Internet-based support and coaching - Exploring the feasibility of an intervention for young people with ADHD and autism spectrum disorder

Abstract

Background: For individuals with Neurodevelopmental Disorders (NDDs), such as Attention-Deficit/ Hyperactivity Disorder (ADHD) and autism spectrum disorder (ASD), adolescence and young adulthood can be a vulnerable period associated with a loss of significant structure and support. They can also have a difficult time taking advantage of available support- and treatment options, due to their core deficits. There is limited research into support and treatment specifically targeting individuals with ADHD and/or ASD in this age group, and into how it can be tailored to fit their experienced needs. Methods: With the aim of evaluating the feasibility of an internet-based support and coaching model (IBSC) encompassing 8 weeks of twice weekly chat sessions (and two clinic visits), two studies were conducted using complementary methodological perspectives. Study I used a non-randomized controlled design, including 50 individuals with ADHD and/or ASD ages 15-32 years old in two naturalistic clinical settings. Participants received the intervention (n=30) or Treatment-As-Usual (TAU) (n=20). Six participants dropped out from the Intervention group. Self-report questionnaires were administered at baseline, at the end of the Intervention and after 6-months, including assessments of quality of life, sense of coherence, self-esteem, anxiety and depressive symptoms. Study II, sought to investigate the experiences of the participants taking part in IBSC, using semi-structured interviews with 16 individuals who had received IBSC and analysing data using qualitative content analysis. Results: Results from study I showed significant between-group effects regarding anxiety at post intervention and at 6-month follow-up, and for depressive symptoms at post intervention. A deterioration in the TAU group partly explained these results. The Intervention group experienced a significant increase in self-esteem and a decrease in anxiety at 6-month follow-up. Study II generated three themes; Deciding to participate, Taking part in the coaching process, and The significance of format with a total of ten subthemes. In summary, there was an appreciation of several aspects of the format that corresponded with their needs, e.g. being text-based and accessible from one´s home environment. Participants voiced unmet needs and underscored the importance of coaches’ knowledge about NDDs. Incomplete personal interaction and a desire for increased flexibility in regard to frequency and form of communication were also voiced. Conclusions: IBSC shows promise as a feasible approach to supporting adolescents and young adults with ADHD and/or ASD. Future studies should determine for which diagnostic category the model is best suited and to what degree.