Limitations
autistic, autistic traits, psychiatric, autism
DISORDER, DISORDERS
This study has several limitations. First, as the sample size was small and diagnostic timing was not considered, we did not control for the presence of other mental disorders. Second, when comparing the ACAT program and TAU, it was unclear which aspects of the former contributed to changes in self-awareness of autistic traits (both in adolescents and parents/guardians) and treatment stigma (only in adolescents). As a next step, we need to conduct a randomized controlled trial of the ACAT program vs. PEGASUS. Third, the study was designed for autistic adolescents with an IQ of ≥ 90 on the VCI, which limits its general versatility. Fourth, we excluded the parents/guardians of autistic adolescents who met the diagnostic criteria for a psychiatric disorder. Parents of autistic youth are more likely to have a psychiatric diagnosis than parents of non-autistic youth and thus, this decision limits the generalizability of the findings to parents/guardians of autistic adolescents. Fifth, the fidelity of the intervention was only measured for about 4% of the total sessions (i.e., 12 of 270 sessions), lower than the standard 10–20% range for intervention studies and thus constitutes a limitation. Sixth, only parents/guardians with no psychiatric disorders were included in the study, and therefore, there is little to no understanding of the intervention’s use in real clinical situations where both children and parents/guardians have autistic traits. Finally, we aimed to clarify the effects of autism awareness and coping skills on stigma and mental health. However, as coping skills were not directly measured, future studies should aim to do this.