacy of the PEERS program. Overall, the study of Rabin et al. [START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF] showed a significant group x time interaction for all of their outcomes. In the study of Gantman et al. [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF], the SELSA, SRS, and SSRS scores in the treatment group (TX) increased significantly more than those in the control group (DTC). Also, the SRS-social responsiveness scores decreased significantly more in the TX than DTC group, with significant improvements in social communication and decreased autistic mannerisms. In the trial of Laugeson et al. [START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF], the TX group showed significant improvement in the TYASSK, SRS, SSRS, and QSQ when comparing groups at the end of treatment, whereas there was no significant difference in the EQ. A greater reduction in ASD symptoms relating to social responsiveness on the SRS were also found in the TX than DTC group. Finally, Bonete et al. [START_REF] Bonete | Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study[END_REF] found a significant improvement in socialization, measured by the VABS-S, and learning skills, measured by a subscale of the O-AFP. Ko et al. 2019 [21] demonstrated a significant group x time interaction for questions asked and positive facial expressions but not for mutual engagement. Nadig et al. [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF] did not find any significant intervention effect. Finally, the results from the study of Herbrecht et al. [START_REF] Herbrecht | Pilot evaluation of the Frankfurt Social Skills Training for children and adolescents with autism spectrum disorder[END_REF] only showed significant or trend effects for the GAS, SKS, all subscales of the DCL, and two of six PIA-CV-mini subscales. There was no significant difference in the benefit of the program between the naïve and experienced adolescent groups. The "naïve children" group showed larger behavioural gains than the adolescent groups for some of the subscales.

Cognitive Remediation

The similarities between ASD and schizophrenia for social cognition issues [START_REF] Fernandes | Social Cognition in Schizophrenia and Autism Spectrum Disorders: A Systematic Review and Meta-Analysis of Direct Comparisons[END_REF] have led clinicians to adapt cognitive remediation treatment already widely used in schizophrenia to ASD patients. Three studies [START_REF] Eack | Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18month feasibility study[END_REF][START_REF] Eack | Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial[END_REF][START_REF] Turner-Brown | Brief report: feasibility of social cognition and interaction training for adults with high functioning autism[END_REF] assessed group-based intervention using cognitive remediation.

Assessed Interventions:

In two studies, Eack et al. [START_REF] Eack | Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18month feasibility study[END_REF][START_REF] Eack | Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial[END_REF] assessed cognitive-enhancement therapy (CET), a group-based cognitive remediation program that targets social and non-social impairment (attention, memory, and problem-solving), whereas in the third study, Turner-Brown et al. [START_REF] Turner-Brown | Brief report: feasibility of social cognition and interaction training for adults with high functioning autism[END_REF] assessed social cognition and interaction training-autism (SCIT-A), a group-based social cognition therapy, of which the aim is to improve social cognition, social skills, and community functioning.

Sessions: CET was delivered over a period of 18 months and 45 sessions. SCIT-A included 18 weekly sessions.

Target Population and Diagnostic Criteria: All three studies targeted young adults with ASD without ID. The diagnostic criteria of ASD were the ADI-R or ADOS for both studies of Eack et al. [START_REF] Eack | Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18month feasibility study[END_REF][START_REF] Eack | Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial[END_REF], whereas Turner-Brown et al. [START_REF] Turner-Brown | Brief report: feasibility of social cognition and interaction training for adults with high functioning autism[END_REF] used only the ADOS.

Study Design: The 2018 study of Eack et al. used a RCT design, whereas all participants were in the experimental group in the 2013 study. Turner-Brown et al. [START_REF] Turner-Brown | Brief report: feasibility of social cognition and interaction training for adults with high functioning autism[END_REF] only initially used a RCT design as two participants were reassigned to the control condition.

Control Condition: CET was compared to enhanced support therapy (EST) in the 2018 study, which includes individual psychoeducation and supportive therapy, whereas the 2013 study had no control group, instead opting for a pre-post design. Finally, SCIT-A was compared to TAU.

Primary Outcomes: Primary outcomes in the first study of CET [START_REF] Eack | Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18month feasibility study[END_REF] were treatment satisfaction, measured by the CSQ-8 [START_REF] Larsen | Assessment of client/patient satisfaction: development of a general scale[END_REF], neurocognition, measured by the MATRICS Consensus Cognitive Battery [START_REF] Kern | The MATRICS Consensus Cognitive Battery, part 2: co-norming and standardization[END_REF][START_REF] Nuechterlein | The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity[END_REF], and cognitive flexibility, measured by the WCST [START_REF] Heaton | Wisconsin Card Sorting Test (WCST)-manual revised and expanded[END_REF]. Primary outcomes for the second CET study [START_REF] Eack | Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial[END_REF] for ASD individuals were neurocognition, measured by the MATRICS Consensus Cognitive Battery [START_REF] Kern | The MATRICS Consensus Cognitive Battery, part 2: co-norming and standardization[END_REF][START_REF] Nuechterlein | The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity[END_REF], social cognition, measured by the MSCEIT [START_REF] Mayer | Measuring emotional intelligence with the MSCEIT V2.0[END_REF] and Social

Cognition Profile, and employment, measured by the Major Role Adjustment Inventory [START_REF] Hogarty | Drug and sociotherapy in the aftercare of schizophrenic patients. II. Two-year relapse rates[END_REF]. Primary outcomes in the study of Turner-Brown et al. were the perception of emotion, measured by the FEIT [START_REF] Kerr | Emotion perception in schizophrenia: specific deficit or further evidence of generalized poor performance?[END_REF], ToM abilities, measured by the hinting task [START_REF] Corcoran | Schizophrenia, symptomatology and social inference: investigating "theory of mind" in people with schizophrenia[END_REF], and social functioning, measured by the SCSQ [START_REF] Mcgann | Social competence and head injury: A practical approach[END_REF].

Main Results: The 2013study of Eack et al. [START_REF] Eack | Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18month feasibility study[END_REF] found a significant improvement in neuro-and social cognition post-intervention relative to that pre-intervention. The 2018 study of Eack et al. [START_REF] Eack | Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial[END_REF] found a significant improvement in neurocognition in both groups, with larger effect sizes for the CET group. Participants treated with CET showed a rapid and significant differential increase in competitive employment at nine months, which remained significant at 18 months. perceived comprehensibility, manageability, and meaningfulness of life, measured by the SoC scale [START_REF] Antonovsky | The structure and properties of the sense of coherence scale[END_REF], and self-esteem, measured by the RSES [START_REF] Rosenberg | The association between self-esteem and anxiety[END_REF], as primary outcomes. The primary outcomes in the study of McGillivray et al. [START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF] were depression and anxiety, measured by the DASS [START_REF] Lovibond | The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories[END_REF], the frequency of cognitive self-statements associated with depressed mood, measured by the ATQ [START_REF] Hollon | Cognitive self-statements in depression: Development of an automatic thoughts questionnaire[END_REF],

and the frequency of cognitive self-statements associated with anxiety measured by the ASSQ [START_REF] Kendall | Anxious self-talk: Development of the anxious self-statements questionnaire (ASSQ)[END_REF].

