Psycho-Education for High-Functioning Adults with Autism Spectrum Disorder: Summary and Outcomes from a Novel Intervention

Background:  There is a lack of evidence-based interventions available for adults with autism spectrum disorder (ASD).  Psycho-education offers a group setting in which to develop knowledge and strategies to manage core and associated difficulties, and has been noted as an effective intervention in a range of mental and physical conditions (McLoone et al., 2013).  Psycho-education is becoming increasingly popular as a form of intervention and support for individuals with ASD (Bishop-Fitzpatrick et al., 2013); however, previous studies have not measured effectiveness or described satisfaction from participants.   

Objectives:  We sought to develop a novel psycho-education course for male adults with ASD. In addition, we aimed to acquire preliminary data on the association, if any, between adapted psycho-education, self-esteem/well-being, and other psychological variables. 

Methods:  The course was developed and facilitated by a multidisciplinary team of clinical researchers from the Autism Assessment Clinic at the Maudsley Hospital.  Three courses were run; each was completed over three half-day sessions with one session / week.  There were 5-7 participants in each group with approximately 1 facilitator / 2 participants. Sessions included: talks with visual aids and discussion, small group exercises, role-play, handouts and worksheets to take away, and several opportunities to recap and take breaks.

18 recently diagnosed male adults engaged in a course.  Participants also completed cognitive tasks to measures verbal, performance and full-scale IQ, verbal fluency, and working memory.  All participants were average or above average intelligence.  Additionally, they completed the Broader Autism Phenotype Questionnaire (BAP) to assess autism phenotype traits, which confirmed the presence of a high level of ASD traits.

Self-report outcome measures were administered at baseline and post- intervention, as follows: knowledge about autism, anxiety, wellbeing, social anxiety, depression, self-esteem, and understanding emotions.

Results:  Preliminary analyses indicated that participants scored significantly higher on the Autism Knowledge Questionnaire after completing the course (t (14) = 3.25, p<0.01).  There were no other significant differences between pre- and post-course trait measures.

The difference between pre- and post-course trait measures was correlated with autism trait scores and IQ measures.  Participants with higher scores on the Broader Autism Phenotype (BAP) questionnaire had lower self-esteem (assessed by the Rosenburg Questionnaire; r (18) = -.63, p<0.01, and moreover, those with higher BAP scores showed a greater increase in self-esteem, r (15) = 0.71, p<0.01.  Working memory performance was also positively associated with improvement on self-esteem questionnaire (r (15) = 0.76, p<0.01) and well-being (assessed by the Warwick-Edinburgh Wellbeing Scale; r = 0.74, p<0.01).  No other correlations were significant.

Conclusions:  This is the first study to report a) a summary of a psycho-education course that can be used in adults with ASD, and b) outcome measures for participants who have completed the course.  Preliminary outcome measures indicate significant improvements in knowledge about ASD and sense of well-being.  The lack of improvement with respect to anxiety might indicate that a different intervention may be needed to address this issue. An important next step will be to test the effectiveness of the group with a comparator group.