The psychological and social impact of the digital self-support system 'Brain in Hand' on autistic people: Prospective cohort study in England and Wales

Samuel Tromans, William Henley, Ian Summers, Danielle Bilkey, Jenna Datson, Nicola Doherty, Louise Morpeth, Sarah Benbow, Rebecca Jelbert, Ashok Roy, Lance Watkins, Bhathika Perera, Saman Shazad, Richard Pender, Regi Alexander, Richard Laugharne, Rohit Shankar*

*Corresponding author for this work

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Abstract

Background
Brain in Hand (BIH) is a UK-based digital self-support system for managing anxiety and social functioning. Aims To identify the impact of BIH on the psychological and social functioning of adults with autism.
Method
Adults with diagnosed or suspected DSM-5 (level 1) autism, identified by seven NHS autism services in England and Wales, were recruited for a 12-week prospective mixed-methods cohort study. The primary quantitative outcome measures were the Health of the Nation Outcome Scales for People with Learning Disabilities (HONOS-LD) and the Hospital Anxiety and Depression Scale (HADS). Fisher’s exact test explored sociodemographic associations. Paired t-test was utilised for pre– post analysis of overall effectiveness of BIH. Multivariable linear regression models, univariable pre–post analysis, Wilcoxon signed-rank test, logistic regression analysis, Bonferroni correction and normative analysis were used to give confidence in changes identified. A thematic analysis of semi-structured exist interviews following Braun and Clarke’s six-step process of 10% of participants who completed the study was undertaken.
Results
Sixty-six of 99 participants completed the study. There was significant reduction in mean HONOS-LD scores, with 0.65 s.d. decrease in those who used BIH for 12 weeks. Significant positive changes were identified in HONOS-LD subdomains of ‘selfinjurious behaviours’, ‘memory and orientation’, ‘communication problems in understanding’, ‘occupation and activities’ and ‘problems with relationship’. A significant reduction in the anxiety, but not depression, component of the HADS scores was identified. Thematic analysis showed high confidence in BIH. Conclusions
BIH improved anxiety and other clinical, social and functioning outcomes of adults with autism.
Original languageEnglish
Article numbere96
JournalBJPsych Open
Volume9
Issue number3
Early online date26 May 2023
DOIs
Publication statusPublished - 26 May 2023

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