Emotion regulation interventions in autism (Systematic Review) ; Evaluating a goal-setting intervention for children and young people with executive dysfunction : a single-case experimental design (Empirical Paper)

Systematic Review abstact: Background: Emotion regulation (ER) impairments are a common feature of autism spectrum disorders (ASD). It is believed that by targeting ER difficulties directly, individuals with ASD might be better able to manage their difficult emotions and consequently improve their quality of life. Emerging research has begun to explore interventions aimed at treating ER difficulties in ASD, however, it remains unclear which approaches are most effective. Objectives: This review aimed to evaluate the effectiveness of various interventions targeting ER impairments in ASD. Method: Studies evaluating interventions targeting ER impairments in individuals under 18 years with ASD were included. 772 papers were identified across four databases: Ovid MEDLINE, PsycINFO, Embase, and Global Health. A systematic screening process led to the inclusion of nine papers in the review. Results: This review found promising evidence to suggest that behavioural and CBT-informed approaches, if appropriately adapted, can be effective at improving ER abilities in children with ASD. One study focused solely on mindfulness techniques with adolescents, demonstrating similarly encouraging findings for its application in ER treatment. Conclusions: Most studies comprised small sample sizes and thus, all results are interpreted with caution. Preliminary evidence indicates that ER impairments can be treated using a range of CBT, behavioural and mindfulness approaches. Larger randomised control trials are needed to determine confidently the efficacy of such treatments in this population. Empirical Paper abstract: Objective: Research shows that structured goal-setting enables goal progress and engenders well-being; however, it is not clear the extent to which this is true in executive dysfunction (EDF) populations. This study aimed to determine the effectiveness of a goal-setting intervention, supported by the Brain in Hand (BiH) app, on goal progress and well-being in individuals under 18 years with EDF. Methods: Using a multiple-baseline single-case experimental design, six participants (mean age = 14.8 years; SD = 1.94; male: female 2:1) underwent structured goal-setting sessions, during which goals were identified and broken down into achievable steps. Potential challenges to reaching these goals, along with suggested solutions were also considered. This information was uploaded to participants’ personalised BiH accounts on their smartphones, with scheduled prompts/reminders to encourage progress. Repeated measurements of “happiness” and goal satisfaction ratings were taken each weekday over a period of seven weeks. Outcome measures were administered pre- and post-intervention to determine if there were reliable changes in overall functioning and well-being. Results: Statistically significant improvements were found for goal progress, at a group level. No statistically significant changes were observed in participants’ “happiness” ratings. Two participants demonstrated reliable improvements in everyday functioning, with one showing reductions in negative affect. Conclusion: The findings suggest that structured goal-setting supported by the BiH app has the potential to aid young people with EDF progress towards their goals. Future recommendations are made, including extending the data collection period and investigating gender differences. Clinical implications are also described.