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Lee V, Vashi N, Roudbarani F, Modica PT, Pouyandeh A, Sellitto T, Ibrahim A, Ameis SH, Elkader A, Gray KM, Kerns CM, Lai MC, Lake J, Thomson K, Weiss JA. Utility of a virtual small group cognitive behaviour program for autistic children during the pandemic: evidence from a community-based implementation study. BMC Health Serv Res 2024; 24:685. [PMID: 38816827 PMCID: PMC11140895 DOI: 10.1186/s12913-024-11033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/23/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Autistic children often experience socioemotional difficulties relating to emotion regulation and mental health problems. Supports for autistic children involve the use of adapted interventions that target emotion regulation and social skills, alongside mental health symptoms. The Secret Agent Society Small Group (SAS: SG), an adapted cognitive behavioural program, has demonstrated efficacy through lab-delivered randomized control trials. However, research is still needed on its effectiveness when delivered by publicly funded, community-based autism providers under real-world ecologically valid conditions, especially within the context of a pandemic. The COVID-19 pandemic has disrupted access to community-based supports and services for autistic children, and programs have adapted their services to online platforms. However, questions remain about the feasibility and clinical utility of evidence-based interventions and services delivered virtually in community-based settings. METHODS The 9-week SAS: SG program was delivered virtually by seven community-based autism service providers during 2020-2021. The program included the use of computer-based games, role-playing tasks, and home missions. Caregivers completed surveys at three timepoints: pre-, post-intervention, and after a 3-month follow-up session. Surveys assessed caregivers' perception of the program's acceptability and level of satisfaction, as well as their child's social and emotional regulation skills and related mental health challenges. RESULTS A total of 77 caregivers (94% gender identity females; Mean = 42.1 years, SD = 6.5 years) and their children (79% gender identity males; Mean = 9.9 years, SD = 1.3 years) completed the SAS: SG program. Caregivers agreed that the program was acceptable (95%) and were highly satisfied (90%). Caregivers reported significant reduction in their child's emotion reactivity from pre- to post-intervention (-1.78 (95% CI, -3.20 to -0.29), p = 0.01, d = 0.36), that continued to decrease after the 3-month booster session (-1.75 (95% CI, -3.34 to -0.16), p = 0.02, d = 0.33). Similarly, improvements in anxiety symptoms were observed (3.05 (95% CI, 0.72 to 5.36), p = 0.006, d = 0.39). CONCLUSIONS As online delivery of interventions for autistic children remains popular past the pandemic, our findings shed light on future considerations for community-based services, including therapists and agency leaders, on how best to tailor and optimally deliver virtually based programming. TRIAL REGISTRATION This study has been registered with ISRCTN Registry (ISRCTN98068608) on 15/09/2023. The study was retroactively registered.
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Affiliation(s)
- Vivian Lee
- Department of Psychology, Carleton University, 214E Social Science Research Building, Ottawa, ON, K1S 5B6, Canada.
| | - Nisha Vashi
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Flora Roudbarani
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Paula Tablon Modica
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Ava Pouyandeh
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Teresa Sellitto
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Alaa Ibrahim
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Stephanie H Ameis
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
| | - Alex Elkader
- Kinark Child and Family Services, 7271 Warden Ave, Markham, ON, L3R 5X5, Canada
| | - Kylie M Gray
- Centre for Education Development, Appraisal, and Research, University of Warwick, Coventry, CV4 7AL, UK
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Meng-Chuan Lai
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
| | - Johanna Lake
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
| | - Kendra Thomson
- Department of Applied Disabilities Studies, Brock University, 1812 Sir Issac Brock Way, St. Catherines, ON, L2S 3A1, Canada
- Azrieli Adult Neurodevelopmental Centre at the Centre for Addiction and Mental Health, 1451 Queen Street West, Toronto, ON, M63 1A1, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
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Keefer A, White SW, Vasa RA, Reaven J. Psychosocial interventions for internalizing disorders in youth and adults with ASD. Int Rev Psychiatry 2018. [PMID: 29537895 DOI: 10.1080/09540261.2018.1432575] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Internalizing disorders are common in individuals with ASD. Psychosocial interventions targeting these disorders in the ASD population have burgeoned in the last decade. Cognitive-behavioural therapy, modified for ASD, is the most frequently investigated model, although other interventions, including behaviour therapy, third-wave interventions, models targeting transdiagnostic constructs, and alternative interventions and treatment delivery methods are now emerging. This review provides a summary of the efficacy of these interventions in treating internalizing disorders in youth and adults with ASD. The barriers to accessing these treatments, which are experienced by many individuals with ASD and their families, as well as future research directions, are also discussed.
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Affiliation(s)
- Amy Keefer
- a Center for Autism and Related Disorders , Kennedy Krieger Institute , Baltimore , MD , USA.,b Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Susan W White
- c Department of Psychology , Virginia Tech , Blacksburg , VA , USA
| | - Roma A Vasa
- a Center for Autism and Related Disorders , Kennedy Krieger Institute , Baltimore , MD , USA.,b Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Judy Reaven
- d Department of Psychiatry , University of Colorado Anschutz Medical Campus , Aurora , CO , USA
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