In the study of Murphy et al. [START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF], the primary outcomes were anxiety, measured by the ADIS C/P [START_REF] Silverman | Anxiety disorders interview schedule for DSM-IV[END_REF] and the CASI-Anx [START_REF] Hallett | Exploring the manifestations of anxiety in children with autism spectrum disorders[END_REF], and severity of ASD symptoms, measured by the SRS [START_REF] Constantino | Social Responsiveness Scale: SRS-2 Software Kit[END_REF]. White et al.

[65] used the severity of ASD symptoms, measured by the SRS [START_REF] Constantino | Social Responsiveness Scale: SRS-2 Software Kit[END_REF], anxiety, measured by the CASI-Anx [START_REF] Hallett | Exploring the manifestations of anxiety in children with autism spectrum disorders[END_REF], symptoms of separation anxiety disorder, social phobia, and generalized anxiety disorder, measured by the PARS [START_REF] Ruoppas | The pediatric anxiety rating scale (PARS): Development and psychometric properties[END_REF], and global functioning, measured by the DD-CGAS [START_REF] Wagner | Developmental disabilities modification of the Children's Global Assessment Scale[END_REF], as primary outcomes. The primary outcomes in the study of Maddox et al. [START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF] were anxiety, measured by the ADIS C/P [START_REF] Silverman | Anxiety disorders interview schedule for DSM-IV[END_REF], severity of ASD, measured by the SRS [START_REF] Constantino | Social Responsiveness Scale: SRS-2 Software Kit[END_REF], and loneliness, measured by the Loneliness Questionnaire [START_REF] Bauminger | Peer interaction and loneliness in high-functioning children with autism[END_REF]. Pahnke et al. [START_REF] Pahnke | Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study[END_REF] assessed stress-related behaviors, measured by the SSS [START_REF] Groden | The development of a stress survey schedule for persons with autism and other developmental disabilities[END_REF], behavioral screening with the the SDQ [START_REF] Goodman | The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden[END_REF], and anxiety, stress, and anger, measured by the BYI [START_REF] Beck | Beck youth inventories-Second edition (BYI-II)[END_REF] subscales. The primary outcome in the study of Leung et al. [START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF] was social competence, as assessed by the MSCS-C [START_REF] Leung | A psychometric study of the Chinese version of the multidimensional social competence scale (MSCS-C) on adolescents with autism spectrum disorder (ASD) in Hong Kong[END_REF]. Finally, in the study of Santomauro et al. [START_REF] Santomauro | Depression in adolescents with ASD: A pilot RCT of a group intervention[END_REF], the primary outcomes were depression, anxiety, and stress, measured by the DASS [START_REF] Lovibond | The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories[END_REF], depression severity, measured by the BDI [START_REF] Beck | [END_REF], and cognitive reappraisal and expressive suppression, measured by subscales of the ERQ [START_REF] Gross | Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being[END_REF].

Main Results: At the end of the study of Hesselmark et al. [START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF], the only outcome found to be significantly improved in the CBT group was QOLI. In the study of McGillivray et al. [START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF], the overall DASS and ASSQ improved over time, independently of treatment. However, focusing on participants who scored above the normal range on the depression, anxiety, and stress subscales of the DASS and ATQ, they observed a greater significant decrease in depressive symptoms relative to that of participants on the waiting-list. Similar significant findings were observed for the DASS stress scores.

No outcome showed significant improvement in the study of Murphy et al. [START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF]. Furthermore, no differences were observed between the experimental group and the controls, either in the self-ratings or teacher ratings with the SSS in the study of Pahnke et al. [START_REF] Pahnke | Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study[END_REF]. Concerning the self-ratings, a statistically significant group-by-time interaction was observed for the SDQ hyperactivity and prosocial behavior subscales. The significant group-by-time interaction effects indicated differences over time between the two groups in the teacher-ratings SDQ total score and the SDQ emotional symptoms and hyperactivity subscales. A group-by-time interaction effect was also observed for the BYI total scores. There were no statistically significant intergroup differences between the experimental group and controls for the BYI subscales. Leung et al. [START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF] found a significant improvement of parent and self-reports of the MSCS-C. Santomauro et al. [START_REF] Santomauro | Depression in adolescents with ASD: A pilot RCT of a group intervention[END_REF] did not find a significant group x time interaction for the BDI or DASS. The same was true for both ERQ subscales. White et al. [START_REF] White | Randomized controlled trial: Multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder[END_REF] found a significant group x time interaction on the SRS, but not the PARS or CASI-Anx. The MASSI participants showed significant improvement from pre-to post-treatment on the DD-CGAS. There was also a significant group difference on the DD-CGAS. For the CGI-I, 6 of 15 (40%) MASSI participants were rated as responders versus 3 of 15 (20%) of the waiting-list participants. Finally, Maddox et al. [START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF] showed that improvements in social skills, measured by the SRS, anxiety, measured by the ADIS C/P, and loneliness, measured by the Loneliness Questionnaire, were partially maintained one year after MASSI ended.

Multimodal Interventions

There Control Condition: ACCESS was compared to TAU.

Primary Outcomes: The primary outcomes were social and adaptive functioning, measured by the ABAS-3, self-determination, measured by the Seven Component Self-Determination Skills Survey [START_REF] Carter | Self-determination among transition-age youth with autism or intellectual disability: Parent perspectives[END_REF] and the Coping Self-Efficacy Scale [START_REF] Chesney | A validity and reliability study of the coping self-efficacy scale[END_REF], and anxiety, measured by the ASR [START_REF] Achenbach | Manual for the ASEBA adult forms & profiles: For ages 18-59: Adult self-report and adult behavior checklist[END_REF].

Main Results: Overall, adaptive functioning of the participants improved significantly more in the ACCESS group, whereas an improvement in only the Performance score was observed concerning self-determination, measured by the SCSS. Finally, there was no significant group difference between baseline and post-treatment for the Participant self-reported ASR Anxiety Problems or Composite

Coping Self-Efficacy Scale.

Leisure Program

One study assessed a leisure program developed to improve the involvement of young adults with ASD, without ID, in social activities. that were not previously validated.

Main Results: Overall, there was a significant decrease in the need for leisure support, favoring the intervention group. However, there was a general trend towards a more regular leisure activity pattern in both groups over time. The mean percentage of leisure satisfaction for the program group increased and between-group statistics indicate a medium effect.

The lowest level of evidence was found for the leisure program [91], for which only one study has been published, with the methodological quality rated as fair.

Finally, although there is an increasing number of high-level-evidence studies published concerning psycho-educational interventions, their number is still limited, thus limiting any generalizations. In addition, most of the reviewed studies were conducted on small samples, in which participants were recruited from a single center. Moreover, they used a wide range of outcomes and measures, which limits their comparison. Also, each intervention was compared to TAU without describing what it consisted of.

