New research published in the journal Mindfulness provides evidence that a self-guided mindfulness app can reduce anxiety symptoms and perceived stress in autistic adults. The study found that participants who used the smartphone-based program reported significant improvements in their emotional well-being, and many of these gains were still evident six weeks after the program ended.
Autistic adults tend to report higher levels of anxiety and chronic stress than the general population. Research suggests that as many as two-thirds of autistic adults may meet criteria for an anxiety disorder at some point, and elevated stress levels are often linked to difficulties in everyday functioning and reduced quality of life.
Although in-person mindfulness-based interventions have shown promise for helping autistic adults manage these symptoms, they are not always accessible. Some autistic individuals may face challenges such as transportation barriers, difficulty with social settings, or limited financial resources that make it harder to attend in-person sessions. Remote, app-based mindfulness programs offer a flexible alternative, but there has been little research on how effective they are for autistic users.
This study aimed to test the feasibility and effectiveness of a six-week smartphone mindfulness intervention designed specifically for autistic adults. The researchers wanted to see whether this app-based approach could reduce anxiety and stress, and whether the benefits would persist after the program ended.
“We were motivated to explore this topic because autistic adults are often diagnosed with mental health conditions at higher rates than in the general population, with anxiety being among the most common condition,” said study author Cindy E. Li, the autism research coordinator at the Hock E. Tan and K. Lisa Yang Center for Autism Research at Massachusetts Institute of Technology.
“In-person mindfulness-based interventions have been shown to decrease symptoms of anxiety and stress in autistic adults. However, little is known about the effectiveness of remote mindfulness-based interventions for this population. Due to barriers autistic adults often face in accessing in-person treatment, remote interventions are a cost-effective, convenient, and highly accessible tool that could reach many individuals who might not otherwise seek or be able to obtain treatment.”
The researchers recruited 89 autistic adults from two large databases: the Massachusetts Institute of Technology Autism Research Participant Database and the SPARK autism research cohort. All participants reported a formal autism diagnosis and had regular access to a smartphone. To be eligible, participants had to meet certain cognitive and language comprehension thresholds to ensure they could use the app effectively. Those with extensive prior meditation experience were excluded.
Participants were randomly assigned to one of two groups. One group began the mindfulness intervention right away, while the other group was placed on a waitlist and received the intervention six weeks later. This design allowed the researchers to compare outcomes between the groups and test whether the waitlist group would experience similar improvements after completing the program.
The intervention used a modified version of the Healthy Minds Program app. Over six weeks, participants were encouraged to complete short daily sessions that alternated between guided meditations and educational lessons on mindfulness. Each practice lasted either 10 or 15 minutes, and users could select the type of practice (sitting or active), the narrator’s voice, and other preferences to personalize their experience.
Participants completed surveys at multiple timepoints to measure anxiety symptoms, perceived stress, positive and negative emotions, and mindfulness traits. These assessments occurred before the intervention, at the halfway point, at the end of the six weeks, and again six weeks after the program concluded. The researchers also tracked how much time each participant spent using the app and collected feedback on their experience.
The results suggest that the mindfulness app was both feasible and effective for autistic adults. Participants in the initial intervention group showed reductions in anxiety symptoms and perceived stress compared to those in the waitlist group. These improvements were measured using multiple standardized tools, and effect sizes ranged from medium to large.
The benefits extended beyond anxiety and stress. Participants also reported decreases in negative emotions and increases in mindfulness-related traits. The positive changes in emotional well-being were supported by statistical tests that accounted for potential differences between groups at the beginning of the study.
“We were surprised by just how effective the intervention was and how consistent the effects were across all of the measures that we assessed,” Li told PsyPost.
After the waitlist group completed the same mindfulness program, they showed a nearly identical pattern of improvement. This replication added strength to the findings by showing that the results were not limited to the first group.
Importantly, most of the improvements were sustained six weeks after the program ended. This included lower anxiety and stress levels and higher mindfulness scores. Even though participants used the app very little during the follow-up period, their mental health outcomes remained stable, suggesting that the effects of the program may have lasting benefits.
“It was interesting to see that the effects were sustained over the 6-week follow-up period even though most participants had stopped using the app during that time,” Li said. “This suggests that in the span of the intervention the participants may have found ways to incorporate mindfulness into their daily lives, which is the ultimate goal of mindfulness practice.”
The study also found a strong relationship between gains in mindfulness traits and reductions in anxiety and stress. Participants who reported becoming more mindful during the program tended to show greater emotional improvement. This pattern is consistent with the idea that mindfulness itself may help buffer against anxiety and stress.
Feasibility was another key focus of the study. Over 70% of participants completed at least 75% of the app’s core curriculum, and most reported that the app was easy to use and fit into their schedules. Very few reported emotional discomfort, and no participants dropped out due to negative reactions.
“The main takeaway is that this app-based mindfulness intervention was both feasible and helpful for autistic adults and that remote mindfulness interventions may be especially beneficial for autistic adults who might not otherwise seek in-person treatment due to barriers in accessing mental health care,” Li explained.
While the findings are promising, there are some caveats to consider. The sample was relatively homogeneous, consisting primarily of white, cisgender adults without intellectual disabilities.
“The results may not be generalizable to individuals with backgrounds different from those in our study, such as adults whose nonverbal intellectual ability is well below average,” Li noted “We did not involve autistic collaborators who may have suggested important changes to the study. It is possible that if the intervention had been specifically tailored to autistic participants that the effects may have been even stronger. Including an active control group would be important in a follow-up study, both to help determine the specific effects of the intervention and to control for the possibility of any placebo effect.”
“The autistic adults in our sample exhibited high rates of anxiety symptoms, according to their trait anxiety scores,” she added. “This makes it all the more valuable that the mindfulness intervention reduced anxiety symptoms and perceived stress. Although at baseline, 72% of the autistic adults enrolled in the study were categorized as having a high level of trait anxiety, at follow-up that percentage dropped to 51%.”
The study, “Smartphone Mindfulness Intervention Reduces Anxiety Symptoms and Perceived Stress in Autistic Adults: A Randomized Controlled Trial,” Cindy E. Li, Kimberly L. Wang, Isaac N. Treves, Lindsay Bungert, John D. E. Gabrieli, and Liron Rozenkrantz.
