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Feasibility and acceptability of autism adapted safety plans: an external pilot randomised controlled trial

Lookup NU author(s): Professor Jacqueline Rodgers, Mirabel Pelton, Dr Jane Goodwin, Dr Nawaraj BhattaraiORCiD, Isabel Gordon, Colin Wilson, Dr Emmanuel Ogundimu, Professor Sheena Ramsay, Professor Luke Vale



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2024 The Authors. Background: Autistic people are a high-risk group for self-harm and suicide. There are no evidence-based suicide prevention interventions developed specifically for autistic people. We undertook a pilot feasibility randomised controlled trial of autism adapted safety plans (AASP) to reduce self-harm and suicide for autistic people. Methods: This study took place in the United Kingdom and followed a randomised, two-arm, controlled design. Autistic adults (n = 53, mean age = 39, gender = 49% female, 29% not male or female) were recruited via third sector organisations and self-referral between 11.8.21 and 19.10.22. Participants were randomised without stratification to usual care with or without AASP. The AASP was completed by the autistic adults together with someone trained to support them. Research staff who completed follow-up assessments were blind to participant allocation. Primary outcomes were feasibility and acceptability. Participants were assessed at baseline, 1 and 6 months. Primary data were analysed under the intention to treat principle. Study protocol is published. The trial is closed to new participants. This study is registered with the ISRCTN registry, ISRCTN70594445. Findings: 53 participants consented, 49 were randomised to either AASP with usual care (n = 25) or usual care (n = 24). 68% of participants in the AASP arm were satisfied with the AASP and 41% rated it as useable. Feedback on the AASP and research methods were positive with suggested adaptations to some outcome measures. Retention and completion of outcomes measures in both arms was excellent, as was fidelity of delivery of the AASP. Interpretation: Study progression criteria were met, suggesting that the parameters of a future definitive trial of clinical and cost effectiveness of AASP to reduce self-harm and suicide in autistic adults are achievable, with minor recommended adaptions to outcome measures and AASP. Future research should explore the use of AASP in routine clinical practice. Funding: This study is funded by the NIHR [ Public Health Research Programme (NIHR129196)].

Publication metadata

Author(s): Rodgers J, Cassidy S, Pelton M, Goodwin J, Wagnild J, Bhattarai N, Gordon I, Wilson C, Heslop P, Ogundimu E, O'Connor RC, Ramsay SE, Townsend E, Vale L

Publication type: Article

Publication status: Published

Journal: eClinicalMedicine

Year: 2024

Volume: 73

Print publication date: 01/07/2024

Online publication date: 01/06/2024

Acceptance date: 08/05/2024

Date deposited: 11/06/2024

ISSN (electronic): 2589-5370

Publisher: Elsevier Ltd


DOI: 10.1016/j.eclinm.2024.102662


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Funder referenceFunder name
Autism Centre for Excellence at Cambridge (Grant no.: G124306)
NIHR Applied Research Collaboration (ARC), North East and North Cumbria (NENC), Newcastle upon Tyne