Young man with a red hat sitting on a park bench using a mobile phone
A digital innovation that provides autistic adults with 24/7 support and practical tools to manage the challenges of everyday life has been shown to significantly reduce anxiety levels.
Brain in Hand combines practical solution-based coaching with a user-led digital self-management system to help individuals build their independence in a variety of situations. 
When trialled by a small cohort of adults diagnosed as being, or suspected to be, autistic with low support needs, Brain in Hand was found to significantly lower reported anxiety levels. 
The independent study, published in British Journal of Psychiatry Open, is the first of its kind to investigate the impact of digital self-management in helping to support autistic adults. 
As well as reducing anxiety levels, the study also revealed significant improvements for other aspects of quality of life. 
In particular, self-injurious behaviour scores on the Health of the Nation Outcome Scales (HoNOS) were halved, reducing from 1.30 at baseline to 0.58 on follow up, and memory and orientation problems reduced from 0.88 to 0.47. 
Communication problems, sleep problems, problems with eating and drinking, and problems with relationships were also significantly reduced, while using the app also helped participants feel a greater sense of self-awareness. 
The study was commissioned and funded by SBRI Healthcare, an Accelerated Access Collaborative (AAC) initiative, in partnership with the Academic Health Science Networks (AHSNs).
Rohit Shankar
Professor Rohit Shankar MBE
The study was led by Professor Rohit Shankar MBE, Professor of Neuropsychiatry at the University of Plymouth and Director of CIDER – Cornwall Intellectual Disability Equitable Research. He said:
“There are more than 700,000 autistic people in the UK and, therefore, it’s important to find and research therapeutic methods of helping those who need it. Every autistic individual has a unique set of experiences and needs but we know that many suffer chronic day-to-day anxiety, which can impact their mental health. The development of the Brain in Hand app is just one tool which could provide vital assistance to them at home or elsewhere.” 
Dr Samuel Tromans, Associate Professor of Psychiatry at the University of Leicester, led the writing of the study and said:
“Autistic adults often face increased challenges in their daily life because of differences in their social interaction and communication. This can make everyday tasks sometimes feel overwhelming or anxiety-inducing, such as going into a shop to buy groceries, picking something up or ordering an item. The digital app, which can be installed on phones, is designed for people whose needs may include support with planning, problem solving, and initiating tasks. It helps them establish routines, deal with unexpected events, and manage the stress and anxiety that can arise when things go off track. While anxiety is a part of the human condition, continuous feelings of anxiety can have a profoundly negative impact on a person’s ability to function adequately.”
The app, which can be installed on a mobile phone (making it easily accessible), works by providing on-demand human support through a chat function, should the individual user need it. 
Connor Ward, autistic consultant and Co-Production Lead at Brain in Hand, added:
"For a lot of autistic people, anxiety can make it really hard to do the things we want to do and live life to the full. It's really exciting to be part of something that could genuinely help a lot of people manage the challenges of day-to-day life better so they can focus on the things that matter most to them."

Brain in Hand helps individuals build their independence in a variety of situations

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  • The full study – Tromans et al., The psychological and social impact of the digital self-support system “Brain in Hand” on autistic people: An England and Wales prospective cohort study – is published in the British Journal of Psychiatry Open, DOI: 10.1192/bjo.2023.57.

Cornwall Intellectual Disability Equitable Research – CIDER

Formally launched in October 2018 and led by Professor Rohit Shankar, Cornwall Intellectual Disability Equitable Research (CIDER) is a partnership between the University of Plymouth and Cornwall Partnership NHS Foundation Trust (CFT) focusing on epilepsy in people with intellectual disabilities.
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