Transforming Mental Health Screeners for and with
Autistic Youth

Transforming the Depression and Anxiety Mental Health Screeners with direct collaboration with autistic youth, integrating gamification, universal design and entertainment practices. The team is collaborating with key stakeholders including the youth, caregivers, doctors, nurses, psychylogists and school social workers to develop a tool that can be used to give more access to mental health care for autistic youth.

Disparities in anxiety/depression screening rates in autistic youth

Scientific Research Poster: Scoping Reviews on Disparities in Mental Health Screening Rates for Autistic Youth

Scoping review on disparities in mental health screening rates in autistic youth

Scientific Research Poster: Scoping Reviews on Dispairities in Mental Health Screening Rates

CoCreatingMentalHealth ScreeningToolsforAndWithAutistic Youth

Co-Creating a revised Mental Health Screening Tool for and With Autistic Youth

Current Phase:

The Prototype being tested on the phones

The Scholarly Project:

The proposed scope of the Honors Seminar:

The proposed seminar is part of a long-term goal to narrow mental health disparities that disadvantage autistic adolescents by designing more accessible mental health screening tools. During the seminar, students would learn about how to integrate design and research to develop interventions that are a critical step toward mental health equity. Specifically, students would further develop functional prototypes of mental health screening tools, assist with data analysis, and write reports. The seminar would start in Fall of 2024, after a Summer 2024 ideation workshop with autistic youth, professionals who administer the tool, and caregivers/guardians of autistic youth.

At the conclusion of the seminar, we will move into further user testing and production of refined mental health screening tools. The Co-PIs intend to get funding from Blue Cross Blue Shield of Michigan Foundation (BCBSMF), with a start date of Summer 2024. A similar concept paper was accepted by BCBSMF and when Bonner joined the team the project was enhanced further to include co-designing the tools with autistic youth. We intend to also apply for an R21 from the National Institutes of Mental Health (NIMH) and, in the future, an R01 from NIMH and a PCORI grant, which will help the tool scale nationally and aim at reducing health disparities for autistic youth.

We will discuss each of these funding mechanisms with students, alongside similar others, to contextualize how the seminar fits within the timeline of our long-term goals. Accordingly, the seminar would demonstrate to the students how to begin with co-designing with a small set of stakeholders and catalyze into a venture with broader reach.

The background / disciplinary content to be covered in the seminar:

The Honors Seminar will cover the social determinants of health, which is an interdisciplinary framework for understanding the multiple mechanisms that underlie health disparities, such as the gap in mental health between autistic youth and their neurotypical peers. With this framework in mind and interview data collected from the summer prior, we will work on understanding why mental health screening rates are lower among autistic youth compared to their neurotypical peers and possible interventions. Among these, which the Co-PIs identified from their previous work with autistic youth, is the need for more accessible screening tools. We will review research design frameworks that are relevant for designing a tool for and by autistic youth, including co-design, community-based participatory research, participatory design, and implementation science.

We will discuss barriers in engaging diverse users and how to overcome them when attempting to be inclusive of the input from these populations. For example, to co-design with autistic youth, the youth would need to have a level of behavioral, cognitive, and social functions to adequately participate, yet the tools need to be accessible to those with wider abilities. Moreover, while autistic youth is just one example of a minoritized population, we will emphasize applications to others and brainstorm ways to creatively reach out and incorporate ways to broaden the backgrounds of the users who participate in co-design. Such ideas would be informative for students, researchers and practitioners of several fields, including business, computer science, mechanical engineering, medicine, nursing, psychology, UX design, interactive design, and public health, which generates an opportunity to publish with interested students a report of best practices for engaging diverse users.

The initial prototype co-created with autistic youth in the summer prior to the seminar will move into stages of iteration and development based on the quantitative and qualitative data findings. Students in the seminar will collaborate to design the mental health screening tools that aim to improve completion rates for autistic youth.

Previous designs, interactive tools, videos, and animations that Bonners’ teams have produced focus on accessible and universal design, ensuring that all youth, including visual, hearing, and cognitively impaired can access the media. Students will be introduced to a blueprint for accessibility that informs design decisions using inclusion, socio-emotional design and entertainment design strategies.

The relevant training or techniques students will learn:

Students will be engaged in undergraduate research and the creative arts. There are 2 parts to the training and techniques:

Students will participate in taking the initial prototype from the autistic youth into production, using techniques such as UX, illustration, sound design, animation, and/or film under the direction of Professor Bonner.
Students will then user test the prototype with initial autistic youth and trusted adults. They will analyze data and write report(s) under the direction of Professor Campos-Castillo.

The anticipated research or creative product(s):

Our research includes revising the current mental health screening tools for anxiety and depression for and with autistic youth and their trusted adults.

The creative products are screening tools that reduce the disparities in the prevalence of mental health and access to mental health care through using universal design techniques. For example, if we can use text, images, sound and movement to ask the screening questions, we may be able to connect more with the young patient who is autistic when doing a mental health screening. If the screening tool is interactive and focuses on one question on the screen at a time, we may be able to remove the distraction of the current tools. The precise design of the new screening tools will be contingent on the information gathered during the summer prior to the seminar. The research products include reports summarizing qualitative data from the workshops and best practices for engaging diverse users in co-design.

The significance of the proposed scholarly project:

Autistic youth report greater rates of anxiety and depression than their neurotypical peers, yet the gap in mental health may be even larger due to lower completion rates of mental health screening by autistic youth. Current mental health screeners may be difficult for some autistic youth to translate to their own feelings, which may explain low completion rates, reliability, and validity.

The Patient Health Questionnaire and Generalized Anxiety Disorder scales are text-based screening tools for depression and anxiety, respectively, which require a high cognitive load to comprehend each statement and recall symptom frequency. We will begin our work by making these mental health screeners more accessible for autistic youth.

Our long-term goal is to improve screening tools that in turn improve access to mental health care and health and quality outcomes.

Our transdisciplinary team would teach students how to seamlessly integrate art, design, research, and implementation at a level comparable to what master’s students in our department experience.