Coping with uncertainty in everyday situations (CUES©) to address intolerance of uncertainty in autistic children: an intervention feasibility trial.
Jacqui Rodgers, Jane Goodwin, Deborah Garland and 9 others
PMID 35790596WHAT IT FOUND
A parent group programme for autistic children's uncertainty was feasible and acceptable.
It improved parents' confidence and helped children with specific 'wanted' situations, but showed no significant difference in general child anxiety scores compared to a control group.
Key findings
01The intervention was feasible and acceptable, with high therapist fidelity and low attrition in the treatment group, though many parents in the control group did not attend.
02At 26 weeks, more parents in the intervention group reported their child as a 'responder' for situations they wanted to do (12 vs 2) compared to the control group, a statistically significant difference.
03There were no significant differences between the groups on standard parent-report measures of child anxiety or intolerance of uncertainty at the 26-week primary endpoint.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was a pilot and not powered to detect effectiveness differences; conclusions about efficacy cannot be drawn. High non-uptake and attrition in the control group (Understanding Autism) may bias the comparison, as participants preferred the active intervention. The sample size was small (50 families), and many outcome measures had missing data, reducing the precision of estimates. The study relied heavily on parent report, which may be subject to expectation bias, especially given the lack of blinding to treatment allocation.
Declared interests
Funded by Autistica. The authors declare no other conflicts of interest.
The easy way to misread this
Do not interpret the significant finding for 'wanted' situations as evidence that CUES© reduces general anxiety. The primary standardised anxiety outcomes showed no significant difference between the groups, and the study was not powered to prove effectiveness.