About

Heather Joy Nuske, Ph.D., is a Research Assistant Professor of Psychiatry in the Department of Psychiatry at the University of Pennsylvania's Perelman School of Medicine. Her research is dedicated to utilizing digital mental health technology to support the implementation of evidence-based practices for individuals with neurodevelopmental and psychiatric disorders. A particular focus of her work is on measuring and supporting emotion regulation in children on the autism spectrum, employing digital mental health platforms combined with psychophysiological indices and treatment approaches such as social and emotional learning programs, mindfulness-based approaches, and emotion regulation training. Dr. Nuske's research employs community-partnered participatory research and user-centered design methods, conducting mixed-method randomized controlled trials to investigate the implementation, efficacy, and effectiveness of digital mental health interventions. Her contributions aim to enhance understanding and support for emotion regulation in children with autism, integrating innovative technology and collaborative research approaches.

Research topics

• Psychology
• Developmental psychology
• Social psychology
• Applied psychology
• Marketing

Selected publications

• Connecting care circles: co-development of a digital platform to improve communication between professional caregivers and family members of adults with profound autism in residential care

  BMC Digital Health · 2026-02-27

  articleOpen accessSenior author

  Effective collaboration between professional caregivers and families is fundamental to quality residential care for individuals on the autism spectrum requiring 24/7 care (i.e., “profound autism”). However, maintaining consistent communication and care coordination is a challenge. To address this, we designed a web-based platform and phone application to streamline communication and care coordination between professional caregiving teams and families (Pletly). Our main objective was to iteratively build on Pletly’s original family member-facing features and functionality to create a new professional-facing platform, and improve communication channels between professional caregivers and family members. Using a mixed-methods and community-partnered participatory design, we co-developed these new features with residential caregiving partners. Through 3 rapid prototyping cycles involving 9 professional caregivers and 9 family members, feedback was gathered on the technology’s usability, feasibility, acceptability, appropriateness and its potential impact in a residential care setting to optimize care communication between caregiving teams of adults with profound autism. Our secondary objective was to gather preliminary data on hypothesized secondary outcomes of this technological intervention, such as increasing family’s awareness of loved one’s experiences and family’s engagement and collaboration with professional care teams, and others. Participants rated the developing prototypes as highly acceptable, appropriate, feasible, and with excellent usability. Both family members and professionals saw Pletly’s greatest potential impact was in the realm of interpersonal connections – both in terms of family members’ connection to their loved ones and their daily activities, and in professionals’ connection to family members. This was followed by both groups agreeing they would be better informed, engaged and collaborative in caring for care recipients. This feedback was shared with the development team to ensure subsequent iterative improvements are maximally responsive to community’s needs. Results suggest that the communication technology developed in this study (Pletly) has potential to improve communication in care circles for autistic individuals living in residential care. Future research should experimentally evaluate its anticipated impact in residential care facilities and other sectors in which teaming between family members and professional caregivers is essential for high quality care, such as in aged care and special education.

  PublisherOA PDFDOI

• Teachers’ and Caregivers’ Predictions of Autistic Students’ Kindergarten Transition Success

  SSRN Electronic Journal · 2026-01-01

  preprintOpen access
  PublisherDOI

• Wellness for Warriors: A Randomized Controlled Trial of a Digital Health App for First Responders, Military Personnel and Veterans (Preprint)

