A Scoping Review of Anxiety in Young Children with Autism Spectrum Disorder
Abstract
Research on anxiety in children and adolescents with autism spectrum disorder (ASD) has burgeoned in the past 15 years. Most of the research has focused on school‐age children, ages 6 to 18 years. Yet, recent studies suggest that anxiety can emerge in young children, under 6 years, with ASD. This scoping review synthesized the literature on anxiety in young children with ASD. Three domains of anxiety research were reviewed: (a) prevalence/severity, phenomenology, and course; (b) correlates; and (c) treatment. Four online databases were searched from the start of the database until March 2020. Keywords pertaining to anxiety, autism, and young children were entered. The search identified 44 articles for inclusion. These studies varied with respect to sample source, informants, and measures to assess anxiety. The overall prevalence of anxiety ranged from 1.6 to 62%. Sixteen of 17 studies found that young children with ASD had higher levels of anxiety compared to various control groups. A variety of DSM anxiety symptoms and disorders were present in young children with the most common symptoms being specific, social, and generalized fears. Correlates of anxiety included sensory over‐responsivity, sleep disturbance, aggression/defiance, and attention deficit/hyperactivity disorder. Three cognitive behavioral treatment studies for anxiety and one developmental intervention targeting ASD symptoms showed promise in reducing anxiety. Findings indicate an early emergence of anxiety in some children with ASD. Further research on the measurement, pathophysiology, and treatment of anxiety in early childhood is critical to improving outcomes in children with ASD. Lay summary: This scoping review synthesizes the literature on anxiety in young children with autism spectrum disorder (ASD). Results indicate that children with ASD have higher levels of anxiety than children without ASD. Potential factors that could be contributing to anxiety include sensory, sleep, and behavioral problems. Preliminary studies show that anxiety can improve with cognitive behavioral treatment. These findings suggest that research on anxiety in young children with ASD should be prioritized to improve mental health outcomes.
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Approximately 20% of children under 6 years and 40% of children ages 6 to 18 years with ASD have one or more anxiety disorders.
“Approximately 20% of children under 6 years and 40% of children ages 6 to 18 years with ASD have one or more anxiety disorders [45, 47].”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [47]
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CNVs inform the biological network of Autism spectrum disorder
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- Authors
- Vasa, R. A., Keefer, A., McDonald, R. G., Hunsche, M. C., & Kerns, C. M.
- Affiliations
- Kennedy Krieger Institute (US)
- University of British Columbia (CA)
- Corresponding author
- Vasa, Roma A.
- Venue
- Autism Research
- Publisher
- Wiley
- Published
- 2020-09-25
- Volume
- 13
- Issue
- 12
- Pages
- 2038-2057
- ISSN
- 1939-3792 (ISSN-L)
- 1939-3806
- OpenAlex
- W3088049075
- Cited by
- 127
- References
- 110
- Citations by year
- 2026: 19 · 2025: 22 · 2024: 29 · 2023: 31 · 2022: 14 · 2021: 10 · 2020: 1
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Autism Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Social Sciences and Humanities Research Council of Canada
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD08472)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, anxiety, young children, early childhood, anxiety prevalence, sensory hypersensitivity, sleep disorders, aggression, attention deficit hyperactivity disorder, cognitive behavioral therapy, developmental intervention
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Anxiety, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Child, Humans
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