Cognitive Behavioral Therapy for Early Adolescents With Autism Spectrum Disorders and Clinical Anxiety: A Randomized, Controlled Trial
Open accessAbstract
Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Thirty-three adolescents (11-15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and posttreatment/postwaitlist. In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators' ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed.
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In the autistic population, with appropriate adaptations, CBT has also demonstrated efficacy in children and in adolescents and young adults.
“En población autista, con las debidas adaptaciones, también se ha demostrado su eficacia tanto en niños y niñas (Chalfant et al., 2006;Sofronof et al., 2005;Sung et al., 2011;Weiss et al., 2018;Wood et al., 2009) como en adolescentes y jóvenes adultos (Wood et al., 2015).”
From Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa (2022) · cites this paper as Wood et al., 2015
The Method describes an ASD-adapted CBT trial in adolescents aged 11–15, and the Results report lower clinician-rated anxiety and more positive treatment responses than with a waitlist. This supports efficacy for early adolescents with ASD and clinical anxiety, but Wood et al. (2015) did not study young adults. (LLM, conf=0.88)
Experimental — accuracy not yet measuredTogether, the clinical trials consulted indicate that CBT intervention is promising as a treatment for anxiety in autistic children and adolescents.
“De forma conjunta, los ensayos clínicos consultados (Attwood, 2004;Wood et al., 2015;Wood et al., 2009) indican que la intervención TCC es prometedora como tratamiento para la ansiedad en niños y adolescentes autistas.”
From Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa (2022) · cites this paper as Wood et al., 2015
Available evidence supports the use of adapted CBT protocols for autistic youth.
“y la evidencia disponible apoya el uso de protocolos de TCC adaptados para jóvenes autistas (Kilburn et al., 2020;Wood et al., 2015;Storch et al., 2013).”
From Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa (2022) · cites this paper as Wood et al., 2015
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- Authors
- Wood, J. J., Ehrenreich-May, J., Alessandri, M., Fujii, C., Renno, P., Laugeson, E., Piacentini, J. C., De Nadai, A. S., Arnold, E., Lewin, A. B., Murphy, T. K., & Storch, E. A.
- Affiliations
- University of California, Los Angeles (US)
- University of Miami (US)
- University of South Florida (US)
- Corresponding author
- Wood, Jeffrey J.
- ORCID
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 46
- Issue
- 1
- Pages
- 7-19
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC4272761
- OpenAlex
- W2015814763
- Cited by
- 229
- References
- 68
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 19 · 2023: 17 · 2022: 16 · 2021: 27 · 2020: 25 · 2019: 23 · 2018: 21 · 2017: 26 · 2016: 11 · 2015: 11 · 2014: 6
- FWCI
- 10.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behavior Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R34HD065270)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, autism spectrum disorder, clinical anxiety, early adolescents, exposure therapy, irrational beliefs, autism severity, treatment manual development, waitlist control
- MeSH terms
- Adolescent, Anxiety Disorders, Child, Child Development Disorders, Pervasive, Family Therapy, Female, Follow-Up Studies, Humans, Male, Neuropsychological Tests, Parents, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders
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