Functional Outcome in Late Adolescence/ Early Adulthood of Patients With Autism Spectrum Disorder and Its Relationships With Parental Burnout and Depression: Multi-center, Cross-sectional Study

The aim of this study is to determine functioning of adults with Autism Spectrum Disorders (ASDs) diagnosed in childhood and also depression and burnout levels among their parents. 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported “good” or “very good” outcome. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/ hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD.

An Internet Based Intervention for Adults With Autism Spectrum Disorder—A Qualitative Study of Participants Experiences

Background: Adults with autism spectrum disorder face several barriers to accessing evidence-based care, including difficulties in communicating needs, social anxiety or in traveling to a health care unit. In recent years, several forms of internet-based treatments have shown to be effective for a variety of psychiatric conditions. Internet-based treatment alternatives allow convenient and flexible formats, and therefore have the potential to increase access to health care for individuals with autism spectrum disorder. However, knowledge about how internet-based treatment features may suit the needs of individuals with autism is limited. The aim of this study was to explore the participant experiences of an internet-based intervention for adults with autism spectrum disorder. The primary focus of the investigation was on autism-specific needs in relation to the features unique to the online format.Methods: In this qualitative study, semi-structured telephone interviews were conducted with 14 participants who had completed a text-based internet-based intervention for adults with autism spectrum disorder. We used an inductive approach and analyzed the data using qualitative content analysis.Results: Five main categories were identified: (1) implications of the online format, (2) the fixed non-individualized model, (3) therapist interaction, (4) interacting with other participants, and (5) making use of the treatment content. Overall, participants appreciated the availability and that they could work on their treatment independent of time or location. Among those participating in group-based chat-sessions with the other participants, it was considered a generally positive experience. Furthermore, most participants felt safe and relaxed in relation to the therapist and appreciated the text-based format. However, several participants felt that the format and content of the treatment was not sufficiently adapted to their individual life situation.Conclusion: In conclusion, this internet-based treatment constitutes an accessible and energy-saving treatment alternative for adults with autism. Further, integrating group-based components seems feasible in an otherwise individual internet-based treatment for individuals with autism. However, group-based components do require a clear purpose and rationale. Future studies should develop and evaluate treatment adaptations tailored to individual needs.

Effects of A Gamified, Behavior Change Techniques-Based Mobile Application on Increasing Physical Activity and Reducing Anxiety in Adults with Autism Spectrum Disorder: A Preliminary Study (Preprint)

BACKGROUND Physical activity (PA) has an impact on physical and mental health in neurotypical populations, and addressing these variables may improve the prevalent burden of anxiety in adults with autism spectrum disorder (ASD). Gamified mobile applications using behavior change techniques (BCTs) present a promising way to increase PA and reduce sedentary time, thus reducing anxiety in adults with ASD. OBJECTIVE This study aimed to compare the efficacy of a gamified and BCTs-based mobile application, PuzzleWalk vs. a commercially available application Google Fit (Google LLC, CA) on increasing PA and reducing sedentary time as an adjunct anxiety treatment for this population. METHODS Twenty-four adults with ASD were assigned to either PuzzleWalk or Google Fit group for five weeks, using a covariate adaptive randomization design. Physical activity and anxiety were assessed over 7 days at three different data collection periods (i.e., baseline, intervention start, intervention end) using triaxial accelerometers and the Beck Anxiety Inventory. Group differences in outcome variables were assessed by repeated measures ANCOVA adjusting for age, sex, and BMI. RESULTS Findings indicated that PuzzleWalk group spent a significantly larger amount of time for application use compared to Google Fit group (F 2, 38 = 5.07, p = 0.011, partial η2 = 0.21) while anxiety was unfavorably associated with increases in light PA and decreases in sedentary time after intervention (all p < 0.05). CONCLUSIONS Additional research is needed to clarify the determinants of physical and mental health as well as their interrelationship in adults with ASD. In addition, more research is needed to identify the factors that facilitate the use and adoption of mobile health technology in these individuals. The small, albeit insignificant, changes in PA and/or anxiety may be of clinical significance to adults with ASD. CLINICALTRIAL N/A

Effectiveness of Virtual Reality on Employment Training for Young Adults with Autism and Intellectual and Developmental Disabilities: A Systematic Review

The purpose of this study was to conduct a systematic review of the effectiveness of virtual reality on vocational rehabilitation for young adults with autism and intellectual and developmental disabilities (IDD). An electronic search was conducted among peer-reviewed English journals published from 1994 to 2018. Databases included CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, PsycINFO, Web of Science, EBSCO, and Scopus. Six primary studies employing group experimental (Gersten et al., 2005) or single-subject design (Horner et al., 2005) or pre-post design met the inclusion criteria. Each study was assessed for the presence and clarity of quality indicators according to Reichow et al.’s (2008) framework and definition. Results suggested that the use of virtual reality in vocational rehabilitation for young adults with autism and intellectual and developmental disabilities (IDD) “have established evidence-based practice”. Limitations, as well as implications for future research, practices, and policy, are discussed.

Stronger Associations Between Sleep and Mental Health in Adults with Autism: A UK Biobank Study

This study examined sleep and its cognitive and affective correlates in adults with and without autism spectrum disorder (ASD), utilizing UK Biobank data. There were no group differences in subjective sleep duration [n = 220 ASD; n = 2200 general population (GP)]. Accelerometer measures of sleep duration or nighttime activity did not differ by group, but sleep efficiency was marginally lower in ASD (n = 83 ASD; n = 824 GP). Sleep efficiency was associated with wellbeing and mental health, and pathways between accelerometer sleep measures and wellbeing and mental health were significantly stronger for adults with ASD (who also reported substantially poorer wellbeing and > 5 × likelihood of experiencing mental distress). These findings highlight the need to monitor sleep to maintain good mental health in adult ASD.