Pemovska, Tamara, Loizou, Sofia, Appleton, Rebecca, Spain, Debbie, Stefanidou, Theodora, Kular, Ariana, Cooper, Ruth, Greenburgh, Anna, Griffiths, Jessica, Barnett, Phoebe, and others. (2024) Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis. Psychological medicine, . pp. 1-31. ISSN 0033-2917. E-ISSN 1469-8978. (doi:10.1017/S0033291724001089) (KAR id:106120)
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Language: English 
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| Official URL: https://doi.org/10.1017/S0033291724001089 |
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Abstract
Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.
| Item Type: | Article |
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| DOI/Identification number: | 10.1017/S0033291724001089 |
| Additional information: | For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. |
| Uncontrolled keywords: | autism, mental health, children, psychological therapy, adaptations, young people |
| Subjects: | H Social Sciences |
| Divisions: | Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Tizard |
| Funders: | National Institute for Health Research (https://ror.org/0187kwz08) |
| SWORD Depositor: | JISC Publications Router |
| Depositing User: | JISC Publications Router |
| Date Deposited: | 05 Jun 2024 08:20 UTC |
| Last Modified: | 05 Nov 2024 13:11 UTC |
| Resource URI: | https://kar.kent.ac.uk/id/eprint/106120 (The current URI for this page, for reference purposes) |
University of Kent Author Information
Sapiets, Suzi J.
| Creator's ORCID: |
 https://orcid.org/0000-0002-0221-2731
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