Strengths and Limitations of our Study

Our study had several strengths. First, the studies included in the review should be commended for being of generally high quality. There were however, factors that may have limited the interpretability of the results. One issue is the fact that only studies published in English or French were included in the review and that unpublished data were not included. The strong heterogeneity of the primary endpoints should also be noted. The use of a specific search equation, although allowing us to include as many studies as possible, may have missed some papers, especially if the authors did not use the same keywords and MeSH terms that we used. It should also be noted that we chose to focus on group-based intervention, because this can help young adults with ASD to meet other patients and as a result, increase their social engagement. However, it could be argued that this setting could increase anxiety and thus encourage individual psycho-educational programs. One such program has been tested [START_REF] Connan | Un programme de psychoéducation pour les adultes avec autisme sans déficience intellectuelle[END_REF] and also shows promise. Individual programs can also be better tailored for an individual's needs.

Recommendations for Practice

We found the strongest evidence for SST-, CBT-, and ACT-based interventions. Indeed, the description of the SST program and available information were better than for the other interventions, which can facilitate its implementation in clinical settings. In addition, ASD occurs frequently and is a life-long condition [START_REF] Brugha | Epidemiology of autism spectrum disorders in adults in the community in England[END_REF], which have been widely acknowledged as key factors that affect the provision of care, with many young people with high-functioning autism experiencing delays of many months before accessing educational intervention. In this context and from a purely economic perspective, the group format may allow for more efficient use of staff time and may also reduce waiting times for educational programs. As for other chronic conditions, the group format may also bring therapeutic benefits to young people with ASD by giving them opportunities to meet peers living with the same condition. As we have outlined above, research suggests that group-based psychoeducational intervention has a wide range of potential benefits beyond being a pragmatic delivery mode for existing program content and that it can serve as a powerful basis to support behavioral change. Thus, professionals should consider group-based psycho-educational intervention is an appropriate and relevant service for ASD. • The severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, according to his/her experience regarding the current diagnosis

Recommendations for Research: In

• The improvement scale (CGI-I) is a 7-point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention.

• The Cognitive Style and Social Cognition Eligibility Interview [100] is designed to elicit responses and behaviors from participants about cognitive and functional challenges in their lives that reflect the core cognitive profiles or "styles" that become key treatment targets in CET.

• The Contextual Assessment of Social Skills [START_REF] Ratto | Development of the contextual assessment of social skills (CASS): A role play measure of social skill for individuals with high-functioning autism[END_REF] is a live role-play assessment of conversational skills, developed for adolescents with high-functioning ASD.

• The Coping Self-Efficacy Scale [START_REF] Chesney | A validity and reliability study of the coping self-efficacy scale[END_REF] is a 26-item self-report measure of one's own perceived ability to cope effectively with life challenges.

• The Depression Anxiety Stress Scales [START_REF] Lovibond | The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories[END_REF] is a 42-item rating scale in which respondents are asked to rate on a 4-point scale, ranging from ''did not apply to me at all'' to ''applied to me very much, or most of the time'' a range of possible events that may have occurred during the past week. It consists of 3 sub scales: depression, anxiety and stress.

• The Developmental Disabled Children's Global Assessment Scale [START_REF] Wagner | Developmental disabilities modification of the Children's Global Assessment Scale[END_REF] is a measure of global functioning in children with developmental disabilities.

• The Diagnostic CheckList for pervasive developmental disorders [START_REF] Döpfner | A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children[END_REF] (DCL) is an ICD-10/DSM-IV based scale, which covers abnormalities in the areas of social interaction (DCL-S), communication (DCL-K) and stereotyped, repetitive behaviours and interests (DCL-ST).

• The Emotion Regulation Questionnaire [START_REF] Gross | Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being[END_REF] is a 10-item measure designed to assess participants' use of two prominent emotion regulation strategies: cognitive reappraisal and expressive suppression.

• The Empathy Quotient [START_REF] Baron-Cohen | The Empathy Quotient: An Investigation of Adults with Asperger Syndrome or High Functioning Autism, and Normal Sex Differences[END_REF] is a caregiver-report measure of empathy.

• The "Evaluación de Solución de Conflictos Interpersonales" (Evaluation of Interpersonal Conflicts Solutions) scale [37] is aimed at interpersonal problem solving skills. It consists of 12 sequences of images representing an interpersonal conflict, shown on the computer. Participants are required to give written answers to the following questions: (1) How does the principal character in the drawing feel? (2) Why does he/she feel this way? (3) What could he/she do to improve this situation? The task provides a total score and a score for each dimension: Emotion (ESCI-E), Situational Concordance (ESCI-C) and Solutions (ESCI-S).

• The FaBel is a German adaptation of the internationally well-established Impact-on-Family-Scale [START_REF] Stein | The development of an impact-on-family scale: preliminary findings[END_REF]. It is a 33-item questionnaire to assess the family burden caused by a mentally ill offspring. Items are scored on a 4-point scale. The items assess the general negative impact of parents, the description of social relationships, the concern for siblings, the financial impact and problems in coping as well as a total score • The Face Emotion Identification Test [START_REF] Kerr | Emotion perception in schizophrenia: specific deficit or further evidence of generalized poor performance?[END_REF] is a 19-item test comprised of photographs of faces expressing six basic emotions (i.e., happy, sad, angry, afraid, surprised, and ashamed). Participants indicates which emotion is expressed in each photograph.

• The Global Assessment of functioning Scale [43] is a rating scale to measure the level of every day's psychosocial functioning scoring from 0 to 100 • The Hinting Task [START_REF] Corcoran | Schizophrenia, symptomatology and social inference: investigating "theory of mind" in people with schizophrenia[END_REF] is a measure of ToM skills. This task consists of 10 brief, written vignettes that describe social interactions between two characters that end with one uttering a hint. Participants indicate what the character really means by the hint.

• The Hong Kong Chinese Version of Autism-Spectrum Quotient-10 Items (AQ-10-Adult-HK) is shortened Chinese version of the AQ.

• The Loneliness and Social Dissatisfaction Questionnaire [START_REF] Asher | Loneliness in children[END_REF] is a 16-item, standardized self-report measure that assesses global feelings of loneliness and social inadequacy on a scale of 1 (not true at all) to 5 (always true). Higher scores represent greater loneliness.

• The Loneliness Questionnaire [START_REF] Bauminger | Peer interaction and loneliness in high-functioning children with autism[END_REF] is a 30-item self-report measure used to assess loneliness in youth with ASD. The questionnaire distinguishes between emotional loneliness and social loneliness.

• The Major Role Adjustment Inventory [START_REF] Hogarty | Drug and sociotherapy in the aftercare of schizophrenic patients. II. Two-year relapse rates[END_REF] is an interview-based assessment of role functioning • The Mayer-Salovey-Caruso Emotional Intelligence Test [START_REF] Mayer | Measuring emotional intelligence with the MSCEIT V2.0[END_REF] is a test that assesses measures of emotion processing and regulation abilities that in the domains of emotion perception, facilitation (using emotions to facilitate thought).