  2025-01-10

  preprintOpen accessSenior author

  <sec> <title>BACKGROUND</title> First responders, military personnel and veterans face a disproportionate risk for mental health and wellness issues due to the stress of their occupations. Stigma and confidentiality concerns are common barriers to use of traditional mental health services. Digital interventions offer a promising alternative, as they can be anonymous, convenient, and cost-effective. </sec> <sec> <title>OBJECTIVE</title> This study aimed to test GUIDE, a digital wellness app designed for first responders, military personnel, and veterans. We explored the impact of GUIDE on various aspects of wellness, emotional wellbeing, mental health, social connectedness, and personal growth. </sec> <sec> <title>METHODS</title> This randomized waitlist-controlled trial enrolled 115 participants allocated into 3 groups: GUIDE with financial incentives (GUIDE+Incentives, n=37), GUIDE-only (n=39), or waitlisted GUIDE control (waitlist, n=39). Surveys assessed baseline and post-trial wellness (PERMA total score, WHO-5 score, Personal Wellbeing Score, PERMA Health sub-scale score), emotional wellbeing (PERMA Positive, Negative, and Happiness sub-scale scores; Difficulties in Emotion Regulation Scale), mental health/health (PHQ-8 for depression and GAD-7 for anxiety), social connectedness (PERMA Relationships and Loneliness sub-scale scores), and personal growth (PERMA Accomplishment, Meaning, and Engagement sub-scale scores). App engagement and technical merit were also evaluated. </sec> <sec> <title>RESULTS</title> Overall, 93.04% of enrolled participants (107/115) completed the post-trial assessment and were included in our intent-to-treat analyses. In repeated measures ANOVAs, there were no significant group × time interactions. In post-hoc pairwise comparisons of pre-post deltas per group, the GUIDE-only group improved significantly over the Waitlist in wellness, emotional wellbeing, and mental health. No group differences were significant for social connectedness or personal growth measures. Of participants allocated to GUIDE intervention groups, 67.10% (51/76) completed at least three activities per week for all four weeks. GUIDE+Incentives completed significantly more activities, posts and replies compared to the GUIDE-only group – but not lessons, likes, or mood surveys. App engagement was correlated with improvements on wellness, emotional wellbeing, mental health, and personal growth measures, driven mostly by lessons, posts and replies – the educational and peer support aspects of GUIDE. Participants who engaged more felt more accomplished, regardless of feature used. Participants gave GUIDE good appropriateness and feasibility scores, and satisfactory acceptability and usability scores. Exploratory subgroup analyses suggest the app may be most beneficial to military-affiliated individuals and males. </sec> <sec> <title>CONCLUSIONS</title> This trial indicates that GUIDE-only participants improved significantly compared to the waitlist and that GUIDE is a feasible and appropriate intervention with the potential to improve mental health and wellbeing of first responders, veterans and active military. Financial incentives increased engagement with peer support aspects of GUIDE, but did not lead to significant improvements over the waitlist. Future research should test the effect of longer-term GUIDE use and whether improvements sustain. </sec> <sec> <title>CLINICALTRIAL</title> clinicaltrials.gov (NCT06336967) </sec>

  PublisherDOI

• Evaluating a Mobile Health Intervention (GUIDE App) for First Responders, Military Personnel, and Veterans: Randomized Controlled Trial

  Journal of Medical Internet Research · 2025-05-01

  articleOpen accessSenior author

  Background First responders, military personnel, and veterans face disproportionate risk for mental health and wellness issues. Stigma and confidentiality are common barriers to traditional services. Mobile health interventions offer anonymous, convenient, and cost-effective alternatives. Objective This study aimed to evaluate the impact of GUIDE, a mobile health intervention, on wellness, emotional well-being, mental health, social connectedness, and personal growth in first responders, military personnel, and veterans. Methods In this unblinded, randomized, waitlist-controlled trial, 115 participants recruited online and offline were virtually enrolled and allocated into 3 groups: GUIDE with financial incentives (GUIDE+incentives, n=37), GUIDE-only (n=39), or waitlist control (n=39). Web-based surveys assessed baseline and posttrial wellness (PERMA [Positive Emotion, Engagement, Relationships, Meaning, Accomplishment] Overall, World Health Organization 5-item Well-being Index, Personal Well-being Score, and PERMA Health), emotional well-being (PERMA Positive Emotion, Negative Emotion, and Happiness; and Difficulties in Emotion Regulation Scale), mental health (Patient Health Questionnaire-8 [depression] and Generalized Anxiety Disorder-7 [anxiety]), social connectedness (PERMA Relationships and Loneliness), and personal growth (PERMA Accomplishment, Meaning, and Engagement). App engagement and technical merit were also evaluated. Results Among the participants, 93.0% (107/115) completed the posttrial assessment and were included in the main analysis. In repeated measures ANOVAs, there were no significant group×time interactions for wellness (ηp2=0.02-0.04), emotional well-being (ηp2=0.01-0.12), mental health (ηp2=0.01-0.02), social connectedness (ηp2=0.03-0.04), and personal growth (ηp2=0.01-0.02) (P≥.05). In post hoc pairwise comparisons of pre-post deltas per group, the GUIDE-only group showed significant improvements over the waitlist control group in wellness (d=0.05-0.31), emotional well-being (d=0.06-0.31), depression (d=–0.30), and anxiety (d=–0.29) (P&lt;.05). No group differences were significant for social connectedness (d=–0.20 to 0.20) or personal growth (d=–0.04 to 0.06) (P≥.05). Among participants allocated to GUIDE interventions, 67% (51/76) completed at least three activities weekly. Compared to the GUIDE-only group, the GUIDE+incentives group completed significantly more activities (t72=2.01; P=.05), posts (t72=2.15; P=.04), and replies (t72=3.40; P=.001) but not lessons (t72=0.73; P=.47), likes (t72=1.22; P=.23), or mood surveys (t72=0.48; P=.63). App engagement correlated with improvements in wellness, emotional well-being, mental health, and personal growth measures, driven by educational and peer-support features. Participants who engaged more felt more accomplished, regardless of the features used (r=0.23-0.36). GUIDE had good appropriateness (mean 4.01) and feasibility (mean 4.01) scores, and satisfactory acceptability (mean 3.81) and usability (mean 70.62) scores. Exploratory subgroup analyses suggested that GUIDE may be most beneficial to military-affiliated and male individuals. Conclusions GUIDE is a feasible and appropriate intervention with the potential to improve the mental health and well-being of first responders, veterans, and military personnel. Financial incentives increased engagement with peer-support features but did not lead to significant improvements over waitlist controls. Future research should assess whether improvements are sustained in the long term. Trial Registration ClinicalTrials.gov NCT06336967; https://clinicaltrials.gov/study/NCT06336967

