Healthy Relationships on the Autism Spectrum (HEARTS): A feasibility test of an online class co-designed and co-taught with autistic people

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Rothman, E. F., Graham Holmes, L., Caplan, R., Chiang, M., Haberer, B., Gallop, N., Kadel, R., Person, M., Sanchez, A., Quinn, E., & Wharmby, P. (2022). Healthy Relationships on the Autism Spectrum (HEARTS): A feasibility test of an online class co-designed and co-taught with autistic people. Autism, 26(3), 690-702. https://doi.org/10.1177/13623613211069421

Publication date: 9 Jan 2022 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
11
Publication authors identified as autistic
1 / 11 (9.1%)
  1. Emily F. Rothman
  2. Laura Graham Holmes
  3. Reid Caplan *
  4. Melody Chiang
  1. Brandy Haberer
  2. Nick Gallop
  3. Rabindra Kadel
  4. Mariah Person
  1. Amelia Sanchez
  2. Emily Quinn
  3. Peter Wharmby

Abstract

This study tested the feasibility and preliminary efficacy of a six-session online class on healthy relationships for autistic individuals ages 18–44 years old ( N = 55). The content of the Healthy Relationships on the Autism Spectrum class was informed by formative research with 25 autistic individuals, and developed collaboratively by two non-autistic professionals and seven autistic self-advocates. Fifty-five autistic people participated in Healthy Relationships on the Autism Spectrum and completed pre- and post-surveys. The study found that it was feasible to deliver Healthy Relationships on the Autism Spectrum online. Pairing an autistic and non-autistic person to co-teach was well-received. Participants decreased hostile automatic thoughts ( p < 0.05), involvement in dating abuse in intimate relationships ( p < 0.05), fight-or-flight response ( p < 0.05), and rejection sensitivity ( p < 0.001). Participants experienced improved flourishing ( p < 0.001), coping with rejection and jealousy ( p < 0.001), motivation to engage with others for socializing ( p < 0.05), self-compassion ( p < 0.05), and positive thinking ( p < 0.05). Scores on a measure of interpersonal competence did not change, and loneliness did not decrease. The majority of participants reported high satisfaction with the class. Healthy Relationships on the Autism Spectrum is a promising healthy relationships promotion class that should be evaluated through a randomized controlled trial. Lay abstract The Healthy Relationships on the Autism Spectrum class is unique because autistic people helped to develop it and co-taught it. It is an online, six-session class. The class was piloted in 2020–2021 with 55 autistic people who were ages 18–44 years old. This feasibility study found that most people who took the class liked it. Surveys filled out by the students before and after the class showed that they became less sensitive to rejection, used more positive thinking skills, and were more interested in being social. However, the class may not have made them feel less lonely. The team that invented the class is using the feedback to improve it. The class holds promise for improving the quality of friendships and dating relationships for autistic adults and should be tested further.

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These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
43
Total cited references integrated for this publication.
Cited references with an identified autistic author
4 / 43 (9.3%)
Cited author occurrences identified as autistic
8 / 143 (5.6%)
Among occurrences linked to AutiHub author records: 8 / 35 (22.9%). Distinct cited authors identified as autistic: 8 / 128 (6.2%).
Cited author occurrences linked to AutiHub author records
35 / 143 (24.5%)
Distinct linked cited authors: 32 / 128 (25.0%)
Linked cited-author occurrences not identified as autistic
27 / 35 (77.1%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 27 / 143 (18.9%). Distinct linked cited authors not identified as autistic: 24 / 32 (75.0%).
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