• The Measurement and Treatment Research to Improve Cognition in Schizophrenia

Consensus Cognitive Battery [START_REF] Nuechterlein | The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity[END_REF][START_REF] Kern | The MATRICS Consensus Cognitive Battery, part 2: co-norming and standardization[END_REF] aims at assessing cognitive deficits. This battery has been validated initially for patients with schizophrenia.

• The Multidimensional Social Competence Scale-Chinese Version [START_REF] Leung | A psychometric study of the Chinese version of the multidimensional social competence scale (MSCS-C) on adolescents with autism spectrum disorder (ASD) in Hong Kong[END_REF] aims to assess social competence of high-functioning individuals with ASD in a multidimensional perspective. The questionnaire contains 77 items and a higher score indicating greater social competence. It contains seven domain scores on Social Motivation (SM), Social Inferencing (SI), Demonstrating Empathic Concern (DEC), Social Knowledge (SK), Verbal Conversation Skills (VCS), Nonverbal Sending Skills (NSS) and Emotional Regulation (ER).

• Mutual engagement [START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF] was defined as the percentage of intervals in which both individuals contributed equally in a back-and-forth manner • The Osnabruck Work Capabilities Profile [START_REF] Wiedl | The Osnabruck Work Capabilities Profile (O-AFP) for persons with psychiatric illness: concept, development, and testing in schizophrenic patients[END_REF] consists of 30 items using a Likert-type scale. Assessment is carried out by the participant's supervisor and self-reports. The scale ranges from 1 (total lack of skill) to 4 (always present). Assessment of rehabilitants is performed on three subscales, each with 10 items: learning ability (LA), social communication and interactional competence (SIC) and social adaptation and motivation (SAM).

• The Parental Stress Scale-Chinese Version [101] (PSS-C) is an 18-item questionnaire for assessing parental stress and parental role' satisfaction.

• The Pediatric Anxiety Rating Scale [START_REF] Ruoppas | The pediatric anxiety rating scale (PARS): Development and psychometric properties[END_REF] is a dimensional rating designed to assess symptoms across SAD, SoP, and GAD. The first section includes 50 specific anxiety symptoms rated as present or absent over the previous week. In the second section, the clinician rates symptom severity for the past week on a six-point scale (0 = none, 5 = extreme) across seven different dimensions (number of endorsed symptoms, frequency, severity of distress, severity of physical symptoms, avoidance, interference at home, and interference out of home).

• The Penn Emotion Recognition Test- 40 [102] assesses facial emotion recognition ability and includes 40 color photographs of faces expressing 4 basic emotions.

• Positive facial expressions [START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF] was calculated to determine the percentage of time the participant was displaying positive facial expressions.

• The Primary Care Therapy Process Rating Scale [103] comprises three subscales; one assessing the extent to which the therapist uses CBT techniques, one assessing the use of counselling and one to provide a measure of therapeutic alliance.

• The Quality of Life Inventory [START_REF] Frisch | Clinical validation of the Quality of Life Inventory. A measure of life satisfaction for use in treatment planning and outcome assessment[END_REF] is a 32-item measurement of life satisfaction assessing areas, such as health, relationships, employment and living conditions.

• The Quality of Life Questionnaire, Abridged Version [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF] evaluates quality of life and is an abridged version of the Quality of Life Questionnaire [104]. The original 40-item questionnaire assesses the domains of satisfaction, competence/productivity, empowerment/independence, and social belonging/community integration in people with disabilities. The parts regarding employment were stripped in the abridged version.

• The Quality of Play Questionnaire [START_REF] Frankel | A Randomized Controlled Study of Parent-assisted Children's Friendship Training with Children having Autism Spectrum Disorders[END_REF] consists of 12-items administered to parents and adolescents to assess the frequency of hosted and invited get-togethers over the previous month and to assess the level of conflict during the last hosted get-together.

• The Quality of Socialization Questionnaire [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF] is a 12-item self-and caregiver-report measure adapted from the Quality of Play Questionnaire for children with ASD [START_REF] Frankel | A Randomized Controlled Study of Parent-assisted Children's Friendship Training with Children having Autism Spectrum Disorders[END_REF]. It assesses the young adults' frequency of hosted and invited get-togethers over the previous month.

• The questionnaire Engagement in Leisure Activities [91] consists of eight items assessing participation and variation in leisure activities.

• The Questionnaire for the Assessment of Group Behaviour (FEG) [START_REF] Bölte | Fragebogen zur Erfassung des Gruppenverhaltens[END_REF] is a 23-item questionnaire measuring social behaviour in school setting.

• Questions asked [START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF] was defined as the percentage of questions asked by the participant during conversation • The questionnaire Need for Leisure Support [91] consists of eight items assessing participants' need for assistance in managing leisure.

• The questionnaire Satisfaction with Leisure Lifestyle [91] consisted of 15 items measuring the degree of participants' satisfaction with his/her leisure lifestyle.

• The Rosenberg Self-Esteem Scale [START_REF] Rosenberg | The association between self-esteem and anxiety[END_REF] is a 10-item instrument that measures self-esteem.

• The Sense of Coherence Scale [START_REF] Antonovsky | The structure and properties of the sense of coherence scale[END_REF] is a 29-item scale that measures perceived comprehensibility, manageability and meaning-fulness in life.

• The Seven Component Self-Determination Skills Survey [START_REF] Carter | Self-determination among transition-age youth with autism or intellectual disability: Parent perspectives[END_REF] is an informant report that has been used to measure self-determination skills and capacities of young adults with ASD and measures two domains; Performance and Importance.

• The shortened version of the Parent's Interview for Autism (PIA-CV-mini) [START_REF] Bölte | Eltern-Kurzinterview zur Erfassung autistischen Verhaltens[END_REF] is a measure of the severity of ASD which comprises 31 five-point scaled items (0-4), which are assigned to six behavioural domains: social area (eight items, PIA-S), affective reactivity (five items, PIA-AR), interaction with peers (four items, PIA-INT), communication (six items, PIA-K), stereotyped behaviour (five items, PIA-ST) and need for sameness (three items, PIA-GL)

• The Social and Emotional Loneliness Scale for Adults [30] is a 37-item self-report measure of romantic, social, and family loneliness.

• The Social Cognition Profile [100] is a 50-item clinician-rated measure of social-cognitive behaviours which assesses the domains of tolerant, perceptive, and self-confident behaviours indicative of adequate social cognition.

• The Social Communication Skills Questionnaire [START_REF] Mcgann | Social competence and head injury: A practical approach[END_REF] is a a self-report measure of socialcommunication skills. It is a 26-item measure developed for use with individuals with traumatic brain injury that focuses on communication as a central feature of social competence.

• The Social Competence Scale (SKS) [START_REF] Bölte | Soziale Kompetenzskala (SKS)[END_REF] is a parent questionnaire comprising 25 five-point scaled items measuring general social skills.

• The Social Problem-Solving Task [41] is a measure of social skills, initially developed for patients with brain injury. It was adapted by [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF] for use with ASD patients. It involves 10 twothree sentence scenarios that present a social problem or situation that could occur in daily life.