  PublisherDOI

• Review and Developmental Model: Early Childhood Emotion Regulation and Co-Regulation in Autism

  Journal of the American Academy of Child & Adolescent Psychiatry · 2025-09-02 · 1 citations

  reviewOpen access
  PublisherOA PDFDOI

• Connecting Care Circles: Co-Development of a Digital Platform to Improve Communication between Professional Caregivers and Family Members of Adults on the Autism Spectrum in Residential Care

  Research Square · 2025-03-20

  preprintOpen accessSenior author
  PublisherOA PDFDOI

• Social network support is associated with teacher’s perceptions of transition planning for their autistic students

  Research in autism spectrum disorders · 2024-03-01

  article
  PublisherDOI

• Building Better Bridges: Outcomes of a Community-Partnered New School Transition Intervention for Students on the Autism Spectrum

  Journal of Autism and Developmental Disorders · 2024-06-12 · 2 citations

  articleOpen access1st authorCorresponding

  New school transitions can be challenging for students on the autism spectrum. No published, evidence-based interventions exist to support families and teachers of students transitioning to elementary and secondary school during this critical period. Using Community Partnered Participatory Research, we developed Building Better Bridges (BBB), a caregiver coaching intervention that includes training on effective school communication, educational rights, advocacy, and child preparation strategies. We compared BBB (n = 83) to a module/resources-only comparison (n = 87) in a four-site randomized controlled trial in racially and ethnically diverse, under-resourced communities. In our intent-to-treat analysis, caregivers and teachers in BBB rated students' transitions to the new classroom as more positive, relative to the comparison group. Results suggest this low-cost intervention can improve the transition process for families and students at high risk of poor transitions.

  PublisherOA PDFDOI

• Helping Practitioners Stop, Drop, and Roll: Suggestions to Help Improve Responses to Intense Clinical Events

  Psychiatric Services · 2024-02-27 · 2 citations

  articleOpen access

  Community practitioners inconsistently implement evidence-based interventions. Implementation science emphasizes the importance of some practitioner characteristics, such as motivation, but factors such as practitioners' emotion regulation and cognitive processing receive less attention. Practitioners often operate in stressful environments that differ from those in which they received training. They may underestimate the impact of their emotional state on their ability to deliver evidence-based interventions. This "hot-cold state empathy gap" is not well studied in mental health care. In this Open Forum, the authors describe scenarios where this gap is affecting practitioners' ability to implement evidence-based practices. The authors provide suggestions to help practitioners plan for stressful situations.

  PublisherOA PDFDOI

• Using Heart Rate and Behaviors to Predict Effective Intervention Strategies for Children on the Autism Spectrum: Validation of a Technology-Based Intervention

  Preprints.org · 2024-10-14

  preprintOpen accessSenior author

  Many children on the autism spectrum engage in challenging behaviors, like aggression, due to difficulties communicating and regulating their stress. Identifying effective intervention strategies is often subjective and time-consuming. Utilizing unobservable internal physiological data to predict strategy effectiveness may help simplify this process for teachers and parents. This study examined whether heart rate data can predict strategy effectiveness. Teachers and coders from the research team recorded behavioral and heart rate data over three months for each participating student on the autism spectrum using the KeepCalm app, a platform that provides in-the-moment strategy suggestions based on heart rate and past behavioral data, across 226 instances of strategy interventions. A binary logistic regression was performed to assess whether heart rate reduction, time to return to heart rate baseline, and documented skills and challenging behaviors predicted strategy effectiveness. Results suggested that heart rate reduction may be a significant predictor, and supported the existing practice of using behavioral patterns as proxies for strategy effectiveness. Additional analyses indicate proactive strategies are more effective and are associated with greater reduction in heart rate, relative to reactive strategies. Further exploration of how internal physiological data can complement observable behaviors in assessing intervention strategy effectiveness is warranted given the novelty of our findings.

  PublisherOA PDFDOI

Frequent coauthors

• David S. Mandell

  May Institute

  48 shared

• Melanie Pellecchia

  University of Pennsylvania

  15 shared

• Giacomo Vivanti

  Drexel University

  14 shared

• Cheryl Dissanayake

  La Trobe University

  12 shared

• Connie Kasari

  University of California, Los Angeles

  12 shared

• Jessica Tan

  University of Pennsylvania

  11 shared

• Zabryna Atkinson‐Diaz

  University of Pennsylvania

  11 shared

• Brenna B. Maddox

  10 shared

Labs

• Heather Joy Nuske LabPI

Education

• PhD, School of Psychology and Public Health

  La Trobe University

  2024