Healthy Relationships on the Autism Spectrum (HEARTS): A feasibility test of an online class co-designed and co-taught with autistic people.
Emily F Rothman, Laura Graham Holmes, Reid Caplan and 8 others
PMID 35000417WHAT IT FOUND
Autistic adults reported improved flourishing and reduced rejection sensitivity after a six-session online class.
They valued co-teaching by autistic peers and specific activities. However, loneliness and interpersonal competence did not change, and the lack of a control group means these gains cannot be attributed solely to the class.
Key findings
01Participants reported decreased hostile automatic thoughts, dating abuse, fight-or-flight responses, and rejection sensitivity.
02Participants reported improved flourishing, coping with rejection and jealousy, motivation to socialize, self-compassion, and positive thinking.
03Loneliness and interpersonal competence scores did not show significant improvement.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
There was no control or comparison group, so improvements cannot be confidently attributed to the HEARTS class rather than time or other factors. The study was conducted during the COVID-19 pandemic, which limited opportunities for participants to practise social skills in person and may have influenced loneliness scores. Some measures, particularly for loneliness and positive thinking, had low internal consistency reliability in this sample. The sample was relatively small (N=55) and self-selected through advocacy networks, which may limit generalisability. Approximately one-quarter of participants were self-diagnosed autistic, which introduces variability in the definition of the population.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute of Mental Health.
The easy way to misread this
Do not interpret the improvements in flourishing and rejection sensitivity as proof that the HEARTS class caused them. Because there was no control group, these changes could reflect natural fluctuation, the passage of time, or the effects of participating in any social group. The lack of change in loneliness and interpersonal competence further suggests that a six-session class may not be sufficient to alter deeper social patterns.