• The Social Responsiveness Scale [START_REF] Constantino | Social Responsiveness Scale: SRS-2 Software Kit[END_REF] is a measure of social impairments of ASD, initially developed for children and adolescents 4-18 years old.

• The Social Skills Improvement System [START_REF] Gresham | Social skills improvement system: Rating scales manual[END_REF] is a standardized rating scale that assesses global social competence for children aged 3-18 years.

• The Social Skills Inventory [105] is a 90-item self-report measure of social skills for adults.

• The Social Skills Performance Assessment [106] is a role-play assessment in which the subject participates in three conversations for 3 min each on predetermined topic. For each roleplay, ratings of interest, fluency, clarity, focus, affect, social appropriateness, and conversation, are provided. Across the three role-plays, a total of 16 skills are rated.

• The Social Skills Rating System [29] is a 52-item, caregiver-report questionnaire using standard scores. It assesses the frequency of the display of a variety of social skills at home, in the classroom, and in interactions with peers. SSRS subscales include cooperation, assertion, responsibility, and self-control.

• The Strengths and Difficulties Questionnaire [START_REF] Goodman | The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden[END_REF] is a brief behavioural screening instrument developed for 3-to 16-year-old children, consisting of 25 items. The scale has five subscales representing emotional symptoms, behaviour problems, hyperactivity/ inattention, peer relationship problems and prosocial behaviour.

• The Stress Survey Schedule for Autism and Other Developmental Disorders [START_REF] Groden | The development of a stress survey schedule for persons with autism and other developmental disabilities[END_REF] is a scale used to assess behaviours related to stress and the items are categorized into eight subscales representing categories of situations that children with ASD and other developmental disabilities normally perceive as stressful: changes, anticipation, social interaction, pleasant events, sensory stimuli, unpleasant events, food situations and rituals.

• The Symptom Checklist 90 [107] is a 90-item questionnaire assessing the presence and severity of various psychiatric symptoms. The primary symptom dimensions assessed are (1) somatization, (2) obsessive-compulsive, (3) interpersonal sensitivity, (4) depression, (5) anxiety, (6) hostility, (7) phobic anxiety, (8) paranoid ideation, (9) psychoticism, and (10) a category of "additional items".

• The Test of Adolescent Social Skills Knowledge-Revised [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: the UCLA PEERS program[END_REF] is a 26-item criterionreferenced measure developed to assess treatment changes related to the adolescent's knowledge about the specific social skills taught during UCLA PEERS. The TASSK-R is based upon the original Test of Adolescent Social Skills Knowledge [START_REF] Laugeson | Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders[END_REF]. Specific changes are not outlined between the 2 versions.

• The Test of Young Adult Social Skills Knowledge is a 23-item criterion-referenced measure based on the Test of Adolescent Social Skills Knowledge [START_REF] Laugeson | Parent-assisted social skills training to improve friendships in teens with autism spectrum disorders[END_REF] and modified for young adults.

• The Therapy Process Observational Coding System-Alliance Scale [108] is a nine-item measure consisting of a child and parent form designed which result in a comprehensive coding system capable of objectively describing child-therapist and parent-therapist alliance.

• The Vineland Adaptive Behavior Scales, Second Edition [START_REF] Sparrow | Vineland Adaptive Behavior Scales[END_REF] is designed to measure adaptive behaviour in subjects up to 90 years old, on the basis of a report with a Likert-type scale completed by parents or informers. It consists of 3 subscales: Communication (Receptive, Expressive, and Written); Daily Living Skills (Personal, Domestic, Community) and Socialization (Interpersonal Relationships, Play and Leisure Time, Coping Skills).

• The Wisconsin Card Sorting Test [START_REF] Heaton | Wisconsin Card Sorting Test (WCST)-manual revised and expanded[END_REF]

  efficacy[Title/Abstract]) OR effectiveness[Title/Abstract]) OR efficiency[Title/Abstract]) OR improve*[Title/Abstract]). The filters were Adolescent: 13-18 years and Young Adult: 19-24 years.

Assessed Interventions:

  Palmen et al. [91] assessed a leisure program in a single study. Sessions: The program spanned more than six months and consisted of 15 group sessions, starting with a frequency of once a week for the first four sessions that decreased to once every six weeks by the last two. Target Population and Diagnostic Criteria: The target population was young adults with a diagnosis of ASD without ID established by a licensed psychiatrist according to DSM-IV criteria Study Design: As group assignment was based on the order in which participants applied for participation, it was not a RCT. Control Condition: This program was compared to TAU.Primary Outcomes: Primary outcomes were Need for Leisure Support, Engagement in Leisure Activities, and Satisfaction in Leisure Lifestyle, three scales developed specifically for this study[91]

  de Solución de Conflictos Interpersonales, VABS-II = Vineland Adaptive Behavior Scales, Second Edition, MATRICS Consensus Cognitive Battery = Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery, O-AFP = Osnabruck Work Capabilities Profile, MSCEIT = Mayer-Salovey-Caruso Emotional Intelligence Test, SSRS = Social Skills Rating System, SELSA = Social and Emotional Loneliness Scale for Adults, SSI = Social Skills Inventory, TYASSK = Test of Young Adult Social Skills Knowledge, SRS = Social Responsiveness Scale, EQ = Empathy Quotient, SoC Scale = Sense of Coherence Scale, CGI(-I) = Clinical Global Impression (-I = Improvement), RSES = Rosenberg's Self-Esteem Scale, BDI = Beck Depression Inventory, QOLI = Quality of Life Inventory, AQ = Autism Quotient, ASRS = Adult ADHD Self-Report Scale, SCL-90 = Symptom Checklist-90, QSQ = Quality of Socialization Questionnaire, DASS = Depression Anxiety Stress Scales, ATQ = Automatic Thoughts Questionnaire, ASSQ = Autism Spectrum Screening Questionnaire, ADIS C/P = Anxiety Disorders Interview Schedule : Child and Parent Version, ASD = Autism Spectrum Disorder, PCTPRS = Primary Care Therapy Process Rating Scale, ABAS-3 = Adaptive Behavior Assessment System -Third Edition, ASR = Adult Self Report, SDQ = Strengths and Difficulties Questionnaire, BYI = Beck Youth Inventories, SCSQ = Social Communication Skills Questionnaire, FEIT = Face Emotion Identification Test, DD-CGAS = Developmental Disabilities modification of Children's Global Assessment Scale, CASI-Anx = Childhood Anxiety Sensitivity Index -Anxiety, PARS = Pediatric Anxiety Rating Scale, CSES = Coping Self-Efficacy Scale, SSPA = Social Skills Performance Assessment, QPQ = Quality of Play Questionnaire, TASSK-R = Test of Adolescent Social Skills Knowledge-Revised, CBT-CSCA = CBT-Context-Based Social Competence Training for ASD, MSCS-C = Multidimensional Social Competence Scale-Chinese Version, AQ-10-Adult-HK = Hong Kong Chinese Version of Autism-Spectrum Quotient 10 Items, DASS-21 = Depression Anxiety and Stress Scales-21, PSS-C = Parental Stress Scale-Chinese Version, SCQ = Social Communication Questionnaire, SDS = Self-Determination Scale, QoL-Q-Abridged = Quality of Life Questionnaire, Abridged Version, TASSK = Test of adolescent Social Skills knowledge, CASS = Contextual Assessment of Social Skills, LSDQ = Loneliness and Social Dissatisfaction Questionnaire, SSIS = Social Skills Improvement System, ASDI = Asperger Syndrome Diagnostic Interview, ERQ = Emotion Regulation Questionnaire Primary Outcomes as marked in green

