Randomized Feasibility Pilot of an Executive Functioning Intervention Adapted for Children's Mental Health Settings.
Kelsey S Dickson, Megan Galligan, Tana Holt and 4 others
PMID 38678517WHAT IT FOUND
Therapists delivering an adapted executive-function intervention with training, consultation, and implementation supports used more intervention strategies, and families found it acceptable.
Children showed planning gains, but mental health symptoms improved similarly in both groups.
Key findings
01Therapists trained in the adapted executive-function intervention used more intervention strategies than usual-care therapists, except positive praise and parent engagement.
02Caregivers and children rated the adapted intervention acceptable, with caregivers finding the activities, session structure, and executive-function vocabulary helpful.
03Children of trained therapists showed a significant improvement in planning on an executive-function task, but mental health symptoms did not improve significantly more than in usual care.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample was small because this was a pilot, so it could not reliably detect most effects or test moderators. Some children lacked post-participation data, which limited the analyses. The study used baseline and end-of-participation data without follow-up, so it could not test whether executive-function change led to later symptom change. Not all child participants had a confirmed autism diagnosis; eligibility included reported symptoms confirmed by measures. Participants came from publicly funded mental health services in the study region, so results may not apply elsewhere. The intervention was delivered as a package of adapted Unstuck, training, consultation, and implementation supports, so the study cannot identify which component drove any effects.
Declared interests
Drs. Anthony and Kenworthy receive royalties from the sale of Unstuck and On Target, and Dr. Kenworthy also receives royalties from the sale of the BRIEF-2. The paper does not state a funding source.
The easy way to misread this
Do not conclude that adapted Unstuck alone improves mental health symptoms better than usual care. The child outcomes followed a package of adapted Unstuck, therapist training, consultation, and implementation supports, so the contribution of any single component cannot be separated. The mental health comparisons also did not show a significant difference between conditions.