Date of Award

August 2023

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Bonita P Klein-Tasman

Committee Members

Amy Van Hecke, Shawn Cahill, Hobart Davies, Kristin Smith


neurofibromatosis type 1, NF1, PEERS, social, telehealth, virtual


Research that has included children and adolescents with neurofibromatosis type 1 (NF1) suggests an elevated rate of social difficulties in comparison to same-aged peers. However, interventions for social difficulties have not been investigated in the NF1 population. The Program for the Education and Enrichment of Relational Skills (PEERS®; Laugeson & Frankel, 2010) has been widely established as an intervention to improve social functioning in autism spectrum disorders (Laugeson et al., 2012) and more recently, in a pilot study for attention-deficit/hyperactivity disorder (Gardner et al., 2015). This research aimed to 1) conduct a pilot study to examine the effectiveness of a 14-week telehealth PEERS® intervention using both an open trial and a pilot randomized controlled trial, and 2) determine the acceptability and feasibility of the intervention for adolescents with NF1. Participants were 27 adolescents with NF1 (Mage = 13.91 years, SD = 1.51) with social skills difficulties and at least one caregiver. Caregivers and adolescents completed several measures of social outcomes at pre-test and post-test. Following the intervention, caregiver-reported social-emotional skills, social impairment, caregiver-reported number of adolescent get-togethers, and social knowledge showed improvement. Additionally, caregiver treatment ratings following the intervention indicated a high level of acceptability and feasibility for telehealth-delivered PEERS®. The pilot data from this investigation show the promise of the specific social skills intervention, PEERS®, to support the social and friendship skills of adolescents with NF1 who have social difficulties. Identifying an intervention strategy for improving aspects of social functioning may help to mitigate negative social outcomes.

Available for download on Thursday, August 28, 2025