Using formative research to develop HEARTS: A curriculum-based healthy relationships promoting intervention for individuals on the autism spectrum.
Emily F Rothman, Laura Graham Holmes
PMID 34120485WHAT IT FOUND
Autistic young adults described struggling to stay motivated to maintain friendships, overcome anxiety from past rejections, take emotional risks, ensure reciprocity, and set boundaries.
These five themes directly shaped the content of the new HEARTS curriculum.
Key findings
01Participants reported that knowing basic social skills was not the issue; the challenge was maintaining motivation to keep relationships going and overcoming anxiety rooted in prior negative experiences.
02Youth identified difficulty with taking emotional risks, cultivating reciprocity where both parties invest equally, and identifying or respecting sexual and emotional boundaries.
03Stakeholder preferences for the intervention included mixed-gender groups to avoid excluding non-binary people and team facilitation by both neurotypical and autistic adults.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was limited to 25 participants who were verbal, had at least one friend, and reported no intellectual disability, so findings may not apply to those with more significant communication or cognitive differences. The study took place during the COVID-19 pandemic, which may have influenced participants' reports of social isolation and the nature of their friendships. The definition of a close friend was restrictive (within two years of age, not related, not employed), which may have excluded valid support networks. Qualitative findings are not generalizable to the broader autistic population and serve only to inform the development of a specific curriculum.
Declared interests
The authors declared no conflicts of interest. The study was funded by the National Institute of Health (Extramural).
The easy way to misread this
Do not interpret these themes as evidence that the HEARTS curriculum works. This paper describes the needs identified by participants to shape the curriculum's content; it does not report any outcomes from the intervention itself.