Information for professionals
Thank you for your interest in the REACH-ASD trial. We want to ensure that effective support services are available to families and children following an autism spectrum disorder (ASD) diagnosis.
This page provides useful information about the REACH-ASD trial for professionals such as psychiatrists, paediatricians, speech and language therapists and mental health practitioners.
How are parents affected by their child’s ASD diagnosis?
The period following a child’s ASD diagnosis can be disorientating for many parents. Parental emotional responses to the diagnosis are diverse and often multifaceted and parents often find themselves navigating a new and complex landscape of information, advice and service structures. The incidence of clinically significant parental mental health need around this time is 20-50%. Improved parent wellbeing is important in and of itself, but is also likely to result in downstream benefits for the child and family and a more effective uptake of subsequent evidenced-based parent-mediated interventions known to bring long-term benefits for the child with ASD and parents alike. Professionals are often aware of the needs of parents in the post-diagnostic period but do not have a framework or the resources to support them effectively.
Are evidence-based services currently available for parents of children diagnosed with ASD?
Following diagnosis, current evidence supports the effectiveness of some specific pre-school intervention strategies on parent and child communication. Previous work led by our group has shown the long-term benefits of a parent-mediated, video-aided communication intervention (read more here). However, there has been little research into the effectiveness of service provision in the immediate post-diagnostic period.
There is no formal evidence base for parental post-diagnostic ASD psychoeducation support within the UK. Observational studies suggest preliminary support of manualised psychoeducation programmes like EarlyBird, ASCEND and Cygnet. Anecdotal clinical reports are also of good acceptance. Internationally there have been a small number of randomised controlled trials (RCTs) of psychoeducation with generic/child outcomes and one RCT with a treatment effect on parental mental health.
Acceptance and Commitment Therapy (ACT) has a growing evidence base for effectiveness in adult mental health. ACT shares lineage with cognitive-behavioural interventions and shows similar general effectiveness. ACT holds particular relevance to the distinct psychological task faced by parents in these circumstances due to:
- its emphasis on psychological acceptance (validating challenging emotions and cognitions, rather than seeking to change them)
- the incorporation of mindfulness techniques (successful in reducing parental and child mental health problems) but in a way that is more sustainable than full mindfulness interventions that have high time and training costs
- a ‘core values’ focus that may help parents re-assert parenting values challenged by realisation of the child’s condition.
How did the REACH-ASD trial work?
The trial aimed to evaluate the clinical and cost effectiveness of the EMPOWER-Autism, a newly developed post-diagnostic programme which aims to address the mental health needs of parents of children recently diagnosed with ASD through integrating problem-focused autism psychoeducation and a psycho-therapeutic approach based on Acceptance and Commitment Therapy.
The project has undergone feasibility piloting, and then the intervention was subject to rigorous testing through a randomised controlled trial with a one-year follow-up period. If shown to be effective, this theoretically based targeted approach to parental education, empowerment and emotional wellbeing will fill a key evidential gap in the provision of efficient and effective developmentally sequenced ASD interventions from diagnosis onwards.