Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: a randomized trial
Open accessAbstract
Background: Children with high‐functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety. Anxiety can adversely impact functioning across school, home and community environments. Cognitive behavioral therapies (CBT) are frequently used with success for children with anxiety symptoms. Modified CBT interventions for anxiety in children with ASD have also yielded promising results. Methods: Fifty children with high‐functioning ASD and anxiety were randomized to group CBT or treatment‐as‐usual (TAU) for 12 weeks. Independent clinical evaluators, blind to condition, completed structured interviews (Anxiety Disorders Interview Schedule – Parent Version; ADIS‐P) pre‐ and post‐intervention condition. Results: Forty‐seven children completed either the CBT or TAU condition. Results indicated markedly better outcomes for the CBT group. Significant differences by group were noted in Clinician Severity Ratings, diagnostic status, and clinician ratings of global improvement. In the intent‐to‐treat sample, 10 of 20 children (50%) in the CBT group had a clinically meaningful positive treatment response, compared to 2 of 23 children (8.7%) in the TAU group. Conclusions: Initial results from this randomized, designed treatment study suggest that a group CBT intervention specifically developed for children with ASD may be effective in decreasing anxiety. Limitations of this study include small sample size, lack of an attention control group, and use of outcome measures normed with typically developing children.
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Numerous RCTs have shown that modified CBT programmes are effective in reducing anxiety in autistic children aged 8-16 years, as evidenced by interviews and parent and child questionnaires.
“Numerous RCTs have shown that such modified CBT programmes are effective in reducing anxiety in autistic children ranging in age from 8 - 16 years, as evidenced by reports in interviews (Chalfant et al., 2007; McConachie et al., 2014; Reaven et al, 2012; Wood et al., 2009, Clarke et al 2016) and on parent and child questionnaires (Chalfant et al., 2007; McConachie et al., 2014; Sofronoff et al., 2”
From The design and implementation of a CBT-based intervention for sensory processing difficulties in adolescents on the autism spectrum (2016) · cites this paper as Reaven et al, 2012
The Methods (Procedure; page unavailable) describe parent interviews, and the Results (Treatment Outcome; page unavailable) report lower clinician-rated anxiety severity after modified CBT. However, the Methods (Participants; page unavailable) specify ages 7–14, not 8–16. Reaven et al. is cited for the interview evidence, not the questionnaire evidence. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCognitive-behavioral therapy-based approaches for clients with autism spectrum disorder often incorporate content to address emotion regulation deficits.
“CBT-based approaches for clients with ASD often incorporate content to address ER deficits.42,43”
From Emotion Regulation (2014) · cites this paper as [43]
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References 35 · Cited by 314
Research works printed but not linked: 1
- Lord C Rutter M DiLavore P Risi S 1999 Autism Diagnostic Observation Schedule – WPS Edition Los Angeles, CA Western Psychological Services
- Authors
- Reaven, J., Blakeley‐Smith, A., Culhane‐Shelburne, K., & Hepburn, S.
- Affiliations
- University of Colorado Anschutz (US)
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2011-11-15
- Volume
- 53
- Issue
- 4
- Pages
- 410-419
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC4392045
- OpenAlex
- W2162322078
- Cited by
- 314
- References
- 35
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 20 · 2023: 11 · 2022: 17 · 2021: 21 · 2020: 27 · 2019: 16 · 2018: 24 · 2017: 28 · 2016: 24 · 2015: 27 · 2014: 37 · 2013: 26 · 2012: 7
- FWCI
- 11.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- Autism Speaks
- Centers for Disease Control and Prevention (90DD0561)
- University of Colorado Denver
- National Institute of Mental Health (R21MH089291)
- 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 › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- group cognitive behavioral therapy, autism spectrum disorder, high-functioning autism, childhood anxiety, childhood anxiety disorders, treatment efficacy, usual care
- MeSH terms
- Adolescent, Analysis of Variance, Anxiety Disorders, Child, Child Development Disorders, Pervasive, Family Therapy, Female, Follow-Up Studies, Humans, Interviews as Topic, Male, Parents, Psychiatric Status Rating Scales, Severity of Illness Index, Cognitive Behavioral Therapy
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