Exploring computer mediated communication with autistic adolescents and how this relates to their friendships and wellbeing
Creators: name: Evans, Jessica Frances
Publisher: name: University of Surrey
Year: 2023

description: <b>Background:</b> This systematic review is an update which aimed to build on a previous review completed by Walters et al. (2016) and was conducted with the same research questions. This review sough to determine how many studies, published since the last review, reported a statistically significant decrease in measurable mental health difficulties in autistic young people after they received Cognitive Behavioural Therapy (CBT). Further aims were to conclude whether CBT interventions were modified to better suit autistic youth, whether these modifications adhered to NICE guidelines, and whether additional adaptions had been made. The researcher acknowledges that NICE guidelines represent evidence-based recommendations specific to healthcare practices in England, and as such does not assume that mental health professionals in other countries are obliged to be familiar with or adhering to these guidelines. However, they were considered a useful evidence-based framework to refer to, as the researcher is based in a UK context.<br>
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description: <b>Method:</b> Consistent with Walters et al. (2016), searches were performed in PsycINFO, PubMed, Scopus, and WEB of SCIENCE, in June 2023. Searches returned 1,123 papers. Screening of titles and abstracts led to retrieval of (n=61) articles, of which seven studies, 363 participants, met the inclusion criteria. After quality appraisal, extracted data revealed key characteristics, which were synthesized.<br>
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description: <b>Results:</b> Results of the current systematic review were integrated with those from the previous review to allow for comparison of findings since the update. CBT interventions, which required a statistically significant reduction in measurable symptoms of mental health difficulty in order to meet inclusion criteria, were delivered to autistic youth through diverse modes and formats. While interventions are frequently modified, substantial variability exists, and adherence to NICE guidelines is inconsistent. Although modification might not be essential, it could lead to the best outcomes for autistic youth based on a three-armed RCT which directly compared modified to unmodified CBT. However, limitations in the generalisability of the results were acknowledged as only studies reporting statistically significant reduction in symptoms were included, thus it cannot be assumed that CBT is an effective intervention for all young autistic people experiencing mental health distress. Notably, a growing trend since the previous review involves digitally delivered CBT interventions. To situate the findings, the majority of studies had moderate methodological quality ratings, with one study having low risk of bias and one having high risk of bias. This was acknowledged as a limitation, in addition to the inclusion of two studies which included some participants over the age of 18 years. <br>
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description: <b>Conclusion:</b> CBT can effectively reduce symptoms of anxiety for some young autistic people. Empirical research should assess the impact of CBT for other mental health difficulties commonly comorbid with autism, such as OCD and depression. Future studies should explore recommended CBT modifications and evaluate different delivery modes (e.g., group vs. individual, in-person vs. digital). <br>