Reduced anxiety following pivotal response treatment in young children with autism spectrum disorder
Open accessAbstract
Up to 40% of children with Autism Spectrum Disorder (ASD) exhibit co-occurring anxiety symptoms. Despite recent success in mitigating anxiety symptoms in school-aged children with ASD (mean age >9 years) using adapted versions of Cognitive Behavioural Therapy, little is known about potential treatment outcomes for younger children. To address the gap in the literature, this open-label study evaluated change in anxiety following a 16-week open-label trial of Pivotal Response Treatment (PRT) in children with ASD aged 4-8 years. PRT is a behavioural treatment based on the principles of Applied Behaviour Analysis and has a primary aim of increasing social communication skills in children with ASD through natural reinforcements. To minimise conflation of anxiety and other co-occurring symptoms such as disruptive behaviour and attention-deficit hyperactivity disorder, we measured anxiety using the autism anxiety subscale of the Child and Adolescent Symptom Inventory (CASI) devised by Sukhodolsky et al. (2008). We observed significant anxiety reduction over 16-weeks of PRT. Furthermore, anxiety reduction was independent of changes in autism symptom severity. This study shows promising results for PRT as an intervention for reducing anxiety in young children with ASD.
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Only four anxiety treatment studies have been conducted in children under 6 years old.
“Only four anxiety treatment studies have been conducted in children under 6 years old”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
The Introduction says anxiety-treatment studies in children with ASD have mostly focused on those with an average age of 9 or older, and the Implications section identifies a gap concerning younger children (page numbers unavailable). The paper does not say that exactly four studies were conducted in children under 6; its own study included children aged 4–8. (LLM, conf=0.81)
Experimental — accuracy not yet measuredPreliminary findings from anxiety treatment studies in children under 6 years old suggest that CBT may be effective for this age range.
“Preliminary findings from these studies suggest that CBT may be effective for this age range; however, further study is needed.”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
The Introduction reports that CBT reduced anxiety in children with ASD, but says the studies mostly involved children with an average age of 9 or older. The paper’s preliminary findings for younger children concern pivotal response treatment (PRT), not CBT; it does not establish CBT’s effectiveness in children under 6. No page numbers are available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOf the four anxiety treatment studies in children under 6 years old, three utilized CBT approaches.
“of which three utilized CBT approaches [3, 8, 9, 26].”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
The Abstract identifies this as an anxiety-outcome study of pivotal response treatment (PRT), not CBT. Methods §2.1 says participants were aged 4–8, so the paper does not establish that the study was confined to children under 6. It also does not establish the count of three CBT studies among four; it supports only the identification of this study as a non-CBT example. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe fourth study investigates changes in anxiety following a naturalistic developmental behavioral intervention for ASD, Pivotal Response Training.
“The fourth study investigates changes in anxiety following a naturalistic developmental behavioral intervention for ASD, Pivotal Response Training [26].”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
Parents reported that their children displayed a significant reduction in anxiety after Pivotal Response Treatment.
“Although PRT does not directly target anxiety, parents reported that their children displayed a significant reduction in anxiety after treatment.”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
Pivotal Response Treatment duration was 48 sessions.
“treatment duration was quite intensive, i.e., 48 sessions”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
The final study examined changes in anxiety as a secondary outcome following a trial of Pivotal Response Treatment.
“The final study, which is not a CBT study, examined changes in anxiety as a secondary outcome following a trial of Pivotal Response Treatment (PRT; [26]).”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [26]
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- Authors
- Lei, J., Sukhodolsky, D. G., Abdullahi, S. M., Braconnier, M. L., & Ventola, P.
- Affiliations
- Yale University (US)
- Corresponding author
- Ventola, Pamela
- Venue
- Research in Autism Spectrum Disorders
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 43-44
- Pages
- 1-7
- ISSN
- 1878-0237 (ISSN-L)
- 1750-9467
- PMC
- PMC5761743
- OpenAlex
- W2754789514
- Cited by
- 18
- References
- 48
- Citations by year
- 2025: 3 · 2024: 1 · 2022: 3 · 2021: 1 · 2020: 6 · 2019: 3 · 2018: 1
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Research in Autism (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Autism Science Foundation, Simons Foundation (#383661)
- Women’s Health Research at Yale University (#1087045)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- Pivotal Response Treatment, autism spectrum disorder, anxiety symptoms, young children, social communication skills, applied behaviour analysis, autism severity, disruptive behavior, attention deficit hyperactivity disorder
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