  For columns C-M: Y = Yes, N = No For column N: Overall Quality: Dark blue = Excellent, Light blue = Good, Yellow = Fair, Orange = Poor (Number corresponds to the number of Y for the study in question)

  Turner-Brown et al. found a significant group x time interaction for only the hinting task. All but two studies[START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF][START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF] used a RCT design. McGillivray et al.[START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF] assigned participants according to their alternating order of enrolment. Leung et al.[START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF] opted for a pre-post design. Four studies[START_REF] White | Randomized controlled trial: Multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder[END_REF][START_REF] Pahnke | Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study[END_REF][START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF][START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF] compared their programs to TAU, whereas that of Murphy et al.[START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF] used person-centered counselling and that of Hesselmark et al.[START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF], a recreational group. The study of Leung et al.[START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF] had no control group. Hesselmark et al.[START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF] used quality of life, measured by the QOLI[START_REF] Frisch | Clinical validation of the Quality of Life Inventory. A measure of life satisfaction for use in treatment planning and outcome assessment[END_REF],

	Cognitive Behavioral Therapy (CBT) and ACT (Acceptance and Commitment Therapy)-based Interventions CBT and ACT are well-validated strategies commonly used to treat many psychiatric conditions, such as anxiety. Eight studies assessed the efficacy of group-based interventions using ACT or CBT. Control Condition: Primary Outcomes:
	Target Population and Diagnostic Criteria: Three studies [69,62,68] targeted young ASD adults
	with associated depression and/or anxiety. The programs of Hesselmark et al. [62] and Leung et al.

Assessed Interventions: Hesselmark et al.

[START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF]

studied the effect of a group-based intervention using CBT and elements of dialectical and behavioral therapies, psychoeducation, social training, and cognitive-behavioral therapy. The study published by McGillivray et al.

[START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF]

evaluated the "Think well, feel well, and be well" intervention based on CBT and the targeting of depression and anxiety.

Three studies

[START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF][START_REF] White | Randomized controlled trial: Multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder[END_REF][START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF]

evaluated the multimodal anxiety and social skill intervention (MASSI). MASSI is a group-based intervention using CBT and targets anxiety and social disabilities. More specifically, Maddox et al.

[START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF]

focused on the long-term effects of MASSI, following the RCT of White et al. [65]. Pahnke et al. [67] evaluated an ACT-based group. Leung et al. [68] assessed CBT-CSCA (Adult), a CBT program that aims to teach social skills. Finally, Santomauro et al. [69] assessed a program called Exploring Depression, based on CBT. Sessions: The program of Hesselmark et al. [62] consisted of 36 weekly 3-h sessions. "Think well, feel well, and be well" consisted of nine weekly sessions. MASSI consisted of 14 weekly sessions. The program of Pahnke et al. [67] consisted of 12 sessions, twice a week. CBT-CSCA consisted of 15 weekly sessions. Finally, Exploring Depression was composed of 11 sessions. The first 10 were organized once a week and the final and 11 th session occurred four weeks after the 10 th .

[68] targeted young adults with ASD without ID, whereas that of Santomauro et al.

[START_REF] Santomauro | Depression in adolescents with ASD: A pilot RCT of a group intervention[END_REF]

targeted adolescents with ASD without ID. Three studies

[START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF][START_REF] Pahnke | Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study[END_REF][START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF][START_REF] Santomauro | Depression in adolescents with ASD: A pilot RCT of a group intervention[END_REF]

relied on a previous diagnosis of ASD established by a healthcare professional. Murphy et al.

[START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF]

confirmed the diagnosis of ASD using the ADI-R, Hesselmark et al.

[START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF]

using the ADOS, and Maddox et al. and White et al.

[START_REF] White | Randomized controlled trial: Multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder[END_REF][START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF]

using both.

Study Design:

  was one study on multimodal interventions, which was a RCT that assessed ACCESS, published by Oswald et al. in 2018.

	Assessed Interventions: ACCESS [87] was a CBT group-based intervention comprising SST,
	adaptive skills training, psycho-education, and a caregiver coaching group.
	Sessions: The intervention consisted of 19 1.5-h weekly sessions
	Target Population and Diagnostic Criteria: The study targeted young adults with a diagnosis

of ASD without ID, ascertained by the ADOS.

Study Design: Oswald et al.

[START_REF] Oswald | A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder[END_REF]

used a RCT design.

Table 1 :

 1 Future Systematic ReviewsThere is a growing number of studies assessing the efficacy of group-based psycho-educational interventions in young adults with ASD but the limitations of the existing studies necessitate further research to improve our knowledge concerning effective interventions that need to be implemented.In future studies, authors should use larger samples and a multicentric design. Moreover, further studies must take into account the varying outcomes and measures used in the existing studies. Finally, if researchers compare their intervention to TAU, we recommend that they specify what it refers to.ConclusionsIl existe un nombre croissant de preuves montrant que les interventions éducationnelles de groupe sont une approche efficace pour améliorer les comportements chez les jeunes adultes avec TSA. En revanche, nous avons observé une hétérogénéité considérable parmi les études dans cette Study Designs

	revue, à la fois en termes de taille d'effet et de design interventionnel, de délivrance et de comparaison
	à un groupe contrôle. En conséquence, et malgré la présence de preuves encourageantes que les
	interventions de groupe peuvent en effet être le support de programmes psycho-éducationnels, peu de
	choses sont connues sur la façon dont les groupes devraient être organisés pour optimiser leur
	efficacité. Nos observations suggèrent que des études supplémentaires sont nécessaires afin de valider
	les programmes existants en utilisant des échantillons plus grands et représentatifs et afin
	d'implémenter ces programmes innovants ciblant les symptômes du TSA ou les pathologies
	comorbides.

