Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools.
Sebastian B Gaigg, Paul E Flaxman, Gracie McLaven and 7 others
PMID 32267168WHAT IT FOUND
Autistic adults using self-guided online mindfulness and CBT tools showed large anxiety reductions at 3 months.
However, the waitlist group also improved by 6 months, eliminating any advantage of the active treatments. These tools are acceptable for high-functioning adults but may not offer lasting benefit over time.
Key findings
01Participants in the mindfulness and CBT groups showed significant reductions in anxiety with large effect sizes, while the waitlist group did not show significant change at the same early time points.
02By the 6-month follow-up, the waitlist group had also demonstrated reliable reductions in anxiety, resulting in no clear advantage for the active treatment groups compared to the waitlist.
03Retention was higher for the mindfulness group (88%) than the CBT group (64%), with the authors suggesting the mindfulness platform's weekly reminders helped maintain engagement.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a pilot with a small sample size (39 participants analysed) and was not pre-registered. The sample was self-selected and not representative of the wider autistic community, particularly those with intellectual disabilities or significant language impairments. Participants who dropped out had lower verbal IQs and more social-communication difficulties, meaning the results may only apply to high-functioning adults. Groups were not matched for baseline anxiety levels, with the mindfulness group starting with lower anxiety than the others. The waitlist group showed spontaneous improvement over time, which confounds the assessment of the treatment's unique efficacy at the 6-month mark.
Declared interests
The study was supported by a Medical Research Council studentship and internal university resources. The authors disclosed no other financial or non-financial conflicts of interest.
The easy way to misread this
Do not interpret the initial 3-month improvements in the treatment groups as proof that these online tools are superior to doing nothing. By 6 months, the waitlist group had improved to a similar degree, and the study design (self-selected participants, lack of pre-registration, and baseline anxiety differences) makes it impossible to confirm that the specific online programmes were the cause of the improvement.