Interventions to address health outcomes among autistic adults: A systematic review.
Teal W Benevides, Stephen M Shore, May-Lynn Andresen and 13 others
PMID 32390461WHAT IT FOUND
Adapted cognitive behavioral therapy and mindfulness had some support for reducing anxiety and depression in autistic adults without intellectual disability.
Most other interventions, including medical treatments, had no established evidence.
Key findings
01The review found 19 studies that met its criteria, and the overall risk of bias across the included intervention studies was high.
02Cognitive behavioral interventions and mindfulness approaches were considered emerging evidence for autistic adults' mental health outcomes.
03Medical interventions were unestablished, and electroconvulsive therapy had four reported cases with one negative response.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 19 studies were found, and the overall risk of bias was high. Most studies had weak designs; only 4 were randomized trials. CBT and mindfulness evidence was limited to verbal autistic adults without apparent intellectual disability, so it may not apply to adults with intellectual disability. The samples were mostly young adults, few were over 40, and 42% of studies included only male samples. The review excluded system-level, caregiver, educational, and vocational interventions unless they measured health outcomes, so access and service-quality issues were not evaluated. Outcome measures and interventions were very heterogeneous, so firm conclusions were difficult. The last search was in 2018, so newer studies may not be included.
Declared interests
The authors declared no potential conflicts of interest. Funding came from a Patient-Centered Outcomes Research Institute Eugene Washington PCORI Engagement Award.
The easy way to misread this
Do not read the review as proof that CBT or mindfulness works for autistic adults. The evidence is emerging, the included studies had high risk of bias, and the CBT and mindfulness studies were done only with verbal adults without apparent intellectual disability.