Conclusions

There is a growing body of evidence that group-based educational interventions are effective approaches to improve behaviors in young adults with ASD. However, we observed considerable heterogeneity across studies in this review, both in terms of effect sizes and intervention design, delivery, and comparison to controls. Thus, despite encouraging evidence that group interventions can effectively support psycho-educational programs, very little is actually known about how groups should be organized to optimize their effectiveness. Our findings suggest that additional research is needed to validate existing programs using larger and more representative samples and to implement innovative programs targeting ASD behaviors or comorbid conditions. Figure 1 PRISMA Flow Chart

Table 2 :

 2 Quality Assessment using PEDro Scale

	Authors	Publication Year	eligibility criteria were specified	subjects were randomly allocated to groups (in a crossover study, subjects were randomly allocated an order in which treatments were received)	allocation was concealed	the groups were similar at baseline regarding the most important prognostic indicators	there was blinding of all subjects	there was blinding of all therapists who administered the therapy	there was blinding of all assessors who measured at least one key outcome	measures of at least one key outcome were obtained from more allocated to groups subjects initially than 85% of the	all subjects for whom outcome measures were available received the treatment or control condition as allocated or, where to treat" key outcome was analysed by "intention this was not the case, data for at least one	the results of between-group statistical outcome least one key reported for at comparisons are	the study provides both point measures and outcome for at least one key measures of variability	Overall Quality
							Cognitive Remediation
	Eack et al.	2013	Y	N	N	N	N	N	N	Y	Y	N	Y
	Eack et al.	2018	Y	Y	Y	Y	N	N	Y	Y	Y	Y	Y
	Turner Brown et al	2008	Y	N	N	Y	N	N	N	Y	N	Y	Y
							Social Skills Training
	Bonete et al.	2015	Y	N	N	N	N	N	N	Y	N	Y	Y
	Gantman et al.	2012	Y	Y	Y	Y	N	N	N	Y	Y	Y	N
	Herbrecht et al.	2009	Y	N	N	N	N	N	Y	N	Y	Y	Y
	Ko et al.	2019	Y	Y	Y	Y	N	N	Y	Y	N	Y	Y
	Laugeson et al.	2012	Y	Y	Y	Y	N	N	Y	Y	Y	Y	Y
	Laugeson et al.	2015	Y	Y	Y	Y	N	N	N	Y	Y	Y	Y
	Nadig et al.	2018	Y	Y	Y	Y	N	N	Y	Y	Y	Y	Y
	Rabin et al.	2018	Y	Y	Y	Y	N	N	N	Y	N	Y	Y
								CBT/ACT
	Hesselmark et al	2014	Y	Y	Y	Y	N	N	N	Y	Y	Y	Y
	Leung et al.	2019	Y	N	N	N	N	N	N	Y	N	N	Y
	Maddox et al.	2017	Y	Y	Y	Y	N	N	N	N	N	Y	Y
	McGillivray et al.	2014	N	N	Y	Y	N	N	N	Y	Y	Y	Y
	Murphy et al.	2017	Y	Y	Y	Y	N	N	Y	N	Y	Y	Y
	Pahnke et al.	2014	Y	Y	Y	Y	N	N	N	Y	Y	Y	Y
	Santomauro et al.	2016	Y	Y	Y	Y	N	N	N	Y	N	Y	Y

  is a measure of cognitive flexibility. Legend Scales in dark red evaluate Social Skills/Self Determination Skills Scales in dark green evaluate Adaptive and Global Functioning Scales in orange evaluate Work Capabilities Scales in teal evaluate Neuro or Social Cognition Scales in dark blue evaluate Knowledge about ASD Scales in purple evaluate Severity of ASD Scales in pink evaluate Self-esteem Scales in light green evaluate Depression/Anxiety Scales in light red evaluate Quality of Life Scales in light blue evaluate Therapeutic Adherence and Alliance Scales in maroon evaluate Leisure capabilities Scales in coral evaluate Inattention, hyperactivity and impulsivity Scales in grey are Broad Psychiatric Measures

typique ou présentant d'autres troubles du neurodéveloppement. De plus, ces jeunes personnes avec TSA sont souvent sans emploi et, si elles ont un emploi, ont souvent un salaire plus bas. Enfin, de nombreux jeunes adultes avec TSA luttent contre des comorbidités psychiatriques, telles que la dépression et l'anxiété, altérant d'autant plus le fonctionnement global de ces personnes, déjà bas. Ces facteurs contribuent tous à des difficultés, dans cette population, à atteindre une indépendance sociale, financière et émotionnelle. En conséquence, il est urgent de créer des interventions ciblant les jeunes personnes avec TSA sans déficience intellectuelle transitionnant vers l'âge adulte. L'objectif principal doit être d'améliorer le fonctionnement général et les résultats, en proposant à cette population un support efficace durant la période critique de transition vers l'âge adulte, tout en créant des opportunités. L'un des obstacles à cela est que très peu de recherches ont été réalisées sur la transition vers l'âge adulte des personnes avec TSA sans déficience intellectuelle (DI). En conséquence, notre connaissance des interventions efficaces pour les jeunes adultes TSA sans DI est encore limitée. Les recommandations internationales (NICE Clinical guideline [CG142]) suggèrent que les interventions devraient cibler le fonctionnement adaptatif et l'autonomisation, et qu'une attention particulière doit être portée sur les périodes de transition. En pratique clinique, les interventions de groupe ont été utilisées pour aider les jeunes individus avec TSA à comprendre leurs symptômes et à améliorer leur fonctionnement social.

Remerciements

Acknowledgments: The authors warmly thank Philippe Antoine for his assistance with the literature search.

Madame le Professeur BAGHDADLI et à Monsieur le Professeur Merci à Marion BUR pour ton soutien, ton m'avoir encouragé à manger aux repas. pour ton aide en tant que co-référent. SCHIPHORST pour ton soutien et merci d'avoir été là pour moi. Merci pour ton amitié. Merci à Pauline CANTIER pour toutes les discussion que nous avons pu avoir, pour ton soutien

Discussion

We systematically reviewed the literature concerning the efficiency of existing psychoeducational interventions for young people with ASD without ID transitioning to adulthood. It should thus be representative of the current state of research regarding this field.

Overall, very little research concerning group interventions has been conducted in adults with ASD without ID, especially as they grow older. As a result, studies targeting adults/adolescents with ASD without ID transitioning to adulthood are the source of the largest samples to date of adult-age ASD individuals, which make our findings difficult to compare with those of other studies. However, although there are specific features pertaining to the period of the transition to adulthood, our findings are consistent with those obtained for younger individuals, showing that both SST [START_REF] Gates | Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis[END_REF] and CBT/ACT [START_REF] Sukhodolsky | Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis[END_REF] interventions are efficient in improving ASD core symptoms and comorbidities.

Our eligibility criteria focused on group-based interventions, which we believe can be a true asset for this population, especially in light of the proof of their efficacy in younger individuals with ASD. Existing studies encompass a wide range of interventions, ranging from SST and psychoeducation to CBT and ACT-group based interventions. Overall, most of the reviewed studies reported a significant positive impact of group-based intervention on socialization, cognition, global functioning, and psychiatric comorbidities, such as anxiety or depression.

