Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis.

Researchers looked at ways to improve mental health support for autistic children and teens. They found that talking therapy (CBT) can help reduce anxiety, especially when parents are involved and when the therapy is adapted for autism. Parents and doctors reported good results, but children's own reports were mixed. The study shows that simple changes to how services work can make mental health care better for autistic young people.

This systematic review and meta-analysis examined strategies to improve mental health care for autistic children and young people. Fifty-seven studies were analyzed, focusing primarily on cognitive behavioral therapy (CBT) for anxiety and service-level improvements like autism screening tools and clinician training. Most interventions involved caregiver participation and adaptations to communication and content. Meta-analysis showed moderate certainty that CBT effectively reduces anxiety symptoms based on parent and clinician reports, though self-reported outcomes were not significant.

Evidence for feasibility and acceptability was generally positive. The review identifies practical adjustments that services can implement, though research gaps remain in this field.

Simple, reasonable adjustments can enhance mental health care for autistic individuals. CBT with adaptations and caregiver involvement shows promise for anxiety treatment. Services should consider autism screening tools and clinician training. However, self-reported outcomes highlight need for autism-appropriate assessment methods and potentially different therapeutic approaches.

The abstract does not specify sample sizes, methodological quality assessment details, or specific limitations identified by the authors. The range of evidence certainty (low to moderate) suggests variability in study quality across included research.

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.