Autism & Developmental

Socio-emotional determinants of depressive symptoms in adolescents and adults with autism spectrum disorder: A systematic review.

Smith et al. (2020) · Autism : the international journal of research and practice 2020
★ The Verdict

Autistic youth self-reported less anxiety and depression during early COVID-19, so check each client instead of assuming decline.

✓ Read this if BCBAs screening adolescent and adult clients for mood symptoms in clinic or school settings.
✗ Skip if Practitioners serving only pre-verbal or profoundly impaired populations where self-report is not possible.

01Research in Context

01

What this study did

Green et al. (2020) looked at how autistic teens and adults felt during the first COVID-19 year.

They asked youth to rate their own anxiety and depression in summer and again in winter.

The team compared the scores to non-autistic peers living through the same pandemic.

02

What they found

Autistic youth said their anxiety and depression went down, not up.

The drop was bigger than what non-autistic kids reported.

The study warns clinicians not to assume every autistic client got worse in 2020.

03

How this fits with other research

Heald et al. (2020) seems to disagree. They found autistic early teens scored higher on depression than typical peers before the pandemic. The gap is timing: M measured baseline levels, while C captured change during COVID-19.

Ridgway et al. (2024) also clashes. Their 2024 data show autistic adolescents feel lower wellbeing than peers. Again, the difference is context: Kathryn reflects normal life stress; C shows a brief pandemic dip.

Older work backs the tools used. Ozsivadjian et al. (2014) proved autistic kids can reliably fill out depression questionnaires, giving C confidence in the self-report numbers.

04

Why it matters

Do not assume every autistic client suffered in 2020. Some felt relief from social demands. Ask each teen directly using validated self-report scales. A simple mood check at intake can catch both drops and rises, letting you tailor coping skills or celebrate real gains.

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Add a quick self-report mood scale to your intake packet and compare scores to last year instead of guessing pandemic impact.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
76
Population
autism spectrum disorder, neurotypical
Finding
positive
Magnitude
medium

03Original abstract

The COVID-19 pandemic elicited increases in anxiety and depression in youth, and youth on the autism spectrum demonstrate elevations in such symptoms pre-pandemic. However, it is unclear whether autistic youth experienced similar increases in internalizing symptoms after the COVID-19 pandemic onset or whether decreases in these symptoms were present, as speculated in qualitative work. In the current study, longitudinal changes in anxiety and depression during the COVID-19 pandemic in autistic youth were assessed in comparison to nonautistic youth. A well-characterized sample of 51 autistic and 25 nonautistic youth (ageM  = 12.8, range = 8.5-17.4 years, IQ > 70) and their parents completed the Revised Children's Anxiety and Depression Scale (RCADS), a measure of internalizing symptoms, repeatedly, representing up to 7 measurement occasions from June to December 2020 (N ~ 419 occasions). Multilevel models were used to evaluate changes in internalizing symptoms over time. Internalizing symptoms did not differ between autistic and nonautistic youth in the summer of 2020. As reported by youth themselves, internalizing symptoms decreased in autistic youth, both overall and compared to nonautstic peers. This effect was driven by decreases in generalized anxiety, social anxiety, and depression symptoms in autistic youth. Reductions in generalized anxiety, social anxiety, and depression in autistic youth may be due to COVID-19 pandemic-specific differences in response to social, environmental, and contextual changes that unfolded in 2020. This highlights the importance of understanding unique protective and resilience factors that may be evident in autistic individuals in response to broad societal shifts such as those seen in response to COVID-19.

Autism : the international journal of research and practice, 2020 · doi:10.1177/1362361320908101