Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial.
BACKGROUND
Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or remediate the social and adaptive skill deficits of children with ASD that could pose barriers to anxiety reduction.


METHODS
Forty children (7-11 years old) were randomly assigned to 16 sessions of CBT or a 3-month waitlist (36 completed treatment or waitlist). Therapists worked with individual families. The CBT model emphasized behavioral experimentation, parent-training, and school consultation. Independent evaluators blind to treatment condition conducted structured diagnostic interviews and parents and children completed anxiety symptom checklists at baseline and posttreatment/postwaitlist.


RESULTS
In intent-to-treat analyses, 78.5% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 8.7% of the waitlist group. CBT also outperformed the waitlist on diagnostic outcomes and parent reports of child anxiety, but not children's self-reports. Treatment gains were maintained at 3-month follow-up.


CONCLUSIONS
The CBT manual employed in this study is one of the first adaptations of an evidence-based treatment for children with autism spectrum disorders. Remission of anxiety disorders appears to be an achievable goal among high-functioning children with autism.
Wood
Jeffrey J
JJ
University of California, Los Angeles, California 90095, USA. jeffwood@ucla.edu
Drahota
Amy
A
Sze
Karen
K
Har
Kim
K
Chiu
Angela
A
Langer
David A
DA
D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D001321:Autistic Disorder / Q000453:epidemiology*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education; D012720:Severity of Illness Index; D013663:Teaching / Q000379:methods; D016896:Treatment Outcome