Date Presented 04/01/2022

There is an increasing need for efficacious interventions to promote activities of daily living, social participation, academic and work skills, and well-being among adolescents with autism spectrum disorder (ASD). Therefore, we conducted a systematic review to characterize the evidence related to telehealth-delivered interventions for adolescents with ASD. Findings point to the need for increased research in this area.

Primary Author and Speaker: Liron Lamash

Additional Authors and Speakers: Lauren Little, Liat Hen-Herbst

PURPOSE: Given the rapid increase in telehealth (i.e., live videoconferencing) to deliver occupational therapy (OT) services during COVID-19 and the likelihood of its ongoing use (White et al., 2021), we needed to understand the state of evidence related to hybrid (i.e., telehealth with elements of face-to-face) delivered interventions for adolescents with ASD. The purpose of this study was to conduct a systematic review of hybrid interventions for adolescents with ASD. Occupational therapy (OT) practitioners can use evidence from intervention research to inform telehealth practice with adolescents with ASD.

DESIGN: We used the Preferred Reporting Items of Systematic Reviews and Meta-Analyses document (PRISMA) We used the following databases to conduct searches: MEDLINE, PubMed, CINAHL, PsycINFO, Web of Science, Cochrane Library, ERIC, Scopus, and EBSCO Discovery service. All titles and abstracts were imported into Covidence, which was used for screening.

METHOD: We included studies that empirically evaluated interventions delivered remotely in a hybrid approach (includes some in-person time, but the main intervention occurs remotely). Interventions could have addressed any adolescent outcome (e.g., health, education, work). Studies were included if at least 30% of participants were adolescents with ASD; “adolescence” was considered as ages 12-25 years old. We excluded reviews and meta-analyses, dissertations, study protocols, conference proceedings, interventions that were conducted in-person with technology, and assessment studies that investigated telehealth delivery of diagnostic measures.

RESULTS: Of the n = 4618 studies screened, we then assessed n = 259 for full text eligibility. The final number of studies included in the review was n = 13, all of which were published between 2012-2021. According to the risk of bias criteria proposed by the Cochrane group (Higgins et al., 2011), n = 6 studies included a control group, while n = 4 studies used a single subject design. The intervention targets greatly varied, ranging from promotion of participation in social and daily activities to acquiring job/employment skills.

CONCLUSION: Findings from this systematic review point to the paucity of research on hybrid delivered interventions for adolescents with ASD. The field of OT would benefit from increased research on interventions to promote participation among this group as well as studies that use rigorous methodology.


Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., ... & Sterne, J. A. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Bmj, 343.

White, L. C., Law, J. K., Daniels, A. M., Toroney, J., Vernoia, B., Xiao, S., ... & Chung, W. K. (2021). Brief report: impact of COVID-19 on individuals with ASD and their caregivers: a perspective from the spark cohort. Journal of autism and developmental disorders, 1-8.