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

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.