Internet-based, parent-led cognitive behavioral therapy for autistic youth with anxiety-related disorders: A randomized trial comparing email vs. telehealth support.

Researchers tested two online anxiety treatments for autistic children aged 7-15, where parents delivered the therapy with professional support. One group got weekly email help, the other got emails plus video calls every two weeks. Both treatments worked well - about 55-67% of children improved. The type of support didn't matter much, but children who completed more treatment modules did better. Both approaches required little therapist time, making them practical options for families.

This randomized controlled trial compared two forms of parent-led, internet-delivered cognitive behavioral therapy (iCBT) for 57 autistic youth aged 7-15 with anxiety disorders. One group received weekly email support (iCBT-Email), while another received alternating bi-weekly emails and video calls (iCBT-Video) over 12 weeks. Both interventions showed similar effectiveness, with posttreatment response rates of 55% for email support and 67% for video support. No significant differences were found between groups in clinician-rated, child-reported, or parent-reported anxiety measures.

Module completion predicted better outcomes regardless of support type. Therapist time requirements were modest: 16.29 minutes per family per week for email support versus 24.13 minutes for video support, making both approaches resource-efficient treatment options.

Parent-led iCBT represents a scalable, low-resource intervention for anxiety in autistic youth. Both email and video support formats are viable options, allowing flexibility based on family preferences and resources. Focus should be on maximizing treatment engagement rather than support delivery method.

Single study with modest sample size (n=57). No comparison to face-to-face therapy or control group. Limited follow-up data on sustained improvements. Unclear how findings generalize across different autism presentations or anxiety severity levels.

This study tested two versions of parent-led, Internet-delivered cognitive behavioral therapy for anxiety among autistic youth; one that provided weekly email support (iCBT-Email), and one that provided alternating bi-weekly emails and video calls (iCBT-Video) across 12 weeks. It was expected that those in the iCBT-Video condition would complete more treatment content, which in turn would lead to more anxiety improvement. Fifty-seven autistic youth (7-15 years-old) with anxiety disorders were randomized to iCBT-Email or iCBT-Video. There were no significant differences in improvement in clinician-rated, child-reported, or parent-reported anxiety severity or functional impairment.

Posttreatment response rates were 55% in iCBT-Email and 67% in iCBT-Video. Module completion predicted improved treatment outcome, though there was no difference in module completion across groups. Therapists spent an average of 16.29 min/family/week (SD = 7.11) in the iCBT-Email condition and 24.13 min/family/week (SD = 6.84) in the iCBT-Video condition. Email and telehealth-supported, parent-led iCBT both appear to be effective treatments for autistic youth with anxiety disorders that require reduced therapist effort.

Future research should seek novel methods to enhance engagement with iCBT content. CLINICALTRIALS.GOV IDENTIFIER: NCT05284435.