Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial.
Shaun M Eack, Susan S Hogarty, Deborah P Greenwald and 4 others
PMID 29286586WHAT IT FOUND
By 18 months, social-cognitive gains were not different between cognitive enhancement therapy and enriched supportive therapy.
Cognitive enhancement therapy improved neurocognition more, and employment was more likely.
Key findings
01The cognitive enhancement therapy package, combining neurocognitive training, social-cognitive group sessions, and individual therapy, improved neurocognitive function more than enriched supportive therapy.
02Social-cognitive gains were greater with the cognitive enhancement therapy package at mid-treatment, but not at treatment completion, compared with enriched supportive therapy.
03Competitive employment was more likely with the cognitive enhancement therapy package than with enriched supportive therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was modest, with 54 randomized participants, and had some group imbalances, so smaller effects may have been missed. Participants were mostly young adults, and the authors state the results may not generalize to older adults with autism. The social-cognitive measures focused on emotion processing, so other social-cognitive effects may have been missed. Cognitive enhancement therapy combined neurocognitive training, social-cognitive groups, and individual therapy, and the treatment hours were not matched to enriched supportive therapy, so the contribution of any single component cannot be separated. The trial did not measure work readiness, motivation to seek employment, or job interviewing skills, so how cognitive gains led to employment is unclear.
Declared interests
The supplied article text does not include a conflicts-of-interest or funding declaration. The publication types list NIH and other government research support.
The easy way to misread this
Do not conclude that cognitive enhancement therapy is proven to improve social cognition or employment in adults with autism. The social-cognitive primary outcome was not different at treatment completion, employment was a secondary outcome, and the intervention combined several treatment components with more contact time than supportive therapy.