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Communicative Behaviors in an Internet-Based Intervention for Individuals With Autism: Mixed Methods Analysis.

Britta Westerberg1,2, Karin Jacobson1,2, Maria Unenge Hallerbäck1,3,4

  • 1School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Journal of Medical Internet Research
|February 4, 2026
PubMed
Summary
This summary is machine-generated.

Communicative behaviors in autism interventions are key. Self-reflection and recognizing treatment gains correlate with better outcomes in internet-based cognitive behavioral therapy for autism.

Keywords:
autismcommunicative behaviorsinternet-based treatmentnarrative identity

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Area of Science:

  • Psychology
  • Autism Spectrum Disorder Research
  • Digital Health Interventions

Background:

  • Internet-based interventions are increasingly used for individuals with autism spectrum disorder (ASD).
  • Understanding mechanisms of change, specifically communicative behaviors, is crucial for tailoring interventions.
  • The relationship between communication patterns and clinical outcomes in text-based ASD interventions is under-explored.

Purpose of the Study:

  • To investigate the communicative behaviors of individuals with autism during an internet-based intervention.
  • To determine if specific behavioral patterns correlate with treatment outcomes and adherence.
  • To inform therapeutic strategies for optimizing engagement and results in digital ASD interventions.

Main Methods:

  • Analysis of messages from 34 participants in an 18-week internet-based cognitive behavioral therapy (iCBT) program.
  • Abductive qualitative content analysis to identify behavioral categories.
  • Correlational analyses linking behavioral categories with outcome measure changes and module completion rates.

Main Results:

  • Fourteen behavioral categories were identified, grouped into 'This is me' (identity, circumstances), 'Working with the treatment' (engagement), and 'I struggle' (challenges).
  • Specific communicative behaviors, particularly those related to identity and recognizing treatment gains, were associated with improved quality of life.
  • Positive correlations were found between certain behavioral categories and higher treatment adherence.

Conclusions:

  • Self-narrative formulation and identity reflection are important in internet-based therapy for autism.
  • Communicative behaviors indicating engagement and recognition of progress positively impact therapeutic outcomes.
  • Findings provide insights for therapists to guide expectations and identify individuals needing additional support in iCBT for ASD.