OARacle Newsletter

In October 2025, OAR’s Board of Directors authorized funding for eight applied autism research grants. These new research grants, totaling $397,372, bring OAR’s total research funding to $5.8 million since 2002. This article is the sixth of the previews in The OARacle this year. 

In 2022, the prevalence of children with autism was 1 in 31, compared to 1 in 150 in 2002. That 384% increase has resulted in more children needing services that may not be available to them. Those services include community-based mental health services, which have grown by 70% in the last 15 years. Yet only 50% of providers reported delivering mental health services to autistic youth in 2021, creating a growing service gap.

Autistic individuals’ sensory preferences, communication styles, and cognitive strengths/difficulties may affect their ability to engage with and benefit from traditional mental health services. However, there are ways to modify mental health services to make them beneficial for autistic youth. Unfortunately, training community mental health clinicians is expensive. This leaves many clinicians in community settings like schools with limited knowledge of autism and difficulty tailoring clinical services to support their autistic clients’ needs, although they are motivated  to participate in training to better support those clients.

Grace Lee Simmons, Ph.D., will address the need for accessible training through her OAR-funded, two-year study, An Evidence-Based, Virtual Toolkit for Community Mental Health Clinicians Serving Autistic Youth. She and her research team aim to develop and conduct an open pilot trial that will: 

1. Use a community-partnered approach to develop a virtual toolkit for community mental health clinicians providing mental health services to autistic youth. 
2. Collect preliminary data on the feasibility, acceptability, and usability of the toolkit, as well as therapists’ ability to implement the toolkit’s strategies. 
3. Assess clinical efficacy of the toolkit.

Dr. Simmons is a post-doctoral research fellow in the TEACCH Autism Program at the University of North Carolina-Chapel Hill. Her research focuses on designing, implementing, and disseminating psychosocial interventions targeting socioemotional difficulties in autistic youth. She specializes in implementation science and community-partnered work that aims to understand the needs of autistic individuals and develop and disseminate evidence-based practices to meet their identified needs. 

Her coinvestigators are: 

• Dr. Laura Klinger, director, TEACCH Autism Program; professor, Department of Psychiatry; UNC Chapel Hill School of Medicine 
• Dr. Eric Storch, professor of Psychiatry & Behavioral Sciences, Baylor College of Medicine  
• Jennifer Eigenrauch, director of Training, UNC Chapel Hill TEACCH Autism Program

Methodology

The research team will meet with a community advisory board to review feedback on qualitative data collected for an earlier project that can also support development of this toolkit. A group of autistic individuals and community mental health clinicians identified themes in that dataset, including the need for foundational training on how autism presents in autistic youth; their learning styles; and support for intervention delivery, modification, and training formats. The study’s community advisory board members, which include autistic youth, caregivers, and community mental health clinicians, will provide additional perspective on autistic youths’ and community mental health clinicians’ needs.

With that information in hand, the research team will create a web-based toolkit to include approximately five modules, each 20-30 minutes long: 

1. Autism overview: Communication differences, sensory processing differences, executive functioning difficulties, etc. 
2. Session management: To include things like room structure; light, sound, and temperature; visual supports 
3. Engagement: Such as building rapport and integrating client’s interests 
4. Mental health services’ modifications: Such as pacing and modifying language, modeling, reinforcement, and home practice 
5. Continuation of Module 4: Mental health services’ modifications

Twelve community mental health clinicians employed in outpatient clinics or in school-based settings will be recruited to review the toolkit. The therapists will be screened by completing an online survey, demographic questionnaire, and measures of autism knowledge, self-efficacy, and current service delivery. They will also complete a 60-minute interview with Dr. Simmons to assess current clinical practices with autistic youth.

Once enrolled, they will each identify an autistic client (ages 8-15) with whom they are currently working or will begin working with to take part in the study. Those youth and their caregivers will complete screening questionnaires. Caregivers will also complete a demographic questionnaire and the youth will complete the Youth Top Problems Assessment.

Clinicians will complete the virtual toolkit, completing pre/post knowledge tests at the beginning and end of each module. When they finish the toolkit, they will complete surveys addressing toolkit acceptability, feasibility, and usability and the same measures of autism knowledge and self-efficacy.

The next step will be for the clinicians to implement the strategies with their clients in six therapy sessions. Those sessions will be videotaped to assess therapist fidelity to the strategies and treatment engagement. After the sessions, clinicians will complete a 60-minute interview and their clients and caregivers will participate in individual interviews addressing the clinical services. At six months after the sessions, clinicians will complete the same measure of mental health service delivery.

Relevance

This study will be the first to design a brief, accessible, and innovative virtual toolkit designed to educate community mental health clinicians on how to tailor their services to autistic youth using evidence-based practices. The researchers hope that this study will lead to larger studies, ultimately providing community mental health clinicians with strategies designed for autistic clients, thereby expanding much-needed mental health services to autistic youth who need them and leading to improved therapeutic outcomes.

Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.