# Three-Character Training of Question-Asking (TCT-Q) for Children with High-Functioning Autism Spectrum Disorder: A Randomized Controlled Trial

## TL;DR

A new training method called TCT-Q improved question-asking skills in children with high-functioning autism, leading to better social communication.

## Contribution

The study introduces and evaluates a novel three-character training method (TCT-Q) for teaching question-asking to children with high-functioning autism.

## Key findings

- Children in the TCT-Q group showed a significant increase in question-asking frequency after the intervention.
- Improvements in the TCT-Q group were greater than those in the treatment-as-usual group.
- The TCT-Q group showed numerical improvements in social communication and autistic mannerisms, though not statistically significant.

## Abstract

Question-asking is a key component of social communication, and interventions targeting this skill may be able to improve social functioning in children with high-functioning autism spectrum disorder (HFASD). This study introduced a novel intervention method called the three-character training of question-asking (TCT-Q), aimed at teaching children with HFASD how to appropriately use 11 questions in social interactions. The effectiveness of TCT-Q was tested through a randomized controlled trial. Thirty-seven children were assigned to TCT-Q group (n = 19) or treatment as usual (TAU) group (n = 18). Children and their caregivers received two 60 min sessions weekly. Outcome variables were measured before training (T1), after training (T2), and three months after training (T3). Results showed that the question-asking frequency in the TCT-Q group increased significantly after the intervention (ps < 0.001), and the increase was significantly greater than that in the TAU group (ηp2 = 0.089–0.370). Although the TCT-Q group showed greater numerical improvements in social communication and autistic mannerisms (ps < 0.05), the group-by-time interaction did not reach statistical significance. In conclusion, TCT-Q is a promising method for enhancing question-asking behaviors and social skills in children with HFASD.