title: Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis.
abstract: BACKGROUND
  Anxiety is a common and impairing problem in children and adolescents with autism spectrum disorder (ASD). There is emerging evidence that cognitive-behavioral therapy (CBT) could reduce anxiety in children with high-functioning ASD.
  
  
  OBJECTIVE
  To systematically review the evidence of using CBT to treat anxiety in children and adolescents with ASD. Methods for this review were registered with PROSPERO (CRD42012002722).
  
  
  METHODS
  We included randomized controlled trials published in English in peer-reviewed journals comparing CBT with another treatment, no treatment control, or waitlist control. Two authors independently screened 396 records obtained from database searches and hand searched relevant journals. Two authors independently extracted and reconciled all data used in analyses from study reports.
  
  
  RESULTS
  Eight studies involving 469 participants (252 treatment, 217 comparison) met our inclusion criteria and were included in meta-analyses. Overall effect sizes for clinician- and parent-rated outcome measures of anxiety across all studies were d = 1.19 and d = 1.21, respectively. Five studies that included child self-report yielded an average d = 0.68 across self-reported anxiety.
  
  
  CONCLUSIONS
  Parent ratings and clinician ratings of anxiety are sensitive to detecting treatment change with CBT for anxiety relative to waitlist and treatment-as-usual control conditions in children with high-functioning ASD. Clinical studies are needed to evaluate CBT for anxiety against attention control conditions in samples of children with ASD that are well characterized with regard to ASD diagnosis and co-occurring anxiety symptoms.
authors.affiliation: Yale Child Study Center, 230 South Frontage Road, New Haven, CT 06520. denis.sukhodolsky@yale.edu.
authors.forename: Denis G
authors.initials: DG
authors.lastname: Sukhodolsky
authors.forename: Michael H
authors.initials: MH
authors.lastname: Bloch
authors.forename: Kaitlyn E
authors.initials: KE
authors.lastname: Panza
authors.forename: Brian
authors.initials: B
authors.lastname: Reichow
mesh_terms: D001007:Anxiety / Q000453:epidemiology* / Q000628:therapy*; D001321:Autistic Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods
keywords: adolescents; anxiety; autism spectrum disorder; children; cognitive–behavior therapy; meta-analysis; randomized controlled trial