Technology-Based Assessments and Treatments of Anxiety in Autistic Individuals: Systematic Review and Narrative Synthesis

Adams, Lucy; Valmaggia, Lucia; Simonoff, Emily

doi:10.1007/s40489-021-00275-6

Cited by 3 publications

(2 citation statements)

References 73 publications

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“…email support outside the session). As such, present findings were not considered against psychological interventions in ASD using apps or web-based platforms (see reviews by Adams et al, 2022;Hollis et al, 2017;Sandgreen et al, 2021).…”

Section: Strengths Limitations and Future Directionsmentioning

confidence: 99%

“…Pre-pandemic, the few intervention studies that tested the remote delivery of psychological interventions to autistic individuals did provide preliminary indication of efficacy, feasibility and acceptability, but limitations constrain the transferability of conclusions to routine service delivery (e.g. see reviews by Adams et al, 2022 ; Ellison et al, 2021 ). Principally, samples lacked representativeness due to restrictive eligibility criteria and the potential for self-selection bias, and the studies focused solely on anxiety or insomnia and did not involve clinical implementation.…”

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confidence: 99%

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Autistic young people’s experiences of remote psychological interventions during COVID-19

Adams

Adamo

Hollocks

et al. 2023

Autism

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Telepsychiatry has been rapidly adopted to help control the spread of coronavirus. Clinicians have raised concerns over this for individuals diagnosed with autism spectrum disorder. The remote delivery of psychological interventions in particular requires further attention as their in-person delivery has autism spectrum disorder–associated challenges which overlap with the challenges of telepsychiatry broadly (i.e. beyond autism spectrum disorder). Autistic service-users (aged 15–18 years, n = 6) and clinicians working with this client group ( n = 8) were therefore interviewed about their experience of remote psychological interventions during the pandemic. The sample size was determined using preregistered thematic saturation calculations. Thematic analysis of responses identified challenges/barriers, benefits, facilitators, and factors perceived to cause variability in experiences of remote delivery. These broadly echoed those identified in existing literature, but their underlying reasons had not been explored before and some were novel. Novel findings mostly surrounded difficulties navigating a new social system online, and the intensity of the social interaction feeling reduced remotely. Themes were broadly the same between young people and clinicians, aside from subtle differences. For example, young people provided distinct reasons for some of the perceived benefits. Most participants advocated for the provision of hybrid delivery post-pandemic. Implications of findings are discussed. Lay abstract Recently, therapy has been delivered at a distance (i.e. remotely) to help control the spread of coronavirus. Clinicians have voiced concerns that remote delivery is unsuitable for certain individuals, including those who are autistic, but they have also highlighted potential benefits for autistic individuals. Benefits include some individuals feeling more comfortable receiving therapy at home. This is the first study to interview autistic individuals about their experience of remote therapy. Participants were six young people aged 15–18 years and eight clinicians. Participants described their experience of remote delivery, including challenges, benefits, and suggestions. Most of these supported previous research findings, but some were new or provided further insight into those already identified. A newly identified challenge was knowing online social etiquette. All participants found aspects of the experience challenging, but all identified benefits and most voiced that remote sessions should be offered to young people. Participants further identified individual characteristics that may make someone less suited to remote delivery (e.g. shyness). They also identified ways of making the experience of remote delivery easier (e.g. sitting with a pet). Young people’s and clinicians’ views were similar overall, with only subtle differences. For example, young people uniquely voiced that remote delivery was similar to in-person, that benefits were hard to identify, and provided distinct reasons for the social interaction feeling less intense remotely. Findings may be used to improve remote delivery, for guiding future research, and as a case for continuing to offer it to those who may most benefit.

