Internet-Based Support and Coaching With Complementary Clinic Visits for Young People With Attention-Deficit/Hyperactivity Disorder and Autism: Controlled Feasibility Study

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Abstract

Background

Individuals with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can experience obstacles in traditional health care situations due to difficulties associated with their impairment.

Objective

This controlled study aims to investigate the feasibility of an internet-based support and coaching intervention (IBSC), including 2 weekly chat sessions and 2 complementary clinic visits with coaches over the course of 8 weeks, for adolescents and young adults with ADHD and/or ASD in 2 naturalistic routine care settings.

Methods

Individuals with ADHD and/or ASD aged 15-32 years were recruited in 2 clinical settings, where they received either IBSC (n=24) or treatment as usual (TAU; n=20). Outcome measures included self-report questionnaires assessing quality of life (Manchester Short Assessment for Quality of Life), sense of coherence (Sense Of Coherence 29), self-esteem (Rosenberg Self-Esteem Scale), and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale [HADS] and Montgomery-Åsberg Depression Rating Scale-Self-reported, respectively).

Results

Significant between-group effects were observed in measures of anxiety (HADS) at postintervention ( P=.02) as well as at the 6-month follow-up ( P=.004). Significant between-group effects were also noted for depressive symptoms (HADS) postintervention ( P=.04). The between-group effects were partially explained by a deterioration in the TAU group. A significant increase in self-esteem ( P=.04) as well as a decrease in anxiety ( P=.003) at the 6-month follow-up was observed in the intervention group following IBSC. Findings from a qualitative study of the intervention are consistent with the results.

Conclusions

The findings from this study suggest that IBSC holds promise as a feasible complement or alternative to traditional face-to-face health care meetings.

Related collections

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In spite of the growing literature about adult attention-deficit hyperactivity disorder (ADHD), relatively little is known about the prevalence and correlates of this disorder. To estimate the prevalence of adult ADHD and to identify its demographic correlates using meta-regression analysis. We used the MEDLINE, PsycLit and EMBASE databases as well as hand-searching to find relevant publications. The pooled prevalence of adult ADHD was 2.5% (95% CI 2.1-3.1). Gender and mean age, interacting with each other, were significantly related to prevalence of ADHD. Meta-regression analysis indicated that the proportion of participants with ADHD decreased with age when men and women were equally represented in the sample. Prevalence of ADHD in adults declines with age in the general population. We think, however, that the unclear validity of DSM-IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD.

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Author and article information

Contributors

Helena Sehlin:

ORCID: https://orcid.org/0000-0003-1067-6672

Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgKungsgatan 12Gothenburg, SE 411 19Sweden46 736838212helena.sehlin@vgregion.se

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: December 2020

Publication date (Electronic): 31 December 2020

Volume: 22

Issue: 12

Electronic Location Identifier: e19658

Affiliations

[1 ] Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology University of Gothenburg Gothenburg Sweden

[2 ] Department of Health Sciences University West Trollhättan Sweden

[3 ] Habilitation & Health, Region Västra Götaland Skövde Sweden

[4 ] Department of Behavioral Sciences and Learning Linköping University Linköping Sweden

[5 ] Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology University of Gothenburg Gothenburg Sweden

Author notes

Corresponding Author: Helena Sehlin helena.sehlin@ 123456vgregion.se

Author information

Helena Sehlin https://orcid.org/0000-0003-1067-6672

Britt Hedman Ahlström https://orcid.org/0000-0001-5705-5705

Ingrid Bertilsson https://orcid.org/0000-0001-9547-162X

Gerhard Andersson https://orcid.org/0000-0003-4753-6745

Elisabet Wentz https://orcid.org/0000-0002-1264-6517

Article

Publisher ID: v22i12e19658

DOI: 10.2196/19658

PMC ID: 7808894

PubMed ID: 33382381

SO-VID: 8503d896-80e1-40e6-8b9e-35fadde7b266

Copyright © ©Helena Sehlin, Britt Hedman Ahlström, Ingrid Bertilsson, Gerhard Andersson, Elisabet Wentz. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 31.12.2020.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 27 April 2020

Date revision requested : 18 July 2020

Date revision received : 28 July 2020

Date accepted : 22 September 2020

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