The strongest level of evidence was found for SST-, CBT-, and ACT-based interventions. The methodological quality of SST studies was rated as excellent for two [START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF][START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF], good for four [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF][START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF][START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF][START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF], and fair for two [START_REF] Bonete | Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study[END_REF][START_REF] Herbrecht | Pilot evaluation of the Frankfurt Social Skills Training for children and adolescents with autism spectrum disorder[END_REF]. The methodological quality of seven papers studying CBT and ACT-based interventions was rated as good [START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF][START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF][START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF][START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF][START_REF] Pahnke | Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study[END_REF][START_REF] Santomauro | Depression in adolescents with ASD: A pilot RCT of a group intervention[END_REF][START_REF] White | Randomized controlled trial: Multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder[END_REF], and poor for one [START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF]. However, although the SST protocol was well described in an appendix of one study [START_REF] Bonete | Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study[END_REF] and online for four others [START_REF] Gantman | Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study[END_REF][START_REF] Laugeson | Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program[END_REF][START_REF] Laugeson | A Randomized Controlled Trial to Improve Social Skills in Young Adults with Autism Spectrum Disorder: The UCLA PEERS(®) Program[END_REF][START_REF] Rabin | A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnairebased outcomes[END_REF], START [START_REF] Ko | Social conversation skill improvements associated with the Social Tools And Rules for Teens program for adolescents with autism spectrum disorder: Results of a randomized controlled trial[END_REF], KONTAKT [START_REF] Herbrecht | Pilot evaluation of the Frankfurt Social Skills Training for children and adolescents with autism spectrum disorder[END_REF] and the program of Nadig et al. [START_REF] Nadig | Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life[END_REF] were insufficiently described. The CBT and ACT protocols were also insufficiently described [START_REF] Hesselmark | Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: a preliminary randomized controlled trial[END_REF][START_REF] Mcgillivray | Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[END_REF][START_REF] Pahnke | Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study[END_REF][START_REF] Leung | Applicability and Effectiveness of Social Competence Group Intervention on Adults with Autism Spectrum Disorder in a Chinese Context: A Community-Based Study with Self-and Parent-Report[END_REF][START_REF] Santomauro | Depression in adolescents with ASD: A pilot RCT of a group intervention[END_REF] or accessible only upon request [START_REF] Murphy | Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial[END_REF][START_REF] Maddox | Long-term effects of CBT on social impairment in adolescents with ASD[END_REF][START_REF] White | Randomized controlled trial: Multimodal Anxiety and Social Skill Intervention for adolescents with autism spectrum disorder[END_REF].

The findings were more mixed for the three papers studying cognitive remediation, the methodological quality having been rated as excellent for one paper [START_REF] Eack | Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial[END_REF] but fair for the two others [START_REF] Eack | Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18month feasibility study[END_REF][START_REF] Turner-Brown | Brief report: feasibility of social cognition and interaction training for adults with high functioning autism[END_REF], with no description or available information of the intervention protocol.

The methodological quality of the study examining the "ACCESS" multimodal intervention [START_REF] Oswald | A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder[END_REF] was rated as good and the protocol was well described in the paper. However, only one study was available concerning this intervention and the results should be replicated. A RCT is ongoing for STEPS [START_REF] White | Development of a college transition and support program for students with autism spectrum disorder[END_REF], another multimodal program.

Conflict of interests:

The authors declare that they have no conflict of interests Supplementary Data 1: Scales used as Primary and Secondary Outcomes • The Adaptive Behavior Assessment System-Adult Form, Third Edition [START_REF] Harrison | ABAS-3: Adaptive behavior assessment system[END_REF] is an informant report providing comprehensive assessment of adaptive functioning in individuals with developmental delays, including ASD. The ABAS-3 includes the norm-referenced General Adaptive Composite (GAC), and three Composite scales : Social, Conceptual & Practical.

• The Adult ADHD Self-Report Scale [97] measures inattention, hyperactivity and impulsivity in adults.

• The Anxiety Disorders Interview Schedule for Children/Parents [START_REF] Silverman | Anxiety disorders interview schedule for DSM-IV[END_REF] is an interview that assesses the following dimensions : (1) School History, (2) School Refusal Behavior, (3) Separation Anxiety Disorder, (4)Interpersonal Relationships, (5) Social Phobia (Social Anxiety Disorder), ( 6) Specific Phobia, (7) Panic Disorder, ( 8) Agoraphobia (With or Without Panic Disorder), ( 9) Generalized Anxiety Disorder, [START_REF] Derosier | The Efficacy of a Social Skills Group Intervention for Improving Social Behaviors in Children with High Functioning Autism Spectrum Disorders[END_REF] • The Anxious Self-Statements Questionnaire [START_REF] Kendall | Anxious self-talk: Development of the anxious self-statements questionnaire (ASSQ)[END_REF] is a measure of the frequency of cognitive self-statements associated with anxiety.

• The ARC's Self-Determination Scale [START_REF] Wehmeyer | The Arc's self-determination scale (adolescent version)[END_REF] is a measure of self-determination and is a 72item self-report measure with four subscales: Autonomy, Self-regulation, Psychological Empowerment and Self-Realization.

• The ASEBA Adult Self-Report [START_REF] Achenbach | Manual for the ASEBA adult forms & profiles: For ages 18-59: Adult self-report and adult behavior checklist[END_REF] is a standardized self-report completed by the participant that contains the DSM-oriented scale Anxiety Problems.

• The Autism Quotient [START_REF] Baron-Cohen | The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Malesand Females, Scientists and Mathematicians[END_REF] is a 50-item screening instrument for measuring autistic traits.

• The Automatic Thoughts Questionnaire [START_REF] Hollon | Cognitive self-statements in depression: Development of an automatic thoughts questionnaire[END_REF] is a measure of frequency of cognitive selfstatements associated with depressed mood and includes 30 negative self-statements theoretically associated with depression.

• The Beck Depression Inventory [START_REF] Beck | [END_REF] is s a 21-question multiple-choice self-report inventory used to assess depression severity.

• The Beck Youth Inventories [START_REF] Beck | Beck youth inventories-Second edition (BYI-II)[END_REF] are a self-rating questionnaire that consists of five subscales : anxiety, depression, anger, disruptive behaviour and self-concept.

• The Checklist for Group Behaviours [START_REF] Bölte | Checkliste zur Beurteilung von Gruppenfertigkeiten[END_REF] (CGB) is a rating scale comprising 19 six-point scaled items (0-5) detecting social skills in group context • The Child and Adolescent Symptom Inventory-4 ASD Anxiety Scale [START_REF] Hallett | Exploring the manifestations of anxiety in children with autism spectrum disorders[END_REF] is a measure of anxiety specifically developed for people with ASD.

• The Client Satisfaction Questionnaire-8 [START_REF] Larsen | Assessment of client/patient satisfaction: development of a general scale[END_REF] is a measure of treatment satisfaction that has been widely employed to assess the acceptability of psycho-therapy programs.

• The Clinical Global Impression Scales [START_REF] Guy | ECDEU assessment manual for psychopharmacology[END_REF] are a set of two scales:

Abstract/Résumé

Background: There is a growing number of young people transitioning to adulthood diagnosed with an autismspectrum disorder (ASD). Among them, individuals without an intellectual deficiency have significant adaptive deficits and need individualized care and support services targeting better vocational, social, and educational outcomes.

Mots-Clés

Troubles du spectre de l'Autisme, Psychiatrie du développement, Psychiatrie, Psychiatrie de l'Enfant et de l'Adolescent, Neurodéveloppement, Interventions de Groupe, Psychoeducation, TCC