Systematic Review of Acceptance and Commitment Therapy in Individuals with Neurodevelopmental Disorders, Caregivers, and Staff.
ACT offers interesting possibilities for neurodevelopmental clients, but current studies are too weak to guarantee results.
01Research in Context
What this study did
Garcia et al. (2022) hunted for every paper that used Acceptance and Commitment Therapy with people who have autism, ADHD, or other neurodevelopmental disorders. They also grabbed studies that trained caregivers or staff with ACT tools.
The team kept 30 studies. Most were small. Many lacked control groups or clear outcome measures.
What they found
Results were all over the map. Some studies said ACT helped with anxiety or stress. Others showed no change.
When the authors rated quality, most studies carried a moderate or serious risk of bias. That means we can’t yet bank on ACT as a sure-fire fix.
How this fits with other research
Suarez et al. (2022) looked at the same year and the same population, but only counted single-case ACT training studies. Their map shows big gaps: almost no data on which ACT parts actually work.
Hoffmann et al. (2016) argued ACT should fill a hole in ABA by targeting private events. Yors et al. agree the idea is promising, yet the review shows the hole is still barely patched.
Blair et al. (2025) found strong, clean evidence for FCT with young children with ASD. ACT, in contrast, still lacks that level of clear, replicated success.
Why it matters
If you serve clients with autism or ADHD, view ACT as an experimental add-on, not a stand-alone treatment. Track your own data and watch for bias pitfalls the review flagged—like vague target behaviors or missing follow-ups. Until larger, better-controlled trials appear, lean on proven tools first and let ACT play a supportive role.
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02At a glance
03Original abstract
The purpose of this review was to quantitatively synthesize studies using acceptance and commitment therapy (ACT) with individuals with neurodevelopmental disorders (NNDs), their parents, and staff members that support them. Thirty studies published in peer-reviewed journals between 2006 and 2020 met inclusion criteria. They were reviewed and coded on variables associated with participants' characteristics, settings, dropouts, design type, ACT procedures and measures, social validity, treatment integrity, and main findings. The What Works Clearinghouse (WWC), the revised Cochrane risk-of-bias tool for randomized trials (RoB2) and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) were applied to evaluate the quality of the studies. Results indicated that 20 studies used group designs and 10 studies used single-case designs. Participants with NNDs consisted predominantly of those with autism spectrum disorder, attention deficit hyperactivity disorder, and learning disabilities. Group studies reported process and outcome measures exclusively; whereas, single-case studies also incorporated behavioral/direct measures. Overall, results showed mixed improvements across studies using indirect and direct measures. Lastly, quality assessment for group studies presented moderate or serious risk of bias and two single-case studies did not meet WWC evidence of effectiveness. Directions for future research and practice are discussed.
Behavior modification, 2022 · doi:10.1177/01454455211027301