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Section: Strengths Limitations and Future Directionsmentioning

confidence: 99%

mentioning

confidence: 99%

Autistic young people’s experiences of remote psychological interventions during COVID-19

Adams

Adamo

Hollocks

et al. 2023

Autism

Self Cite

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Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review

Lai,

Liu,

Johnston

et al. 2024

Crit Care

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Background It remains unclear how to optimise critical care rehabilitation to reduce the constellation of long-term physical, psychological and cognitive impairments known as Post Intensive Care Syndrome (PICS). Possible reasons for poor recovery include access to care and delayed treatment. eHealth could potentially aid in increasing access and providing consistent care remotely. Our review aimed to evaluate the effectiveness of eHealth interventions on PICS outcomes. Methods Studies reporting eHealth interventions targeting Post Intensive Care Syndrome outcomes, published in Medline, CINAHL, PsycINFO, Embase, and Scopus from 30th January 2010 to 12th February 2024, were included in the review. Study eligibility was assessed by two reviewers with any disagreements discussed between them or resolved by a third reviewer. Study quality and risk of bias were assessed using the Mixed Method Appraisal Tool. Further to the identification of effective strategies, our review also aimed to clarify the timeline of recovery considered and the outcomes or domains targeted by the interventions. Results Thirteen studies were included in our review. Study duration, eHealth intervention delivery format, and outcome measures varied considerably. No studies reported a theory of behavioural change and only one study was co-produced with patients or carers. Most studies were conducted in the early post-discharge phase (i.e., < 3 months) and had feasibility as a primary outcome. The cognitive domain was the least targeted and no intervention targeted all three domains. Interventions targeting the psychological domain suggest generally positive effects. However, results were underpowered and preliminary. Though all studies were concluded to be feasible, most studies did not assess acceptability. In studies that did assess acceptability, the main facilitators of acceptability were usability and perceived usefulness, and the main barrier was sensitivity to mental health and cognitive issues. Conclusion Our systematic review highlighted the promising contributions of eHealth with preliminary support for the feasibility of interventions in the early stages of post-critical care rehabilitation. Future research should focus on demonstrating effectiveness, acceptability, the cognitive domain, and multi-component interventions.

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Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review.

Lai,

Liu,

Johnston

et al. 2024

Preprint

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Background: It remains unclear how to optimise critical care rehabilitation outcomes to reduce the constellation of long-term physical, psychological and cognitive impairments known as Post Intensive Care Syndrome (PICS). Possible reasons for poor recovery include access to care and delayed treatment. eHealth could potentially aid in increasing access and provide consistent care remotely. Our review aimed to evaluate the effectiveness of eHealth interventions on PICS outcomes. Methods: Studies reporting eHealth interventions targeting Post Intensive Care Syndrome outcomes, published in Medline, CINAHL, PsycINFO, Embase, and Scopus from 30th January 2010 to 12th February 2024, were included in the review. Study eligibility was assessed by two reviewers and any disagreements were discussed between them or resolved by a third reviewer. Study quality and risk of bias were assessed using the Mixed Method Appraisal Tool. Further to the identification of effective strategies, our review also aimed to clarify the timeline of recovery considered and the outcomes or domains targeted by the interventions. Results: Out of 3,673 articles screened, 13 studies were included in our review. Most studies were conducted in the early post discharge phase (i.e., < 3 months) and presented preliminary effectiveness of eHealth interventions on physical and psychological outcomes. Despite evidence suggesting an optimisation of rehabilitative effects when multiple domains are targeted in the intervention, research has yet to concurrently target all three domains of PICS. Though the interventions were described as feasible and acceptable in all studies, the lack of robust monitoring systems to track the PICS domain outcomes is indisputable. Conclusion: Our systematic review highlighted the promising contributions of eHealth with preliminary support for the feasibility and effectiveness of interventions in the early stages of post-critical care rehabilitation. However, it also highlights the fragmented approach to the concept of PICS. The 3 domains should be viewed as interrelated and not as distinct areas of recovery. Future research needs to investigate an integrative approach to these three domains, explore potential domain interrelationships, consider the challenges associated with large-scale eHealth implementation, and greater use of remote monitoring systems. Despite these challenges, eHealth is a critical solution in providing access, continuity, and sustainable care in the post-critical care setting.

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Technology-Based Assessments and Treatments of Anxiety in Autistic Individuals: Systematic Review and Narrative Synthesis

Cited by 3 publications

References 73 publications

Autistic young people’s experiences of remote psychological interventions during COVID-19

Autistic young people’s experiences of remote psychological interventions during COVID-19

Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review

Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review.

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