Pilot randomized controlled trial of MINDful TIME,a novel telehealth mindfulness-based intervention for autistic adolescents and their caregivers

Abstract

A growing body of research suggests that mindfulness-based interventions may be a valuable method for reducing internalizing symptoms in autistic individuals. The current study extends this work using an effectiveness-implementation hybrid type 1 study. In this parallel randomized controlled trial, we examined a novel telehealth intervention for autistic adolescents and their caregivers. MINDful TIME includes eight weekly group meetings and regular use of a commercially available mindfulness meditation app. Participants were 42 adolescent-parent dyads randomized to the treatment or delayed treatment control (DTC) group. The program was implemented with fidelity (91.24%–94.78%), and 90% of treatment group dyads completed the program. On average, participants attended >90% of sessions and reported high acceptability. Treatment group adolescents demonstrated statistically and clinically significant reductions in parent-reported depression symptoms relative to DTC (F(1, 34) = 7.31, p = 0.01, ${\eta }_p^2$  = 0.18). Female adolescents in the treatment group showed significant reductions in parent-reported anxiety symptoms (F(1, 34) = 4.22, p = 0.05, ${\eta }_p^2$  = 0.11). Exploratory analyses indicated treatment-related improvements in adolescent executive functioning, parent mindfulness and well-being, and adolescent-parent relationship dysfunction. Findings warrant future examination of MINDful TIME to address well-documented challenges with mental health in this population. This trial was registered on clinicaltrials.gov (NCT05685589).

Lay abstract

Previous research studies have found that mindfulness (i.e. focused attention on, and acceptance of, the present moment) training programs can reduce stress, depression, and anxiety. However, more research is needed to understand whether mindfulness strategies are helpful for autistic teens. We examined a new telehealth intervention for autistic teens and their caregivers. MINDful TIME is an 8-week group program that meets weekly through Zoom meetings. Participants learn mindfulness strategies through didactic lessons and using a commercially available mindfulness meditation mobile app. We randomly assigned 42 teens (ages 13–18 years) with an autism diagnosis and their parents to complete MINDful TIME or an 8-week wait period before beginning the program. Ninety percent of teens and parents assigned to MINDful TIME completed the program and reported that they found the program to be acceptable. Teens who completed MINDful TIME showed large reductions in depression symptoms, whereas teens in the wait period group did not. Females who completed MINDful TIME also showed reductions in anxiety symptoms, whereas males who completed MINDful TIME and females and males in the wait period group did not. Parents who completed MINDful TIME with their teens showed increased mindfulness traits, well-being, and adolescent-parent relationship functioning. Findings suggest that MINDful TIME is a promising program that may improve accessibility of mindfulness strategies for autistic teens and their caregivers. Future research with a larger sample size is needed to fully understand the benefits of the program.