TF-CBT for Autistic Youth Pilot Implementation - Open Pilot

Parents/caregivers and therapists will complete the Acceptability of Intervention Measure (AIM), a widely used four-item measure that assesses the extent to which individuals believe an intervention is acceptable. Participants rate the intervention on a 5-point Likert scale, with higher scores indicating greater acceptability. Scores range from a minimum score of 4 to a maximum score of 20. This measure demonstrates good reliability and validity. Parents/caregivers and therapists trained in how to modify Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for autistic youth will complete the AIM at the 6-month (post-treatment) timepoint.

Therapists will complete the Feasibility of Intervention Measure (FIM), a widely used four-item measure that assesses the extent to which individuals believe an intervention is feasible. Participants rate the intervention on a 5-point Likert scale, with higher scores indicating greater feasibility. Scores range from a minimum score of 4 to a maximum score of 20. This measure demonstrates good reliability and validity. Therapists trained in how to modify Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for autistic youth will complete the FIM at the 6-month (post-treatment) timepoint.

Therapists will complete the Intervention Appropriateness Measure (IAM), a widely used four-item measure that assesses the extent to which individuals find an intervention to be appropriate. Participants rate the intervention on a 5-point Likert scale, with higher scores indicating greater appropriateness. Scores range from a minimum score of 4 to a maximum score of 20. This measure demonstrates good reliability and validity. Therapists trained in how to modify Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for autistic youth will complete the IAM at the 6-month (post-treatment) timepoint.

Therapists will complete the Perceived Characteristics of Implementation Scale (PCIS), a 20-item measure that assesses providers' views on interventions. Participants rate their perceptions of the intervention on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Higher scores reflect more positive perceptions of the intervention. This measure has good reliability and construct validity.

Therapists will complete the Intervention Usability Scale (IUS), a 10-item measure that is closely based on the well-validated System Usability Scale. Participants rate the intervention on a 1 to 5 scale and yield a total score from 0 to 100. High scores reflect greater usability. The IUS has good internal consistency.

The Child and Adolescent Trauma Screen 2 (CATS-2) Self-report includes 20 symptom items (assessed over the past month) that map onto the DSM-5 Posttraumatic Stress Disorder (PTSD) diagnostic criteria. Symptom items are rated on a 4-point scale from 0 (never) to 4 (almost always) based on the frequency and severity of the reported symptom experienced, with higher scores indicating greater trauma-related symptoms. Scores range from a minimum score of 0 to a maximum score of 60. This measure demonstrates acceptable to excellent internal consistency. Autistic youth will complete the CATS-2 at baseline and at the 6-month timepoints.

The Child and Adolescent Trauma Screen 2 (CATS-2) Parent-report includes 20 symptom items (assessed over the past month) that map onto the DSM-5 Posttraumatic Stress Disorder (PTSD) diagnostic criteria. Symptom items are rated on a 4-point scale from 0 (never) to 4 (almost always) based on the frequency and severity of the reported symptom experienced, with higher scores indicating greater trauma-related symptoms. Scores range from a minimum score of 0 to a maximum score of 60. This measure demonstrates acceptable to excellent internal consistency. Parents/caregivers will complete the CATS-2 at baseline and at the 6-month timepoints.

Parents/caregivers will complete the Child Behavior Checklist (CBCL), a broadband parent report measure of child problem behavior. Caregivers rate 113 items assessing a range of child emotional and behavioral problems on a 3-point Likert scale from 0 (not true) to 2 (very true or often true). This measure demonstrates good reliability and validity. Raw scores from the internalizing and externalizing scales will be used in this study; higher scores reflect greater psychopathology.

Youth (11 and up) will complete the Youth Self-Report, a broadband self-report measure of child problem behavior. Youth rate 113 items assessing a range of child emotional and behavioral problems on a 3-point Likert scale from 0 (not true) to 2 (very true or often true). This measure demonstrates good reliability and validity. Raw scores from the internalizing and externalizing scales will be used in this study; higher scores reflect greater psychopathology.

Youth will complete the Child Post-Traumatic Cognitions Inventory (CPTCI), a 25-item measure of trauma-related cognitions. Youth rate their agreement with a list of statements on a 4-point Likert scale from "don't agree at all" to "agree a lot", and scores range from a minimum score of 25 to a maximum score of 100. Higher scores reflect more trauma-related cognitions. This measure has high internal consistency and test-retest reliability.

Parents will complete the Emotion Dysregulation Inventory (EDI), a 30-item measure of emotion dysregulation, including reactivity and dysphoria. Parents/caregivers rate the severity of their child's symptoms on a 5-point Likert scale from "not at all" to "very severe". The 24-item EDI Reactivity Index is scored separately from the 6-item Dysphoria Index. Scores on the Reactivity Index range from 0 to 96 and are converted to T-scores. Higher scores reflect greater emotion dysregulation. The EDI has demonstrated good validity and strong test-retest reliability in both autistic youth and general community and clinical samples.

Youth (11 and up) will complete the Emotion Dysregulation Inventory Self-Report (EDI-SR), a 31-item measure of emotion dysregulation, including reactivity and dysphoria. Youth rate the severity and/or frequency of their experiences on a 5-point Likert scale from "never happens" to "almost always happens or causes a serious problem". Scores on the Reactivity Index range from 0 to 100 and are converted to T-scores. Higher scores reflect greater emotion dysregulation. The EDI-SR is based on the Emotion Dysregulation Inventory (EDI), which has demonstrated good validity and reliability.

Youth will complete the Posttraumatic Avoidance Behavior Questionnaire (PABQ), a 25-item measure of trauma-related avoidance behavior. Youth rate the frequency with which they avoid experiences on a 4-point Likert scale from "(almost) never" to "(almost) always", and scores range from a minimum score of 25 to a maximum score of 100. Higher scores reflect greater avoidance behavior. This measure has good test-retest validity and convergent validity with PTSD symptom severity.