Family Cognitive-Behavior Therapy for Psychoeducation in Multicenter, Aware and Care for My As Traits for High-Functioning Autism Spectrum Disorders in Adolescence: Study Protocol

Background: Adolescents with Autism Spectrum Disorder (ASD) are especially sensitive to stigma（Luisa, 2012). Generally, stigma is a barrier to gaining practical support（Wright et al., 2011; Yap et al., 2011) and psychoeducation for ASD, which works to counter effects of stigma, is important (Luisa, 2012).　However, there are few approaches targeting psychoeducation on core ASD symptoms after childhood, many of which seek to treat various psychiatric disorders as co-morbidities in ASD (Sepúlveda, 2017; Sze, 2007). Gordon et al. (2015) showed that psychoeducation for ASD symptoms improved self-understanding and noticing of ASD symptoms, in both parents and children. We developed a psychoeducational program by using cognitive behavior therapy, Aware and Care for my AS Traits (ACAT) to adolescents with high-functioning ASD and their parents in Japan.

Objectives: This study aimed to clarify whether ACAT can improve an adolescent’s own understanding of their own ASD features and help improve their resilience for ASD.

Methods: The study was multi-centered and was conducted as a randomized controlled trial. Forty-eight adolescents, who were diagnosed with ASD, and their parents were recruited as participants through our research center’s website. Twenty-four participants were assigned to the treatment as usual（TAU）group and the rest to the ACAT group. The ACAT group received a 100-minute session once a week for 6 consecutive weeks and one follow-up session in addition to regular medical care. The TAU group only continued regular medical care. In both the groups, effectiveness evaluation was conducted during pre-intervention, post-intervention, and follow-up session. The entire trial design is illustrated in Figure 1.

Results: This clinical trial is ongoing. Approximately 50% (23 pairs of patients) have participated until now, of which 15 have finished the trial. We will compare scores of measures between the two groups during the pre- and post–intervention. The primary outcome measure was the Autism Knowledge Questionnaire and the secondary outcome measures were Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, Vineland Adaptive Behavior Scales Second Edition, Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, Depression Self-Rating Scale for Children, and Electroencephalogram.

Conclusions: It is expected that participants of the ACAT group will significantly increase their self-understanding and noticing of for ASD symptoms compared to the TAU group. Additionally, it is expected that the ACAT group will improve in social adaptation and mental health significantly if children and parents can understand the characteristics of their own ASD features through their sessions. This intervention will contribute to the establishment of an effective treatment strategy based on evidence for adolescents with ASD.

Trial Registration：This clinical trial study registered on the UMIN Register No.000029851